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Name and describe the two layers of skin
- 1. epidermis-outer layer protects from sun, water loss, and infection
- 2. dermis-inner layer-contains hair follicles, sweat glands, nerves and blood vessels
Describe subcutaneous tissue
lies beneath skin (dermis) and consists of fat an connective tissue
Compare closed and open wounds
Closed wounds like contusions, eccymoses or hematoma are caused by blunt trauma. Open wounds like lacerations, abrasions, avulsions, amputations, punctures or penetrations can be caused by blunt trauma or penetrating trauma
bruise. leakage of blood and swelling under the skin.
Black and blue marks caused by bleeding beneath or within the layers of the skin.
Describe care of an extruded eyeball
cover with a moist dressing and a cup and bandage. Cover the good eye too.
Name 3 causes of burns
thermal, electrical, or chemical
General burn management includes:
- 1. Stopping the burning process
- 2. removing pt. from burning environment
- 3. Supplemental O2 (non rebreather)
- 4. Treat for shock
- 5. transport to appropriate facility
3 major catagories of burn injuries:
- 1. Superficial (first degree). painful, reddened dry skin that is warm to touch (ie. sunburn)
- 2. Partial thickness (second degree). Very painful. pink, red, blotchy (deeper 2nd degree can be pale) and a wet weepy surface with edema and blisters.
- 3. Full thickness (3rd degree) Not painful. deep-red, black or brown appearance, edema, and may have no sensation to touch. Areas around can be 2nd degree and painful.
Describe rule of 9s.
- Evaluation of burns.
- 1. Head and Neck 9%
- 2. each upper extremity 9%
- 3. Anterior/Posterior Trunk-each is 18%
- 4. Each lower extremity-9 %
- 5. genitals-1%
Describe how children and infants rule of 9s differ
Lower extremities are 14% each (instead of 18) and head is 18% (instead of 9)
High Priority Burns:
- 1. Full thickness involving hands, feet, face or genitals. or that affect more than 10% of BSA
- 2. Burns associated with respiratory injury
- 3. Partial thickness affecting more than 30% BSA
- 4. Burns complicated with by an extremity injury like a fracture
- 5. Moderate burns in children or elderly
- 6. Circumferential burns to arm, leg or chest.
Medium Priority Burns:
- 1. Full thickness burns affecting 2-10% of BSA excluding hands, feet, face, genitals or upper airway.
- 2. Partial thickness burns affecting 15-30% of BSA
- 3. Superficial burns affecting more than 50% of BSA
Low priority burns
- 1. Full thickness burns affecting less than 2% of BSA
- 2. Partial thickness burns affecting less than 15% of BSA
- 3. Superficial burns affecting less than 50% of BSA
Describe care of chemical burns.
- Proper BSI
- Brush off powders prior to flushing skin.
- Irrigate for at least 20-30 minutes before transport to hospital
Describe care of electrical burns.
- 1. Have an entry and an exit wound.
- 2. May be more extensive that it looks on outside.
- 3. May cause fractures or lead to respiratory or cardiac arrest.
collection of blood beneath the skin.
What is an air embolism?
A bubble of air that enters the circulatory system. Common with neck injuries. Can cause obstruction of blood flow to the heart or lungs.
Treatment for a bleeding neck injury
Cover with occlusive dressing or gloved hand. Transport in supine or head down position
Steps in bleeding control
- 1. direct pressure
- 2. elevation
- 3. use of pressure points
- 4. tourniquet if necessary