Avulsions and Degloving Injuries for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Avulsions and Degloving Injuries for Certified Emergency Nursing (CEN)
Outline
Avulsions and Degloving Injuries
Definition/Etiology:
An avulsion is an injury that involves peeling the skin from the underlying tissues. As the skin separates from the underlying tissue, it can lead to further tissue devascularization. When the skin is completely separated from the underlying tissue, it is considered a devloging injury. Imaging the skin on your hand was a glove, and you could actually pull all the skin from the muscle and bone, that’s what degloving looks like.
Most avulsions are described as proximal-based or distal based. Proximal-based avulsions usually have better circulation.
Typically, these wounds affect the hands or feet. They occur with machinery, or possibly MVC, or maybe even a bad fishing trip…can you say filet knife?
Pathophysiology:
The actual pathology of avulsions would be based on a traumatic injury. There are some medications that can make individuals more susceptible to an avulsion injury. For instance, corticosteroid use can lead to thinning skin and make it easier to suffer this type of injury.
Clinical Presentation:
The clinical presentation of an avulsion injury or a degloving would be….they are missing some of their skin! Not much more complicated than that. We need to assess the injury. Again, as in other trauma lectures, don’t forget to assess the whole patient. Just because they have no skin left on their hand, does not mean they are breathing!
Collaborative Management:
- Depending on the extent of the injury, we can determine the treatment. This can range from sutures to adhesive strips, to even just lying the skin back and place and placing a tegaderm over it.
- Before covering, you must make sure to thoroughly clean the area!
- Just because some of the edges of the skin may appear gray or dusky, does not mean they won’t heal. Do not trim these edges.
- If suturing, avoid lido or epi as these are vasoconstrictive and can further compromise blood flow to the avulsed fragment.
Evaluation | Patient Monitoring | Education:
Evaluation of these injuries in the ER will depend on the injury. If there is a complete degloving, it’s likely they will go to the OR, whether it’s for grafting, or simply debridement and wound care. If it’s a simple avulsion that will be discharged from the ED, make sure we stress the need to keep it clean and follow up for wound checks.
Linchpins: (Key Points)
- Clean the area
- No lido
- Cover appropriately
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Emergency Nurses Association. (2022). Emergency Nursing Orientation 3.0. Cambridge, MA: Elsevier, Inc.
- Sheehy, S. B., Hammond, B. B., & Zimmerman, P. G. (2013). Sheehy’s manual of emergency care (Vol. 7th Edition). St. Louis, MO: Elsevier/Mosby.
Katies NCLEX
Concepts Covered:
- Test Taking Strategies
- Medication Administration
- Adult
- Emergency Care of the Cardiac Patient
- Microbiology
- Anxiety Disorders
- Depressive Disorders
- Nervous System
- Gastrointestinal Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Understanding Society
- Circulatory System
- Concepts of Pharmacology
- Studying
- Newborn Care
- Adulthood Growth and Development
- Respiratory Disorders
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Substance Abuse Disorders
- Bipolar Disorders
- Learning Pharmacology
- Psychotic Disorders
- Prenatal Concepts
- Tissues and Glands
- Factors Influencing Community Health
- Concepts of Population Health
- Community Health Overview
- Developmental Considerations
- Communication
- Legal and Ethical Issues
- Cardiovascular
- Emergency Care of the Neurological Patient
- Emergency Care of the Respiratory Patient
- Emergency Care of the Trauma Patient
- Delegation
- Multisystem
- Health & Stress
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Trauma-Stress Disorders
- Developmental Theories
- Concepts of Mental Health
- Gastrointestinal
- Newborn Complications
- Labor Complications
- Fetal Development
- Terminology
- Labor and Delivery
- Postpartum Care
- Prefixes
- Suffixes
- Proteins
- Statistics
- Med Term Basic
- Med Term Whole
- Cardiac Disorders
- Preoperative Nursing
- Intraoperative Nursing
- Vascular Disorders
- Noninfectious Respiratory Disorder
- Upper GI Disorders
- Central Nervous System Disorders – Brain
- Shock
- Immunological Disorders
- Postoperative Nursing
- Perioperative Nursing Roles
- Hematologic Disorders
- Disorders of Pancreas
- Neurological Trauma
- Neurological Emergencies
- Musculoskeletal Trauma
- EENT Disorders
- Peripheral Nervous System Disorders
- Respiratory Emergencies
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Respiratory
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Documentation and Communication
- Oncology Disorders
- Female Reproductive Disorders
- Cognitive Disorders
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Integumentary Disorders
- Urinary Disorders
- Integumentary Disorders
- Musculoskeletal Disorders
- Disorders of Thermoregulation
- Basics of NCLEX
- Integumentary Important Points
- Urinary System
- Neurologic and Cognitive Disorders
- Central Nervous System Disorders – Spinal Cord
- Renal and Urinary Disorders
- Respiratory System
- Infectious Disease Disorders
- EENT Disorders
- Eating Disorders
- Personality Disorders
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Endocrine and Metabolic Disorders
- Oncologic Disorders
- Behavior
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Basics of Sociology
- Note Taking
- Basics of Human Biology