CHAPTER 26 Flashcards

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1
Q

what are some soft tissues?

A

skin, fatty tissues, muscles, blood vessels, fibrous tissues, nerves, glands, and membranes

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2
Q

true or false: skin filters air?

A

false

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3
Q

what are the 5 things that skin does for our body

A

protects, water balance, temperature regulation, excretion, shock absorption

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4
Q

_____ is a closed wound that is a bruise

A

contusion

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5
Q

_____ is a closed wound that is a collection of blood it causes more tissue damage than a contusion and it involves bigger blood vessels

A

hematoma

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6
Q

these injuries have excessive force crushing or rupturing internal organs ( spleen )

A

closed crush injuries

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7
Q

blood collected at a injury site?

A

hematoma

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8
Q

_____ is the bruising that can be associated to a contusion or other injury ( this is the actually injury itself where a contusion is the bruising )

A

ecchymosis

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9
Q

when you get a _____ bruise it usually means internal bleeding or injury

A

ecchymosis

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10
Q

when assessing a closed wound injury you have to look at the _____because bruising might not can be seen on scene

A

MOI

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11
Q

if someone had severe blunt trauma you would assume _____

A

internal bleeding

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12
Q

when treating closed wound injuries you:

A

take standard precautions, manage ABC’s, always manage for internal bleeding and shock if there is a possibility of internal bleeding, splint extremities that are swollen, painful and deformed, stay alert for vomiting, monitor patient and transport

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13
Q

this is when your guts are hanging out

A

eviseration

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14
Q

this is a surgical cut

A

laceration

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15
Q

examples of open wounds are:

A

abrasion, laceration, puncture, avulsion, amputation, crush injury ( closed or open ), blast injury

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16
Q

a ____ is when the skin is hanging on in place

A

avulsion

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17
Q

when treating open wounds:

A

expose wound, clean surface of wound leaving small stuff on it, control bleeding, care for shock, prevent further contamination, bandage dressings in place after bleeding is controlled, keep patient still, reassure patient its going to be okay

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18
Q

treating abrasions and lacerations:

A

reduce wound contamination, apply direct pressure to control bleeding, always check a distal pulse and pms distal to injury ( beyond injury )

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19
Q

treatment of puncture wounds:

A

use caution objects may be embedded deeper than they look, check for exit wounds, assess need for shock, follow local protocols regarding spinal immobilization

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20
Q

treating penetrating wounds:

A

use caution as objects may be embedded deeper than they appear, check for exit wounds

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21
Q

treating impaled objects:

A

do not remove, expose wounds, control profuse bleeding by direct pressure, apply several layers of bulky dressings to splint object in place, secure dressings, treat for shock, rapid transport

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22
Q

impaled object in the cheek:

A

take care that object does not enter oral cavity causing airway obstruction, bleeding into the mouth and throat can cause vomiting and nausea, if you can’t control flow of blood into airway then you’ll have to remove it

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23
Q

treating objects impaled into cheek:

A

examine wound site both inside and outside of mouth, stabilize in place unless interfering with airway, position patient to allow for drainage, monitor patients airway, dress outside of wound, provide oxygen, care for shock

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24
Q

puncture wound or impaled object in the eye:

A

stabilize the object, apply rigid protection, treat for shock, hive oxygen, reassure patient, dress and bandage uninjured eye

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25
Q

treating avulsions:

A

clean wound surface, fold skin back into normal position, control bleeding and dress with bulky dressings, if avulsed parts are completely torn away save in sterile dressing and keep moist with sterile saline

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26
Q

treating amputations:

A

take steps to control hemorrhage immediately, may need a tourniquet either way apply direct pressure, if the part can be transported wrap it in sterile gauze ( dry) and put it in a ziplock bag over ice don’t let item get wet, if still bleeding apply pressure dressing over stump, use pressure points to control bleeding use tourniquet as needed, try and splint

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27
Q

treating genital injury :

A

control bleeding, preserve parts if you can, consider if injury suggest another possibly more serious, have a calm professional manner, maintain patients dignity, dress and bandage wound

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28
Q

burns:

A

may involve more than just skin level structures, burns may affect the patient long term, don’t let a burn distract you from a serious life threatening injury, if respiratory structures are affected swelling may occur causing life threatening obstruction

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29
Q

a ____ burn is like a sunburn

A

superficial

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30
Q

____ burns are recognized by their blisters and are very painful

A

partial thickness burns

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31
Q

these burns are chalky, black in color, layers of the skin are burned off, your nerves are burnt off also

A

full thickness burns

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32
Q

the most painful burn is a ___ burn

A

partial thickness

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33
Q

when classifying burns we look at what?

