ch 27 soft tissue injuries

MOI of soft tissue injuries

blunt, penetrating barotrauma or burns

steps when skin injury

 Control bleeding.

 Prevent further contamination to decrease the risk of infection.

 Protect wounds from further damage.

 Apply dressings and bandages to various parts of the patient’s body

Closed injuries

skin doesnt break bleeding beneath the skin but does not break the skin

contusion hematoma

bruise where blood collected within damaged tissue or in a body cavity

crushing injury

significant amount of force is applied to the body

crush syndrome

tissues are crushed beyond repair, muscle cells die and release

harmful substances into the surrounding tissues

how long does it take for crush syndrome to occur

4 hours

compartment syndrome

high pressure build up inside enclosed muscle compartment

abrasion

wound of the superficial layer of the skin

abrasion penetration

doesn’t penetrate fully through dermis

laceration

jagged cut

incision

sharp, smooth cut

depth of laceration and incision

through skin, subcutaneous tissue, underlying muscles, nerves and blood vessels

avulsion

separates various layers of soft tissue so that they become either completely detached or hang as a flap

amputation

body part completely severed

documentation of

Description of the MOI

 Position in which you found the patient

 Amount of blood loss

 Location and description of any soft-tissue injuries or other wounds

 Size and depth of the injury

 How you treated the injurie

how to cover wounds of chest, upper abdomen or upper back

occlusive dressing and sterile gauze

eviseration

organs protrude through the wound

only remove impaled objects when

The object is in the cheek or mouth and obstructs the airway or The object is in the chest and interferes with CP

treatment of neck injuries

occlusive dressing, apply manual pressure but do not compress both carotid arteries at the same time

Thermal burns occur when the skin is exposed to temperatures higher than ___ºF.

111

severity of burns determined by

 Temperature

 Concentration

 Amount of heat energy possessed by the object or substance

 Duration of exposure

circumferential burns

burns that wrap around limbs and restrict blood flow leading to neurovascular compromise and irreversible damage

critical burn area

Face, upper airway, hands, feet, genitalia

superficial 1st degree burns

Involve only the top layer of skin, skin red

Partial-thickness (second-degree) burns

Involve the epidermis and some portion of the dermis, mottled, white and red blistered skin

Full-thickness (third-degree) burns

Extend through all skin layers, skin is dry, leathery and often white or charred

adult rule of nines

head and each arm is 9, torso, back and each leg is 18

toddler rule of nines

torso and back is 18, head is 12, each arm is 9, each leg is 16.5

baby rule of nines

head, back and torso is 18, arms are 9, legs are 13.5

classifications of burns

source, depth and severity of burn

signs of inhaled hot gases or vapors

singed facial hair, soot present in and around the airway, secretion and frequent coughing

thermal burns

caused by heat

steam burn produces

topical/scald burn

flash burn caused by an

explosion

type of dressing for burns

dry sterile dressing

Upper airway damage is often associated with the inhalation of

superheated gases

Lower airway damage is often associated with the inhalation of

chemicals and particulate matter

is group of people in same place have headache likely bc

carbon monoxide

dry chemical management

Always brush dry chemicals off the skin

and clothing before flushing with water

for liquid chemicals

flush with water for 15-20minutes

electrical burns effected by

type of electric current, magnitude of current, and voltage

dangers of electrical burns

There may be a large amount of deep tissue injury.

 The patient may go into cardiac or respiratory arrest from the electric shock

management of electrical burns

cpr and aed, supplemental o2, treat soft tissue with dry and sterile dressings

alpha radiation burns

Little penetrating energy easily stopped by the skin

beta radiation burns

Greater penetrating power, but blocked by simple protective clothing

gamma radiation burns

Very penetrating; easily passes through the body and solid materials

functions of dressing

 To control bleeding

 To protect the wound from further damage

 To prevent further contamination and infection

for large wounds

universal dressing

for smaller wounds

gauze pad

for minor wounds

adhesive-type dressing

treatment for a sucking chest wounds/pneumothorax

cover wound with occlusive dressing to prevent air from entering

What effects will the application of an ice have on a hematoma?

Vasoconstriction and decreased bleeding

treatment for abdominal evisceration

applying a moist, sterile dressing to the wound and covering the moist dressing with an occlusive dressing

severe burns include

• full-thickness burns involving the hands, feet, face, airway, or genitalia

• full-thickness burns covering more than 10% of the body’s total surface area (BSA)

• partial-thickness burns covering more than 30% of the BSA

• burns involving the respiratory tract (eg, smoke inhalation)

• burns complicated by fractures

• burns on patients younger than 5 years or older than 55 years that would otherwise be classified as “moderate” burns on younger adults