Traumatic Injuries
May 2013 EMD CE
Silver Cross EMSS
Our last CE covered
bleeding and shock. This
month’s will continue the
trauma theme and focus on
injuries to soft tissue,
muscles and bones.
Wounds

A wound is an injury caused by any physical
means that leads to damage of a body part.
– Wounds are classified as open or closed.
WARNING!
THIS POWERPOINT CONTAINS GRAPHIC
PICTURES OF TRAUMATIC INJURIES
AND OPEN WOUNDS.
Closed Wounds

The skin remains intact.

The only closed wound is the bruise.
– Injury of the soft tissue beneath the skin
– Small blood vessels are broken.
– The area becomes discolored and swells.
– A simple bruise heals quickly.

Bruising and swelling may be a sign of
an underlying fracture.
SKIN

The skin serves as a protective barrier that
prevents foreign substances from entering the
body.

It is a sense organ and sends messages to the
brain.

It helps to regulate body temperature.

It also prevents loss of body fluids.
– When the skin is damaged, it can no longer perform
these essential functions.
SKIN
Open Wounds

An open wound results in a break in the
skin. Bleeding and infection are concerns
with:
– Abrasions
– Penetrating Wounds
– Lacerations
– Avulsions
– Amputations
Open Wounds

Abrasion
– Also called a scrape,
road rash, or rug burn
– Occurs when the skin
is rubbed across a
rough surface
– Affects the epidermis
or outermost layer of
skin.
Open Wounds

Puncture or penetrating wound
– Occurs when a sharp object penetrates the
skin
– May cause deep injury that is not
immediately recognized
– Puncture wounds do not always bleed freely
– An impaled object may stick out of the skin
– A gunshot wound is a special type of
puncture wound that may have an entrance
and exit wound
Open Wounds

Impaled objects are
to be left in place and
stabilized. Control
bleeding around
them.
Open Wounds

Laceration or Incision
– Most common type of open wound
– Commonly called a cut
– Minor lacerations may require little care
– Large lacerations can cause extensive
bleeding and even be life threatening
Open Wounds
Open Wounds

Avulsions and amputations
– An avulsion is a tearing away of body tissue.
– If an entire body part is torn away, the wound is
called a traumatic amputation.
– Amputated parts should be:
 Located
 Placed in a clean cloth or plastic bag
 Kept cool but not put on ice
 Taken to the hospital for possible reattachment
Open Wounds
Principles of Wound Treatment

Very minor bruises need no treatment.

Other closed wounds should be treated
by:
– Applying ice and gentle compression
– Elevating the injured part if no fracture

Splint all major contusions

Stop bleeding as quickly as possible
using the cleanest dressing available.
Dressing and Bandaging
Wounds

Dressings
– If bleeding
continues after
you have applied
a dressing, put
additional gauze
or clean cloth
over the original
dressing.
Dressing and Bandaging
Wounds

Bandaging
– A bandage is used to hold the dressing in
place.
– Roller gauze and triangular bandages are
commonly used and found in most first aid
kits.
Burn Depth

Superficial burns (firstdegree burns)
– Reddened and painful
skin
– The injury is confined
to the outermost
layers of the skin.
– The patient
experiences minor to
moderate pain.
Burn Depth

Partial-thickness burns
(second-degree burns)
– Do not damage the
deepest layers of the
skin
– Blistering
– Fluid loss and moderate
to severe pain
– Usually heal within 2 to
3 weeks
Burn Depth

Full-thickness burns
(third-degree burns)
– Damage all layers of
the skin
– Pain is absent because
the nerve endings have
been destroyed.
– Patients lose large
quantities of body fluids
and are susceptible to
shock and infection.
Extent of Burns

Rule of nines
– Method for determining what percentage of
the body has been burned
– In an adult, the head and arms each equal
9% of the total body surface.
– The front and back of the trunk and each leg
are equal to 18% of the total body surface.
– This formulation is slightly modified for
children.
Extent of Burns
Cause or Type of Burns

Thermal burns
– Caused by heat
– Stop the burning process.
– Cover it with a dry, sterile dressing or a burn
sheet.
– Do not break blisters.
– Patients with large burns must be treated for
shock and transported to a hospital.
Cause or Type of Burns

