1. SOFT TISSUE INJURIES: CUTS, SCRAPES AND BRUISES
Chapter 7
SOFT TISSUE INJURIES: CUTS, SCRAPES AND BRUISES

2. WHAT ARE WOUNDS?
Injury to the soft tissue

3. TYPES OF WOUNDS Closed Wounds- under the skins surface
Open Wounds-Skins surface is broken
Abrasion
Laceration
Avulsion
Puncture
Scrapes
Burse
Burns

4. Open Wound-Scrapes
This can be as minor as a scrape of the surface of the skin or as severe as a deep penetration.
This is the most common type of injury
The skin can be rubbed or scraped away
Bleeding depends on location and severity.
It can easily be infected in not cleaned

5. Types of Open Wounds
Abrasion -Most common type- caused by something rubbing roughly against skin (strawberry)
Laceration-Cut caused by a sharp object
Avulsion- cut which a portion of the skin and sometimes soft tissue is partially or completely torn away.
Bleeding is usually significant

6. Types of Wounds –Bruise
Bruise (contusion, charley horse)
Damage to soft tissue and blood vessels causes bleeding under the skin
Tissue discoloration and swelling
First red, then dark red and purple
Could be sever damage to the deep tissue

7. Cuts and Punctures Cut- (incision or laceration)
Caused by sharp edged objects
Knives
Scissors
Broken Glass
Usually bleed freely
Puncture- Caused by pointing objects into piercing the skin
Nails, glass, knife, gun shot wounds
DO NOT bleed a lot but can be easily infected

8. Stitches (p. 135) Speed up healing process Lesson chances of infection
Improve the appearance of scars
Preventing Tetanus – booster shot every 10 years
Common germs – bacteria and viruses
Signs of infection:
Red swollen
Stiffness above the wound
Grayish color

9. Open Wounds

10. Caring for an Open Wound
Needs to be covered to prevent infection and control bleeding.
Dressing and pads should be used.
Open wounds need some type of covering to help control the bleeding and prevent infection
Dressings – placed directly on the wounds to soak up blood and help keep germs out
Should be sterile
Loosely woven to let air reach the wound

11. Bandages refer to page 115-117
Bandage – any material used to wrap or cover a part of the body
Often used to hold dressings in place
Apply pressure to control bleeding and help support an injured part of the body
Roller Bandages – Pressure bandages p. 140

12. Caring for Major Open Wound p. 144-145
Control bleeding – place a clean covering over wound and apply pressure
If there is no broken bones – elevate the injured area
Apply a bandage over the dressing
Bleeding cannot be controlled – put pressure on nearby artery (Pressure point)
Seek medical attention
Wash hands after care

13. Video Controlling External Bleeding (2:28)

14. Signals of Internal Bleeding
Tender, swollen, bruised or hard area of the body such as the abdomen
Rapid week pulse
Skin that feels cool or moist, pale or blush
Vomiting or coughing up blood
Excessive thirst
Confused, faint, drowsy, unconscious

15. SHOCK Any severe bleeding can lead to shock
Condition in which circulatory system fails to deliver blood to all parts of the body
Organs DO NOT receive blood – they fail to function properly

16. Signs of Shock Restless and Irritable Altered consciousness
Pale, cool, moist skin
Rapid breathing
Rapid pulse

17. Impelled Object
Leave the object in – bulking dressing

18. Nose Injuries Cause by a blow from a blunt object. Cause nose bleeds
Sit with head forward, while pinching the nostrils together for about 10 minutes.

19. Mouth Injuries Make sure person is able to breath.
If person is bleeding from the mouth and there is no suspected head, neck or back injuries put them in a seated position.
Lip Injuries- Place a rolled dressing between the lip and gum.
Tooth Injuries- If tooth in knocked out, control bleeding and save the tooth so it may possibly be reinserted.

20. Injuries to the Chest Leading cause of trauma death each year.
Injuries to the chest may result from car accidents, falls and or sports mishaps.
There are Two types of chest wounds, open and closed.

21. Open Chest Wound Recognition An open chest wound – escaping air
Entrance and possible exit wound (exit wounds are more severe)
Trouble breathing
Sucking sound as air passes through opening in chest wall
Blood or blood-stained bubbles may be expelled with each exhalation
Coughing up blood

22. Treatment Assess ABCs and intervene as necessary
Do not remove any embedded objects
Call for an ambulance
Flutter valve over wound
Lateral positioning: victim's injured side down
Treat for shock
Conduct a secondary survey
Monitor vitals carefully

23. Closed Wound
Chest injuries can be inherently serious, as this area of the body houses many critical organs, such as the heart, lungs, and great blood vessels. Most chest trauma should receive professional medical attention, and always consider calling for an ambulance for any potentially serious chest injury.

24. Rib Fracture
A common result of trauma to the chest is damage to the victim's rib cage. The curved shape of the rib cage helps to deflect the force of some injuries, but damage to cartilage or the ribs themselves can still result. While a single broken rib can be very painful for the patient, a number of broken ribs can lead to other complications. A victim with broken ribs may take very shallow breaths without even noticing it, as their body tries to prevent the pain with taking a full breath.

