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96 Cards in this Set
- Front
- Back
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major Functions of skin |
protection, water balance, temperature regulation, excretion, shock absorption |
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epidermis |
outer layer of the skin |
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dermis |
inner (2nd) layer of the skin found beneath the epidermis; rich in blood vessels and nerves |
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subcutaneous layers |
layers of fat and soft tissue found below the dermis |
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closed wound |
internal injury with no open pathway from the outside; usually result from impact of a blunt object |
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contusion |
a bruise; pain/swelling/discoloration at the wound site; epidermis remains intact but cells and blood vessels in the dermis are damaged |
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hematoma |
swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel |
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crush injury |
an injury caused when force is transmitted from the body's exterior to its internal structures |
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closed wound patient assessment |
-consider possibility of closed soft-tissue injuries whenever there is swelling, pain, or deformity, as well as mechanism of blunt trauma -always consider the mechanism of injury (MOI) when examining closed wound -pts w/ a significant MOI should be considered to have internal bleeding & shock until ruled out in the ED |
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closed wound patient care |
-manage pts ABC, apply high conc. O2 by NRB -manage as if there's internal bleeding & provide care for shock if poss. of internal injuries -splint painful/swollen/deformed extremities -stay alert in case pt vomits -continue to monitor for development of shock & transport ASAP |
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open wound |
injury in which the skin is interrupted, exposing the tissue beneath |
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abrasion |
scratch or scrape; may be no detectable bleeding or only minor ooze from capillary beds; pt may be experiencing great pain even if minor; great opportunity for infection |
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laceration |
cut; may be smooth or jagged; often caused by object w/ sharp edge, can result from a severe blow/impact w/ blunt object |
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puncture wound |
open wound that tears through the skin & destroys underlying tissues; a penetrating puncture wound can be shallow or deep; a perforating puncture wound has both an entrance & an exit wound |
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avulsion |
tearing away or tearing off of a piece/flap of skin or other soft tissue; term may also be used for an eye pulled from its socket or a tooth dislodged from its socket |
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amputation |
surgical removal or traumatic severing of a body part, usually an extremity; can be massive or small amount of bleeding |
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open crush injuries |
can result when an extremity is caught between heavy items; blood vessels, nerves, & muscles are involved & swelling may be a major problem w/ resulting loss of blood supply distally; bones are fractured & may protrude through wound site; soft tissues can be crushed to produce profuse bleeding both externally & internally |
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blast injuries |
can result in mixture of open & closed injuries; primary injuries come from intense high pressure wave that hits pt; injuries can include damage to any air/fluid filled body organ/cavity; secondary injury is result of projectiles hitting the body; tertiary (3rd level) injuries occur if pt is picked up & moved to a diff location; injuries can also be from exposure to chemicals/toxins/burns/crush injuries (quaternary, 4th level) |
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high pressure injection injuries |
occur when a pt is working w/ a machine that injects grease, air, or some other substance under high pressure; typically very little or no injury apparent; treatment includes elevating & splinting the limb, do NOT apply cold |
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open wound patient assessment |
-ABC & severe bleeding are identified in the primary assessment -once the primary assessment & the appropriate physical exam is completed, care for the individual wound begins |
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open wound patient care |
-expose the wound -clean wound surface;remove large debris -control bleeding; start w/ direct pressure or direct pressure & elevation; when necessary, apply tourniquet -provide care for shock for all serious wounds including admin of high conc. O2 -prevent further contamination;use sterile dressing or cleanest cloth material on scene -bandage after bleeding is controlled; check for distal pulse if extremity involved -keep pt lying still -reassure the pt |
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treating abrasions & lacerations |
take care to reduce wound contamination; apply direct pressure |
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treating puncture wounds |
-reassure the alert pt -search for an exit wound, esp when there's a gunshot wound;control bleeding & provide adequate treatment to both entry/exit wounds -assess the need for BLS when there's a gunshot wound; care for shock, admin. high conc. O2 -follow local protocols -transport |
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treating impaled objects |
do not remove the impaled object, if removed may cause severe bleeding or further injury to nerves, muscles, or other soft tissues -expose wound area -control profuse bleeding by direct pressure if poss; do not put DP on the object -manually stabilize & apply bulky dressings around the object, secure them in place -care for shock, provide O2 at highes poss. flow and concentration -keep pt at rest and transport |
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agent of burn: thermal |
source: flame, radiation, excessive heat from fire, steam, hot objects/liquids |
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agent of burn: chemicals |
source: various acids, bases, & caustics |
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agent of burn: electricity |
source: alternating current, direct current, lightning |
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agent of burn: light (typically involving the eyes) |
source: intense light sources |
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agent of burn: radiation |
source: usually from nuclear sources; UV light |
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superficial burn |
burn that only involves the epidermis; characterized by reddening of the skin & perhaps some swelling; also called a 1st degree burn (sunburn) |
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partial thickness burn |
burn in which the epidermis is burned through & the dermis is damaged; reddening, blistering, & mottled appearance; also called a 2nd degree burn |
