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2. 2. Page 2 OBJECTIVES Describe the different types of soft tissue injuries Describe the principles of sterile dressing Explain field care for various types of injuries Apply proper First Aid for soft tissue injuries
3. 3. Page 3 SCOPE INTRODUCTION TO WOUNDS TYPES OF SOFT TISSUE INJURIES CLOSED WOUNDS OPEN WOUNDS PRINCIPLES OF STERILE DRESSING FIELD CARE MANAGEMENT (PRACTICAL) CONCLUSION
4. 4. Page 4 WHAT IS A WOUND? Types of wounds : Open Wound Closed Wound A break in the continuity of soft tissue (flesh)
5. 5. Page 5 CLOSED WOUNDS
6. 6. Page 6 WARNING! The following slides contain (OR may contain) pictures of shocking nature
7. 7. Page 7 CONTUSION
8. 8. Page 8 CONTUSION
9. 9. Page 9 HEMATOMA
10. 10. Page 10 OPEN WOUNDS Break in the skin Risk of infection Open wounds can be classified according to the object that caused the wound, and the severity of the wound. Some examples of open wounds are: Small cuts / Grazes Incisions / Incised Wound Lacerations Abrasions Penetration Wounds (Impaled Objects)
11. 11. Page 11 Procedure for Treatment of Small Cuts and Grazes Wash your hands thoroughly, and put on disposable gloves if available. Apply pressure with a clean piece of cloth to stop the bleeding If the wound is dirty, clean the wound by rinsing lightly under running tap water The best way to remove superficial pieces of glass or grit is with tweezers if you have them. Wipe away the water with a piece of clean cloth/ tissue paper. Do not cough or sneeze over the wound and avoid touching the wound directly. Apply the plaster. If there is a special risk of infection, advise the casualty to see a doctor.
12. 12. Page 12 Pointers to take note of Use each plaster only once. Store the plaster in a cool dry place. Do not use if package is damaged. Do not use after expiry date.
13. 13. Page 13 Pointers to take note of A cut might become infected if it is not washed and cleaned. If the bleeding is severe and cannot be stopped, send the victim to a doctor immediately.
14. 14. Page 14 ABRASION
15. 15. Page 15 LACERATION
16. 16. Page 16 INCISION
17. 17. Page 17 AVULSION
18. 18. Page 18 PARTS of FAD STERILE PADDING Shorter End Longer End
19. 19. Page 19 PRINCIPLES OF STERILE DRESSING
20. 20. Page 20 PRINCIPLES OF STERILE DRESSING
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22. 22. Page 22 FIELD CARE MANAGEMENT PRIMARY DRESSING HEAD 1. 2. 3. 4. 5. 6. Use FAD 14/15. Place sterile pad on wound, apply firm & direct pressure on it throughout procedure. Use FAD 14/15. Place sterile pad on wound, apply firm & direct pressure on it throughout procedure. The other side before the ear. Follow through (slightly below chin), covering the rest of the sterile pad. (Do not choke victim by tying too tight) Criss-cross the bandages when pad is fully covered. Wrap the remaining bandage round his head (above eyebrow). Make sure the bandage is wrapped by the crown of the head Tie a reef knot at the top of the pad and tidy up the dressing and twirl the ends together and tuck it underneath the wrap. Tuck shorter side of the bandage behind ear.
23. 23. Page 23 FIELD CARE MANAGEMENT HEAD SECONDARY DRESSING 1. 2. 3. 4. 5. 6. Wrap round head, cross ends of bandage (at the back) and tie a reef knot once theyre brought to the front. Tuck the excess sheet beneath the wrap. Tuck the dressing in neatly.
24. 24. Page 24 FIELD CARE MANAGEMENT PRIMARY DRESSING SECONDARY DRESSING EYE Cross method. 1. 2. 3. 4. 1. 2. Shorter side goes above ear. Longer side below. Do not cover the other eye. Use FAD 13. Place sterile pad on wound, apply firm & direct pressure on it throughout procedure. Use FAD 13. Place sterile pad on wound, apply firm & direct pressure on it throughout procedure. Cover both eyes to blind both sides so as not to aggravate the pain in the injured eye
25. 25. Page 25 FIELD CARE MANAGEMENT PRIMARY DRESSING SHOULDER 7. 1. 2. 3. 4. 5. 6. 8. Shorter end of bandage remains behind. Longer end will be doing the wrapping. Wrap around sterile pad (front to back, under the armpit) When sterile pad is firmly in place, wrap the bandage across chest. And round to the back. Use FAD 15. Place sterile pad on wound, apply firm & direct pressure on it throughout procedure. Use FAD 15. Place sterile pad on wound, apply firm & direct pressure on it throughout procedure. Tie a reef knot directly onto the wounded area. Tuck ends of remaining bandage in neatly. Avoid wrapping the shorter end of the dressing.
