EMT - Soft Tissue Injuries

Skin

• control bleeding

• prevent further contamination → decrease infection risk

• protect wounds from further damage

• apply bandages/dressings

• next wound healing stage → inflammation

Closed Injuries

• contusion (bruise) → bleeding beneath the skin (no break)

• hematoma (clot) → blood collected w/in damaged tissue/cavity

• crushing injury

  • crush syndrome → 4hrs after trapped

  • compartment syndrome → swelling by increased pressure

    • primary injury → damage from compression

    • secondary injury → damage from circulation issues

Open Injuries

• abrasion → on superficial layer from friction

• avulsion (flap) → layers separate; place in correct position and bandage

• amputation → severed body part

• penetration → from piercing object

  • count #, determine gun type if possible

  • remove only if interference w/ airway/CPR

Vital Signs

• Code 3 → ambulance

• Code 2 → on scene

• Hypoperfusion → tachycardia, tachypnea, low BP, weak pulse, cool/moist/pale skin

Documentation/Communication

• description of MOI

• position pt was found

• amount of blood loss

• location/description of injuries

• size of injury

• treatment of injury

Treatment

• chest, upper abd, back → occlusive dressing

• abdominal → sterile gauze + occlusive dressing

• neck → occlusive dressing + one-handed manual pressure

• bites → dry, sterile dressings, immobilize + transport

Burns

correlate w/ temperature, concentration, heat energy, duration of exposure

• greater heat energy = deeper wound

• risk of: infection, hypothermia, hypovolemia, shock

• circumferential burn → work type regardless of position

  • compromises breathing (chest)

  • leads to neurovascular compromise (extremity)

• airway burns → sever swelling impedes airway, transport immediately

Burn Severity

1. superficial (1st degree) - top layer only

2. partial-thickness (2nd degree) - epidermis + some dermis → blisters + pain

3. full-thickness (3rd degree) - all skin layers & nerve endings severed

Rule of Nines

only partial & full-thickness burns

• Adult → 9 (head), 9 (each arm), 18 (torso), 18 (each leg), 18 (back), 1 (genital)

• Children → 12 (head), 16.5 (each leg)

• Infants → 18 (head), 13.5 (each leg)

Thermal Burns

exposure to high heat for a brief amount of time

• stop source

• cool under running water

• dry sterile dressing

Inhalation Burns

lower airway damage associated with inhalation of chemicals

• upper airway damage associated with inhalation of superheated gases

• sever upper airway swelling → call ALS for intubation

Chemical Burns

decontaminate before loading

• brush dry chemicals off

• flush with water

• remove clothing

• flood for 15-20min after burning stops

Electrical Burns

energy moving through body & possible damage

• supplemental oxygen

• dry, sterile dressings

Radiation Burns

only time EMT will irrigate a wound on scene