Emergency Care for Wounds and Burns

Standard Precautions

Infection control practices used to prevent the transmission of diseases, including the use of gloves, masks, and proper hygiene.

CSM

An acronym for Circulation, Sensation, and Movement, which are assessed distal to an injury to evaluate the status of the limb.

Epidermis

The outermost layer of skin, primarily composed of dead cells that are continuously shed and replaced.

Dermis

The layer of skin beneath the epidermis that contains blood vessels, nerves, and structures like sweat and oil glands.

Subcutaneous Layer

The layer of fat and soft tissue beneath the dermis that provides insulation and shock absorption.

Closed Wound

An injury where the skin remains intact, preventing an open pathway from the outside to the injury site.

Contusion

A type of closed wound commonly known as a bruise, resulting from blood vessels breaking under the skin.

Hematoma

A localized collection of blood outside of blood vessels, often occurring at the site of an injury.

Crush Injury

An injury caused by a force that compresses body parts, potentially damaging internal organs.

Open Wound

An injury characterized by a break in the skin, exposing underlying tissues.

Abrasion

A type of open wound resulting from the scraping away of the skin's outer layer.

Laceration

A cut in the skin that can be smooth or jagged, varying in depth and severity.

Puncture Wound

An injury caused by an object piercing the skin, which can lead to deeper tissue damage.

Avulsion

An injury where flaps of skin and tissue are torn away or completely removed.

Amputation

The complete removal of a body part, such as fingers, toes, or limbs.

Shock

A life-threatening condition that occurs when the body is not getting enough blood flow, leading to organ failure.

Direct Pressure

A method used to control bleeding by applying pressure directly over the wound.

Impaled Object

An object that has penetrated the body and remains lodged in the wound, requiring careful management.

Mechanical Traction

A method used to stabilize and align bones or joints by applying a pulling force.

Splinting

The process of immobilizing an injured body part to prevent further injury and alleviate pain.

Cold Packs

Ice or cold compresses applied to injuries to reduce swelling and manage pain.

High-Concentration Oxygen

Oxygen delivered at a higher concentration to support patients with respiratory distress or shock.

Bulky Dressing

A type of dressing that provides significant padding and support, used to control bleeding and stabilize injuries.

Pressure Dressing

A dressing applied tightly to control bleeding by applying direct pressure to a wound.

Superficial Burn

A burn that affects only the outer layer of skin, causing redness and minor swelling.

Partial Thickness Burn

A burn that damages both the epidermis and part of the dermis, characterized by pain, redness, and blisters.

Full Thickness Burn

A severe burn that destroys all layers of skin, often resulting in charred or dry, white areas.

Avulsed Part

A body part that has been forcibly detached or torn away, often requiring preservation for potential reattachment.

Oxygen Therapy

The administration of oxygen to a patient to improve oxygenation, especially in cases of respiratory distress.

Rigid Protection

A method of securing an impaled object to prevent movement and further injury, often using a protective covering.

Emotional Support

Providing reassurance and comfort to a patient during treatment to help alleviate anxiety and fear.

Skin Flap

A section of skin that is partially detached but still attached at one end, requiring careful management to promote healing.

Direct Hand Pressure

Applying pressure directly to a wound with the hands to control bleeding before further treatment.

Dignity in Care

Maintaining respect and privacy for a patient during medical treatment, especially in sensitive situations.

Rule of Nines

A method used to estimate the total body surface area affected by burns, where specific body regions are assigned a percentage of 9% for adults.

Rule of Palm

An estimation technique for burn surface area where the size of the patient's palm represents approximately 1% of their total body surface area.

Chemical Burn

A type of injury caused by contact with a corrosive substance that can damage skin and underlying tissues.

Inhalation Burn

Injury to the respiratory tract caused by inhaling hot air, steam, or chemical fumes, which can lead to airway obstruction.

Sterile Dressing

A covering applied to a wound to protect it from infection and promote healing.

Electrical Burn

Injury caused by electrical current passing through the body, which can cause deep tissue damage and cardiac issues.

