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First aid for wounds is designed to reduce the risk of developing serious complications, in particular, infection through an open wound surface with various pathogens. The sooner assistance is provided, the higher the chances of a speedy recovery without a number of side effects.
In professional terminology, a wound is a damage to the skin or mucous membrane, as well as an internal organ with an external mechanical effect on the lesion.
The main characteristic signs of injury are pain, divergence of the edges of the damaged tissue and bleeding. In this case, it is necessary to differentiate the injury from the classical trophic ulcer.
The difference between the two is that ulcers are a direct consequence of the destabilization of the natural circulation. And in case of injuries, the so-called wounding tool becomes the source of injury, and it does not matter whether it is stab wounds or some rarer types of wounds.
Narrow classification
Before providing the necessary assistance to the victim, experts recommend classifying the category of damage according to a convenient peculiar scheme with hints.
The standard medical classification provides for the division in relation to the cavities of the human body into penetrating and non-penetrating types. The first point provides for lesions associated with a violation of the integrity of the membranes lining any cavity.
This applies to the peritoneum, pleura and articular covering. Such injuries are considered the most dangerous. Particularly serious consequences are associated with stabbing injuries to internal organs.
Another classification provides for the circumstances of the injury, when operational and random subspecies are distinguished. The second category prevails in the frequency of fixing clinical cases, since they include various domestic injuries.
Despite the fact that traditional first aid does not provide for a mandatory understanding of the difference between wounds by the presence and severity of the infectious process, however, the following versions are distinguished:
- infected, which are also called purulent;
- contaminated;
- aseptic.
As a rule, purulent processes are characteristic of advanced stages, which are due to untimely seeking qualified help. Aseptic cases are the result of “clean operations” that were performed under protocol-compliant conditions.
All other violations of tissue integrity are classified as contaminated subcategories. Their primary treatment should be performed when providing first aid, since there are no signs of suppuration. Sometimes postoperative wounds are added to the presented class, which remained as a result of “dirty” operations.
Standard classification
The most extensive classification is based on the mechanism of damage, that is, the object that has become the source of injury to the victim is determined. Everyone who wants to help victims should know this classification, because medical care for each category will be provided according to a different scheme. The same can be found in the summaries of the rules of emergency measures if the patient has open or closed fractures.
Briefly, the division will include the following types of injuries:
- chipped;
- cut;
- chopped;
- bruises;
- torn;
- bitten;
- scalped;
- firearms.
With stab injuries, the victim is found to have an inlet of a relatively small diameter with a long and narrow wound channel. Damage can be inflicted by any long, sharp object. Doctors call this wound the most life-threatening for the patient, despite the seemingly insignificant defeat.
The latent danger lies in the increased risk of concomitant traumatization of internal organs and infection with anaerobic bacteria.
Sometimes doctors fix a stab wound, which is no less dangerous, as it is due to the supposed larger area of the wound surface.
Classic incised wounds are characterized by smooth edges with a small depth of penetration caused by flat, sharp objects. In the absence of concomitant alarming symptoms, such household superficial incised wounds are successfully treated at home.
Superficial wounds with capillary bleeding quickly heal on their own. Simply sterile dressings are enough, which are applied after disinfection of a possible focus of inflammation.
Chopped wounds are much less common and are the result of damage by a heavy sharp object. Their processing is performed according to an algorithm similar to incised injuries, but taking into account a more extensive degree of damage and increased penetration depth. Such injuries require qualified medical attention, as damage to bones or other parts of the body is possible.
During the diagnosis of bruised injuries, it is extremely important to correctly assess the area of tissues crushed by a blunt object. Outwardly, the deviation will be expressed only by slight bleeding, however, thrombosis of large and small vessels is possible.
With lacerated wounds, the degree of damage depends on the force of pressure of a sharp injuring weapon on the skin. Therefore, the severity of the injury can only be determined after an external examination with monitoring of the severity of tissue damage.
The healing of such extensive foci is a lengthy procedure, since almost always recovery is accompanied by infection and even necrosis if a foreign body gets inside.
In case of bites to the patient, in addition to standard care, additional diagnostics are required due to the fact that the wound is caused by the teeth of animals that may suffer from rabies or any other disease transmitted to humans, therefore, specialized therapy is required.
