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American Medical Association Family Medical Guide - American Medical Association [130]

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attention (see page 160). If a cut is on the face, or is deep (you can see yellow fatty tissue), irregular, or gapes so badly that you cannot bring the edges together, get the person to an emergency department immediately. Such cuts probably need stitches to aid healing and reduce scarring. A doctor should clean a cut or scrape caused by an obviously dirty object, that has visible dirt or foreign material embedded in it, or that was caused by an animal or human bite. A doctor should evaluate any cut or scrape that becomes infected or has red streaks leading from it (which is a sign that the infection is spreading in the bloodstream).

To treat a minor cut or scrape:

1. Wash your hands before treating the cut or scrape.

2. Use a clean gauze or cotton pad to gently wash the wound with soap and water. Remove all bits of dirt if you can do so without further damaging the skin. For a scrape that has foreign material or dirt in it, gentle scrubbing may be necessary. Rinse thoroughly under running water for at least 5 minutes.

3. Pat the wound dry with a clean or sterile cloth. Do not apply any over-the-counter medications or home remedies.

4. If the injury is a minor scrape or scratch, leave it uncovered and exposed to the air. Cover a cut with a sterile dressing, and tape it in place. Use one or two strips of surgical tape to hold the edges of a slightly gaping cut closed.

Hold the edges of a cut closed with surgical tape

Puncture Wound

A deep wound caused by a long, narrow object (such as a nail or a tooth) that does not produce much bleeding is more likely than other wounds to become infected because dirt and bacteria are carried deep into the tissues and are not washed out by blood. All puncture wounds should be examined and treated by a doctor, especially if they become infected, if red streaks radiate from them (which is a sign that the infection is spreading in the bloodstream), or if they were caused by an animal bite. Numbness, tingling, or weakness in an arm or leg after a puncture wound may indicate that nerves or tendons are damaged. Antibiotics and a tetanus shot may be necessary after a deep wound to prevent infection.

To treat a puncture wound:

1. Wash your hands before treating the wound.

2. Do not poke around in the wound or put any medication in it.

3. Do not try to remove an object that is deeply embedded in the wound because the object may break off in the wound or because removing it could cause severe bleeding. If the piercing object is small and goes no deeper than the skin, remove it with tweezers that have been sterilized with rubbing alcohol or placed over an open flame or in boiling water and cooled.

4. Encourage bleeding (to wash out germs) by gently pressing on the edges of the wound. Don’t press too hard because you could cause additional tissue damage.

5. Using a clean gauze or cotton pad, wash the wound with soap and water. Rinse thoroughly under running water for at least 5 minutes.

6. Pat the wound dry with a clean cloth. Do not apply any medications or home remedies.

7. Cover the wound with a sterile dressing, and tape it in place.


Bruises

Bruises occur when an injury breaks small blood vessels under the skin but the skin is not broken. The discoloration and swelling in the skin are caused by blood seeping into the tissues. The skin will usually turn colors—from reddish blue, to green and yellow, to brown—before fading. Bruises usually disappear without treatment after 10 to 14 days.

Bruises on the head or shin or around the eye (a black eye) may swell significantly because bone is just beneath the skin and there is little fatty tissue to cushion the blow. If a bruise does not fade or disappear completely or if it becomes painful and swollen, or if bruises continue to appear for no reason, see your doctor. You may have a broken bone or other injury or a blood-clotting disorder.

To treat a bruise:

1. Gently apply an ice pack or a cold, wet cloth to the bruise to reduce bleeding, pain, and swelling. Don’t apply too much pressure.

2. If the bruise

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