Chapter 9

Wounds

Open Wounds
A break in the skins 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
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.