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The Wound Care Guide
RYL First Aid Wound Care Guide.

This guide is designed to give the people of RYL an idea of how to properly care for wounds. The advice in this guide is not intended to replace the services of a doctor, and if at any point you are concerned about a wound being examined by a doctor is the safest thing to do. The pictures in this guide are examples only, RYL does not endorse any specific brand of wound care item over another.


Basic care for open wounds (except burns)


1. Stop the bleeding by putting pressure on the wound with a clean, absorbent item that will not disintegrate when exposed to fluid like toilet paper or tissues. Gauze pads and clean towels are good for stopping bleeding.

  • Once applying pressure do not remove the absorbent pad for 10 minutes. If it appears that you are bleeding through the pad, place more absorbent material on top of it.
  • If after 10 minutes the wound is still bleeding steadily the wound needs to be evaluated ASAP by a doctor. It is normal for the wound to "fill up" with blood once you remove pressure, but blood that continues to flow out of the wound is not.
  • If bleeding continues after 10 minutes, re-apply pressure and raise the body part above the level of the heart if possible. Make arrangements to go to A&E or an Urgent Care/Walk In Center right away.
  • Any wound that spurts blood needs to be evaluated by a doctor ASAP.

2. Clean the wound using clean water, wound wash/Sterile saline (purchased from a store) and a mild anti-bacterial soap. Do not scrub the wound because that could dislodge any blood clots that are stopping the bleeding.
  • Do not use home made salt water, iodine or on wounds as they can interfere with and slow down healing, cause damage to healthy cells, and increase the amount of scaring.
  • When you clean the wound also wash your hands with anti-bacterial soap thoroughly to prevent getting germs from your hands into the wound. Once you've washed your hands do not touch your nose, eyes or mouth without re-washing your hands.

3. Determine if the wound may need stitches or not. A wound may need stitches if;
  • It is still bleeding after 10 minutes of pressure.
  • The edges of the wound gape more than 1cm apart.
  • You can see stringy stuff, or yellowish bubbly stuff inside the wound.
  • The wound is on your lower leg.
  • The wound is on a joint, or an area where the skin is pulled a lot.
  • If you work in a job where you get dirty and the wound has a high chance of getting contaminated.

4. If you think a wound needs stitches you need to be seen by a doctor within 12 hours. After 12 hours most wounds can not be stitched except for under special circumstances. This time can vary depending on the doctor, so it's always a good idea to get a wound checked out ASAP.


5. There are 2 main ways to dress wounds, way A. is for shallow/minor wounds that don't gape wider than this tilde ~. Way B is for wounds that are wider than ~ but not wide enough to need stitches.
Method A (shallow/minor wounds, deeper wounds that are still bleeding)
  • Once the area is clean, gather your supplies and wash your hands again. You will need medical tape, non-stick gauze, antibacterial/antiseptic cream, and roll gauze/tubi grip/ace wrap.
  • Make sure you have non-stick gauze large enough to cover the entire wound. You can cut down the gauze to fit if needed.
  • Put a generous amount of the cream on the gauze, making sure that all the wounds will be completely covered. Never touch the tip of the anti-bacterial cream tube to a wound, as it can contaminate the whole tube of cream.
  • Place the non-stick gauze over the wounds, and use the roll gauze/tubi grip/ace wrap to keep it in place.
  • Tape the ends of the roll cauze/ace wrap down to keep it on.
  • If the wound bleeds through, do not remove the dressing, just put more gauze on top of it. If it continues to bleed through, get checked out by a doctor.
  • Change the dressing every 12 hours, do not let the dressing dry out, as it can stick to the wound.
  • If you use this on a deeper wound that is still bleeding, remove the dressing after no more than 6 hours and use Method B to dress the wound.
Method B (deeper/gaping wounds that aren't bleeding)
  • Gather all your materials and wash your hands. You will need steri strips/butterfly bandages (steris work the best), Tincture of benzoin ( if you can get it), anti-bacterial/anti-septic cream, non-stick gauze, roll gauze/tubigrip/ace wrap.
  • Lay out the steris/butterflies and figure out how many you will need. Steris should be placed about 1cm apart, on deeper wounds .5cm may be necessary.
  • If you have it, apply the tincture of benzoin along each side of your wound, at least .5 cm from the edge of the wound. Allow it to dry for about 20 seconds.
  • Starting at one end of the wound apply the steris/butterflies perpendicular to the wound pulling the edges of the wound as close together as possible. If the steris/butterflies keep popping off your wound probably needs stitches.
  • Press each steri/butterfly into the skin where the Benzoin was applied for a second to make sure it sticks.
  • One you reach the end of the wound let the extra tinzure of benzoin dry. Benzoin is not necessary to keep steris/butterflies on, but it helps them stay on longer.
  • Apply antibiotic/antiseptic cream over the wound.
  • If using tubigrip or an ace wrap to cover the wound place a non-stick gauze pad over the wound.
  • Apply gauze, ace wrap or tubi grip over the wound to keep to clean.

