Epidermis
External layer of skin. Forms a water tight layer
Skin color is produced by what?
Deeper cells in the germinal layer contain pigment granules. along with blood vessels in the dermis, these granules produce skin color.
Dermis
Inner layer of skin. It lies in below the germinal cells of the epidermis.
Sebaceous Glands produce ____ which is the oily material that waterproofs the skin
Sebum
Blood vessels in the skin reach no farther than ___
The epidermis
The Mouth, Anus, Nose and vagina are not covered by skin. The are covered by what?
The are lined by mucous membranes
How does mucous membranes differ from skin?
Mucous membranes secrete watery substances that lubricates the openings.
Mucous membranes are moist / skin is dry
Closed Injuries
Soft tissue damage occurs beneath the skin or mucous membrane but the surface remains intact
Open injuries
Break in the surface exposing deeper tissues to possible contamination
Burns
Soft tissue damage occurs as a result from thermal heat, frictional heat, toxic chemicals, electricity or nuclear radiation
Thermal Burns (temp)
Can occur when skin is exposed to temps higher than 111 degrees f
What causes a burn of greater degree, solids or gases?
Solids. The have a higher heat content
Contusion
Bruise that causes bleeding beneath the skin but does not break the surface
They result from blunt forces striking the body. The epidermis remains intact but the cells in the dermis are damaged and small blood vessels are torn
Ecchymosis
Black and blue discoloration caused by build up of blood beneath the layers of skin
Hematoma
Blood that has collected within damaged tissues or in a body cavity
Crushing injury
Occurs when a great amount of force is applied to the body
Crush Syndrome
An area of the body is trapped for longer than 4 hours and arterial blood flow is compromised.
It is significant metabolic derangement that can lead to renal failure and death.
Renal Failure
Kidney Failure; is a medical condition in which the kidneys fail to adequately filter toxins and waste products
Compartment Syndrome
the compression of nerves(by fluid), blood vessels, and muscle inside a closed space (compartment) within the body
Compartment Syndrome (Hallmark Sign)
Pain out of proportion to the injury
Four Types of Open Injuries
Abrasions
Lacerations
Avulsions
Penetrating wounds
Abrasion
Wound to the superficial layer of the skin
(Rugburn)
Laceration
Caused by a sharp object or blunt force that tears the tissue
(Cut)
Incision
Sharp, smooth cut
Avulsion
An injury that separates various layers of soft tissue, usually between the subcutaneous and the fascia.
Hangs as a flap or completely detached
Amputation
Part of the body that is completely severed
Penetrating Wound / Puncture Wound
Injury resulting from a sharp pointed object
3 MOI's of Blast injuries
Primary Blast injury
Secondary Blast Injury
Tertiary Blast injury
Primary Blast Injury
Damage caused by the pressure generated by the explosion
Secondary Blast Injury
Damage from flying debris propelled by the force of the blast
Tertiary Blast injury
Victim is thrown by the force or explosion into an object or the ground
AVPU scale
Alert to person, place and day
Responsive to Verbal Stimuli, Responsive to Pain, Unresponsive
DCAP-BTLS
Used to assess an area of the body for:
Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling
OPQRST
Used to evaulate a patients pain
Onset, Provocation/Palliation, Quality, Radiation, Severity, Time of Onset
SAMPLE
Brief history of the patients condition
Signs/Symptoms, Allergies, Medications, Pertinent past history, Last oral intake, Events leading to the injury or illness
RICE
Used to treat a closed soft tissue injury
Rest - Keep patient quiet & comfortable
Ice - or cold packs reduces pain and slows bleeding
Compression - Direct pressure slows bleeding
Elevation - Raise injured part above the heart decreases swelling
Splinting
Evisceration
Organs that protrude through an open wound in the abdomen
When should you remove an impaled object?
If it's in the cheek that obstructs breathing or in the chest that interferes with CPR
Severe Burns in adults
- Full Thickness burns involving hands, feet, face, upper airway or genitalia
- Full thickness burns covering more than 10% of body's total surface area
- Partial thickness burns covering more than 30% of the body's total surface area
- Burns associated w
Moderate Burns in adults
- Full thickness burns 2-10% of total body surface excluding (hands, feet, face, genitalia and upper airway)
- Partial thickness burns covering 15-30% of the body's total surface area
- Superficial burns covering more than 50% of total body surface area
Minor Burns in adults
- Full thickness burns covering less than 2% of total body surface area
- Partial thickness burns covering less than 15% of total body surface area
- Superficial burns covering less than 50% of total body surface area
Five factors to help you determine the severity of a burn
- What is the depth of the burn
- What is the extent of the burn
- Are any critical areas involved
- Does patient have any preexisting medical conditions or injuries
- Is the patient younger than 5 or older than 55
1st degree burns
Superficial burns that involve only the top layer (epidermis).
Skin reddens but does not blister or burn through. (sunburn)
2nd degree burns
Partial thickness burns that involve the epidermis and some portions of the dermis.
skin is moist, mottled and red to white
intense pain
3rd degree burns
Full thickness burns extend through all skin layers. May involve subcutaneous layers, muscle, bone or internal organs.
Skin is dry and leathery, may look white, dark brown or charred. May feel hard to the touch. May have no feeling
Rule of Palm
A method to estimate the burn surface area. Use the patients palm, which is 1% of the patients total surface area.
Rule of 9's
Divides the body into sections, each of which is approx 9% of the total surface area
Severe Burns in infants & children
- Any full thickness burn
- Partial thickness burns covering more than 20% of the body's total surface area
Moderate Burns in infants & children
- Partial thickness burns covering 10-20% body's total surface area
Minor burns in infants & children
- Partial thickness burns covering less than 10% of the body's total surface area
Thermal burns
Caused by heat, scalds or open flames