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Medical Advice in this blog is based on experience and education by the author and colleagues. For all medical emergencies please go to the Emergency Department if one is available or call 911. For serious conditions medical providers should always be your first line. This blog is NOT a substitute for a DOCTOR. For Chronic conditions please seek out a specialist in that area. The information provided in this publication is for educational and informational purposes only and does not serve as a replacement to care provided by your own personal health care team or physician. The author does not render or provide medical advice, and no individual should make any medical decisions or change their health behavior based on information provided here. Readers are encouraged to confirm the information contained herein with other sources. Readers should review the information in this publication carefully with their professional health care provider. The information in this or other publications authored by the writer is not intended to replace medical advice offered by physicians. Reliance on any information provided by the author is solely at your own risk. The author does not recommend or endorse any specific tests, products, medication, procedures, opinions, or other information that may be presented in the publication. The author does not control information, advertisements, content, and articles provided by discussed third-party information suppliers. Further, the author does not warrant or guarantee that the information contained in written publications, from him or any source is accurate or error-free. The author accepts no responsibility for materials contained in the publication that you may find offensive. You are solely responsible for viewing and/or using the material contained in the authored publications in compliance with the laws of your country of residence, and your personal conscience. The author will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising from the use of information contained in this or other publications.

Showing posts with label Wound Care. Show all posts
Showing posts with label Wound Care. Show all posts

Wednesday, April 28, 2010

Tourniquet

Disclaimer: The rules and regulations for tourniquets are constantly changing, I will try to keep up but it's a never ending battle. There are some basic guidelines on how to make a tourniquet; from there you are free to use your own imagination. Basic Guidelines: don’t use shoe lace, or other thin strands of fiber, these can easily break and if they don’t they can actually do more damage by cutting into the flesh. Use something broader and less likely to act like a piece of dental floss wrapped around a block of cheese. I like the rule of thumb; as wide as your thumb or two of your fingers put together. Much wider and you’ll have a tough time tying it off. Make sure it’s strong enough to hold a good wrenching. Make sure it’s long enough to wrap around the arm or leg.
Okay, now that we have the guidelines out of the way lets cover the basics. You will need a lever of some sort, it can be a stick, screw driver, curling iron, butter knife (not the plastic kind). Take the strap you chose to use as a tourniquet and wrap it once around the limb two to four inches above the wound. (If it is near a joint try to go below the joint if you can, if you can’t then two to four inches above the joint). Tie half a knot then put your stick over the half knot and tie the other half so the stick is tied into the knot. You can tie one or two knots on top of this just to be safe. Once the stick is in place here is the important part, twist the stick just enough to significantly slow the bleeding. It doesn’t have to be 100% stopped. If you can stop the bleeding and still keep a pulse in the hand or foot, then you are an A+ medic. But keep in mind this is not always possible. Once you have the tourniquet to the desired tightness, tie one end of the stick down so it doesn’t accidently come undone. Using a permanent marker, write on the forehead of the patient the date and time the tourniquet was put on. (The time is more important than the date since people can remember dates better than time). Take said person to the hospital right away.

Thursday, April 22, 2010

Clean and Steril

Clean: sanitary, significantly low levels of germs
Steril: void of all pathogens both viral and bacterial.
You can sterilize things by using strong household products such as ammonia and bleach. Keep in mind that these products can cause serious damage to the skin and tissues so do not apply them to body parts. Rubbing alcohol and iodine can be used to clean and sterilize skin. Do not use hydrogenproxide on open wounds, I don’t care what your mother or grandmother use to do. Yes I know it’s cool to feel the sting and watch the bubbles bubble, but it’s very bad for the skin. Hydrogenproxide will kill any tissue it touches and dead tissue has a hard time coming back to life and healing.
You can use extreme heat to sterilize thing such as needles or knifes by boiling them for long periods of time or running them under a flame until red hot. Keep in mind that once these items touch anything that is not sterile they themselves are no longer sterile the border of the sterile field is at least two inches. That means if you are holding a sterile knife, two inches past your fingers holding the knife is no longer sterile. Since needles are scarcely longer than two inches be sure to wear sterile gloves when handling a newly sterilized needle or use a pair of sterilized pliers or hemostats.
Sterilized situations are very finicky; if you are unsure of the sterility of something, error on the side of caution. And remember, a sterile field unwatched is no sterile field at all (always keep the sterile field in view).

