Chapter 26-soft Tissue Injuries Flashcards
Epidermis
Tough, external layer of skin that forms watertight coverage for the body
Dermis
Inner layer of skin. It lies below the germinal cells of the epidermis. Contains structures that give the skin it’s characteristic appearance: hair follicles, sweat glands, and sebaceous gland.
What is sebum?
Produced by sebaceous glands, and is the oily material that waterproofs the skin and keeps it supple
Mucous membranes
Lines openings of body that aren’t exposed by skin (vagina, anus, mouth, nose)
Protects openings from bacterial invasion, but is different from skin because it secretes a watery substance that lubricates the openings
Closed injuries
When soft tissue damage occurs beneath The skin or mucous membranes but the surface of the skin or mucous membranes remains intact
Open injuries
In which there is a break in the surface of the skin or the mucous membrane, exposing deeper tissue to potential contamination
Burns
In which the soft tissue damage occurs as a result of thermal heat, frictional heat, toxic chemicals, electricity, or nuclear radiation
Contusion
Bruise: an injury that causes bleeding beneath the skin but the skin doesn’t break
Caused by blunt forces striking the body
Ecchymosis
A blue or black discoloration caused by blood build up under the skin
Hematoma
Blood that has collected within a damaged tissue or within a body cavity. A hematoma occurs when a large blood vessel is damaged and bleeds rapidly
Crushing injury
Occurs when significant force is applied to the body
Crush syndrome
When an area of the body is trapped for longer than four hours and arterial blood flow is comprised
Compartment syndrome
Develops when swelling results in increased pressure within a closed soft tissue compartment. It can cause a lack of circulation
Contamination
The presence of infectious organisms (pathogens) or foreign bodys in the wound
What are the four types of wounds you need to be prepared to manage?
Lacerations, abrasions, punctures, avulsions
Abrasion
A wound of the superficial layer of the skin, caused by friction when a part of the body rubs against a hard or rough surface
Laceration
A jagged cut in the skin caused by a sharp object or blunt force that tears the tissue
Incision
A sharp, smooth cut
Avulsion
An injury that separates various layers of soft tissue, so they become either completely detached or hang as a flap
Amputation
An injury in which part of the body is completely severed
Penetrating wound
An injury resulting from a piercing object, such as a knife, gun, or pickaxe. Usually entrance wounds aren’t too big, but underlying tissue can be damaged bad
Impaled objects
Objects that penetrate the skin but stay in place.
What should you use to treat a penetrating wound in the neck, chest, back, or upper abdomen?
An occlusive dressing
What three factors usually influence the MOI in a blast?
Primary blast injury: injuries caused by the blast wave itself
Secondary blast injury: injuries caused by the body being struck by flying debris’s
Tertiary blast injury: injuries to the body from being thrown or Hurled by the force of the explosion into an object or on the ground
What mnemonic can be used to treat closed soft tissue injuries?
RICES
What does RICES stand for?
Rest
Ice: slows bleeding by causing blood vessels to constrict
Compression: compressing blood vessels can slow bleeding
Elevation: raise the injury Just above the patients heart to decrease swelling
Splinting: immobilize a soft tissue injury or injured extremity to decrease bleeding and reduce pain
Three methods to control external bleeding or open injuries
- direct, even pressure and elevation
- pressure dressings/splints
- tourniquets
What is a risk for any patient who had significant bleeding or bleeding that cannot not be controlled?
Hypovolemic shock
Evisceration
When an organ protrudes through a wound
How to treat an impaled object
- Don’t remove the object unless it’s in the cheek or mouth obstructing the airway, or in the chest if the patient is pulseless and you need to to CPR
- Remove any clothing around the injury, apply direct pressure and if the injury is in the chest neck or back, consider putting an occlusive bandage around entry hole. Use combination of soft dressings, gauze and tape. Secure the object into place so it doesn’t move
- Protect impaled object from being bumped. Y taping something over it to secure it (cup, supply container)
What is air ebolism?
Air sucked into a blood vessel, blocking the flow of blood into the lungs causing cardiac arrest
The emergency treatment of bites
- Apply a dry sterile dressing
- Promptly immobilize the area with a splint or bandage
- Provide transport to the ED for surgical cleansing of the wound and antibiotic therapy
What five factors can help you determine the severity of a Burn
- What is the depth of the burn?
- What is the extent of the burn?
(First two most important question) - Are any critical areas involved?
- Does the patient have any preexisting medical conditions or other injuries?
- Is the patient younger than 5 or older than 55?
What are the classifications of severe burns in adults
- full thickness burns involving hands, feet, face, upper airway or genetalia
- for thickness burns covering more than 10% of the body’s total surface area
- partial thickness burns covering more than 30% of the body’s total surface area
- Burns associated with respiratory injury
- burns complicated by fractures
- Burns on patients younger than five years old or older than 55 that would be classified as “moderate” for young adults
Classifications of burns in adults for moderate burns
- full thickness burns involving 2% to 10% of the body’s total surface area (excluding hands, feet, face, upper air way, genitalia)
- Partial thickness Burns covering 15 to 30% of the body’s total surface area
- superficial burns covering more than 50% of the body’s total service area
Classification of burns in adults for minor burns
- for thickness burns covering less than 2% of the bodies TSA
- partial thickness burns covering less than 15% of the bodies TSA
- superficial burns covering less than 50% of the body’s total surface area
Superficial burn (first degree)
Involves only the top layer of skin, the epidermis. The skin turns red but does not blister or burn through
For example, a sunburn
Partial thickness (second degree) burn
Involves the epidermis and some portion of the dermis. These brands do not destroy the thickness of the skin or injure subcutaneous tissue. Typically the skin is moist, mottled, and white to red
Full thickness (third degree) burn
Extends through all layers of skin and may involve subcutaneous layers, muscle, bone, or internal organs. Burned area is dry and leathery
Rule of mines
Divides the body into sections, each of which is approximately 9% of the total surface area of the body.
Classification of burns in infants and children severe burns
- Any full thickness burn
* partial thickness burns covering more than 20% of the body’s total surface area
Classifications of burns in infants and children moderate
Partial thickness burns covering 10 to 20% of the body’s total surface area
Classifications of burns in infants and children minor
Partial thickness burns covering less than 10% of their bodies TSA