It is aimed at neutralizing the impact of significant microbial contamination. Enhanced treatment is required if there was a deep or even slight penetration.
Scalped wounds are characterized by exfoliation of the skin flap, and in aggravated cases, a piece of skin exfoliates along with subcutaneous fat.
The final broad class is gunshot wounds, which are also divided into through and non-penetrating, when the bullet remains in the tissue. A little more difficult with a fraction.
In combat conditions, field surgeons often have to deal with shrapnel injuries and burns from explosives.
Help with superficial wounds
The easiest way to deal with superficial, small-sized injuries of the forearm or other parts of the body. These are, as a rule, injuries in children and household injuries.
They do not cause concern, if not affected:
- vessels;
- tendons;
- muscles.
But if, in addition, the patient has a dislocation or other complication, an ambulance team should be called immediately.
For small cuts of the skin area without affected deep tissues, it is advisable to first disinfect the wound to prevent infection. You need to do the following:
- Rinse the wound with a hydrogen peroxide solution, which will disinfect the wound and stop any bleeding. If peroxide is not on hand, dilute alcohol solutions can be used.
- Apply a bandage to prevent infection of the wound surface.
In the field, it is allowed to use ordinary cold clean water for washing. It is forbidden to use water from a lake, pond or any other body of water. It is likely that the water contains harmful impurities and even pathogens of serious diseases.
After washing, it is necessary, if possible, to combine the edges of the cut and press them firmly, which will help stop the bleeding.
For abrasions or cuts, it is forbidden to pour iodine or brilliant green on an open wound surface, as this will only aggravate the situation. It is necessary to carefully treat only the edges of the wound.
Separately, the issues of the need to seal the wound with a plaster are considered. With a small wound area, and if the area is not subjected to stress, the wound can not be closed. Air access has a beneficial effect on the rate of healing of injuries.
In addition, the patch can be used only when the wound edges diverge, or the area of the lesion turned out to be large enough. It is impossible to seal deep stab wounds with a plaster, as this provokes the rapid multiplication of pathogens.
The patch is also not used for prolonged bleeding, it is necessary to seek qualified help and conduct a study of blood coagulation parameters.
Help with deep wounds
Signs of muscle damage and severe pain indicate a deep lesion, which is visually estimated at 6-7 mm, involving the surrounding muscle fibers of adipose tissue, tendon damage, leading to a limitation of natural mobility. Often, a deep injury is accompanied by a rupture of a medium, large vessel, as indicated by profuse bleeding.
Here, the sequence of care should begin with stopping the bleeding. If the blood does not stop for five minutes or more, then it is necessary to try to clamp the edges of the affected vessel before the arrival of the ambulance.
It is extremely important to distinguish between the types of bleeding that accompany open wound surfaces. With venous bleeding, dark red blood flows out of the wound, which evenly fills the focus.
With arterial bleeding, scarlet blood splatters in a pulsating stream. This option is considered more serious, as it significantly limits the time of those who began to help the victim.
To stop venous bleeding, it is necessary to apply a tourniquet below the wound. Even a cord or belt can be used as a harness. With the right actions, when the density of the overlay is maintained, the blood gradually slows down the current. But with a loss of pulse, the patient must necessarily loosen the tourniquet.
If arterial bleeding is detected, the tourniquet is applied as quickly as possible above the injury site. It is extremely important to monitor the time, from the moment the tourniquet is applied, it should be no more than forty minutes. Otherwise, the risk of developing necrosis will increase every minute. It is most effective to install a tourniquet and fix the exact time of the procedure.
In case of injury with a rusty object contaminated with soil, mandatory tetanus prophylaxis will be required. The sooner a special serum is administered to the victim, the greater the chance that he will successfully cope with a dangerous pathogen.
Cases of lesions are considered separately, when toxic substances get inside along with a rupture of the skin. In case of violation of the integrity of the eye, it is most important to determine the cause of the problem and send the patient to the hospital as soon as possible. This will avoid extensive inflammation of the eyelids and the eyeball itself.
Experts remind that even with a seemingly harmless wound, one should not delay medical advice if the affected area turned out to be significant in depth or width.