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First Aid Refreshers, part 2: Wound Care

December 1, 2011

First Aid, Frontier Medicine

Bandaging a wound

There are certain number of cuts, scrapes, and bruises that are a part of everyone’s life.  We rarely think much about them, unless it is one of our children crying with a boo-boo.  Then we may soothe the tears with a Scooby-Doo bandage and pat them on the head.

Usually, this works out alright and our strong immune systems fight off the germs present in the “ow-ie” and it heals over.  That’s not always the case though, and we occasionally get an infection that needs more attention or even a prescription to get rid of it.

I want to encourage you to be more diligent as a matter of habit now, so that if professional medical care is someday unavailable, you will be less likely to have serious complications because you prevented the problem.

A Personal Experience

About a year ago, one of the preschoolers had a yearly well check-up.  As part of it, she had a finger-stick and blood drawn to check her iron level.  I watched the nurse swab her finger and then do the stick and take a sample.  Then the child got the cartoon character bandage and all seemed well.

The next day, I wanted to take the bandage off, but she squealed and begged that I wouldn’t because it hurt.  I thought it was just drama from a tired little one, so I told her she could keep it on only until the next morning.

As I said I would, I removed it after breakfast.  There was crying and the finger looked awful.  I then realized it must have hurt for real.  I couldn’t imagine why it would have gotten infected, but I began treating it with antibiotic ointment and fresh bandages twice a day.  It steadily got worse.

After another day, I took her back to the doctor and had him look at it.  By that time, the skin was sloughing off and it was red and angry and working its way toward the nail.  He diagnosed it as a Staph infection.

I couldn’t believe it!  She got a Staph infection from a “sterile” finger stick?!

I asked some more questions and began doing more research.  That was when it really clicked with me how cavalier I had been toward wound care.

Modern Germs

We’ve probably all heard the scary news stories about MRSA– the bacterial infection that is resistant to most common antibiotics.  And then there are the even more frightening ones about “flesh-eating” microbes.

Our modern over-reliance on antibiotics has led to more and more virulent germs.  And each time we only “kinda kill” them (by not finishing our course of medicine or just “stunning” them with poor hand-washing techniques), we give them the opportunity to grow more resistant.  Even the present cornucopia of medicines at a physician’s disposal sometimes isn’t enough once an infection has set in thoroughly enough.

The best way to approach this is with prevention, starting now- every wound, every time.

Combating the Microbes

As I mentioned in the posting on the importance of soap, our skin is covered with microbes all the time.  Many are benign, some are beneficial, and some are a disaster waiting to happen.  Our skin is a very valuable defense against them.  As long as the germs have no entry into the body, things go along pretty well.

When we do get an injury, it is very important that the wound is cleaned.  Your body often begins this process itself by bleeding.  Have you ever realized how beneficial that can be?  As soon as you receive a cut, your body’s capillaries flood the area with blood to attempt to flush out the germs.  We often try to stop all bleeding immediately, but a small wound will not lose a life-threatening amount of blood.  The out-going pressure of the blood can help clear the wound.  This is another way we can  maximize the natural systems we were given.

The next step, especially if it didn’t bleed much, is to flush the wound with lots of water.  You will hear different opinions about using soap, rubbing alcohol, iodine, or hydrogen peroxide.  The last is a pretty harsh liquid to use and can actually further traumatize the tissue many think, particularly if too much is used.  If it is used, it should only be used at the time of injury and not on subsequent bandage changes or healing may be slowed.

Since our skin’s role in our immune system is to keep out harmful invaders but now that skin is damaged, we need to mimic that by covering the wound with a clean dressing.  Most commonly, we apply a self-sticking bandage, maybe with some antibiotic ointment to assist.  This should be checked and changed regularly to keep clean.

There is much more that could be said about this topic, but I will end it here this time with just a few more thoughts.

Diligence Pays Off

Remember the finger-stick wound?  I asked the doctor how that could possibly have happened since I watched the nurse use an alcohol swab before the stick.  His response surprised me.

He reminded me that we have lots of Staph germs (as well as others) on our skin all the time, especially our hands.  Then he said that the alcohol swab is relied on too much and gives a false sense of comfort.  To really be effective, it would need to be applied for a longer duration and then time allowed for the germs to actually die before the stick.  (This was my first clue that hand sanitizer must not be overly relied upon).

It’s given me a lot to think about.  Now I try to look over the little ones every night at bath time to be sure there are no unreported injuries that need watching or treatment.  In addition, I’m trying to change my own thinking about how I approach even the little wounds.

About 7 weeks ago, I received an unwanted aggressive licking on the face by a dog (not ours).  Apparently, the sandpaper tongue broke the skin just enough to let who knows what germs in.  I washed my face then, again the next day, and so on, but I got an infection.  Antibiotic ointment didn’t phase it, even the stuff that was supposed to be effective on Staph.  The course of oral antibiotics I was given for my sinus infection didn’t slow it down any either.  I finally went to see a dermatologist feeling dumb that something so inconsequential was becoming a big red bloom on my face.  He diagnosed it as a “gram-negative bacterial infection” and prescribed a different topical antibiotic.  I’m still not completely over it.  Who would have thought being licked by a dog could cause such a problem?!

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25 Comments on “First Aid Refreshers, part 2: Wound Care”

  1. Jarhead Survivor Says:

    Wow, that’s an eye opener. It’s interesting how sometimes we can get a terrible cut and barely tend to it other than flushing with water and slapping a bandage on it and it heals up fine, but something as benign as a needle stick or a dog licking your face can cause such issues.