6. Once you have dressed your wound the dressing will need to be changed at least every 24 hours. If you used steris/butterflies they can stay on for a week or more, but you will still need to reapply the antibacterial/antiseptic cream at least twice a day.


7. Be alert for signs of infection. Information on infections can be found here .


Basic Care for Thermal Burns

1. Stop the burning process. Was the area with cool water for at least 10 minutes. Never use ice, ice water, or submerge a person in cold water as this can cause shock.

2. Determine the degree of the burn. Information on how to do this can be found here . When determining the size of the burn, use the FINGERS only, not the palm of your hand.

3. Often burns need to be checked out by a doctor, your burn should be evaluated by a doctor if;

  • It is a 3rd degree burn and is larger than 2 fingers put together.
  • It is a 2nd degree burn and is larger than 3 fingers put together.
  • It is a 1st degree burn and is larger than 4 fingers put together.
  • The burn is on a joint, the hands, feet, genitals, face or the burn has jewelry, dirt or anything else stuck in it.
  • The burn goes all the way around a part of your body.

4. If the burn is minor it is fairly easy to dress at home. Once you have thoroughly cooled the burn wash your hands with antibacterial soap and collect the supplies needed. Minor burns can be dressed using Method A listed above.

5. Burn dressings will need to be changed more frequently, a minimum of every 6 hours for the first 2 days, and at least every 12 hours for the next 4 days. After 6 days the dressing can be changed every 24 hours.

It is very important to keep wounds clean and dry, and look out for infections. A guide to infections can be found here.

Tips for keeping wounds clean and dry
1. Avoid having the wound exposed until new skin has formed.
2. Do not swim until new skin has formed.
3. Use plastic/saran wrap and tape to cover the wound when showering.
4. Wear long sleeves or pants over the wound.

 

Below is a list of common products used for wound care that the First Aid Advisor's will often refer to when explaining how to dress a wound.

Wound wash
Wound Wash Image
Other names: Sterile Saline, Saline, wound cleaner
Uses: Cleaning wounds
Do not use: If uou are allergic to any ingredients in the wound wash, in the eyes, ears or mouth unless it specifically says on the package that it is ok to use in those areas.
Instructions: Use as much as necessary to clean wounds and the area around them to remove blood and contaminants (dirt, hair etc).

 

 

Gauze (see below)
Other Names: Gauze pad
Uses: Absorbing blood and discharge from wounds. Protecting wounds.
Do not use: If it is a puncture wound, on burns, or without copious amounts of anitbacterial/antiseptic cream, otherwise the gauze will become stuck in the wound.
Instructions: Place on top of wounds to help absorb blood.
Gauze Pads

 Non-Stick Pads

Non-Stick Dressing

Other Names: Non-stick gauze, non-adherent gauze, non-adherent dressing.
Uses: To put on wounds to protect them until the body is able to create new skin.
Do not use: On puncture wounds.
Instructions: Apply antibacterial/antiseptic cream to the dressing and then apply to the wound making sure there is enough cream to cover the entire area.

