WOUNDS
INTRODUCTION
Optimal patient care requires that the
EMT-I and EMT-P understand the signs/symptoms and field treatment of
wounds. The following topics will be
discussed during this lesson:
Types
of wounds
Management
of wounds
·
Transport
decisions
LEARNING
OBJECTIVES
At the end of this lesson the
participants will be able to:
1. Name six types of soft tissue wounds.
2. Verbalize the field management of each
of the six types of soft tissue wounds.
3. Discuss the care of an amputated part.
4. Differentiate between arterial and
venous bleeding.
5. Discuss
the use of tourniquets and understand the risks and consequences of their use.
6. Describe
the field management of mouth, neck, facial, and eye injuries.
7. Describe
the field management of impaled objects.
8. Discuss
transport decisions for patients with wounds.
SKILLS
Impaled
object stabilization
Bleeding control tourniquet
Bandaging
KEY
VOCABULARY
The following terms will be used during
this lesson:
Contusion
- tissue damage leading to capillary bleeding (bruise)
Hematoma
- tissue damage beneath outer layer of skin in which blood vessels are torn
Abrasion
- damage to epidermis and portion of dermis as a result of scrapping across a
rough or hard surface
Puncture
- stab wound or hole in skin
Laceration
- a tear of the skin having either sharply defined or jagged edges.
Avulsion
- a tearing away of a body tissue or structure; may range from a simple flap to amputation.
KEY
CONCEPTS
The following section provides
information and space for taking notes on the key concepts discussed by the
instructor:
Treatment for soft tissue injuries
|
Contusion elevation and cold pack Hematoma elevation and cold pack Abrasion cleanse area, sterile dressing Puncture cleanse wound, sterile dressing Laceration cleanse area, sterile dressing, pressure prn Avulsion cleanse area, sterile dressing, pressure prn. If avulsed part is amputated, rinse with
saline, wrap in sterile saline dressing, place in plastic bag and then into
ice water. NEVER place
an amputated part directly in water or saline or directly on ice. |
Arterial vs. Venous Bleeding
|
Arterial
bleeding bright
red in color and may "spurt" in relationship to pulse Venous bleeding dark red in color and occurs at
steady rate |
Tourniquet Risk
|
Improper
use of a tourniquet can cause injury to soft tissue as well as significant
impairment of perfusion and lead to loss of a limb. |
FIELD
MANAGEMENT OF SPECIFIC WOUNDS
Mouth Wounds
|
Field
management ·
BLS
procedures ·
Airway
patency ·
Spinal
immobilization if indicated ·
Remove
loose or broken dentures ·
Apply
pressure to inside and outside of cheek to control bleeding ·
Remove
impaled object in cheek if necessary to manage the airway or control bleeding ·
Assist
with ALS procedures as indicated ·
ALS
procedures ·
Advanced
airway prn ·
Venous
access prn ·
Monitor
prn |
Bleeding Neck Wounds
|
Field management ·
BLS
procedures ·
Airway
patency ·
Manual
pressure ·
Occlusive
dressing ·
Assist
with ALS procedures ·
ALS
procedures ·
Advanced
airway prn ·
Venous
access (large bore) ·
Monitor
prn ·
Transport |
Impaled Objects
|
Field management ·
Stabilize with bulky dressings ·
Do not attempt to remove an
impaled object unless absolutely required to maintain airway (cheek) or
perform CPR (back or chest) |
Eye Injuries
|
Field
management ·
Cover
affected eye with loose dressing ·
Position
of comfort ·
Reassure
patient |
Face and Scalp Injuries
|
Field
management ·
BLS
procedures ·
Spinal
immobilization if indicated ·
Airway
patency ·
Control
external bleeding ·
Apply
loose, absorbent dressing ·
Watch for
halo sign (CSF leak) ·
Monitor
level of consciousness ·
Assist
with ALS procedures ·
Transport
if indicated ·
ALS
procedures ·
Advanced
airway prn ·
Venous access
prn ·
Monitor
prn ·
Transport
if indicated |