Primary Assessment

The initial evaluation of a patient's condition to identify life-threatening issues, including airway, breathing, and circulation.

Cool the Burned Area

The first step in burn treatment, which involves cooling the affected area to reduce pain and prevent further injury.

Dry Lime Burn Treatment

A specific procedure for treating burns caused by dry lime, which involves brushing off the substance before washing with water.

Carbolic Acid Burn Treatment

The recommended initial treatment for burns caused by carbolic acid, which involves using alcohol for washing before applying water.

Hydrofluoric Acid Burn Treatment

The treatment for burns caused by hydrofluoric acid, which requires immediate flooding of the affected area with water.

Burn Center Criteria

Guidelines for determining which patients require specialized treatment at a burn center, including the extent and location of burns.

Assess Breathing

The process of evaluating a patient's respiratory status, especially in cases of burns that may affect the airway.

Soot Deposits

Black residue that may indicate inhalation injury, often found in the nose or mouth of burn patients.

Genital Region

The area of the body that is assigned 1% of the total body surface area in the Rule of Nines for burn assessment.

Burn Severity Evaluation

The process of determining the depth, extent, and potential complications of burns to guide treatment decisions.

Inhalation Injury

Damage to the respiratory system resulting from inhaling harmful vapors or chemicals.

Electrical Injury

Injury caused by the passage of electrical current through the body, which can lead to burns and cardiac disturbances.

Dressing

Material applied to a wound to control bleeding and prevent contamination.

Bandage

Material used to secure a dressing in place, which may not need to be sterile.

Universal Dressing

A large, bulky dressing used to cover wounds.

Occlusive Dressing

A dressing that forms an airtight seal over a wound.

Moistened Pads

Pads that are dampened to provide comfort and prevent further irritation to burned areas.

Transport

The process of moving a patient to a medical facility for further treatment.

Exit Wound

The site where a projectile exits the body, often requiring additional care and assessment.

Transport Protocols

Guidelines for safely moving a patient to a medical facility while ensuring their stability.

Tourniquet

A device used to apply pressure to a limb or extremity to control bleeding when direct pressure is insufficient or not possible.

Genital Injury Care

Involves controlling bleeding, preserving avulsed parts, and maintaining the patient's dignity while assessing for potential sexual assault.

Cooling the Burned Area

The initial step in burn treatment, which involves stopping the burning process and cooling the affected area to minimize damage.

Burn

A type of injury to the skin or other tissues caused by heat, chemicals, electricity, or radiation.

Thermal Burn

A burn caused by exposure to heat sources such as flames, hot liquids, or steam.

Dry Lime Burn

An injury caused by contact with dry lime, which requires careful brushing off before washing with water.

Carbolic Acid Burn

An injury caused by phenol that requires initial washing with alcohol followed by water.

Hydrofluoric Acid Burn

A burn from a highly corrosive acid that can cause delayed symptoms and requires immediate washing with water.

Inhaled Vapors Burn

An injury resulting from inhalation of caustic chemical vapors that necessitates high-concentration oxygen and prompt transport.

Control Bleeding

The process of stopping blood loss from a wound, often involving the application of dressings.

Burn Sheet

A sterile covering specifically designed for burn injuries to protect and promote healing.

Cool Dressing

A wet, cool cloth applied to a burn to help reduce pain and swelling.

The circulatory (or cardiovascular) system

is responsible for the distribution of blood to all parts of the body. This system has three main components: the heart, blood vessels, and the blood that flows through them

Arteries

carry freshly oxygenated blood away from the heart. They are under a great deal of pressure during the heart's contractions.

Capillaries

supply every cell of the body. Oxygen and nutrients are given up by the blood and pass through the extremely thin capillary walls into the cells. At the same time, carbon dioxide and other waste products given up by the cells pass through the capillary walls and are taken up by the blood.

Veins

Blood that has been depleted of oxygen and loaded with carbon dioxide and other wastes in the capillaries empties into veins that carry it back to the heart. Veins have one-way valves that prevent the blood from flowing in the wrong direction. Blood in a vein is under much less pressure than blood in an artery.

