First Aid Treatment of Wounds

New Zealand Journal of Agriculture, Volume 74, Issue 1, 15 January 1947, Page 107

First Aid Treatment of Wounds

CLEANSING, dressing, bandaging, and the general principles in V-/ the treatment of all wounds are discussed in this article, the fifth in a series on first aid by C. Meachen, secretary of the St. John Ambulance Association, Wellington.

IF bleeding from a wound is severe, the patient must be placed in a lying position with the bleeding part elevated, unless a bone has been fractured or a foreign body is in the wound. Immediately stop the bleeding by applying direct pressure over the wound with a clean, firm pad, or indirectly by applying pressure to the bleeding blood-vessel with a ligature or tourniquet. Pressure must not be applied directly to a wound where there is a fracture or a foreign body; in such cases bleeding must be arrested by the indirect method. Remove foreign bodies unless they are deeply embedded in the wound, in which case make the part immovable and cover the wound lightly when applying dressings. Protect the wound against infection by making sure that hands and objects used in treating wounds are • clean and sterile. > Dressings used must also be clean. Cleaning of Wounds

Dirty wounds must be made as clean as possible by washing them with water that has .been boiled.

Always wash away from the wound to avoid rubbing dirt into it. The wound may also be cleaned with a piece of cotton wool soaked with hydrogen peroxide, weak tincture of iodine, or other antiseptic. Wounds may be 1 treated with any of the following antiseptics: — . Hydrogen Peroxide: A good general antiseptic. Potassium Permanganate (Condy’s crystals): Used in weak solution, this is a good general antiseptic, especially suitable for wounds near the bone—on the shin, for example. Melasol: A good general antiseptic, used in a solution of a quarter teaspoonful to 1 pint of sterile water, hot

or cold. It is most suitable for wounds in which there is danger of infection. Tincture of lodine: A good antiseptic for deep and punctured wounds when

penetration is desired and when bruising accompanies the wound, but its use should be avoided if possible when the wound is over or near a bone.

Boracic Acid Solution: Half to one teaspoonful in 1 pint of sterile water can be used as a general antiseptic, but dry boracic acid powder should never be used on wounds, because it destroys tissue and may cause' the wound to become septic. Saline Solution: A teaspoonful of salt to 1 pint of sterile water is especially useful for cleansing purposes. Ointments, Plaster, ,and Lotion Never use ointments in the first-aid treatment of a wound. They make the surrounding tissue soft, may enclose dirt in the wound, and make the wound / difficult to clean when fresh dressings are required. Never apply adhesive plaster directly to a wound. It also makes the edges of the wound and the surrounding tissue soft, and when being removed is likely to tear the wound open again. If plaster must be used in ' the dressing of wounds, always place a piece of plain lint or clean material over the wound first, and apply the plaster over the top of it. If the use of a lotion seems advisable, dressings of “L” healing lotion may be applied, but if there is the least possibility of foreign matter or other causes of infection being enclosed in a wound, it should be kept open until it is properly cleaned, or until it heals naturally. “L” healing lotion consists of 2 parts by volume of Friar’s balsam to 1 part each of castor oil and olive oil.

After a wound has been cleaned and antiseptic has been applied, cover it with a clean dressing. Place a clean piece of plain lint, woolly side out, or other material next to the ■ wound,

