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Questions and Answers
What is the primary function of the skin?
What is the primary function of the skin?
Which layer of the skin contains blood vessels and nerve endings?
Which layer of the skin contains blood vessels and nerve endings?
What distinguishes closed injuries from open injuries?
What distinguishes closed injuries from open injuries?
Which statement about contusions is accurate?
Which statement about contusions is accurate?
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How does the skin transmit sensations such as heat and pain?
How does the skin transmit sensations such as heat and pain?
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What might a bruise over a vital organ indicate?
What might a bruise over a vital organ indicate?
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What is a key characteristic of the epidermis?
What is a key characteristic of the epidermis?
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Which of the following is considered a soft tissue injury?
Which of the following is considered a soft tissue injury?
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What characterizes a hematoma compared to a contusion?
What characterizes a hematoma compared to a contusion?
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Which type of injury is characterized by a crushing force applied to the body?
Which type of injury is characterized by a crushing force applied to the body?
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What is a common outcome of an avulsion injury?
What is a common outcome of an avulsion injury?
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What type of open wound is characterized by a break in skin depth that can be linear or stellate?
What type of open wound is characterized by a break in skin depth that can be linear or stellate?
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Which injury type may occur due to a sharp, pointed object and might not show external bleeding?
Which injury type may occur due to a sharp, pointed object and might not show external bleeding?
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In the event of a soft tissue injury, which action is NOT a recommended treatment?
In the event of a soft tissue injury, which action is NOT a recommended treatment?
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What is the main purpose of a universal dressing in emergency care for soft-tissue injuries?
What is the main purpose of a universal dressing in emergency care for soft-tissue injuries?
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What method is generally not used for managing severe bleeding in soft-tissue injuries?
What method is generally not used for managing severe bleeding in soft-tissue injuries?
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What might indicate a severe internal injury during a crush injury?
What might indicate a severe internal injury during a crush injury?
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Which type of bandage is specifically designed to hold dressings in place?
Which type of bandage is specifically designed to hold dressings in place?
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What should be done if an object is impaled in a chest wound?
What should be done if an object is impaled in a chest wound?
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How should an eviscerated abdominal injury be treated?
How should an eviscerated abdominal injury be treated?
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What is the appropriate action for a patient with a large open neck injury?
What is the appropriate action for a patient with a large open neck injury?
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What should you do if a dressing becomes saturated with blood?
What should you do if a dressing becomes saturated with blood?
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When dealing with amputated parts, what is a critical step to ensure proper transport?
When dealing with amputated parts, what is a critical step to ensure proper transport?
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What is not an appropriate action when treating a penetrating injury?
What is not an appropriate action when treating a penetrating injury?
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Which statement about handling soft tissue injuries is true?
Which statement about handling soft tissue injuries is true?
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In which scenario is it acceptable to remove an impaled object?
In which scenario is it acceptable to remove an impaled object?
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What is typically the first step when addressing a soft tissue injury?
What is typically the first step when addressing a soft tissue injury?
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What is a key factor to assess after bandaging a wound?
What is a key factor to assess after bandaging a wound?
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What is the first step to take when treating a chemical burn?
What is the first step to take when treating a chemical burn?
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Which type of burn involves both the epidermis and the dermis but does not damage underlying tissues?
Which type of burn involves both the epidermis and the dermis but does not damage underlying tissues?
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What is the purpose of the 'Rule of Nines' in burn assessment?
What is the purpose of the 'Rule of Nines' in burn assessment?
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Which of the following indicates a critical burn?
Which of the following indicates a critical burn?
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What should you NOT do when treating a burn?
What should you NOT do when treating a burn?
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Which burn classification involves skin that appears dry, leathery, and may be charred?
Which burn classification involves skin that appears dry, leathery, and may be charred?
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In treating an eye injury caused by a chemical, how long should you flush the eye?
In treating an eye injury caused by a chemical, how long should you flush the eye?
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What is a common risk associated with burns in infants and children?
What is a common risk associated with burns in infants and children?
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Which of these wounds to the mouth requires urgent attention due to airway obstruction risk?
Which of these wounds to the mouth requires urgent attention due to airway obstruction risk?
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What should be done first after a burn injury?
What should be done first after a burn injury?
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When dealing with electrical burns, what is a primary concern?
When dealing with electrical burns, what is a primary concern?
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Which statement regarding the assessment of burn severity is correct?
Which statement regarding the assessment of burn severity is correct?
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Why is it important not to apply ointments on burns?
Why is it important not to apply ointments on burns?
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What classification represents minor burns in adults?
What classification represents minor burns in adults?
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Study Notes
Bomb Blast Patient Assessment
- A patient is brought in after a bombing.
- The patient's injuries are severe, showing extensive wounds and visible trauma.
- Initial treatment should focus on the immediate needs of the patient, prioritizing safety and life support, like checking the ABCs (airway, breathing, and circulation)
Soft Tissue Injuries
- Skin is the largest organ in the body.
