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FIRST AID/CPR CHAPTER 10 SOFT TISSUE INJURIES
Terms in this set (51)
Material used to wrap or cover a part of the body; commonly used to hold a dressing or splint in place
An injury to the skin or to other body tissues caused by heat, chemicals, electricity, or radiation
A wound in which soft tissue damage occurs beneath the skin and the skin is not broken
Any burn that is potentially life threatening, disabling or disfiguring; a burn requiring advanced medical care
A pad placed directly over a wound to absorb blood and other body fluids and to prevent infection
A burn injury involving all layers of skin and underlying tissues; skin may be brown or charred, and underlying tissues may appear white; also referred to as third-degree burn
A wound resulting in a break in the skin's surface
A burn injury involving the epidermis and dermis, characterized by red, wet skin and blisters; also referred to as a second-degree burn
Body structures that include the layers of skin, fat and muscles
A burn injury involving only the top layer of skin, the epidermis, characterized by red, dry skin; also referred to as a first-degree burn
An injury to the soft tissues
Outer layer of skin that provide a barrier to bacteria and other organisms that can cause infection
Deep layer of skin that contains the nerves, sweat glands, oil glands and blood vessels.
The subcutaneous layer located beneath the epidermis and dermis, contains adipose (fat), blood vessels and connective tissue. The adipose layer insulates the body to help maintain body temp., mechanical cushion, and a source of energy.
Examples of MINOR soft tissue injuries
Scrapes, bruises, mild sunburns
Examples of SERIOUS soft tissue injuries
Large cuts that require stitches and partial-thickness burns
Examples of LIFE-THREATENING soft tissue injuries
Stab wounds to the abdomen, lacerations that cause serious bleeding, and full-thickness burns
Closed wound, the simplest form is a bruise (contusion). Results from damage to soft tissue layers and vessels beneath the skin, causing internal bleeding.
Symptoms of severe closed wound (internal bleeding)
-Tender, swollen, bruised or hard areas of the body, such as the abdomen
-Skin that feels cool or moist or looks pale or bluish
-Vomiting blood or coughing up blood
-An injured extremity that is blue or extremely pale
-Altered mental state, such as the person becoming confused, faint, drowsy, or unconscious.
Care for Closed Wounds
-Fill a plastic bag with ice and water or wrap ice in a wet cloth and apply it to the injured area for periods of about 20 minutes. Place a thin towel as a barrier between the ice and the bare skin.
-Remove the I've and wait 20 minutes before reapplying
-If the person is not able to tolerate a 20-minute application, limit application to 10 minutes.
-Elevating the injured part may help to reduce swelling; however, do not elevate the injured part if doing so causes more pain or you suspect a dislocation or fracture.
Do not assume all closed wounds are minor injuries...
Take the time to evaluate. Call 911 immediately if:
-Person complains of severe pain or cannot move a body part without pain
-You think the force that caused injury was great enough to cause serious damage
-An injured extremity is blue or extremely pale
-The person's abdomen is tender and distended
-The person is vomiting blood or coughing up blood
-The person shows signals of shock or becomes confused, drowsy, or unconscious.
Six main types of open wounds:
Most common type of open wound. Characterized by skin that has been rubbed or scraped away.
Sometimes called scrape, road rash, or strawberry.
Bleeding is not severe, easily controlled, only small capillaries are damaged.
Susceptible to dirt and germs, important to clean and irrigate.
A cut with either jagged or smooth edges. Caused by sharp-edged objects.
Could also occur from a blunt force that splits the skin in a location where a bone lies directly under the skin's surface (such as chin or skull).
Usually bleed freely, and could bleed heavily.
Serious injury in which portion of the skin and sometimes other soft tissue is partially or completely torn away. Bleeding is usually significant.
Severed body part.
Damage to tissue is severe, however bleeding may not be as bad as expected.
Blood vessels usually constrict and retract at point of injury, slowing bleeding and making it relatively easier to control with direct pressure.
Results when skin is pierced with a pointed object. (e.g. nail, glass, splinter, knife, gunshot wound.)
Skin usually closes around penetrating object, external bleeding is generally not severe. However, internal bleeding can be severe if the penetrating object damages major blood vessels or internal organs.
An object remaining in the open wound is called an EMBEDDED OBJECT.