A

agent and source, depth, and severity how bad it is

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34
Q

____ burns involve only the epidermis you have reddening with minor swelling

A

superficial

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35
Q

____ burns burn the epidermis and dermis, there is intense pain, blisters and mottling and reddening

A

partial thickness burn

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36
Q

____ burns all the layers of the skin are burned, blackened areas surrounded by dry and white patches

A

full thickness burns

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37
Q

we use this to determine a burn severity it helps estimate the burn extent, the adult body is divided into 11 parts, each part represents 9% of body surface

A

rule of nines

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38
Q

what are some things we look at when determining a burn severity:

A

agent and source, body regions burned, depth of burn, extent of burn, age of patient, other illness and injuries

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39
Q

burns must be classified to determine what:

A

order and type of care, order of transport, maximum information to provide to emergency department

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40
Q

this is a method we use to determine a burn severity its when you use the patients palm as 1%

A

palmar method

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41
Q

geriatric and pediatric burns:

A

minor burn areas in a young adult can be fatal to a geriatric adult

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42
Q

geriatric and pediatric burns:

A

infants and children have a much greater relationship of body surface are to total body size resulting in greater fluid and heat loss from burned skin

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43
Q

suspect an airway burn if:

A

you see swelling of the face or throat, singed nasal or facial hairs, black flecks in the septum, burns to face, raspy voice, respiratory distress, sooty smell to breath

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44
Q

treating thermal burns:

A

stop burning process and cool it running water on it, use sterile dry dressings, ensure an open airway and assess breathing, never apply ointments, butters and sprays, do not break blisters, treat for shock

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45
Q

we loss ____ % of our body heat when we are wet

A

25

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46
Q

treating chemical burns:

A

wash away chemical with a continuing flow of water, remove contaminated clothing, apply dry sterile dressings, treat for shock, transport, if dry chemical is brushed off then flush with water

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47
Q

what kind of dressing do you use to treat a thermal burn

A

dry sterile dressing

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48
Q

______ burns are exposure to high levels of radiation which can harm the body both immediately and later on

A

radiological burns

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49
Q

_____ burns are extremely harmful, most will present like thermal injuries, see patients only after they have been decontaminated

A

radiological burns

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50
Q

these are injuries to the nerve pathways, you will usually see an exit and entry, bones may fracture from violent muscle contractions, respiratory/ cardiac arrest are possible

A

electrical injuries

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51
Q

treating electrical injuries :

A

provide airway care, be alert and prepared for cardiac rhythm changes be ready to defibrillate, care for spinal and head injuries as well as extremity fractures, evaluate burn sites, cool burn areas and apply dry sterile dressings

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52
Q

a _____ goes on a wound

A

dressing

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53
Q

a _____ holds the gauze in place it goes around it

A

bandage

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54
Q

any material applied to the wound to control bleeding and prevent contamination

A

dressing

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55
Q

any material used to hold dressing in place

A

bandage

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56
Q

when dressing an open wound:

A

expose wound, completely cover wound area, dressings should not be removed unless bulky dressings are blood soaked and new one must be applied to maintain pressure, control bleeding by direct pressure or pressure dressing

57
Q

bandaging an open wound:

A

do not bandage too tightly or too loosely, do not leave loose ends hanging tuck them in, do not cover finger tips or toes because you need to check for circulation

58
Q

a ____ dressing os available for profuse bleeding, large wound this is pretty thick and big to cover a large area

A

universal dressing

59
Q

a ____ dressing is used to control bleeding

A

pressure

60
Q

_____ dressings form a airtight seal, use these on wounds to the neck, chest and eviscerations or wounds to the abdomen

A

occlusive dressings

61
Q

patient care in dressing an open wound:

