Basics to Wound Management
Most of us will be carrying or have readily accessible a first aid kit for treating wounds.
The primary focus to managing a wound is to minimize complications and promote healing. Before using any of your fancy tools you need to do follow these basic steps.
Primary Survey – Identify and stabilize any associated traumatic injuries. Stabilize other more serious injuries before first managing the wound
Control Hemorrhage – Most often this can be done with direct pressure to the wound. If bleeding continues despite pressure, tourniquets may be used with the knowledge that a limb may be sacrificed. With applied release every 5-10 minutes if possible to restore perfusion.
Minimize Infection – Irrigate, irrigate, irrigate. Rinse the wound as much as possible to remove debris and other agents that may lead to an infection. Use cleanest water available, or saline. Do not use hydrogen peroxide, iodine, alcohol or other agents as they will typically hinder the healing process. Antibiotics do not need to be used on every open wound, use judgement on how severe and how big of a risk infection may be, also what other issue the person may have that puts them at risk for infection. Debridment of the wound comes next for any devitalized (dead or damaged tissue). Get as much of it out as safely as possible without making matters worse.
Closure – Depending on the wound size, how long it has been open and how dirty it is, you need to decide how to close it. Sutures are not always the best option. If the wound is older than 6 hours, do not close, manage it as an open wound, changing bandages etc daily. Closure can be done with sutures, tape, adhesives, glue, or staples.
Definitive care – Now that it has been cleansed and possibly closed, you need to develop a plan to manage the wound. How often to change the bandage and inspect, when to start antibiotics, and if the injury needs more advanced medical care and transport.
These steps are basic, but should be followed for each wound you have to manage. It will minimize supplies used, infection, and further complications. Just remember the common saying, "keep it simple". No need to bust out the trauma kit on every injury and perform a brain transplant to a more healthy body.
This was our Quick & Dirty Medical tip from a few episodes ago. Take a listen -