Care of Bleeding, Wounds, and Burns Chapter 4 Care of Bleeding, Wounds, and Burns

Lesson Objectives (1 of 2) List the steps to control bleeding. Identify the different types of open wounds. Describe the procedure for cleaning a wound. Explain the procedure for wound irrigation. Evaluate movement and sensation beyond the wound. Recognize the signs and symptoms for an infected wound. Know how to close a wound.

Lesson Objectives (2 of 2) Identify risks for infection and know how to recognize an infected wound. Know how to care for special wounds, such as amputations, blisters, and bruises, and know when to consider evacuation because of a wound. Recognize burns by classification and severity. Know how to manage electrical burns. Know how to manage sunburn.

Bleeding (1 of 2) Controlling bleeding First priority is to control bleeding Major bleeding can lead to cardiovascular shock. Shock occurs when tissues do not get enough oxygenated blood.

Bleeding (2 of 2) Steps to control bleeding: Use a barrier device. Apply direct pressure. Use elevation. Use a pressure bandage. Add more dressings.

Wounds (1 of 14) Types of wounds Abrasions Lacerations Incisions Puncture wounds Avulsions Amputations © E. M. Singletary, M.D. Used with permission.

Wounds (2 of 14) Cleaning a wound Wash the wound. Use soap and clean water for shallow wounds. Cover with a sterile or clean dressing.

Wounds (3 of 14) Wound irrigation Clean with a large syringe, bulb syringe, or plastic bag with a small hole in the corner. Remove remaining fragments. Do not use disinfectant in the wound. Clean only the surface of puncture wounds.

Wounds (4 of 14) Evaluating function Check movement and sensation beyond the wound. © Howard Backer, M.D.

Wounds (5 of 14) Wound closure Close small wounds with tape or “butterfly” strips. Pack large wounds with sterile dressings. Cover all wounds with sterile or clean dressings. Change dressings every 24 to 48 hours.

Wounds (6 of 14) Wound infection Deep, dirty wounds, punctures, and bites are at high risk for infection. Animal and human bites have high risk of infection.

Wounds (7 of 14) Wound infection What to look for Redness Warmth Swelling Pain Tenderness Pus © Shout/Alamy Images

Wounds (8 of 14) Wound infection What to do Clean the area. Allow pus to escape. Soak in warm water. Change dressings often.

Wounds (9 of 14) Amputations Attempt to preserve part. Control breathing and treat victim for shock. If amputated part is found: Rinse with clean water. Wrap part in sterile gauze. Place in waterproof container. Place on ice or in snow. Take part to hospital with victim.

Wounds (10 of 14) Blisters A collection of fluid underneath the skin caused by friction. Prevent by taping susceptible areas with duct tape or adhesive or cover with adhesive felt.

Wounds (11 of 14) Blisters What to do Unbroken blisters: Clean with soap and water, puncture edges with sterile needle, cover with nonstick dressing. Broken blisters: Wash; cover with tape or a nonstick pad; If infected, cut away skin and begin warm soaks.

Wounds (12 of 14) Bruises A collection of blood within or under the skin What to look for Pain and discoloration Possible fraction

Wounds (13 of 14) Bruises What to do Apply a cold pack for 20 minutes, four times a day. If cold pack is not available, wrap firmly with an elastic bandage. Do not cut off circulation.

Wounds (14 of 14) Wounds requiring evacuation Uncontrolled or severe bleeding Deep wounds Severe wounds of hands or feet Large or deep puncture wounds or embedded objects Human or animal bites Serious eyelid injuries Infected wounds Amputations Open fractures

Burns (1 of 9) Caused by: Thermal energy Electrical energy Radiant energy Chemicals

Burns (2 of 9) Burn classification Depth Extent Location Severity Other considerations

Burns (3 of 9) Immediate action Stop the burning! Remove victim from flame or smoke-filled area. Cut off smoldering clothing or soak it with water.

Burns (4 of 9) What to do at first Check breathing. Care for burns. Check for additional injuries. Remove jewelry and watches. Remove belts and clothing from burned area. Keep burn clean and prevent blisters from breaking. Evacuate. Give large amounts of fluids. Relieve pain and inflammation.

Burns (5 of 9) What to do later First-degree burns: Apply ointment or cream to soothe. Second- and third-degree burns: Wash gently, apply antibiotic ointments, cover with nonstick dressing and bandage.

Burns (6 of 9) Electrical burns Caused by lighting strikes, in remote households, or job sites. Can produce entrance and exit wounds. Can penetrate nerves and blood vessels, causing extensive damage.

Burns (7 of 9) Electrical burns: What to do Unplug or disconnect power. Check breathing. Check for fractures. Monitor for shock. Perform CPR if necessary. Treat entrance and exit wounds. Evacuate if necessary.

Burns (8 of 9) Sunburn Caused by ultraviolet rays from the sun. Sun reflects strongly of water, sand, and snow. Prevent by wearing sun-protective clothing and sunscreen.

Burns (9 of 9) Sunburn What to look for Red skin Blisters What to do Soothe burned skin with cool compresses, baking soda, or calamine lotion. Give antihistamine pills for itching and ibuprofen for pain and inflammation.