A

take standard precautions, expose wound, use sterile or clean material, cover entire wound, control bleeding by direct pressure and hemostatic agents or dressings, do not remove dressings

62
Q

patient care bandaging open wounds:

A

dont bandage to tightly or loosely, do not leave loose ends, do not cover finger tips or toes, cover all edges of dressing

63
Q

you must keep a ___ patient warm

A

burned

64
Q

in a ___ injury you will most likely see a respiratory distress

A

electrical

65
Q

in a skin tissue injury an open or closed wound means if the skin is ___ or not

A

broken

66
Q

_____ are considered hard tissues

A

teeth, bones and cartilage

67
Q

_____ is the largest organ of the body

A

skin

68
Q

the skin protects against debris and unwanted _____

A

chemicals

69
Q

during temperature regulation _____ can dilate or constrict to regulate our body heat

A

blood vessels

70
Q

during _____ salts, carbon dioxide, and excess water can be released through our skin

A

excretion

71
Q

during _____ the skin helps protect the underlying organs from minor impacts and pressure

A

shock absorption

72
Q

the 3 layers of skin are:

A

epidermis , dermis and subcutaneous layer

73
Q

what layer of the skin is composed of dead cells and has no blood vessels or nerves

A

epidermis

74
Q

this layer of skin has lots of blood vessels , nerves and sweat glands, oil glands and hair follicles

A

dermis layer

75
Q

this layer of skin has shock absorption and insulation

A

subcutaneous

76
Q

this is the layer of skin that has layers of fats and tissues

A

subcutaneous

77
Q

an internal injury with no open pathway from the outside

A

closed wound injury

78
Q

a____ is the most common closed wound injury

A

contusion

79
Q

as much as a _____ of blood can be accumulated in a hematoma

A

liter

80
Q

in a closed crush injury the liver and spleen bleed a lot which may cause ____ in a person

A

shock

81
Q

digested food or urine can leak into the body cavities causing severe ____ and ____ in a closed crush injury

A

inflammation and tissue damage

82
Q

the potential for____ internal damage from a blast trauma is much higher

A

massive

83
Q

the most common closed injuries associated with blast trauma are the rupture of ____ organs

A

hollow

84
Q

this injuries will not be evident just by viewing the external surface of the skin they must be anticipated based on the type of force that caused them

A

blast

85
Q

_____ damage can be demonstrated by bleeding from the ears and nose, vagina, rectum and bloody urine

A

internal

86
Q

patients will a significant MOI should be considered to have internal bleeding and ____

A

shock

87
Q

you must rely on your ___ when identifying a closed crush injury

A

MOI

88
Q

when you have swelling or deformity at the site of the contusion this could indicate an underlying _____

A

fracture

89
Q

when you have bruising on the head or neck this could indicate injury to the _____ or _____

A

cervical spine or brain

90
Q

bruising on the trunk or signs of sternum or rib damage could indicate what

A

chest injury

91
Q

bruising on the abdomen could indicate?

A

injury to underlying organs such as the spleen, liver and kidneys

92
Q

if someone is coughing up frothy red blood this could indicate?

A

punctured lung

93
Q

an injury in which the skin is interrupted exposing the tissue beneath

A

open wound

94
Q

a scratch or scrape

A

abrasion

95
Q

examples of abrasions are:

A

skinned elbows, road rash, mat burns, rug burns, brush burns

96
Q

lacerations can be caused by:

A

razor blade, broken glass, and with a sharp edge

97
Q

am open wound that tears through the skin and destroys underlying tissues.

A

puncture wound

98
Q

a ___ puncture would be shallow or deep

A

penetrating

99
Q

a _____ wound has both a entrance and an exit wound

A

perforating wound

100
Q

examples of puncture wounds are:

A

bullets, nails, ice picks, splinters, or knives

101
Q

the most significant damage from a penetrating trauma will occur in the structures ____ the skin

A

beneath

102
Q

the tearing away or tearing off of a piece or flap of the skin or tissue

A

avulsion

103
Q

a ____ avulsion occurs when the hand is caught in a roller

A

degloving avulsion

104
Q

an eye out of socket is also called a ____

A

avulsion

105
Q

the surgical removal or traumatic severing of a body part usually an extremity

A

amputation

106
Q

emt treatment for high pressure injuries include:

A

elevating and splinting the limb

107
Q

in a high pressure injury do not apply cold, this can cause____ and can lead to further tissue damage and death

A

vasoconstriction

108
Q

in the primary assessment of a open wound what takes place?

