First Aid - Wounds (EXAM 3) Flashcards
How long does it take for acute and chronic wounds to heal?
Acute - 1 month -> eligible for self-treatment
Chronic - not healed within 30 days
What causes friction of the epidermal layer and uppermost dermis?
Abrasions
-Stage 1 pressure ulcer, first-degree burn - SUPERFICIAL
-Stage 2 pressure ulcer, second-degree burn - PARTIAL THICKNESS
What causes sharp piercing of the epidermis or deeper layers?
Punctures (like bites)
What causes Burns?
Can be electrical, thermal, sunburn, chemical
Term for cuts through various layers
Laceration
When to refer acute wounds
When depth reaches subcutaneous tissue
-third degree burn
-Stage III or IV pressure ulcer
-Penetrating wound/surgical incision
FULL THICKNESS
Ways to classify injuries
-Degree of burn (1st, 2snd, 3rd)
-Depth (Stage 1-4)
-Amount of body surface involved (rules of 9):
front/back of upper leg = 9%
upper body = 18%
each arm = 4,5%
head = 4,5%
What are the three phases of healing?
-Inflammatory: red, immediate response of the body, subsides after days
-Proliferative: cells and connective tissues regrow - takes 3 weeks
-Maturation: takes 60 days to fully recover
Phases overlap
Local factors that impact healing
-poor circulation (f.e. in extremities)
-on the wound: not enough moisture, foreign bodies (glass, dirt), necrotic tissue
-infection
Systemic Factors that impact healing
-Increased Age (> 60)
-nutrition
-medical condition: diabetic, obesity, immunocompromised
-alcoholics, smoking (poor circulation)
-medication
Number of Poison control
1-800-222-1222
Types of poisoning
-Ingestion
-Inhaling
-Contact with skin and eyes
Signs of Symptoms
OTC: Analgesics, dietary supplements, Vitamins, Antihistamines
Prescription drugs: Analgesics, Antidepressants, Stimulants, Antipsychotics, Hormones
Household items: Cosmetics, cleaning supplies, toys
Step 1: Cleanse the Wound
-Irrigate with saline or water -> remove debris
-Wash with mild soap and cool to warm water,
-gently pat the area dry (may use antiseptic wipes)
Step 2: Stop the Bleeding
NO tourniquets (only when extreme bleeding)
-Protect the wound with gauze or cloth
-Apply pressure
If bleeding does not stop OR if the wound is gaping,
dirty, or caused by an animal or human bite -> REFER
What are Clot-Promoting Agents?
-Kaolin-impregnated polyester/rayon gauze (QuikClot®)
-Hydrophilic polymer and potassium ferrate powder (WoundSeal®)
-Other mineral astringents like anhydrous aluminum sulfate, potassium alum, or titanium dioxide
-side effect: warming sensation
Step 3: Apply topical agents
Astringents, Protectans, Antibiotics, Anesthetics,..
Protectants
-cocoa butter, calamine, white petrolatum,
lanoline, zinc oxide
-moisture and protection
Astringents
-Aluminum acetate (Burow’s solution, DOMEBRERO)
-Witch hazel (hamamelis water)
-drying, cause vasoconstriction, cleanses the skin
Topical Antibiotics
-Bacitracin, Neomycin, Polymyxin B (=Triple Antibiotic Ointment)
-NEOSPORIN, POLYSPORIN (no Neomycin in Polysporin)
3x day
-when the wound contains debris or foreign matter
-prevent infection
-Apply after cleansing and before dressing
Topical Antiseptic
-disinfect the wound
-Ethyl alcohol, Isopropyl alcohol, Hydrogen peroxide, Iodine
-ONLY TO INTACT SKIN bc of alcohol
Topical Anesthetics
-temporarily pain relief (15-45 min)
- Benzocaine/dibucaine/lidocaine, Phenol, Pramoxine
3-4x a day but NOT more than 7 days
Topical Antihistamines
-relieve itching from contact irritant
-Diphenhydramine 1st gen Antihistamine
-bc of topical administration less sedation or excitement in kids
-3-4x a day NOT longer than 7 days
Topical Antihistamines
-relieve itching from contact irritants (like poison ivy)
-Diphenhydramine 1st gen Antihistamine
-bc of topical administration less sedation or excitement in kids
-3-4x a day NOT longer than 7 days
Topical Anti-Inflammatories
-reduce inflammation and itching
-HYDROCORTISONE-based drugs (CORTIZONE-10, CORTAID)
Honey
-sucks up exudate, keeps moisture, antimicrobial, antifungal
-MEDIHONEY, Manuka honey
-Use only medical-grade honey (bc steril)
Step 4: Cover the wound
Cover the wound but keep it MOISTURE
-Primary: on wound
-Secondary: on primary to keep in place
-Non-adherent: for wounds with no exudate
-> allow oxygenation but they don’t absorb much
3 types of Wound dressing
-absorb moisture: Foam, Alginates (salt), Antimicrobial -> during inflammatory phase
-maintain moisture: Hydrocolloids, transparent film -> in the proliferative phase
-apply moisture: Hydrogels/Gels -> dry wounds
Adhesive Bandages
-for superficial wounds (minor abrasions and lacerations)
-Gauze, Hydrocollidial (maintain moisture -> scar-minimizing), Liquid bandage (small wounds)
Which dressing to use
Stage 1- Small wounds: protect -> with adhesive bandages
Stage 2: Protect, hydrate, isolate, Absorb
-> with an adhesive bandage, transparent film (maintain moisture), Alginates (absorb moisture), Foams (absorbs moisture)
Stage 3 and 4: REFER
Step 5: Stop Swelling with ICE
-indirect ICING (in a sock) 15-20 every hour
-should subside within 12-24 hr
Step 6: Systemic medication
-to treat pain: Analgesic
or itching: Antihistamine
Step 7: Reassess
After 24-48 hr: Wound and pain worse? Yes -> refer
After 5-7: Healing? if no -> REFER
It takes 2-3 weeks to heal
What are Scar-preventing Agents?
Dry wound = scabbing = scarring
-Skin protectants, Sunscreen, Non-medicated ointment bases, Silicon, Anti-oxidant agents (Vitamin E, Green Tea)
Natural: Mederma
Burn
Step 1: Soothe the burn, cool it with water
Step 2: Cleans with water, mild soap, or antiseptic
Step 3: If unbroken -> protectant and anesthetic (numbing) If broken use topical antibiotics -> DO NOT PUT menthol or camphor it has a hot effect afterward
Aloe Vera: reduces pain and inhibits prostaglandin (+antibacteral, antifungal)
Step 4: Protect and cover the area
No blistering: nonadherent (gauze-type) dressing
Blistering: hydrocolloid dressing
Step 5: Reassess: after 24-48 h pain and wound;
after 5-7 days: Healing
First Aid Kit
-Topical anesthetic spray: to numb
-Topical hydrocortisone: anti-inflammatory
-Topical antibiotic ointment
-Sunscreen
-Epi-pen or epinephrine (severe allergic reaction)
-Antihistamine
-analgesic/antipyretic
-Antidiarrheal