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Ch09 presentation wounds

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First Aid Wounds

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Ch09 presentation wounds

  1. 1. Chapter 9 Wounds
  2. 2. Open Wounds • A break in the skin’s surface resulting in external bleeding • May allow bacteria to enter the body, causing an infection
  3. 3. Types of Open Wounds • Abrasion – Top layer of skin removed – Little or no blood loss – Painful © American Academy of Orthopaedic Surgeons.
  4. 4. Types of Open Wounds • Laceration – Cut with jagged, irregular edges – Tearing away of skin tissue • Incision – Smooth edges © Scott Camazine/Alamy. © American Academy of Orthopaedic Surgeons.
  5. 5. Types of Open Wounds • Puncture – Deep, narrow – High risk of infection • Avulsion – Flap of skin torn loose • Amputation – Cutting or tearing off of body part © American Academy of Orthopaedic Surgeons. © American Academy of Orthopaedic Surgeons.
  6. 6. Care for Open Wounds • Protect yourself from disease (exam gloves, etc.). • Expose the wound. • Control bleeding with direct pressure.
  7. 7. Cleaning a Wound • Scrub hands with soap and water. • Clean wound. – For shallow wound: • Wash with soap and water. • Flush with clean water under pressure. © Jones & Bartlett Learning.
  8. 8. Cleaning a Wound • Clean wound (cont’d). − For wound with higher infection risk: • Clean wound. • Seek medical care for additional cleaning. • Use tweezers to remove remaining embedded debris. • If bleeding restarts, apply direct pressure.
  9. 9. Covering a Wound • Dressing: applied over a wound to control bleeding and prevent contamination − Should be sterile or as clean as possible • Bandage: holds dressing in place – Need not be sterile
  10. 10. Covering a Wound • If the wound is small, apply thin layer of antibiotic ointment. • Cover with a sterile dressing. • Do not pull off dressing that has become stuck. – If you must remove, soak in warm water. • Change wet or dirty dressings.
  11. 11. When to Seek Medical Care • High risk wounds – Embedded foreign material – Animal and human bites – Puncture wounds – Ragged, large, or deep wounds – Visible bone, joint, muscle, fat, or tendon – Wound entering joint or body cavity – “Fight bite”
  12. 12. • Wounds needing sutures – Best placed within 6 to 8 hours • Anyone who has not had a tetanus vaccination within 10 years – 5 years in the case of a dirty wound When to Seek Medical Care
  13. 13. Risk of Infection • Wounds with foreign material • Ragged or crushed tissue • Injury to underlying nerves, tendons, joints • Bite wounds • Hand and foot wounds • Puncture wounds or wounds that cannot drain
  14. 14. Infected Wound: What to Look For • Swelling and redness around the wound • Sensation of warmth • Throbbing pain • Pus discharge • Fever • Swelling of lymph nodes • Red streaks leading from wound toward heart © Dr. P. Marazzi/Photo Researchers, Inc.
  15. 15. Infected Wound: What to Do • Soak wound in warm water, or apply warm, wet packs over infected wound. • Apply antibiotic ointment. • Change dressings several times per day. • Give pain medication. • Seek medical care if the infection persists or worsens.
  16. 16. Tetanus • Caused by toxin-producing bacterium • Travels to nervous system • Causes muscle contraction (lockjaw) • No known antidote to toxin • Tetanus vaccine and boosters can prevent the disease.
  17. 17. Tetanus • Seek vaccine and/or booster if: – Never immunized – No tetanus booster in past 10 years – Dirty, contaminated wound and no booster in past 5 years • Must receive within 72 hours
  18. 18. Amputations and Avulsions • In many cases, an amputated extremity can be successfully reattached. • Avulsions most often involve ears, fingers, and hands. – Can bleed heavily
  19. 19. Types of Amputations • Clean − Clean-cut, complete • Crushing − Crushed or mashed off • Degloving – Skin is peeled off. © Chuck Stewart, MD.
  20. 20. Amputations: What to Do © Jones & Bartlett Learning. • Call 9-1-1. • Control bleeding and treat for shock. • Care for the part: – Wrap in a wet sterile gauze or a clean cloth. – Put in a waterproof container of ice. – Send to the medical facility.
  21. 21. Avulsions: What to Do • Gently move the skin back to normal position. • Cover with sterile or clean dressing and apply pressure. • If bleeding continues, apply tourniquet or hemostatic dressing, if available.
  22. 22. Blisters • A collection of fluid in a bubble under the outer layer of skin • Caused by repeated rubbing of the skin • Treatable and preventable © Maximillian Weinzierl/Alamy.
  23. 23. Blisters: What to Do • Hot spot – Relieve pressure by applying: • Blister bandage • Surgical tape • Elastic tape – Trim and round edges of tape. • Blister that is closed and not very painful – Use the most appropriate method discussed.
  24. 24. Blisters: What to Do • Blister that is closed and very painful – Clean blister and needle with alcohol pad. – Make several small holes at base of blister with needle. © Jones & Bartlett Learning.