Object may also pass completely through, creating two open wounds. (Entry point, exit point).
Susceptible to infection, such as the microorganism that causes tetanus.
Result of a body part, usually an extremity, being subjected to a high degree of pressure.
May result in serious damage to underlying tissues and cause bleeding, bruising, fracture, laceration and COMPARTMENT SYNDROME (swelling and an increase in pressure within a limited space that presses on and compromises blood vessels, nerves and tends that run through that space).
Can be open or closed.
Injury happens when crushed muscle is released from compression and the tissue is reperfused with blood.
General Care for Open Wounds using Dressings and Bandages
Control bleeding and prevent infection
Pads placed directly on wound to absorb blood and other fluids to prevent infection.
Closes a wound or damaged area of the body and prevents it from being exposed to the air or water. Help keep in medications that are applied to the affected area. Also keep in heat, body fluids, and moisture. Can be manufactured or improvised (such as plastic wrap secured with medical tape)
Types of bandage (5)
-Elastic roller bandage
Any bandage applied snugly to create pressure on a wound or injury
Common type of bandage, applied directly to minor wounds,
Thick gauze dressing attached to a bandage that is tied in place.
Specially designed to help control severe bleeding and usually come in sterile packages.
Made of gauze or gauze-like material.
Narrow bandage would be used to wrap hand or wrist. Medium-width bandage used to arm or ankle. Wide bandage used to wrap a leg.
-Check for feeling, warmth and color of the area distal to (below) the injury site, especially fingers and toes, before and after applying bandage.
-Secure the end of the bandage in place with a turn of the bandage. Wrap the bandage around body part until dressing is completely covered and bandage extends several inches beyond dressing. Tie or tape bandage in place.
-Do not cover fingers or toes. If fingers or toes become cold or begin to turn pale, blue, or ashen, bandage is too tight and should be loosened.
-If blood soaks through, apply additional dressings and another bandage.
Elastic roller bandage
Designed to keep continuous pressure on a body part.
-Place bandage against the skin and use overlapping turns.
-Gently stretch the bandage as you continue wrapping The wrap should cover a long body section, such as an arm or calf, beginning at the point farthest from the heart.
-Tape the end of the bandage in place.
Specific Care for Minor Open Wounds
-Use a barrier between your hand and the wound. If readily available, put on disposable gloves and place a sterile dressing on the wound.
-Apply direct pressure for a few minutes to control any bleeding.
-Wash the wound thoroughly with soap and water and gently dry with clean gauze. If possible, irrigate an abrasion for 5 minutes with clean, warm, running tap water.
-Cover the wound with a clean dressing and a bandage (or with an adhesive bandage) to bandage first if the person has no known allergies or sensitives to the medication.
-Wash hands immediately after giving care.
Specific Care for Major Open Wounds
-Call 911 or local emergency number
-Put on disposable gloves. If blood has the potential to splatter, you may need to wear eye and face protection.
-Control external bleeding using the general steps below:
.Cover the wound with a dressing, and press firmly against the wound with a gloved hand until bleeding stops.
.Apply a pressure bandage over the dressing to maintain pressure on the wound and to hold the dressing in place.
.If the blood soaks through the bandage, do not remove the blood-soaked bandage. Instead, add more pads and bandages to help absorb the blood and continue to apply direct pressure.
-Continue to monitor the person's condition. Observe the person closely for signals that may indicate that the person's condition is worsening, such as faster or slower breathing, changes in skin color and restlessness.
-Take steps to minimize shock. Keep the person from getting chilled or overheated.
-Have the person rest comfortably and reassure him or her.
-Wash your hands immediately after giving care, even if you wore gloves.
Special Considerations When Caring for Open Wounds - Amputations
-Put on disposable gloves
-First care for the wound as described above in Specific Care for Major Open Wounds
-After controlling external bleeding, locate and care for the severed body part (or have another person on the scene follow these steps while you control the bleeding)
. Wrap the severed body part in sterile gauze or any clean material, such as a washcloth. Moisten the cloth with sterile saline if available.
. Place the wrapped part in a plastic bag or container. Label it with the person's name and the time and date it was placed in the bag.
.Keep the bag cool by placing it in a larger bag or container of an ice and water slurry, NOT on ice alone and NOT on dry ice.
