Soft-tissue Injury Deck Flashcards
What are soft tissues and how are their injuries classified?
Soft tissues include all body structures except organs and bones. Injuries to soft tissues can be classified into wounds (open and closed), muscle or tendon strains, ligament sprains, or any combination of these.
What is the difference between open and closed wounds?
Closed wounds involve injury to underlying structures without a break in the skin, while open wounds involve a break in the skin surface with underlying tissue exposure.
What are the main types of closed wounds?
The main types of closed wounds are bruises (contusions) and hematomas. Closed wounds result from blunt force or excessive pressure.
How are small contusions typically managed?
Small contusions usually require no emergency treatment. Cold application and modest pressure during the first 48 hours can limit swelling, decreasing pain and disability.
Which closed wounds should be referred for medical aid?
Closed wounds around joints, those impairing distal circulation, and those with nerve impairment should be referred for medical aid.
What are the types of open wounds?
Open wounds include abrasions, lacerations, punctures, avulsions, and amputations. They are characterised by a break in the skin surface, exposing underlying tissue.
Describe an abrasion and its common complications.
An abrasion is a superficial wound that roughens the skin’s surface, often causing slight bleeding. It may become infected due to dirt or foreign material.
What is a laceration, and what are its potential complications?
A laceration is a cut with sharp or jagged edges that may involve subcutaneous tissue, muscles, nerves, and blood vessels. Complications include blood loss, infection, and functional impairment.
What should be considered with puncture wounds?
Puncture wounds vary in size and depth, potentially damaging major blood vessels, organs, muscles, bones, tendons, and nerves. They are prone to infection due to deep foreign material.
What defines an avulsion injury, and what are its complications?
An avulsion involves the loss or pulling away of the full thickness of skin, exposing deeper tissues. Complications include blood loss, infection, and delayed healing.
What is the primary concern with amputations?
Amputations, whether partial or complete, expose bone and tissues, posing risks of severe bleeding, shock, infection, and disability.
What are dressings and their essential characteristics?
Dressings are used to cover open wounds to prevent contamination. They should be larger than the wound, sterile, thick, soft, compressible, and have a lint-free surface.
How should a triangular bandage be used and stored?
A triangular bandage can hold dressings, apply pressure, and secure splints. It should be folded into a narrow bandage for storage by bringing the point to the base, folding once, and doubling it upon itself.
What are the different types of bandages and their primary uses?
Bandages include elastic fracture straps, crepe rollers, self-adhering rollers, elastic adhesive-backed rollers, gauze rollers, tubular bandages, and triangular bandages. They secure dressings, apply pressure, and immobilize injuries.
Why are square knots recommended for securing triangular bandages?
Square knots do not slip once tightened and can be easily untied, making them ideal for securing triangular bandages.
What is the role of bulky supports in managing open wounds with foreign bodies?
Bulky supports made from triangular bandages or drainage dressings provide pressure to control hemorrhage and prevent further tissue injury in wounds with embedded foreign bodies.
What are the principles of bandaging?
Principles include:
- Bandage must control hemorrhage and immobilize the wound without constricting circulation.
- Pressure must be evenly distributed over the wound.
- Bandage must cover the entire dressing.
- Fingers and toes should be accessible for checking circulation and neurological function.
- Bandage knots must be accessible and not cause sores.
- Roller bandages must not encircle a limb underneath splints.
What is the initial procedure for managing minor wounds?
Follow the Priority Action Approach:
- Conduct a scene assessment.
- Complete the primary survey with appropriate modifications.
- Complete the required components of the secondary survey.
What is a hematoma?
A hematoma is a collection of blood and plasma in a damaged area, causing swelling. It can lead to complications such as circulation deficiencies, loss of feeling, or increasing pain.
What is the management protocol for small contusions?
Apply cold and modest pressure during the first 48 hours to limit swelling, decrease pain, and reduce disability.
When should closed wounds be referred to medical aid?
Closed wounds should be referred to medical aid if they:
- Are significant around joints
- Impair distal circulation
- Have nerve impairment
When should cold be applied to a wound?
Cold should be applied to slow bleeding, limit swelling, and reduce pain. Use caution to avoid hypothermia and ensure good circulation distal to the injury.
Cold should be applied to slow bleeding, limit swelling, and reduce pain. Use caution to avoid hypothermia and ensure good circulation distal to the injury.
Refer minor wounds to medical aid if they:
- Are longer than 3 cm through the full thickness of the skin.
- Involve joints, tendons, or the palm/back of the hand.
- Require sutures.
- Are dirty or contaminated.
- Are human or animal bites.
- Have embedded foreign materials.
- Are significant second or third-degree burns.
How should rings be removed from a swollen finger?
Lubricate the finger with soap or petroleum jelly. If this fails, use the string method or remove the ring with diagonal cutters or a special ring cutter.
Wound Cleansing
What are the guidelines for wound cleansing?
