1. Soft Tissue Injury

2. Soft Tissues Injuries  They include skin, fatty tissue, muscles, blood vessels, fibrous tissues, membranes, glands and nerves.  The most obvious soft tissue injuries involves the skin  It is divided into: Closed wounds Open wounds

3. Closed Wounds  It is an internal injury with no open pathway from the outside to the injured site.  It results from blunt injuries.  It includes: Contusion: Hematoma Crush injuries

4. Contusion  Bruise  Disruption of small blood vessels and extravasation of blood into the skin and/or mucous membranes that does not interrupt the skin integrity  S & S: pain, swelling and discoloration at wound site.  It may be an indication of internal injuries and related internal bleeding.

5. Hematoma  Swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel.

6. Crush Injury  It is an injury caused when force is transmitted from the body’s exterior to its internal structures.  Bones can be broken; muscles, nerves and tissues damaged and internal organs ruptured causing internal bleeding.

7. Care of patients with closed wound  ABC  Consider presence of internal bleeding, care for shock.  Splint painful, swollen and deformed extremities.  Be alert for possible vomiting  Monitor for shock  Transport as soon as possible

8. Open Wounds  It is an injury in which the skin is interrupted, exposing the tissue beneath.  The interruption can come outside as laceration or from inside caused by fractured bones  Types: Abrasions Lacerations Punctures Avulsions Amputations Crush injuries

9. Abrasions  A scratch or scrape  An epidermal and dermal injury caused by a friction, rubbing, or scraping motion  S & S: no bleeding but mild oozing, pain

10. Lacerations  A cut  Open wound from external forces causing a tearing or splitting of the skin, involving the dermis, epidermis, or underlying structures

11. Puncture Wound  An open wound that tears through the skin and destroys underlying tissues.  Can be shallow or deep  Perforated wound has both an entrance and exit wound.  Puncture wounds bleed minimally and tend to trap foreign material that can lead to infection.  Animal and human bites can be considered puncture wounds and should be treated as contaminated wounds.

12. Avulsion  Tearing away or tearing off of a piece or flap of skin or other soft tissue.  A full thickness skin loss or resultant flap in which the wound edges cannot be approximated  Also used for eye pulled form its socket or dislodged teeth.  Deploring: A serious type of avulsion injury resulting from high-energy shearing forces that tear large areas of skin and subcutaneous tissue away from the underlying vascular supply

13. Amputations  The surgical removal or traumatic severing of a body part usually an extremity.  Complete amputations will have less active bleeding than partial amputations because of retraction and constriction of the severed arteries.

14. Crush Injury

15. Care of patients with open wounds  Expose the wound  Clean wound surface (large pieces)  Control bleeding  Care for shock  Prevent further contamination  Bandage dressing in place after bleeding control  Keep patient lying still  Reassure the patient