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full thickness burn |
burn in which all layers of skin are damaged; usually areas that are charred black or dry & white; also called a 3rd degree burn |
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determining severity of a burn |
-agent/source of burn -body regions burned -depth of the burn -extent of the burn -age of the pt -other illnesses & injuries |
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rule of nines - adult |
method for determining extent of a burn; each following area represents 9% of the body surface: head & neck, each upper extremity, chest, abdomen, upper back, lower back, & buttocks, the front of each lower extremity & the back of each lower extremity; remaining 1 % assigned to genital region |
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rule of nines - infant or child |
same as adult except modified so that 18% is assigned to the head and 14% to each lower extremity |
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rule of palm |
method for determining extent of a burn; the palm of the pt's own hand, which = about 1% of the body's surface area, is compared to the pt's burn to estimate its size |
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minor burns - adult |
-full thickness of < 2% of body surface, excluding the face, hands, feet, genitalia, or respiratory tract -partial thickness of < 15% of body surface -superficial of 50% of body surface or less |
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moderate burns - adult |
-full thickness of 2-10% of body surface, excluding the face, hands, feet, genitalia, or respiratory tract -partial thickness of 15-30% of body surface -superficial involving >50% of body surface |
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critical burns - adult |
-all burns complicated by injuries of the respiratory tract, other soft tissue injuries, & injuries of the bones -partial or full thickness involving the face, hands, feet, genitalia, or respiratory tract -full thickness >10% -partial thickness >30% -burns complicated by musculoskeletal injuries -circumferential burns |
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minor burns - children < 5 |
partial thickness <10% of body surface |
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moderate burns - children < 5 |
partial thickness 10-20% of body surface |
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critical burns - children <5 |
full thickness of any extent or partial thickness of > 20% of body surface |
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electrical injuries patient assessment |
victim of an electrical injury may have any/all of the following signs & symptoms: -burns where energy enters/exits the body -disrupted nerve pathways displayed as paralysis -muscle tenderness, w/ or w/out twitching -respiratory diff or arrest -irregular heartbeat or cardiac arrest -elevated BP or low BP w/ signs/symps of shock -restlessness/irritability/loss of cons. -visual difficulties -fractured bones/dislocations -seizures in severe cases |
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electrical injuries patient care |
-provide airway care -basic cardiac life support as required -care for shock & admin high conc O2 -care for spine/head injuries & severe fractures -evaluate electrical burns -cool the burn areas -apply dry sterile dressings to burn sites -transport ASAP |
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dressing |
any material (preferably sterile) used to cover a wound that will help control bleeding and prevent further contamination |
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bandage |
any material used to hold a dressing in place |
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universal dressing |
a bulky dressing |
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pressure dressing |
dressing applied tightly to control bleeding |
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occlusive dressing |
any dressing that forms an airtight seal |
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dressing open wounds |
-expose the wound -use sterile or very clean materials -cover entire wound -control bleeding -do not remove dressings |
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bandaging open wounds |
-dont bandage too tightly or loosely -dont leave loose ends -dont cover tips of fingers and toes -cover all edges of the dressing |
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flail chest |
fracture of 2 or more adjacent ribs in 2 or more places that allows for free movement of the fractured segment |
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paradoxical motion |
movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity |
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flail chest patient assessment |
pt will have a MOI capable of causing it, diff breathing, pain at the injury site, signs of shock and hypoxia; pt will become tired and weak |
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flail chest patient care |
-perform a primary assessment-ID flail chest movements ASAP -administer O2 -assist ventilations if necessary -use a bulky dressing to stabilize the flail segment & tape the dressing in place -monitor pt carefully -watch pt resp rate & depth, if become too shallow, assist ventilations |
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open chest wound |
skin is broken & chest wall is penetrated; often usually penetrating puncture wounds |
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sucking chest wound & patient assessment |
open chest wound in which air is "sucked" into the chest cavity; signs include: wound to the chest, may/may not be characteristic sucking sound, pt may be gasping for air |
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open chest wound patient care |
-maintain an open airway -seal the open chest wound as quickly as possible -apply an occlusive dressing -administer high conc o2 -care for shock -transport ASAP -consider ALS intercept |
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pneumothorax |
air in the chest cavity |
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tension pneumothorax |
type of pneumothorax in which air that enters the chest cavity is prevented from escaping |
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hemothorax |
condition in which chest cavity fills with blood |
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hemopneumothorax |
chest cavity fills with both blood and air |
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traumatic asphyxia |
associated with sudden compression of the chest; sternum & ribs exert severe pressure on the heart & lungs forcing blood out of the R atrium & up into the jugular veins in the neck; this will usually result in blood vessels in & near the skin rupturing, causing extensive bruising of the face and neck |
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cardiac tamponade |
occurs when an injury to the heart causes blood to flow into the surrounding pericardial sac; the heart's unyielding sac fills with blood & compresses the chambers of the heart to the point where they'll no longer adequately fill, backing up blood into the veins; usually the result of a penetrating stab wound; pts w/ this condition will usually have distended neck veins, exhibit signs of shock & a narrowed pulse pressure |
