Chapter 9Wounds

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 woundsWash 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.

• TypesGuillotineCrushingDegloving

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: PencilsScrewdrivers KnivesGlassSteel rodsFence 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 contusionsHematomasCrush injuries

Wounds That Require Medical Attention

• Uncontrolled bleeding

• Deep wounds• Large or deeply

embedded objects• Foreign matter in

wound• Human or animal

bite

• Possibility of a scar• Eyelid cut • Slit lip• Internal bleeding• Uncertain how to

treat• Need a tetanus shot

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.