SOFT TISSUE INJURY MR BRIAN BURGESS

INTRODUCTION COMMON PRESENTATIONS TO THE EMERGENCY DEPARTMENT CURRENT TREATMENT REGIMES POINTS FOR DISCUSSION

WOUNDS TAKE FULL HISTORY ? FALL – FURTHER EVALUATE UNDERLYING CAUSE GLASS / CERAMIC – X-ray TETANUS STATUS DIABETES / IMMUNOSUPPRESSION

WOUNDS EXAMINATION SITE OF INJURY INCISION v. LACERATION DEPTH DISTAL NEUROVASCULAR FUNCTION DOCUMENTATION

INVESTIGATION X-RAY – Glass OR Bony Injury BLOODS

TREATMENT LOCAL WOUND TOILET DEBRIDEMENT L.A. SUTURE / STERISTRIP / GLUE ANTISEPTIC ? TOPICAL ANTIBIOTIC DRESSING SYSTEMIC ANTIBIOTIC

WOUND INFECTIONS ASSESSMENT INCLUDES DOCUMENTING: SITE OF WOUND – VASCULARITY (FACE v. LEG) NATURE OF WOUND – PUNCTURE, BITES

TREATMENT LOCAL TREATMENT I&D CELLULITIS ANTIBIOTIC CHOICE ? ADMIT/ CELLULITIS PATHWAY TETANUS

INSECT BITE

INFECTED WOUND

BURNS FULL HISTORY – EXPLOSION, CLOSED SPACE– ATLS THERMAL AIRWAY INJURY INHALATION INJURY OTHER INJURIES

BURN CLASSIFICATION PARTIAL THICKNESS DEEP DERMAL FULL THICKNESS DIFFERENTIATED BY SENSORY LOSS AND APPEARANCE

ERYTHEMA IS NOT A BURN

TREATMENT ATLS ANALGESIA ASSESSING SIZE OF THE BURN (“RULE OF NINES” SPECIAL SITES FLUID REPLACEMENT CONSIDERATIONS

DRESSINGS MEPETIL v. JELONET CLINGFILM REVIEW REFERRAL TO BURNS UNIT

ERYTHEMA & P.T. BURN

P.T. BURN & DEEP DERMAL

PT BURN & MACERATION

SPECIAL CONSIDERATIONS

NAIL COMPLEX

NAIL BED NAIL FOLD / GERMINAL MATRIX VOLAR OBLIQUE v. DORSAL OBLIQUE COMPOUND # / STERILITY FUNCTIONAL RESULT ? PLASTICS REFERRAL

LAC NAILBED

LAC NAIL

FLAP LACERATIONS LOCATION – VASCULARITY APEX PROXIMAL v. APEX DISTAL SUTURE v. STERISTRIP

DEEP PRE-TIBIAL LAC

FLAP LAC KNEE

TENDON SHEATH INFECTION

SPRAINS ANKLE – OTTAWA RULES NECK – CANADIAN RULES A-C JOINT OTTAWA KNEE RULES WRIST INJURIES – SPLINT v. X-RAY (WRISTS IN CHILDREN) TOE & TUFT FRACTURES

QUESTIONS

SUMMARY WIDE RANGE OF INJURY CAREFUL ASSESSMENT JUDICIOUS REFERRAL TO SPECIALIST COLLEAGUES