Survival

8. The Essential First Aid Course, Part 2: Managing Bleeding and Infection

How can you treat wounds in a disaster/emergency situation?

In the first part of our series on first aid, we talked about the proper method of assessing an unconscious individual and applying CPR as needed. We learned that the safety of the first aider is of utmost priority and should be considered first before any attempts at giving CPR are carried out.

In today’s blog post I’m going to share with you the proper ways of caring for different types of wounds. Wound care is another important skill that can help ward off infection and sepsis if someone is physically injured during a disaster.

What are the objectives of wound care?

All wound care techniques are ruled by 4 major objectives:

  1. To reduce and completely stop bleeding whenever possible.
  1. To reduce the incidence of bacterial/viral infection through proper cleaning of the wound.
  1. To apply adequate dressing to the wound to protect it from further contamination and to increase the comfort of the victim/patient.
  1. To initiate the natural healing of the wound and improve the function and/or mobility of the affected body part.

How can you control or stop bleeding?

Bleeding naturally occurs when blood vessels are damaged or torn.

All types of wounds (whether closed or open) bleed. If you scratch your skin because of an itch and the skin breaks, you may see a few rivulets of blood escape. This type of bleeding can easily be addressed through the application of minor pressure on the affected area.

However, there are instances when a large wound bleeds profusely and it’s difficult to staunch the flow of blood.

If a wound is large and deep, you will be dealing with innumerable damaged capillaries, arteries and veins all pouring out blood. Follow these guidelines in the event that you’re faced with a wound that is bleeding heavily:

  1. Apply Pressure – Applying pressure on the bleeding area can help speed up the clotting process. Use a clean gauze or cloth to press down on the affected area. The secret is applying a consistent, heavy pressure on the wound. However, don’t press down too hard as this can cause further injury to the skin.
  1. Change the Person’s Position – Whenever possible, ask the patient to lie down to lower his blood pressure and heart rate. This will help slow down the blood flow. If your patient is anxious or afraid, you can expect a lot more blood as his heart is pumping twice as fast.
  1. Elevate! – If your patient is bleeding from his hands/arms/feet/legs, reposition the person so that the affected limb is elevated above the heart. This will help reduce the blood pressure in the affected area/s of the body.
  1. Practice Layering – There are situations when the size and depth of the wound will not allow the first aider to completely stop the bleeding. If direct pressure and additional gauze can’t stop the bleeding, the wound may be too severe for first aid.

All you can safely do at this point would be to add additional layers of clean gauze to the first few layers to ensure that blood is absorbed readily. Do not attempt to remove the layer that is closest to the wound as this may undo the clotting that has already occurred in that area.

How can you protect a wound from infection?

Large, infected wounds can cause speedy tissue death and even gangrene in extreme cases.

Preventing infection is your next priority after you’ve staunched the bleeding of the wound. You can reduce the chances of wound infection by following these steps:

  1. Inspect the wound at least once a day. Remove any foreign matter on the wound. If something is deeply embedded in the wound, do not try to remove it. Doing so may damage more tissue and cause complications (e.g. tetanus).
  1. After inspection, apply a disinfectant such as povidone iodine or alcohol to disinfect the wound and the area surrounding it. Make sure that the wound is cleaned and disinfected at least once every 24 hours.
  1. If gauze has been applied beforehand, carefully remove old gauze and replace with fresh gauze.

Old gauze can cause damage and may become a hotbed for bacterial infection if it is not replaced daily. Use nonstick gauzes and dressings as much as possible as these will not damage the surface of the wound when removed.

  1. Always apply adequate bandaging so that the nonstick gauze will not move about or fall off. If you don’t have medical bandage, use any long piece of cloth to keep all the gauze/s in place.
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