Most common and dangerous types of accidents are scrapes and cuts. They cause bleeding, open up the possibility of infections and spreading of blood-borne diseases at the same time. Having proper wound dressing supplies should be a priority of every EMS practitioner. Have your supplies include bandages, gauze, and wraps. For added prevention of everyday injuries, include ice packs and emergency mylar blankets to help with sprains and bumps.
Dressings Stop Bleeding and Reduce Psychological Stress
Wound dressing supplies serve multiple important purposes. They stem bleeding and quicken the blood clotting process, defend the wound from infection and germs, absorb blood, plasma, and other fluids exuding from the body in case of damage. They also help the patient by alleviating pain and causing no further trauma. Finally, they reduce psychological stress by hiding the wound from view for the patient and others at the scene of the injury.
A dressing is a sterile pad or compresses applied to a wound to promote healing and protect the injury from further harm. Dressings are designed to be in direct contact with a wound, as opposed to a bandage, which is used to hold a dressing in place. Many modern dressings are self-adhesive.
A person can bleed to death in as little as five minutes. Rapid access to emergency bleeding control products reduces time to treatment and saves lives in incidents involving severe hemorrhage. Applying a dressing is a first aid skill, even though many people undertake the practice with no training – especially on minor wounds. Dressing the wounds correctly is done by applying pressure to stop bleeding either on the exposed part of the skin or tissue or by cutting off the blood loss to the exposed portion of the wound to keep the blood from spreading to the outside environment.
Mostly, dressings will be improvised on the spot. Anything can become a dressing, including clothing or spare textile material. Modern wound dressings almost always come in a prepackaged sterile wrapping, date coded to ensure sterility - sterility is necessary to prevent infection from pathogens residing within a dressing itself. Cleaning wounds and keeping the area clean and disease free should include cleaning agents. Washing an exposed area with water is not enough to kill germs. After washing wounds and your own hands, use a first aid antiseptic spray and antibacterial solutions to stop the spread of dangerous viruses. Wound dressing supplies are one of the necessary parts of equipment found in any standard first aid cases, EMS bag, or first aid cabinet. To manage bleeding effectively, one must be able to quickly identify types of wounds.
Wounds can be described in multiple ways. Visually, they are either open or closed. By origin, they are acute or chronic. EMS and medical terms will go into further detail, describing a wound as contusion incision, laceration, abrasion, puncture, avulsion or amputation.
1) Contusion or a bruise occurs when blood vessels under the skin rupture form impact but the skin stays intact. It is often a minor injury, but it can point to deeper tissue damage.
Managing external injuries is, first, about pinpointing which area of the body has been hurt, and second, about elevating the body part, applying direct pressure on or around the wounded area.
Elevation has long been a well-known technique for stemming blood loss, but in the last fifteen years, it has been put into question. Some instructions continue to include it, but there is contradictory evidence showing that it might not be as useful as previously thought. We still recommend it as a precaution until proven otherwise.
Placing pressure directly on the wound constricts the exposed blood vessels, helping to stem the blood flow. A patient can apply pressure directly to their wound if they are conscious enough., A sterile, low-adherent gauze should be used between the pressure supplier and the wound as a barrier to help reduce chances of infection. The gauze will also help the wound to seal. An EMS assisting a patient will always use protective latex or nitrile medical gloves to reduce the risk of infection or contamination going either from the victim to the rescuer, or the other way. In case there is a foreign object stuck in the wound, padding is applied to each side of the object to push it in and seal the wound as best as possible. Protruding objects are never removed at the site of the accident. A tourniquet may be applied above the puncture wound.
Pressure points constriction - In situations where direct pressure and elevation are either not possible or seem not to stem the blood flow, some training protocols advocate the use of pressure points to constrict the major artery around the bleeding point. Points on the body, such as the femoral artery, where the pulse can be felt under the fingertips, are where this pressure can be applied. However, there are risks involved in performing pressure point constriction, the biggest being necrosis of the area below the constriction. Most protocols agree on a maximum time for constriction to be around 10 minutes. For instance, constricting the carotid artery in the neck can result in brain damage within minutes of applying pressure. The brain is especially sensitive to hypoxia.
A tourniquet is a band tied tightly around a limb to restrict blood flow. Tourniquets are routinely used to bring veins to the surface for blood extraction, but they can be used in emergency medicine. Using a tourniquet can be a high-risk move, and is restricted to physicians and paramedics in most countries. A typical image of providing first aid is tying a belt or a piece of cloth to stem an arterial blood injury above a wound. Unfortunately, this can often do more harm than good by untrained health professionals. A good Samaritan who happens to find herself at the site of the accident trying to help should be aware that improvised tourniquets usually fail to compress the arteries of the limb adequately. As a result, they fail to stop arterial bleeding and may increase it by impairing venous blood flow. If you do not have training on how to use one, apply elevation or pressure to the wound and wait for an EMS to arrive at the scene.
Internal Wound Management
Initially, internal bleeding may manifest as internal pain, but otherwise, cause no symptoms. An injured organ that is bleeding may be painful. However, the person may be distracted from this pain by other, more immediate injuries, or may be unable to express pain because of confusion, drowsiness, or unconsciousness. Internal wounds often have an external cause, such as a puncture or an avulsion. They are much harder to treat than external wounds. Massive internal bleeding occurs in the abdominal and chest cavity, the digestive tract or tissues surrounding large broken bones, and once it manifests, it has usually already caused extensive blood loss. Blood loss begets low blood pressure, making the person feel weak and light-headed. The person may faint when standing or even sitting and, if blood pressure is very low, lose consciousness.
In the event of bleeding caused by an external source (trauma, penetrating wound), the patient is usually inclined to the injured side, so that the 'good' side can continue to function properly, without interference from the blood inside the body cavity.
Take These Steps to Manage Serious Bleeding
We have described the role of wound dressing supplies, defined different types of external and internal bleeding wounds, and pointed out some risks of management in general. Finally, here are short and clear instructions on taking steps to prevent loss of life and minimize long term damage from bleeding injuries. Follow these six steps to optimally manage bleeding:
1. Remove clothing or debris on and around the wound. Do not remove large or deeply embedded objects. Do not attempt to clean the wound yet. Your first job is to stop the bleeding. If available, wear disposable protective gloves.
2. Stop the bleeding. Place a sterile bandage or clean cloth on the wound. To control bleeding, press the bandage firmly with your palm. Apply constant pressure until the bleeding stops. Maintain pressure by binding the wound with a thick bandage or a piece of clean cloth. Don't put direct pressure on an embedded object.
3. Secure the bandage with adhesive tape or continue to maintain pressure with your hands. If possible, elevate an injured limb above the level of the heart.
4. Have the injured person lie down. Place the person on a rug or blanket to prevent loss of body heat. Even better, a thermal blanket will absorb outward and reflect body heat on the inside, maximizing body heat retention.
5. If the bleeding seeps through the gauze or other cloth on the wound, add another bandage on top of it. Keep pressing firmly on the area. Do not remove the original bandage!
6. Immobilize the injured body part as much as possible. Leave the bandages in place and get the injured person to an emergency room, and a physician or even better, a surgeon.
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