Chapter 26 Flashcards
soft tissues of the body can be injured through a variety of mechanisms: ... injury ... injury ... ...
blunt
penetrating
barotrauma
burns
skin varies in thickness
… in the very young and very old
… on the eyelids, lips, and ears than on the scalp, back, soles of feet
skin has two principal layers: the … and the … –> …: the tough, external layer; …: the inner layer
thinner; thinner; epidermis; dermis; epidermis; dermis
bodily openings are lined with …
mucous membranes
skin serves many functions: barrier against ... helps maintain ... helps body regulate ... ... organ
infection
fluid balance
temperature
sensory
any break in the skin may allow bacteria to enter and increases the potential for:
…
… loss
loss of …
infection
fluid
temperature control
three types of soft-tissue injuries:
… injuries
… injuries
…
closed; open; burns
pathophysiology of closed and open injuries:
cessation of … is primary concern
the next wound healing stage is …
a new layer of cells is then moved into the damaged area
new … form
… provides stability to the damaged tissue and joins wound borders
bleeding; inflammation; blood vessels; collagen
(closed injuries) a … (bruise) results from blunt forces striking the body. the epidermis remain intact but … are usually torn. the buildup of blood produces …
a … is blood that collects within damaged tissue or in a body cavity
contusion; small blood vessels; ecchymosis; hematoma
(closed injuries) a … injury occurs when a significant amount of force is applied to the body
extent of damage depends on:
amount of …
length of … that the force is applied
when an area of the body is trapped for longer than 4 hours, … syndrome can develop
crushing; force; time; crush
(closed injuries) … syndrome results from the swelling that occurs whenever tissues are injured
severe closed injuries can damage internal organs
compartment
four types of open injuries: ... ... ... ...
abrasions
lacerations
avulsions
penetrating wounds
(open injuries) abrasion: a wound of the … layer of the skin–> caused by … when a body part rubs or scrapes across a rough/hard surface
superficial; friction
(open injuries) laceration: a … cut–> caused by a sharp object or blunt force that tears the tissue
jagged
(open injuries) avulsion: a wound that separates various layers of soft tissue so that they become either … or hang as a …
completely detached; flap
(open injuries) amputation: an injury in which part of the body is completely ….
a penetrating wound is an injury resulting from a … object –> can damage structures deep within the body; can lead to infection
severed; piercing object
stabbings and shootings often result in multiple penetrating injuries: assess the patient carefully to identify all wounds, count the … of penetrating injuries; determine the type of … when possible but do not delay transport
number; gun
it is more difficult to assess a … injury than to assess an … injury
closed; open
immediately transport in these cases: poor initial ... altered ... ... abnormal ... ... severe ...
general impression level of consciousness dyspnea vital signs shock pain
… as well as a host of other medical conditions can complicate open soft-tissue injuries
chronic medical conditions
vital signs: signs that indicate hypoperfusion and the need for rapid transport-- ... ... low ... weak ... .., ..., and ... skin
tachycardia tachypnea blood pressure pulse cool; moist; pale
communication and documentation: description of the ... ... in which you found the patient amount of ... location and description of any ... injuries or other wounds ... and .. of the injury how you treated the injuries
MOI position blood loss soft-tissue size; depth
no special emergency care is necessary for …
small contusions
treat closed soft-tissue injury using the RICES mnemonic: R.... I... C... E... S...
rest ice compression elevation splinting
signs of developing shock: ... or ... changes in ... increased ... rate increased ... rate ... ... or ... skin decreased ...