    Great info, Laura. Thanks.

    Reply

    • Laura Says:

      Good to hear from you, Jarhead! Hope you and yours are all doing well.

      I too have marveled at how the more serious looking injuries often do fine and it’s the ones I would write off as nothing that prove problematic.

      And in case anyone was wondering about the dog lick infection- it started off as a rash-like thing of little zits that popped, crusted over (gross, huh?), and then then it peeled away and looked like it was healing for a day or so. Then the next day is started over, but covering a larger section of skin. It was red and painful. It seemed to have a 5-6 day cycle and I have been fooled several times into thinking it was FINALLY going away. I am still having to put the topical antibiotic on it weeks later to keep it in check. I’m not even completely certain it is doing anything but preventing the spread. I may still need something else to defeat it. I hate to think what would have happened if I had not been able to get to a doctor. Nothing in our supplies was helping. You’d better believe I will be refilling this Rx as many times as possible and squirreling it away!

      Thanks for the comment. By the way, did you check to see if Green Deane is headed your way any time? He visits up that way and I think he would be willing to do a local plant ID class if you are interested. Eattheweeds.com

      Reply

  2. Beck Says:

    One thing I had not thought of keeping a supply on is the saline solution used for eyes. Last summer a group from our church went to Guatamala on a mission trip. In going to the outlying areas, they came into contact with a man who had a serious infection on his leg. In preparing for the trip, they were not expecting to come across such infections. One of those on the trip was an RN and she had brought her saline solution and a small tube of antibiotic cream. She cleaned the wound (with the saline solution), medicated it and then bandaged it as best as she could. She did leave the cream and additional bandages with him since they were leaving the next day.

    Things are so primitive in third world countries that we could learn a lot from their living conditions about what we need to do to prepare.

    Reply

    • Laura Says:

      Beck,

      You are so right that we completely take for granted our access to decent and plentiful emergency care! And when I think about what a difference even a bar of soap could make for people, I wonder why there isn’t more emphasis by the WHO and Doctors without Borders to send soap and other disinfectants.

      Looking forward to seeing you soon!

      Reply

  3. Janet Szabo Says:

    Overuse of antibiotic ointment can cause allergies to it, so be judicious with its use. The first thing I always do is flush a wound with hydrogen peroxide, because hydrogen peroxide will kill certain bacteria that the antibiotic ointment won’t touch. It’s not just for bleaching hair. 🙂

    Reply

    • Laura Says:

      Janet, thanks for sharing that tip about hydrogen peroxide. I keep hearing different things lately about it. One of our dogs was torn up and got terrible infections from a neighbor dog that attacked her. It brewed under the skin (and fur) unbeknownst to us for a while and when it surfaced, we didn’t see how she could live through it, it was that extensive and bad. Anyway, even under those circumstances, the vet told us not to use hydrogen peroxide on the wounds because it was so caustic that it would prevent healing. That really surprised us. It was only the surgical cleaning and draining of the wounds and months of antibiotics that saved her. Of course, that has further convinced me of the need to clean wounds and stockpile antibiotics!

      I’ve never heard anyone developing an allergy to antibiotic ointment, but that is good to keep in mind. Thanks.

      Reply

  4. Dave Summers Says:

    Very good blog post. I always mention that one of the most important reasons for first aid is to preserve Life, not only the casualty\’s life, but your own as well. Far too often only one person\’s life
    is in danger when the emergency services are called, but by the time they arrive there
    are more. If you put your life in danger, you can end up fighting for your OWN life
    instead of the casualty\’s.

    Reply

  5. Tom Says:

    I’ve been through chemotherapy, and when they access your port-a-cath (a small, bubble like device implanted under the skin to deliver medicine right to central arteries), nurses have to be very careful, as any infection would go right down the line, and then into the heart to be pumped throughout the body, which would be bad for business WITHOUT a compromised immune system. The proper scrub was two alcohol swabs with heavy scrubbing, and then wait 15 seconds for the alcohol to dry. Then most to all bacteria would be dead.
    Just thought I’d leave this comment, as to quell fears that alcohol doesn’t work at all.
    Nice blog by the way, will read some more.

    Reply

    • Laura Says:

      Thanks for sharing your experience and for the nice compliment.

      Any idea why they used alcohol vs. betadine? When I’ve donated blood, it seems they’ve scrubbed my arm in a huge circle for 30 seconds or more with 2 separate swabs of betadine. Seemed like overkill to me. I’m not sure why some sticks call for alcohol and others an iodine solution. And then, when we get an injury, we usually pour hydrogen peroxide on it. I’m not sure if there is some rule-of-thumb I’m missing to determine which is better for a given situation.

      From what I understand, that delay between swabbing and sticking is really important since the microbes don’t die immediately.

      Reply

  6. Brain Nate Says:

    Staph infections can be a very painfull experience specially if you got the full infection within days. `,,:;

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  7. Jennifer Says:

    Miracle Mist Plus is a great product for any prepper to have on hand. It is anti-fungal, anti-biotic and anti-viral. Easy to apply. Cleanses the wound and treats it in one step. http://www.WoundCareSpray.com for more information. It has replaced EVERY topical First Aid in my kit–and I even use it in my eyes for infections and down my throat for sore throats.

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