Soft Tissue Trauma

You and your partner have responded to a patient who was bitten on the hand by her neighbor's dog. After the patient is treated with a non-rebreather mask and the wound is properly bandaged, you need to decide what to do about the dog. Which is the most appropriate response?

Call Animal Control.

Which layer of skin contains blood vessels, nerve endings, sweat glands, and hair follicles?

Dermis

Which layer of skin is damaged in a superficial burn?

Epidermis

Which of the following is an example of blunt-force trauma?

Falling down the stairs

All penetrations have an entry wound and an exit wound.

False

Signs of closed soft tissue trauma are always evident on the outside of the body.

False

With amputations, external bleeding is always severe.

False

Which of the following is an example of crush-force trauma?

Getting trapped between a vehicle and a tree

Which type of burn may be caused by overexposure to the sun?

Radiation

EMT Carl has located an amputated finger in a puddle of mud. What is the best method for cleaning it off?

Rinse it with sterile water or saline

In most cases, why should fingers and toes be left uncovered during bandaging?

So that circulation may be elevated

Why is it important to remove jewelry before bandaging a wound?

So the circulation will not be hindered

Exit wound

Some penetrations will also have

While examining a pedestrian who was struck by a car, you notice swelling and discoloration in the patient's forearm. You suspect a fracture. Which of the following treatments would be most appropriate, assuming that patient has no other major injuries?

Splint the arm. Then elevate it and apply a cold compress.

Which of the following is most important when treating a patient with an amputated limb?

Stabilize the patient and control bleeding

Which type of laceration is jagged and irregular?

Stellate laceration

What is the first step when assessing a patient with soft tissue trauma?

Take appropriate BSI precautions

crush syndrome.

a toxic protein is released into the bloodstream which could eventually cause kidney failure, heart attack, and blood clots

Superficial burns

also called first-degree burns, are the mildest classification of burns. These burns are shallow and cause damage only to the epidermis.

Penetrations

also called punctures, occur when an object is pushed or driven into the skin, soft tissue, and possibly even the underlying organs.

Partial-thickness burns

also called second-degree burns, affect the epidermis and the dermis.

Subcutaneous

also called the hypodermis, is the innermost layer of skin. It contains fatty tissue and helps to regulate body temperature and absorb shock.

Crush-force trauma

also known as a crush injury, occurs when the body or part of the body is trapped between two surfaces

Dressings and bandages

are an important part of managing soft tissue injuries

Pressure bandages

are applied to wounds on extremities that are actively bleeding. They are typically made from a cravat in which the ends are tied in a knot over the site of the wound. The knot will create pressure to help control bleeding.

Chemical burns

are caused by contact with acidic or alkaline substances. Contact includes ingesting, inhalation, and injection.

Linear lacerations

are caused by sharp objects, such as a knife or broken glass. These wounds have smooth edges and usually heal quickly.

Trauma dressings

are large, layered gauze pads. They are thicker than standard gauze because they are used for large open wounds. They also go by the name universal dressing or abdominal pad

Occlusive dressings

are made of an airtight material. They are used to prevent air and moisture from entering or exiting a wound. Occlusive dressings are often used for sucking chest wounds and eviscerations. Some occlusive dressings are made from petroleum gauze. The petroleum will prevent the gauze from sticking to the wound. Other occlusive dressings are made from plastic wrap

Gauze pads

are pads of layered gauze. They are usually individually-wrapped and sterile; although non-sterile gauze is also available. Common sizes include 2" x 2", 4" x 4", 5" x 9", and 8" x 10". They are used for small- to medium-sized wounds

Thermal burns

are perhaps the most common. They are caused by exposure to fire, steam, hot objects, and hot liquids.

Adhesive dressings

are self-adhering and are available in a variety of sizes and shapes. A popular brand of adhesive dressing is Band-Aid®. These dressings are most appropriate for small cuts and scrapes.

Electrical burns

are the result of exposure to an electrical current that enters and exits the body. They can be caused by faulty electrical wiring, chewing on electrical cords, high-voltage power lines, and lightning strikes. In most cases, electrical burns will cause serious internal damage with very minimal external evidence

Cravats

are triangular bandages that have been folded. They are often used to secure dressings on the extremities

Stellate lacerations

are typically caused by blunt objects that tear the skin. This type of laceration has a jagged and irregular edge, which results in prolonged healing.

Air splints

are used to hold dressings in place on an extremity. The air also creates pressure which will slow the bleeding and stabilize the site of the wound

Triangular bandages

are usually made of cotton. They are commonly used to create slings and to support injured arms, but they can also be used to bandage the forehead and scalp

Bites

can be a combination of lacerations, penetrations, or crush injuries.

Abrasions result in ____ bleeding.

capillary

Bandages

do not make contact with open wounds

Causes Partial-thickness burns include:

exposure to fire, hot liquids and objects, chemical substances, and extreme sunburn.

laceration

is a break in the skin that usually results in significant bleeding, especially when an artery has been severed

Dressing

is a covering that goes directly over an open wound.

Burn

is an injury caused by fire, heat, chemicals, radiation, or electricity.

Soft tissue trauma

is any wound that occurs to the skin, muscles, nerves, and blood vessels

Roller gauze

is rolled, mesh gauze. Roller gauze is often secured with tape, but self-adhering gauze is also available. With self-adhering gauze, the overlapping edges stick together, so tape is not necessary.

Skin

is the largest organ of the body

Dermis

is the middle layer of skin. It contains blood vessels, nerve endings, sweat glands, and hair follicles.

Epidermis

is the outermost layer of skin.

