Class 8 (Skin A&P, Soft Tissue Injuries & Vitals & S.A.M.P.L.E.) Ch 4 (Partial) , Ch24 & Ch 5

1. Class 8 (Skin A&P, Soft Tissue Injuries & Vitals & S.A.M.P.L.E.)Ch 4 (Partial), Ch24 & Ch 5

2. The Skin (1 of 2)

3. The Skin (2 of 2) • Protects the body from the environment • Regulates body temperature • Transmits information from environment to the brain

4. Functions of Dressingand Bandaging • Control bleeding. • Protect wound. • Prevent contamination.

5. Dressings and Bandages • Sterile dressings • Used to cover wounds • Bandaging • Used to keep dressing in place

6. Soft-Tissue Injuries • Closed injuries • Soft-tissue damage beneath the skin • Open injuries • Break in the surface of the skin • Burns • Soft tissue receives more energy than it can absorb

7. Contusion • Results from blunt force striking the body

8. Hematoma • Pool of blood that has collected in the body

9. Crushing Injury • Occurs when a great amount of force is applied to the body

10. Mechanism of Injury • Underlying organ damage • Hidden injury • Shock from internal bleeding

11. Interventions • Provide complete spinal immobilization early if spinal injuries are suspected. • Provide high-flow oxygen. • Treat aggressively for shock. • Request ALS if necessary. • Do not delay transport.

12. RICES • Rest—keep patient quiet and comfortable as possible. • Ice slows bleeding. • Compression over an injury slows bleeding. • Elevation above the level of the heart reduces swelling. • Splinting decreases bleeding and reduces pain.

13. Transport Decision • If patient has signs of shock or airway or breathing problem, consider quickly transporting or requesting ALS. • Do not delay transport of closed-injury patient who may have more serious deeper injury.

14. Open Soft Tissue Injury • Protective skin is damaged and open • Contaminated • Possible heavy bleeding • 4 Types • Abrasion • Laceration • Avulsion • Penetrating

15. Abrasions • Caused by friction

16. Laceration • Jagged cut

17. Avulsion • Separation of various layers of the skin

18. Penetrating Wound • Results from a sharp pointed object

19. Gunshot Wounds • Gunshot wounds have unique characteristics

20. Crushing Open Wound • May involve damaged internal organs or broken bones

21. Interventions • Control bleeding. • If bleeding is not significant, control later in assessment. • Stabilize spine and assist breathing. • Splint painful, swollen, deformed extremities.

22. Emergency Medical Care (1 of 3) • Use proper BSI precautions. • Administer oxygen if needed. • Treatment priority is ABCs—including controlling bleeding.

23. Emergency Medical Care (2 of 3) • Apply dry, sterile dressing over entire wound. • Maintain pressure and secure dressing with a roller bandage.

24. Emergency Medical Care (3 of 3) • Leave original dressing in place if bleeding continues. • Apply a second dressing on top of first and secure. • Splint the extremity.

25. Abdominal Wounds • Open wound in abdomen may expose organs. • Organ protruding through abdomen is called an evisceration.

26. Abdominal Wound Management • Do not touch exposed organs. • Cover organs with a moist sterile dressing. • Transport immediately.

27. Impaled Objects (1 of 2) • Do not attempt to move or remove object.

28. Impaled Objects (2 of 2) • Control bleeding and stabilize object. • Tape a rigid item over object to prevent movement. • Transport to hospital carefully.

29. Amputations • Immobilize partial amputation with bulky dressings and splint. • Wrap complete amputation in dry sterile dressing and place in plastic bag. • Put bag in cool container filled with ice. Do not let object freeze! • Transport severed part with patient.

30. Neck Injuries (1 of 2) • An open neck injury can be life threatening. • Air can get into the veins and cause an air embolism.

31. Neck Injuries (2 of 2) • Cover the wound with an occlusive dressing. • Apply manual pressure. • Secure a pressure dressing loosely over the neck and firmly through the opposite axilla.

32. Transport Decision • Consider quick transport if patient has airway or breathing problem or significant bleeding. • Stay focused on problems at hand. • Patients with significant bleeding or internal bleeding may quickly become unstable. • Watch for signs of shock.

33. Burns • Burns account for over 10,000 deaths/year. • Burns are the most serious and painful injuries. • Remember to perform a complete assessment on burn patients for other injuries.

34. Determining Burn Severity • What is the depth of the burn? • What is the extent of the burn? • Are any critical areas involved? • Are there any preexisting medical conditions or other injuries? • Is the patient younger than 5 years or older than 55 years of age?

35. Depth of Burns

36. Extent of Burns

37. Critical Burns (1 of 2) • Full-thickness burns involving hands, feet, face, upper airway, genitalia, or circumferential burns of other areas • Full-thickness burns covering more than 10% of total body surface area • Partial-thickness burns covering more than 30% of total body surface area • Burns associated with respiratory injury

38. Critical Burns (2 of 2) • Burns complicated by fractures • Burns on patients younger than 5 years old or older than 55 years old that would be classified as moderate on young adults

39. Moderate Burns • Full-thickness burns involving 2% to 10% of total body surface area excluding hands, feet, face, upper airway, or genitalia • Partial-thickness burns covering 15% to 30% of total body surface area • Superficial burns covering more than 50% of total body surface area

40. Minor Burns • Full-thickness burns involving less than 2% of the total body surface area • Partial-thickness burns covering less than 15% of the total body surface area • Superficial burns covering less than 50% of the total body surface area

41. Critical Burns in Infantsand Children • Full-thickness burns covering more than 20% of total body surface area • Burns involving hands, feet, face, upper airway, genitalia

42. Moderate Burns in Infantsand Children • Partial-thickness burns covering 10% to 20% of total body surface area

43. Minor Burns in Infants and Children • Partial-thickness burns covering less than 10% of total body surface area

44. Pediatric Needs • Burns to children are considered more serious than burns to adults. • Children have more surface area relative to body mass than adults. • Many burns result from abuse. • Report all suspect cases of abuse to the authorities.

45. Emergency Care for Burns (1 of 3) • Follow proper BSI precautions. • Move patient away from burning area. • Immerse affected area in cool sterile water or saline solution to stop burning • Cover with dry dressing.

46. Emergency Care for Burns (2 of 3) • Provide high-flow oxygen. • Prevent body heat loss. • Rapidly estimate the burn’s severity. • Check for traumatic injuries.

47. Emergency Care for Burns (3 of 3) • Treat the patient for shock. • Provide prompt transport.

48. Chemical Burns • Occur whenever a toxic substance contacts the body • Eyes are particularly vulnerable. • Fumes can cause burns. • To prevent exposure, wear appropriate gloves and eye protection.

49. Care for Chemical Burns (1 of 2) • Remove the chemical from the patient. • If it is a powder chemical, brush off first. • Remove all contaminated clothing.

50. Care for Chemical Burns (2 of 2) • Flush burned area with large amounts of water for about 15 to 20 minutes. • Transport quickly.