chapter seven soft tissue injuries. wounds soft tissues are the layers of skin and the fat and...
TRANSCRIPT
Chapter Seven
Soft Tissue Injuries
Wounds
Soft tissues are the layers of skin and the fat and muscle beneath the skin’s outer layer.
Wounds are defined as:– injury to the soft tissue of the body.
Closed Wounds
Closed wounds occur when:– the body is hit and the force of the blow damages
the soft tissue layers beneath the skin causing internal bleeding.
This type of wound could be as simple as a
contusion (bruise) or as severe as internal bleeding
Signals of Internal Bleeding
Tender, swollen, bruised or hard areas of the body such as the abdomen
Rapid, weak pulse Skin that feels cool or moist or look pale or bluish Vomiting blood or coughing up blood Excessive thirst An injured extremity that is blue or extremely pale Becoming confused, drowsy, or unconscious
Call 9-1-1 if…
A person complains of severe pain or cannot move a body part without pain.
You think the force that caused the 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 signs of shock.
Care for Closed Wounds
Help the person rest in a comfortable position
Apply direct pressure on the area
Apply ice early on Elevate the injured area
only if it will not cause more pain
Open Wounds
Open wounds occur when there is a break in the skin.
The four main types of open wounds are – – Abrasions– Lacerations– Avulsions– Punctures
Abrasions
Most common type of open wound
Caused by something rubbing roughly against the skin
Does not bleed very much It is usually painful because
scrapes expose sensitive nerve endings
Lacerations
A cut in the skin commonly caused by a sharp object
Deep lacerations can cut through fat and muscle, damaging both nerves and blood vessels
Laceration can become easily infected
Avulsions
An injury in which a portion of the skin and sometimes soft tissue is partially or completely torn away
Bleeding is often significant
Punctures
Usually caused by a pointed object piercing the skin
Do not bleed very much unless a blood vessel has been injured
Can carry germs deep into the body
If the object remains in the wound, it is called an embedded object
Infection
Signs & Symptoms– Swollen and red– Warm to the touch– Injury will throb with pain– Wound may discharge pus– Person may become feverish and
ill
Care– Wash the area with soap and
water– Irrigate with large amounts of
fresh running water– Do not wash major open wounds
Determining if the Person Needs Stitches
The wound edges of the skin do not fall together The laceration involves the face The wound is over ½ inch long Bleeding from an artery or uncontrolled bleeding Can see muscle, bone, involve joints, hands or
feet Wounds from large or deeply embedded objects Wounds from human or animal bites If left unstitched, could leave conspicuous scars
Materials used when caring for an open wound include -
Disposable gloves – create a barrier between you and the victim
Dressings – pads placed directly on the wound to absorb blood and other fluids to prevent infection
Occlusive dressings – prevents the wound from being exposed to the air or water
Bandages – material used to wrap or cover any part of the body, used to hold dressings in place
General Guidelines Applying a Roller Bandage
Check for feeling, warmth and color below the injury site before and after applying the bandage.
Elevate the injury only if it doesn’t cause further injury.
Do not cover fingers or toes with a bandage. Apply additional dressing if blood soaks through
the first bandange.
Applying an Elastic Bandage
Check for circulation of the limb beyond where you will be placing the bandage.
Place the end of the bandage against the skin and use overlapping turns.
Gently stretch the bandage as you wrap. Check the snugness, a finger should easily
pass under the bandage.
Care for Minor Open Wounds
1. Put on gloves2. Apply direct pressure for
a few minutes to control any bleeding
3. Wash the wound thoroughly with soap and water
4. Apply an antibiotic ointment
5. Cover the wound with a sterile dressing and a bandage
Care for a Major Open Wound
Call 9-1-1 Put on gloves Control bleeding by –
– Covering the wound and pressing firmly
– Apply a pressure bandage– Adding more bandages if
necessary Monitor life signs Care for shock Wash hands immediately
after giving care
Using Tourniquets When Help is Delayed
A tourniquet is a tight band placed around an arm or leg to constrict blood vessels in order to stop blood flow around the wound.
Use only as a last resort. If used, a tourniquet should not be removed in
until the victim gets to the hospital.
Hemostatic Agents
Substances that speed up clot formation by absorbing excess moisture caused by bleeding.
Can be a treated sponge or gauze pad, powder or granular form.
Burns
Burns are a special kind of soft tissue injury Burns can be classified in two ways –
– The source of the burn Heat Chemical Electricity Radiation
– The depth of the burn Superficial (first degree) Partial Thickness (second degree) Full Thickness (third degree)
Depth Classifications
Top layer of skin Red, dry skin Pain, swelling Usually heals within a week
Top layers of skin Red, painful, blisters that may
open and weep clear fluid Usually heals in 3 to 4 weeks May scar
May destroy layers of skin and underlying structures
Charred skin, tissue underneath white, painful or painless
Healing may require medical care Scarring likely
Critical Burns
Critical burns require immediate medical attention because they are potentially life threatening, disfiguring, and/or disabling.
You should always call 9-1-1 if the burned person – – Has trouble breathing or suspected burned airway– Has burns covering more than one body part– Has burns to the head, neck, hands, feet or genitals– Has a burn and is younger than 5 or older than 60– Has burns resulting from chemicals, explosions, or electricity
Caring for a Thermal Burn
1. Check the scene
2. Remove the person from the source of the burn
3. Check for life threatening conditions
4. Cool the burn with large amounts of cool running water
5. Cover the burn loosely
6. Prevent infection
7. Minimize shock
Care for a Thermal Burn
DO NOT – – Apply ice or ice water– Touch a burn with anything except a clean
bandage– Remove pieces of clothing that stick to the burn– Try to clean a severe burn– Break blisters– Use ointment on a severe burn
Care for a Chemical Burn
1. Important – chemical burns will continue to burn as long as the chemical is on the body.
2. If the burn was caused by dry chemicals, brush off the chemical using gloved hands before flushing with water.
3. Flush the burn with large amount of running water. Flush for at least 20 minutes.
4. Eyes burns should be flushed with water until EMS arrive
5. If possible have the person remove contaminated clothes.
Care for Electrical Burns
1. Important – Never go near the victim until you are sure he or she is no longer in contact with the power source.
2. Call 9-1-1
3. Turn off the power source
4. Be prepared to give CPR or use an AED
5. Care for shock and thermal burns
Radiation (Sun) Burns
Care for sunburn the same way you would for any other burn.
Always cool the burn and protect the area from further damage by keeping it out of the sun.
Preventing Burns
Follow safety practices that prevent fire Follow manufacturer’s guidelines when
handling chemicals Follow safety practices around electrical lines
and go indoors when lightning could strike Wear appropriate clothing and use
sunscreen
Crush Injuries
Call 9-1-1 Care for specific injuries found Assume that internal injuries are present Care for shock
Care for an Embedded Object
Do not remove the object. Place several dressings around it to keep it
from moving. Bandage around the object to keep it from
moving.
Sucking Chest Wound
This injury occurs when a puncture wound penetrates the chest cavity and air passes in and out of the wound.
Care for a Sucking Chest Wound
Cover the wound with a large occlusive dressing (closes the wound) and tape the dressing except for one side.
The dressing will keep air from entering the wound when the person inhales and allow the air to escape when the person exhales.
Care for Abdominal Injury