Class 8 (Skin A&P, Soft Tissue Injuries & Vitals & S.A.M.P.L.E.) Ch 4 (Partial), Ch24 & Ch 5The Skin (1 of 2)The Skin (2 of 2)Functions of Dressing and BandagingDressings and BandagesSoft-Tissue InjuriesContusionHematomaCrushing InjuryMechanism of InjuryInterventionsRICESTransport DecisionOpen Soft Tissue InjuryAbrasionsLacerationAvulsionPenetrating WoundGunshot WoundsCrushing Open WoundSlide 21Emergency Medical Care (1 of 3)Emergency Medical Care (2 of 3)Emergency Medical Care (3 of 3)Abdominal WoundsAbdominal Wound ManagementImpaled Objects (1 of 2)Impaled Objects (2 of 2)AmputationsNeck Injuries (1 of 2)Neck Injuries (2 of 2)Slide 32BurnsDetermining Burn SeverityDepth of BurnsExtent of BurnsCritical Burns (1 of 2)Critical Burns (2 of 2)Moderate BurnsMinor BurnsCritical Burns in Infants and ChildrenModerate Burns in Infants and ChildrenMinor Burns in Infants and ChildrenPediatric NeedsEmergency Care for Burns (1 of 3)Emergency Care for Burns (2 of 3)Emergency Care for Burns (3 of 3)Chemical BurnsCare for Chemical Burns (1 of 2)Care for Chemical Burns (2 of 2)Chemical Burn to the EyeElectrical BurnsSmall Animal BitesRabiesHuman BitesSlide 56Baseline Vital Signs and SAMPLE HistoryGathering Key Patient InformationChief ComplaintObtaining a SAMPLE History (1 of 2)Obtaining a SAMPLE History (2 of 2)OPQRST (1 of 2)OPQRST (2 of 2)Baseline Vital Signs (1 of 3)Baseline Vital Signs (2 of 3)Baseline Vital Signs (3 of 3)RespirationsRespiratory RatesPulse OximetryPulse (1 of 3)Pulse (2 of 3)Pulse (3 of 3)Normal Ranges for Pulse RateDrill TimeThe SkinCapillary RefillBlood PressureMeasuring Blood PressureBlood Pressure EquipmentPalpation of Blood PressureAuscultation of Blood Pressure (1 of 2)Auscultation of Blood Pressure (2 of 2)Normal Ranges of Blood PressureLevel of ConsciousnessPupil AssessmentAbnormal Pupil ReactionsPupillary ReactionsReassessment of Vital SignsClass 8 (Skin A&P, Soft Tissue Injuries & Vitals & S.A.M.P.L.E.)Ch 4 (Partial), Ch24 & Ch 5The Skin (1 of 2)The Skin (2 of 2)•Protects the body from the environment•Regulates body temperature•Transmits information from environment to the brainFunctions of Dressingand Bandaging•Control bleeding.•Protect wound.•Prevent contamination.Dressings and Bandages•Sterile dressings–Used to cover wounds•Bandaging–Used to keep dressing in placeSoft-Tissue Injuries•Closed injuries–Soft-tissue damage beneath the skin•Open injuries–Break in the surface of the skin•Burns–Soft tissue receives more energy than it can absorbContusion•Results from blunt force striking the bodyHematoma•Pool of blood that has collected in the bodyCrushing Injury•Occurs when a great amount of force is applied to the bodyMechanism of Injury•Underlying organ damage•Hidden injury•Shock from internal bleedingInterventions•Provide complete spinal immobilization early if spinal injuries are suspected.•Provide high-flow oxygen.•Treat aggressively for shock.•Request ALS if necessary.•Do not delay transport.RICES•Rest—keep patient quiet and comfortable as possible.•Ice slows bleeding.•Compression over an injury slows bleeding.•Elevation above the level of the heart reduces swelling.•Splinting decreases bleeding and reduces pain.Transport Decision•If patient has signs of shock or airway or breathing problem, consider quickly transporting or requesting ALS.•Do not delay transport of closed-injury patient who may have more serious deeper injury.Open Soft Tissue Injury•Protective skin is damaged and open•Contaminated•Possible heavy bleeding•4 Types–Abrasion–Laceration–Avulsion–PenetratingAbrasions•Caused by frictionLaceration•Jagged cutAvulsion•Separation of various layers of the skinPenetrating Wound•Results from a sharp pointed objectGunshot Wounds•Gunshot wounds have unique characteristicsCrushing Open Wound•May involve damaged internal organs or broken bonesInterventions•Control bleeding.•If bleeding is not significant, control later in assessment.•Stabilize spine and assist breathing.•Splint painful, swollen, deformed extremities.Emergency Medical Care (1 of 3)•Use proper BSI precautions.•Administer oxygen if needed.•Treatment priority is ABCs—including controlling bleeding.Emergency Medical Care (2 of 3)•Apply dry, sterile dressing over entire wound.•Maintain pressure and secure dressing with a roller bandage.Emergency Medical Care (3 of 3)•Leave original dressing in place if bleeding continues.•Apply a second dressing on top of first and secure.•Splint the extremity.Abdominal Wounds•Open wound in abdomen may expose organs.•Organ protruding through abdomen is called an evisceration.Abdominal Wound Management•Do not touch exposed organs.•Cover organs with a moist sterile dressing.•Transport immediately.Impaled Objects (1 of 2) •Do not attempt to move or remove object.Impaled Objects (2 of 2)•Control bleeding and stabilize object.•Tape a rigid item over object to prevent movement.•Transport to hospital carefully.Amputations•Immobilize partial amputation with bulky dressings and splint.•Wrap complete amputation in dry sterile dressing and place in plastic bag.•Put bag in cool container filled with ice. Do not let object freeze!•Transport severed part with patient.Neck Injuries (1 of 2)•An open neck injury can be life threatening.•Air can get into the veins and cause an air embolism.Neck Injuries (2 of 2)•Cover the wound with an occlusive dressing.•Apply manual pressure.•Secure a pressure dressing loosely over the neck and firmly through the opposite axilla.Transport Decision•Consider quick transport if patient has airway or breathing problem or significant bleeding.•Stay focused on problems at hand.•Patients with significant bleeding or internal bleeding may quickly become unstable.•Watch for signs of shock.Burns•Burns account for over 10,000 deaths/year.•Burns are the most serious and painful injuries.•Remember to perform a complete assessment on burn patients for other injuries.Determining Burn Severity•What is the depth of the burn?•What is the extent of the burn?•Are any critical areas involved?•Are there any preexisting medical conditions or other injuries?•Is the patient younger than 5 years or older than 55 years of age?Depth of BurnsExtent of BurnsCritical Burns (1 of 2)•Full-thickness burns involving hands, feet, face, upper airway, genitalia, or circumferential burns of other