First Aid Management of Wounds
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First Aid Management of Wounds
A wound refers to damage or breaks on the skin surface. It can either be open or closed. An open wound is a break on the surface of the skin with the presence of external bleeding. Open wounds include abrasions, laceration, incisions, puncture, avulsion, and amputation. An abrasion occurs when the top covering of the skin is damaged or removed. It can occur with or without loss of blood. A laceration is a wound that occurs when the skin is cut and has irregular edges. It mainly occurs as a result of forceful tearing of the skin. Unlike lacerations, incisions have smooth edges. They include surgical cuts or a paper cut. A puncture is a deep narrow wound occurring on the skin and the underlying tissues. An avulsion occurs when the skin is damaged such that it is left hanging on the body or completely torn off. Lastly, an amputation is a wound resulting from complete tearing off of a body part.
On the other hand, closed wounds occur when the body is strike by a blunt object. Here, the skin is not always broken, but the underlying tissues and blood vessels are damaged, leading to bleeding within the area. Closed wounds include bruises, contusions, and hematoma. Bruises and contusions happen when the blood is confined under the skin in the injured part, while a hematoma is any clot that forms under the skin. The first aid management of wounds is important since wounds occur every day. Application of proper first aid management of wound increases the speed of the healing process while decreasing the probability of infections.
First aid management of wound requires a nurse to wash his/her hands before handling the wound. Washing hands helps maintain the wound clean and avoid any infections. Secondly, one should wear gloves to protect themselves while keeping the wounds clean and uninfected. One should remove the casualty’s clothes to expose the wound if it is covered. The other step involves assessing the wound to determine the extent of the cut. The nurse should examine the type of injury to establish any internal injury. The next step involves stopping the bleeding. Stopping the bleeding is especially critical for deep wounds such as laceration s and avulsions. This is important in preventing excessive bleeding that can cause fatal hemorrhagic shock (Korting, Schöllmann, & White, 2011). One should apply mild pressure on the wound using a clean piece of cloth or a bandage. Then, the injured part should be elevated slightly till the bleeding ends.
Additionally, one should clean the wound after stopping the bleeding. Anyone should clean a wound by moistening it with water. One can use either running tap water, soap, and water or boiled water. A nurse should then pass water into the wound and let it run out. Water is used to remove any foreign objects. Then, one should dry the wound smoothly, tapping the skin surrounding the wound using a clean towel. If any hanging skin flan, a person should softly return the skin flap into the wounded area using a damp cotton pad. The wound should then be disinfected by applying any topical antimicrobial to prevent any infections. Dressing the injured area is essential to protect the entry of objects, increasing the extent of injury while slowing down the healing process (Nicks, Ayello, Woo, Nitzki-George, & Sibbald, 2010).
Furthermore, the wound should be covered to prevent it from soaking with body fluids which may slow the healing process. Generally, covering the wound facilitates the healing process. The wound can be protected using a sterile dressing and a bandage. A dressing stops bleeding and prevents wound infection, while a bandage is used to protect the dressing, prevent bleeding, decrease the extent of swelling, as well as to immobilize and support the limbs. It is not mandatory to cover minor wounds such as abrasions. One should then refer the casualty to a hospital clinic if the wound is deeply injured or if the casualty is experiencing severe bleeding. Severely bleeding wounds may need intensive and emergency treatment interventions like suturing and various surgical interventions. One should seek the assistance of a nurse or a physician whenever the casualty portrays signs and symptoms of wound infection, or in case one cannot reposition the skin (Felson, 2011).
Moreover, they should call for emergency assistance if any foreign objects such as dirt and glass cannot be removed by running water. It is essential to take the casualty to the hospital if the wound is not healing yet or if it has resolved after four weeks. Individuals with comorbidities such as diabetes and anemia or co-existing injury or injured their head should seek immediate medical help. Anyone should monitor the patient experiencing persistent bleeding for manifestations of hypovolemic shock, which include pale skin, cyanosis, lethargy, faintness, weak and faster heart rate, as well as, irregular breathing. A person managing the casualty should administer painkillers to relieve painful wounds (Department of Health. (n.d)). One should ask for emergency help if they are unsure of how to provide first aid management of the wound.
The wound healing process can be hindered by the presence of dead skin or if the skin is infected. A poorly managed wound may acquire bacteria infection, making the body concentrate on fighting the infection instead of wound healing. Continuous bleeding can also slow down the healing process since it makes the wound edges remain separated. Immobility can also contribute to decreased wound healing due to the development of bedsores caused by persistent pressure and abrasion. The casualty should be advised against cigarette smoking because cigarette smoke hinders the healing process and facilitate its progression to a chronic wound. Diseases such as varicose veins limit blood flow and edema, increasing skin damage and continuous ulceration.
First aid management of wounds is essential to prevent persistent bleeding and infection. More attention should be given to the management of deep wounds since they increase the risk of hypovolemic shock resulting from excessive blood loss. A nurse should follow all the first aid steps to assist the casualty.
References
Department of Health. (n.d). Wounds first aid. Retrieved from: https://healthywa.wa.gov.au/Articles/U_Z/Wounds-first-aid
Korting, H. C., Schöllmann, C., & White, R. J. (2011). Management of minor acute cutaneous wounds: importance of wound healing in a moist environment. Journal of the European Academy of Dermatology and Venereology, 25(2), 130-137. https://doi.org/10.1111/j.1468-3083.2010.03775.x
Nicks, B. A., Ayello, E. A., Woo, K., Nitzki-George, D., & Sibbald, R. G. (2010). Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations. International journal of emergency medicine, 3(4), 399-407. DOI 10.1007/s12245-010-0217-5
Felson, S. (2011, December 5). Bleeding cuts or wounds.. WebMD. https://www.webmd.com/first-aid/bleeding-cuts-wounds
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