1. Introduction to Emergency Medical Care 1
Advance Preparation
Prepare anatomy models for demonstration.
Research related multimedia links for illustration purposes.
Prepare bandaging equipment for demonstration.
Prepare moulage supplies to simulate injuries.
Reach out to the local burn center for educational resources.
Reach out to the local power company. Power companies often have educational resources available.
Invite assistant instructors and programmed patients to assist with psychomotor sessions.

2. OBJECTIVES
28.1 Define key terms introduced in this chapter. Slides 13, 16–17, 22, 43– Describe the structure and function of the skin. Slide Describe types of closed soft tissue wounds and the assessment and management of closed soft tissue wounds. Slides 16–20
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3. OBJECTIVES
28.4 Predict internal injuries that may be indicated by various contusion (bruise) types and locations. Slide Describe types of open soft tissue wounds and general assessment and care for open soft tissue wounds. Slides 22, 24–25
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4. OBJECTIVES
28.6 Describe specific treatment for abrasions and lacerations, puncture wounds, impaled objects, avulsions, amputations, and genital injuries. Slides 27– Discuss complications associated with burns. Slide 41
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5. OBJECTIVES
28.8 Classify burns by agent, source, depth, and severity. Slides 42– Describe specific treatment for thermal burns and chemical burns. Slides 47–49
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6. OBJECTIVES
28.10 Describe assessment and management for electrical burns. Slides 51– Describe considerations in the dressing and bandaging of open wound. Slides 56–59

7. MULTIMEDIA
Slide 14 Integumentary Anatomy Video Slide 54 Electrical Injuries Video
These videos appear later in the presentation; you may want to preview them prior to class to ensure they load and play properly. Click on the links above in slideshow view to go directly to the slides.

8. Understanding closed wounds and emergency care for closed wounds
Understanding open wounds and emergency care for open wounds
Understanding burns and emergency care for burns
continued

9. Understanding electrical injuries and emergency care for electrical injuries
How to dress and bandage wounds

10. Topics Soft Tissues Closed Wounds Open Wounds
Treating Specific Types of Open Wounds
Burns
Electrical Injuries
Dressing and Bandaging
Planning Your Time: Plan 155 minutes for this chapter.
Soft Tissues (15 minutes)
Closed Wounds (20 minutes)
Open Wounds (20 minutes)
Treating Specific Types of Open Wounds (20 minutes)
Burns (40 minutes)
Electrical Injuries (20 minutes)
Dressing and Bandaging (20 minutes)
Note: The total teaching time recommended is only a guideline.

11. Soft Tissues Teaching Time: 15 minutes
Teaching Tips: Use multimedia graphics to demonstrate anatomy. Spend time now on the function of the skin to improve comprehension of later lessons.

12. Soft Tissues Skin Fatty tissues Muscles Blood vessels Fibrous tissues
Membranes
Glands
Nerves
Point to Emphasize: The skin, fatty tissues, muscles, blood vessels, fibrous tissues, membranes, glands, and nerves are considered the soft tissues of the body.
Discussion Topic: List and describe the types of soft tissue.
Knowledge Application: Have students label the layers of the skin on a blank illustration.

13. Skin Protection Water balance Temperature regulation Excretion
Shock absorption
Talking Points: The skin serves as a barrier to keep out microorganisms, debris, and unwanted chemicals. It prevents water loss and stops environmental water from entering the body. The blood vessels in the skin dilate and constrict to allow more or less blood near the surface to better radiate heat from the body. The skin excretes salts, carbon dioxide, and excess water. The skin and its fatty layers help to protect underlying organs. The epidermis is the outermost layer of the skin. The dermis is rich in blood vessels, nerves, sweat glands, and hair follicles. The subcutaneous layer is the innermost layer, and is comprised mostly of fat.
Discussion Topics: Describe the functions of the skin. List and describe the layers of the skin.
Knowledge Application: Have students work in small groups to discuss the functions of the skin. Assign a function of the skin to each group; then have each group present the impact of losing skin on its particular function.
Critical Thinking: Many people die from infection after a large surface-area burn. How does this fact relate to our discussion about functions of the skin?

