Chapter 9 Wounds

Open Wounds A break in the skin’s surface resulting in external bleeding May allow bacteria to enter the body, causing an infection

Types of Open Wounds Abrasion Laceration Incision Puncture Avulsion Amputation

Care for Open Wounds Protect yourself with medical exam gloves. Expose the wound. Control bleeding. Wash with soap and water.

Wound Cleaning (1 of 2) Shallow wounds Wash with soap and water and flush with clean water. Wound with high risk of infection Seek medical care for wound cleaning. If in remote area, clean as best you can. Remove small objects with sterile tweezers.

Wound Cleaning (2 of 2)

Covering a Wound Cover with thin layer of antibiotic ointment. Cover with a sterile dressing. Change any wet or dirty dressings.

When to Seek Medical Care To clean high-risk wounds For wound closure Victim has not had a tetanus booster in past 10 years Victim has a dirty wound and has not had tetanus booster in 5 years Must receive booster within 72 hours

Signs of Infection Swelling and redness around the wound Sensation of warmth Throbbing pain Pus discharge Fever Swelling of lymph nodes Red streaks leading from the wound toward the heart

Care for Infected Wound (1 of 2) Keep area clean. Soak in warm water or apply warm, wet packs. Elevate the infected portion of the body.

Care for Infected Wound (2 of 2) Apply antibiotic ointment. Change the dressings daily. Seek medical help if infection persists or becomes worse.

Tetanus Tetanus bacterium enters a wound that contains little oxygen and produces powerful toxin. No known antidote to the toxin once it enters bloodstream. A tetanus vaccine can completely prevent the disease.

Amputations In many cases, amputated extremity can be replanted. Types Guillotine Crushing Degloving

Care for Amputations Control bleeding. Treat for shock. Recover amputated part. Wrap part in gauze, place in a bag, and keep bag cool. Transport the part with the victim.

Blisters A collection of fluid in a “bubble” under outer layer of skin. Repeated rubbing of small area will produce a blister.

Care for Blisters If blister on foot is open or very painful: Clean with soap and water. Drain fluid from blister with a sterilized needle. Apply layers of moleskin or molefoam. Apply antibiotic ointment.

Impaled (Embedded) Objects Many kinds of objects can become impaled and cause significant internal damage: Pencils Screwdrivers Knives Glass Steel rods Fence posts

Care For Embedded (Impaled) Objects Expose area. DO NOT remove the object. Control bleeding around the object. Stabilize the object.

Slivers Can be painful and irritating Usually easily removed with tweezers After removal, clean with soap and water and apply adhesive strip. Special cases: Cactus spines: Use white wood-working glue Fishooks: Use pliers with tempered jaws or fishline method

Closed Wounds Results when a blunt object strikes the body Skin is not broken but tissue and blood vessels are crushed. Types of closed wounds: Bruises and contusions Hematomas Crush injuries

Wounds That Require Medical Attention Possibility of a scar Eyelid cut Slit lip Internal bleeding Uncertain how to treat Need a tetanus shot Uncontrolled bleeding Deep wounds Large or deeply embedded objects Foreign matter in wound Human or animal bite

Gunshot Wounds A bullet causes injury in two ways: Laceration and crushing Shock waves and temporary cavitation Initial care for gunshot wounds is roughly the same as for any other wound.