PCPA 1100 Integumentary Pathophysiology - Burns, Lacerations, Skin Conditions

Learning Outcome 3 PCPA 1100 Essential Life Sciences Integumentary Pathophysiology Let’s Review! https://youtu.be/Orumw-PyNjw?si=8yiJO1P7nSJtgV41 Objectives Traumatic Injuries Burns Lacerations Avulsions Abrasions Objectives Cont'd Infectious/Inflammatory Allergy/Uticaria I...

Learning Outcome 3 PCPA 1100 Essential Life Sciences Integumentary Pathophysiology Let’s Review! https://youtu.be/Orumw-PyNjw?si=8yiJO1P7nSJtgV41 Objectives Traumatic Injuries Burns Lacerations Avulsions Abrasions Objectives Cont'd Infectious/Inflammatory Allergy/Uticaria Infections Infestations Skin Conditions  Different Types/Sources of Burns Thermal: can be caused by fire of other sources of heat injury and occurs when the skin is exposed to temperatures of higher than 44 degrees C. -depends on concentration, amount of heat energy possessed by the object or substance and duration of exposure. Chemical: can occur when the skin comes into contact with strong acids, alkalis or bases, or other corrosive materials Electrical: caused by a power source and can cause a number of burn types, the most common being contact burn. Radiation: three types of ionizing radiation: alpha, beta & gamma Burns First, Second, and third degree What layer is affected? Is there pain and why? How does it present? How long does it take to heals ? First Degree Burns First Degree Burns Also known as superficial burns Involves only the outer layers of the epidermis Present as pink, dry and painful The skin is still able to maintain its ability to function as a water vapor and bacterial barrier. Usually heals in 3-10 days Second Degree Burns Second Degree Burns Also known as partial thickness burns Involve the epidermis and various degrees of the dermis Present as painful, moist, red and blistered Underneath the blisters is pink of red skin sensitive to temperature changes, air exposure and touch. Heal in approx. 1-2 weeks Third Degree Burns Third Degree Burns Also known as full thickness burns Can extend into the subcutaneous tissue and may involve muscle or bone Presentation may vary in color to waxy white or yellow to tan, brown, deep red and black Burns appear hard, dry and leathery The nerve sensors have been destroyed in 3rd degree burns so no pain in this area but almost always surrounded by 2nd degree burns that are painful Healing time varies and can take weeks/months Combinations are Common... Rule of Nines Lacerations Cut inflicted by a sharp instrument –Clean or jagged incision through skin surface and underlying structure Laceration usually term for jagged Incision usually term for clean –Severity depends on depth and damaged structures –First priority: control bleeding Apply direct manual pressure over wound Avulsions A flap of skin torn loose (partially or completely) –May be accompanied by profuse bleeding –Principal danger is loss of blood supply to the avulsed flap. –Irrigate with normal saline and place into anatomic position. Abrasions Superficial wound –Occurs when skin is rubbed or scraped –Typically ooze small amounts of blood –May be painful –May be contaminated –Don’t try to clean in the prehospital environment. Allergy/Uticaria Is a response to allergic reaction or anaphylaxis Multiple small raised areas on the skin Can be itchy Also known as "Hives" Infections/Infestations Lice Cellulitis Impetigo Lice Small insects that live in hair and feed on blood through the skin Three types -Head louse (Pediculus humanus capitis –Body louse (P humanus corporis) –Pubic louse (Phthirus pubis) All types of lice are acquired through direct contact with a person with an infestation. Head and body lice can be acquired from objects such as hats, combs, or clothes infested with lice. Pubic or crab lice transmitted through intimate physical or sexual contact. Communicable period ends when all lice and eggs are destroyed. Cellulitis Deeper bacterial infection affecting the dermis and subcutaneous tissues. Usually caused by group A strep, but can also be specific to certain activities such as fish handling, swimming in fresh water/salt water, or animal bites or scratches. Pre-existing wounds are often portals of entry. Expanding red, swollen, tender plaque with an indefinite border. Often accompanied by fever, erythema, heat, edema, and pain. Impetigo Common, superficial bacterial infection caused by group A strep Most common in infants and young children, rare in adults Appears as a small vesicle/pustule (can be itchy & painful) on the face or elsewhere on the body. As the lesion ruptures, it leaves an area that discharges a honey-colored crust. Highly infectious Types of Skin Cancer basal cell carcinoma squamous cell carcinoma malignant melanoma – ** most serious – early metastases is common ABCD Rules to Recognition of Melanoma A.Asymmetry B.Border C.Color varies within lesion D.Diameter > 6 mm Abnormal Skin Conditions Cyanosis: blue colour due to lack of oxygen in hemoglobin due to respiratory / cardiac problems Erythema: redness due to increased blood supply due to exercise, fever, hemorrhage under skin, inflammation Abnormal Skin Conditions Cont'd Pallor: paleness, blanching, due to decreased blood supply or hemoglobin (e.g. anemia) Jaundice: yellowish tones to skin and eyes due to increased bilirubin in the blood due to liver disease, obstructed bile duct i.e. bile not being removed from the body References Norris, T. (2019). Porth’s Pathophysiology. (Tenth Edition). Wolters Kluwer Health. Caroline, Nancy. (2021). Emergency Care in the Streets. (Canadian 8th Edition). Jones & Bartlett Learning.