MANAGEMENT OF SOFT TISSUE
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
Visible indications of internal soft tissue in-
jury include the following:
Hematemesis - vomiting bright red blood.
Hemoptysis - coughing up bright red
Melena - excretion of tarry black stools.
Hematochezia - excretion of bright red
blood from the rectum.
Hematuria - pass blood in the urine.
Nonmenstrual vaginal bleeding.
Epistaxis - nosebleed.
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:
Pale, moist, clammy skin.
Rapid, feeble pulse.
Falling blood pressure.
Dilated, slowly reacting pupils with im-
Dehydration and thirst.
Yawning and air hunger.
Anxiety, with a feeling of impending
There is little that a corpsman can do to cor-
rect 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:
Treat for shock.
Keep the victim warm and at rest.
Replace lost fluids with a suitable blood
volume expander (refer to the Intra-
venous Therapy section of the Nursing
Procedures Manual); DO NOT give the vic-
tim anything to drink until the extent of
the injury is known for certain.
Give oxygen, if available.
Splint injured extremities.
Apply cold compresses to identifiable in-
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.
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 impro-
vise, but never put materials directly in contact
Figure 4-23.Roller bandages.