• Abdominal and chest wounds can be quite serious because internal
organs may be damaged, which can cause internal bleeding and even shock. • Abdominal and chest wounds are considered an emergency, and you should call for immediate medical help, sespecially if there are symptoms of shock, such as dizziness, weakness, pale and clammy skin, shortness of breath, and increased heart rate.
• While waiting for medical care, give first aid treatment for shock. • Have the injured person lie quietly with his or her feet elevated about 12 inches. • Cover him or her with a blanket to maintain body warmth. Wound: Management: • Help the person to remain calm. If the cut is large or bleeding heavily, have them lie down. • If the wound is on an arm or leg, raise the limb above the heart to slow bleeding. • Remove obvious debris from the wound, such as sticks or grass. • If the object is embedded in the body, do NOT remove it. • If the cut is small, wash it out with soap and water. • Do NOT clean a large wound. • After putting on clean latex gloves apply firm pressure to the wound with a folded cloth or bandage for about 10 minutes. • Do not remove the bandage to look at the wound during this time, as it may begin bleeding again. • If blood soaks through, add another cloth or bandage and continue holding pressure on the cut for an additional 10 minutes. • When bleeding has stopped, tape a clean bandage over the cut. Wound Seek medical care for a cut or wound if: • It’s jagged or deep, or if it is a puncture wound. • it’s on the face • it’s the result of an animal bite • there is dirt that won’t come out after washing • the bleeding will not stop Hemorrhage/Bleeding: External bleeding: This is where the blood vessels and the skin are cut and blood is escaping the body. Causes: • Damage to the skin caused by trauma. • Can be a laceration (clean cut), abrasion, or avulsion (with skin still hanging). Management: • If it’s a minor bleed allow some bleeding to take place as this will help clean the wound. • Then wash with warm water and soap, apply a dressing to keep it clean, change the dressing every few hours, and monitor for signs of infection. Hemorrhage/Bleeding: Management conti—” • If the bleeding is severe then apply the RED principle: • Rest: make sure the person is resting so as to decrease the heart rate and blood pressure. • Elevate: raise the injured limb above the heart to slow down the bleeding. • Direct Pressure: put pressure directly over the wound to help control bleeding, tie the dressing in place. But, do not make the dressing too tight so as to restrict blood flow. Do not remove the dressing. • Pressure Points: Applying pressure over the pressure points pressing over the underlying bone pressure points on the arms (brachial pressure point) on the groin (femoral pressure point). • Applying a tourniquet: A standard tourniquet is a piece of web belting about 36" long with a buckle device to hold it tightly in place when applied. This is used to stop bleeding. Care to be taken not to cutoff the circulation. • Get medical help. Notes: • If there is an impaled object do not remove it as this can cause more bleeding. Instead, apply a dressing around the object then tie it in place to control bleeding. • Take extra care not to move the object. RED Hemorrhage/Bleeding: Internal bleeding: This is where the blood vessels are broken but the skin is not, so the person is bleeding under the skin. Injured organs will result in internal bleeding. Causes Usually physical trauma, being hit, falling. Very common in car : accidents.
Signs/Symptoms: • Bruising, pain • Tenderness • Mechanism of the injury (what happened). • There may be blood in their spit, vomit, or urine. Hemorrhage/Bleeding: Internal bleeding conti: Management: • If it’s a minor bruise on the arm or leg then rest the injured part, apply an ice pack for a few minutes, and watch for signs that it is not healing. • If it’s severe internal bleeding in the core of the body then active the ambulance, make sure the person is resting, treat for shock, apply an ice pack, but do NOT put pressure over the wound. Notes: • Internal bleeding is not always obvious, but can be life threatening. • Infection can occur with any wound whether internal or external. If you suspect an infection then seek medical help immediately, as it can become life threatening. • Watch out for warning signs such as; the wound is not healing or is getting bigger, discoloration, fluid discharge, and increased pain. Bandaging: • Bandaging is something you would do to control severe bleeding. Ideally you want to use sterile dressings but they may not be readily available so use whatever you have (e.g. towels, clothing). The idea is to put constant pressure over the cut to control bleeding. You want to tie with enough pressure to control the bleeding but not so much so that blood does not get through to the remainder of the limb. If you restrict blood flow that area may die and may require amputation, so be very careful. Once you’ve tied the dressing you need to check to make sure you did not make it too tight, and check this every couple of minutes. For example, if you’ve bandaged a forearm here’s how you check for circulation: • Compare both hands to make sure they are similar in temperature and color. • Check the hand to make sure it is not swelling or turning blue. • Ask the person if the hand feels numb or tingly. • If they lose sensation then it’s too tight. Do not remove the bandage but loosen it a bit. • If the first dressing becomes soaked with blood then simply put another one on top. Do not remove the original one as you will be reopening the wound. • Notes: • Always use caution when dealing with bodily fluids. Wear gloves and wash your hands immediately after. • Keep in mind that the injured person may go into shock. Purposes of bandage:
(1) To secure dressing in position.,
(2) To form slings for support. (3) To secure pads • Roller Bandages: These bandages are made of cotton, gauze crepe, elastic fabric or linen are wrapped around the injured in spiral turns, figure of eight. To improvise, material may be torn into strips of the required length and width. • Width required for finger 2.5 cm • For head and arm 6 cm • For the leg, about 9 cm • For the body 15 cm • The bandages should be tightly and evenly rolled. Rules for Applying Roller Bandages:
• Face the casualty, except for bandages the head or back ofthe neck. • When bandaging the left limb, hold the roll of bandage in the right hand and vice versa. • Apply the outer side of the bandage to the part, and unroll no more than 5 cm at a time. • To bandage a limb, work from below upwards, and from inside towards the outside over the front of the limb. • See that the bandage is neither too tight nor too loose. • Each layer should cover two thirds of the previous layer of bandage. • Finish in front, not over the wound, and fix the end with a safety pin, sticking plaster, stitching, or by tearing the end into two tails and tying. • The completed bandage should be comfortable, look neat and fulfil its purpose with no restriction of circulation. Patterns Used in Bandaging
• Circular turns, as used for head and trunk.