Chemical burns
– The longer the chemical remains in contact
with the skin or eyes, the more damage it
does.
– Initial treatment
 Remove as much of the chemical as possible.
 Brush away any dry chemical.
 Flush with water.
 Cover the area with a dry, sterile dressing.
 Arrange for prompt transport.
Cause or Type of Burns

Electrical burns
– Occur when an electrical current enters the
body at one point, travels through the body
tissues and organs, and exits at the point of
ground contact
– Electricity causes major internal damage.
– Patients may experience irregularities of
cardiac rhythm or full cardiac arrest and
death.
Cause or Type of Burns

Electrical burns
– Be certain that a patient is not still in contact
with the electrical power source before you
touch or treat them.
– Call for assistance from the power company
or from a qualified rescue squad.
– Monitor the ABCs of electrical burn patients
and arrange for prompt transport.
Injuries to Muscles or Bones

Musculoskeletal injuries:
– Fractures
– Dislocations
– Sprains and strains
– Head injuries
– Spinal cord injuries
– Chest injuries
Musculoskeletal System

Functions of the skeletal system:
– To support the body
– To protect vital structures
– To assist in body movement
– To manufacture red blood cells

The muscles of the body provide support and movement
– Muscles are attached to bones by tendons and cause movement
by alternately contacting and relaxing.
– Movement occurs at joints, where two bones come together.
– The bones are held together by ligaments.
Types of Injuries
Fractures
– A fracture is a broken bone.
– It most often occurs as a
result of a significant force.
– In a closed fracture, the bone
is broken but there is no break
in the skin.
– In an open fracture, the bone
is broken and the overlying
skin is lacerated.
– Both result in bleeding at the
fracture site.
Types of Injuries

Dislocations
– A dislocation is a disruption
that tears the supporting
ligaments of the joint.
– The bone ends separate
completely from each other
and can lock in one
position.
– Any attempt to move a
dislocated joint is very
painful.
– A dislocation can damage
nearby nerves and blood
vessels.
Types of Injuries

Sprains and strains
– A sprain is a joint
injury caused by
excessive stretching of
the supporting
ligaments.
– A strain is caused by
stretching or tearing of
a muscle.
Signs and Symptoms of Extremity Injuries
– Pain at the injury site
– An open wound
– Swelling and discoloration
– The patient’s inability or unwillingness to
move the extremity
– Deformity or angulation
– Tenderness at the injury site
Anything that is painful, swollen, deformed or discolored should
be considered a fracture, until it is x-rayed.
Treatment of Musculoskeletal
Injuries

All limb injuries are treated the same
way:
– Cover open wounds with dry, sterile
dressings.
– Apply firm but gentle pressure to control
bleeding.
– Apply a cold pack to painful, swollen, or
deformed extremities.
– Stabilize to keep it from moving.
Injuries to the Head
(Skull and Brain)

Head and spinal cord injuries are common
causes of death.
– Can also lead to irreversible paralysis and
permanent brain damage
– In a closed head injury, bleeding and swelling
within the skull may increase pressure on the brain,
leading to brain damage and death.
– An open head injury usually bleeds profusely
Injuries of the Spine

Mechanisms of Injury
– Injury to the spinal cord high in the neck paralyzes
the diaphragm and results in death.
– Gunshot wounds to the chest or abdomen may
produce spinal cord injury at that level.
– Falls, motor vehicle crashes, and stabbings are
other common MOIs.
– Suspect a spinal injury if the patient has sustained
high-energy trauma.
Injuries of the Chest

Fractures of the ribs
– Even a simple
fracture produces
pain at the site and
difficulty breathing.
– Rib fractures may be
associated with
injury to the
underlying organs.
General Treatment for
Traumatic Injuries
Keep the trauma patient from moving so
they won’t aggravate any injuries they
may have.
 Monitor A – B - C’s and treat for shock.
 Control external bleeding with direct
pressure.
 Refer to the proper protocol for additional
information.

Sources
AAOS Emergency Medical Responder, 5th
edition
 Google and Bing Images
 Will County 9-1-1 EMDPRS
