Think About It Thursday Cuts so deep Youre assembling some new shelves for your garage and as you’re putting some pressure on a screw, the flathead screwdriver in your right hand slips out of the groove and cuts a jagged line in your left forearm. You look down in shock as dark red blood runs steadily down your arm from the 3” laceration and drips off of your fingers, sprinkling all over the concrete. You immediately grab the shop towel lying next to you, wad it up into a ball and put some deep, steady pressure on it. As you make your way into the house you notice that the dressing is almost soaked through so you grab your D.A.R.K. and open it up and open the QuikClot Combat Gauze LE and apply it in place of the soaked towel. You hold pressure on it for at least 3 minutes and wrap it tightly with the 4 Emergency Bandage. While youre doing this, you notice that your thumb and index finger are slightly numb and tingly and wont straighten out and you know its time to get your spouse to drive you to the nearest ER. Weve all cut ourselves in some way from time to time and some have been bad and some, not so bad. The key in treating a laceration is knowing what to do. Ask the key questions: What is it? How do I recognize it? How do I treat it? A laceration is simply an interruption of the tissue by means of an instrument that can be dull or sharp. (How many of you took a woodshop class and were taught that a dull chisel is more dangerous than a sharp one?) A laceration can be simple or deep and complex. It will, most of the time, be painful and depending on the depth and vessels interrupted, bleed lightly or heavily. Stop the bleeding. Most lacerations are non-life threatening and can be controlled with direct, manual pressure. However, if a bleed is difficult to control, hemostatics and pressure dressings may be considered. In the rare instance that it is a life-threatening bleed or the situation won’t allow you the luxury of time needed to apply hemostatics or pressure dressings, a tourniquet may be considered and used provided the individual has the proper training. If caring for someone elses laceration, first, put on gloves, then ensure the area is clear of dangers and if there are dangers, move the victim to a safe area. Again, direct pressure remains the most effective method of controlling the bleeding from a laceration. Consider the underlying tissues, organs and other structures that may have been damaged, depending on the depth of the laceration. Look at the length and width of the laceration. Is it clean or jagged? Are the edges close together or separated? Is the bleeding dark red and steady or bright red and spurting? (venous vs arterial bleeding) Put pressure on it. If you place a dressing on top of the wound and place steady pressure on it and it becomes saturated, put another on top and keep adding them as you may pull away a clot that has begun to form. In the event that you have hemostatics, remove the dressing and place the hemostatics in contact with the wound as you need that contact with the source of the bleed to enable the hemostatic to work properly. Hold direct pressure for 2-3 minutes with the QuikClot and reinforce the wounded area with a compression bandage to maintain constant pressure on the wound site. Check the distal circulation of the wounded area, if its an extremity, by blanching the fingernails and checking for capillary refill, skin color and skin temperature. Ask the victim if they can feel their extremities and if they can move them. If they complain of numbness or tingling and lack of movement, consider that nerves and tendons may have been cut. Other considerations are the victims tetanus status. Tetanus is good for 10 years but if it’s been more than 5 years since you got the immunization, you may get a booster. Get it looked at. If it is a simple lac it may still need to be evaluated at a definitive care facility to determine whether or not it needs to be sutured. Keep it clean. Good wound care is essential. Keep the wound clean (twice daily with soap and warm water) and if needed, a light coating of Bacitracin, Neosporin or other antibiotic ointment. Utilize a non-stick dressing for comfort and keep the dressing dry. Remember bacteria loves a warm, dark and moist environment. Watch for infection. Observe the area for any signs and symptoms of local infection like redness, swelling, red streaking, warmth and pus draining from the wound. Also be aware of any fever, chills or swollen lymph nodes as this can signify systemic infection. Any signs or symptoms of infection should be addressed at a care facility immediately. Stop the bleeding, put pressure on it, get it looked at, keep it clean and watch for infection. Pretty simple. Until next time, stay safe. Simplicity Under Stress darkangelmedical
Posted on: Thu, 07 Aug 2014 17:21:15 +0000
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