14. Integumentary Anatomy Video
Video Clip
Integumentary Anatomy
What does the epidermis do?
What is a superficial wound?
List the purposes of the dermis.
What is a full thickness wound?
Discuss the importance of knowing the depth of a wound.
Click here to view a video on the subject of skin layers and wounds.
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15. Closed Wounds Teaching Time: 20 minutes
Teaching Tips: Use multimedia graphics to illustrate closed injuries. Review anatomy to identify body areas that potentially threaten underlying vital organs. Relate to the lessons on internal bleeding. Closed injuries and internal bleeding are closely related.

16. Closed Wounds Contusion Hematoma Bruise Similar to contusion
More tissue damage
Involves larger blood vessels
Points to Emphasize: In a closed wound, the skin has not been broken. Blunt trauma causes closed wounds. There are three types of closed wounds: contusions, hematomas, and crush injuries.
Talking Points: A closed wound is an internal injury with no open pathway from the outside to the injured site. A contusion is a bruise. The epidermis remains intact, but cells in the dermis are damaged causing a varied amount of internal bleeding. Although the skin is not broken, careful attention to Standard Precautions are still necessary.
Discussion Topics: Discuss what is meant by closed wound. Describe the three types of closed wounds. Discuss the forces that create closed injuries. How could these forces transfer damage to underlying structures?
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17. Closed Wounds Closed crush injury
Excessive force crushing or rupturing internal (generally solid) organs
Critical Thinking: Ecchymosis is a sign that blood vessels have broken under the skin. What is the significance of ecchymosis around the eyes and at the base of the skull in the context of a head injury?

18. Assessment: Closed Wounds
Bruising may be internal injury or bleeding
Consider mechanism of injury
Crush injuries are difficult to identify
Point to Emphasize: To assess and treat a closed wound appropriately, consider the mechanism of injury and the structures that lie beneath the skin.
Talking Points: Bruising may be an indication of soft tissue injury or of more severe internal bleeding from organ damage. Always consider the mechanism of injury and treat based upon that. Any closed bleeding in the presence of severe mechanism should be treated as internal bleeding and shock until ruled out in the emergency room.

19. Treatment: Closed Wounds
Take appropriate Standard Precautions
Manage airway, breathing, and circulation
Always manage for internal bleeding and shock if there is a possibility of internal injuries
Point to Emphasize: When treating major closed injuries, assume internal bleeding.
Discussion Topic: Describe the treatment of a closed wound.
Class Activity: Describe closed injuries to different areas of the body. Discuss with the class what structures and organs are at risk.
Knowledge Application: Use multimedia graphics to demonstrate different types of closed injuries. Distribute pictures to groups of students and ask groups to formulate an assessment and treatment strategy.
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20. Treatment: Closed Wounds
Splint extremities that are painful, swollen, or deformed
Stay alert for vomiting
Continuously monitor for changes and transport
Knowledge Application: Use programmed patients to simulate closed injuries. Have teams of students practice assessment and treatment.

21. Open Wounds Teaching Time: 20 minutes
Teaching Tips: Use multimedia graphics to demonstrate the various types of open injuries. Discuss the specific and varied threats that each type of open wound can pose. Use specific examples.

22. Open Wounds Abrasion Laceration Puncture Avulsion Amputation
Crush injury
Blast injury
Talking Points: In an open wound, the skin is broken as a result of the injury. An abrasion is a simple scrape that damages the outer layer of skin. A laceration is a cut, smooth or jagged, and is often caused by a sharp edge. It can also be the result of a blow from a blunt object. A puncture wound is the result of a sharp, pointed object passing through the skin. In an avulsion, a flap of skin and tissue is torn loose or pulled off completely. An amputation occurs when a section or sections of the body, usually extremities, are completely torn away. Crush injuries can also be open if bones are fractured as a result of the heavy force and those bone ends break the skin. A blast injury may cause a number of the injury patterns described all at once.
Discussion Topics: Describe the major types of open wounds. Discuss the specific dangers of each. Discuss why a small puncture wound may disguise a major injury. Use a gunshot wound as an example.
Knowledge Application: Have students work in small groups. Give each group a picture of an open wound. Have the group classify the type of wound and then discuss the potential dangers.

23. Think About It
Does an open wound necessitate using more than just gloves as standard precautions?
Can an open injury affect the patient’s airway or breathing?

