LO7 Integumentary Trauma (Chapter 14/5/Nancy)

Question 1

Open wounds 

Answer 1

If the initial CABC shows exsanguinating bleeding apply tourniquet 

If you have an area that cannot be stopped with pressure or tourniquet such as axilla, neck or groin you should use a hemostatic dressing 

Hemostatic agents are not to be used in abdominal or chest wounds 

For open wound from a fracture where bleeding is controlled carefully cover with a moist sterile dressing in bandage 

Question 2

Amputations 

Answer 2

Amputation is a disabling an often life-threatening injury that may present as a partial or complete loss of a body part usually the bleeding can be controlled and direct pressure 
 
The stump should be covered with a damp sterile dressing and an elastic wrap that will apply uniform reasonable pressure across the entire stump 

Small amputated part should be rinsed off wrapped in Celine moistened sterile gauze and placed in a plastic bag 

Label the bag with the patients name, date, Time the amputation happened and the time the part was wrapped and cooled 

Never immerse apart in water or saline or used ice directly on it 

Question 3

Tourniquets

Answer 3

Should not be used for longer than 2-4hours

Never cover a tourniquet

Write time on it or on forehead of pt

Question 4

Control of Life Threatening bleed

Answer 4

Pressure points are not effective in controlling hemorrhage

If direct pressure doesn’t work use tourniquet

Question 5

How to pack a wound

Answer 5

1. PPE
2. Direct pressure push gauze into wound
3. Keep feeding gauze in wound then hold pressure for 3mins if bleeding stops apply pressure dressing
4. If bleeding continues may have to repack wound

Question 6

Closed wounds

Answer 6

Are soft tissues beneath the skin surface are damaged but there is no breakage in the epidermidis

Trauma to the nerve endings produce pain and leakage of fluid into spaces between the damage cell producing swelling

Question 7

Contusion

Hematoma

Answer 7

bruise

a collection of blood beneath skin

Question 8

Abrasion

Answer 8

a superficial wound that occurs when the skin is rubbed or scraped over a rough surface and part of the epidermis is removed

Infection is a danger

Do not try to clean an abrasion cover the wound lightly with sterile dressing

Question 9

Lacerations

Answer 9

The laceration is a cut inflicted by a sharp instruments such as a knife or razor blade that produces a clean or jiggered incision through the skin surface and underlying structures

First priority in treating a laceration is to control bleeding by applying pressure

Question 10

Incision

Answer 10

used to refer to a clean cut tend to heal better than lacerations

Question 11

Puncture wounds

Answer 11

A puncture moon is a stab from a pointed object such as a nail or knife

Bullet wound is a puncture wound

Most punctual wounds do not cause bleeding but may produce extensive internal bleeding

Consider the potential depth of the wound the location and type and speed of object

Question 12

Avulsions

Answer 12

occurs when a flap of skin is torn loose partially or completely it may or may not be accompanied by profuse bleeding

Loss of blood supply to the flap is a concern if it is folded back or kinked circulation will be compromised and that piece of skin will die

Irrigated with normal saline than trying to place it back into a more anatomical or untwisted position