• Simple spiral, for parts of uniform thickness, e.g. fingers, wrist. • Reverse spiral, used on limbs where the thickness of the part various e.g. Forearm, leg • Figure – of – Eight: This may be used on limbs instead of the reverse spiral, also for the hand and foot. • Spica, used for the shoulder, hip and thumb • Divergent Spica, for a flexed joint, e.g. elbow, knee, heel • Recurrent, to cover tips of fingers or a stump Patterns Used in Bandaging
• Special bandages such as capelin for the head, eye bandage, ear and breast bandages. • Choosing the Correct Size: Before applying a roller bandage, check suitable width for the injured area • Applying a Roller Bandage: Keep the roller part of the bandage (Head) upper most as your work (the unrolled part) is called the “tail”. Stand in front of the casualty except in cape line (Head bandaging and eye bandage are applied standing behind the client).Support the part while bandaging. • Learn to use both hands equally, changing the bandage hand to hand. Work from below to upwards. • Finish off securely with either reef knot, safety pin, bandage clip, adhesive tape. Tucking in the end. • Splinting: Splints can be made out of wood, card board, iron rods used to support the fractured part and for immobilization. Patterns Used in Bandaging
• Triangular Bandages: have various use in first aid. To make two
bandages, take a 1 meter square piece of strong cotton cloth, cut in across from corner, and hem the edges. The long side is called the ‘base’, and the corner opposite to it the ‘point’, The bandages may be applied opened out or it can be folded into a ‘broad’ or ‘narrow’ bandages.A reef knot is used to tie the ends of the bandage, because it is flat and will not slip. The rule for tying a reef knot is ‘right over left, then left over right’. If you keep this rule you cannot go wrong. • Bandage for the Scalp: Place the open bandage on the head with the point at the back. Fold a narrow hem at the base, place it just above the eyebrows, then take the two ends backwards, cross them below the occiput with the point underneath, then back to the forehead where they are tied. Draw the point down and then upwards, and fix it with a safety pin. Patterns Used in Bandaging • Slings are used to support or limit movement of the upper limb, in cases of injury or inflammation. Three types of slings are used: • Large Arm sling: This is used in cases of simple rib fracture and for fracture of the forearm.When applied, only the finger tips should show, the whole arm being well supported. • Collar and Cuff Sling: This supports the wrist only. With the casualty’s forearm flexed and fingers touching the opposite shoulder, a clove hitch, made from a narrow bandage, is placed round his wrist. The ends of the bandages are taken around the neck and tied in the hollow just above the collar bone, on the injured side. • Triangular Sling: This supports the arm with the hand well raised. It gives relief from pain when used in fracture of the collar bone. First place the open bandage across the chest with the point beyond the elbow and one end over the hand. Tuck the base comfortably under the forearm. Take the end behind the elbow across the back and tie to the first end with the knot just in front of the shoulder, on the uninjured side. Fold in the point and fix the bandage with the safety pin. • Improvised Slings: The lower edge of the casualty’s coat or shirt may be turned up and pinned to support the arm, or the hand may be passed inside a buttoned up coat.A muffler, tie or other suitable cloth may be used to support the arm. • Amputation (e.g. a finger): treat the injured body part as you would any other cut. Then take the amputated body part and place it in a clean plastic bag. Take that first bag and place it in a second plastic bag containing ice. Make sure it goes to the hospital with the person, as they can sometimes reattach the body part. Nose bleeds/epistaxis: • Have the person rest, have them pinch their nose just below the bone, and lean slightly forward. • If the bleeding is severe, if it does not stop in about 10-15 minutes, or if there was an injury to the head or face, medical attention is needed. • Do not have the person lean their head back, as all this does is have them swallow their blood, which is not desired.
