BY DR.S.RAM PRAKASH SR.DMO / NGO.MAS.

1. BY DR.S.RAM PRAKASH SR.DMO / NGO.MAS.

2. WOUNDS: • Wound is caused when any tissue(Skin, Muscle, Bone, etc. ) is torn or cut by an injury. • DEPTH of the wound is more important than AREA. • TYPES OF WOUND: • OPEN WOUND • CLOSED WOUND

3. OPEN WOUND: • INCISED WOUND • LACERATED WOUND • PUNCTURED WOUND • GRAZE OR ABRASION • GUN SHOT WOUND • AVULSIONAMPUTATION • CLOSED WOUND: • CONTUSED WOUND

4. TYPES OF WOUNDS CONTUSED INCISED PUNCTURED BURNS LACERATED

5. DANGERS OF WOUNDS: • BLEEDING • INFECTION • AIMS OF FIRST AID: • STOP BLEEDING. • MINIMISE GERMS ENTERING THE WOUND. • GERMS COME FROM: • OBJECT CAUSING THE WOUND. • HANDS OF THE FIRST AIDER. • CLOTHES OF THE PATIENT. • DIRTY DRESSING. • AIR. • CONTAMINATED WATER.

6. MANAGEMENT: • STOP BLEEDING. • HANDLE GENTLY. • WASH YOUR HANDS THOROUGHLY. • REMOVE ANY FOREIGN BODY, IF POSSIBLE. • DO NOT REMOVE EMBEDDED OBJECTS. • DON’T DISTURB BLOOD CLOTS. • PLACE CLEAN DRESSING & BANDAGE FIRMLY. • SHIFT TO HOSPITAL.

8. BLEEDING: • BLEEDING RESULTS DUE TO RUPTURE OF BLOOD VESSELS. • TYPES OF BLEEDING: • EXTERNAL BLEEDING • INTERNAL BLEEDING • VARIETIES OF BLEEDING: • ARTERIAL BLEEDING: • BLOOD COMES FROM AN ARTERY. • BLOOD IS BRIGHT RED IN COLOUR. • BLOOD COMES IN JETS & IT CORRESPONDS TO HEART BEAT. • BLOOD LOSS IS RAPID & PROFUSE & CAN CAUSE DEATH QUICKLY. 

9. VENOUS BLEEDING: • BLOOD COMES FROM A VEIN. • BLOOD IS DARK RED IN COLOUR. • BLOOD FLOWS AS A CONTINUOUS STREAM & MAY BE PROFUSE. • CAPILLARY BLEEDING: • BLOOD COMES FROM CAPILLARIES. • BLOOD OOZES. • COLOUR IS LESS RED THAN ARTERIAL BLOOD. • NOT SERIOUS.

10. NATURES RESPONSE TO INJURY: • RESTRICTS BLOOD FLOW TO THE AREA BY: • CONTRACTING THE ENDS OF CUT BLOOD VESSELS. • FORMATION OF BLOOD CLOTS WITH THE HELP OF CLOTTING FACTORS, FIBRINOGEN, ETC.

11. SIGNS & SYMPTOMS OF BLEEDING: • FAINT & GIDDINESS. • COLD & CLAMMY SKIN. • WEAK & RAPID PULSE. • SHALLOW BREATHING WITH GASPS & SIGHS. • PROFUSE SWEATING. • THIRST. • BLURRED VISION. • UNCONSCIOUSNESS.

12. MANAGEMENT: • EXTERNAL BLEEDING CAN BE CONTROLLED BY: • DIRECT PRESSURE. • ELEVATION. • INDIRECT PRESSURE ON PRESSURE POINTS. • SPLINTING. • INFLATABLE SPLINTS. • BLOOD PRESSURE CUFF. • TOURNIQUET.

13. DIRECT PRESSURE: • CAN BE APPLIED BY: • FIRST AIDER’S HAND. • DRESSING & FIRST AIDER’S HAND. • PRESSURE DRESSING. • PRESSURE TO BE APPLIED FOR 10 TO 30 MINUTES. • AFTER CONTROL, APPLY FIRM BANDAGE. • NEVER REMOVE EXISTING BANDAGE IF BLEEDING RECURS. APPLY ANOTHER OVER IT. • ELEVATION: • GRAVITY HELPS TO LOWER BLOOD PRESSURE & BLEEDING IS SLOWED. • NOT TO BE USED IN CASES OF FRACTURES & SPINAL INJURIES.