A

assess ABC’s and control severe bleeding

109
Q

treatment for moderate or serious puncture wounds:

A

reassure patient, search for additional penetrations including exit wounds, control bleeding, provide adequate wound treatment, assess the need for basic life support, care for shock, give oxygen, follow protocols on spinal immobilization, transport

110
Q

you _____ dressings for a puncture wound to the eye with no impaled object

A

loose

111
Q

when treating avulsions place _____ dressings on injury

A

large bulky pressure

112
Q

in treating avulsions if the skin has been torn and is flapping you should:

A

clean the wound surface, fold the skin back to its normal position, control bleeding and dress the wound using bulky pressure dressings

113
Q

in treating avulsions that skin or another body part is torn off you should:

A

control bleeding, dress wound with bulky pressure dressing, save the part if you can in a sterile dressing kept moist

114
Q

treating an amputation:

A

apply direct pressure first use a tourniquet if direct pressure fails or if direct pressure is not possible

115
Q

blood at the meatus of the genitals might indicate a _____ fracture

A

pelvic

116
Q

these burns come from flames, radiation, excessive heat from fire, steam, hot liquids, and hot objects

A

thermal burns

117
Q

these burns come from various acids, bases and caustics

A

chemical burns

118
Q

these are alternating current, direct current and lightening burns

A

electrical burns

119
Q

burns usually from nuclear sources, and uv light

A

radiological burns

120
Q

a burn that involves only the epidermis it is characterized by reddening of the skin and perhaps some swelling

A

superficial burn

121
Q

a 1st degree burn

A

superficial burn

122
Q

when the epidermis is burned through and the dermis is damaged but the burn does not pass underlying tissues

A

partial thickness burns

123
Q

a 2nd degree burn

A

partial thickness burn

124
Q

a burn in which all layers of skin are burned usually u see charred black ares

A

full thickness burns

125
Q

3rd degree burns

A

full thickness burns

126
Q

in a full thickness burn the patient may not feel no pain why?

A

because all the nerves might be burned

127
Q

burns that encircle the body or a body part are called____ burns

A

circumferential

128
Q

minor burns:

A

full thickness burns less than 2% of body surface excluding the face, hands, feet and genitalia and respiratory tract…partial thickness burns of less than 15% of body surface …..superficial burns of 50% of body surface

129
Q

burns that are usually classified as moderate are critical in adults over ___ yrs old

A

55

130
Q

children 5 and under:

A

minor burn- less than 10% burned……moderate burn 10-20% burned….critical burn more than 20% burned

131
Q

care for thermal burns:

A

stop the burning process, ensure an open airway, look for airway injury, complete primary assessment, treat for shock, evaluate burns by depth, do not clear small debris, wrap with dry sterile dressing, remove jewelry, separate fingers and toes

132
Q

in a 1st degree burn or superficial burn:

A

red, painful no blisters just the outside layer burned

133
Q

in a 2nd degree burn partial thickness:

A

outer layer and 2nd layer burned, deep red, painful, and you will have blisters

134
Q

in a 3rd degree burn full thickness burn

A

outer layer burn, 2nd layer burn, tissue damage, charred black or white, not painful, and no blisters

135
Q

if you have a chemical burn to the eyes flush the burn for _____ mins

A

20

136
Q

during a chemical burn flush the skin with flowing water for ___ mins

A

20

137
Q

chemical burns to the eye:

A

flood eyes with water, keep water flowing into the eye, transport continue washing eye for 20 mins, cover both eyes with moist pads, if he starts complaining again wash eyes for 5 more mins

138
Q

a patient of a electrical injury may have:

A

burns where the energy enters and exits the body, disrupted nerve pathways displaying paralysis, muscle tenderness, respiratory difficulty, irregular heartbeat or cardiac arrest, increased bp or low bp, signs of shock, restlessness or irritability, vision problems