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What do we look for in wound history?
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How do we assess minor injuries?
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Injury Management
Trauma
| Question | Answer |
|---|---|
| What do we look for in wound history? | Time of injury, environmental, MOI, blood loss, severity of pain, medical history and tetanus vaccine |
| How do we assess minor injuries? | Inspection, Palpation, Movement |
| What do you look for at inspection? | "look" for asymmetry of deformity |
| What do you look for at movement? | "move" to test movement of affected limb- with caution |
| What do you look for at Palpation? | "feel" for tenderness and swelling |
| What do we check for in the physical examination of a wound? | • Bleeding • Size • Depth • Presence of foreign bodies • Amount of tissue lost • Oedema • Deformity |
| What else do we need to check for within the surrounding area of the wound? | Artieries, nerves, tendons, muscles |
| If there is an injury to the leg, what else do we need to assess? | Sensory and/or motor function and perfusion status of the wound and distal to the wound |
| How does a haemorrage occur? | When disruption occurs in the vascular system |
| How to is an arterial bleed characterised? | Bright red blood and spurting |
| How to is a venous bleed characterised? | Dark reddish-blue and flowing |
| How is a capillary bleed characterised? | Bright red and oozing |
| In the pre-hospital setting, what is our main concern with a haemorrage call? | Control bleeding |
| What are some methods of haemorrhage control? | Direct pressure, immobilisation (splinting), Pneumatic pressure, tourniquets |
| What does the seriousness of the external haemorrhage depend on? | Anatomical source (arterial/venous/capillary), degree of vascular disruption, amount of blood loss the patient can tolerate |
| What can cause internal haemorrhage? | blunt or penetrating trauma, acute or chronic illness |
| What are the signs and symptoms of internal haemorrhage? | • Bright red blood (frank) from mouth, rectum, or other orifice • Coffee-ground appearance of vomitus • Melena (black, tarry stools) • PR loss (passage of red blood through rectum) • Dizziness or syncope on sitting or standing • Orthostatic hypotension |
| Why do we need to cover open neck wounds with occlusive dressings? | To prevent an air embolism |
| What sort of injuries can occur from not closing abdomen and chest wounds? | Pneumothorax, tension pneumothorax, haemothorax |
| What can be a major complication of a penetrating abdominal injury? | Haemorrhage from a major blood vessel, perforation of a bowel segment |
| How would we manage a penetrating wound to chest and abdomen? | Do not remove object, do not manipulate the object unless required, Control bleeding with direct pressure, stabilise with bulky dressings to prevent movement |
| Why would an injected puncture wound seem not serious and have minimal bleeding? | Because there is an increase of tissue pressure of injected substance. It can cause numbness and blanching |
| What do most injected puncture wounds require? | Surgical intervention |
| What do patients with an injected puncture wound highly succeptible to? | Developing compartment syndrome |
| What is compartment syndrome? | A painful and dangerous condition caused by pressure build-up from internal bleeding or swelling of tissues |
| If the tissue is still attached to the body, how would we treat the injury? | 1. Clean surfact with sterile sailne solution, 2. Gently fold skin back to orginal poistion, 3. Control bleeding, dress wound with bulky dressings, and maintain direct pressure |
| If the avultion injury has caused the tissue to unattach from the body, how would you treat the wound? | 1. Control bleeding with direct pressure, 2. Retrieve avulsed tissue if possible, 3. Wrap tissue in gauze, either dry or moistened with lactated Ringer’s or saline solution 4. Seal tissue in plastic bag . 5. Place sealed bag on crushed ice |
| When placing an amputated tissue onto ice, what do we never do? | Place tissue directly on the ice |
| How would you control a haemorrhage from an amputation? | 1. Direct pressure |
| What are some complications of a bite? | – Abscesses – Lymphangitis – Cellulitis – Osteomyelitis – Tenosynovitis – Tuberculosis – Hepatitis B – Tetanus |
| What aren't we not allowed to do? | Remove the dressing once it has been applied |
| What do we do if the 1st bandage fills with blood? | Place a second bandage over the top of the first one |
| Why don't we remove a dressing from an external haemorrhage? | We could remove the fresh blood clott starting to form |
| When dressing a patient, when could you use a non sterile dressing? | When infection isn't the main concern |
| What are occlusive dressings? | Ones that don't allow air through the dressing |
| When is it dangerous to use an nonocclusive dressing? | For treating wounds of the thorax and other major vessels. It can result in pneumothorax or air embolism, respectively |
| What would happen if the bandages were too loose? | Wouldnt stop the bleeding etc. |
| What could happen if the bandages were too tight? | tissue ischemia and structural damage to vessels, nerves, tendons, muscles, skin |
Created by:
maddunn23
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