Chapter 19: Wound Emergencies

Definition

A wound is an injury to soft tissue (tissue that is not bone). Wounds are generally classified as either closed or open.

Common Causes

Wounds may result from:

• Abrasions, cuts, or lacerations
• Amputations
• Blows or impacts
• Bites
• Falls
• Physical fights
• Motor vehicle accidents
• Puncture or penetrating injuries (sharp objects, glass, etc.)

Signs and Symptoms

• Bleeding
• Bruising
• Pain
• Redness or swelling

Types of Wounds

Closed Wound

A closed wound does not break the skin. A bruise is the most common example.

More serious closed wounds can involve damage to deeper tissues, blood vessels, or muscles and may cause internal bleeding.

Open Wound

An open wound breaks the skin. It can range from minor scrapes and small cuts to deeper or more severe injuries.

Major open wounds, especially those involving heavy bleeding or amputation, require immediate medical attention.

First Aid Steps

1. Check the scene for safety.
2. Put on gloves if available and get a First Aid kit.
   Provide care based on the injury:
   
   • Nosebleed:
     Have the person sit upright and lean slightly forward. Pinch the soft part of the nose and apply steady pressure. Apply a cold pack to the bridge of the nose if available.
   • Mouth bleeding (dental injury):
     Apply gentle pressure with gauze. Avoid blocking the airway.
     If a tooth is knocked out, rinse it gently with water (do not scrub) and place it in milk. Seek dental care right away.
   • Minor closed wound (bruise):
     Elevate the area if possible and apply a cold pack for short intervals (about 15–20 minutes at a time).
   • Minor open wound (cuts, scrapes):
     Apply firm pressure with clean gauze until bleeding stops.
     Clean the wound and cover it with a sterile dressing or bandage.
3. Call 9-1-1 if:
   • There is heavy bleeding
   • Bleeding does not stop with pressure
   • The person shows signs of shock
   • The injury appears severe
4. If the person becomes unresponsive, begin CPR.