CH04 Bleeding

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Chapter 4

Care of Bleeding, Wounds, and Burns


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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 thewound.

Recognize the signs and symptoms for aninfected wound.

Know how to close a wound.


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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.


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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.


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Bleeding (2 of 2)

Steps to control bleeding:

Use a barrier device. Apply direct pressure.

Use elevation.

Use a pressure

bandage. Add more dressings.


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Wounds (1 of 14)

Types of wounds

Abrasions Lacerations

Incisions

Puncture wounds

Avulsions Amputations

E. M. Singletary, M.D. Used with permission.


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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.


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Wounds (3 of 14)

Wound irrigation

Clean with a large syringe, bulb syringe, orplastic 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.


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Wounds (4 of 14)

Evaluating function

Check movementand sensation

beyond the wound.

Howard Backer, M.D.


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Wounds (5 of 14)

Wound closure

Close small wounds with tape orbutterfly strips.

Pack large wounds with sterile dressings.

Cover all wounds with sterile or clean

dressings. Change dressings every 24 to 48 hours.


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Wounds (7 of 14)

Wound infection

What to look for Redness

Warmth

Swelling

Pain Tenderness

Pus Shout/Alamy Images


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Wounds (8 of 14)

Wound infection

What to do Clean the area.

Allow pus to escape.

Soak in warm water.

Change dressings often.


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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.


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Wounds (10 of 14)

Blisters

A collection of fluid underneath the skincaused by friction.

Prevent by taping susceptible areas with

duct tape or adhesive or cover with

adhesive felt.


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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 andbegin warm soaks.


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Wounds (12 of 14)

Bruises

A collection of blood within or under the skin What to look for

Pain and discoloration

Possible fraction


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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.


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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


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Burns (1 of 9)

Caused by:

Thermal energy Electrical energy

Radiant energy

Chemicals


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Burns (2 of 9)

Burn classification

Depth Extent

Location

Severity

Other considerations


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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.


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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.


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Burns (5 of 9)

What to do later

First-degree burns: Apply ointment or cream tosoothe.

Second- and third-degree burns: Wash gently,

apply antibiotic ointments, cover with nonstick

dressing and bandage.


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Burns (6 of 9)

Electrical burns

Caused by lighting strikes, in remotehouseholds, or job sites.

Can produce entrance and exit wounds.

Can penetrate nerves and blood vessels,

causing extensive damage.


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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.


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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.

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CH04 Bleeding