First Aid - Wounds (EXAM 3)

Question 1

How long does it take for acute and chronic wounds to heal?

Answer 1

Acute - 1 month -> eligible for self-treatment
Chronic - not healed within 30 days

Question 2

What causes friction of the epidermal layer and uppermost dermis?

Answer 2

Abrasions
-Stage 1 pressure ulcer, first-degree burn - SUPERFICIAL
-Stage 2 pressure ulcer, second-degree burn - PARTIAL THICKNESS

Question 3

What causes sharp piercing of the epidermis or deeper layers?

Answer 3

Punctures (like bites)

Question 4

What causes Burns?

Answer 4

Can be electrical, thermal, sunburn, chemical

Question 5

Term for cuts through various layers

Answer 5

Laceration

Question 6

When to refer acute wounds

Answer 6

When depth reaches subcutaneous tissue
-third degree burn
-Stage III or IV pressure ulcer
-Penetrating wound/surgical incision

FULL THICKNESS

Question 7

Ways to classify injuries

Answer 7

-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%

Question 8

What are the three phases of healing?

Answer 8

-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

Question 9

Local factors that impact healing

Answer 9

-poor circulation (f.e. in extremities)
-on the wound: not enough moisture, foreign bodies (glass, dirt), necrotic tissue
-infection

Question 10

Systemic Factors that impact healing

Answer 10

-Increased Age (> 60)
-nutrition
-medical condition: diabetic, obesity, immunocompromised
-alcoholics, smoking (poor circulation)
-medication

Question 11

Number of Poison control

Answer 11

1-800-222-1222

Question 12

Types of poisoning

Answer 12

-Ingestion
-Inhaling
-Contact with skin and eyes

Question 13

Signs of Symptoms

Answer 13

OTC: Analgesics, dietary supplements, Vitamins, Antihistamines
Prescription drugs: Analgesics, Antidepressants, Stimulants, Antipsychotics, Hormones
Household items: Cosmetics, cleaning supplies, toys

Question 14

Step 1: Cleanse the Wound

Answer 14

-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)

Question 15

Step 2: Stop the Bleeding

Answer 15

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

Question 16

What are Clot-Promoting Agents?

Answer 16

-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

Question 17

Step 3: Apply topical agents

Answer 17

Astringents, Protectans, Antibiotics, Anesthetics,..

Question 18

Protectants

Answer 18

-cocoa butter, calamine, white petrolatum,
lanoline, zinc oxide
-moisture and protection

Question 19

Astringents

Answer 19

-Aluminum acetate (Burow’s solution, DOMEBRERO)
-Witch hazel (hamamelis water)

-drying, cause vasoconstriction, cleanses the skin

Question 20

Topical Antibiotics

Answer 20

-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

Question 21

Topical Antiseptic

Answer 21

-disinfect the wound
-Ethyl alcohol, Isopropyl alcohol, Hydrogen peroxide, Iodine
-ONLY TO INTACT SKIN bc of alcohol

Question 22

Topical Anesthetics

Answer 22

-temporarily pain relief (15-45 min)

• Benzocaine/dibucaine/lidocaine, Phenol, Pramoxine
  3-4x a day but NOT more than 7 days

Question 23

Topical Antihistamines

Answer 23

-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

Question 24

Topical Antihistamines

Answer 24

-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

Question 25

Topical Anti-Inflammatories

Answer 25

-reduce inflammation and itching

-HYDROCORTISONE-based drugs (CORTIZONE-10, CORTAID)

Question 26

Honey

Answer 26

-sucks up exudate, keeps moisture, antimicrobial, antifungal

-MEDIHONEY, Manuka honey
-Use only medical-grade honey (bc steril)

Question 27

Step 4: Cover the wound

Answer 27

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

Question 28

3 types of Wound dressing

Answer 28

-absorb moisture: Foam, Alginates (salt), Antimicrobial -> during inflammatory phase
-maintain moisture: Hydrocolloids, transparent film -> in the proliferative phase
-apply moisture: Hydrogels/Gels -> dry wounds

Question 29

Adhesive Bandages

Answer 29

-for superficial wounds (minor abrasions and lacerations)
-Gauze, Hydrocollidial (maintain moisture -> scar-minimizing), Liquid bandage (small wounds)

Question 30

Which dressing to use

Answer 30

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

Question 31

Step 5: Stop Swelling with ICE

Answer 31

-indirect ICING (in a sock) 15-20 every hour
-should subside within 12-24 hr

Question 32

Step 6: Systemic medication

Answer 32

-to treat pain: Analgesic
or itching: Antihistamine

Question 33

Step 7: Reassess

Answer 33

After 24-48 hr: Wound and pain worse? Yes -> refer
After 5-7: Healing? if no -> REFER
It takes 2-3 weeks to heal

Question 34

What are Scar-preventing Agents?

Answer 34

Dry wound = scabbing = scarring
-Skin protectants, Sunscreen, Non-medicated ointment bases, Silicon, Anti-oxidant agents (Vitamin E, Green Tea)

Natural: Mederma

Question 35

Burn

Answer 35

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

Question 36

First Aid Kit

Answer 36

-Topical anesthetic spray: to numb
-Topical hydrocortisone: anti-inflammatory
-Topical antibiotic ointment
-Sunscreen
-Epi-pen or epinephrine (severe allergic reaction)
-Antihistamine
-analgesic/antipyretic
-Antidiarrheal