Treating Simple Wounds

Treat all blood as if it were contaminated with blood borne viruses. Do not use bare hands to stop bleeding; always use a protective barrier; always wash exposed skin areas with hot water and soap immediately after treating the victim.

The first thing you must do for any wound is to stop the bleeding. For small wounds--minor cuts, a scraped knee, any wound where bleeding is not severe--the bleeding is easily stopped. It might even stop without treatment. To prevent infection, the wound should be cleaned and bandaged as soon after the injury as possible.

Sharp cuts through the skin, such as those caused by knives, razors, raw edges of metal, broken glass, or other sharp objects, are known as incisions. Lacerations are rough, jagged cuts made by tearing and breaking skin and flesh.

An incision or clean-edged cut might bleed freely and heavily. Deep cuts can injure muscles, tendons and nerves. A laceration, with its jagged tearing of the skin, may damage a larger area than a cut. Bleeding may be rapid and heavy. Deep contamination of the wound increases the chances of infection. Dirt and debris can enter any break in the skin and cause infection that could become a greater threat than the original injury.

For cuts or lacerations with minor bleeding or where bleeding readily stops, follow these steps:

1. Wash your hands, then get some sterile gauze or a few scraps of cotton, and plenty of clean water. For best results, wash the wound under running water or put the water into a container from which you can squirt a steady stream. You can modify a plastic bag for the purpose by pricking a small hole in one corner, filling the bag with water, twisting the top closed, and then applying enough pressure to force a jet of water from the hole.
2. Gently pull apart the sides of the wound and clean away dirt and dead tissue by flushing the area with a stream of water and swabbing it with gauze or wool. Use plenty of water. If cleaning the wound restarts the bleeding, stop the bleeding by placing a sterile gauze pad over the cut and applying direct pressure.
3. Allow the wound to air dry.
4. To keep the edges of a cut from pulling apart, close the wound with tape. Draw the sides of the cut together and secure with butterfly bandages, sterile wound-closure strips, or regular adhesive tape.
5. If the injury is on a flexible part of the body--an elbow or knee, for example--apply a splint to immobilize the joint and prevent the wound from pulling open.
6. Cover the wound with a clean, dry dressing.
7. Find out when the injured person was immunized against tetanus. Talk with a physician about the need for a booster shot.

For a wound that is large, deep, and continues to bleed:

1. Control the bleeding. Apply direct pressure to the wound with a sterile or clean dressing.
2. If the injury does not involve a broken bone, raise the wounded area above the victim's heart. If a broken bone is suspected, treat the injury as a fracture.
3. If these steps fail to control the bleeding , apply pressure to the artery while continuing to apply direct pressure over the wound.
1. Treat for shock.
2. Get medical help immediately.

Guard against cuts and lacerations by handling knives, tools, and all sharp objects with care. Keep all knives and tools sharp and well maintained. Prevent falls and the torn skin that often results by staying in good shape physically and wearing good boots during hikes.

A puncture wound is caused by something piercing the skin, making a small hole in the tissues. This type of wound can be caused by a nail, wood splinter, fishhook, and similar objects. Bullet and stab wounds also fall into this group, though they are much more serious than common puncture wounds.

Puncture wounds usually do not bleed much, at least not on the outside. Deep punctures can cause internal damage, with possibly severe internal bleeding. Because bleeding from the wound is usually slight, dirt and debris might stay in the puncture and increase the danger of infection.

Encourage the wound to bleed to help remove anything that might have been forced inside. Use tweezers, sterilized over a flame or in boiling water, to pull out any wood splinters, bits of glass, or other foreign matter that you can see. Clean the injury thoroughly with soap and water and rinse well with clear water. Allow the wound to air dry, and cover with clean, dry dressing. Tetanus is a very real danger with puncture wounds. Be sure that the injured person sees a physician about the possible need for a tetanus booster shot.

How to Prevent It

Puncture wounds to the feet are common. To prevent them, don't go barefoot in places where sharp objects might pose a threat.