Packing a Wound

If you have a deep cut or wound on your legs or arm you should pack the wound with clean or sterile gauze or any supper absorbent material. Pack it into the wound and pack it outside of the wound. Applying direct pressure to the wound will help reduce bleeding. After packing the wound tie a bandage over it with the knot of the bandage directly over the wound (this will add additional pressure to the site). Be sure to write the time and date on or near the bandage with a permanent marker. Keep an eye on it and look for excessive swelling and redness in the area. Also watch for spider veins (red streaks) coming from the site or foul smells. These are all signs of serious infection. Seek medical assistance ASAP. P.S. packing the wound with Salt (though painful it may be) will help act as an antibiotic (due to hypertonicity) and can also assist in slowing the blood loss. Do not add cayenne (as previously mentioned in an earlier blog) to these wounds.

When to apply a tourniquet

"All bleeding stops eventually"
Disclaimer: Please keep in mind that the guidlines are constantly changing.
When to apply a tourniquet is very important. I’m sure you’ve heard lots of rumors as to why or why not applying a tourniquet is bad. Let me clear the air of confusion. You’ve heard that applying a tourniquet to a limb will cut off the blood supply and kill the limb. This is true… if you leave it on for days however a tourniquet can be applied for several hours without any damage on the cellular level. Surgeons leave tourniquets on for up to two hours while doing surgery on the legs. So what is the big deal? When a tourniquet is applied it causes the blood in that limb to become stagnant (not moving) blood that isn’t moving tends to form clots. Clots in the bloodstream are never a good thing. Clots can stay in the limb and continue to cut off blood supply which will eventually lead to tissue damage or worse they could break free and end up in your lungs or brain. I know you just had an “Ah Ha” moment. You see when surgeons put a tourniquet on they always test your blood for coagulation factors and give you medication to thin the blood or stop it from coagulating. The longer the tourniquet is on the higher the risk for blood clots forming. Everybody has a different coagulation time and so there is no set time to how long a tourniquet can be on before running the risk of clots forming. There are two rules of thumb I like to use. #1 never put a tourniquet on a limb you aren’t willing to lose. #2 it’s better to lose a limb than a life. Keep in mind that if you can stop the bleeding by applying direct pressure, this is always the preferred method. All bleeding stops eventually, the sooner you can stop it the better the out come.

P.S. I'm sorry I assumed everyone knew how to make a tourniquet. For instructions on how to make one, go to the “Tourniquet” blog I posted.

How to stop bleeding

cayenne pepper -- also known as the Guinea spice, aleva or bird pepper.
If you have a small cut that just won’t stop bleeding no matter how many roles of toilet paper you applied, just sprinkle a little Cayenne Pepper on it and watch the magic. Now I know what you’re thinking, “Ouch!” well don’t worry because believe it or not it really doesn’t hurt. You are not suppose to rub it in, just sprinkle over the top. Keep in mind this is for small cuts. Don’t rub your eyes after touching peppers and always wash your hands thoroughly before using the bathroom for obvious reasons.

Wednesday, April 21, 2010

Disinfect a wound

Antibiotics are debate cesspool in the medical field. When to take them, how long, pros and cons, the list goes on. The first thing you need to know about Antibiotics is they are not a cure-all and in many cases can make the situation worse. A bacterial infection and a viral infection may present with very similar signs and symptoms and antibiotics won't do diddly squat for viral infections. Topical antibiotics are in most cases never a bad thing. Your skin is the number one defense against the grime and grunge of the world. Any time you have a break in the skin you are at risk of infection. Now here is where combat medicine comes into play. Suppose you are in the wilderness (back yard, camping trip, or away from medical assistance) and you sustain a small abrasion (fancy word for scratch) or laceration (fancy word for cut), you don't have an ounce of topical antibiotic cream; here is what you do: you can pour sugar or honey on the wound. You see the object is to kill or keep away bacteria. Sugar and honey are considered a hyper tonic substance and are deadly to most bacteria. So the idea is to make the wound uninhabitable. You could also use salt (ouch) keep in mind that there are some bacteria’s that love hyper tonic solution, they are called halophiles. so using this method will only decrease your chances drastically, they will not eliminate it. Also keep in mind that when using honey you run the risk of contracting botulism which is found in some honey, though the risk is low. I know your mother and possibly your grandmother has taught you that hydrogen peroxide is the cure all for scrapes and cuts but using this on a wound could make it worse and does lengthen the time it takes to heal. Hydrogen peroxide kills the any living organism INCLUDING the tissue. dead tissue doesn't heal it only gets in the way of progress.