Trainees should be able to:

Describe the different types of soft tissue injuries

Describe the principles of sterile dressing

Explain field care for various types of injuries

Apply proper First Aid for soft tissue injuries

INTRODUCTION TO WOUNDS

TYPES OF SOFT TISSUE INJURIES CLOSED WOUNDS OPEN WOUNDS

PRINCIPLES OF STERILE DRESSING

FIELD CARE MANAGEMENT (PRACTICAL)

CONCLUSION

Types of wounds :Types of wounds :

• Open WoundOpen Wound

• Closed WoundClosed Wound

A break in the continuity of soft tissue (flesh)

The following slides contain (OR may contain) pictures of shocking nature

WARNING!

• Break in the skinBreak in the skin

• Risk of infectionRisk of infection

Open wounds can be classified according to the object Open wounds can be classified according to the object that caused the wound, and the severity of the wound. that caused the wound, and the severity of the wound. Some examples of open wounds are:Some examples of open wounds are:

• Small cuts / GrazesSmall cuts / Grazes• Incisions / Incised WoundIncisions / Incised Wound• LacerationsLacerations• AbrasionsAbrasions• Penetration Wounds (Impaled Objects)Penetration Wounds (Impaled Objects)

Small Cuts and Grazes

Procedure for Treatment Procedure for Treatment of Small Cuts and Grazesof Small Cuts and Grazes

• Wash your hands thoroughly, and put on disposable gloves if available.

• Apply pressure with a clean piece of cloth to stop the bleeding

• If the wound is dirty, clean the wound by rinsing lightly under running tap water

• The best way to remove superficial pieces of glass or grit is with tweezers if you have them.

• Wipe away the water with a piece of clean cloth/ tissue paper.

• Do not cough or sneeze over the wound and avoid touching the wound directly.

• If there is a special risk of infection, advise the casualty to see a doctor.

1) Peel open the finger-sized plaster as shown:

Peel open here (top & bottom)Or tear from the side

2) Peel open the plaster from the top and remove it

from its packaging :

Peel open here (top & bottom)

Or tear from the side (might be

easier

3) Remove adhesive strip from package

4) Remove the two shield protectors from the center of the plaster. Do not touch the sterile pad.

Sterile Pad.

Shield Protectors

5) Place the sterile pad on the wound and fix the

adhesive plaster firmly on both sides of the wound.

Secure adhesive bandage firmly

6) Inform your parent/guardian

Pointers to take note ofPointers to take note of

• Use each plaster only once.Use each plaster only once.

• Store the plaster in a cool dry place.Store the plaster in a cool dry place.

• Do not use if package is damaged.Do not use if package is damaged.

• Do not use after expiry date.Do not use after expiry date.

Pointers to take note ofPointers to take note of

• A cut might become infected if it is not A cut might become infected if it is not washed and cleaned. washed and cleaned.

• If the bleeding is severe and cannot be If the bleeding is severe and cannot be stopped, send the victim to a doctor stopped, send the victim to a doctor immediately.immediately.

STERILE PADDING

Shorter End

Longer End

PRIMARY DRESSING

HEAD

1. 2. 3. 4. 5. 6. 7. 8.

The other side before

the ear.

Follow through (slightly below chin),

covering the rest of the sterile pad. (Do not choke victim by tying too

tight)

Criss-cross the

bandages when pad is

fully covered.

Wrap the remaining bandage round his

head (above eyebrow).

Tie a reef knot.

Twirl the ends

together and tuck it underneath the wrap.

Tidy up the dressing.

Tuck shorter side of the bandage behind ear.

HEAD

SECONDARY DRESSING

1. 2. 3. 4. 5. 6.

Wrap round head, cross ends of

bandage (at the back) and tie a reef knot once they’re

brought to the front.

Tuck the excess sheet beneath the

wrap.

Tuck the dressing in neatly.

PRIMARY DRESSING SECONDARY DRESSING

EYE

Cross method.

1. 2. 3. 4.

1. 2.

Shorter side goes above ear.

Longer side

below.

Do not cover the other eye.

Cover both eyes to ‘blind’ both sides so as not to aggravate the pain in the injured eye

PRIMARY DRESSING

SHOULDER

7.

1. 2. 3. 4.

5. 6. 8.

Shorter end of bandage remains behind. Longer end will be doing the wrapping.

Wrap around sterile pad (front to back, under the

armpit)

When sterile pad is firmly in place, wrap the bandage

across chest.

And round to the back. Tie a reef knot directly onto the wounded area.

Tuck ends of remaining bandage in neatly.

Avoid wrapping the shorter end of the dressing.

SECONDARY DRESSING

1.

Apex of triangular bandage facing casualty’s neck.

Wrap bandage round upper arm. Secure bandage in

place with tying a reef knot.

Tuck apex underneath tee shirt (below the primary dressing).

2. 3.

SHOULDER

1. 2.Immobilize injured limb to prevent aggravation.

PRIMARY DRESSING

LEG

1. 2. 3. 4.

Place FAD 15 on the wound. Wrap round the sterile padding

with the longer end of the bandage.

Once sterile padding is

covered, tie a reef directly

over the wounded area.

SECONDARY DRESSING

LEG

1. 2. 3.

Using a broad bandage, wrap it over the FAD and tie a reef knot on the wounded area

(similar to FAD shown earlier)

VICTIM

Put on disposable gloves if possible.

As with other open wounds, the first aider should attempt haemorrhage control for amputation with direct pressure and elevation.

You should avoid use of tourniquet if possible because the resultant damage can interfere with the reimplantation attempts.

Reassure the victim.

Raise the severed limp up.

Apply sterile dressing ,or an non-fluffy clean pad

AMPUTATION

Amputated part:

Put on glove and wrap the severed part with plastic bag

Wrap the package in gauze or soft fabric and place in a container full of crushed ice

Mark the container with time of injury and casualty name . Pass the container to the emergency personnel yourself.

DO NOT allow the amputated part to come into contact with moisture.

AMPUTATION

PRIMARY DRESSING

AMPUTATION

1. 2. 3. 4.

5.

Raise amputated limb to reduce

blood loss.

Place FAD 14 or 15 directly on the amputated limb.

Wrap around the limb as shown in the diagrams with the longer end of the

bandage.Tie both the shorter and the longer ends

of the bandage.

SECONDARY DRESSING

AMPUTATION

1. 2. 3.

If the bleeding cannot be stopped by the first layer of FAD, add another layer of FAD on top of the first layer.

Using a broad triangular bandage wrap

amputated limb.

Twirl excess bandage and tuck it into the

wrap.

IMPALED OBJECT

1.

2. 3. 4.

5. 6.

Unwrap 2 FAD 13 and place them upright- locking the impaled object in position.

2 narrow-fold bandages to be looped in opposite directions.

Tie the ends of one bandage together with the ends of the other

bandage.Be wary of the impaled object- make sure it is not being shifted when you’re attending to it.

Protruding Intestines

(Evisceration)

Using a triangular (narrow) bandage make a ring pad (donut shape) and place it round the

protruding intestines.

Place FAD 15 on the wound. Wrap round the moistened sterile padding with the longer end of the

bandage.

In supine position, knees have to be bent to prevent the

stretching/tensing of the intestines.

PRIMARY DRESSING

1. 2. 3. 4.

5. 6.

Protruding Intestines

(Evisceration)

Fold the triangular bandage into half, and wrap it round

the FAD.

SECONDARY DRESSING

1. 2. 3.

4. 5.

Question 1Question 1

Question 2Question 2

Conclusion

It is important for trainees to be able to differentiate the types of soft tissue injuries and to be able to provide proper first aid dressing.