ECare - Chapter 26 (Soft-Tissue Trauma) Flashcards
types of closed wounds
contusions, hematomas, and crush injuries
hematoma
swelling caused by blood under skin/damaged tissues due to injured blood vessel
crush injury
force is transmitted from exterior to interior structures. Bones can be broken; muscles, nerves, and tissues damaged, and internal organs ruptured, causing internal bleeding.
blast injuries
type of soft-tissue injury associated with rupture of hollow organs
Patient Care: Closed Wounds
ABCs, oxygen, manage internal bleeding and shock, splint extremities, cold packs
avulsion
tearing away a piece of skin ex. eye/tooth pulled from socket
blast wave injuries
primary: pressure wave
secondary: blast wave (debris)
tertiary: patient displacement
quaternary: exposure to hazardous material
Patient Care: Open Wounds
- Expose the wound and clean it
- control bleeding (direct pressure + elevation)
- shock and oxygen
- sterile dressing after bleeding is controlled (except for pressure dressing)
- patient lays still
close-range shootings
look for burns around entry wound
patient care: impaled objects
- expose wound
- control bleeding by direct pressure around object
- bulky dressing around object
- secure dressings
- care for shock/oxygen
- transport
patient care: impaled cheek
- remove object if ONLY the cheek is impaled
- position patient for drainage
- pressure dressing
- oxygen/shock
patient care: puncture wound to the eye
loose dressings
patient care: impaled eye
- stabilize object
- apply rigid protection
- stabilize dressings/cup
- dress and bandage uninjured eye
- oxygen/shock
patient care: avulsions
- clean wound surface
- fold skin back to normal position
- control bleeding using bulky dressings
Patient Assessment: Burns
evaluated/classified by:
agent/source, depth (degrees), and severity
rules of nines
estimates extent of a burn
each area represents 9% of body surface: head and neck, both arms, chest, abdomen, upper back, lower back and butt, front of leg, back of leg
rule of palm
estimates extent of a burn
palm of hand + fingers = 1%
Patient Care: Thermal Burns
- flame: wet down, smother, remove clothing OR semi-solid: water
- open airway
- signs of airway injury
- primary assessment
- shock/oxygen
- evaluate burns by depth, extent, and severity
- do not clear debris
- wrap with dry sterile dressing
- remove jewelry
burns to eyes: chemical
flush with water for 20 minutes
burns to eyes: thermals
sterile gauze to both eyes
patient care: chemical burns
- wash away chemical with water; brush off it dry chemical
- sterile dressing/burn sheet
- shock
- transport
patient care: dry lime
brush it off then use water
patient care: carbolic acid (phenol)
wash with alcohol then use water
patient care: sulfuric acid
use water
patient care: hydrofluoric acid
use water
patient care: inhaled vapors
use oxygen
patient care: chemical burns to eyes
- flood eyes with water (from medial to corner of eye)
- transport
- cover both eyes with moistened pads
patient assessment: electrical injuries
burn where energy enters, disrupted nerve pathways (paralysis), muscle tenderness, respiratory difficulties, irregular heartbeat, high/low BP, restlessness, visual difficulties, fractured bones, seziures
patient care: electrical injuries
- ABC
- Life support if needed
- Shock/oxygen
- Spine/head injuries
- Look for two external burn sites
- cool burn areas and smother clothing
- dry sterile dressings
- transport
universal dressing
bulky dressing
pressure dressing
dressing applied tightly to control bleeding
occlusive dressing
forms airtight seal
