Soft Tissue Injuries Drill

EMTB Soft Tissue Injuries Drill Instructor Guide Session Reference: 1 Topic: Soft Tissue Injuries Level of Instruction: 3 Time Required: 3 hours Materials:    • Various size sterile dressings    • Various...


  5. Respirations increase to compensate

      a. late sign

      b. more rapid, labored, shallow or irregular

  6. Blood pressure drops

      a. late sign

      b. life threatening

  7. Thirst

  8. Dilated pupils

  9. Cyanosis at lips and nail beds

C. Treatment

  1. Take body substance isolation precautions

  2. Maintain an open airway

      a. high concentration oxygen

      b. assist ventilations or administer CPR if indicated

  3. Control external bleeding

  4. Pneumatic anti-shock garments (PASG) as indicated

  5. Elevate legs 8" - 12" if no lower body or spinal injuries

      a. contraindicated with PASG

  6. Splint fractures

  7. Prevent loss of body heat

  8. Transport immediately

  9. Speak calmly and reassure the patient

 

III. External Bleeding Control (1-3)

A. Direct Pressure

  1. Apply pressure to the wound

      a. sterile dressing if light bleeding

      b. gloved hand if profuse or spurting

  2. Apply pressure until bleeding stops

B. Pressure Dressing

  1. Bandage dressing in place once bleeding is controlled

  2. Apply additional pressure dressings as needed

      a. NEVER remove a dressing once it is in place

C. Elevation

  1. Raise extremity above level of the heart a. be aware of

      i. musculoskeletal injuries

      ii. spinal injuries

      iii. impaled objects

D. Pressure Point

  1. Located where a large artery lies close to the skin surface and directly over a bone

  2. Brachial artery

      a. control bleeding from upper extremities

      b. located on the inner aspect of the upper arm midway between the armpit and elbow

      c. apply pressure with fingertips

  3. Femoral artery

      a. control bleeding from the lower extremities

      b. located on the medial side of the anterior thigh where it joins the trunk

      c. apply pressure with the heel of your hand

E. Tourniquet

  1. Last resort to control life threatening bleeding

  2. Use may cause permanent damage to the extremity

  3. Application

      a. no further than 2" from the wound

      b. apply above joint if wound is on joint

      c. always apply between wound and heart

     d. place pad over main artery

     e. wrap cravat around extremity and tie knot over pad

     f. place stick into knot and tighten to control bleeding

     g. secure in place

     h. DO NOT REMOVE

     i. note time on patient that tourniquet was applied

 

IV. Treatment of Soft tissue Injuries of the Head and Neck (1-4)

A. Scalp

  1. Very vascular so it bleeds freely

  2. Control with direct pressure

  3. Be aware of skull fractures

      a. no pressure if injury shows bone fragments or depression

      b. use loose sterile dressing

B. Eye

  1. Impaled object or puncture wound

      a. stabilize the object

             i. 3" roller bandage

             ii. folded 4" x 4"s

             iii. place on both sides along vertical axis of the head

      b. fit paper cup or cone over object

             i. rest on the stabilizing rolls

             ii. do not allow it to touch object

      c. second rescuer stabilizes cup and dressing

            i. secure with self adherent roller bandage

      d. dress uninjured eye to reduce sympathetic eye movement

      e. administer oxygen

      f. care for shock

      g. speak calmly and reassure the patient

  2. Laceration/bleeding around eye

      a. apply pressure dressing using same techniques as for impaled objects

C. Neck

  1. Arteries and veins close to the surface

  2. Low pressure in veins increases the possibility of an air embolus

  3. Treatment strategy includes

      a. stop bleeding

      b. prevent an embolus from entering the system

  4. Procedures

      a. maintain an open airway

      b. place gloved hand over wound

      c. apply occlusive dressing

             i. at least 2" past edges of wound

      d. place a dressing over the occlusive dressing