First Aid Information
Closed Head Injury
First On Scene
by Buck Tilton
In the big food chain,
big meateaters munch smaller meateaters and humans find themselves, except
for an occasional bear attack, comfortably at the top of the order and
ready to eat anything. But then there's
the invisible world of microorganisms in which you might be the food of
invading germs. Doorways to that world are invitingly opened when you
get scraped, sliced, hacked, or otherwise disturbed along the natural
barrier, your skin, that stands between you and bacteria, viruses and
parasites. Open wound care needs to accomplish three things: 1) stop dangerous
blood loss, 2) prevent infection, and 3) promote healing.
Open wounds should be properly cleaned in order to prevent infection and
promote healing. The best method of wound cleaning is mechanical irrigation
and the best irrigation fluid is clean fresh water or a solution of diluted
povidone-iodine. You can carry povidone-iodine solution in your first
aid kit or prepare it by adding an ounce of povidone-iodine to a liter
of the cleanest fresh water you can find. Shake it up and wait at least
five minutes to allow the iodine time to disinfect the water completely.
A teaspoon of salt dissolved in this solution increases its effectiveness.
(Warning: This solution is not safe to drink.) Draw the solution up into
an irrigation syringe. Hold the syringe two to four inches above the wound
and perpendicular to the wound, and push down on the plunger forcefully.
The wound should be tipped allowing the solution to run out. Repeat until
at least half a liter of solution has been forced through the wound. If
visible contaminants are left embedded in the wound, they should be carefully
removed with tweezers. The tweezers should be disinfected before use.
Then continue irrigation with the second half of the liter of solution.
After cleaning small wounds, facial wounds, or scalp wounds, if they gape
open, they can be closed with closure strips. If hair gets in the way,
it can be carefully clipped short, but it should not be shaved off. Begin
by smearing a line of tincture of benzoin compound, if you have any, along
both sides of the wound. Benzoin is an irritant so take care to keep it
out of the wound. Let the benzoin dry for about 30 seconds. Benzoin's
stickiness will help keep the closure strips in place. Touch the closure
strips only on their ends. Apply one to one side of the wound and another
to the opposite side. By using the opposing strips as handles, you can
pull the wound edges together, pulling the skin as close as possible to
where it should lie naturally, but without pulling the wound tightly shut.
Open wounds heal better and faster if they are kept slightly moist. Begin
by applying an antibiotic ointment over the closed cut or scrape. Dress
the wound with a non-adherent sterile dressing, making sure it completely
covers the wound. Dressings that stick to the wound will slow the healing
process. Finish with a protective gauze pad which you tape in place or
wrap in place with a roll of stretch gauze. Small wounds can be covered
with Spenco 2nd Skin which protects, moisturizes, and soothes.
Check all wounds regularly for signs of infection. Signs of infection
include 1) increasing pain, redness, and swelling, 2) draining of pus
from the wound, 3) appearance of red streaks just under the skin near
the wound, and 4) systemic fever.