Continues with the information taught in Bleeding and Shock, discussing the anatomy
of the skin and the management of soft tissue injuries and the management of burns.
Techniques of dressing and bandaging wounds will also be taught in this lesson. Lesson meets or exceeds USDOT NHTSA EMT/EMR 2009 training requirements. Presentation is over 100 slides in length. Recommended classroom time is 3 hours & 2 hours lab time.
2. FUNCTION OF THE SKIN
The skin provides
Protection from the environment
Extreme temperature
Pathogens (Bacteria, viruses)
Blunt trauma
Helps regulate temperature
Feeling of sense
Helps maintain body fluid balance
3. CLOSED SOFT TISSURE INJURY
Injury injury with no pathway from outside the
injured area
Types of injury
Signs and Symptoms
Assessment
Management
4. Outermost layer of
skin is scraped off
Painful
Superficial
No bleeding or small amount of blood oozes
from wound
ABRASION
6. IMPALED OBJECT
Object that creates the puncture wound
remains embedded
Leave in place unless it is in the cheek with
uncontrolled bleeding
Apply pressure around the object and secure in
place
Avoid movement
8. BLAST INJURY/HIGH PRESSURE
Often seen in WMD attacks
Be careful of secondary explosions
These injuries are compounded when the
explosion occurs in a confined space
11. HEMATOMA
Collection of blood
beneath the skin
Larger amount of
tissue damage as
compared to
contusion
Larger vessels are
damaged
May lose one or more
liters of blood
13. GENERAL ASSESSMENT
Safety of Environment / Standard Precautions
Airway Patency
Respiratory Distress
Concepts of Open Wound Dressings/Bandaging
Hemorrhage Control
Associated Injuries
14. CONCEPTS OF OPEN WOUND
DRESSING/BANDAGING
Sterile
Non-sterile
Occlusive
Non-occlusive
Wet
Dry
Tourniquet
Complications of dressings/bandages
15. DRESSING & BANDAGING
Used to
Stop bleeding
Protect the wound from further
damage
Prevent further contamination and
infection
Dressing
Bandage
18. MANAGEMENT
Appropriate PPE
Airway management
Expose the wound
Control hemorrhage
Dress/bandage open wounds with dry sterile
dressing
Prevention of shock
Prevent infection
Transport to the appropriate facility
24. RULE OF ONES
The patient's palm can serve a reference point
roughly equivalent to 1% of the body surface
area
25. DEPTH
Full thickness extends through all layers of the
skin
White, yellow, tan, brown or charred
appearance
Leathery feel
No pain in those areas
Usually there is pain in surrounding
areas with other depth of burns
26. RESPIRATORY BURNS
Facial burns are an
indication of respiratory
burns
Patient may have burns
to airway & lungs
Respiratory burns have
double the mortality
rate
27. PART OF BODY BURNED
Severity should be increased with certain body
parts including
Fingers
Face
Genitals
Feet
28. INFANTS & CHILDREN
Greater surface area in relationship to the
total body size
Results in greater fluid and heat loss
Any full thickness burn or partial thickness
burn greater than 20%, or burn
involving the hands, feet, face , airway
or genitalia is considered to be a critical
burn in a child
30. THERMAL
Complete general management
May be associated with an inhalation injury
Large burns may cause hypovolemia and
hypothermia
Cool small burns or those remaining hot (patient
who has just been rescued from fire)
Dry dressing help prevent infection and provide
comfort
Time in contact with heat increases damage
31. COMPLICATIONS ARE RELATED TO
TOXIC CHEMICALS WITHIN INHALED
AIR
Carbon monoxide
Cyanide
Other toxic gasses
32. INHALATION
Edema of mucosa of airway can be rapid
Consider ALS backup if signs and symptoms of
edema are present, such as:
Hoarseness
Singed nasal or facial hair
Burns of face
Carbon in sputum
Burns in enclosed spaces without ventilation cause
inhalation injuries
33. ELECTRICAL
Scene safety - never touch a patient in contact
with an electric source
Often internal damage more severe than
external injuries appear
Sometimes electric current crosses the chest
and causes cardiac arrest or arrhythmias
Patient may be in cardiac arrest when EMT
arrives (probably V-fib or asystole)
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Editor's Notes
Bruise Harm Score
Harm score Severity level Notes
0 Light bruise No damage
1 Light bruise Little damage
2 Moderate bruise Some damage
3 Serious bruise Dangerous
4 Extremely serious bruise Dangerous
5 Critical bruise Risk of death