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McFatter Technical Center
Emergency Medical Technician - Basic
Health Science Core
Chapter 18
Trauma Incidents
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Different Trauma Incidents
• Burns
• Musculoskeletal injury
– Fractures
– Dislocation
– Sprains/Strains
• Nosebleeds
• Soft Tissue Injuries
• Hypovolemic shock
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Burns
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Burns
• Burn occurs when the body or body part
receives more radiant energy than it can
absorb without injury
• Three classifications of burns:
– 1st degree or superficial burns
– 2nd degree or partial thickness burns
– 3rd degree or full thickness burns
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
1st degree or Superficial burns
• Involves only the top layer
of the skin
• Skin turns red but does not
blister
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
2nd degree or partial thickness burns
• Involves the epidermis and
some portion of the dermis
• Skin is moist, mottled, and
white to red
• Blisters common
• Intense pain
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
3rd degree or full thickness burns
• Extends through all the skin
layers and involves
subcutaneous layer, muscle,
bone or internal organs
• Skin dry and leathery
• Skin color white, dark brown,
or charred
• No pain at area of burn, but
pain around area
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Burns
Assessment
• Scene size-up:
– Observe for hazards or threats to safety of
crews
– “Scene Safety”
• Initial Assessment:
– Evaluate areas affected by the burn and
determine amount of area
– Hoarse voice or singed nostril/facial hair
could mean burns to the airway
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Burns
Body Surface Area
Rule of Nines
• Dividing the body into
sections
• Each section
represents 9% of total
body surface area
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Burn Treatment
• Chemical Burns – Flush
continuously with large
amounts of water for at
least 20 minutes
• Superficial burns – flush
with cold water
• Partial thickness burns –
flush with cold water and
do not open any blisters
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Burn Treatment
• Full thickness burns –
stop the burning process
and cover with dry sterile
dressing or Water-Jel
• Remove any smoldering
clothing and/or jewelry
• Never use or apply
ointments, lotions, or
antiseptics
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Musculoskeletal Injury
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Musculoskeletal Injury
Fractures – break in the continuity of a bone
Open Fracture
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Fracture Types
A comminuted
fracture
occurs when
the bone is
broken into
more than two
fragments.
McFatter Technical Center, Broward County Public Schools
A
Greenstick
or hairline
fracture is
a split in a
young,
immature
bone
Revised: August 2007
Fracture Types
A spiral
fracture occurs
when the
fracture line
spirals around
the shaft of the
bone - a result
of a pure
twisting injury.
McFatter Technical Center, Broward County Public Schools
A transverse
fracture occurs
when the fracture
line is transverse
across the shaft
of the bone
(perpendicular to
the long axis of
the bone) usually a result of
a bending injury.
Revised: August 2007
Fracture Types
An oblique fracture occurs
when the fracture line is
oblique across the shaft of
the bone -usually a result
of a combination bending
and twisting injury.
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Musculoskeletal Injury
Sprains – Injury to ligaments
and tendons
A strain is an injury to a
muscle or tendon, and is
often caused by overuse,
force, or stretching.
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Fracture, Strain, and Sprains
Signs and Symptoms
•
•
•
•
Pain
Swelling
Deformity at the site
Possible loss of use
of the affected site
• Fractures may have
crepitus
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Fracture, Sprain, and Strain
Treatment
•
•
•
•
Rest – keep patient comfortable
Ice – slow bleeding and reduce pain
Compression – over the site
Elevation – just above the level of the
heart
• Splinting – Joint – immobilize the bone above
and below the joint
– Bone – immobilize the joint above
and below the bone
• Check distal circulation after splinting
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Nosebleeds
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Nosebleeds
• Epistaxis – medical
term for nosebleed
• Bleeding from trickle to
hemorrhage
• Spontaneous epistaxis
can be caused by
hypertension or
medications like
anticoagulants
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Nosebleed Treatment
• Sit up and lean forward (do
not lean back)
• Pinch nostrils for 15 to 20
minutes
• Apply ice to the nose
• Apply commercial device
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Soft Tissue Injuries
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Soft Tissue Injuries
Puncture
Wound –
penetration
of a sharp
object
Abrasion –
outer layer
of skin has
been
scraped off
McFatter Technical Center, Broward County Public Schools
Incision –
clean,
straight,
knife-like
cut
Revised: August 2007
Soft Tissue Injuries
Contusion
– seepage
of blood
into tissue
Laceration
– jagged
tears
McFatter Technical Center, Broward County Public Schools
Avulsion – flap
of skin is torn
loose or pulled
off completely
Revised: August 2007
Soft Tissue Injuries
Treatment for Open Wounds
• Minor bleeding – clean
wound
• Control bleeding:
– Direct pressure
– Elevate
– Pressure point
• Apply sterile dressing
bandage
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Hypovolemic shock
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Hypovolemic shock
• Shock due to severe blood loss
• Examples:
– Bleeding from an incision
– Wound drainage
– Rectal bleeding from area in the intestines
– Vomiting blood due to internal bleeding
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Hypovolemic shock
Signs and Symptoms:
• Shock due to severe blood loss.
– Change in mental status
– Staring of the eyes
– Pale, cool, and diaphoretic
– Rapid and shallow respirations
– Low blood pressure (hypotension)
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
Hypovolemic shock
Treatment
• Control bleeding
• Elevate legs 8 – 12
inches into the
trendelenburg
position
• Keep warm
McFatter Technical Center, Broward County Public Schools
Revised: August 2007
References
•
•
Pollak, Andrew N. Emergency Care and
Transportation of the Sick and Injured. 9th ed.
Sudbury, Massachusetts: Jones and Bartlett,
2005.
Stevens, Kay, and Garber, Debra. Introduction
to Clinical Allied Healthcare. 2nd ed. Clifton
Park, New York: Thomson Delmar Learning,
1996.
McFatter Technical Center, Broward County Public Schools
Revised: August 2007