United States
Department of Transportation
National Highway
Traffic Safety Administration
Paramedic: National Standard Curriculum
(Reprinted with
permission)
http://www.nhtsa.dot.gov/people/injury/ems/
Soft Tissue Injuries: 3
UNIT TERMINAL
OBJECTIVE
4-3 At
the completion of this unit, the paramedic student will be able to integrate
pathophysiological principles and the assessment findings to formulate a field
impression and implement the treatment plan for the patient with soft tissue
trauma.
COGNITIVE
OBJECTIVES
At the completion
of this unit, the paramedic student will be able to:
4-3.1 Describe the incidence, morbidity, and
mortality of soft tissue injures. (C-1)
4-3.2 Describe the layers of the skin,
specifically: (C-1)
a. Epidermis and dermis (cutaneous)
b.
Superficial fascia (subcutaneous)
c.
Deep fascia
4-3.3 Identify the major functions of the
integumentary system. (C-1)
4-3.4 Identify the skin tension lines of the body. (C-1)
4-3.5 Predict
soft tissue injuries based on mechanism of injury. (C-1)
4-3.6 Discuss the pathophysiology of wound
healing, including: (C-1)
1.
Hemostasis
2.
Inflammation phase
3.
Epithelialization
4.
Neovascularization
5.
Collagen synthesis
4-3.7 Discuss
the pathophysiology of soft tissue injuries. (C-2)
4-3.8 Differentiate
between the following types of closed soft tissue injuries: (C-3)
a. Contusion
6.
Hematoma
7.
Crush injuries
4-3.9 Discuss the
assessment findings associated with closed soft tissue injuries. (C-1)
4-3.10 Discuss
the management of a patient with closed soft tissue injuries. (C-2)
4-3.11 Discuss
the pathophysiology of open soft tissue injuries. (C-2)
4-3.12 Differentiate
between the following types of open soft tissue injuries: (C-3)
a. Abrasions
8.
Lacerations
9.
Major arterial
lacerations
10.
Avulsions
11.
Impaled objects
12.
Amputations
13.
Incisions
14.
Crush injuries
15.
Blast injuries
16.
Penetrations/ punctures
4-3.13 Discuss the
incidence, morbidity, and mortality of blast injuries. (C-1)
4-3.14 Predict
blast injuries based on mechanism of injury, including: (C-2)
a. Primary
17.
Secondary
18.
Tertiary
4-3.15 Discuss
types of trauma including: (C-1)
a. Blunt
19.
Penetrating
20.
Barotrauma
21.
Burns
4-3.16 Discuss
the pathophysiology associated with blast injuries. (C-1)
4-3.17 Discuss
the effects of an explosion within an enclosed space on a patient. (C-1)
4-3.18 Discuss the
assessment findings associated with blast injuries. (C-1)
4-3.19 Identify
the need for rapid intervention and transport of the patient with a blast
injury. (C-1)
4-3.20 Discuss
the management of a patient with a blast injury. (C-1)
4-3.21 Discuss
the incidence, morbidity, and mortality of crush injuries. (C-1)
4-3.22 Define the
following conditions: (C-1)
22.
Crush injury
23.
Crush syndrome
24.
Compartment syndrome
4-3.23 Discuss
the mechanisms of injury in a crush injury. (C-1)
4-3.24 Discuss
the effects of reperfusion and
rhabdomyolysis on the body. (C-1)
4-3.25 Discuss
the assessment findings associated with crush injuries. (C-1)
4-3.26 Identify
the need for rapid intervention and transport of the patient with a crush
injury. (C-1)
4-3.27 Discuss
the management of a patient with a crush injury. (C-1)
4-3.28 Discuss
the pathophysiology of hemorrhage associated with soft tissue injuries,
including: (C-2)
25.
Capillary
26.
Venous
27.
Arterial
4-3.29 Discuss the
assessment findings associated with open soft tissue injuries. (C-1)
4-3.30 Discuss
the assessment of hemorrhage associated with open soft tissue injuries. (C-1)
4-3.31 Differentiate
between the various management techniques for hemorrhage control of open soft
tissue injuries, including: (C-3)
a. Direct
pressure
28.
