Wounds

1
Chapter 9

• Wounds

2
Open Wounds

• A break in the skins surface resulting in
  external bleeding
• May allow bacteria to enter the body, causing an
  infection

3
Types of Open Wounds

• Abrasion
• Laceration
• Incision
• Puncture
• Avulsion
• Amputation

4
Care for Open Wounds

• Protect yourself with medical exam gloves.
• Expose the wound.
• Control bleeding.
• Wash with soap and water.

5
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.

6
Wound Cleaning (2 of 2)
7
Covering a Wound

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

8
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

9
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

10
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.

11
Care for Infected Wound (2 of 2)

• Apply antibiotic ointment.
• Change the dressings daily.
• Seek medical help if infection persists or
  becomes worse.

12
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.

13
Amputations

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

14
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.

15
Blisters

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

16
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.

17
Impaled (Embedded) Objects

• Many kinds of objects can become impaled and
  cause significant internal damage
• Pencils
• Screwdrivers
• Knives
• Glass
• Steel rods
• Fence posts

18
Care For Embedded (Impaled) Objects

• Expose area.
• DO NOT remove the object.
• Control bleeding around the object.
• Stabilize the object.

19
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

20
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

21
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

22
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.