Open Injuries Siap

8/8/2019 Open Injuries Siap

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OPEN INJURIES

In an open wound, the skin is broken. Open wound is An injury that exposed

due to broken skin. An open wound is at high risk for infection. The victim is

susceptible to external bleeding and wound contamination. It may allow bacteria to

enter the body, causing an infection. There are several types of open wound such

as abrasion, laceration, avulsion, penetrating and puncture wounds, and

amputations.

ABRASION

Abrasion is a superficial wound caused by rubbing, scraping, or shearing.

(Please refer to picture 1 in the appendix). Bleeding in this type of wound is usually

limited, but it is important that the skin be cleaned in order to guard against infection.

The top layer of skin is removed, with little or no blood loss. Part of the skin layer is

lost. That is usually the epidermis and part of the dermis.

Abrasion injuries most commonly occur when exposed skin comes into

moving contact with a rough surface, causing a grinding or rubbing away of the

upper layers of the epidermis.(Please refer to picture 2 in the appendix). All

abrasion, regardless of size, are extremely painful because of the nerve ending

involved. Mild abrasions, also known as grazes or scrapes, do not scaror bleed, but

deep abrasions may lead to the formation of scar tissue. Abrasions can pose a

threat if large areas of skin are involved. The most serious threat from abrasions is

that of contamination and infection.
http://en.wikipedia.org/wiki/Scarhttp://en.wikipedia.org/wiki/Scar


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LACERATION

A laceration is a break in the skin of varying depth. (Please refer to picture 3

in the appendix). Laceration caused by a forceful tearing away of skin tissue. It can

be either linear or irregular. Laceration can occur either in isolation or together with

other types of soft-tissue injury. Its can cause significant bleeding if the sharp object

cuts the wall of a blood vessel, especially an artery. This is particularly true in areas

where major arteries lie close to the skin surface, such as in the wrist.

Linear lacerations, also known as incisions, are characterized by sharp, even

cuts with smooth edges. (Please refer to picture 4 in the appendix). It also cause by

a sharp, cutting object, such as knife, razor blade, or broken glass. Linearlacerations tend to bleed freely. The greatest dangers with linear lacerations are

severe bleeding and damage to tendons and nerves. They usually heal better than

irregular lacerations, though, because the edges of the wound are smooth and

straight. An irregular lacerations is tear caused by a sharp, uneven instrument such

as a broken bottle that produces a ragged incision through the skin surface and

underlying tissues.

AVULSION

A piece of skin in torn loose and is hanging from the body or completely

removed. (Please refer to picture 5 in the appendix). This type of wound can bleed

heavily. If the avulsed tissue is still attached by a flap of skin and is folded back,

circulation to the flap can be severely compromised. The seriousness of an avulsion

depends on how disrupted circulation is to the flap. If the avulsed tissue is still


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attached by a flap of skin and is folded back, circulation to the flap can be severely

com promised.

The seriousness of an avulsion depends on how disrupted circulation is to

the flap. T he most commonly avulsed skin on the body is that on the fingers and

toes, hands, forearms, legs, feet, ears, nose, and penis. Avulsions commonly occur

in automobile accidents and industrial settings.

PENETRATING AND PUNCUTURE WOUNDS

A puncture wound is caused by the penetration of sharp object such as a nail

that through the skin and underlying structures. The opening in the skin may appear

very small, resulting in little external bleeding, but the puncture wound may be

extremely deep causing severe internal bleeding and posing a serious threat of

infection. (Please refer to picture 6 in the appendix). Punctures also can causes

damaged of Internal organs. (Please refer to picture 7 in the appendix). In some

cases, the object that causes the injury remains embedded in the wound. Gunshot

wounds may cause both entrance and exit wounds.

The entrance wound is usually much smaller than the exit wound, which is

generally two to three times large and tends to bleed heavily. Knife and stab wounds

are dangerous. Because knife wounds easy to see, First Aider too frequently

concentrate only on the superficial skin wound and fail to consider the damage to

underlying organs. The superficial skin wound is almost never fatal. The fatalities all

relate to the injured organs that lie beneath the skin wound.

AMPUTATIONS


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The ripping, tearing force of industrial and automobile accidents can be great

enough to tear away limbs from the body, amputations can also involve other body

part. (Please refer to picture 8 in the appendix). Amputation involves the cutting ortearing off of a body part. Complete amputations may cause relatively limited

bleeding, because blood vessels are elastic , they tend to spasm and retract into

surrounding tissue in cases of complete amputation.

