Internal soft tissue injuries may result from deep wounds, blunt trauma, blast exposure, crushing accidents, bone fracture, poison, or sickness. They may range in seriousness from a simple contusion to life-threatening hemorrhage and shock.
Visible indications of internal soft tissue injury include the following:
1. Hematemesis - vomiting bright red blood.
2. Hemoptysis - coughing up bright red blood.
3. Melena - excretion of tarry black stools.
4. Hematochezia - excretion of bright red blood from the rectum.
5. Hematuria - pass blood in the urine.
6. Nonmenstrual vaginal bleeding.
7. Epistaxis - nosebleed.
8. Pooling of the blood near the skin surface.
More often than not, however, there will be no visible signs of injury, and the corpsman will have to infer the probability of internal soft tissue injury from other symptoms that include:
1. Pale, moist, clammy skin.
2. Subnormal temperature.
3. Rapid, feeble pulse.
4. Falling blood pressure.
5. Dilated, slowly reacting pupils with impaired vision.
8. Dehydration and thirst.
9. Yawning and air hunger.
10. Anxiety, with a feeling of impending doom.
There is little that a corpsman can do to correct internal soft tissue injuries since they are almost always surgical problems. The hospital corpsmans goal must be to obtain the greatest benefit from the victims remaining blood supply. The following should be done:
1. Treat for shock.
2. Keep the victim warm and at rest.
3. Replace lost fluids with a suitable blood volume expander (refer to the Intravenous Therapy section of the Nursing Procedures Manual); DO NOT give the victim anything to drink until the extent of the injury is known for certain.
4. Give oxygen, if available.
5. Splint injured extremities.
6. Apply cold compresses to identifiable injured areas.
7. Transport the victim to a medical treatment facility as soon as possible.
Dressings and Bandages A dressing is a pad or bolster of folded linen that is placed in direct contact with the wound. It should be large enough to cover the entire area of the wound and to extend at least 1 inch in every direction beyond the edges. If the dressing is not large enough, the edges of the wound are almost certain to become contaminated.
Figure 4-23.Roller bandages.
In most situations, a corpsman will have sterile, prepackaged dressings available. However, emergencies will sometimes arise when they will be impossible to obtain, or the supplies will run out. In such a situation, use the cleanest cloth available. A freshly laundered handkerchief, towel, or shirt may be used. Unfold these material carefully so that you do not touch the part that goes next to the skin. Always be ready to improvise, but never put materials directly in contact