anxiety; agitation mental status heart respiratory diaphoresis cool; clammy; blood pressure
cover wounds of the chest, upper abdomen, or upper back with … dressings
occlusive
control bleeding by … the extremity, even if there is no fracture
splinting
abdominal wounds: an open wound in the abdominal cavity may expose … organs
…: the organs protrude through the wound
internal; evisceration
impaled objects
remove an impaled object only when the object is in the … or … and … or the object is in the … and interferes with …
cheek; mouth; obstructs the airway; chest; CPR
neck injuries:
… injuries can be life threatening
… may suck in air and cause cardiac arrest
cover the wound with an occlusive dressing
apply manual pressure but do not compress both carotid arteries at the same time
open neck; open veins
small-animal bites:
a small animal’s mouth is heavily contaminated with … bites should be evaluated by a physician
a major concern is the spread of … –> acute, potentially fatal viral infection of the CNS
small-animal; rabies
human bites: the human mouth contains exceptionally wide range of bacteria and viruses. regard any human bite that has penetrated the skin as a … injury
can result in a serious, spreading …
very serious; infection
emergency treatment for open injuries:
apply a …, … dressing
promptly .. the area with a splint/bandage
provide transport to the ED
dry; sterile; immobilize
burns account for approximately 3400 deaths per year
among the most serious and painful of all injuries
a burn occurs when the body receives more … than it can absorb
radiant energy
children, older patients, and patients with chronic illnesses are more likely to experience … from burn injuries
shock
burns are .. injuries created by the transfer of .., …, or … energy
thermal burns occur when the skin is exposed to temperatures higher than … degrees Fahrenheit
soft-tissue; radiation; thermal; electrical; 111
severity of a thermal injury correlates directly with:
…
…
amount of .. possessed by the object/substance
… of exposure
temp
concentration
heat energy
duration
the greater the heat energy, the … the wound
… is an important factor
people reflexively limit heat energy and exposure time
deeper; exposure time
when a person is burned, the skin that acts as a barrier is destroyed burn victims are at high risk for: .. ... ... ...
infection
hypothermia
hypovolemia
shock
burns to the airway are of significant importance
circumferential burns of the chest can …
circumferential burns of an extremity can lead to … compromise and … damage
compromise breathing; neurovascular compromise; irreversible
burn severity depends on: ... of burn ... of burn ... areas involved preexisting medical conditions patient younger than ... or older than ...
depth;
extent
critical
5; 55
depth of burns:
… burns (first degree)
… burns (2nd degree)
… burns (3rd degree)
superficial
partial-thickness
full-thickness
extent of burns:
estimated using the rule of … or the rule of …
the proportions differ for infants, children, and adults
include only … and … in estimation of the extent of burn injury
palm; nines; partial-thickness; full-thickness
when you are assessing a burn, it is important to classify the victim's burns classification involves determining: ... of the burn ... of the burn ... of the burn
source
depth
severity
primary assessment–> airway and breathing
be alert to signs that that the patient has inhaled .. or …: … facial hair, … present in and around the airway
hot gases; vapors; singed; soot
transport decision consider rapid transport for a patient who has: an airway/breathing problem significant ... injuries significant external bleeding signs and symptoms of internal bleeding
burn
if patient was in a confined space, suspect an … injury
inhalation
secondary assess--> physical exam: perform exam of entire body make a rough estimate, using the rule of nines, of the ... of the burned area determine the ... of the burn determine the ... of the burn package patient for transport
extent; classification; severity
communication and documentation:
provide hospital personnel with a description of … the burn occurred
describe the … of the burns
document if … are involved
how; extent; special areas
thermal burns:
caused by …
most commonly, caused by … or an …
coming in contact with hot objects produces a … burn
heat; scalds; open flame; contact
thermal burns cont:
a … burn can produce a topical (scald) burn
a … burn is produced by an explosion
steam; flash
thermal burns–> management:
stop the burning source, … the burned area, and remove all …
maintain a high index of suspicion for … injuries
all patients should have a … applied
cool; jewelry; inhalation; dry dressing
(inhalation burns) can occur when burning takes place in … spaces without … –> upper airway damage is often associated with the inhalation of … gases
lower airway damage is often associated with the inhalation of … and … matter
enclosed; ventilation; superheated; chemicals; particulate
severe upper airway swelling requires immediate intervention
the .. process produces a variety of toxic gases
combustion
(inhalation burns) … intoxication should be considered whenever a group of people in the same place all report a headache/nausea
…–> generated by combustion
carbon monoxide; hydrogen cyanide
(inhalation burns) prehospital treatment of a patient with suspected hydrogen cyanide poisoning includes ... and ... care care for any toxic gas exposure: ... ... ...
