Recently, during the emergency work, I have seen many patients with broken skin or even fractures due to various reasons. Learning how to treat wounds and mastering wound dressing skills can reduce the strain of traveling to and from hospitals and economic pressure, which has practical significance.
A. Commonly used items for wound treatment
1, cleaning and disinfectant: 75% alcohol, sulfur tincture (or sulfur vol), 3% hydrogen peroxide, 0.9% saline. The above disinfectants can be purchased from pharmacies or hospitals. Liu Weidong, Department of Orthopedic Injuries, Shenzhen Affiliated Hospital of Guangzhou University of Chinese Medicine
2, dressing class: gauze blocks, cotton balls, cotton swabs, bandages, adhesive tape, band-aids, etc. The above dressings can be bought from pharmacies or hospitals. Such as self-made gauze blocks, cotton balls, cotton swabs, be sure to place the lunch box for steamer sterilization.
3.Medication changing utensils: disposable medication changing bowl, containing one each of short anatomical toothed and toothless forceps and appropriate amount of cotton balls.
Second, the treatment of fresh wounds
If the wound is not large, the edge of the wound neatly to fit well, cleaning the wound with a cotton swab dipped in hydrogen peroxide, disinfection of iodine tincture and alcohol around the wound, with a band-aid dressing cover the work mouth. If the wound surface epidermis peeling, after cleaning and disinfection treatment, covered with sterilized gauze adhesive tape fixed. Wounds large, deep or wound edge peeling, should go to the hospital to clear the wound suture. If the wound is caused by rust or pollutants, you need to go to the hospital to inject tetanus antitoxin to prevent tetanus disease.
Third, the treatment of infected (or septic) wounds
1, the treatment of ordinary wounds. Remove the wound dressing with toothed tweezers, then disinfect the skin around the wound with iodine tincture and alcohol cotton balls, clean the wound with 3% hydrogen peroxide or saline, pay attention not to make the alcohol soak into the wound skin, so as not to cause pain. Cover with Vaseline gauze or other gauze or gauze to promote wound healing as needed, then cover with 3-4 layers of dry gauze, and finally, fix with adhesive tape or bandage. The direction of the adhesive tape should be perpendicular to the limb or body to avoid dislodgement. Wound 1-4 days to change medicine once.
2, heavy wound infection, pus, tissue blackening, bad odor or dressings with green, these types of wounds are difficult to deal with at home, should go to the hospital in a timely manner.
Four, the rapid treatment of cat and dog bites
Cat bite
If accidentally bitten by a cat, the local wound will appear red, swollen, painful, serious can cause lymphangitis, lymphadenitis or cellulitis, such as cats infected with rabies, the consequences will be more serious. Therefore, first aid treatment must be done on the spot.
If the extremity is bitten, a tourniquet should be tied above the wound, and then the wound should be cleared. First rinse the wound with water, salt water or 1:2000 potassium permanganate solution, then use iodine or 5% carbolic acid local cautery wound (other parts of the wound treatment with the extremities), the injury should be sent to the hospital emergency. In rabies endemic areas, cat bites should be handled with reference to dog bites to prevent rabies.
Dog bites
Dog bites, whether it is a rabid dog or a normal dog, should be flushed with a large amount of water (10,000 ml or more) as quickly as possible, in situ. If there is no water source around for a while, then you can use human urine instead of water to flush first, and then try to find water.
Rinse the wound thoroughly. Dog bite wounds are often small outside the mouth inside deep, which requires flushing as much as possible to expand the wound, and squeeze the surrounding soft tissue, trying to stain the wound on the dog’s saliva and blood on the wound rinsed clean. If the wound bleeds excessively, you should try to put a tourniquet on it immediately and then send it to the hospital for emergency treatment. Remember: do not bandage the wound! In situ, immediately, thoroughly rinse the wound, is the key to determine the success or failure of rescue, do not forget to rinse the wound, or sloppy rinse, or even apply some red mercury bandage wound on the hospital, which is absolutely wrong.
Five, how to dress the wound
Open injuries in sports are less common, but in the comprehensive hundred complex training, accidents are still more common, so the treatment of open wounds should be strict requirements, skilled in handling methods.
1, the training due to accidents caused by deeper and larger and complex wounds, to deal with in a timely manner, as soon as possible dressing. For wound dressing, should be in a simple disinfection, use first aid kit including sterile gauze, such as no sterile gauze, then available clean towels, clothing, etc. instead, so as not to continue to contaminate the wound.
2, for special wounds, such as cranial, thoracic, abdominal, limb fracture exposed treatment, to be decisive, rapid, accurate and strict. Because this to the kind of injury can quickly endanger life, causing serious consequences. Specific methods.
(1) craniocerebral injury, open craniocerebral injury. Regardless of the severity, bleeding is more, once the fracture leading to the intracranial danger is even greater. In this case, to have skilled bandaging techniques, both to protect the wound clean, brain tissue does not continue to damage, but also to achieve the purpose of hemostasis, the method can be used in the field conditions, make a large than the wound of the circle set on the wound. Then the appropriate pressure bandage can be.
(2) chest injury, serious chest damage will soon endanger the life of the patient, must be dealt with immediately. If it is an open injury and pneumothorax occurs, the wound should be closed immediately in an effective way to block the gas entering and exiting from the wound. If it is a closed and multiple rib fracture, the chest loses support and the chest wall floats and cannot breathe effectively, the wounded part is lifted or appropriately squeezed too the wounded part, such as lying on the side, to stop the chest wall floating for further processing time.
(3) Open fractures of the extremities are mostly seen when the fracture end pierces the exposed skin and the wound is contaminated. Do not return the fracture end and choose sterile gauze dressing. Patients who return the fracture while fixing the affected limb on their own should speak to the hospital physician and take measures to prevent infection.
(4) Viscera exposed to severe injuries resulting in abdominal viscera prolapse patients, covered with sterile dressing, without sterile gauze can be wrapped with towels or cleaner clothing, with concave object buckle, never directly compress the viscera. Both to prevent continued prolapse, but also to prevent ischemic necrosis caused by too tight compression.