OTC Wounds Flashcards
Types of skin injuries:
- wounds
- burns
Examples of wounds:
- abrasions
- lacerations
- punctures
Examples of burns:
- chemical
- electrical
- thermal
- UV radiation
There are how many stages of injury?
4
Stage 1 of injury:
- only epi
- unbroken, nonblistering skin
Treatment of stage 1 injury:
self care
Stage 2 of injury:
- epi and part of derm
- blistering or partial thickness skin loss
- prone to infection
Treatment of stage 2 injury:
self care or medical attention
Stage 3 of injury:
- entire epi, derm, and possibly subcutaneous tissue
- full thickness burns, which can cause death to entire skin layer
- deep punctures and lacerations, which can be painful with a lot of bleeding
Treatment of stage 3 injury:
medical attention or hospitalization immediately
Stage 4 of injury:
- all of stage 1-3 and underlying muscle, tendon, and bone
Treatment of stage 4 injury:
same as stage 3, which is medical attention/hospitalization immediately
Healing process has three phases. What are they?
- inflammatory phase
- proliferative phase
- maturation phase
Inflammatory phase:
- lasts 3-4 days
- prepare wound for new tissue development
Proliferative phase:
- lasts up to 3 weeks
- new connective tissue begins to form
Maturation phase:
- > 3 weeks (1-6 months)
- wound is completely closed by CT
- high strength collagen matrix is formed
Goals of treatment:
- relieve symptoms
- promote healing/protect from further damage
- minimize scarring
Exclusions for self treatment:
- over stage 2
- injury covers over 2% of BSA (for palms, 1%)
- children and elderly
- face, mucous membranes, genitals
- becomes infected
- other comorbid conditions
How to clean areas:
- remove visible debris
- irrigate water/normal saline
- can relieve pain of burns
Which type of oral analgesics are preferred?
NSAID
- ibu 200mg Q4-6H prn
- naproxen 200 mg Q6-8H prn
What is the second line of oral analgesics?
acetaminophen 325mg Q4-6H prn
- children: 10-15mg/kg Q4-6H prn
Function of skin protectants:
- protect from friction and rubbing
- prevent dryness
Examples of skin protectants:
- allantoin
- cocoa butter
- petrolatum
Topical anesthetics:
- inhibit pain signals from pain receptors
- effect lasts 15-45 minutes
Application of topical anesthetics:
- no more than 2% of BSA
- max application of 3-4 times/day
Examples of topical anesthetics:
- benzocaine 5%
- lidocaine 2-4%
First aid antiseptics are applied to…
intact skin up to edges of wound for disinfectant purposes
- same benefit as using soap and water
T/F: alcohol containing products should be used in wound bed
F b/c it can cause dehydration and cell damage
Examples of first aid antiseptics:
- hydrogen peroxide 3%
- ethyl alcohol 20-70%
- isopropyl alcohol 70%
Hydrogen peroxide 3% should only be used when…
released gas can escape
- don’t cover area
Things to note about isopropyl alcohol 70%:
- stronger bactericidal activity than ethyl alcohol
- flammable
First aid antibiotics:
- prevent infection
- not for treatment of injuries that are already infected
- used when wound has debris or foreign matter
Examples of first aid antibiotics:
- bacitracin
- neomycin
- polymyxin B sulfate
- neosporin
Bacitracin:
- polypeptide bactericidal antibiotic
- inhibits cell wall synthesis in gram negative organisms
- apply 1-3 times a day
Adverse effects of bacitracin:
contact dermatitis/rash
Neomycin:
- aminoglycoside antibiotic
- irreversibly binds to the 30S ribosomal subunit to inhibit protein synthesis of gram negative and staphylococcus
Adverse effects of neomycin:
- hypersensitivity (3.5%-6%)
- ototoxicity or nephrotoxicity
Neomycin dosage:
- apply 1-3 times a day
- used in combination products
Polymyxin B sulfate:
- polypeptide antibiotic
- alters cell wall permeability of gram negative organisms
Polymyxin B sulfate dosage:
- apply 1-3 times a day
- used in combination products
Triple product Neosporin contains:
- bacitracin 400 units/gram
- neomycin 3.5 mg/gram
- polymyxin B 5,000 units/gram
Double product has:
polysporin
For combination products, you apply it…
1-3 times/day
Ointments are used for…
- minor burns and wounds w/ intact skin
- trap moisture and could promote bacterial growth
Creams are used for…
- broken skin
- allows fluid to pass through
Lotions are used for…
- larger areas of unbroken skin
- has a drying effect b/c alcohol is in most forms
Aerosols are used for…
- wounds/burns that are painful to touch
- hold can 6 inches away and spray for 1-3 seconds
- alcohol spray can dehydrate wound
Different types of wound dressing:
- gauze
- foams
- hydrocolloids
- hydrogels
- adhesive/wafer dressings
Gauze is used for…
minor burns and wounds that are currently draining or require debris removal
Gauze is used in combination w/…
- petrolatum
- antiseptics
- antimicrobials
Advantages of gauze:
- many size forms
- affordable
Disadvantages of gauze:
- bust be held in place by second agent
- fibers may adhere to wound
- must be changed often
Foams:
- absorb excess moisture
- used in early inflammatory phase of healing
Advantages of foams:
fewer dressing changes
Disadvantages of foams:
trauma upon removal
Hydrocolloids:
- maintain moisture
- preferred in proliferative phase
Advantage of hydrocolloids:
long wear time
Disadvantages of hydrocolloids:
- for uninfected wounds only
- trauma upon removal
Hydrogels:
- supply moisture
- applied to dry wounds w/ dead tissue
Advantages of hydrogels:
- non-adherent
- easily removed
Disadvantages of hydrogels:
frequent changes
Adhesive/wafer dressings:
- minor burns and wounds
- average band-aid
Advantages of adhesive/wafer dressings:
- easy to apply
- many sizes
- high bond strength
Disadvantages of adhesive/wafer dressings:
- for uninfected wounds
- trauma upon removal