- Use warm, clean running tap water for irrigation.
2 Avoid using hydrogen peroxide, alcohol, iodine, zephirin hydrochloride, or mercurochrome in wounds. - Use diluted soap or detergent for bite wounds.
- Cleanse around the wound with sterile gauze, working outward.
- Use warm running water or sterile saline for inside the wound.
- Reassess the need for medical aid after cleansing.
When should skin closures be used to hold a wound closed?
Skin closures should be used to hold a wound closed only if the patient is returning to work.
What are the steps to ensure the adhesion of a skin closure?
- Dry the wound edges and remove hair.
- Apply tincture of benzoin sparingly to intact skin around the wound.
- Use cotton-tipped applicators to apply the compound, ensuring it does not get into the wound.
How should skin closures be applied to a wound?
- Start from the center of the wound and work in both directions.
- Apply half of the skin closure up to the wound margin and press it firmly into place.
- Close up the skin edges and press the free half of the closure firmly into place.
- Apply additional skin closures to complete the closure.
What should be done if a skin closure is incorrectly applied?
Lift the edges on the same side of each flap and gently pull the closure off along the long axis of the wound to avoid straining the other skin closures. Reapply as needed.
How long should skin closures stay in place?
Skin closures should stay in place for 7 to 10 days.
After applying skin closures, what is the next step in dressing a wound?
Apply a sterile dressing large enough to cover the wound and secure it in place with a bandage large enough to cover the entire wound dressing.
What should be advised to a patient regarding tetanus immunization?
Ensure the patient’s tetanus immunization is up to date. For clean minor wounds, immunization within the past 10 years is adequate; for all other wounds, it should be within the past 5 years.
What instructions should be given to a patient on wound care until follow-up?
- Keep the dressings clean and dry.
- Watch for signs of infection.
- Remove supportive bandages when not actively using the limb (for sprains/strains).
- Reapply supportive bandages when sleeping (for sprains/strains).
- Return to first aid for reassessment and redressing.
When should a patient report back for reassessment or redressing?
- If the dressings become wet or soiled.
- If there is a significant increase in pain in the area.
- If tingling or a loss of sensation develops in or distal to the area.
- If the patient notices signs of infection.
What should the OFA attendant check during follow-up care after 24 hours?
- Check the wound for infection.
- If there is infection, remove all closures so the wound can drain, dress it, and refer the patient to medical treatment.
- If no infection is found, continue treatment until the wound heals, checking progress every 2 days.
What are signs of infection in a wound?
Redness, heat, swelling, increased tenderness, and pus.
What are the risks associated with puncture wounds?
Puncture wounds may appear small on the outside but can cause severe internal damage and are prone to infection due to contamination below the surface.
What should be considered when assessing a puncture wound?
Consider the mechanism of injury, depth, location, appearance, restriction of movement, and alteration of function.
When should a patient with a puncture wound be referred to medical aid?
Refer to medical aid if the wound involves the head, neck, chest, abdomen, groin, or a joint.
How should a small wooden sliver be located and removed?
- Cleanse the area with antibacterial detergent solution and dry it with gauze.
- Paint the area with a colored antiseptic solution (e.g., Povidone or iodine).
- Allow the area to remain wet for 15 to 30 seconds, then wipe the color away with gauze.
- If the end of the sliver is close to the surface, it will soak up the colored antiseptic and show up as a dark spot.
- Grasp the end of the sliver with disinfected sliver forceps and withdraw it along the same angle it entered.
What is the initial treatment for a patient with a puncture wound who can return to work?
- Cleanse the wound.
- Soak the wound in warm potable tap water, normal saline, or a diluted antibacterial detergent solution for 15 to 20 minutes.
- Dress the wound.
- Instruct the patient to continue warm saline soaks at home 3 or 4 times a day for 48 hours.
- Have the patient return for reassessment after 24 hours.
What steps should be taken if a puncture wound is caused by an object contaminated with blood or bodily fluids, or an animal bite?
- Allow the wound to bleed.
- Wash the area promptly with sterile saline or clean water and mild soap.
- Dress the wound.
- Refer the patient to medical aid promptly.
How should metal slivers be managed?
If metal slivers can be seen and easily removed, they are managed the same way as wooden slivers, but without using a colored solution, which can make it difficult to locate the sliver.
What is the protocol for removing glass slivers?
- Soak the affected area in a warm, diluted antibacterial detergent solution for 20 minutes.
- Attempt to remove the sliver with gentle scrubbing.
- If the sliver can be seen and easily removed, manage it as a wooden sliver, without using a colored solution.
What is the procedure for removing a fish hook that is poking through the skin?
- Push the hook further through the skin.
- Cut off the barb.
- Back out the remaining portion of the hook.
Soak the wound in a warm diluted antibacterial detergent solution for 15 to 20 minutes and apply an appropriate dressing.
What should be done if the fish hook is pointing towards deeper structures?
Refer the patient to medical aid.