Wound: Abnormal break in skin which permits the escape of blood, and may allow the entrance of germs, causing infection.

Types of Wound:

1. Incise Wound – Clean cut caused by sharp instrument.
2. Laceration Wound – Jagged cut or tear caused by sharp irregular edges.
3. Contusion – Caused by blunt instrument / fall against hard surface. Skin is not broken.
4. Abrasion – Simple scrapes and scratches usually from a sliding fall.
5. Puncture Wound – Penetrating wound by sharp, pointed instrument. Can result in serious internal injury.
6. Stab Wound – Caused by a bladed object.
7. Gun Shot Wound

Ways to Stop Bleeding:

1. Direct pressure
2. Indirect pressure
3. Elevation

Wound Management:
Slight Bleeding
-Wash your hands and wear a pair of gloves.
– Rinse wound with running water.
– Dab gently to dry.
– Apply direct pressure or elevation if bleeding still occurs.
– Cover wound with sterile swab.
– Clean surrounding area of skin with water and soap.
– When cleaning, wipe away from wound and use each swab only once.
– Avoid wiping away blood clots.
– Pat dry.
– Dress wound with adhesive dressing.

Severe Bleeding
Aim of managing severe bleeding: a) control bleeding b) minimize risk of infection
– Lay casualty down to prevent shock.
– Support injured part.
– Send to hospital.
– Wash hands.

Bandaging:

1. Triangular bandage (Reef Knot – L over R; R over L)
2. Broad bandage
3. Narrow bandage

Slings and Bandaging:

1. Simple sling
2. Elevated sling
3. Scalp bandage
4. Palm bandage
5. Fist bandage

Fracture: A break or crack in the bone caused by direct force and indirect force.

Type:

1. Closed or simple fracture (no wound)
2. Open or compound fracture (wound is present)
3. Comminuted (totally crushed)
4. Green stick injury (In children; mixture of bend and break)
5. Unstable fracture

Management of Closed Fractures:

1. Do not move the casualty until you support the injured part.
2. Steady and support the injured part.
3. Immobilize the injured part using bandages and slings.
4. Elevate the injured part.
5. Treat for shock if possible.
6. Check circulation every 10 minutes.
7. Send to hospital.
8. Do not give him anything to eat or drink.

Management of Open Fractures:

1. Cover wound with sterile / clean dressing.
2. Control bleeding.
3. If wound is jutting, place padding.
4. Immobilize the injured part.

Dislocation: Displacement of a bone at a joint caused by strong force, wrenching the bone into an abnormal position or violent muscle contraction.

Sprain: Injury to a ligament at or near a joint frequently caused by wrenching movement at joint that tears the surrounding tissue.

Strains: Partial tearing of the muscles at the junction of muscle and tendon that joins it to a bone.

Management of Sprain and Strains (Soft Tissue Injury):

R	Rest
I	Ice – Reduce swelling
C	Compression
E	Elevation

If injury is very bad, send the casualty to the hospital.

Cramps: Sudden, involuntary and painful muscle spasm.

Cramp in Foot:

1. Ask casualty to stand on toes.
2. Massage foot with fingers.

Cramp in Calve:

1. Straighten the knee.
2. Draw the foot firmly and steadily upwards towards the shin.
3. Massage.

Cramp in Back of Thigh:

1. Straighten the knee by raising his leg.
2. Massage the muscles.

Cramp in Front of Thigh:

1. Bend knee.
2. Massage muscles slowly.

Signs & Symptoms:

1. Difficult to move a limb
2. Pain near the site of injury
3. Tenderness
4. Distortion
5. Swelling
6. Bruising
7. Shortening, bending or twisting of the limb
8. Crepitus (sound) caused by grating of the bone end

Lifting and Moving Casualty

Rules:

1. Do not move casualty unless absolutely necessary.
2. Explain to casualty what you are doing.
3. Never move casualty alone.
4. Instruct helpers what they are supposed to do.
5. Protect yourself using the correct techniques.
6. Ensure casualty’s safety.

Correct Lifting Techniques:

1. Place feet comfortably apart, one slightly in front of the other.
2. Keep back straight.
3. Bend your knees.
4. Grip with both hands.
5. Keep weight of person you are lifting as close to you as possible.

Lifting Method:

Casualty is conscious and able to walk:

1. Use the human crutch

Casualty is conscious but unable to walk:

1. Pick-a-back
2. Drag method
3. 4 handed seat
4. 3 handed seat
5. 2 handed seat
6. Fore & aft
7. Carry chair

Casualty is unconscious:

1. Cradle method
2. Drag method
3. Fore & aft
4. Stretcher method