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aortic injury |
pt may complain of pain in the chest, abdomen, or back - depending on the injury's location; pt will often exhibit signs of shock, have differences in pulse or BP b/n the R & L arms (in proximal aortic injury) or differences in pulses b/n the arms & legs or the legs themselves (in abdominal aortic injury) |
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commotio cordis |
Latin for commotion or disturbance of the heart; when someone is hit in the center of the chest, the result is usually a bruise or perhaps a fracture; in this condition, the impact occurs when the heart is most vulnerable; for ex.: young athlete tries to catch a baseball but misses, the ball strikes him in the center of the chest & the pt collapses in cardiac arrest; treat a pt like this as VFIB, not as a trauma |
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chest cavity injury patient assessment |
signs of pneumothorax:respiratory difficulty, uneven chest wall movement, reduction of breath sounds on affected side of the chest; signs of tension pneumothorax include items in previous plus: increasing resp. difficulty, indications of developing shock including rapid weak pulse, cyanosis, low BP, distended neck veins, tracheal deviation to the uninjured side (late sign) reduced/absent breath sounds on affected side, signs of pneumothorax plus coughing up frothy red blood |
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chest cavity injury patient assessment |
signs of traumatic asphyxia: distended neck veins, head/neck/shoulders appearing dark blue or purple, bloodshot & bulging eyes, swollen & blue tongue & lips, chest deformity
signs of cardiac tamponade: distended neck veins, very weak pulse, low BP, steadily decreasing pulse pressure signs of aortic injury or dissection: tearing chest pain radiating to the back, diffs in pulse or BP b/n the R & L extremities or b/n the arms & legs, palpable pulsating mass (if the abdominal aorta involved), cardiac arrest |
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chest cavity injury patient care |
-maintain open airway, be prepared to apply suction -administer high concentration O2 -follow local protocols as to preferred type of dressing for any open wound -care for shock -transport ASAP -consider ALS intercept if it will not delay pt's arrival at the hospital |
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evisceration |
an intestine or other internal organ protruding through a wound in the abdomen |
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abdominal injury patient assessment |
pain often starting as mild then rapidly becoming intolerable, cramps, nausea, weakness, thirst, obvious laceration/puncture wounds to the abdomen/pelvis/middle & lower back/chest/near the diaphragm, indications of blunt trauma, developing shock, coughing or vomiting blood, rigid/tender/distended abdomen |
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extremities |
portions of the skeleton that include the clavicles, scapulae, arms, wrists, and hands (upper extremities) & the pelvis, thighs, legs, ankles, and feet (lower extremities) |
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bones |
hard but flexible living structures that provide support for the body and protection to vital organs |
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joints |
places where bones articulate, or meet; generally classified according to their appearance- long, short, flat, irregular |
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axial skeleton |
skull, spine, ribs, sternum |
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appendicular skeleton |
extremities |
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bones of the axial skeleton |
skull - cranium & face, 22 bones cervical vertebrae - 7 sternum - 1 bone thoracic vertebrae - 12 ribs - 24 lumbar vertebrae - 5 sacrum - 5 fused vertebrae coccyx - 4 fused vertebrae |
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bones of the appendicular skeleton |
pectoral girdles - clavicle & scapula, 4 bones upper extremities - humerus, radius, ulna, carpals, metacarpals, phalanges - 60 bones pelvic girdles - ilium, pubis, ischium - 6 bones lower extremities - femur, patella, tibia, fibula, tarsals, metatarsals, phalanges - 60 bones |
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muscles |
tissues or fibers that cause movement of body parts and organs |
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cartilage |
tough tissue that covers the joint ends of bones and helps to form certain body parts such as the ear |
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tendons |
tissues that connect muscle to bone TMB = tissues - muscle - bone |
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ligaments |
connective tissues that connect bone to bone BLB = bone - ligament - bone |
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3 types of muscle |
skeletal, cardiac, smooth |
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traction splint |
splint that applies constant pull along the length of a lower extremity to help stabilize the fractured bone & to reduce muscle spasm in the limb; used primarily on femoral shaft fractures |
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fracture |
any break in a bone |
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comminuted fracture |
fracture in which the bone is broken in several places |
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greenstick fracture |
an incomplete fracture |
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angulated fracture |
fracture in which the broken bone segments are at an angle to each other |
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dislocation |
the disruption or "coming apart" of a JOINT |
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sprain |
the stretching and tearing of LIGAMENTS |
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strain |
muscle injury resulting from overstretching or overexertion of the MUSCLE |
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closed extremity injury |
injury to an extremity with no associated opening in the skin |
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open extremity injury |
injury in which the skin has been broken or torn through from the inside by an injured bone or from the outside by something that has caused a penetrating wound with associated injury to the bone |
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compartment syndrome |
injury caused when tissues such as blood vessels and nerves are constricted within a space as from swelling or from a tight dressing or cast |
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crepitus |
grating sensation or sound made when fractured bone ends rub together |
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the six P's |
method of assessing compromise to an extremity when a musculoskeletal injury is suspected: -Pain or tenderness -Pallor (pale skin or poor capillary refill) -Paresthesia (sensation of "pins & needles") -Pulses diminished or absent in injured ext. -Paralysis -Pressure |
