Ch. 7: Soft Tissue Injuries: Cuts, Scrapes and Bruises pgs. 101-109 Health III St. Ignatius

Wounds An injury to the soft tissues is called a wound Wounds are closed or open Closed wounds result in damage or bleeding below the surface of the skin Open wounds result in tears in the skin which allow blood to leave the body

Closed Wounds Signals of Internal Bleeding Tender, swollen, bruised or hard areas of the body Rapid, weak pulse Skin – cool or moist/pale or bluish Vomiting/coughing blood Excessive thirst Extremity that is blue/pale Altered mental state

Caring for Closed Wounds Apply cold early - decrease pain and swelling Apply ice for no more than 20 minutes Place barrier between ice and bare skin Place victim in comfortable position/Elevate Call 911 if- A person complains of severe pain or cannot move a body part without pain You think the force that caused the injury was great enough to cause serious damage An injured extremity is blue or extremely pale

Open Wounds Abrasions Lacerations/Incisions Avulsions Punctures

Treatment Objectives Control the Bleeding Prevent Further Contamination Treat for Shock

Methods to Control Bleeding 1. Direct Pressure 2. Elevation 3. Indirect Pressure – Brachial Artery - arm Femoral Artery - leg 4. Tourniquet

Caring for Open Wounds Dressings/Compress are pads placed directly on wound to absorb blood and prevent infection Dressings are porous to allow air to pass through and promote healing Occlusive dressings close the wound and prevent air from getting to it Bandages are used to: hold dressings, control bleeding, protect wounds, provide support for injured limbs/body part. A pressure bandage fits snugly and creates pressure on a wound

Signs of Infection F = fever A = a heat sensation R = redness T = tenderness T = throbbing sensation E = evidence of pus R = red streaks from wound S = swelling

Bandages Adhesive compresses- small pad of nonstick gauze on a strip of adhesive tape applied directly to minor wounds Bandage compresses- thick gauze dressings attached to a bandage that is tied in place Roller bandages- made of gauze, used to hold dressing in place, secure a splint or control external bleeding

Types of Wraps Spiral – arm/leg Closed Figure 8 – wrist/ankle Open Closed Figure 8 – wrist/ankle Cravat - head

Guidelines for Applying a Roller Bandage (pg. 107) Check for warmth, feeling and color of the area below the injury site Elevate injured body part if you do not suspect a broken bone and it does not cause pain Anchor bandage at beginning of wrap. Secure the end of the bandage in place – Loop Knot Do not cover fingers or toes Apply additional dressings and another bandage by placing them over the blood-soaked ones

Elastic Roller Bandages Sometimes called elastic wraps, are designed to keep continuous pressure on a body part Available in 2, 3, 4 and 6-inch widths Use appropriate width for injury

Applying an Elastic Roller Bandage (pg. 108) Check circulation of limb beyond where you will be applying the bandage Place end of bandage against skin and use overlapping turns Gently stretch the bandage as you continue wrapping Always check area above and below injury site for feeling

Situation Treat the following injuries: 2” incision to the right for-head 5” laceration to the left lower arm 3” abrasion to the left knee

Caring for Minor Open Wounds Use a barrier between hand and wound Apply direct pressure for a few minutes to control bleeding Wash the wound thoroughly with soap and water Apply triple antibiotic ointment if the person has no known allergies to the medication Cover wound with a sterile dressing and bandage

Caring for Major Open Wounds Call 911 Put on disposable gloves Control bleeding by— Covering wound with a dressing and pressing firmly with a gloved hand Applying a pressure bandage over the dressing to maintain pressure on the wound and hold the dressing in place Continue to monitor the person’s ABCs

Caring for Major Open Wounds Keep the person from getting chilled or overheated Have person rest comfortably and reassure him or her Wash your hands immediately after giving care

Burns A special kind of soft tissue injury Classified by their sources: “CHER” Chemicals Heat Electricity Radiation Classified by their depth: Superficial Partial Thickness Full Thickness

Superficial – 1st Degree Involve top layer of skin Skin becomes red and dry Usually painful Area may swell Usually heal within a week without permanent scarring.

