ЗАДАНИЯ ДЛЯ ВНЕАУДИТОРНОЙ САМОСТОЯТЕЛЬНОЙ РАБОТЫ
Wounds
By Amy H. Kaji, MD, PhD, Associate Professor, Department of Emergency Medicine, Harbor-UCLA Medical Center
Cuts or tears in tissue (lacerations), scrapes (abrasions), and puncture wounds can be caused by bites (see Introduction to Bites and Stings) or by other mechanisms. Wounds that are not caused by bites and are clean and relatively small usually heal rapidly without any problems. However, some wounds can cause extensive blood loss. In some wounds, deeper structures, such as nerves, tendons, or blood vessels, are also injured. Other wounds can become infected. A piece of foreign material (such as a splinter, glass, or a clothing fragment) can also remain hidden inside a wound, causing later problems such as infection.
Shallow cuts to most areas of the skin rarely bleed much and often stop bleeding on their own. Cuts to the hand and scalp as well as cuts to arteries and larger veins often bleed vigorously.
DidYouKnow...
| · Even shallow cuts to the scalp or fingertip may bleed vigorously. |
Infection can develop when a wound is contaminated with dirt and bacteria. Although any wound can become infected, infection is particularly likely in deep scrapes, which grind dirt into the skin, and in puncture wounds (particularly those resulting from animal or human bites), which introduce contamination deep under the skin. Also, wounds that contain foreign material frequently become infected. The longer a wound remains contaminated, the more likely it is that infection will develop.
Wounds can be painful at first, but usually the pain lessens after the first day. If a cut affects a nerve or tendon, the person may be unable to move the body part fully. Some nerve injuries cause weakness or paralysis, loss of sensation, or numbness. If foreign material remains inside a puncture wound, the part of the wound near the material is usually painful when touched.
Pain that worsens a day or more after the injury is often the first sign of infection. Later, an infected wound becomes red and swollen and may ooze pus. A fever may also develop.
First-Aid Treatment
The first step in treating a cut is to stop the bleeding. Visible bleeding can almost always be stopped by firmly compressing the bleeding area with a finger or hand for at least 5 minutes. Whenever possible, the bleeding part is elevated above the level of the heart. Because tourniquets shut off all blood flow to a body part and deprive it of oxygen, they are used only for very severe injuries (such as combat casualties).
|
|
|
To prevent infection, dirt and particles are removed and the wound is washed. Large, visible particles are picked off. Smaller dirt and particles that cannot be seen are removed by washing with mild soap and tap water. Dirt and particles that remain after washing often can be removed with a more highly pressured stream of warm tap water. Harsher agents, such as alcohol, iodine, and peroxide, are not recommended. These solutions can damage tissue, impairing the capacity to heal. Scrubbing is required to clean deep scrapes. If a wound is very small, it can be kept closed with certain commercially available tapes. Stitches may be needed for deep or large cuts. After cleaning and, if necessary, closing the wound, antibiotic ointment and a bandage are applied.
Medical assistance is needed under the following circumstances:
· If a cut is longer than about 1/3 inch (¾ centimeter), is on the face, appears deep, or has edges that separate
· If bleeding does not stop on its own or within several minutes after pressure is applied
· If there are symptoms of a nerve or tendon injury, such as loss of sensation, loss of movement, or numbness
· If a scrape is deep or has dirt and particles that are difficult to remove
· If there is a puncture wound, particularly if foreign material in the wound is likely
· If the person has not had a tetanus vaccination within the past 5 years
All wounds, whether treated at home or by health care practitioners, should be observed for symptoms of infection during the first several days after treatment. If any symptoms of infection develop, medical assistance should be sought within several hours. Most small wounds heal within a few days.
Soft-Tissue Injuries
By Amy H. Kaji, MD, PhD, Associate Professor, Department of Emergency Medicine, Harbor-UCLA Medical Center
Soft-tissue injuries include bumps and bruises (contusions) and small tears of muscles (minor strains) or of ligaments and tendons near joints (minor sprains).
Contusions, mild strains, and mild sprains cause mild to moderate pain and swelling. The swelling can become discolored, turning purple after a day and becoming yellow or brown days later. The person usually can continue using the body part. People with more severe symptoms, such as deformity, an inability to walk or use an injured part, or severe pain, may have a complete separation of bones that were attached within a joint (dislocation), partial separation of bones that were attached within a joint (subluxation), fracture (see Overview of Fractures, Dislocations, and Sprains), severe sprain or strain, or other severe injury. People with severe symptoms usually need medical care to determine the nature of the injury.
|
|
|
First-Aid Treatment
Commonly Used Splints
A splint can be anything that prevents movement of a limb). A splint is used to prevent further damage and limit pain. To be effective, a splint must immobilize the joints above and below the injury.
Splints can be made from readily available objects, such as a rolled magazine or stack of newspapers. But splints usually consist of a rigid, straight object, such as a board, strapped to the limb. A sling may be used with a splint to support the forearm when an arm, a wrist, or a collarbone is injured.
|
Contusions, mild strains, and mild sprains can be treated at home with rest, ice, compression, andelevation (RICE—see seeInitial treatment), which speeds recovery and decreases pain and swelling. If a fracture, severe strain, severe sprain, subluxation (partial dislocation), or dislocation is a possibility, a splint should be applied until medical help is available.
Дата добавления: 2018-02-28; просмотров: 304; Мы поможем в написании вашей работы! |
Мы поможем в написании ваших работ!