Transcript PPT 8 Core
McFatter Technical Center Emergency Medical Technician - Basic Health Science Core Chapter 18 Trauma Incidents McFatter Technical Center, Broward County Public Schools Revised: August 2007 Different Trauma Incidents • Burns • Musculoskeletal injury – Fractures – Dislocation – Sprains/Strains • Nosebleeds • Soft Tissue Injuries • Hypovolemic shock McFatter Technical Center, Broward County Public Schools Revised: August 2007 Burns McFatter Technical Center, Broward County Public Schools Revised: August 2007 Burns • Burn occurs when the body or body part receives more radiant energy than it can absorb without injury • Three classifications of burns: – 1st degree or superficial burns – 2nd degree or partial thickness burns – 3rd degree or full thickness burns McFatter Technical Center, Broward County Public Schools Revised: August 2007 1st degree or Superficial burns • Involves only the top layer of the skin • Skin turns red but does not blister McFatter Technical Center, Broward County Public Schools Revised: August 2007 2nd degree or partial thickness burns • Involves the epidermis and some portion of the dermis • Skin is moist, mottled, and white to red • Blisters common • Intense pain McFatter Technical Center, Broward County Public Schools Revised: August 2007 3rd degree or full thickness burns • Extends through all the skin layers and involves subcutaneous layer, muscle, bone or internal organs • Skin dry and leathery • Skin color white, dark brown, or charred • No pain at area of burn, but pain around area McFatter Technical Center, Broward County Public Schools Revised: August 2007 Burns Assessment • Scene size-up: – Observe for hazards or threats to safety of crews – “Scene Safety” • Initial Assessment: – Evaluate areas affected by the burn and determine amount of area – Hoarse voice or singed nostril/facial hair could mean burns to the airway McFatter Technical Center, Broward County Public Schools Revised: August 2007 Burns Body Surface Area Rule of Nines • Dividing the body into sections • Each section represents 9% of total body surface area McFatter Technical Center, Broward County Public Schools Revised: August 2007 Burn Treatment • Chemical Burns – Flush continuously with large amounts of water for at least 20 minutes • Superficial burns – flush with cold water • Partial thickness burns – flush with cold water and do not open any blisters McFatter Technical Center, Broward County Public Schools Revised: August 2007 Burn Treatment • Full thickness burns – stop the burning process and cover with dry sterile dressing or Water-Jel • Remove any smoldering clothing and/or jewelry • Never use or apply ointments, lotions, or antiseptics McFatter Technical Center, Broward County Public Schools Revised: August 2007 Musculoskeletal Injury McFatter Technical Center, Broward County Public Schools Revised: August 2007 Musculoskeletal Injury Fractures – break in the continuity of a bone Open Fracture McFatter Technical Center, Broward County Public Schools Revised: August 2007 Fracture Types A comminuted fracture occurs when the bone is broken into more than two fragments. McFatter Technical Center, Broward County Public Schools A Greenstick or hairline fracture is a split in a young, immature bone Revised: August 2007 Fracture Types A spiral fracture occurs when the fracture line spirals around the shaft of the bone - a result of a pure twisting injury. McFatter Technical Center, Broward County Public Schools A transverse fracture occurs when the fracture line is transverse across the shaft of the bone (perpendicular to the long axis of the bone) usually a result of a bending injury. Revised: August 2007 Fracture Types An oblique fracture occurs when the fracture line is oblique across the shaft of the bone -usually a result of a combination bending and twisting injury. McFatter Technical Center, Broward County Public Schools Revised: August 2007 Musculoskeletal Injury Sprains – Injury to ligaments and tendons A strain is an injury to a muscle or tendon, and is often caused by overuse, force, or stretching. McFatter Technical Center, Broward County Public Schools Revised: August 2007 Fracture, Strain, and Sprains Signs and Symptoms • • • • Pain Swelling Deformity at the site Possible loss of use of the affected site • Fractures may have crepitus McFatter Technical Center, Broward County Public Schools Revised: August 2007 Fracture, Sprain, and Strain Treatment • • • • Rest – keep patient comfortable Ice – slow bleeding and reduce pain Compression – over the site Elevation – just above the level of the heart • Splinting – Joint – immobilize the bone above and below the joint – Bone – immobilize the joint above and below the bone • Check distal circulation after splinting McFatter Technical Center, Broward County Public Schools Revised: August 2007 Nosebleeds McFatter Technical Center, Broward County Public Schools Revised: August 2007 Nosebleeds • Epistaxis – medical term for nosebleed • Bleeding from trickle to hemorrhage • Spontaneous epistaxis can be caused by hypertension or medications like anticoagulants McFatter Technical Center, Broward County Public Schools Revised: August 2007 Nosebleed Treatment • Sit up and lean forward (do not lean back) • Pinch nostrils for 15 to 20 minutes • Apply ice to the nose • Apply commercial device McFatter Technical Center, Broward County Public Schools Revised: August 2007 Soft Tissue Injuries McFatter Technical Center, Broward County Public Schools Revised: August 2007 Soft Tissue Injuries Puncture Wound – penetration of a sharp object Abrasion – outer layer of skin has been scraped off McFatter Technical Center, Broward County Public Schools Incision – clean, straight, knife-like cut Revised: August 2007 Soft Tissue Injuries Contusion – seepage of blood into tissue Laceration – jagged tears McFatter Technical Center, Broward County Public Schools Avulsion – flap of skin is torn loose or pulled off completely Revised: August 2007 Soft Tissue Injuries Treatment for Open Wounds • Minor bleeding – clean wound • Control bleeding: – Direct pressure – Elevate – Pressure point • Apply sterile dressing bandage McFatter Technical Center, Broward County Public Schools Revised: August 2007 Hypovolemic shock McFatter Technical Center, Broward County Public Schools Revised: August 2007 Hypovolemic shock • Shock due to severe blood loss • Examples: – Bleeding from an incision – Wound drainage – Rectal bleeding from area in the intestines – Vomiting blood due to internal bleeding McFatter Technical Center, Broward County Public Schools Revised: August 2007 Hypovolemic shock Signs and Symptoms: • Shock due to severe blood loss. – Change in mental status – Staring of the eyes – Pale, cool, and diaphoretic – Rapid and shallow respirations – Low blood pressure (hypotension) McFatter Technical Center, Broward County Public Schools Revised: August 2007 Hypovolemic shock Treatment • Control bleeding • Elevate legs 8 – 12 inches into the trendelenburg position • Keep warm McFatter Technical Center, Broward County Public Schools Revised: August 2007 References • • Pollak, Andrew N. Emergency Care and Transportation of the Sick and Injured. 9th ed. Sudbury, Massachusetts: Jones and Bartlett, 2005. Stevens, Kay, and Garber, Debra. Introduction to Clinical Allied Healthcare. 2nd ed. Clifton Park, New York: Thomson Delmar Learning, 1996. McFatter Technical Center, Broward County Public Schools Revised: August 2007