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...

      e. apply pressure to control bleeding

            i. do not compress both carotid arteries

      f. bandage in place when bleeding stops

      g. immobilize the spine per mechanism/protocol


V. Treatment of Penetrating Chest Wounds (1-5)

A. Signs and symptoms

  1. Wound to the chest

  2. May or may not have sucking sound

  3. Patient may gasp for air

  4. Consider all open chest wounds to be life threatening

B. Treatment

  1. Maintain an open airway

      a. provide Basic Life Support as needed

  2. Seal the wound as quickly as possible

      a. use a gloved hand if necessary

  3. Apply an occlusive dressing

  4. Administer high concentration oxygen

  5. Care for shock

  6. Transport immediately

      a. transport on injured side if not contraindicated

      b. consider Advanced Life Support

C. Chest Injury Complications

  1. Pneumothorax and tension pneumothorax

      a. lung collapses are a result of air in the chest cavity

  2. Tension pneumothorax

      a. air pressure increases

           i. no place to escape

           ii. puts pressure on heart, great vessels and unaffected lung

           iii. reduces cardiac output/blood oxygenation

  3. Signs of pneumothorax and tension pneumothorax

      a. increasing respiratory difficulty

      b. indications of developing shock

      c. distended neck veins

      d. tracheal deviation to uninjured side

      e. uneven chest wall movement

      f. reduction of breath sounds on affected side

  4. Hemothorax and hemopneumothorax

      a. chest cavity fills with blood

      b. chest cavity fills with blood and air

  5. Signs of hemothorax and hemopneumothorax

      a. signs of pneumothorax

      b. coughed up red frothy blood

  6. Traumatic asphyxia

      a. sudden compression of the chest

      b. rapid build-up of pressure within the chest

  7. Signs of traumatic asphyxia

      a. distended neck veins

      b. head, neck and shoulders appear dark blue or purple

      c. eyes may be bloodshot and bulging

      d. tongue and lips may be swollen and blue

      e. chest deformity may be present

  8. Cardiac tamponade

      a. heart injury

      b. pericardial sac fills with blood

  9. Signs of cardiac tamponade

      a. distended neck veins

      b. very weak pulse

      c. low blood pressure

      d. steadily decreasing pulse pressure

            i. difference between systolic and diastolic pressure


VI. Treatment of Impaled Objects (1-6)

A. General Principles

  1. Do not remove the impaled object

  2. Expose the wound area

  3. Use direct pressure to control profuse bleeding

  4. Manually stabilize the impaled object

  5. Stabilize the object with bulky dressings

  6. Secure the dressing in place

  7. Administer high concentration oxygen

  8. Care for shock

  9. Keep patient at rest

  10. Provide emotional support

  11. Carefully transport as soon as possible

      a. if abdominal injury, leave legs in position found

  12. Reassure the patient

B. Object in the Cheek

  1. Be aware of potential airway obstruction

      a. the object

      b. blood if the cheek is perforated

      c. vomitus

  2. Examine external cheek and inside the mouth

  3. If cheek is perforated and you can see both ends of the object, remove it by pulling it out in the

      direction it entered

  4. If cheek is perforated and the tip of the object is impaled deeper, stabilize in place

  5. Position head to allow for drainage

  6. Monitor airway; be prepared to suction

  7. Dress the outside of the wound

  8. Administer oxygen

  9. Care for shock


VII. Treatment of Eviscerations (1-7)

A. General Principles - Open and Closed Abdominal Injuries

  1. Maintain an open airway

  2. Place patient on back, flex the legs at the knees

  3. Administer high concentration oxygen

  4. Care for shock

  5. Give the patient nothing by mouth

  6. Monitor vital signs

  7. Transport as soon as possible