WOUNDS AND WOUND CARE:
1, A wound is a break in the continuity of the tissues of the body.
2. Wounds occur frequently in sports, especially in contact and collision sports.
3. A wound can be either internal or external.
A. Internal (closed) wounds are a breaking or tearing of tissues or organs inside
the body.
B. External (open) wounds are a break in the skin or mucous membranes.
General Wound First Aid:
1. Always Wear Gloves.
2. Stop the bleeding immediately.
3. Protect the wound from contamination and infection.
4. Provide traumatic shock care if necessary.
5. Obtain medical attention for serious wounds.
6. Cleanse the wound if it does not need sutures.
7. Use antibiotic ointment if the wound does not need sutures.
8. Cover the wound with a dressing and a bandage.
9. Always observe for infection.
10. They may require a tetanus update shot.
Training Room Wound Procedures:
1. Make sure all instruments such as tweezers, scissors, and swabs are sterilized.
2. Wash/cleanse your hands thoroughly.
3. Clean in and around the skin lesion thoroughly.
4. Do not put ointments on wounds or dressings that must be sent to a doctor for
sutures.
5. Avoid touching any parts of a sterile dressing that may come in contact with a
wound.
6. Place medication or ointment on the pad or dressing rather than directly on the
wound.
7. Secure the dressing with tape or a wrap/bandage. Try to avoid putting pressure
directly on the wound.
The Main Types of Wounds: APAIL
1. Abrasion:
A. Occur when the skin is scrapped against a rough surface.
B. Usually has a high risk of infection because the wound is exposed to
and/or penetrated by dirt and foreign materials.
2. Punctures:
A. Occur from a direct penetration of the skin by a sharp or pointed object.
B. Punctures usually lead to an infection.
C. Puncture wounds have a high risk of tetanus infection.
D. Punctures usually do not bleed extensively.
3. Avulsions:
A. Occur when the skin or tissue is torn from the body.
B. Avulsions are frequently associated with severe bleeding.
C. You must save avulsed tissue on a moist gauze pad, preferably soaked in
sterile saline solution.
4. Incision:
A. These are cuts or splits in the tissue. They can be caused by sharp objects
or by a blow over a sharp or poorly padded bone.
B. Incisions are usually small and not serious unless they are deep.
5. Lacerations:
A. Occur when a sharp, pointed or jagged objects tears the tissues.
B. They have a high risk of infection.
C. A laceration can lead to an avulsion.
Symptoms of Infection:
1. Edema (swelling)
2. Redness
3. Sensation of Heat
4. Throbbing Pain
5. Tenderness
6. Fever
7. Headache
8. Evidence of pus or drainage
9. Swollen lymph glands
10. Red streaks from the wound
Infection First Aid:
1. Infection usually occurs within 2 to 7 days after the trauma/injury.
2. Infections, even from small wounds, can be fatal if not treated quickly and
properly.
3. Staphylococcus is a common organism that infects wounds.
4. An infected wound must be referred to a physician.
5. Infected wounds should be cleaned, and a dressing and bandage should be applied.
6. Do not delay in getting medical help for suspected infections.
Other Types of Wounds:
1. Amputations:
A. These are a serious type of avulsion.
B. These involve avulsion of an extremity.
C. The fingers, toes, hands, feet, or limbs are completely cut through or torn
off.
D. There may be massive bleeding, or occasionally, the blood vessels may be
closed off, resulting in limited bleeding.
E. Treat these like an avulsion. Treat for traumatic shock from blood loss.
2. Crushing Injury:
A. Occur when an extremity is caught between heavy or fast moving objects.
B. There may be fractures (broken bones), internal or external wounds, and
internal or external bleeding.
C. Treat these as necessary.
3. Different Types of Puncture Wounds:
A. In a penetrating puncture wound, an object pokes or enters into the body.
B. In a perforating puncture wound, there is both an entrance wound and an
exit wound. The object passes through the body.