What is one function of blood related to gas exchange?

Transportation of gases: Oxygen is diffused into the blood at the alveoli in the lungs and is carried to the body's cells, while carbon dioxide is carried back to the alveoli to be exhaled.

How does blood circulate nutrients?

Blood circulates nutrients from the intestines or storage tissues (such as fatty tissue, the liver, and muscle cells) to other body cells.

What role does blood play in excretion?

Blood carries waste products from the cells to organs, such as the kidneys, that excrete (eliminate) the waste products from the body.

How does blood provide protection in the body?

Blood carries antibodies and white blood cells that help fight disease and infection, and it contains platelets and clotting factors that control bleeding by forming blood clots.

What substances does blood carry for regulation of body functions?

Blood carries substances such as hormones, water, salt, enzymes, and chemicals that control the body's functions.

relative hypovolemia

blood is not actually lost from the circulatory system, but conditions like dehydration or burns shift the liquid portion of blood, called plasma, out of the blood vessels and therefore out of the circulatory system

Hypovolemic shock

an insufficient volume in the circulatory system, and applies to both relative and absolute hypovolemia.

hemorrhagic shock

refers specifically to a loss of blood

cardiogenic shock

Pump problems

referring to the root cardiac cause of the hypoperfusion state.

distributive shock

Hypoperfusion caused by failed blood vessel tone

Neurogenic shock

occurs as a result of a spinal cord injury.

Septic shock

a very dangerous form of distributive shock that also incorporates elements of hypovolemic and cardiogenic shock

a body infection causes a systemic inflammatory response to occur. This inflammatory response causes blood vessels to dilate and capillary membranes to become permeable.

obstructive shock

Some shock states are caused not by the circulatory system itself, but rather by problems that cause the flow of blood to be blocked

compensated shock

period when the patient is developing shock but the body is still able to maintain perfusion.

decompensated shock

When compensation fails

Signs of shock

Pulse increases to maintain cardiac output

Blood Vessels constrict, causing pale, clammy skin

Respiration rate increases

Blood is shunted away from the GI organs causing nausea

Decreasing blood pressure is a late sign of shock

The deadly triad

three conditions that significantly contribute to mortality in shock patients

acidosis, hypothermia, and coagulopathy.

General treatment steps that address the deadly triad

Initiate transport to an appropriate destination

Prevent hypoxia—Managing the airway and preventing hypoxia reduces the effects of acidosis and its associated coagulopathies.

Prevent heat loss—Hypothermia is linked to coagulopathy. Temperature regulation should be considered in all shock patients, regardless of ambient environmental temperatures.

Consider shock positioning—It is logical that blood is distributed throughout the body with less difficulty when a patient is in a supine position

Consider advanced life support (ALS)

In patients with signs and symptoms indicating shock:

Initiate rapid transport to an appropriate destination.

Manage specific underlying causes of shock. Consider the need for hemorrhage control in hypovolemia, epinephrine in anaphylaxis, and early recognition and transport for sepsis.

Manage the airway and breathing to prevent hypoxia. Consider supplemental oxygen if the patient is hypoxic or demonstrating potential signs of hypoxia.

Take steps to prevent heat loss. Remove wet clothing and insulate the patient.

If possible, place the patient in a supine position.

Request ALS.

Hemorrhage

Severe bleeding. the major cause of shock (hypoperfusion) in trauma

Arterial bleeding

Massive hemorrhage occurs when extensive wounds open up large blood vessels or many smaller blood vessels.

venous bleeding

has less pressure behind it than arterial bleeding does, the sheer volume of blood carried by some veins is enough to create immediately life-threatening hemorrhage in some patients

capillary bleeding

Superficial wounds to the surface of the skin

The major methods of controlling massive external bleeding are

Direct pressure

Hemostatic agents

Wound packing

Tourniquet use on extremities

Specialized compression devices for junctional bleeding