Trauma Emergencies Flashcards
What are soft tissues and what is an injury to soft tissues called?
Soft tissues are the layers of skin and the fat and muscle beneath the skin’s outer layer. A physical injury to the body’s soft tissue is called a wound. Any time the soft tissues are damaged or torn, the body is threatened.
What are some key reminders for Soft Tissue Injuries and Wounds?
Injuries may damage the soft tissues at or near the skin’s surface, or deep in the body. Germs can enter the body through a scrape, cut, puncture or burn and cause infection. Bleeding can occur at or under the skin’s surface, where it is harder to detect.
Closed wounds occur beneath the surface of the skin. The simplest closed wound is a bruise or contusion.
Bruises result when the body is subjected to blunt force, such as when you bump your leg on a table or chair. Such a blow usually results in damage to soft tissue layers and blood vessels beneath the skin, causing internal bleeding.
Most closed wounds do not require special medical care. However, a significant violent force can cause injuries involving larger blood vessels and the deeper layers of muscle tissue.
These rare injuries can result in severe bleeding beneath the skin. In these cases, medical care is needed quickly.
What are some key reminders for Amputations?
In some severe injuries, the force is so violent that a body part, such as a finger, may be severed.
A complete severing of a part (usually involving a bone or limb) is called an amputation.
Although damage to the tissue is severe, bleeding may not be as profuse as you might expect. The blood vessels usually constrict and retract (pull in) at the point of injury, slowing bleeding and making it relatively easy to control with direct pressure.
In the past, a completely severed body part could not be successfully reattached. With today’s technology, reattachment is often successful, making it important to carefully handle and send the severed part to the hospital with the person.
First, provide emergency care. Control external bleeding. While it is important to care for the severed body part, it is vital to care for the person first. Ask another responder to search for and provide care for the body part while you tend to the person.
If the amputation is incomplete (i.e., an avulsion), never remove the body part. Care for it as you would any soft tissue injury, stabilizing the part.
If the body part is completely severed, find it, wrap it in sterile gauze, moistened in sterile saline if available.
Place it in a plastic bag, seal the bag, and label it with the person’s name and the time and date it was placed in the bag. Keep the bag cool by placing it in a larger bag or container of an ice and water slurry, not on ice alone and not on dry ice.
Transfer the bag to the EMS personnel transporting the person to the hospital.
What is an impaled object?
An impaled object is one that has been embedded into an open wound.
There are two situations in which it is appropriate to remove an impaled object, what are they?
There are two situations in which it is appropriate to remove an impaled object.
- The impalement is through the cheek, with uncontrolled bleeding and interference with airway management.
- The object impales the chest and interferes with CPR.
What is an open chest wound?
Open chest wounds occur when an object, such as a knife or bullet, penetrates the chest wall. Open chest wounds also can be caused by fractured ribs that break through the skin.
What is a closed chest wound?
A chest wound is considered closed if the skin is not broken. Closed chest wounds are generally caused by a blunt object.
What is blunt trauma caused by and what are the signs and symptoms?
Blunt trauma is injury caused by the force of an object that impacts with, but does not penetrate the body.
Signs and symptoms include severe shortness of breath, chest pain and rapid, possibly irregular pulse.
The possibility of blunt trauma should be considered in people who sustain a blow to the abdomen or chest and show signs of respiratory distress. Often, associated injuries will occur with blunt trauma, including major trauma to the spleen, liver or large blood vessels.
What is traumatic asphyxia?
Traumatic asphyxia, or severe lack of oxygen due to trauma, can result from chest injury. These injuries often are caused by a strong crushing mechanism or by situations in which people have been pinned under a very heavy object.
What are some signs and symptoms of traumatic asphyxia?
Signs and symptoms of traumatic asphyxia include:
o Shock
o Distended neck veins
o Bluish discoloration of the head, tongue, lips, neck and shoulders (cyanosis)
o Broken blood vessels in the eyes (subconjunctival hemorrhage)
o Black eyes
o Pinpoint-sized red dots (petechiae) on the head and neck
o Rounded, “moon-like” facial appearance
o Bleeding from the nose or ear
o Coughing up or vomiting blood
o Loss of consciousness, seizures or blindness
What are some possible complications of broken ribs?
Possible complications of broken ribs include:
o Collapse of a lung due to air in the chest cavity pressing on the lung (pneumothorax).
o Accumulation of blood between the lungs and chest wall (hemothorax).
o Air in the tissues under the skin (subcutaneous emphysema).
o Bruising or piercing of the lung and injuries to the spleen or liver.
o Lacerated blood vessels between the ribs.
The first priority with broken ribs is adequate breathing. A person with a fractured rib often has shallow breathing because normal or deep breathing is painful.
Give the person a blanket or pillow to hold against the fractured ribs. Use a sling and binder to hold the person’s arm against the injured side of the chest. Monitor breathing.
What is Pneumothorax and how can it occur?
Pneumothorax is the collapse of a lung due to air in the chest cavity pressing on the lung and preventing it from expanding.
Pneumothorax can occur in two ways. In blunt chest trauma, it may result when a fractured rib penetrates the lung, causing air to leak. It can also occur when air enters the chest cavity because of a sucking chest wound. Pneumothorax reduces lung pressure and leads to respiratory distress.
People may report pain while breathing, and pain at the site of the rib fractures. Decreased breath sounds will be present upon examination, and many people with traumatic pneumothorax also have some element of severe bleeding (hemorrhage), causing a hemopneumothorax.
People with pneumothorax will require a chest tube in the hospital setting to fully re-expand the lung.
What is Hemothorax?
Hemothorax is an accumulation of blood between the lungs and chest wall (pleural space), which creates pressure on the heart and lungs and prevents the lungs from expanding, resulting in the same symptoms as those which occur in pneumothorax.
The bleeding that leads to hemothorax may be from the chest wall, the lung’s functional tissue (parenchyma), or major blood vessels in the thorax.
It may occur following blunt or penetrating injury to the chest, and often occurs together with pneumothorax.
What are the signs and symptoms of a serious chest injury (open or closed wounds)?
o Shortness of breath and difficulty breathing.
o Pain during breathing.
o Pain at the site of the injury that increases with deep breathing or movement.
o Obvious deformity, such as that caused by a fracture.
o Flushed, pale, ashen or bluish discoloration of the skin.
o Coughing up blood.
o Distended (protruding) neck veins.
o Drop in blood pressure.
What is the function of a chest seal?
The chest seal keeps air from entering the wound during inhalation but allows it to escape during exhalation.
