Chapter 24: Soft-Tissue Injuries

Front 1

What are the two principal layers of the skin?

Back 1

epidermis and dermis

Front 2

mucous membrane

Back 2

the covering of the various openings in our body including mouth, not, anus and vagina

Front 3

How are mucous membranes similar and different then skin?

Back 3

Similar: provide a protective barrier against bacterial invasion

Different: secrete a watery substance that lubricates the opening

Front 4

What functions does skin serve?

Back 4

Keeps pathogens out, water in, and assists in body temperature regulation

Front 5

What happens to the skin in hot environments?

Back 5

vessels in skin dilate; it becomes flushed, red and heat radiates out; sweat glands secrete sweat which evaporates causing cooling

Front 6

What are the three types of soft tissue injury?

Back 6

Closed injury; open injury; burns

Front 7

What are closed injuries?

Back 7

soft- tissue damage occurs beneath the skin or mucous membrane but the surface remains intact

Front 8

What are open injuries?

Back 8

there is a break in the surface of the skin or mucous membrane, exposing deeper tissue to potential contamination

Front 9

What are burns?

Back 9

soft tissue receives more energy than it can absorb without injury.

Front 10

What sources of energy cause burns?

Back 10

thermal, friction, toxic chemicals, electricity or nuclear radiation

Front 11

What is a contusion and how do they occur?

Back 11

contusion: bruise

result from blunt force stricking the body

Front 12

What is ecchymosis?

Back 12

the blue or black discoloration caused by a build up of blood under the epidermis

Front 13

What is a hematoma?

Back 13

blood that has collected within damaged tissue or in a body cavity

Front 14

Compartment syndrome:

Back 14

A condition caused when blood vessels become compressed, cutting off blood flow to tissue

Front 15

What are you looking for in the initial assessment of closed injuries?

Back 15

General impression; airway and breathing; circulation; transport decision

Front 16

What are the next steps in a closed injury case after the initial assessment?

Back 16

determinging which type of physical exam needs to be performed; baseline vitals and SAMPLE history

Front 17

When would you perform a rapid physical exam?

Back 17

when there is a significant MOI

Front 18

When would you perform a focused physical exam?

Back 18

when there is a nonsignificant MOI

Front 19

When should a detailed physical exam be performed?

Back 19

anytime there is a serious MOI

Front 20

What are the steps of ongoing assessment in a closed injury case?

Back 20

repeat initial assessment; communication and documentation

Front 21

What is the acronym to be used in soft tissue injury cases?

Back 21

RICES

Front 22

What does RICES stand for? Explain each.

Back 22

R: rest- keep the patient as quiet and comforable as possible
I: ice-slows bleeding by causing blood vessels to constrict and also reduces pain
C: compression- over the injury site slows bleeding by compressing blood vessels
E: elevation- of the injured part just above the level of the patients heart decreases swelling
S: splinting- decreases bleeding and slo reduces pain by immobilizing a soft tissue injury or an injured extremity

Front 23

What is an abrasion?

Back 23

a wound of the superficial layer of the skin caused by friction when a body part rubs or scrapes across a rough or hard surface

Front 24

What is a laceration?

Back 24

a jagged cut caused by a sharp object or a blunt force that tears the tissue

Front 25

What is an incision?

Back 25

a sharp smooth cut

Front 26

What is an avulsion

Back 26

an injury that seperates various layers of soft tissue so they become completely detached or hang as a flap

Front 27

What is a penetrating wound?

Back 27

an injury resulting from a sharp, pointed object

Front 28

T or F: Closed and Open wounds caused by crushing may involve damage to internal organs or broken bones.

Back 28

True.

Front 29

What is the first step when you arrive at a scene with open injuries?

Back 29

scene size up and BSI

Front 30

What are the parts of the initial assessment of a case with open injuries?

Back 30

General impression; airway and breathing; circulation; transport decision

Front 31

What should you do if an open wound is found on the chest?

Back 31

evaluate for air movement through the wound in the form of bubbling or sucking sounds that indicate a deep penetrating injury. Quickly place an occlusive dressing over the wound.

Front 32

What do you do after the initial assessment of a case with open injuries?

