Soft Tissue Injuries — Care of Closed Injuries

BLS providers have various treatment options at their disposal for the care of soft tissue injuries. The following are guidelines for the care of closed soft tissue injuries.

Type of Injury	Signs/Symptoms	Treatment
Contusion Ecchymosis Hematoma Edema	Pain and bruising Blue/black discoloration Pain, swelling and discoloration Pain, swelling and possible loss of function	Reassure patient Immobilize/splint if indicated Apply ice or cold pack Elevate
Sprain Strain Dislocation	Point tenderness Swelling and ecchymosis Pain aggravated by movement Instability of joint Guarding Tenderness on palpation Numbness or impaired circulation Deformity	Reassure patient Gently support the site Check and record CMS before and after splinting Apply ice pack Splint and immobilize injured limb Elevate injured limb Arrange for transport to appropriate care center
Dislocation	Same as above.	Same as above except do not elevate injured limb.

+ View elaboration — Removal of Foreign Objects

BLS providers may remove large, easily removed debris, such as glass, splinters, or gravel before bandaging. Secure large, deeply imbedded fragments or projectiles in place with a dressing and bandage.

+ View elaboration — Decontamination of Skin

To decontaminate skin or soft tissue that has been exposed to toxic chemicals, you should remove wet chemicals (e.g., acid) by repeated flushing with water. Remove dry substances by first brushing the area and then by flushing with water.

General care of burns includes:
Scene safety Remove patient from the source of the burn Administer oxygen or provide ventilatory assistance as needed Remove loose debris on the burned area Remove wet chemicals, such as acid with repeated flushing		Remove dry substances by first brushing then flushing Apply sterile or clean dressings to the wound Maintain body temperature Cover with dressings (follow local protocol) Determine the need for ALS