3: First Aid

If using Cyanoacrylate polymers with a bandage, change ____ time(s) per day.

1

MAXIMUM use for Cyanoacrylate polymers

1 week

Definition of Acute Wound

A wound usually from injuries that can require up to one month to health in otherwise healthy people but is okay to self-treat is they do not extend below the dermis.

What can you do if a person has an allergic reaction to a tape?

Hydrocortisone cream

Purpose of Secondary Wound Dressings

Provides moderate to heavy absorbency, compression, and enhanced protection; FOR CHRONIC WOUNDS ONLY - APPLY ON TOP OF PRIMARY WOUND DRESSING

Which tape is best to use for people with skin allergies?

Paper

Which tape is the least allergenic?

Paper

Which tape is the least sticky?

Paper

Besides super-adhesive polymers, another type of liquid bandaids are:

Cyanoacrylate polymers

Do NOT apply Cyanoacrylate polymers over ____________.

Stitches

Alternative to local anesthetics, ___________ ____________ can be used which seal off ____________ ____________ from the air that causes pain.

Super-adhesive polymers; nerve endings

Proper Procedure for Wound Cleansing

- Tape water with sufficient water pressure is optimal - DON'T USE: wash cloth, soap, alcohol, hydrogen peroxide, or iodine - cause tissue injury and scarring

Proper Procedure for Stopping Bleeding

1) Apply direct pressure with hands or clean tissue/cloth/gauze for 15 minutes to allow clotting factors to work 2) If blood soaks through the initial layer, do not remove it, add layers on top until the 15 minutes is up 3) It may take up to three 15-minute increments to stop the bleeding (up to 45 minutes)

3 Antibiotics found in a triple antibiotic ointment

1) Bacitracin (2% of people allergic) 2) Neomycin (3.5-6% people contact dermatitis) 3) Polymyxin (rarely sensitizing but NOT effective alone)

How to Apply Cyanoacrylate Polymers

1) Clean around wound and dry 2) Apple to area 1-3 times/day with wand or swab 3) To remove, put a fresh layer on and rub it off

If possible, elevate the stitched area in order to:

1) Decrease pain 2) Decrease swelling 3) Help it heal faster

Exclusions to Wound Self-Care

1) Deeper puncture wounds (sub-cutis) can cause infections 2) Animal bites cause infections or tetanus 3) Gaping wounds that might need stitches 4) Wounds showing fat, muscle, or bone 5) Wounds containing foreign material despite cleansing 6) Severe pain or numbness 7) Inability to move structures below the wound 8) New wounds in patients with bleeding disorders or diabetes (don't heal normally) 9) Infected wounds (pus, puffiness/swelling, redness/inflammation, red streak) 10) Chronic wounds

Cyanoacrylate polymers Cautions:

1) Protect from UV light 2) Can sting with application 3) Avoid if wound is infected

Types of Acute Wounds

1) Punctures: sharp object pierces epidermis and lodges in dermis or deeper tissues 2) Abrasions: rubbing/friction injury to epidermis and maybe upper dermis 3) Lacerations: a cut in the skin 4) Burns

Ointment Use

1-3 times/day for UP TO 5 days (if healing is occurring, may use longer)

How do you remove residue from tape?

Alcohol on a cotton ball or nail polish remover

If using a local anesthetic, choose one with:

Anesthetic + antibiotic

Do not use Cyanoacrylate polymers with ____________ ____________.

Antibiotic ointment

Use ____________ ___________ in order to:

Antibiotic ointment; reduce thickness of scab, resulting in a smaller scar

Definition of Chronic Wound

Anything other than an acute wound that requires triage and medical treatment

How to Apply Ointment

Apply thin layer to a pad/bandaid OR use a cotton swab to apply to the edges of the wound

When do you need to clean a wound?

As long as the area stays clean, you only need to clean the wound itself initially but continue to clean the area around the wound

Example of Chronic Wounds

Bed sores, ulcers on the feet, etc.

Which tape is the most flexible?

Fabric

Which tape most commonly causes an allergic reaction?

Fabric

When should you use local anesthetics?

For unbroken skin ONLY ("caines" have sensitivity factor); It's better to use oral anesthetics or nothing

Which wounds bleed more and why?

Head, face, and scalp wounds because there are lots of blood vessels around to nourish the brain

What other alternative exists to using local anesthetics or super-adhesive polymers for painful wounds?

ICE or cold pack for 20 minutes on, 20 off

When to Apply a Primary Dressing to Stitches

If it drains clear or yellowish fluid, cover with a primary dressing for light absorbency

How can you tel if a wound is infected?

Inflammed, thick/creamy drainage, red streak up arm, warm to touch

Why is it important not to apply the ointment on TOP of the wound itself?

It can't be covered up because it needs oxygen to heal

Scab Care

LEAVE scab if no antibiotic ointment is being used - it's there to protect the wound from debris

Is it better to keep a healing wound moist or dry?

MOIST at all time! Increases healing my maintaining moisture

What is the concern for frequent users?

More exposure increases the risk for allergy/contact dermatitis - use for SHORTEST time possible and LEAST amount possible

How to Apply a Secondary Wound Dressing

OVER primary wound dressing, NOT for self-care, must be applied by a HCP

What is the purpose of antibiotic/antiseptic ointments?

PREVENT infection (not treat) - if used after infection occurs, it won't help it will hurt the already growing infection and cause bacterial resistance to the antibiotics

Which is a good option for those with frail skin?

Paper

Which is the least expensive tape?

Plastic

Which tape is most commonly used unless the patient requires other accommodations?

Plastic

Types of Tape

Plastic, Paper, Fabric, and Waterproof

Purpose of Primary Wound Dressings

Provide absorbency, protection, and aesthetic visual; FOR BOTH ACUTE AND CHRONIC WOUNDS

Should one stop bleeding first or clean the wound first?

STOP BLEEDING

What type of antibiotic ointment is best?

Single antibiotics containing Bacitracin has the same efficacy as a triple antibiotic

What is the purpose of bleeding?

To clean the wound and flush out debris from injury

Stitches Care

Wash in 1-3 days after stitching and dry well afterward

Which tape causes the WORSE allergic reaction?

Waterproof

Which tape is the stickiest?

Waterproof

When do you apply the ointment for it to be most effective?

Within 4 hours is most effective and will help with a smaller and quicker healing scar

How to Apply a Primary Wound Dressing

Wrap over wound and adhere/wrap around and dress with tape

Why can't you use a finger to spread the ointment around?

You will spread the bacteria to other places on your body