Ch.2 Wound Management

Question 1

What is considered life threatening bleeding? (4)

Answer 1

1. Spirting
2. Soaks through clothing
3. Pools on the ground
4. Missing Body parts or altered mental status

Question 2

Techniques to control bleeding (4)

Answer 2

1. Manual direct pressure and elevation
2. Wound Packing: Pack the wound with gauze then apply direct pressure
3. Pressure dressings: free hands for other tasks, uses after bleeding is under control.
4. Tourniquet: Should be 1.5” wide minimum, 1/2” above wound tight enough to block distal pulse.

Question 3

Extended Care
How to prevent infection and promote healing.

Clean the wound(6)

Answer 3

1. Wash your hands and put on gloves
2. Clean around wound with soap and water, and rinse with clean disinfected water.
3. remove any foreign matter with disinfected tweezers or brushing out the wound.
4. irrigate wound with disinfected water with pressure from a syringe.
5. Cover with cleanest dressing/bandage keep moist with anti biotic ointment.
6. change dressing once at-least every 24 hours.

Question 4

Specific wound considerations
How to clean and treat:
Abrasions

Answer 4

Cleaning may require scrubbing and copious irrigation, Cover wound with thin layer of antibiotic ointment or transparent film dressing.

Question 5

Specific wound considerations
How to clean and treat:
Lacerations(deep cuts)

Answer 5

Bring wound edges together with wound closure strips.
If cut gaps open or is on face pack with wound moist to dry. keep wound moist during evacuation for stitches.
.

Question 6

Specific wound considerations
How to clean and treat:
Avulsions (cuts at an angle making a flapper)

Answer 6

Irrigate under flap and secure in position

Question 7

Specific wound considerations
How to clean and treat:
Amputations

Answer 7

Wrap amputated in a moist clean dressing place in a bag keep it with patient.

Question 8

Specific wound considerations
How to clean and treat:
Punctures

Answer 8

Wash surface of skin, do not close monitor for infection.

Question 9

Specific wound considerations
How to clean and treat:
Impaled objects

Answer 9

Remove objects that obstruct air way,
remove object in paled in a limb only if:
- cannot be stabilized
- easily fall out
- prevent transport
- prevents bleeding control

Question 10

Evacuation guidelines

Rapid Evacuation (9)

Answer 10

Evacuate any patient with a wound that cannot be cleaned or closed in the field or is not healing.

Rapidly evacuate that is:

• heavily contaminated
• open joint space
• involves tendons or ligaments
• was cause by an animal bite
• on face
• impaled or embeded object
• amputation
• caused by crushing MOI
• Show evidence of serious infection