24. Treatment: Open Injuries
Expose wound
Clean surface of wound
Control bleeding
Provide care for shock
Prevent further contamination
Point to Emphasize: Controlling hemorrhage, recognizing and treating shock, preventing infection, and bandaging are important elements in emergency care of open wounds.
Discussion Topic: Describe the assessment and treatment priorities for an open wound.
Knowledge Application: Place a puncture wound on a manikin or full-body diagram. Have the class discuss what organs and structures lie in the potential pathway. Discuss life threats and treatment strategies.
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25. Treatment: Open Injuries
Bandage dressings in place after bleeding is controlled
Keep patient still
Reassure patient
Class Activity: Describe a type of open wound. Ask the students to discuss what specific threats might be posed by that particular type of injury.
Knowledge Application: Have students work in small groups. Use programmed patients and moulage to simulate different types of open wounds. Practice assessment and treatment procedures.
Critical Thinking: Consider a patient with a large soft-tissue injury to the face. After you dress and bandage it properly, what emotional concerns might you address? How might an injury such as this affect the emotional well-being of the patient?

26. Treating Specific Types of Open Wounds
Teaching Time: 20 minutes
Teaching Tips: Use multimedia graphics to illustrate specific types of injuries. Use moulage to simulate injuries. This will add realism to scenario work. Instill a fear of puncture wounds. Describe a variety of offending objects (knives, bullets, arrows, and so on) and discuss the potential for underlying damage despite minimal external wounding. Research local protocol on treatment of avulsed and amputated parts.

27. Treatment: Abrasions and Lacerations
Reduce wound contamination
Hold direct pressure to control bleeding
Always check pulse, motor, and sensory function distal to injury to assure function
Never open edges of laceration to see inside or further clean wound

28. Treatment: Puncture Wounds
Use caution—objects may be embedded deeper than they appear
Check for exit wounds
May require immediate care
Bullets can fracture bones as they enter
Stab wounds are considered serious if in a vital area of body
Point to Emphasize: Puncture wounds are particularly dangerous as they present with only small external wounds but may damage structures deep into the body.
Discussion Topic: Discuss why a small puncture wound may disguise a major injury. Use a gunshot wound as an example.
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29. Treatment: Puncture Wounds
Reassure patient
Search for exit wound
Assess need for shock care
Follow local protocols regarding spinal immobilization
Transport patient
Knowledge Application: Have students work in small groups. Use a programmed patient and moulage and simulate various types of injuries. Practice specific treatment strategies.

30. Treatment: Impaled Objects
Do not remove object; may cause severe bleeding
Expose wound area
Control profuse bleeding by direct pressure
Apply several layers of bulky dressing to “splint” object in place
Point to Emphasize: Do not remove or apply direct pressure to impaled objects.
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31. Treatment: Impaled Objects
Secure dressings
Treat for shock
Provide rapid transport
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32. Treatment: Impaled Objects
Splint object
Secure dressings
Knowledge Application: Have the students work in small groups. Simulate impaled objects and practice stabilization and treatment.

33. Impaled Object in Cheek
Take care that object does not enter oral cavity, causing airway obstruction
If cheek wall is perforated, profuse bleeding into mouth and throat can cause nausea and vomiting
External wound care will not stop the flow of blood into the mouth

34. Treatment: Impaled Object in Cheek
Examine wound site, both inside and outside mouth
If you find the perforation and can see both ends, remove object
If object is impaled into another structure, stabilize in place
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35. Treatment: Impaled Object in Cheek
Position patient to allow for drainage
Monitor patient’s airway
Dress outside of wound
Provide oxygen
Provide care for shock

36. Treatment: Avulsions Clean wound surface
Fold skin back into normal position
Control bleeding and dress with bulky dressings
If avulsed parts are completely torn away, save in sterile dressing and keep moist with sterile saline
Point to Emphasize: Emergency care for avulsions requires the application of large, bulky pressure dressings. Preserve any avulsed parts and transport them to the medical facility along with the patient.
Class Activity: Use simulated amputated parts. Practice care of amputations and avulsions.
Knowledge Application: Have students work in small groups. Assign each group a specific type of injury. Have the group research and present the most appropriate treatment strategies.

37. Treatment: Amputations
Apply pressure dressing over stump
Use pressure points to control bleeding; use tourniquet only if all other methods fail
Discussion Topics: Describe the specific treatment for the following types of injuries: lacerations, punctures, impaled objects, avulsions, amputations, genital injuries. Discuss why a small puncture wound may disguise a major injury. Use a gunshot wound as an example.
continued

38. Treatment: Amputations
Wrap amputated part in sterile dressing and place in plastic bag; put bag in pan with water and cold packs
Do not immerse amputated part directly in icy cold water
Point to Emphasize: Take care to treat amputated parts carefully as there may be a possibility of reattachment.
Discussion Topic: Describe the specific treatment for the following types of injuries: lacerations, punctures, impaled objects, avulsions, amputations, genital injuries.
Critical Thinking: How does the care of an amputated part impact the emotional side of patient care? What emotional benefit might the patient gain?