.Make sure the bag or container is transported to the medical facility by EMS personnel with the injured person.
Special Considerations When Caring for Open Wounds Embedded/Impaled Objects
Do not remove embedded object
-Put on disposable gloves
-Do not remove the object
-Apply direct pressure with sterile dressings to the edges of the wound. Avoid placing pressure on or moving the object
-Use a bulky dressing to stabilize the object. Any movement of the object can result in further tissue damage
-Control bleeding by bandaging the dressing in place around the object
-Wash your hands immediately after giving care
Disease caused by bacteria that produces a powerful poison in the body. The poison enters the nervous system and can cause muscle paralysis (also known as "lockjaw").
Types of Burns
Superficial burns (sometimes referred to as first degree)
Partial-thickness burns (sometimes referred to as second degree)
Full-thickness burns (sometimes referred to as third degree)
-Involve only the top layer of skin
-Cause skin to become red and dry; are usually painful; and the area may swell
-Usually heal within a week without permanent scarring
-Involve the top layers of skin (epidermis and dermis)
-Cause skin to become red; are usually painful; have blisters that may open and weep clear fluid, making the skin appear wet; may appear mottled; and often swell
-Usually heal in 3 to 4 weeks and may scar
-May destroy all layers of skin and some or all of the underlying structures - fat, muscles, bones and nerves
-The skin may be brown or black (charred), with the tissue underneath sometimes appearing white, and can either be extremely painful or relatively painless (if the burn destroys nerve endings)
-Healing requires medical assistance; scarring is likely.
Identifying CRITICAL BURNS
Critical burn requires immediate medical attention. Call 911 if person:
-Has trouble breathing
-Has burns covering more than one body part or a large surface area
-Has suspected burns to the airway. Burns to mouth and nose may be a signal of this.
-Has burns to the head, face, neck, hands, feet, or genitals.
-Has a partial or full thickness burn and is younger than age 5 or older than age 60.
-Has a burn resulting from chemicals, explosions, or electricity.
Care for Heat (Thermal) Burns
-Check the scene for safety and approach only when safe to do so.
-Stop the burning by removing person from the source of the burn.
-Check for life-threatening conditions
-As soon as possible, cool the burn with large amounts of cold running water, at least until pain is relieved.
-Cover burn loosely with sterile dressing.
-Take steps to minimize shock. Keep person from getting chilled or overheated.
-Comfort and reassure person.
Care for Chemical Burns
-If the chemical is dry or in a powdered form, brush the chemical from the skin with a gloved hand or a towel and remove any contaminated clothing or jewelry Be careful not to get the chemical on yourself or on a different area of the person's skin.
-Flush the burn with large amounts of cool running tap water (under pressure). Continue fishing the burn for at least 20 minutes or until EMS personnel arrive. Do not use a forceful flow of water.
-Take steps to minimize shock.
-If an eye is burned by a chemical, flush the affected eye with water for at least 20 minutes or until EMS personnel arrive. Tilt the head so that the affected eye is lower than the unaffected eye as you flush. This position helps prevent the chemical from getting into the unharmed eye Flush from the nose outward. IF both eyes are affected, direct the flow to the bridge of the nose and flush both eyes from the inner corner outward.
-Be aware that chemicals can be inhaled, potentially damaging the airway or lungs Cal l 911 if you believe chemicals have been inhaled.
Care for Electrical Burns
-Scene safety is of the utmost importance- never go near the person until you are sure he or she is not still in contact with the power source.
-If possible, turn off the power at its source and care for any life-threatening emergencies (if you cannot safely turn power off at its source, call 911 and wait for advanced help to arrive.)
-Call 911. Any person who has suffered an electric shock needs to be evaluated by medical professionals to determine the extent of injury.
-Remember that electrocution can cause cardiac and breathing emergencies. Be prepared to perform CPR or use an automated external defibrillator (AED).
-Care for shock and thermal burns.
-Look for entry and exit wounds and give appropriate car.e
-Check for additional injuries, such as fractures, which may result from severe muscle contractions that occur in resistance to the electrical current.
Signals of Infection
-The area around the wound becomes swollen and red
-The area may feel warm or throb with pain
-Some wounds have pus discharge
-More serious infections may cause a person to develop a fever and feel ill
-Red streaks may develop that progress from the wound in the direction of the heart
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