- Protection from the environment and harmful organisms, like bacteria
- Regulates body temperature
- Senses heat, cold, touch, pressure, and pain and transmits this to the brain and spinal cord
- Skin has layers: epidermis, dermis, and subcutaneous.
Skin Layers
- Epidermis: Outermost layer, made up of dead cells, not sensitive to pain or bleeding
- Dermis: Deeper skin layer, contains sweat glands, hair follicles, blood vessels, and nerve endings, more sensitive
- Subcutaneous: Layer below the dermis, more sensitive to bleeding and pain
Injuries to the Skin
- Soft tissue injuries often appear worse than they are
- Injuries can be closed or open.
Closed Injuries
- Contusion (Bruise): Skin remains intact; damage to cells and blood vessels in the dermis; swelling, pain, and discoloration are typical
- Hematoma: Collection of blood beneath the skin; more tissue damage compared to contusion. May result in loss of liters of blood
- Crush injuries: Crushing force on the body; can rupture internal organs; can cause internal bleeding and shock
Open Injuries
- Abrasion: Damages the outermost layer of skin; painful, superficial injury; slight bleeding
- Laceration: Break in the skin of varying depth; can be linear or stellate; can occur along with other soft tissue injuries; caused by forceful impact; potentially severe bleeding
- Avulsion: Flaps of skin or tissue torn loose
- Penetration/puncture: Caused by sharp or pointed objects; may not have much external bleeding but severe internal bleeding is possible; exit wounds might be present. Includes gunshot wounds and stab wounds
- Amputation: Involves the extremities or other body parts; potential for massive bleeding or limited bleeding
Open Crush Injuries
- Damage to soft tissue and internal organs
- Painful, swollen, deformed extremities
- External bleeding may be minimal or absent; internal bleeding may be severe
Emergency Medical Care for Soft Tissue Injuries
- Body substance isolation
- Ensure a clear airway with artificial ventilation
- Treat for shock (hypoperfusion)
- Manage bleeding
- Expose the wound, control bleeding
- Prevent contamination
- Apply dry sterile dressing; secure in place
- Keep the patient calm and quiet
- Splint painful, swollen, and deformed extremities.
Dressings and Bandages
- Types of dressings include universal dressings, 4x4-inch gauze pads, adhesive dressings, and occlusive dressings
- Dressings and bandages help stop bleeding, protect the wound, prevent further contamination and infection
Specific Areas
- Forehead
- Shoulder
- Hip
- Hand
- Joint
Injuries Requiring Special Considerations
- Chest Injuries: Occlusive dressing for open wounds; administer oxygen if needed
- Abdominal Injuries: Evisceration (organs protruding through the wound) must be managed carefully. Do not replace protruding organs; cover with clean, moist dressing; secure in place. Flex the patient's hips and knees if possible.
- Impaled Objects: Do not remove unless through the cheek; removal could interfere with chest compressions or transport; manually secure the object, expose the wound area, control bleeding, stabilize with a bulky dressing.
- Amputations: Wrap the amputated part in a sterile dressing; wrap loosely in plastic and keep cool; transport with the patient. Do not try to reattach partial amputations but immobilize to prevent further damage
Large Open Neck Injury
- May cause air embolism
- Cover with an occlusive dressing
- Compress carotid artery carefully to stop bleeding.
Chemical Burns
- Remove dry powders
- Immediately flush with copious water
- Continue flushing the contaminated area en route to hospital
- Avoid contamination of uninjured areas
Electrical Burns
- Scene safety: do not touch the patient if there is any chance they are still in contact with the electrical source, unless trained to do so.
- Administer oxygen, closely monitor breathing and heart rate.
- Treat the soft tissue injuries, look for entrance and exit wounds.
Infant and Child Considerations
- Relative size: larger surface area; greater risk of fluid and heat loss
- Critical burns: burns greater than 20% of BSA
- Moderate burns: burns of 10-20% of the BSA
- Minor burns: Partial-thickness burn less than 10% of the BSA
Burns Severity
- Depth of burn
- Location (face, hands, feet, genitalia, upper airway)
- Pre-existing medical conditions
- Age (younger than 5, older than 55)
- Percentage of body surface area (BSA)
Moderate Burns
- Full-thickness: 2% to 10% of the body surface area (BSA)
- Partial thickness: 15% to 30% of the BSA
- Superficial: Greater than 50% of the BSA
Minor Burns
- Full-thickness: less than 2% of the BSA
- Partial-thickness: less than 15% of the BSA
Higher Risk
- Shock (hypoperfusion), airway problem, or hypothermia
- Child abuse - must be considered a possibility
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Description
This quiz focuses on the assessment and management of patients with severe soft tissue injuries, such as those sustained in bomb blasts. It covers the anatomy of skin layers, patient safety priorities, and initial treatment protocols for trauma cases. Test your knowledge on how to effectively handle such critical situations.
