1. 18
Caring for Soft-Tissue Injuries and Bleeding

2. Bell Work
When the skin is cut by an object that does not have a very sharp edge or has a jagged edge, it is called a?
When there is a clean removal of a limb, it is called?
Tearing loose or tearing off of large flaps of skin
A deep open wound to abdomen that can cause organs to protrude is called?

3. Bell Work Answers
Laceration
Amputation
Avulsion
Evisceration

4. BURNS

5. State Standards
13 and 14: Identify signs and symptoms as well as pathophysiology for the following injuries/diseases/disorders as they are connected to Rehabilitation Careers. Relate who the appropriate professional would be to provide the care:
Acute inflammation related to an injury
Open and closed wounds
Soft Tissue Injuries

6. Objectives Students will be able to… Classify types of burns
Determine percent body burned
Apply treatments and dressings for burns

7. Burns Classification of Burns Heat (thermal) burns Chemical burns Fire
Steam
Hot objects
Chemical burns
Caused by caustics such as acids and alkalis
Teaching Tip: Contact a burn center or national burn association for teaching resources.
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8. Burns Classification of Burns Electrical burns Lightning burns
Originate from outlets, frayed wires, or faulty circuits
Lightning burns
Occur during electrical storms

9. Burns Classification of Burns Light burns Radiation burns
Intense light such as an arc welder, industrial laser, ultraviolet
Radiation burns
Result from nuclear sources
Teaching Tip: Use multimedia graphics to illustrate different types of burns. Ask students to classify the depth of each burn presented.

10. Figure 18.25 Burns are classified by depth of injury.

11. Burns Classification of Burns Superficial burns
Involves top layer of skin (epidermis)
Often a result of sunburn
Partial-thickness burns
Involves both epidermis and dermis
Intense pain, white to red skin that is moist and mottled and blisters
Scalding water
Critical Thinking: Why might a hand burn be more serious than the same-sized and type burn on the abdomen?

12. Figure Partial-thickness burns are characterized by the presence of redness and blisters. (© Edward T. Dickinson, MD)

13. Burns Classifications of Burns Full-thickness burns
Extend through all dermal layers
May involve subcutaneous layers, muscle, bone, or organs
Called a painless burn because nerve endings are destroyed.

14. Figure 18. 27 Full-thickness burns involve all layers of the skin
Figure Full-thickness burns involve all layers of the skin. (© Edward T. Dickinson, MD)

15. Burns Rule of Nines for Adults 9 percent to of total body surface area
Head and neck
Abdomen
Back of each leg
Lower back
Chest
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16. Burns Rule of Nines for Adults 9 percent to of total body surface area
Each arm
Upper back
Buttocks
Remaining 1 percent assigned to genital area
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17. Burns Rule of Nines for Infants and Children
18 percent to head and neck
9 percent to each upper limb
18 percent to chest and abdomen
18 percent to entire back
14 percent to each lower limb
1 percent to genital area

18. Figure 18.28 The rule of nines for estimating body surface area affected.

19. Most Critical
Partial or Full thickness burns that are 10% or greater is considered critical

20. Managing Burns
Stop the Burning Support ABC Cool with Sterile water Cover patient (prevent heat loss) Wash away excess debris but do not remove material stuck in wound Remove jewelry Less than 10%: Wet dressing More than 10%: Dry dressing Never use a burn ointment

21. Burns
Chemical Burns
Stop burning process by removing irritant and all contaminated clothing and jewelry.
Primary care for chemical burns is to flush with water for 20 minutes.
Discussion Question: What is an important consideration when treating someone with a chemical burn to the eye?
Answer: Being careful not to contaminate the other eye.
Class Activity: Direct students to work in pairs to practice flushing a simulated chemical burn to the eye; using caution not to contaminate the unaffected eye. Have them complete the treatment with the application of moist pads to both eyes. (This also a good exercise for promoting empathy and the importance of keeping patients informed of what is happening during care).
continued on next slide

22. Burns
Chemical Burns
If dry chemical (e.g., dry lime), use dry dressing to brush chemical away first before flushing with water.
Apply a dry, clean dressing.
Discussion Question: What is an important consideration when treating someone with a chemical burn to the eye?
Answer: Being careful not to contaminate the other eye.
Class Activity: Direct students to work in pairs to practice flushing a simulated chemical burn to the eye; using caution not to contaminate the unaffected eye. Have them complete the treatment with the application of moist pads to both eyes. (This also a good exercise for promoting empathy and the importance of keeping patients informed of what is happening during care).

23. Figure 18.29a Chemical burns: Brush away dried powders.
continued on next slide

24. Burns Electrical Burns Scene of electrical injury often very hazardous
Be sure source of electricity has been turned off before attempting care of patient.
Cardiac arrest, nervous system damage, fractures, injury to internal organs may occur.
Critical Thinking: Why should you always insist that a patient accept transfer to a hospital by EMS after an electrical injury?
continued on next slide

25. Burns Infants and Children
Children frequently victims of accidental burns
Consider possibility of child abuse.
Burns used as form of discipline or punishment by adults
Report your suspicion to appropriate authorities.
Remain objective and focus on caring for child.
Teaching Tip: Review state regulations regarding reporting child abuse.

26. Activity ***We have no covered all of our objectives
Complete the burns worksheet
And continue questions pg

27. Bell Work
What type of burn involves the top layer of skin (epidermis) and is often a result of a sunburn?
What type of burn is called a painless burn because nerve endings are destroyed?
What type of burn causes intense pain, white to red skin that is moist, and is usually mottled with blisters?
When is it appropriate to use a wet dressing?
In an adult, a full thickness burn that is over 10% of the body surface is classified as?

28. Burns Video https://www.youtube.com/watch?v=7gA_a9FXIBo
When watching this video – Afterwards create a journal entry and write 2 paragraphs (5-7 sentences for each paragraph) about what you learned in the video