1. Soft Tissue Injuries
Part 4

2. The Soft Tissues Soft tissues include the layers of the skin
The outer layer is called the epidermis, followed by the dermis
Epidermis - provides a barrier to protect against bacteria that can cause infection
Dermis - contains nerves, sweat glands, oil glands, and blood vessels
The subcutaneous layer, also called the hypodermis, is located beneath the dermis
Contains adipose (fat) tissue, blood vessels, and connective tissue

3. Wounds A wound is any physical injury involving soft tissues
Closed wounds
Skin’s surface is not broken
Tissue damage and bleeding occur beneath the skin
Simplest type of closed wound is a contusion (bruise)
Open wounds
Skin’s surface is broken
Blood may come through the break in the skin
Types include abrasion, laceration, avulsion, amputation, puncture, and crash injury

4. Open Wounds Abrasion Most common type of open wound
Skin has been rubbed or scraped away
Laceration
A cut with jagged or smooth edges
Usually bleed freely and heavily
Avulsion
Serious injury in which a portion of skin is partially or completely torn away
Bleeding is usually significant

5. Open Wounds Amputations Puncture/Penetration Crash Injuries
A body part is severed and damage to the tissue is severe
Bleeding may not be as bad as you might expect
Blood vessels constrict and retract (pull in) at the point of injury
Puncture/Penetration
Skin is pierced with a pointed object
External bleeding is generally not severe because the skin usually closes around the object
An object that remains in the open wound is called an embedded object
Crash Injuries
A body part, usually an extremity, being subjected to a high degree of pressure
Can result in serious damage to underlying tissue
Compartment syndrome is swelling and an increase in pressure within a limited space that presses on an compromises blood vessels, nerves, and tendons

6. Dressings Occlusive dressing
Closes a wound or damaged area of the body and prevents it from being exposed to air or water
Bandage
Material used to wrap or cover any part of the body
Pressure bandage - applied snugly to create pressure on a wound or injury
Adhesive compress - small pad of non-stick gauze on a strip of adhesive tape; minor wounds
Bandage compress - thick gauze dressing attached to a bandage that is tied in place
Roller bandage - gauze or gauze-like material available in all sizes; used to wrap an injury
Elastic roller bandage - designed to keep continuous pressure on a body part

7. Types of Burns
Burns are classified by depth; the deeper the burn, the more sever it is.
Superficial - also referred to as first degree
Involve only the top layer of skin, usually heals within a week
Partial-thickness - also referred to as second degree
Involves the top two layers of skin (epidermis and dermis), heals in 3-4 weeks and may scar
Full-thickness - also referred to as third degree
May destroy all layers of the skin, healing requires medical assistance
Burns are also classified by their source
Heat (thermal)
Chemical
Electrical
Radiation (usually from the sun)

8. Injuries to the Extremities
Upper extremity refers to the arm
Includes clavicle, scapula, humerus, radius, ulna, carpals, metacarpals, phalanges
The upper arm is the area that extends from the shoulder to the elbow
The forearm is the area between the elbow and the wrist
Lower extremity refers to the leg
Includes the femur, patella, tibia, fibula, tarsals, metatarsals, and phalanges
The thigh is part of the lower extremity between the pelvis and knee
The femoral arteries are the major supplier of blood to the lower extremities
The lower leg is the area between the knee and the ankle

9. Head, Neck, and Spinal Cord
The spine, also called the vertebral column, is a strong, flexible column of small bones called vertebrae
Extends from the base of the skull to the tip of the tailbone
Broken up into four sections:
Cervical (7 vertebrae)
Thoracic (12 vertebrae) - the largest section of the vertebral column
Lumbar (5 vertebrae)
Sacral (9 fused vertebrae)
Concussion - temporary loss of brain function due to a blow to the head
If an injury to the head, neck, or spinal cord is suspected, use manual stabilization to minimize movement
Technique used to achieve spinal motion restriction by manually supporting the person’s head and neck in the position found without the use of equipment