14. PRESSURE POINTS: • PRESSURE POINT IS A SITE WHERE MAIN ARTERY LIES NEAR THE SURFACE OF THE BODY, DIRECTLY OVER A BONE. • PULSATION CAN BE FELT IN THESE AREAS. • THERE ARE 22 PRESSURE POINTS(11 ON EACH SIDE). • OF THESE 11 ARE USED TO CONTROL PROFUSE BLEEDING. • BRACHIAL ARTERY - FOR BLEEDING FROM UPPER LIMB. • FEMORAL ARTERY - FOR BLEEDING FROM LOWER LIMB. • CAROTID ARTERY - FOR BLEEDING FROM NECK. • TEMPORAL ARTERY - FOR BLEEDING FROM SCALP. • FACIAL ARTERY -FOR BLEEDING FROM FACE. • SUB CLAVIAN ARTERY - FOR BLEEDING FROM CHEST • WALL & ARMPIT

15. PRESSURE POINTS

16. APPLICATION OF INDIRECT PRESSURE

17. NOTE: • PRESSURE POINT TECHNIQUE IS USED ONLY AFTER DIRECT PRESSURE & ELEVATION FAILS TO CONTROL BLEEDING. • RELAX THE MUSCLES OF THAT AREA, WHICH WILL HELP IN APPLYING PRESSURE BETTER. • CONTINUE PRESSURE TILL BLEEDING IS CONTROLLED OR TILL MEDICAL HELP ARRIVES. • RELEASE PRESSURE ONCE IN 15 MINUTES AND REAPPLY. • SPLINTING • INFLATABLE SPLINTS • BLOOD PRESSURE CUFF • TOURNIQUET : APPLIED AS A LAST RESORT, AS IN CASES OF AMPUTATION, ETC.

18. INFLATABLE SPLINT

19. MINOR BLEEDING: • CONTROLLED BY ELEVATION & DIRECT PRESSURE. • MAJOR BLEEDING: • EXTERNAL BLEEDING: • BRING SIDES OF WOUND TOGETHER & PRESS FIRMLY. • POSITION THE PATIENT IN A COMFORTABLE POSITION. • ELEVATE THE INJURED PART IF POSSIBLE. • IF DIRECT PRESSURE FAILS, APPLY PRESSURE ON PRESSURE POINT FOR 10 TO 15 MINUTES. • APPLY CLEAN PAD, LARGER THAN THE WOUND & PRESS FIRMLY, TILL BLEEDING IS CONTROLLED. • IF BLEEDING CONTINUES, DO NOT REMOVE SOAKED PAD, BUT APPLY MORE PADS. • BANDAGE FIRMLY. • TREAT SHOCK. • SHIFT TO HOSPITAL AS A PRIORITY.

20. INTERNAL BLEEDING: • THIS IS SUSPECTED WHEN YOU DETECT: • WOUNDS THAT HAVE PENETRATED THE SKULL. • BLOOD IN EARS & NOSE. • PATIENT VOMITING OR COUGHING BLOOD. • PENETRATING WOUND OF CHEST & ABDOMEN. LARGE AREA OF BRUISED ABDOMEN. • ABDOMINAL TENDERNESS, RIGIDITY OR SPASM. • BLOOD IN URINE. • RECTAL OR VAGINAL BLEEDING. • FRACTURES.

21. DIAGNOSIS: • HISTORY OF SUFFICIENT INJURY TO CAUSE INTERNAL BLEEDING. • HISTORY OF MEDICAL CONDITION WHICH CAN CAUSE INTERNAL BLEEDING. (PEPTIC ULCER, ETC.) • PAIN & TENDERNESS OVER THE AFFECTED AREA. • SIGNS & SYMPTOMS OF SHOCK. • BLEEDING FROM BODY ORIFICES.

22. MANAGEMENT: • LAY THE CASUALTY DOWN, WITH HEAD LOW & TO ONE SIDE, SO AS TO ENSURE GOOD BLOOD SUPPLY TO THE BRAIN. • RAISE THE LEGS IF THERE IS NO FRACTURE. • CONTROL ALL SERIOUS EXTERNAL BLEEDING. • LOOSEN CONSTRICTIVE CLOTHING. • REASSURE. • CHECK VITAL SIGNS & RESPONSIVENESS AT 10 MINUTES INTERVALS & RECORD. • IF UNCONSCIOUS, ENSURE OPEN AIRWAY & RESUSCITATE IF NEEDED. • AFTER RECOVERY PUT IN RECOVERY POSITION. • KEEP CASUALTY COVERED. • KEEP RECORD OF ANY SPECIMEN PASSED OR VOMITED & SEND THE SAMPLES TO HOSPITAL. • SHIFT TO HOSPITAL ON PRIORITY. • DON’T GIVE ANYTHING TO EAT OR DRINK.

23. MANAGEMENT OF CLOSED WOUNDS: • CONTUSION & BRUISES: • AIM - TO SLOW DOWN BLOOD FLOW, BY GENTLE • COOLING & GENTLE COMPRESSION. • ELEVATE. • APPLY COLD COMPRESSION. • SEEK MEDICAL AID. • MANAGEMENT OF BLEEDING FROM SPECIAL AREAS: • BASE OF SKULL • SCALP • NOSE • EAR • GUMS • PALM • BLEEDING FROM VARICOSE VEINS

24. CLOSED ABDOMINAL INJURY • CRUSH INJURY • CHEST INJURIES • BLAST INJURY • STOVE IN CHEST & WHIP LASH INJURY • STAB WOUND OF CHEST • ABDOMINAL WOUND • AMPUTATION • FOREIGN BODIES

25. MOUTH BLEED HAND INJURY BLEED FROM VARICOSE VEINS NOSE BLEED

26. Thank You !!