Elevation
29.
Pressure dressing
30.
Pressure point
31.
Tourniquet application
4-3.32 Differentiate
between the types of injuries requiring the use of an occlusive versus
non-occlusive dressing. (C-3)
4-3.33 Identify
the need for rapid assessment, intervention and appropriate transport for the
patient with a soft tissue injury. (C-2)
4-3.34 Discuss
the management of the soft tissue injury patient. (C-2)
4-3.35 Define and
discuss the following: (C-1)
a. Dressings
1.
Sterile
2.
Non-sterile
3.
Occlusive
4.
Non-occlusive
5.
Adherent
6.
Non-adherent
7.
Absorbent
8.
Non-absorbent
9.
Wet
10.
Dry
32.
Bandages
11.
Absorbent
12.
Non-absorbent
13.
Adherent
14.
Non-adherent
33.
Tourniquet
4-3.36 Predict the
possible complications of an improperly applied dressing, bandage, or
tourniquet. (C-2)
4-3.37 Discuss
the assessment of wound healing. (C-1)
4-3.38 Discuss
the management of wound healing. (C-1)
4-3.39 Discuss
the pathophysiology of wound infection. (C-1)
4-3.40 Discuss
the assessment of wound infection. (C-1)
4-3.41 Discuss
the management of wound infection. (C-1)
4-3.42 Integrate
pathophysiological principles to the assessment of a patient with a soft tissue
injury. (C-3)
4-3.43 Formulate treatment
priorities for patients with soft tissue injuries in conjunction with: (C-3)
a. Airway/
face/ neck trauma
34.
Thoracic trauma (open/
closed)
35.
Abdominal trauma
4-3.44 Synthesize
assessment findings and patient history information to form a field impression
for the patient with soft tissue trauma. (C-3)
4-3.45 Develop,
execute, and evaluate a treatment plan based on the field impression for the
patient with soft tissue trauma. (C-3)
AFFECTIVE OBJECTIVES
At the completion of this unit, the paramedic student
will be able to:
4-3.46 Defend the
rationale explaining why immediate life-threats must take priority over wound
closure. (A-3)
4-3.47 Defend the
management regimens for various soft tissue injuries. (A-3)
4-3.48 Defend why
immediate life-threatening conditions take priority over soft tissue
management. (A-3)
4-3.49 Value the
importance of a thorough assessment for patients with soft tissue injuries.
(A-3)
4-3.50 Attend to
the feelings that the patient with a soft tissue injury may experience. (A-2)
4-3.51 Appreciate
the importance of good follow-up care for patients receiving sutures. (A-2)
4-3.52 Understand
the value of the written report for soft tissue injuries, in the continuum of
patient care. (A-2)
PSYCHOMOTOR OBJECTIVES
At the completion of this unit, the paramedic student
will be able to:
4-3.53 Demonstrate
the assessment and management of a patient with signs and symptoms of soft
tissue injury, including: (P-2)
36.
Contusion
37.
Hematoma
38.
Crushing
39.
Abrasion
40.
Laceration
41.
Avulsion
42.
Amputation
43.
Impaled object
44.
Penetration/ puncture
45.
Blast
DECLARATIVE
I. Introduction
A. Epidemiology
1. Incidence
2. Mortality/ morbidity
3. Risk factors
4. Prevention strategies
B. Body substance isolation review
1. Risks from exposure to body substances
a. Bloodborne pathogens
(1) HIV
(2) HBV
(3) Other bloodborne pathogens
b. Other body substances posing risk
2. Relationship to body substance
isolation
a. Universal precautions
(1) Gloves
(2) Hand washing
(3) Protective eyewear
(4) Masks
(5) Gowns
(6) Handling and disposal of sharps
b. Disposal of contaminated materials
C. Anatomy and physiology review
1. Layers
a. Cutaneous layer
(1) Epidermis
(a) Stratum germinativum (Basal Layer)
(b) Stratum corneum
(2) Dermis
(a) Fibroblasts
(b) Macrophages
(c) Mast cells
(d) Lymphocytes
(e) Papillary dermis
(f) Reticular dermis
b.