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Soft Tissue Injuries Chapter 19. Whitney Creed Fall 2005. Tonight’s Agenda. Overview of Skin Types of STIs Closed injuries Open injuries Burns. Skin Anatomy and Function. Anatomy - The skin has two layers: Epidermis, Dermis (Subcutaneous Tissue)
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Soft Tissue Injuries Chapter 19 Whitney Creed Fall 2005
Tonight’s Agenda • Overview of Skin • Types of STIs • Closed injuries • Open injuries • Burns
Skin Anatomy and Function • Anatomy- The skin has two layers: Epidermis, Dermis (Subcutaneous Tissue) • Function- Protection, regulating temperature
Closed Injuries • In which soft tissue damage occurs beneath the skin, but the surface remains intact. Typically caused by blunt trauma or crushing injury Examples: contusion (bruise), hematoma
Signs and Symptoms: Blunt trauma, pain on site, swelling, discoloration Treatment: • BSI • RICES (rest, ice, compression, elevation, splinting) • Provide O2 and watch for hypovolemic shock
Open Injuries • There is a break in the surface of the skin exposing deeper tissue to contamination 4 Types: -Abrasions -Lacerations -Avulsions -Punctures/ Penetrations
Abrasions • Wound of the superficial layer of the skin caused by friction across a hard surface blood and plasma may ooze from surface capillaries Ex: Road rash, rug burn
Lacerations • Smooth or jagged cut caused by a sharp object or a blunt force that tears the tissue Depth can vary, may sever arteries or veins
Avulsions • An injury that separates layers of soft tissue so that they are either completely unattached or hanging by a flap
Punctures and Penetrations • Injury resulting from a sharp pointed object Can leave relatively small entrance wounds but can damage structures deep in the body Ex: Stabbings, shootings, ice pick accidents
Treatment • BSI • Stabilize ABCs – control bleeding (direct pressure, elevate, pressure dressing, pressure points, splinting, tourniquet) • Give O2 and monitor for hypovolemic shock Special Circumstances: *Impaled objects- stabilize object in place- unless in the cheek or hinders evacuation/ transport *Eviscerated organs- cover with sterile moist dressing *Chest/ Neck wounds- cover with occlusive dressing *Amputations- wrap part in moist dressing keep w/ patient
Burns • Occurs when the body receives more energy than it can absorb without injury Sources: heat, chemicals, UV, electricity • Rule of Nines (pg. 514) Burn Severity?(critical, moderate, minor) pg. 511 • Depth? • Extent? • Critical areas? • Preexisting medical conditions? • Patient younger than 5 or older than 55?
Superficial (1st degree):involves only the top layer of skin, skin turns red but does not blister (sunburn) • Partial-Thickness (2nd degree):involves both epidermis and parts of the dermis- skin is moist, mottled and blisters are common • Full-Thickness (3rd degree): extends through all skin layers and may involve subcutaneous tissue, muscle, bone or organs- area is dry and leathery or charred and skin feels hard to the touch
Treatment of Burns • BSI • Remove the patient from the source • Immerse the area in cool, sterile water/ saline • Give O2 • Estimate the burn severity and treat burns by covering with dry, sterile dressing • Check for other injuries • Watch for shock and hypothermia • Transport