A fishhook embedded in the skin is a frequent outdoor injury. Two points are especially important to remember in this situation:

1. Do not try to remove a fishhook from the face or from an eye.
2. Never try to remove an embedded hook by pulling it back the way it went it.

If only the point of the hook enters the skin, and does not go deep enough to let the barb take hold, you can safely remove the hood by backing it out. If the fishhook goes deeper and the barb becomes embedded, it's best to let a physician remove the hook.

If medical help is not available, follow these steps:

1. Push the hook farther in, in a shallow curve, until the point comes through the skin.
2. Cut off the barbed end with wire cutters or pliers.
3. Back the shank of the hook out through the entry wound.

Treat a fishhook in the skin as a puncture wound. After removing the hook, wash the area with soap and water and cover it with an adhesive bandage or gauze bandage. Because of the danger of infection, especially tetanus, the injured person should see a physician as soon as possible.

A scrape is a wound caused by rubbing or scraping off the skin. Abrasions often happen when the skin is scraped against a hard, unyielding surface.

The outer layers of the skin are damaged. Bleeding may be limited. The greatest danger lies in contamination and possible infection of the wound.

Treat a scrape as you would a minor cut or laceration:

1. Clean thoroughly with soap and water and rinse well with clear water.
1. Allow the wound to air dry.
1. Cover with a dry, sterile dressing.
1. If tetanus immunization is not up to date, see a physician about the need for a booster.

To protect skin from scrapes, keep it appropriately covered. Wear the proper clothing for the activity--jeans, boots, socks, gloves, long-sleeve shirt.

Blisters form when skin is irritated, usually by friction or heat. Working without gloves could result in blisters on the hands. For outdoor travelers, blisters on the feet are the most common and troublesome problem.

A "hot spot" signals the beginning of a blister. A hiker should stop immediately and protect the tender area by cutting a hole the size of the hot spot in a piece of moleskin or mole foam and using it to encircle the potential blister.

If a blister forms, use the above procedure to take the pressure off it, building up several layers of moleskin or mole foam if needed. If all pressure can be relieved until the fluid is absorbed, blisters are best left unbroken. A hiker might travel more comfortably, however, if the blister is drained.

Follow these steps:

1. Thoroughly wash the foot or other affected area with soap and water.
2. Prick the edge of the blister with a needle that has been sterilized in a flame.
3. Press out the fluid.
4. Apply a sterile dressing and protect the area from further irritation.
5. If the blister has already broken, treat it as an open would like a minor cut, laceration or an abrasion.
6. Watch for signs of infection. These include tenderness, throbbing, swelling, pus, redness, red streak leading from the blister, swollen glands, fever. If one or more of these signs develop, seek medical attention.

Hikers can help stop blisters from forming by keeping their feet dry and clean, using foot powder, wearing properly fitted boots and shoes, and frequently changing socks. Do not wear socks with holes in them.

To prevent blisters from forming on hands, wear gloves when using a shovel, rake, axe or similar hand tool. When learning to swing a tennis racquet, golf club or other item of sports equipment, start slowly and gradually toughen the hands as you practice.

Black-and-blue marks and "black eyes" are common bruises that are easy to recognize and treat. Some bruises, however, can be serious, especially if there are possible fractures or unseen injuries to internal organs. A bad fall could cause large bruises deep within a muscle. A hard blow to the head could result in a concussion. A finger badly mashed by a hammer could be a serious injury.

The black-and-blue mark that is typical of a bruise is caused by blood leaking into skin tissues, often as a result of a blow from a blunt object. The skin is not broken.

Serious bruises such as those described above require the attention of a physician. Most bruises, however, are easily treated at home.

Keep a cold, wet towel over the bruise for 30 to 60 minutes. This help prevent more blood from leaking into the tissues. Resting the injured area also slows bleeding into the bruise. To help make the black-and-blue mark fade, apply a warm, wet cloth the next day.