Wound Care

WOUND CARE

SKIN TRAUMA (WOUNDS)

Mechanical Forces that Cause Injury Friction Compression Shearing Tensile/Stretching Scraping Tearing Avulsing Puncturing Bending

ABRASIONS Scraping of skin against rough surfaces

Top surface of skin is worn away

Increased probability of infection Why?

PUNCTURES

Direct penetration of skin with pointed object

Do not remove object Must be referred to a physician Tetanus shot

LACERATIONS

Object tears tissue, giving wound appearance of jagged edge

Sometimes result of blunt trauma

Susceptible to infection

Tetanus shot needed

INCISIONS

Smooth cut in skin Not jagged

Susceptible o infection

Tetanus shot needed

AVULSIONS Skin torn away from the body

Should be placed in moist gauze with in a plastic bag then immersed in cold water

Transport to hospital with athlete for possible reattachment

Susceptible to infection

Tetanus shot needed

MORE TYPES OF WOUNDS

Burns Immerse the affected part in cold water Extensive burns should be treated by a physician

Animal or Human Bites Chance of infection is VERY HIGH Any break in the skin caused by teeth should be

treated as though it was a bite

MORE TYPES OF WOUNDS Bee stings and insect Bites

A non-allergic person Mild irritation and itching to swelling of an entire

extremity Persons who are highly sensitive

Serious systemic (anaphylactic) reaction that is very dangerous

Seek immediate medical care Credit Card flick the skin Apply ice to bee stings to reduce inflammation Alcohol pad to reduce itching

BLISTERS Etiology

Shearing force Produces red/raised area that accumulates with fluid

Prevention Appropriate shoes that and BROKEN IN Padding, lubricants, powder, layering of socks

Signs and Symptoms (S/S) Hot spot, sharp burning sensation, painful Superficial area of skin raised with clear fluid Superficial area of skin raised with blood

Management Clean and protect To drain of not to drain????

SKIN BRUISES

Result of blunt trauma Causes disruption of superficial blood vessels Results in black and blue discoloration Treatment requires PRICE to control

hemorrhaging Padding can be made to disperse swelling

WOUND MANAGEMENT Control bleeding- CEP

Compression, Elevation, Pressure point (2)

Cleanse around and away from wound Flush would with saline Be careful with hydrogen peroxide, betadine, and

soap/water

Apply ointment

WOUND MANAGEMENT

Cover wound with protective bandage suitable for activity

Safeguard against infection Wash you hands before and after Make sure tetanus shot is current Change bandage frequently

OINTMENTS Do not speed healing

Kill bacteria that may slow healing

Tips from the field Always apply ointments to a well-cleaned wound Apply very thin layer Apply with clean swab or gauze DO NOT apply directly from the tube

WOUNDS REQUIRING STITCHES Any wound the gapes open

A wound that has a fatty layer, white tissue or muscle that is exposed

Larger wounds of the eyes, eats, nose, face, or head

Within 6 hours of injury

SIGNS OF WOUND INFECTION Red, Hot, Swollen Swollen and painful lymph glands near the

area of infection Mild fever and headaches Throbbing pain or tenderness in the wound

area Red streaks in the skin around the wound of

progressing away from the wound Pus or water discharge collected beneath the

skin or draining from the wound Generalized chills or fever

TETANUS Bacterial disease that affects the nervous system

s/s: headache, muscular stiffness in the jaw followed by stiffness in neck, difficulty swallowing, rigidity of abdominal muscles, spasms, sweating, and fever

Every break in the skin is a potential of entry

Important steps in prevention

Routine immunization with tetanus toxoid Every 10 years for adults OR if last shot was more

than 5 years ago and wound has been contaminated with dirt or debris

PRACTICES All wounds are assumed contaminated

Use Universal Precautions

Use clean and sterile instruments

Use gloves and clean hands thoroughly

Clean around skin lesion Be careful not to send debris into wound Start from middle and work outward

PRACTICES Avoid touching any part of sterile dressings

that will contact the wound

Use gauze or cotton tip applicator to apply medication

Secure the dressing in place

Use a non-medicated covering if athlete is to be sent for medical attention

OCCLUSIVE DRESSINGS

Blockage of air

Why its effective Minimizes scab formation Perceived pain from exposed nerves lowered Provide a barrier

SEEK MEDICAL ATTENTION Wound has blood spurting from it OR

continues to bleed after 5 minutes of pressure

Puncture wound where the object is still impaled or is removed

Any wound that may need stitches Any type of bite- Animal or Human Any wound causing severe pain Any wound which causes numbness or

movement loss below the wound If athlete has a chronic medical condition

such as diabetes or a bleeding disorder

SPLINTING Support injured body part Cover open wounds Check area below injury for color, warmth,

sensation Apply splint above and below fracture (fx) Secure splint Check for circulation Elevate if possible