Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

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Wilderness and Rescue Medicine

Chapter 16 Review: Wounds and Burns

• Life-threatening wounds are those that can cause shock, respiratory failure, or brain failure. This includes severe bleeding, penetrating abdominal or chest wounds, respiratory burns, and large surface area skin burns. • Wounds are described with a variety of terms. For field assessment, the important distinction is low risk or high risk? • High-risk wounds have the potential to become serious, primarily due to the anticipated problem of infection. These include deep, grossly contaminated puncture and bite wounds and any full- thickness burn. • Early wound cleaning and dressing can reduce the risk of infection, preserve the wound for later repair, and promote wound healing. Prophylactic antibiotics are sometimes useful to reduce the risk of infection. • Impaled objects are removed in the field unless the procedure will cause more tissue damage, severe bleeding, or unmanageable pain. Do not remove an object impaled into the globe of the eye. • The initial treatment for burns is immediate cooling. Burns are then treated like other wounds. • Hot spots are best treated before becoming blisters. Blisters are treated and protected like other wounds. Blisters are unroofed when contaminated or when necessary for function. • Bandages and dressings should protect from outside contamination, allow for drainage, avoid caus- ing ischemia, and keep the wound warm and moist.

A large but simple thigh wound; clean, straight, and a good candidate for closure with staples in a clinical setting.