objective 2: identify soft tissue injuries and skin conditions

Objective 2: Identify soft tissue injuries and skin conditions

o Trauma that happens to the skin is visually exposed

o Categorized as a skin woundo Defined as a break in the continuity of

the soft parts of body structures caused by a trauma to these tissues

o Mechanical forces include: o Friction, scraping, compression, tearing,

cutting, penetrating

o Skin scraped against a rough surface

o Several layers of skin are torn loose or totally removed

o Usually more painful than a deeper cut b/c scraping of skin exposes millions of nerve endings

o Wash wound to remove all dirt and debriso Soap and water or hydrogen peroxideo Scrub wound if particles of dirt, rocks, or tar

embeddedo Leave open to air, unless oozing of fluid

or bloodo Apply antibiotic ointment to inhibit

infectionso Scrapes scab over quickly

o Loose skin flaps form natural dressing; if flap dirty remove with clean nail clippers

o Check on date of last tetanus immunizationo Watch for signs of infectiono Seek medical attention if any of following:

o Pain increases after several dayso Redness/red streaks appear beyond edges of

woundo Swellingo Drainage

Flesh irregularly torn; cut or tear in the skin

Minimal bleeding, minimal pain, & no numbness or tingling

Cuts ≤ 0.25” (6mm) deep and 0.5” (1.3cm) long & have smooth, edges can be treated at home

Deeper lacerations should be treated by physician (stitches)

o Cleaned with soap and watero Irrigate with clean water to remove

debriso Do NOT use alcohol, iodine, or peroxide

as it may cause further damage and slow healing process

o Stop bleedingo Cover wound with sterile gauzeo Apply direct & constant pressure (15min+)

o Once wound cleaned, antibiotic ointment may be applied to reduce risk of infection & aid healing

o Change sterile dressing daily as needed

o Bruising and swelling are normalo Apply ice to siteo Elevate area above

level of heart

o Contact a physician if:o Laceration more than

0.25” (6mm) deep and 0.5” (1.3cm) long

o The wound is in area where wound by be opened by simple movement of body part

o Wound on face, eyelids, or lips

o Deep cuts on palm, finger, elbow or knee

o Loss of sensation or ROM of body part as result of cut

STITCHES STERI-STRIPS®

o Layers of skin torn off completely or only flap of skin remains

o Same mechanism as laceration, but to extent that tissue is completely ripped from it’s source

o May be considerable bleeding

o Clean wound with soap and watero If flap of skin remains connected

replace skin in its original positiono If deep avulsion, seek medical

attention for stitcheso If large piece of skin torn off place in

plastic bag and put on iceo Skin should not get frozen or soaked in

watero Take skin in plastic bag to doctor; may be

able to save and replace torn-off piece

o A blow compresses or crushes the skin surface and produces bleeding under the skin

o Does not break skino Bruising due to injury to blood vesselso Most mild and respond well to RICE

o Swellingo Pain to toucho Redness

o Ecchymosiso accumulation of blood

in skin & subcutaneous tissue more than one cm in diameter

o General term=bruisingo Result of bleeding;

clotting or bleeding disorders

o Bluish lesion at earliest stages of onset

o Careful monitoringo Anti-inflammatory oral medicationso Compressive dressingo Iceo Modalities to ↓ ecchymosis, ↓ swelling, ↑

ROMo Myositis ossificans: calcification that forms

within muscleo Requires surgical intervention

o Continuous rubbing over the surface of the skin causes a collection of fluid below or within the epidermal layer

o Wash area thoroughly

o Donut padding or moleskin covering

o Prevention:o Wear work gloveso Break in new shoeso Petroleum

jelly/skin lubeo Adhesive bandage

o Skin has been sharply cuto Surgical cut made in skin or flesh

o Remove bandage day after surgery; replace daily or as needed

o Normal for edges of healing incision to be slightly redo Call physician if:

o redness increases/spreads more than half an inch

o pus in incisiono more than mildly tender or painful

o Keep incision clean & dry for several days after surgery

o Non-absorbable sutures or staples must be kept dry until doctor removes

o Steri-strips® should be kept dry 4-5 dayso On face, hands, arms: take showers or

tub baths along as affected area stays dry

Wash with soap and water Cover with sterile dressing Apply antibiotic ointment Apply Ice

Never apply ice with snakebites Stimulates the spread of the

venom

Complications Poisonous

Minimize movement Seek medical attention

Infection Seek medical attention

Treatment Look for stinger If stinger present scrape away from skin with

finger nail or edge of a plastic card Never use tweezers to remove stinger-

squeezing the stinger will release venom into body

Wash area with soap water Cover with sterile dressing Apply Ice Watch for allergic reaction

