Soft Tissue Injuries

advertisement
Soft Tissue Injuries
Treatment Procedures
1
Skin Anatomy and Physiology
• Body’s largest organ
• Three layers
– Epidermis
– Dermis
– Subcutaneous tissue
2
Skin Anatomy and Physiology
• Complex system, variety of functions
– Sensation
– Control of water loss
– Protection against microbes
– Temperature control
3
Soft Tissue Injuries
• Closed
• Open
4
Closed Injury
•
•
•
•
Associated with blunt trauma
Skin remains intact
Damage occurs below surface
Types
– Contusions
– Hematomas
5
Contusion
• Produced when blunt force damages
dermal structures
• Blood, fluid leak into damage area
causing swelling, pain
• Presence of blood causes skin
discoloration called ecchymosis
(bruise)
6
Hematoma
• “Blood lump”
• Larger blood vessel damaged
• Causes mass of blood to collect in the
injured area
• Fist-sized hematoma = 10% volume
loss
7
With Closed Soft Tissue Injury
• How much blood is tied up in that injury
rather than circulating in the vessels?
• What could the force the caused the soft
tissue trauma have done to underlying
organs?
8
Closed Injury Management
•
•
•
•
•
Rest
Ice
Compression
Elevate
Splint
When in doubt assume underlying
fractures are present
9
Open Injury
• Skin broken
• Protective function lost
• External bleeding, infection become
problems
10
Open Injury Types
•
•
•
•
•
Abrasions
Lacerations
Punctures
Avulsions
Amputations
11
Abrasion
• Loss of portions of epidermis, upper
dermis by rubbing or scraping force.
• Usually associated with capillary
oozing, leaking of fluid
• “Road rash”
12
Laceration
• Cut by sharp object
• Typically longer than it is deep
• May be associated with severe blood
loss, damage to underlying tissues
• Types
– Linear
– Stellate
13
Punctures
•
•
•
•
Result from stabbing force
Wound is deeper than it is long
Difficult to assess injury extent
Object producing puncture may
remain impaled in wound
14
Avulsions
• Piece of skin torn loose as a flap or
completely torn from body
• Result from accidents with machinery
and motor vehicles
• Replace flap into normal position before
bandaging
• Treat completely avulsed tissue like
amputated part
15
Amputations
• Disruption of continuity of extremity
or other body part
• Part should be wrapped in sterile
gauze, placed in plastic bag,
transported on top of cold pack
• Do NOT pack part directly in ice
• Do NOT let part freeze
16
Open Wound Management
• Manage ABCs first
• Control bleeding
• Prevent further contamination, but do
not worry about trying to clean wound
• Immobilize injured part
• Mange hypoperfusion if present
17
Special Considerations
•
•
•
•
•
Impaled objects
Eviscerations
Open chest wounds
Neck wounds
Gunshot wounds
18
Impaled Objects
• Do NOT remove
• Stabilize in place
• Exception
– Object in cheek
– Remove, dress inside and outside
mouth
19
Eviscerations
• Internal organs exposed through wound
• Cover organs with large moistened
dressing, then with aluminum foil or dry
multi-trauma dressing
• Do NOT use individual 4 x 4’s
• Do NOT attempt to replace organs
20
Open Chest Wound
• May prevent adequate ventilation
• Cover with occlusive dressing
• Monitor patient for signs of air becoming
trapped under pressure in chest (tension
pneumothorax)
• If tension pneumo develops lift dressing
corner to relieve pressure
21
Neck Wounds
• Risk of severe bleeding from large vessels
• Risk of air entering vein and moving
through heart to lungs
• Cover with occlusive dressing
• Do NOT occlude airway or blood flow to
brain
• Suspect presence of spinal injury
22
Gunshot Wound
• Special type of puncture wound
• Transmitted energy can cause injury
remote from bullet track
• Bullets change direction, tumble
• Impossible to assess severity in field
or ER
• Patient must go to OR
23
Download
Random flashcards
State Flags

50 Cards Education

Countries of Europe

44 Cards Education

Art History

20 Cards StudyJedi

Sign language alphabet

26 Cards StudyJedi

Create flashcards