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Mechanical injury

• Open injury
– Open one in which there is disruption in the continuity of the skin and therefore susceptibility to external hemorrhage and contamination
• An abrasion: caused by rubbing or scraping, where in part of the skin surface has been lost • Laceration: a cut inflicted by a sharp instrument, such as a knife or razor blade, producing a clean or jagged incision through the skin surface and underlying structures • A puncture wound(impaled foreign object): is a stab from a pointed object, such as a nail; advent of the refrigerator has made the ice pick nearly obsolete, but occasionally one still sees puncture wound inflicted by this instrument • An avulsion: involve tearing lose of flap of skin, which may either remain hanging or be torn off altogether

if small blood vessel or vessels beneath the skin have been disruption – Hematoma. there is damage to soft tissues beneath the skin but no break in the continuity of the epidermis) – Ecchymosis (black-and-blue mark). if large blood vessel have been torn beneath the contusion area .• Closed injury – Bruise or Contusion(marked by local pain and swelling.

but do not applied pressure on the impaled object itself • Stabilize the impaled object with bulky dressing • Closed wound Should be treated with cold application to minimize edema but otherwise require no specific treatments .Treatments • Open wound – – – – Control hemorrhage Keep the wound as clean as possible Immobilize If there is impaled object: • Do not remove impaled object • Control hemorrhage by direct compression.

Burn complicated by fracture or major of soft tissue injury . or genitalia . hands. feet.Burn (all degrees) involving more than thirty percent of boy surface .Almost all burn of the face.Burn complicated by respiratory injury .Deep acid and electric burn .Burns Critical burn .Burn occurring in patient with serious underlying disease .Third degree burn of more than ten percent of body surface .

Third degree o Involve damage to or destruction of the full thickness of the skin o Involve underlying muscles.• Thermal burn . bone and other structures as well o The skin may appear charred and leathery or may be dry and pale o No pain o Usually heal in very long time .First degree o Limited to the most superficial layer of the skin o Producing redness and pain o Usually heal in 1 week .Second degree o Penetrate the skin deeper o Producing pain and blistering as well as some subcutaneous edema o Usually heal in about 2-3 weeks .

electricity can cause respiratory or cardiac arrest. gray. The hand is the area most prone to electric injury since it is the means by the which with touch and grabs. the burn will progress so long as the corrosive substance remains in contact with the skin. dry tissue and an outer. . Electricity can cause three types of burn . with a central.Contact burn Lesion characteristic resembles a bull’s eye. charred zone of third degrees burn. a middle zone of cold.• Chemical burn Occur when the skin comes in contact with strong acid. alkalis. red zone of coagulation necrosis .Arcing injury Occurs when a current jumps from surface to surface In addition to burns. or other corrosive material. • Electric burn May produce devastating internal injury with he little external evidence.Flash burn Occurs when an extremity is close to an electric flash .

• Lightning injuries Lightning is Strikes when there is a massive discharge of electricity between two bodies that have different charges Lightning injury is an injury/ burn caused by lightning .

ointments. or any other covering on any type of burns • Never put goo on a burn – Second-degree • immerse the burned area in cold water or applied cold compress to the burn • Do not attempt to rupture blister over the burn • Start IV fluid – Third-degree • Put out the fire • As in any critical injury. edema from circumferential burns can acting as tourniquet. the airway is the most important initial consideration every patient exposed to smoke inhalation of any degree should receive oxygen • Complete the primary survey (record vital signs.• Thermal burn – first-degree: Management Care • first hour: immerse the burned area in cold water or applied cold compress to the burn. butter. leading to arrest circulation to the limb and consequent ischemia of that limb • If more than 10 percent start IV fluid • Do not waste time trying to pick debris off the skin • Remove rings. but sometime continue for up to the first 24hours of hospitalization • Do not use salves. cream. bracelet and other potentially constricting items . check pulse in all extremities. and retake them frequently) • Do the secondary survey. spray.

especially shoes and socks – do not waste time initially looking for specific anti dotes.• Chemical burn – Removal of the chemical from contact with the patient’s body – Begin flushing the area immediately with water – Rapidly remove the patient’s clothing. copious flushing with water is more effective and more immediately available – After finish. give of finally rinse dilute vinegar for alkali burn with baking soda (1 tsp per pint of water) for acid burn – Never use any chemical antidotes in the eyes .

and pulse. and begin resuscitation if necessary – If the patient have adequate vital signs. lasso or any other non conductive object – Immediately check the patient’s airway. water.• Electric Burn – Determine whether he/she is still in contact with current sources. meta object. respiration. proceed with the secondary survey . if so he/she must be removed from contact – beware of touching the patients or any conducting substance (wires. wet ground) with which he may be in contact – Use rubber gloves and gloves protector if it is necessary to touch a patient who is still in contact in current sources – Otherwise use a wooden pole.

or high building • do not hold on to fishing pole. golf club. do not stand along side such things as trees. poles. begin artificial ventilation Check for pulse if absence.• Lightning Injuries – Treatment • • • • • • • • • Triage Establish an airway If the patients is not breathing. begin external cardiac compression Control external bleeding Start an IV fluid Monitor cardiac rhythm Cover opened wound with sterile dressing Immobilize patients on a long backboard – Prevention • Stay low in the outdoor • Stay away from object that project from the ground. keep the windows tightly shut . or other potential lightning rods • If in a car.