26. 26. Page 26 SECONDARY DRESSING 1. Apex of triangular bandage facing casualtys neck. Wrap bandage round upper arm. Secure bandage in place with tying a reef knot. Tuck apex underneath tee shirt (below the primary dressing). 2. 3. SHOULDER 1. 2. Immobilize injured limb to prevent aggravation.
27. 27. Page 27 FIELD CARE MANAGEMENT PRIMARY DRESSING LEG 1. 2. 3. 4. Place FAD 15 on the wound. Wrap round the sterile padding with the longer end of the bandage. Once sterile padding is covered, tie a reef directly over the wounded area.
28. 28. Page 28 FIELD CARE MANAGEMENT SECONDARY DRESSING LEG 1. 2. 3. Using a broad bandage, wrap it over the FAD and tie a reef knot on the wounded area (similar to FAD shown earlier)
29. 29. Page 29 AMPUTATION
30. 30. Page 30 AMPUTATION
31. 31. Page 31 VICTIM Put on disposable gloves if possible. As with other open wounds, the first aider should attempt haemorrhage control for amputation with direct pressure and elevation. You should avoid use of tourniquet if possible because the resultant damage can interfere with the reimplantation attempts. Reassure the victim. Raise the severed limp up. Apply sterile dressing ,or an non-fluffy clean pad AMPUTATION FIELD CARE MANAGEMENT
32. 32. Page 32 Amputated part: Put on glove and wrap the severed part with plastic bag Wrap the package in gauze or soft fabric and place in a container full of crushed ice Mark the container with time of injury and casualty name . Pass the container to the emergency personnel yourself. DO NOT allow the amputated part to come into contact with moisture. AMPUTATION FIELD CARE MANAGEMENT
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34. 34. Page 34 FIELD CARE MANAGEMENT PRIMARY DRESSING AMPUTATION 1. 2. 3. 4. 5. Raise amputated limb to reduce blood loss. Place FAD 14 or 15 directly on the amputated limb. Wrap around the limb as shown in the diagrams with the longer end of the bandage. Tie both the shorter and the longer ends of the bandage.
35. 35. Page 35 FIELD CARE MANAGEMENT SECONDARY DRESSING AMPUTATION 1. 2. 3. If the bleeding cannot be stopped by the first layer of FAD, add another layer of FAD on top of the first layer. Using a broad triangular bandage wrap amputated limb. Twirl excess bandage and tuck it into the wrap.
36. 36. Page 36 IMPALED OBJECT
37. 37. Page 37 FIELD CARE MANAGEMENT
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39. 39. Page 39 FIELD CARE MANAGEMENT IMPALED OBJECT 1. 2. 3. 4. 5. 6. Unwrap 2 FAD 13 and place them upright- locking the impaled object in position. 2 narrow-fold bandages to be looped in opposite directions. Tie the ends of one bandage together with the ends of the other bandage. Be wary of the impaled object- make sure it is not being shifted when youre attending to it.
40. 40. Page 40 EVISCERATION
41. 41. Page 41 FIELD CARE MANAGEMENT
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43. 43. Page 43 FIELD CARE MANAGEMENT Protruding Intestines (Evisceration) Using a triangular (narrow) bandage make a ring pad (donut shape) and place it round the protruding intestines. Place FAD 15 on the wound. Wrap round the moistened sterile padding with the longer end of the bandage. In supine position, knees have to be bent to prevent the stretching/tensing of the intestines. PRIMARY DRESSING 1. 2. 3. 4. 5. 6.
44. 44. Page 44 FIELD CARE MANAGEMENT Protruding Intestines (Evisceration) Fold the triangular bandage into half, and wrap it round the FAD. SECONDARY DRESSING 1. 2. 3. 4. 5.
45. 45. Page 45 Ring Pad (Donut) Form a loop in the middle of the triangular bandage Wrap both ends around the loop. Tuck in any excess.
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47. 47. Page 47 Question 1Question 1
48. 48. Page 48 Question 2Question 2
49. 49. Page 49 Conclusion It is important for trainees to be able to differentiate the types of soft tissue injuries and to be able to provide proper first aid dressing.