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Ch 27 Soft-Tissue
EMT Soft-Tissue
| Question | Answer |
|---|---|
| What should be your MOST immediate priority? 45yo male, rescued from burning house, wrapped in a blanket, conscious alert, severe pain, face covered with a spot | Help prevent further harm Remove the blanket and check burned/burning clothes/skin Pour sterile water on smoldering areas Apply moist, sterile dressings ABCs |
| What is a thermal burn? What are the causes? | Caused by heat, as opposed to radiation, chemicals or electricity Commonly caused by open flames, direct contact at temperatures higher than 111F, prolonged sunlight, scalding water, flash burns |
| What additional info can you get from the firefighters? 45yo male, rescued from burning house, wrapped in a blanket, conscious alert, severe pain, face covered with a spot | What kind of space was he in? Open area, trapped under something, closed in space? Length of exposure? (gross estimate. the longer the more toxins they can inhale, more water loss, more burns) Found conscious or unconscious? |
| How are thermal burns characterized? What are the characteristics of each type? 1/2 | Classified according to depth (how far it goes through layers of skin) Superficial (first degree) - Outer layer only (epidermis) Partial-thickness (second deg) - Epidermis and some portion of the dermis. Does not destroy the entire thickness of the skin |
| How are thermal burns characterized? What are the characteristics of each type? 2/2 | Full-thickness (third deg) - Extend through all layers of the dermis and epidermis. May involve the subcutaneous skin layers, muscle, bone or internal organs. |
| Superficial (first degree) | Skin turns red Painful Does not blister |
| Partial-thickness (second degree) | Very painful Blisters may or may not be intact Does not injure fatty tissue |
| Full-thickness (third degree) | May appear dry and leathery May appear white, dark brown, or even charred Nerve endings in the dermis are destroyed, so they are usually painless |
| What percentage of the patients body has been burned? Partial-thickness to ant chest+abdomen Partial/Full-thickness to both arms, including hands | Rule of 9s Chest + abdomen = 18 Arms + hands = 18 (9 each) Total = 36% of TBSA (total body surface area) |
| What factors should you consider to determine the severity of a burn? | Two important factors: Depth and Extent 3 classifications: minor, moderate, severe |
| Minor burns | Full-thickness that cover less than 2% of TBSA Partial-thickness that cover less than 15% of TBSA Superficial burns that cover less than 50% of TBSA |
| Moderate burns | Full-thickness that cover between 2-10% Partial-thickness that cover 15-30% Superficial that cover more than 50% |
| Severe burns | Full-thickness that include any critical areas of the body and/or cover more than 10% Partial-thickness that cover more than 30% |
| What is the proper treatment of the patients burns? Partial-thickness to ant chest+abdomen Partial/Full-thickness to both arms, including hands | Larger (greater than 10%) covered with dry, sterile, nonadherent dressing (burn sheet). Do not apply water to large burns. High risk of hypothermia, hypovolemia, infection Help maintain body temp Monitor ABCs and signs of shock |
| How has the patients condition changed? What should you do now? Breathing labored. 22 rpm up from 14 HR 120 up from 108 BP 158/84 down from 166/86 98-99% on O2 | Potential upper airway swelling after surviving a fire. Keep high-flow O2 Cool mist or aerosol therapy may help Consider ALS interception |
| What does the skin do? | Protects the body, keeps out pathogens, keeps water in, assists in temp regulation |
| 3 types of soft-tissue injury | Closed (damage beneath the skin or mucus membrane) Open (break in the surface) Burns (tissue received more energy than it can absorb) |
| Closed injuries are characterized by? | History of blunt trauma Pain at the site Swelling beneath the skin Discoloration Contusions, hematomas, crushing injuries |
| RICES | Rest, Ice, Compression, Elevation, Splint |
| Open injuries | Layer of skin is damaged Abrasions, lacerations, avulsions, penetrating wounds |
| Treatment for Open injuries | Apply direct pressure, use a sterile bandage and roller bandage, splint Tourniquet when necessary |
| It is generally easier to assess an ______ injury versus a ________ injury because you can see it | Open vs Closed |
| Small animal and human bites can lead to? | Serious infection Must be evaluated by a physician Animals can carry rabies |
| Burn are caused by? | Heat (thermal) Chemicals Electricity Radiation |
| Burns are classified by? | The depth and extent Total body area involved |
| When providing emergency care for burns do the following | Protect yourself first from contamination and danger Cool the burned area to prevent cellular damage Remove jewelry and restrictive clothing that may melt to the skin ABCs + high-flow O2 Sterile dressings |
| Symptoms of inhalation | Difficulty breathing Stridor (upper air: larynx, windpipe) Wheezing (lower air) |
| Dressings and bandages are designed to control? | Bleeding, protect the wound from further damage, prevent further contamination, prevent infection |
Created by:
cmoney833
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