decontamination; supportive; recognition; identification; supportive treatment
(chemical burns) can occur whenever a toxic substance …
generally caused by … or …
the … are particularly vulnerable
contacts the body; strong acids; strong alkalis; eyes
(chemical burns) severity of the burn is directly related to the:
… of chemical
…of the chemical
… of the exposure
wear appropriate chemical-resistant gloves and eye protection
type
concentration
duration
(chemical burns) management:
remove any chemical from the patient
always … dry chemicals off the skin and clothing before …
remove the patient’s clothing
brush; flushing with water;
(chemical burns) for liquid chemicals, immediately begin to flush the burned area with …
continue flooding the area for … to … minutes after the patient says the burning pain has stopped
if the patient’s eye has been burned, hold the eyelid open while … the eye
conduct proper decontamination prior to loading patient
lots of water;
15; 20;
flooding
(electrical burns) can occur from contact with … or … electricity
for electricity to flow, there must be a … between the source and the ground
…: any substance that prevents this circuit from being completed
…: any substance that allows a current to flow
high; low-voltage; complete circuit; insulator; conductor
(electrical burns) the human body is a good …
the type of electric current, … of current, and … influence the seriousness of the burn
your safety is of particular importance
conductor; magnitude; voltage
(electrical burns) a burn injury appears where the electricity … and … the body
two dangers:
a large amount of … injury
… or … arrest from the electric shock
enters; exits; deep tissue; cardiac; respiratory
(electrical burns) management:
if indicated, begin CPR on the patient and apply an AED
be prepared to … if necessary
give supplemental oxygen and monitor
treat soft-tissue injuries with … dressings. provide prompt transport
defibrillate; dry, sterile
(taser injuries) use of a taser has been associated with … and … make sure you have access to an AED when responding to patients who have been exposed to Taser shots
dysrhythmias; sudden cardiac arrest
(radiation burns) potential threats include:
incidents related to the use and transportation of …
intentionally released radioactivity in terrorist attacks
you must determine if there has been a radiation exposure and then whether ongoing exposure continues to exist
radioactive isotopes
three types of ionizing radiation:
…
…
…
alpha
beta
gamma
most ionizing radiation accidents involve … radiation (…)
management:
maintain safe distance and wait for the Hazmat team to decontaminate the patient
call for additional resources to …
begin ABCs and treat burns/trauma
irrigate …
notify the ED
gamma radiation; x-rays; remove the patient’s clothes; open wounds
(radiation burns) management contd:
identify the … and the length of the patient’s exposure to it
limit your duration of exposure
increase your distance from the source
place … between yourself and the sources of gamma radiation
radioactive source; shielding
all wounds require …–> many different types of dressings and bandages
bandaging
dressings and bandages have three functions:
to control …
to protect the wound from …
to prevent further … and …
bleeding; further damage; contamination; infection
(sterile dressings) most wounds will be covered by:
… dressings
conventional 4 x 4 and 4 x 8 …
assorted small adhesive type dressings and soft self-adherent …
universal dressings are ideal for covering …
universal; gauze pads; roller dressings; large open wounds
(sterile dressings) … are appropriate for smaller wounds
adhesive-type dressings are useful for ….
occlusive dressings prevent … and … from entering/exiting the wound
gauze pads; minor wounds; air; liquids
(bandages) to keep dressings in place during transport, you can use:
… bandages
rolls of …
… bandages
…
the self-adherent, soft roller bandages are easiest to use
soft roller
gauze
triangular
adhesive tape
(bandages) … hold small dressings in place and helps to secure larger dressings
do not use elastic bandages to secure dressings
if a wound continues to bleed despite use of direct pressure, quickly proceed to the use of a ..
adhesive tape; tourniquet
