Soft-Tissue Trauma
Terms
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- What does the integumentary system consist of?
- The skin. The epidermis, the dermis, and the subcutaneous layer.
- What is the most common type of trauma?
- Soft tissue trauma
- Define contusion
- Closed wound in which the skin is unbroken, although damage has occurred to the tissue immediately beneath
- What are the different types of closed wounds?
-
Contusions
Hematoma
Crush injuries - Define erythema
- General deddening of the skin due to dilation fo the superficial capillaries
- Define ecchymosis
- Blue-black discoloration of the skin due to leakage of blood in to the tissues
- Define hematoma
- Collection of blood beneath the skin or trapped within a body compartment
- Define crush injury
- Mechanism of injury in which tissue is locally compressed by high pressue forces
- Define crush syndrome
- Systemic disorder of severe metabolic disturbances resulting from the crush of a limb or other body part
- Name 3 types of the open wounds
-
Abrasions
Lacerations
Incisions
Punctures
Avulsions
Amputations - Define abrasion
- Scraping or abrasing away of the superficial layers of the skin; an open soft-tissue injury
- Define laceration
- An open wound, normally a tear with jagged borders
- Define tension lines
- Natural patterns in the surface of the skin revealing tensions within
- Define incision
- Very smooth or surgical lacerations, frequently caused by a knife, scalpel, razor blade, or piece of glass
- Define puncture
- Specific soft-tissue injury involving a deep, narrow wound to the skin and underlying organs that carries an increased danger of infection
- Define impaled object
- Foreign body embedded in a wound
- Define avulsion
- Forceful tearing away or separation of body tissue; an avulsion may be partial or complete
- Define degloving injury
- Avulsion in which the mechanism of injury tears the skin off the underlying muscle, tissue, blood vessels, and bone
- Define amputation
- Severance, removal, or detachment, either partial or complete, of a body part
- What are the sages of wound healing?
-
Hemostasis
Inflammation
Epithelialization
Neurovascularization
Collagen synthesis - A bright red, pulsating flow of blood indicates what kind of hemorrhage?
- Arterial
- A dark red, steady, slow flow of blood indicates what kind of hemorrhage?
- Venous
- A bright red, slow, even flow of blood indicates what kind of hemorrhage?
- Capillary
- Define hemostasis
- The body's natural ability to stop bleeding, the ability to clot blood
- During assessment, it is important to determine the _________ and ______________ of hemorrhage.
- rate, quantity
- Define inflammation
- Complex process of local cellular and biochemical changes as a consequence of injury or infection; an early stage of healing
- Define chemotactic factors
- Chemicals released by white blood cells that attract more white blood cells to an area of inflammation
- Define granulocytes
- WBC's charged with the primary purpose of neutralizing foreign bacteria
- Define macrophages
- Immune system cell that has the ability to recognize and ingest foreign pathogens
- Define phagocytosis
- Process in which a cell surrounds and absorbs a bacterium or other particles
- Define epithelialization
- Early stage of wound healing in which epithelial cells migrate over the surface of the wound
- Define neovascularization
- New growth of capillaries in response to healing
- Define collagen
- Tough, strong protein that comprises most of the body's connective tissues
- Define fibroblasts
- Specialized cells that form collagen
- Define remodeling
- Stage in the wound healing process in which collagen is broken down and relaid in an orderly fashion
- What is the most common complication of open wounds?
- Infection
- Define lymphangitis
- Inflammation of the lymph channels, usually as a result of a distal infection
- What is a factor that influences the liklihood of infection?
- The type of wound
- Define gangrene
- Deep space infection usually caused by the anaerobic bacterium; Clostridium perfringens
- True or false: Some medications, like ASA, warfarin, and heparin, can interfere with the clotting process.
- True
- Define serous fluid
- A cellular component of blood, similar to plasma
- Define compartment syndrome
- Muscle ischemia that is caused by rising pressures within an anatomical fascial space
- Define keloid
- A formation resulting from overproduction of scar tissue
- True or false: Pressure injuries may occur if a long spind board, splint, or PASG is left on a patient for an extended period.
- True
- Define necrosis
- Tissue death, usually from ischemia
- Define rhabdomyolysis
- Accute disease that involves the destruction of skeletal muscle
- What are the 5 types of dressings?
-
Sterile/Nonsterile
Occlusive/Nonocclusive
Adherent/Nonadherent
Absorbent/Nonabsorbent
Wet/Dry - What are the 4 types of bandages?
-
Gauze
Adhesive
Elastic
Triangular - True or false: No MOI can impact the body without first passing through the skin.
- True
- The detailed _________ ____ _______ examination should be performed at the scene only if significant and life-threatening bleeding can be ruled out.
- head-to-toe
- True or false: The wound should be observed in such a way that it can later be described to the attending physician.
- True
- Unless extensive ___________________ is noted, the management of minor wounds is a late priority in the care of the trauma patient.
- bleeding or hemorrhage
- What are the 3 objectives of bandaging?
-
Controlling hemorrhage
Keep the wound clean
Immobilize the wound site - To halt hemorrhage, apply __________ _________________ to the site for at least 10 minutes.
- firm pressure
- When should a tourniquet be used?
- Only when bleeding cannot be controlled by any other means
- True or false: Immobilization is an important, but frequently overlooked, component of hemorrhage control.
- True
- Why is it important to frequently check the pressure beneath a bandage?
- To assure good distal circulation
- What is the current recommendation for managing an amputated body part?
- Placing the amputated body part in a bag and immersing the bag in cold water, but not allowing direct contact with ice, and rapid transport.
- Implaled objects should/should not be removed because of the risk of serious, uncontrollable bleeding.
- should not
- What are the only two instances an impaled object should be removed prehospital?
-
The object is impaled in the cheek and compromising airway
The object is impaled in the chest and is preventing CPR - What should be anticipated once a crush injury pt is freed from entrapment?
- Rapid development of shock
- What is the most prominent symptom symptom of compartment syndrome?
- Pain out of proportion with the physical findings
- Severe facial soft-tissue injueies may cause what problem for airway management?
- The injuries may distort landmarks used for intubation
- Should an open thoracic wound be explored beyond the edges?
- No. Probing may create a pneumothorax or induce serious bleeding.
- Any open wound chest wound should be watched closely for what developments?
- Pneumothorax or tension pneumothorax
- Injuries to both the _______________ and _________________ should be suspected if the soft-tissue injury involves the region between the rib margin and the 5th rib anteriorly, the 7th rib laterally, and the 9th rib posteriorly.
- thorax, abdomen