39. Treatment: Genital Injuries
Control bleeding
Preserve avulsed parts
Consider if injury suggests another, possibly more serious, injury
Calm, professional manner
Maintain patient’s dignity
Dress and bandage wound
Talking Points: Injuries to the genitals are not very common, but they often bleed heavily and cause significant anxiety in patients. The genitals are very vascular (contain lots of blood vessels), so when they are injured, they bleed heavily. Because they are also part of the reproductive system, injuries in this area can affect a patient’s ability to have children. Males tend to sustain trauma to the genitals more frequently than females because of the less protected position of male genitalia, but anyone can sustain a genital injury. Although treatment is usually the same as for other soft tissue injuries, the patient may need more reassurance. If the patient is a child or other possibly vulnerable person, inquire in a nonthreatening way whether sexual abuse was involved.

40. Burns Teaching Time: 40 minutes
Teaching Tips: Emphasize (and reemphasize) safety and appropriate scene size-up with burn patients. Contact a burn center or national burn care organization for specialized teaching resources. Use multimedia graphics to illustrate different types of burns. Teach students to identify critical burns rapidly. Address specific criteria to make the decision. Follow local protocols.

41. Burns May involve more than just skin-level structures
If respiratory structures are affected, swelling may occur, causing life-threatening obstruction
Don’t let burn distract from spinal damage or fractures
Point to Emphasize: Burns involve immediate destruction of tissue but also can have a long-term effect, both physically and emotionally.

42. Assessment: Burns Classifying burns Agent and source Depth Severity
Point to Emphasize: Burns can be classified and evaluated in three ways: by agent and source, by depth, and by severity.
Talking Points: Burns should be classified by agent (for example, chemical or thermal) and by source (for example, dry line or alternating current).
Discussion Topic: Describe the factors that would make a burn critical.

43. Burns: Depth Superficial (1st Degree) Partial Thickness (2nd Degree)
Involves only epidermis
Reddening with minor swelling
Partial Thickness (2nd Degree)
Epidermis burned through, dermis damaged
Deep, intense pain
Blisters and mottling
Point to Emphasize: The three classifications of burn depth are superficial, partial thickness, and full thickness.
Discussion Topic: Describe the three classifications of burn depth. Compare and contrast the findings for each.
Knowledge Application: Display pictures of burns. Have students classify the depth of the burn based on presentation. Discuss.
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44. Burns: Depth Full Thickness (3rd Degree) All layers of skin burned
Blackened areas surrounded by dry and white patches

45. Burns: Severity Rule of Nines Helps estimate extent of burn area
Adult body is divided into 11 main areas
Each represents 9 percent of body surface
Point to Emphasize: The amount of skin surface involved in a burn can be calculated quickly by using the rule of nines.
Talking Points: For an adult, each of the following areas represents 9 percent of the body surface: head and neck, each upper extremity, chest, abdomen, upper back, lower back and buttocks, the front of each lower extremity, and the back of each lower extremity. These make up 99 percent of the body’s surface. The remaining 1 percent is assigned to the genital region.
Discussion Topics: Explain how to determine the surface area of a burn. Consider an adult patient and a child. Discuss how the location of a burn might impact its severity. How might a hand burn be more serious than a burn of the same size on the abdomen?
Knowledge Application: Determine body surface area. Describe an area burned. Have students use various methods to determine body surface area.

46. Burns: Geriatrics and Pediatrics
“Minor” burn area in a young adult can be fatal to a geriatric adult
Infants and children have a much greater relationship of body surface area to total body size, resulting in greater fluid and heat loss from burned skin
Talking Points: In late adulthood, the body’s ability to cope with injury is reduced due to aging tissues. Burns classified as moderate should be considered critical in adults 55 years and older.

47. Treatment: Thermal Burns
Use sterile dressings
Never apply ointments, sprays, or butters
Do not break blisters
Point to Emphasize: There are special approaches to the care of thermal burns, general chemical burns, and chemical burns to the eyes. EMTs should know the procedures for treating each type.
Knowledge Application: Use a programmed patient to simulate different types of burn scenarios. Have teams of students practice assessment and identification of a critical burn.

