• Wounds

    What is a wound?

    A wound is an injury that results when the skin or other tissues of the body are damaged. Wounds are generally classified as open or closed. Both open and closed wounds often result in bleeding. Open wounds may cause external bleeding, internal bleeding, or both; closed wounds may cause internal bleeding. External or internal bleeding may be life-threatening (e.g., due to major open wounds or closed wounds) or non-life-threatening (e.g., due to minor open wounds or closed wounds).

    What are the types of open wounds?

    The four main types of open wounds are abrasions, lacerations, avulsions and puncture wounds and they may occur together.

    1. An abrasion occurs when something rubs roughly against the skin damaging the skin’s surface. These are often referred to as “scrapes,” “rug burns,” “road rash” or “turf burns.”
    2. A laceration is a cut, commonly from a sharp object. It can also occur when blunt force splits the skin.
    3. An avulsion occurs when a portion of the skin, and sometimes the underlying tissue, is partially or completely torn away.
    4. A puncture wound occurs when an object, such as a nail, animal’s tooth or gunshot, pierces the skin. Puncture wounds may not bleed much unless a blood vessel has been injured, but may also cause life-threatening bleeding.

    Emergency Steps

    1

    Check the scene safety, form an initial impression, obtain consent and put on PPE, as appropriate.


    2

    Check for signs and symptoms.

    • Tender, swollen or rigid area*
    • Bruising*
    • Blood volume equal to about half a soda can (less in small child or infant)*
    • Blood flowing continuously or spurting*
    • Blue or extremely pale, swollen and rigid limb*
    • Coughing, vomiting or urinating blood*
    • Signs and symptoms of shock*
    • Skin scraped, pierced, cut open or torn away
    • Red or purple area with swelling and pain

    *Note: Signs and symptoms with a * require immediate emergency medical treatment.


    3

    Call 9-1-1 and get equipment if the person requires immediate emergency medical treatment.


    4

    Give Care.


    General Care: Bruise

    1. Apply a cold pack to bruised area for no more than 20 minutes.
      1. Wrap cold pack in a thin, dry towel to protect the skin.
    2. Wait at least 20 minutes before re-applying a cold pack.
      1. If not able to tolerate a 20-minute application, apply the cold pack for 10 minutes on and 10 minutes off.

    Wounds FAQs

    How long should I apply direct pressure?

    Hold direct pressure until:

    • The bleeding stops.
    • A tourniquet is applied (for life-threatening bleeding from an arm or leg) and the bleeding has stopped.
    • Another person relieves you.
    • You are too exhausted to continue.
    • The situation becomes unsafe.

    What if blood soaks through the original dressing while I’m applying direct pressure to the wound?

    If blood soaks through the original gauze pad, you do not need to do anything, but you can put another gauze pad on top. Replace the new gauze pad as necessary if blood soaks through the pads. Do not remove the original gauze pad and do not stack multiple gauze pads.

    How do I secure a dressing if I don’t have tape?

    You can use an alternate “bandage splitting” technique to secure the dressing.

    • Once the dressing is covered, roll out the remaining length of bandage.
    • While holding the bandage, use the index finger of the other hand to split the bandage in half, moving it down and underneath the limb.
    • Bring the two ends of the bandage up and tie them in a bow or knot.

    What is shock?

    Shock is a progressive, life-threatening condition in which the body does not get enough oxygen-rich blood often due to disturbed blood flow. As a result, organs and body systems begin to fail.

    Signs and symptoms include:

    • Rapid, weak heartbeat
    • Rapid breathing
    • Pale, gray or cool moist skin
    • Altered level of responsiveness
    • Excessive thirst

    Note: If you see any signs and symptoms of shock, call 9-1-1.

    How do I check for circulation?

    When checking for circulation, check the skin on the side of the injury farthest from the heart (e.g., the hand or foot) for temperature, color and feeling. Also ask the person if there is any numbness or tingling.

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