Back 32

determine type of physical exam needed based on MOI; baseline vitals and SAMPLE history

Front 33

What interventions should you take in a case with open wounds?

Back 33

if bleeding is found control it as quickly as possible. If it is serious this should be done in the initial assessment; if not serious it can be attended to later.

Front 34

What are parts of the ongoing assessment for a case with open wounds?

Back 34

reassess often; may be required to add layers to an insufficient bandage.

Front 35

What are the steps to controling bleeding from a soft-tissue injury?

Back 35

1. Apply a dry, sterile dressing over entire wound and apply pressure with a gloved hand.
2. Maintain the pressure and secure the dressing
3. If bleeding continues or recurs, leave the origional dressing in place and apply a second dressing.
4. Splint the extremity to stabalize the injury even if there is no suspected fracture.

Front 36

What is an evisceration?

Back 36

An open wound in the abdomin in which the organs protrude through the wound.

Front 37

What are the steps to stabilizing an impaled object?

Back 37

1. Do not attempt to move or remove it unless it is causing airway obstruction or interferes with CPR.
2. Remove anyclothing coverin the injury. COntrol bleeding and apply a bulky dressing.
3. Protect the impaled object from being bumped or moved during transport by taping a rigid object over the stabilized object and its bandage.

Front 38

Should you severe partial amputations?

Back 38

No

Front 39

With a complete amputation, do you want the severed part to freeze?

Back 39

No, just to stay cool

Front 40

What is an air embolism and how should it be prevented?

Back 40

air embolism: enough air is sucked into a blood vesselto block the flow of blood

cover the wound with an occlusive dressing to prevent

Front 41

What 5 factors help you determine burn severity?

Back 41

1. depth of burn?
2. extent of the burn
3. any critical areas?
4. any preexisting medical conditions or other?
5. is the patient younger than 5 or older than 55?

Front 42

What are the possible depths of burns?

Back 42

superficial (first-degree); partial-thickness(second-degree); full- thickness (third-degree)

Front 43

What is a superficial burn?

Back 43

1st degree; involves only the epidermis

Front 44

What is a partial-thickness burn?

Back 44

2nd degree; involves the epidermis and some portion of the dermis

Front 45

What is a full-thickness burn?

Back 45

3rd degree; involves all layers of skin and may involve subcutaneous layers, muscle, bone, or internal organs.

Front 46

What is the Palmer Method?

Back 46

Estimating the size of the burn by comparing it to the patients palm which is equal to 1% of the patients total body surface area.

Front 47

What is the Rule of Nines?

Back 47

divides the body into sections, each which is approximately 9% of the total surface area

Front 48

What should you remember about children and infants when using the rule of nines?

Back 48

their head is relatively larger and legs smaller

Front 49

What is considered a critical burn in infants and children?

Back 49

full or partial-thickness burns covering more than 20% of the bodys total surface area; burns involving hands, feet, face, airway, or genitalia

Front 50

What is considered a moderate burn in infants and children?

Back 50

partial-thickness burns covering 10%-20% of the bodys total surface area

Front 51

What is considered a minor burn in infants and children?

Back 51

partial-thickness burns covering less than 10% of the body's total surface area

Front 52

What is the goal in treating patients with burns?

Back 52

to stop the burning process, assess and treat breathing, support circulation and provide rapid transport.

Front 53

What is mandatory of inhalation burns?

Back 53

Oxygen

Front 54

What are the steps to caring for a burn patient?

Back 54

1. Follow BSI
;Move patient away from burning area; If allowed by local protocol, immerse the area in cool sterile water
2. provide high-flow oxygen
3. rapidly estimate burns severity; check for traumatic injury
4. treat patient for shock
5. prevent furthur heat loss by covering the patient with warm blankets; provide prompt transport

Front 55

T or F: You should consider all small animal bites as contaminated and potentially infected wounds that may require antibiotics, tetanus and suturing.

Back 55

true

Front 56

What are the steps of treating a human bite?

Back 56

1. promptly immobilize the area
2. apply a dry, sterile dressing
3. provide transport

Front 57

What are the three primary functions of dressings and bandages?

Back 57

control bleeding; protect the wound from furthur damage; prevent furthur contamination and infection