Because blood vessels are elastic, they tend to spasm and retract into

surrounding tissue in cases of complete amputation. Therefore, complete

amputations may cause relatively limited bleeding. (Please refer to picture 9 in the

appendix). In partial or degloving amputations, however, lacerated arteries continue

to bleed profusely, and blood loss can be massive. (Please refer to picture 10 in the

appendix).

FIRST AID CARE

Always take measures to avoid contact with body substances when caring for

a victim of a soft-tissue injury, because there is a high chance of contact with the

victims blood, body fluids, mucous membranes, traumatic wounds, or sores. Use

protective gloves. If there is a chance of spraying or spattering blood, protect your

face and clothes. After caring for the victim, dispose of the gloves and wash your

hands thoroughly with soap and hot water.

Before begin to treat the injury, maintain an airway and provide artificial

ventilation if necessary. Treat soft-tissue injuries as follows.


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1) Expose the wound to see it clearly. If necessary, cut the victims clothing

from around the wound.

2) Control bleeding with direct pressure, using glove hand and a dry, sterile

compression bandage, if possible.

3) Prevent further contamination by keeping the wound as clean as possible.

Avoid touching the wound with anything that is nit clean. Leave the cleaning

of the wound to medical personnel.

4) Apply a dry, sterile dressing to the wound and bandage it securely in place.

In general, activate the EMS system if any of the following are true:

The wound has spurted blood, even have been controlled the bleeding.

The wound is deeper than the outer layer of skin.

There is uncontrolled bleeding.

There is embedded debris, an embedded object, or extensive contamination.

The wound involves nerves, muscles, or tendons.

The wound involves the mouth, tongue, face, genitals, or any area where a

scar would be disfiguring.

The wound is a human or animal bite.

CLEANING WOUNDS AND PREVENTING INFECTION


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In most cases, let an EMT or personnel at the emergency room take care of

cleaning wounds, especially those that are large, have embedded debris, are

extremely dirty, may require stitches, or are life-threatening.

Wash the area around the wound with soap and water.

Irrigate the wound with clean tap water. The water must flow at moderate

pressure and be clean enough water to drink.

Gently pat the wound dry with sterile gauze and apply antibiotic ointment.

Cover the wound with a sterile, non-stick dressing, and bandage in place.

DRESSING AN OPEN WOUND

Don't dress a wound without first cleaning it as well as possible. Do not dress

a wound with visible contamination. If you can't get it clean, leave it open and seek

medical attention.

Once the wound is clean and not bleeding, dab a bit of antiseptic ointment on

it to keep out the germs. Cover the wound lightly with an adhesive dressing. If bodyhair gets in the way of an adhesive dressing, you may wrap the extremity loosely

with a wide roller gauze. Always change dressings every 12 hours.

For lacerations and incisions, pull the edges of the wound together and use

butterfly enclosures to hold them. Avulsions with a flap of skin can be closed and

butterfly enclosures applied as well. Apply antiseptic ointment over butterfly

enclosures and cover with a bandage as above. Superficial wounds, those that are

not deep enough to see subcutaneous (fatty) tissue, do not need butterfly

enclosures.

If a wound resumes bleeding at any point, follow the steps to control bleeding.

If bleeding doesn't stop, you may need to seek medical attention. If at any point the

victim gets pale, dizzy, or weak, active EMS system and treat forshock.
http://firstaid.about.com/od/bleedingcontrol/ht/shock.htmhttp://firstaid.about.com/od/bleedingcontrol/ht/shock.htm


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REMOVING SLIVERS

Assess the problem. If the area is covered in sawdust or other material which

makes it difficult to see, brush it off. Wash your hands, the area around the splinter

and a pair of tweezers thoroughly with hot, soapy water. Cover an exposed sliver

with piece of sticky tape. Remove the tape, and often the sliver will stick to it, pulling

right out of the skin. If the tape fails, proceed to step four. Place a dab of white glue

on the sliver and allow to dry. Peel away the glue and the splinter may come awaywith it. If not, continue with step five. Remove the sliver with tweezers. To keep

pieces from breaking off under the skin, pull out from the same angle it went in. If

this method fails, advance to the Embedded Slivers section.

Wash your hands, the area around the splinter, a pair of tweezers and a

sewing needle with soapy, hot water. Lay the sewing needle lengthwise across the

skin, just below the deepest end of the splinter. The two should create a very short

letter 'T' shape. Press down on the needle and slowly run it upward. The pressure

beneath the sliver and upward motion should begin gradually coaxing it out of the

skin. Have patience, this may take several tries.

Once enough of it is exposed, remove the splinter with a pair of tweezers. You

may have to pierce the skin. Use the tip of the needle to push from the bottom of the

sliver toward the opening in your skin. Sometimes, a tiny push is all that's needed to

expose enough to remove with tweezers. Open the skin covering the splinter only as

a last result. Carefully do so, one layer of skin at a time until you're able to reach the

splinter. If the problem is more than a few layers deep, see a doctor for removal.

