26 Nov, 2020 | admin | No Comments
Treatment of wounds / Detailed description of all stages of treatment. Part 2
First aid for accidental wounds
The primary task in the treatment of wounds of any localization is to prevent secondary infection and stop bleeding.
Prevention of secondary bacterial contamination is achieved by applying an aseptic dressing with preliminary treatment of the wound edges. Most often, the victim himself applies a bandage, or first aid is provided by relatives, colleagues at work.
The paramedic, along with the provision of first aid, must decide where the victim will be treated: stay at home, be treated at a FAP, or he must be evacuated to a surgeon at a local hospital or CRH. To do this, in most cases, you need to examine the wound. With signs of a penetrating injury to the abdomen, chest, extensive wounds of the hand, foot, or signs of shock, and sometimes just a serious condition of the victim (regardless of the reason), a general examination and the story of the person who provided first aid is enough to make a decision to evacuate the patient to the Central District Hospital.
Any dressing consists of five measures:
• removal of a previously applied bandage;
• toilet circumference of the wound;
• medical manipulations in the wound;
• covering the wound with a new bandage;
• fixation of the dressing in one way or another.
Removing a previously applied bandage
Removing a previously applied bandage is a simple procedure, but it must be done carefully. In a number of cases, especially with injuries to the limbs caused by mechanisms or oblique, sickle, it is necessary to check for the presence of a tourniquet, since sudden heavy bleeding is possible, requiring the application of a tourniquet.
The wet bandage is cut using special scissors, the branches of which are bent at an angle, and the lower branch ends with a button that protects the skin from damage. After removing the bandage, the deeper layers of the bandage are removed with tweezers, and if the gauze is stuck to the wound, it is poured with a 3% solution of hydrogen peroxide, a solution of furacilin at a dilution of 1: 5000, and isotonic sodium chloride solution.
Toilet circumference wound
Toilet circumference of the wound is important as a method to reduce the likelihood of secondary wound infection. The skin is wiped with gauze balls moistened with a 0.5% solution of ammonia, and then with gasoline, after which it is wiped dry, rubbed with alcohol and smeared with a 5% solution of iodonate or 1% solution of brilliant green. The use of the latter is preferable in the area of irritation, where there is redness, weeping, for example, in the groin areas in obese people, in the folds under the mammary glands, with small bowel fistulas and other situations. Sometimes ether is used instead of alcohol and gasoline for the toilet. It must be remembered that ether, getting on the scrotum or perineum, on macerated or “irritated” areas of the skin, causes a sharp burning sensation, therefore it is recommended to put a gauze napkin between the scrotum and thigh in the groin folds to prevent the ether from leaking.
Great difficulties arise when the skin is contaminated with soil mixed with lubricants. In most cases, use high quality gasoline, followed by toilet soap or shaving cream.
Therapeutic manipulations depend on the characteristics of the disease.
Covering the wound with a new bandage
Features of the new dressing applied to the wound depend on the phase of the wound and the characteristics of the disease.
Fixation of the dressing
The fixation of the dressing is performed according to the well-known rules of desmurgy.