48. Treatment: Chemical Burns
Wash away chemical with copious amounts of flowing water
If dry chemical, brush away, then flush with water
Discussion Topic: Compare and contrast treatment modalities for the various types of burns. How are the modalities similar? How are they different?
Class Activities: Tour a burn unit. See firsthand the impact of burns. Interview staff from a burn center. Discuss perils and pitfalls of burn care.
Knowledge Application: Use student volunteers and practice flushing an eye. Discuss necessary equipment and strategies.
continued

49. Treatment: Chemical Burns
Remove contaminated clothing
Apply sterile dressings
Treat for shock
Critical Thinking: How might a burn impact a patient emotionally? How might this be a long-term concern?

50. Electrical Injuries Teaching Time: 20 minutes
Teaching Tips: Emphasize safety. Electrical injury scenes are extremely hazardous to emergency responders. Use multimedia graphics to illustrate electrical injuries. Invite a power company representative to discuss electrical safety and associated injuries. Note the importance of cardiac evaluation. This type of injury is not readily apparent on the outside but can be life threatening.

51. Electrical Injuries
Severe damage through body by disrupting nerve pathways
Entry and exit burns are possible
Respiratory/cardiac arrest are possible
Bones may fracture from violent muscle contractions
Points to Emphasize: The scenes of injuries due to electricity are often very hazardous. Assume that the source of electricity is still active unless a qualified person tells you that the power has been turned off. Electrical current can damage tissue in a variety of ways. Burns, nerve damage, and chemical changes are examples of the destruction that electricity can cause. Specific assessment findings can indicate the presence of electrical injuries.
Discussion Topics: Discuss how you might determine that the scene is safe when approaching an electricity-related emergency. Describe how electricity can damage the body. Use specific examples. Describe the assessment findings that might indicate an electrical emergency.
Knowledge Application: Have students work in small groups. Use programmed patients and simulate electrical emergencies. Focus on safety evaluation and approach strategies.

52. Treatment: Electrical Injuries
Provide airway care
Be alert and prepared for cardiac rhythm changes; be ready to defibrillate
Treat for shock and provide oxygen
Point to Emphasize: Proper care for electrical injuries must include treatment of cardiac dysrhythmias. In addition, spinal immobilization should be considered.
Discussion Topic: Describe the treatment of a patient injured by electricity. What are the most important elements of treatment?
Critical Thinking: You have identified a patient who has been electrocuted. You are not sure if the power has been turned off, so you have decided to hold back. What forces may be present to make you want to push forward? How can you overcome these issues?
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53. Treatment: Electrical Injuries
Care for spinal and head injuries as well as extremity fractures
Evaluate burn sites
Cool burning areas and apply sterile dressings
Knowledge Application: Present pictures of electrical injuries. Discuss treatment priorities.

54. Electrical Injuries Video
Video Clip
Electrical Injuries
What causes heat in an electrical injury?
Discuss how significant internal injury can exist without extensive external damage.
What pathway does electrical current follow?
What are the primary concerns of the EMT when managing a patient with an electrical injury?
Click here to view a video on the subject of injuries caused by electricity.
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55. Dressing and Bandaging
Teaching Time: 20 minutes
Teaching Tips: Have on hand various types of dressings and bandages with which students can practice. Create a culture of infection control. Always require appropriate PPE when practicing potentially infectious skills. Moulage a programmed patient to simulate injuries and bleeding. Foster creativity. Do not always place the wound in the same convenient location. Make students bandage difficult areas. Integrate hemostatic agents with dressings and bandages.

56. Dressing and Bandaging
Pressure Dressing
Occlusive Dressing
Dressing: any material applied to wound to control bleeding and prevent contamination
Point to Emphasize: A dressing is any material that is applied to a wound in an effort to control bleeding and prevent further contamination. A bandage is any material that is used to hold a dressing in place.
Talking Points: A pressure dressing is used to control bleeding. Generally this involves layers of small bandages secured by a roller bandage. An occlusive dressing is used when an airtight seal is necessary.
Discussion Topics: Discuss what PPE might be necessary when dressing and bandaging a bleeding wound. Discuss the rules for the general dressing of wounds.