cover this with cotton wool, and then apply the bandage. If possible, avoid putting cotton wool directly on the wound, as it is very difficult and painful to remove when fresh dressings are required. If the extent and nature of the wound make it necessary, support and rest the injured part with a bandage, arm sling, or splint. Keep the patient warm and give ' treatment for shock. If there is danger of haemorrhage, do not give stimulants. If the wound is large, if there has been a great loss of blood, or if the patient’s condition otherwise requires it, make arrangements for hospital or medical treatment as soon as possible. London Spica Bandage A method of tying a bandage which will prevent it from slipping over the sides of the hand is known as the London spica bandage. Make a simple spica on the finger or thumb. Take the bandage up and across the back of the hand, round the wrist, and down and across the back of the hand to the finger or thumb. Repeat this two or three times. When the wrist has been reached after the required number of spirals has been made, split the bandage about lOin. from the underside of the wrist, tie a knot, take both ends of the bandage round to the top of the wrist, and tie them again. Then draw each loose end under the bandage, crossing on the back of the hand, and tie them on the back of the hand. The Triangular Bandage A piece of material at least 40in. square is required to make a triangular bandage. The square can be folded diagonally or cut so that it makes two bandages. It can be used for almost any purpose for which a bandage is required—1. To cover and hold dressings in place; > 2. To hold splints; 3. To maintain pressure on blood- ‘ vessels to prevent bleeding; 4. To act as a constricting band to control venous bleeding; 5. To act as a ligature to prevent poison from circulating toward the heart; 6. To act as arm slings or support for other injured parts. Surgical Dressings Dry dressings are used to cover wounds after they have been treated with an antiseptic lotion. They exclude the air from the parts, protect against infection, and protect and soothe damaged tissue. They may consist of plain absorbent lint, surgical gauze, any clean plain material which has been boiled, or, in cases of emergency, handkerchief, and clean parts of plain clothing.

Cold packs are used to lessen and control haemorrhage in the tissues and organs and to prevent swelling at injured joints. They should consist of 4 or more folds of material soaked in iced or at least cold water. Suitable materials are plain absorbent lint, flannel, several folds of lighter materials, or cotton wool when it has not to be placed over wounds. Hot fomentations are used to draw foreign . matter from septic parts, to reduce swelling, to ease pain, to reduce inflammation, and to assist Nature in an effort to rid the system of impurities from septic wounds and boils. A hot fomentation consists of 4 or more folds of material wrung out of hot water with the aid of forceps or by being placed inside a clean towel, the ends of which are twisted in opposite directions until most of the water has been wrung out. If it is applied too moist or too hot, the patient may be scalded. If hot fomentations have to be applied over a wound the material used should be clean, sterile, and either of the plain or boracic acid lint. The water should be boiled and, if plain lint is used, an antiseptic . such as melasol can be added to the water. Flannel, or cotton

wool placed between the folds of clean plain cloth, are other suitable materials. Bread poultices are sometimes used to draw foreign matter and pus from infected parts, to reduce inflammation, and to soften skin tissue so that boils or. abscesses can erupt freely. They must be used only on unbroken surfaces. To make a bread poultice take a quantity of soft bread and place it in . a clean piece of cloth or lint; put this in a container and sprinkle a little boracic powder over the bread. Pour boiling water over the bread and, when it is soaked, lift the piece of material containing the bread out of the container, fold the material over, and wring out as much water as possible. When the poultice is cool enough, place it directly against the skin, cover it with cotton wool and bandage just firmly enough to hold the poultice in position without squeezing the bread out from under the bandage. * :fc ❖ The following question was received recently:— “Should a boil be poulticed?” A boil. is caused by certain microbes getting in the skin, where they multiply until a superficial abscess is produced. The application of poultices of

linseed meal, bread, bran, potato, or any other unsuitable substance pro-

duces the degree of moist heat that favours microbic growth. In a day or two the boil develops a nasty appearance. Infective matter from the boil spreads over the patient’s body and to articles in the house. It cannot be too strongly stressed that untrained people should leave all septic conditions alone, for their well-meant interference only makes matters worse. A nurse or doctor should be asked to deal with these complaints. A boil is not a trifling matter; on the contrary, it can have serious consequences. Once a house or a person’s clothing becomes infected there is no limit to the harm that may follow. Readers are invited to forward questions on any problems dealing with first aid or home nursing. Questions should be forwarded to P.O. Box 25, Te Aro, Wellington, E.2.

BATH CLEANER Readers may like to try this bath cleaner. . Mix 1 teaspoon of cream of tartar with sufficient hydrogen peroxide to make a paste. Rub this over the bath and leave on for a while. Remove with a soft cloth. — “Me Too,” Clevedon.