First Aid & Wound Management 3 Flashcards
What is wound management and what are the steps in wound management?
- ongoing treatment of a wound, by providing an appropriate environment for healing
- ideally begins ASAP after injury
Steps: - wound assessment
- wound flushing
- debridement (depends)
- dressing
During wound assessment…
- classify the wound
- determine the degree of contamination
- plan the approach to treatment
Describe the immediate treatment in managing a wound.
- clip around the wound (apply K-Y jelly to the open wound)
- clean around the wound with dilute chlorhexidine solution
- clean the wound: flush with sterile saline or dilute chlorhexidine solution through a 20mL syringe attached to an 18/20G needle or catheter
What is debridement and why is it required sometimes?
- debridement is the procedure to remove devitalised or contaminated tissue
- for older wounds, debridement may be required
- done by vets
- a fresh bleeding edge and tissue bed is needed for healthy wound healing (debridement results in this)
State the type of wound dressings and explain the uses of each.
Wet-to-dry
- used on exudative (a lot of discharge) wounds with an open granulation tissue bed
- wounds that produce exudate (high viscosity)
- often contaminated wounds
- keeps the wound moist to aid healing
Dry-to-dry (encourages the wound to start to dry to form a scab)
- for wounds with low viscosity discharge
- serum or other transudates
- e.g. abrasions
What are the 4 layers to a bandaging system?
- gauze
- softban
(- conforming bandage) - vetRap
- Elastoplast
What is the primary layer used in wet-to-dry and dry-to-dry dressing?
Wet-to-dry
- purpose is to keep the wound moist
- jelonet and bactigras (paraffin wax infused gauze)
- foam dressing (e.g. Allevyn)
- hydrogel (e.g. honey/solosite)
- hydrocolloid
Dry-to-dry
- purpose is to absorb transudate (e.g. serum) to dry the wound
- generally, non-adherent dressings are preferred as they allow easy removal
- most can be cut to size
- e.g. melolin, primapore (pad+adhesive)
What is the purpose of secondary layer of bandaging and give some examples?
Padding - provides padding and helps to wick away excess moisture - softban Conforming - provides pressure and support - stockinette, easifix
What is the purpose of the tertiary layer of bandaging and give some examples?
- provides support and protection
- vetwrap, elastoplast, tensoplast
- for vetwrap, it can tighten with movement so ensure that two fingers, placed side by side, can fit under the bandage comfortably to ensure it’s not too tight
What is the purpose of an Elizabethan collar?
- prevents licking, chewing and biting at the wound or bandage
- the width of the E-collar should extend past the muzzle
Pain management and signs of pain
- pain can cause emotional distress and reduced healing
- unpleasant sensory/emotional experience associated with actual/potential tissue damage
Signs - change in behaviour
- licking/biting at affected area
- vocalisation
- pacing/restlessness
- trachycardia
How to remove bandages?
- use adhesive solvent (e.g. zoff) if adhesive is stuck
- use bandage scissors to help guide scissors between patient and bandage
- in weepy wounds, dressing material may stick to the wounds so using saline to wet the dressing may be helpful
How often should bandages be changed?
- depends on the type of wound
- in new/weepy wounds, daily changes may be required
- once healing well with healthy granulation bed, changes are usually extended to between 3-7 days
- tranquilisers/sedatives may be required
What to look out for during bandage changes?
- check the bandage: damage, seepage, odours
- check the wound: discharge, odour, inflammation, granulation tissue, necrosis (death of tissue)?
What is dehiscence?
- re-opening of the wound (e.g. stitches may rupture)
- can lead to contamination or damage of tissue
