Wound Care

1. Wound Care

2. Skin Trauma (Wounds) • Mechanical Forces that Cause Injury • Friction • Compression • Shearing • Tensile/Stretching • Scraping • Tearing • Avulsing • Puncturing • Bending

3. Abrasions • Scraping of skin against rough surfaces • Top surface of skin is worn away • Increased probability of infection • Why?

4. Punctures • Direct penetration of skin with pointed object • Do not remove object • Must be referred to a physician • Tetanus shot

5. Lacerations • Object tears tissue, giving wound appearance of jagged edge • Sometimes result of blunt trauma • Susceptible to infection • Tetanus shot needed

6. Incisions • Smooth cut in skin • Not jagged • Susceptible o infection • Tetanus shot needed

7. 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

8. 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

9. 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

10. 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????

11. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. Occlusive dressings • Blockage of air • Why its effective • Minimizes scab formation • Perceived pain from exposed nerves lowered • Provide a barrier

22. 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

23. 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