Soft Tissue Injuries

Overview: Basics include control of bleeding through:

• For other than minor injuries CALL 911

  • Direct pressure: Apply up to 10 minutes at a time. If patient bleeds through dressing, do not remove bandage but apply more on top.

  • Elevate above heart (with fractures, spinal injury or head trauma this may not be advisable).

  • Pressure dressing: Maintain pressure with bulky absorbent. Several techniques are available for wrapping and applying sufficient pressure. After 10 minutes, loosen and check pulses to ensure circulation. Bleeding usually can be controlled in 20 to 30 minutes.

  • If unable to control:

    • 1. Remove dressing and look for spurting of blood.

      2. Apply digital pressure to small bleeders.

      3. Apply pressure to pressures points.

      4. Consider hemostatic agent such as Celox                                                         .

      5. Consider tourniquet.

Contusion: Mild bruising

• • RICE: rest, ice compression, elevation

  • Protect from cold

Abrasion: Scrapes (can become easily infected)

• • Usually little bleeding. Scrub and irrigate to remove debris and clean.

  • Allow to air dry before dressing.

  • May use antibiotic ointment.

Laceration: A cut or incision

• • Control bleeding.

  • Cleans with copious irrigation.

  • For large gaps, do not close tightly (call 911).

  • Dress wound and seek medical attention (may need stitches) unless minor wound.

Flap Avulsion: A three sided tear

• • Control bleeding.

  • Cleanse in anatomical position.

  • Call 911 or seek immediate medical attention.

Amputation with copious irrigation under flap.

• • Call 911

  • Bandage: Severing of body part.

  • Usually not a lot to bleeding. Vessel constrict. Pad with dressing.

  • Place body part in bag and place on ice.

Punctures:

• • Copious irrigation to cause wound to bleed and flush debris.

  • Watch for infection.

  • Seek medical attention and tetanus shot.

Impaled Objects:

• • Remove if:

    • 1. In extremity

      2. Cheek

      3. Cold metal

      4. Too large to cut from site where object is attached

  • Do not remove if:

• • • 1. In neck or skull

      2. Chest

      3. Abdomen