Wash the area thoroughly with soap and water, and apply an adhesive bandage to

keep the wound clean. (Please refer to picture 11 in the appendix).


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REMOVING A FISHHOOK

Never remove a fishhook that is embedded in the eye or face; seek medical

attention immediately to have it removed. A fishhook embedded in skin should be

removed by a doctor. If you are in a remote area and a doctor is not available,

remove the fishhook following the directions in the illustration below. If the fishhook

is embedded deeply in tissue, follow the instructions below for a multibarbed

fishhook.

A multibarbed fishhook should ideally be removed by a physician. If this is not

possible, cut the eye off the shank of the hook, and then push the shank of the hook

through the wound, following the path of the hook until the barbs exit and can be

grasped with pliers. Flush the area well with running water, clean it with soap and

water, and cover it with a bandage.

First, make sure that any bystanders are out of the way of the fishhooks path.

Next, loop a piece of fishing line several times around the belly of the hook near the

skin surface. Press the shank of the hook against the skin with your index finger .

Wrap the other end of the string several times around the index finger of your

other hand (use your thumb to hold the loose end of the string tightly) .

Move your index finger close to the hook to generate slack in the line. Pull onthe string suddenly, with a jerk, in line with the hook. Flush the area with water,

clean it with soap and water, and bandage it. (Please refer to picture 12 in the

appendix).


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CAUTION

Never apply hydrogen peroxide, isopropyl alcohol, merthiolate,

mercurochrome, or iodine to a wound because these can injure the tissues and

delay healing.

Do not close a wound with adhesive tape, steri-strips. Or butterfly strips

because these increase the risk of infection.

Do not give the casualty anything to eat or drink. If the casualty complains of

thirst, moisten his lips with a damp cloth.

If a foreign object is protruding from the wound, do not attempt to remove the

object. Improvise bulky dressings from the cleanest material available and build up

the area around the object in order to stabilize the object. Secure the dressing with

improvised bandages.

Do not tie the knots over the wound site. The bandages should be tight

enough to keep the dressing from slipping, but should not be tight enough to place

pressure on the wound. The primary purpose of the dressing is to protect the wound

from further contamination, not to control the bleeding through pressure. Pressure

could cause additional damage to the organs of the abdominal cavity.


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APPENDIX

PICTURE 1


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PICTURE 2

PICTURE 3


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PICTURE 4


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PICTURE 5

PICTURE 6


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PICTURE 7

PICTURE 8


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PICTURE 9


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PICTURE 10

PICTURE 11


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PICTURE 12


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REFERRENCE

I. Internet :

http://www.healthscout.com/ency/68/66/main.html

http://www.medterms.com/script/main/art.asp?articlekey=11768

http://medical-dictionary.thefreedictionary.com/open+wound

http://www.medtrng.com/cls2000a/lesson_9_perform_first_aid_for_a.

htm

http://orthopedics.about.com/od/brokenbones/a/avulsion.htm

http://www.ncemi.org/cse/cse1001.htm

http://www.emedicinehealth.com/puncture_wound/article_em.htm

II. Book :

Castellani, J. W., A. J. Young, M. N. Sawka, and K. B. Pandolf.

Open injuries and first aid care. J. Appl. Physiol. 85: 204-209, 1998

Keith J. Karren, Brent Q. Hafen, Daniel Limmer, and Joseph J.

Mistovich. First Aid For Colleges and Universities. Soft tissue

injuries : 117-123.
http://www.healthscout.com/ency/68/66/main.htmlhttp://www.medterms.com/script/main/art.asp?articlekey=11768http://medical-dictionary.thefreedictionary.com/open+woundhttp://www.medtrng.com/cls2000a/lesson_9_perform_first_aid_for_a.htmhttp://www.medtrng.com/cls2000a/lesson_9_perform_first_aid_for_a.htmhttp://orthopedics.about.com/od/brokenbones/a/avulsion.htmhttp://www.ncemi.org/cse/cse1001.htmhttp://www.healthscout.com/ency/68/66/main.htmlhttp://www.medterms.com/script/main/art.asp?articlekey=11768http://medical-dictionary.thefreedictionary.com/open+woundhttp://www.medtrng.com/cls2000a/lesson_9_perform_first_aid_for_a.htmhttp://www.medtrng.com/cls2000a/lesson_9_perform_first_aid_for_a.htmhttp://orthopedics.about.com/od/brokenbones/a/avulsion.htmhttp://www.ncemi.org/cse/cse1001.htm

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