Avulsion

is when a flap of skin or tissue is partially or fully torn off from the rest of the body.

Amputation

is when an extremity or part of an extremity is separated from the body

Radiation burns

may be caused by overexposure to the sun, tanning beds, x-rays, or radiation treatments for cancer. They may also occur as a result of nuclear fallout and radioactive materials. Special teams, equipment, and training are needed to decontaminate and treat patients who have been exposed to radioactive materials. This is beyond the scope of practice for EMRs and EMTs.

Crush injuries

occur when the body or part of the body is trapped between two surfaces

Abrasions

occur when the epidermis is worn down by scraping, rubbing, or shearing.

Blunt-force trauma

occurs when the body is struck by a blunt object that does not penetrate the skin.

Closed soft tissue trauma

occurs when the skin is injured but not broken.

Open soft tissue wounds

or simply open wounds, occur when the skin is broken or penetrated.

Impaled object.

the penetrating object will remain lodged in the wound.

The three depths of burns include:

•Superficial •Partial-thickness •Full-thickness

Types of bandages include:

1) Roller gauze 2) Triangular bandages 3) Cravats 4) Air splints 5) Pressure bandages

The severity of these wounds depends upon:

1) The mechanism of injury 2) The location of the wound 3) The underlying structures in the path of the penetration 4) The size and depth of the penetration 5) The force at which the penetration was delivered

Types of Burns include:

1) Thermal burns 2) Chemical burns 3) Electrical burns 4) Radiation burns

In which of the following situations is it appropriate for an EMT to remove an impaled object on the field?

A pen is impaled through the patient's cheek.

Five-year-old Gina has received a small cut to her chin as a result of a fall while rollerblading. Which type of dressing is most appropriate for her injury?

Adhesive dressing

What is the purpose of the skin?

All of the above

Which of the following is the correct use of a triangular bandage?

All of the above

Which of the following is NOT a purpose of dressing and bandaging open wounds?

Allow bacteria in the body

What is the primary reason that rescuers are encouraged to keep patients calm during treatment for an open wound?

An anxious patient may have increased bleeding because of high blood pressure.

Which type of open wound involves a flap of skin or tissue that is fully or partially torn off from the body?

Avulsion

What are the two major complications of open wounds?

Bleeding and infection

Which of the following is common with partial-thickness burns?

Blistering

two basic types of lacerations include:

1) Linear lacerations 2) Stellate lacerations

Closed or open wound:

1) A closed wound is when there is no break in the skin and, therefore, no external bleeding. 2) An open wound is when the skin is broken. This will result in external bleeding as well as the possibility of contamination by dirt and bacteria.

Signs and Symptoms include:

1) A contusion is a bruise. It occurs when damage has been done to the tissue and blood vessels in the dermis. Blood from broken vessels will leak into the tissue and cause black-and-blue discoloration, called ecchymosis, at the site of the injury. 2) A hematoma is a large lump of swollen, discolored flesh that results from an accumulation of blood beneath the skin's surface. It is similar to a contusion, but larger. It involves damage to larger blood vessels and larger amounts of tissue.

Single or multiple wounds:

1) A single wound is one injury, such as a single gunshot wound to the leg. 2) Multiple wounds include more than one injury, such as multiple stabbings to the chest.

Types of Open Wounds include:

1) Abrasions 2) Lacerations 3) Avulsions 4) Amputations 5) Penetrations 6) Impaled Objects 7) Crush Injuries

Several types of dressings incude:

1) Adhesive dressings 2) Gauze pads 3) Trauma dressings 4) Occlusive dressings

special treatments for Special Considerations include:

1) Amputations 2) Avulsions 3) Impaled objects 4) Bites

Three ways wounds are classified include:

1) Closed or Open 2) Single or Multiple 3) Location

The purposes of dressings and bandages are to:

1) Control bleeding 2) Absorb drainage 3) Prevent contamination 4) Stabilize the wound site 5) Promote faster healing

The skin is made up of three layers:

1) Epidermis 2) Dermis 3) Subcutaneous

Which type of closed wound results in a lump of discolored flesh below the surface of the skin?

Hematoma

Why are bite wounds considered especially serious?

Infection can spread through the saliva.

Wounds

Injuries to soft tissue

What should be done to the flap of skin that results from a partial avulsion?

Lay the flap of skin flat on the wound and then apply the dressing

Which is the most appropriate response to a leg that is partially amputated below the knee?

Leave the leg attached, immobilize the entire leg, and control bleeding with gauze

Which of the following is NOT a type of soft tissue wound classification?

Obtrusive

Which type of dressing would be most appropriate for an evisceration?

Occlusive dressing

Entry wound

Penetrations will always have a point of entry

What color is the skin after a superficial burn?

Pink to red

Julie and Quinn have responded to a call for a patient who fell off the roof of a house. Quinn is monitoring the airway and has applied a non-rebreather mask. Julie has begun a physical assessment for signs of internal injuries. What should Julie monitor while palpating for crepitus, tenderness, and rigidity?

The patient's face - for signs of grimacing

Which of the following is a true statement about bandaging?

There is not one right way to apply a bandage

Which type of burn may be caused by contact with hot objects or liquid?

Thermal

What is crush syndrome?

Toxic protein is released into the blood as a result of a crush injury

A contusion is rarely life-threatening.

True

A cup may be used to stabilize objects that are impaled in the eye.

True

Air splints may be used to hold dressings in place on extremities.

True

Hematomas can result in significant blood loss.

True

What is the proper method for clearing blood and debris from an open wound?

Wipe away from the wound

Location wound:

Wounds may be classified by the location on the body, such as a chest wound or an abdominal wound.