Chapter 26 Soft Tissue Trauma Flashcards
Puncture wound
An open wound that tears through the skin and destroys underlying tissues.
- A penetrating puncture wound can be shallow or deep
- A perforating puncture wound has both an entrance and an exit wound
- May have internal organ damage
Total surface area of skin
More than 20 ft.² for an average adult
Treatment of Hydrofluoric Acid
This acid is used for etching glass
- Burns from this may be delayed so treat all patients that have come into contact with this chemical
- flood affected area with water then transport immediately
- Fluoride released From the acid combines with calcium and magnesium in the tissue until the fluoride is used up
Epidermis
Outer layer of the skin
Treating an Avulsion
- clean the wound surface
- fold the skin back to its normal position as gently as possible
– control bleeding and dress the wound using bulky pressure dressing’s
• If skin or another body part is Torn from the body, Control bleeding, dress the wound using a bulky pressure dressing
• save the date of avulsed part and wrap it in a sterile dressing kept moist with sterile saline.
Make certain that you label the avulsed part with patients name, date and time that part was wrapped and bagged.
• Also keep part cold but not touching ice
Treatment of object impaled in eye
- Stabilize the object - Place a roll of 3 inch gauze bandage on either side of object a long vertical axis of head in a manner that will stabilize the object
- Apply rigid protection – fit a disposable paper drinking cup or paper cone over the impaled object
- Stabilize dressing and cup
- Dress and bandaged The uninjured eye. Will reduce sympathetic eye movement
- Care for shock
Closed crush injuries
An injury caused when a force is transmitted from the bodies exterior to its internal structures.
- Bones can be broken; muscles, nerves, and tissue damaged;
- internal organ damage: crushed or ruptured, causing internal bleeding: liver and spleen injury or rupture
Contusion
Contusion is a bruise, the most frequently encountered type of closed wound
- epidermis remains intact
- Cells and blood vessels in the dermis or damaged
- pain swelling and discoloration
• swelling caused by collection of blood under skin/inflammation
Treating impaled objects
- Expose the wound area - cut and expose
- Control profuse bleeding by direct pressure, Do not put pressure on the object, positioning hands on sides of object
- Continue stabilization, have another trained rescuer place several layers of bulky dressing around the injury site to stabilize object and provide pressure
- Secure the dressing in place
- Treat and care for shock
Treating Sulfuric Acid
Preferable to wash off with continuous flow of water.
*note heat is produced when water mixes with acid
Critical burns -Classifications by thickness, percent of body surface area, and complicating factors
- all burns complicated by injuries of the respiratory tract, other soft tissue injuries, and injuries of the bones
- Partial thickness or full thickness Burns involving the face, hands, feet, genitalia, or respiratory tract
- Full thickness burns of more than 10% of the body surface
- partial thickness burns of more than 30%
- Burns complicated by musculoskeletal injuries
- circumferential burns
Occlusive dressing
Any dressing that forms in airtight seal, usually used for open wounds to the abdomen, external bleeding from large neck veins and for open wounds to the chest
Minor burns - classifications. By thickness, percent of body surface area, and complicating factors
Minor burns
- full thickness(3 degree burns) burns of less than 2% of body surface, excluding the face, hands, feet, genitalia, respiratory tract
- partial thickness (second degree burns) burns of less than 15% of the body surface
- superficial burns (first degree burns) 50% of the body surface or less
Circumferential burns
Burns that encircle the body or a body part
- very serious because they constrict the skin.
- When they occur to an extremity they can interrupt circulation to the distal tissues.
- When they occur around the chest, they can restrict breathing by limiting chest wall movement
- Circumferential burns occur to joints the chest and abdomen where scarring tends to limit normal functions
Dressing
Any material preferably sterile used to cover a wound that will help control bleeding and prevent additional contamination
Dermis
Layer of skin below the epidermis
- layer is rich with blood vessels, nerves, and specialized structures such as/sweat glands, sebaceous (oil) Glands, hair follicles
- Specialize nerve endings in dermis involved with senses of touch cold heat and pain
- once dermis open contamination and infection become major problems
Hard tissues of the body include
Teeth, bones and cartilage
Blast injuries
Include both open and closed wound types
Significant blunt force trauma from explosions
- most common closed injuries associated with blast trauma are
•rupture of hollow organs
- air filled organs such as lungs and eardrums burst
- liquid filled organs like: stomach, intestines and urinary bladder are also high risk with these kinds of injuries
- bones can be broke, organs crushed, blood vessels lacerated
Treating abrasion and lacerations
– Direct pressure over a dressing usually works well
– how much static dressings
– tourniquet
Do not underestimate the facts of a laceration. When evaluating check CSM. Patient may need stitches, plastic surgery, antibiotics, or tetanus shot. So do not leave patient at scene