Chapter 26-soft Tissue Injuries

Question 1

Epidermis

Answer 1

Tough, external layer of skin that forms watertight coverage for the body

Question 2

Dermis

Answer 2

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.

Question 3

What is sebum?

Answer 3

Produced by sebaceous glands, and is the oily material that waterproofs the skin and keeps it supple

Question 4

Mucous membranes

Answer 4

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

Question 5

Closed injuries

Answer 5

When soft tissue damage occurs beneath The skin or mucous membranes but the surface of the skin or mucous membranes remains intact

Question 6

Open injuries

Answer 6

In which there is a break in the surface of the skin or the mucous membrane, exposing deeper tissue to potential contamination

Question 7

Burns

Answer 7

In which the soft tissue damage occurs as a result of thermal heat, frictional heat, toxic chemicals, electricity, or nuclear radiation

Question 8

Contusion

Answer 8

Bruise: an injury that causes bleeding beneath the skin but the skin doesn’t break
Caused by blunt forces striking the body

Question 9

Ecchymosis

Answer 9

A blue or black discoloration caused by blood build up under the skin

Question 10

Hematoma

Answer 10

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

Question 11

Crushing injury

Answer 11

Occurs when significant force is applied to the body

Question 12

Crush syndrome

Answer 12

When an area of the body is trapped for longer than four hours and arterial blood flow is comprised

Question 13

Compartment syndrome

Answer 13

Develops when swelling results in increased pressure within a closed soft tissue compartment. It can cause a lack of circulation

Question 14

Contamination

Answer 14

The presence of infectious organisms (pathogens) or foreign bodys in the wound

Question 15

What are the four types of wounds you need to be prepared to manage?

Answer 15

Lacerations, abrasions, punctures, avulsions

Question 16

Abrasion

Answer 16

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

Question 17

Laceration

Answer 17

A jagged cut in the skin caused by a sharp object or blunt force that tears the tissue

Question 18

Incision

Answer 18

A sharp, smooth cut

Question 19

Avulsion

Answer 19

An injury that separates various layers of soft tissue, so they become either completely detached or hang as a flap

Question 20

Amputation

Answer 20

An injury in which part of the body is completely severed

Question 21

Penetrating wound

Answer 21

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

Question 22

Impaled objects

Answer 22

Objects that penetrate the skin but stay in place.

Question 23

What should you use to treat a penetrating wound in the neck, chest, back, or upper abdomen?

Answer 23

An occlusive dressing

Question 24

What three factors usually influence the MOI in a blast?

Answer 24

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

Question 25

What mnemonic can be used to treat closed soft tissue injuries?

Answer 25

RICES

Question 26

What does RICES stand for?

Answer 26

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

Question 27

Three methods to control external bleeding or open injuries

Answer 27

• direct, even pressure and elevation
• pressure dressings/splints
• tourniquets

Question 28

What is a risk for any patient who had significant bleeding or bleeding that cannot not be controlled?

Answer 28

Hypovolemic shock

Question 29

Evisceration

Answer 29

When an organ protrudes through a wound

Question 30

How to treat an impaled object

Answer 30

1. 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
2. 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
3. Protect impaled object from being bumped. Y taping something over it to secure it (cup, supply container)

Question 31

What is air ebolism?

Answer 31

Air sucked into a blood vessel, blocking the flow of blood into the lungs causing cardiac arrest

Question 32

The emergency treatment of bites

Answer 32

1. Apply a dry sterile dressing
2. Promptly immobilize the area with a splint or bandage
3. Provide transport to the ED for surgical cleansing of the wound and antibiotic therapy

Question 33

What five factors can help you determine the severity of a Burn

Answer 33

1. What is the depth of the burn?
2. What is the extent of the burn?
   (First two most important question)
3. Are any critical areas involved?
4. Does the patient have any preexisting medical conditions or other injuries?
5. Is the patient younger than 5 or older than 55?

Question 34

What are the classifications of severe burns in adults

Answer 34

• 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

Question 35

Classifications of burns in adults for moderate burns

Answer 35

• 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

Question 36

Classification of burns in adults for minor burns

Answer 36

• 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

Question 37

Superficial burn (first degree)

Answer 37

Involves only the top layer of skin, the epidermis. The skin turns red but does not blister or burn through
For example, a sunburn

Question 38

Partial thickness (second degree) burn

Answer 38

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

Question 39

Full thickness (third degree) burn

Answer 39

Extends through all layers of skin and may involve subcutaneous layers, muscle, bone, or internal organs. Burned area is dry and leathery

Question 40

Rule of mines

Answer 40

Divides the body into sections, each of which is approximately 9% of the total surface area of the body.

Question 41

Classification of burns in infants and children severe burns

Answer 41

• Any full thickness burn

* partial thickness burns covering more than 20% of the body’s total surface area

Question 42

Classifications of burns in infants and children moderate

Answer 42

Partial thickness burns covering 10 to 20% of the body’s total surface area

Question 43

Classifications of burns in infants and children minor

Answer 43

Partial thickness burns covering less than 10% of their bodies TSA