Partial-Thickness – 2nd Degree Involve top layers of skin Skin becomes red, usually painful Blisters develop that may open and weep clear fluid, making the skin appear wet; may appear mottled Area often swells Usually heal in 3 – 4 weeks and may scar

Full Thickness – 3rd Drgree May destroy all layers of skin and some or all underlying structures – fat, muscles, bones, nerves Skin may be brown/black (charred) with tissue underneath sometimes appearing white Extremely painful or relatively painless (nerve endings destroyed) Healing may require medical assistance. Scarring is likely

Caring for Burns Check the scene for safety Stop burning by removing person from source of burn Check for life-threatening conditions Cool burn with large amounts of cool running water Cover burn loosely with sterile dressing Prevent infection Take steps to minimize shock Keep person from getting chilled or overheated Comfort and reassure person

Caring for Burns: “Do Not” Apply ice or water, except on superficial burns and only for 10 minutes Touch a burn with anything except a clean covering Remove pieces of clothing that stick to the burned area Try to clean a severe burn Break blisters Use any kind of ointment on a severe burn

Caring for Chemical Burns Remove chemical from body using these steps: 1. Brush off dry chemicals before flushing with tap water 2. Flush burn with cool running water 3. If eye is burned by a chemical, flush eye with water 4. Have person remove contaminated clothes

Encountering Electrical Burns 1. Never go near person until he or she is not in contact with power source 2. Call 911 in case of high-voltage electrocution 3. Turn off power at its source and care for life-threatening conditions 4. Be prepared to give CPR or use an AED 5. Care for shock and thermal burns 6. Anyone suffering from electrical shock requires advanced medical care

Radiation (Sun) Burns Care for sunburn as you would for any other burn Always cool burn and protect area from further damage by keeping it out of the sun

Preventing Burns Follow safety practices that prevent fire and be careful around sources of heat Chemical burns can be prevented by following manufacturers’ guidelines when handling chemicals Electrical burns can be prevented by following safety practices around electrical lines and equipment Sunburn can be prevented by using sunscreen

Special Situations Severed Body Parts Embedded Objects Nose Injuries Call 911 Wrap severed part in sterile gauze Put part in plastic bag and place bag on ice Embedded Objects Do not remove object Place dressings around it to keep it from moving Bandage dressings in place around object Nose Injuries Have person sit slightly forward while pinching nostrils together for 10 minutes

Special Situations Mouth Injuries Lip Injuries Tooth Injuries Make sure person is able to breathe Place person in seated position with head tilted slightly forward Lip Injuries Place a rolled dressing between the lip and gum If tongue is bleeding, apply a dressing and direct pressure Tooth Injuries Control bleeding and save tooth Place rolled sterile dressing in space vacated by tooth Pick up tooth by white part and place in milk

Special Situations Injuries to the Chest Rib Fractures Leading cause of trauma deaths each year Either open or closed Rib Fractures Painful, but rarely life-threatening Results in shallow breathing Care for Rib Fractures Have person rest in position that makes breathing easier Call 911 Bind person’s upper arm to chest on the injured side to support the injured area and make breathing easier Monitor breathing and skin condition and take steps to minimize shock

Special Situations Puncture Wounds to the Chest Call 911 Care for a Sucking Chest Wound Cover wound with large occlusive dressing Tape dressing in place, leave one corner loose Take steps to minimize shock

Care for Abdominal Injuries 1. Call 911 2. Put on disposable gloves 3. Place person on his or her back with knees bent 4. Do not apply direct pressure 5. Do not push any protruding organs back in 6. Remove clothing from around the wound 7. Apply moist, sterile dressings loosely over the wound 8. Cover dressings loosely with plastic wrap, if available

Controlling External Bleeding Pgs. 126-127