57. Dressing and Bandaging
Bandage: any material used to hold dressing in place
Points to Emphasize: Bandaging frequently exposes providers to bloodborne pathogens. EMTs always should don the correct level of personal protection prior to beginning these procedures. Bandaging is secondary to hemorrhage control. When necessary, stop bleeding before applying a bandage.

58. Dressing Open Wounds Expose wound Completely cover wound area
Dressings should not be removed unless bulky dressing is blood soaked and new one must be applied to maintain direct pressure
Control bleeding by direct pressure or pressure dressings
Knowledge Applications: Select and don appropriate PPE for treating open soft-tissue injuries. Have students work in small groups. Practice the sequence of bleeding control and bandaging. Discuss how the steps flow together.
Critical Thinking: If you did not have EMS equipment, what common items could you use to dress and bandage a wound?

59. Bandaging Open Wounds Do not bandage too tightly or too loosely
Do not leave loose ends
Do not cover tips of fingers or toes—must observe distal skin color changes
Cover all edges of dressings
Point to Emphasize: Completely cover the wound with a dressing. Apply the bandage over the dressing and completely cover the dressing.
Discussion Topic: Discuss the rules for the general bandaging of wounds.
Class Activity: Brainstorm creative bandaging techniques. List an unusual wound site and ask students to formulate creative bandaging solutions.
Knowledge Application: Using a manikin or programmed patient, practice applying dressings and bandaging wounds.

60. Chapter Review

61. Chapter Review Soft-tissue injuries may be closed or open.
Closed injuries include contusions, hematomas, and crush injuries. Open wounds include abrasions, lacerations, avulsions, amputations, and crush injuries.
continued

62. Chapter Review
For open wounds, expose the wound, control bleeding, and prevent further contamination.
For both open and closed injuries, take appropriate Standard Precautions.
continued

63. Chapter Review
Burn severity is determined by considering the source, the region affected, depth of burn, extent of burn, age of the patient, and other patient illnesses or injuries.
continued

64. Chapter Review
Care for burns includes stopping the burning, covering a thermal burn with a dry sterile dressing, flushing a chemical burn with sterile water, protection of the airway, administration of oxygen, treatment for shock, and transport.
continued

65. Chapter Review
For treatment of electrical injuries, be sure that you and the patient are in a safe zone away from possible contact with electrical sources. Protect airway, breathing, and circulation. Be prepared to care for respiratory or cardiac arrest. Treat for shock, care for burns, and transport.

66. Remember
The soft tissue of the body is made up of skin, fatty tissues, muscles, blood vessels, fibrous tissues, membranes, glands, and nerves.
The skin provides protection, water balance, temperature regulation, excretion, and shock absorption.
continued

67. Remember
Open or closed in reference to a soft-tissue injury is dictated by whether or not the skin is still intact.
Closed injuries must be evaluated with consideration to underlying anatomy and mechanism of injury.
continued

68. Remember
Open injuries typically are easier to visualize, but they often can mask underlying injuries.
Burns involve immediate destruction of tissue but also can have a long-term effect, both physically and emotionally.
continued

69. Remember
Safety must be a key concern when treating a patient with a burn or an electrical injury.
The goal of dressing and bandaging wounds is to control bleeding and to prevent infection.

70. Questions to Consider
Does the patient have a patent airway and is breathing adequate?
If the wound is penetrating, is there an exit wound?
What is the best way to immobilize an impaled object?
Talking Points: Have students explain or demonstrate the answers to these questions.
continued

71. Questions to Consider Is there respiratory involvement with the burn?
Have we irrigated the chemical burn sufficiently?
Does the electrical burn have an exit wound?
Is the bandage securely fastened to hold the dressing?

72. Critical Thinking
A 21-year-old male lacerated his anterior elbow when he fell through a window. There is a lot of blood around the patient. Bystanders have applied numerous towels and washcloths over the wound (at least 3 inches thick).
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73. Critical Thinking
There are so many dressings on the wound that you can’t tell if it is still bleeding. The patient is alert, but pale and anxious. The radial pulse on his uninjured arm is weak and rapid. How much assessment of the wound should you do and how do you do it without making things worse?
Talking Points: Ask a student to role-play the patient. Wrap the student’s arm as described in the scenario, and have other students explain how much assessment they would do and demonstrate how best to do it.

74. Please visit Resource Central on www. bradybooks
Please visit Resource Central on to view additional resources for this text.
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