 

Roll Gauze (see below)
Other Names:
Roller Gauze, Rolled Gauze
Uses: To cover wounds and hold on dressings.
Do not use: as a supportive bandage on a joint injury.
Instructions: Unroll firmly around the site making sure to completely cover the area with some extra both above and below the dressing. Make sure it is loose enough that you can slide a finger under it easily.

 Ace Wrap

 

Ace Wrap
Other names: Ace Bandage, Ace
Uses: Holding on dressings and support for injured joints.
Do not use: If you have circulation problems,
Instructions:Unroll firmly around the site making sure to completely cover the area with some extra both above and below the dressing. Make sure it is loose enough that you can slide a finger under it easily. If using as a support bandage over an injured joint, make sure that for the first 24 hours the bandage is loose enough to fit 2 fingers under to allow for swelling.

 

Tubi Grip (see below)
Other names: Tubi, Tube grip
Uses: Providing support and holding on bandages. Covering scars.
Do not use: If you have circulation problems, or for more than 12 hours at a time.
Instructions: Determine the size of the area you need to cover, and cut a piece of tubi grip twice as long. Slide it onto the area without disturbing the dressing, and then double the tubi grip back on itself, making a double layer.

TubiGrip Image

Antibacterial/Antiseptic Cream Savlon
Other names: Neosporin, Bacitracin, Neomycin, Polymyxin B, Polysporin, Tripple Antibiotic Ointment, Germolene, Savlon
Uses: Prevention and treatment of minor infections in minor wounds.
Do not use: If you are allergic to any of the ingredients, on puncture wounds, do not pack into wounds/burns.
Instructions: Place on a bandage before putting on a wound while making sure that there is enough cream to cover the entire area. Never touch the bottle to a wound as that can cause contamination.

 

Tincture of Benzoin (see below)
Other Names: Benzoin, Compound of Benzoin Tincture, Friar's Balsam,
Uses: It is a very sticky substance that helps hold steris and butterflies on.
Do not use: If you are allergic to the substance, inside wounds.
Instructions: Apply at least .5cm away from the edge of a wound, to the area where you are going to apply steris or butterflies to keep a wound closed. 

 steri-strips
Steri Strips
Other Names: Steris
Uses: Closing gaping wounds that are not severe enough to need stitches. Closing wounds with "clean" edges (edges that are straight, not jagged).
Do not use if: it is puncture wound, has been contaminated, has signs of infection, the wound is leaking large amounts of fluid, or the edges can not be matched up.
Instructions : Apply perpendicular to gaping wounds. When applying start at one end of the wound and pinch the edges of the wound closed as you apply the steris so that once the entire wound has been steried the edges touch and the wound is closed.

 

Butterfly Closure (see below)
Other names: Butterfly bandage, Butterflies,
Uses: Closing clean edged wounds
Do not use if: it is puncture wound, has been contaminated, has signs of infection, the wound is leaking large amounts of fluid, or the edges can not be matched up.
Instructions:Apply perpendicular to gaping wounds. When applying start at one end of the wound and pinch the edges of the wound closed as you apply the butterflies so that once the entire wound has been butterflied the edges touch and the wound is closed.

 Band-aid

Band-Aid
Other Names: Plasters
Uses: Covering small wounds
Do not use: on puncture wounds, or on wounds larger than the size of the non-stick pad.
Instructions: Place the non-stick pad over the wound and press down on the "wings" to cover the wound. 

 

 

Where Can I Find This Stuff?

In the UK - Dressings can be found at Pound Shops, Boots, Superdrug, ASDA.

In the US - Wal-Mart, Walgreens, Rite Aid, CVS, Safeway, Osco Drug, anything that says "pharmacy" or "drug store" in it's name. 

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