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Chapter 9 Wounds
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- 2. Open Wounds • Abreak in the skin’s surface resulting in external bleeding • May allow bacteria to enter the body, causing an infection
- 3. Types of OpenWounds (1 of 3) • Abrasion • Top layer of skin is removed. • Little or no bleeding • Painful
- 4. Types of OpenWounds (2 of 3) • Laceration • Cut with jagged, irregular edges • Tearing away of skin tissue • Incision • Smooth edges © SHOUT/Alamy Images
- 5. Types of OpenWounds (3 of 3) • Puncture • Deep, narrow • High risk of infection • Avulsion • Flap of skin torn loose • Amputation • Cutting or tearing off of body part
- 6. Care for OpenWounds • Protect yourself from disease (exam gloves, etc.). • Expose the wound. • Control bleeding with direct pressure.
- 7. Wound Cleaning (1of 2) • Scrub hands with soap and water. • Clean wound. • For shallow wound: • Wash with soap and water. • Flush with clean water under pressure.
- 8. Wound Cleaning (2of 2) • 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. • Apply direct pressure to control bleeding.
- 9. Covering a Wound •Apply thin layer of antibiotic ointment. • Small wounds only • Cover with a sterile dressing. • Do not pull off sticky or blood- soaked dressing. • Change any wet or dirty dressings.
- 10. Seek Medical Carefor High-Risk Wounds • Wounds with embedded material • Bites • Puncture wounds • Ragged wounds, or wounds where skin edges do not come together • Visible nerve, joint, muscle, fat, or tendon • Wound entering joint or body cavity
- 11. 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 wound toward heart
- 12. Care for InfectedWounds (1 of 2) • Keep area clean. • Soak in warm water or apply warm, wet packs. • Elevate limb. © Dr. P. Marazzi/Photo Researchers, Inc.
- 13. Care for InfectedWounds (2 of 2) • Apply antibiotic ointment. • Change dressings daily. • Seek medical help if infection persists or becomes worse.
- 14. Tetanus (1 of2) • 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.
- 15. Tetanus (2 of2) • 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
- 16. Amputations • Guillotine • Clean-cut,complete • Crushing • Crushed or mashed off • Degloving • Skin is peeled off. © Chuck Stewart, MD
- 17. Care for Amputations •Control bleeding. • Treat for shock. • Recover amputated part and take to hospital. • Wrap part in gauze, place in waterproof bag, and keep cool.
- 18. Care for Blisters(1 of 3) • Fluid “bubble” caused by repeated rubbing • For red “hot spot” blisters: • Snugly apply tape. • Or make pad from several layers of moleskin or molefoam. © Maximillian Weinzier/Alamy Images
- 19. Care for Blisters(2 of 3) • For closed blister: • Tape with duct tape. • Should remain for several days • Only remove roof if infection occurs. • Wash with soap. • Use scissors sterilized with rubbing alcohol.
- 20. Care for Blisters(3 of 3) • For open or very painful blister: • Clean with soap and water. • Drain fluid. • Apply pad with opening. • Apply antibiotic ointment and secure with tape.
- 21. Care for Impaled(Embedded) Objects • Do not remove object. • Stabilize object. • Control bleeding. • May shorten object to ease transport • After stabilizing
- 22. Care for ImpaledObjects in Cheek • Remove object if it extends through cheek. • Straddle with two fingers. • Gently pull in direction of entry. • Place dressings: • Between cheek and teeth • On outside of cheek
- 23. Care for ImpaledObjects in Eye • Do NOT exert pressure on eye. • 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. • Seek immediate medical attention.
- 24. Care for Slivers •Can be painful and irritating • Removal • Reposition as needed with end of sterile needle. • Remove with tweezers. • Clean with soap and water. • Apply adhesive strip.
- 25. Care for CactusSpines • 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 • Do NOT use superglue.
- 26. Care for Fishhooks(1 of 2) • Pliers method • Apply cold or hard pressure. • Push hook in shallow curve. • Cut off barb with pliers and push hook through entry. • Treat for tetanus.
- 27. Care for Fishhooks(2 of 2) • 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
- 28. Closed Wounds • Causedby 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
- 29. Care for ClosedWounds • Apply an ice pack. • Injured limb: • Apply elastic bandage for compression. • Splint limb. • Check for fractures. • Elevate extremity above heart level.
- 30. Wounds Requiring MedicalCare (1 of 2) • Still bleeding after 15 minutes of pressure • Long or deep and needs stitches • Over a joint • Impairs function of eye, eyelid, or lip • Removes all layers of skin • Animal or human bite
- 31. Wounds Requiring MedicalCare (2 of 3) • Involves damage to underlying nerves, tendons, joints, or bones • Over a possible broken bone • Crushing injury • Object embedded in wound • Caused by a metal object or a puncture wound
- 32. Wounds Requiring MedicalCare (3 of 3) • 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
- 33. Sutures (Stitches) • Within6 to 8 hours of injury • Benefits: • Faster healing • Reduce infection and scarring • Wound does not require sutures if: • Cut edges of skin come together. • Cut is shallow.
- 34. Gunshot Wounds • Bulletcauses injury by: • Laceration and crushing • Shock waves and temporary cavitation • Penetrating—entry only • Perforating—entry and exit wound
- 35. Care for GunshotWounds • Monitor victim’s breathing. • Expose the wound(s). • Control bleeding with direct pressure. • Apply dry, sterile dressings and bandage. • Treat victim for shock; keep calm. • Seek immediate medical care.
- 36. Legal Aspects • Keepaccurate 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.