Immobilize the injured joint with some type of
splint or with a snugly fitting adhesive or elastic
bandage. Remember that the injured part may continue
to swell, so a bandage that is loose enough when
applied may soon become too tight.
irregular edges and masses of torn tissue underneath.
These wounds are usually made by blunt force, rather
than sharp objects. They are often complicated by
crushing of the tissues as well. Because lacerations are
frequently contaminated with dirt, grease, or other
material that is ground into the tissues, they are very
likely to become infected.
Elevate the injured part, if possible. This helps
reduce the pain and swelling.
PUNCTURES.Punctures are caused by objects
that penetrate deeply into the tissues but leave a
relatively small surface opening. Wounds made by
nails, needles, wire, knives, and bullets are usually
punctures. A puncture wound can be classified as
penetrating or perforating. A perforation differs from a
penetration in that it has an exit as well as an entrance
It is difficult to tell a sprain from a fracture. If you
are not sure which injury is present, always treat it as a
fracture until the casualty has been brought under the
care of a medical officer.
STRAINS.An injury caused by the forcible
overstretching or tearing of a muscle or tendon is
known as a strain. Strains may be caused by lifting
excessively heavy loads, by sudden movements, or by
any other action that pulls the muscles beyond their
As a rule, small punctures do not bleed freely. But,
large puncture wounds may cause severe internal
bleeding. The possibility of infection is great in all
The chief symptoms of a strain are pain, lameness,
stiffness (sometimes involving knotting of the
muscles), moderate swelling at the place of injury, and
discoloration because of escape of blood from the
injured blood vessel into the tissue. Have the patient
rest the injured part. If the injured muscle is in the arm
or leg, elevate the part.
AVULSIONS. An avulsion is the tearing away
of tissue from a body part. Bleeding is usually heavy.
The torn tissue may be surgically reattached in certain
situations. It can be saved for medical evaluation by
wrapping in cool, moist toweling and rushing it, along
with the victim, to a medical facility.
AMPUTATIONS.A traumatic amputation is
the nonsurgical removal of a limb. Bleeding is heavy
and requires a tourniquet. Shock is certain to develop.
The limb can often be successfully reattached. Wrap
the limb in a cool, moist towel and transport to medical
as soon as possible.
Wounds may be classified according to their general
condition, size, location, the manner in which the skin or
tissue is broken, and the agent that caused the wound.
You must usually consider some or all of these factors to
determine what emergency treatment is necessary for a
wound. There are six types of wounds: abrasion,
incision, laceration, puncture, avulsion, and amputation.
HEAD WOUNDS.Head wounds can be open or
closed. In open head wounds, there is an obvious
injury. Closed head wounds may not be obvious, so
you may have to base treatment on the history of how
the accident happened. You may see only the delayed
symptoms, such as a seizure, disorientation, or drastic
ABRASIONS. Abrasions are made when the
skin is rubbed or scraped off. Rope burns, floor burns,
and skinned knees or elbows are common examples of
abrasions. This kind of wound is easily infected because
dirt and germs are usually ground into tissues. There is
usually minimal bleeding or an oozing of clear fluid.
In all injuries to the skull, check for these signs of
an injury to the brain:
INCISIONS.Incisions, commonly called cuts,
are wounds made by sharp cutting instruments such as
knives, razors, or broken glass. Incisions tend to bleed
freely because the blood vessels are cut straight across.
There is relatively little damage to surrounding tissues.
Of all the classes of wounds, incisions are the least
likely to become infected, because the free flow of
blood washes the wound.
Unequal size of the pupils
Deformity of the skull
Blood or sticky fluid coming from the ears and
Any time there is blunt trauma to the skull, keep
the casualtys neck immobilized in case there is
damage to the spine or the neck area.
LACERATIONS. These wounds are wounds
that are torn, rather than cut. They have ragged,