Caused by insect stings, food, other allergens

Known as Anaphylactic shock

Cause serious life-threatening breathing emergencies

Air passages swell and restrict breathing

S/S= rash, tightness in chest, swelling of face and tongue, dizzy, confused

Use of Epi-pen is necessary treatment

HITCH

o Skin always has some amount of bacteria, fungus, and viruses living on it

o Skin infections occur when there are breaks in the skin and the organisms have uncontrolled growth

o It is more important to understand the potential for infection rather than placing a name on the skin problem

o Bacteria—can be curedo Staphlococcus

o Including MRSA & Impetigoo Streptococcus

o Fungal—can be curedo Ringworm

o Viral—cannot be cured, but can be treatedo Wartso Eczema

o Lesions with an irregular border

o Raised skin lesionso “wet” or “moist”

lesionso Lesions that have

different colors within the lesion

o Bright red colored lesions are more of a problem compared to faded lesions

o Lesions that are warmer compared to other skin

o Inflammation & irritation around skin lesion

o Prior history of infectious skin lesion

o Skin abrasionso Deeper or more

traumatic break in skin, higher risk for subsequent infection

o The right antibiotic is required to cure a specific bacterial skin infection

o Antibiotics for bacteria will not improve fungal or viral infections

o Bacterial infections can be the fastest growing infectionso Thus the most easily spread among athletes

o Infection caused by Staphylococcus bacteria

o About 25% of people normally carry staph in the nose, mouth, genitals, and anal areas

o Infection begins with a little cut gets infected with bacteria

o Range from a simple boil to antibiotic-resistant infections to flesh-eating infections

o Difference is: o the strength of the

infectiono How deep it goeso How fast it spreadso How treatable it is

with antibiotics

o Methicillin resistant Staphylococcus aureus

o Resistant to certain antibiotics most are skin infectionso Methicillin, oxacillin, penicillin, amoxicillin

o More severe or potentially life-threatening occur most frequently among patients in healthcare settings

SKIN INFECTIONS SEVERE INFECTIONSo Appear as pustules

or boilso Redo Swolleno Painfulo Pus or other drainageo First look like spider

bites or bumps o Occur at sites of

visible skin trauma

o Potentially life-threateningo Blood stream infectionso Surgical site infectionso Pneumonia

o Signs & symptoms vary by type and stage of infections

o Spread by having contact with someone’s skin infection or personal items they’ve used

o Spread in places where people are in close contact

o Close skin-to-skin contact

o Openings in the skin (cuts or abrasions)

o Contaminated items & surfaces

o Crowded living conditions

o Poor hygiene

o Good hygieneo Keep hands clean—wash with soap and

water thoroughlyo Keep cuts and scrapes clean & covered

with a bandageo Avoid contact with other’s

wounds/bandageso Avoid sharing personal items i.e. towels,

razors

o Practice good personal hygieneo Keep hands cleano Shower after exerciseo Do not share soap or

towelso Wash uniform &

clothingo Take care of your skin

o Cover abrasions/cutso Change bandages

regularly

o Do not share items that come in contact with your skino Towels & razorso Ointments

o Take precautions with common surfaces & equipmento Use barrier between

skin & surface (towel, clothing)

o Antibiotic to drain infectiono DO NOT attempt to treat yourself!

o Includes popping, draining, using disinfectants on area

o If you think you have an infection:o Cover affected skino Wash handso Contact physician

o Mild itching & sorenesso Eruption of small vesicles and/or pustules

that rupture to form honey-colored crustso Combo of 2 bacteria that spread rapidly

when athletes in close contact with one another

o Responds rapidly to proper treatmento Thorough cleansing of crusted areao Application of topical antibacterial agent

o Caused by streptococcus (strep) or staphylococcus (staph) bacteria

o MRSA becoming common causeo May occur on skin where there is no

visible breako Most common in children, particularly

unhealthy living conditionso Infection carried in fluid that oozes from

blisters

o Single or many blisters filled with puso Easy to popo When broken leave a reddish raw-looking

baseo Itching blister

o Filled with yellow or honey-colored fluido Oozing and crusting over

o Rasho Skin lesions on face, lips, arms, or legso Swollen lymph nodes near infection

o Skin infection caused by fungus (not a worm )

o Fungi thrive in warm, moist areas

o Often several patches at once

o Contagious

o Symptoms:o Itchy, red, raised

scaly patches that may blister and ooze

o Patches often have sharply-defined edges

o Redder around outside; normal skin tone in center

o Skin appear unusually dark or light

o Body—tinea corporiso Scalp—tinea capitiso Groin—tinea cruris (jock itch)o Feet—tinea pedis (athlete’s foot)

Warts Verruca vulgaris

Small tumors with dark centers

May appear anywhere on body

Treatment Cryosurgery Salicylic acid

Develop on sole of foot Pinpoint black spots Can be protected with

donut-shaped pad to relieve pressure

Itchy red rash Caused by

Allergies Stress Temperatur

e Drug

reaction Scratching Sun

exposure

Treatment Corticosteroid

Lotions and ointments

Antihistamines Lotions to

hydrate skin