25. How to Recognize Trouble breathing Shallow breathing
Tenderness at site of injury
Deformity & bruising of chest
Pain upon movement/deep breathing/coughing
Dusky or blue lips or nail beds
May cough up blood
Crackling feeling upon touching victim's skin (sounds and feels like "Rice Crispies")

26. Treatment Assess ABCs and intervene as necessary Call for an ambulance
Assist the victim into a position of comfort (typically seated upright, to avoid fighting gravity)
Conduct a secondary survey
Monitor patient's condition carefully
Be vigilant, keep alert for any changes.
If a flail segment is suspected, tightly secure a bulky dressing (such as a tightly folded hand towel) to help stabilize the injury.

27. Puncture to the Chest Stabbing or Gun shot wound.
Holes in the chest can lead to collapsed lungs. Deep puncture wounds to the chest should be immediately sealed by hand or with a dressing that does not allow air o flow. Victims may complain of shortness of breath. If the victim gets worse after sealing the chest puncture wound, unseal it.

28. Abdominal Injuries Can be either open or closed
Always suspect an abdominal injury in a person who has multiple injuries. Signals of serious injuries include.
Severe pain, bruising, nausea, external bleeding, vomiting, thirst, weakness, pain or tenderness, organs protruding from stomach.

29. How to Care for Injuries
With severe open injury , abdominal organs may protrude through the wound.
1. Call 911
2. Put gloves on or another barrier
3. Put the person of there back with knees up
4. Do not apply direct pressure, Do not push organ back in.
5. Remove clothing from around the wound,
Apply moist sterile dressing loosely over the wound. Cover dressing with loose plastic wrap.

30. Burns Causes Heat Electrical current Certain chemicals
Radiation from the sun

31. Severity of Burns Temperature of whichever caused the burn
Length of time exposed to it
Burns location on body (size of burn)
Victims age and medical condition
The deeper the burn the more sever.

32. Definition of the Burns
1st Degree Burns- superficial burns; involves only the top layer of skin:
Red and dry
Most sunburns are 1st degree burns
5-6 day to heal
3rd Degree Burns- destroys all layers of the skin or many or all underlining structure –fat, muscles, bones and nerves

33. 1st Degree Burns
1st Degree Burns- superficial burns; involves only the top layer of skin:
Red and dry
Most sunburns are 1st degree burns
5-6 day to heal

34. 2nd Degree Burns
2nd Degree Burns- partial layers of the skin are burned; involves the top layers of the skin
Red and has blisters that may open
3-4 weeks (scaring may occur)

35. 3rd Degree Burns
3rd Degree Burns- destroys all layers of the skin or many or all underlining structure –fat, muscles, bones and nerves
Brown, black and charred

36. Care for Burns Stop the burning
Cool the burn – use water to cool the burned area
Do not use ice unless minor burn
Cover the burn with dry, clean dressing to help prevent infection (bandage loosely)
Do not use ointment, Do not break blisters

37. Special Kinds of Burns Chemical Burn
Must know that a chemical burn will continue to burn as long as it is on your skin.
Remove chemicals from the skin as soon as possible and call an ambulance

38. Special Kinds of Burns Electrical Burn Burns are often deep
Sources – power lights, lightening, defective or electrical equipment, unprotected outlets
Burns are often deep
Never go near the person until you are sure the person is no longer in touch with the source.

39. Thermal Burns
Critical Burns- requires medical attention. Potentially life threatening, disfiguring and disabling.
Always call 911 if the person…
Has trouble breathing
Has burns covering more than one body part or large area.
Has suspected airway burns.
Burns to the mouth or nose.

40. Burns to the skin and eyes
Flush the burn with large amounts of cool running water until ambulance arrives
Take cloths off with chemicals on them
1 eye – flush they affected eye from the nose outward to prevent washing the chemicals into the good eye.
Check breathing – pulse if victim is unconscious
Cover with dry sterile dressing and do not cool

41. Sun Burn Ways to avoid sun burn Treatment
Avoid exposure between 10 am and 2 pm
Wear proper clothing
Protect skin and eyes
Treatment
Cool the burn
Use products to put on mild burns

42. Caring for this burn Check scene for safety
Stop the burning by removing the person from source of burn.
Check for life threatening conditions
Cool the burns with large amounts of cold water
Cover the burn loosely.
Prevent infection
Take steps to minimize shock
Comfort

43. DO NOT Apply ice or ice water
Touch burn with anything but a clean covering
Remove pieces of clothing that stick to the burn area
Try to clean a severe burn
Break blisters
Use any kind of ointment

44. Special Situations
Severed body part- call 911. Try to find body part and wrap it in sterile gauze or any clean material. Put in a plastic bag and keep cool in a plastic bag. BE SURE BODY PART IS TAKEN TO THE HOSPITAL.
Embedded Object- DO NOT REMOVE place dressing around object and go to the emergency room. If it is only a splinter remove with tweezers.