C. The exit wound is often more serious than the entrance wound.
4. Mouth Lacerations:
A. Usually occur from a blow to the mouth that forces soft tissue against the
teeth.
B. They can involve the lips, tongue or gums.
C. Deep cuts should be sutured by a physician. All dental injuries should be
referred to a dentist.
D. You may have the athlete rinse their mouth with water before you examine
them.
E. Wear gloves.
F. Check their teeth for chips and fractures.
G. Control bleeding with dental cotton or gauze pads.
H. Hydrogen peroxide and antiseptic rinses can be used to control infection..
I. Edema and bleeding can be controlled by having the athlete suck on ice.
5. Scalp Lacerations:
A. These wounds are difficult to treat.
B. Bleeding is often extensive, and matted hair and dirt can also disguise the
actual point of injury.
C. First Aid: Wear gloves; cleanse with soap and water; clip away enough
hair to adequately expose the wound, control bleeding, apply ointment and
a dressing, unless it is a large or deep wound that needs sutures.
D. Refer to a physician if necessary.
BLEEDING:
1. Loss of a quart or more of blood can cause shock and unconsciousness.
2. Bleeding should be treated in the following order:
A. Direct pressure
B. Pressure bandage
C. Elevation
D. Pressure points
E. Tourniquet
3. Direct Pressure:
a.Wear gloves.
Pressure is applied with the gloved had over the wound with a gauze pad.
Once you apply a gauze pad or dressing, don’t remove it. You could disturb
blood clots. If necessary apply more gauze or dressings on top of the
original pad.
C. Pressure bandage:
a. This is when you apply a wrap or bandage in order to hold down the
dressing, and to apply continuous pressure.
b. This allows you to free your hands for other things.
D. Elevation:
a. Elevating the hemorrhaging part makes the blood flow against gravity,
Reduces the blood pressure near the wound, and slows bleeding.
b. Do not elevate suspected fractures (broken bones)
E. Pressure Points:
a. There are 11 pressure points on each side of the body.
b. They are at locations where major arteries pass near the skin and a bone.
c. The two most commonly used points are the brachial artery on the
inside of the upper arm, and the femoral artery on the front of the pelvis.
d. You can apply force to the point until blood slows or stops in the limb.
F. Tourniquet:
a. A tourniquet is a last – resort, life – saving measure.
b. It is rarely used in sports medicine.You usually don’t get wounds and
bleeding severe enough in spots for a tourniquet.
c. The time a tournaiqet is applied should be written down on the patient.
You can also write a “T” on their forehead.
d. If a tourniquet is left on for more than 10 minutes, a clot will occur in
the vessels, along with nerve and blood vessel damage. This can lead to
a loss of the limb due to gangrene infection.
G. Characteristics of Bleeding:
a. Venous bleeding (from veins) is usually dark red with a continuous
flow.
b. Capillary bleeding oozes or exudes from the tissue and is a reddish
color.
c. Arterial bleeding flows in spurts and is bright red.
H. Internal Hemorrhage:
a. Occurs from internal wounds.
b. It is invisible if you just look at the patient. Xrays and other diagnostic
tests are needed to diagnose internal bleeding.
c. Bleeding subcutaneously (under the skin) or intramuscularly (in the
muscles) or intra-articularly (in the joints), is usually non-life
threatening.
d. Other internal bleeding is life-threatening. It will lead to shock if left
untreated.
e. Treat suspected serious internal bleeding for shock and transport to a
medical facility.
I. Symptoms of Closed Wounds and Internal Bleeding:
a. Cold, clammy, pale skin
b. Rapid, but weak pulse
c. Rapid, but shallow breathing.
d. Dizziness
e. Pain and tenderness
f. Restlessness
g. Excessive thirst
h. Vomited or coughed up blood
i. Blood in the urine or feces
j. Edema (swelling)
k. Ecchymosis (discoloration)
l. Deformity
m. Bruises over large organs
n. Blood in the mouth, nose, or ears
o. Ridged or tender abdomen
p. Rebound tenderness of the abdomen