  25. 25. Blisters: What to Do • Blister that is closed and very painful (cont’d) – Apply paper tape and cover with elastic or adhesive tape. • Trim and round edges of tape. – Watch for signs of infection.
  26. 26. Blisters: What to Do • Blister that is very painful and open or torn – Trim off dead skin. – Place blister pad over raw skin; cover with paper tape. – Cover with elastic or adhesive tape. • Round edges of tape. – Watch for signs of infection.
  27. 27. Impaled (Embedded) Objects • Embedded objects should be stabilized to prevent internal damage. © American Academy of Orthopaedic Surgeons.
  28. 28. Sliver (Splinter): What to Do • Remove with tweezers. • Wash the area with soap and water. • Apply antibiotic ointment. • Apply adhesive bandage.
  29. 29. Large Impaled Object: What to Do • Stabilize object. • If bleeding, apply direct pressure around base of object. • If necessary, reduce length or weight of object by cutting or breaking it. • Call 9-1-1.
  30. 30. Impaled Object in Cheek: What to Do • If you are more than 1 hour from medical help, consider removing it. – To remove object: • Place two fingers next to object. • Gently pull it in the direction from which it entered. – If it cannot be removed easily: • Leave it in place. • Secure with bulky dressings.
  31. 31. Impaled Object in Cheek: What to Do • Control the bleeding. – After removing object, place dressings over wound inside mouth. – Place dressing over outside of wound.
  32. 32. Impaled Object in Eye: What to Do • Do not exert pressure on eyeball. • Stabilize object. – If long: use bulky dressing and place paper cup or cone over eye. – If short: surround eye with ring pad held in place with roller bandage. • Cover undamaged eye. • Call 9-1-1.
  33. 33. Cactus Spines: What to Do • Removal methods: – Tweezers – Glue or rubber cement • Apply in thin layer. • Allow to dry and roll up dried glue. • Combination of tweezers and glue most effective – Adhesive, duct, or cellophane tape
  34. 34. Fishhooks: What to Do • Tape fishhook in place. • If barb has not penetrated skin: – Remove by “backing out.” – Treat as puncture wound. – Seek care for tetanus. • If barb has entered skin: – Transport person. – If far from medical care, remove hook with pliers or string-jerk method. © Tosh Brown/Alamy.
  35. 35. Fishhooks: What to Do • Pliers method – Apply an ice pack or hard pressure. – Push further in until it emerges through skin. – Cut off barb with pliers and push hook back out through entry. © Jones & Bartlett Learning.
  36. 36. Fishhooks: What to Do • String-jerk method – Loop fishing line over curve of hook. – Stabilize and apply pressure. – Press down on shank and eye; jerk line out. • Movement parallel to skin’s surface © Jones & Bartlett Learning.
  37. 37. Closed Wounds • Caused by strike with blunt object • Skin is not broken, but tissue and blood vessels are crushed. • Types of closed wounds: – Bruises and contusions – Hematomas – Crush injuries
  38. 38. Closed Wounds: What to Do • Apply an ice pack. • Injured limb – Apply elastic bandage for compression. – Splint limb. • Check for fractures. • Elevate extremity above heart level.
  39. 39. Wounds Requiring Medical Care • Long or deep and needs stitches • Over a joint • Animal or human bite • Impairs function of eye, eyelid, or lip • All layers of skin removed • Caused by a metal object or a puncture wound • Over possible broken bone
  40. 40. Wounds Requiring Medical Care • Deep, jagged, or gaping open • Involves damage to underlying bones, joints, or tendons • Foreign material embedded • Cuts that show signs of infection • Cuts that include issues with movement or sensation, or increased pain
  41. 41. Wounds Requiring Medical Care • Call 9-1-1 immediately if: – Bleeding does not slow within 15 minutes. – Signs of shock – Cut to neck or chest causes difficulty breathing. – Deep cut to abdomen, painful – Eyeball cut – Amputation or partial amputation
  42. 42. Sutures (Stitches) • Within 6 to 8 hours of injury • Benefits – Faster healing – Reduced infection and scarring • Wound does not require sutures if: – Cut edges of skin fall together. – Cut is shallow.
  43. 43. Gunshot Wounds • At the scene of an active shooter: run, hide, fight • Bullet causes injury by: – Laceration and crushing – Shock waves and temporary cavitation
  44. 44. Gunshot Wounds: What to Look For • Penetrating wound—entry only • Perforating wound—entry and exit points © American Academy of Orthopaedic Surgeons.© American Academy of Orthopaedic Surgeons.
  45. 45. Gunshot Wounds: What to Do • Monitor person’s breathing. • Expose the wound(s). • Control bleeding with direct pressure. • Apply dry, sterile dressings and bandage. • Treat person for shock; keep calm. • Seek immediate medical care.
  46. 46. Legal Implications of Gunshot Wounds • Keep accurate record of observations. • Preserve evidence, such as shells or casings. • Do not touch or move anything unless it is necessary. • All gunshot wounds must be reported to police.

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