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Chapter 9
Wounds
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Open Wounds
A break in the skins surface
resulting in external bleeding
May allow bacteria to enter the
body, causing an infection
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Types of Open Wounds (1 of 3)
Abrasion
Top layer of skin
is removed. Little or no
bleeding
Painful
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Types of Open Wounds (2 of 3)
Laceration
Cut with jagged,
irregular edges Tearing away of
skin tissue
Incision
Smooth edges
SHOUT/Alamy Images
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Types of Open Wounds (3 of 3)
Puncture
Deep, narrow
High risk of infection
Avulsion Flap of skin torn
loose
Amputation Cutting or tearing off
of body part
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Care for Open Wounds
Protect yourself from disease
(exam gloves, etc.).
Expose the wound. Control bleeding with direct
pressure.
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Wound Cleaning (1 of 2)
Scrub hands with
soap and water.
Clean wound. For shallow wound:
Wash with soap
and water.
Flush with clean
water under
pressure.
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Wound Cleaning (2 of 2)
Clean wound (contd).
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.
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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.
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Seek Medical Care for High-RiskWounds
Wounds with embedded material
Bites
Puncture wounds Ragged wounds, or wounds where skin
edges do not come together
Visible nerve, joint, muscle, fat, ortendon
Wound entering joint or body cavity
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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
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Care for Infected Wounds (1 of 2)
Keep area clean.
Soak in warm
water or apply
warm, wet packs.
Elevate limb. Dr. P. Marazzi/Photo Researchers, Inc.
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Care for Infected Wounds (2 of 2)
Apply antibiotic ointment.
Change dressings daily.
Seek medical help if infectionpersists or becomes worse.
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Tetanus (1 of 2)
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.
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Tetanus (2 of 2)
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
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Amputations
Guillotine
Clean-cut, complete
Crushing
Crushed or mashed
off
Degloving
Skin is peeled off. Chuck Stewart, MD
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Care for Amputations
Control bleeding. Treat for shock.
Recover
amputated partand take tohospital.
Wrap part in
gauze, place inwaterproof bag,and keep cool.
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Care for Blisters (1 of 3)
Fluid bubblecaused by repeatedrubbing
For red hot spotblisters:
Snugly apply tape.
Or make pad fromseveral layers ofmoleskin ormolefoam. Maximillian Weinzier/Alamy Images
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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.
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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.
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Care for Impaled (Embedded)Objects
Do not removeobject.
Stabilize object.
Control bleeding.
May shortenobject to ease
transport After stabilizing
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Care for Impaled Objects in Cheek
Remove object if it extends throughcheek.
Straddle with two fingers. Gently pull in direction of entry.
Place dressings:
Between cheek and teeth
On outside of cheek
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Care for Impaled Objects in Eye
Do NOT exert pressure on eye.
Stabilize object.
If long: use bulky dressing and place papercup or cone over eye.
If short: surround eye with ring pad held inplace with roller bandage.
Cover undamagedeye. Seek immediate medical attention.
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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.
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Care for Cactus Spines
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.
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Care for Fishhooks (1 of 2)
Pliers method
Apply cold or hard
pressure.
Push hook inshallow curve.
Cut off barb with
pliers and pushhook through entry.
Treat for tetanus.
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Care for Fishhooks (2 of 2)
String-jerk method
Loop fishing lineover curve of hook.
Stabilize and applypressure.
Press down onshank and eye; jerk
line out. Movement parallel to
skins surface
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Closed Wounds
Caused by 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
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Care for Closed Wounds
Apply an ice pack.
Injured limb:
Apply elastic bandage for compression.
Splint limb.
Check for fractures.
Elevate extremity above heart level.
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Wounds Requiring Medical Care(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
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Wounds Requiring Medical Care(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 puncturewound
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Wounds Requiring Medical Care(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
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Sutures (Stitches)
Within 6 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.
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Gunshot Wounds
Bullet causes injury by:
Laceration and crushing
Shock waves and
temporary cavitation Penetratingentry only
Perforatingentry and
exit wound
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Care for Gunshot Wounds
Monitor victims 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.
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Legal Aspects
Keep accurate record ofobservations.
Preserve evidence, such as shellsor casings.
Do not touch or move anythingunless it is necessary.
All gunshot wounds must bereported to police.