Immediate TreatmentThere is little that a Corpsman can do to correctinternal soft-tissue injuries since they are almostalways surgical problems. The Hospital Corpsman’sgoal must be to obtain the greatest benefit from thevictim’s remaining blood supply. The following stepsshould be taken:1. Treat for shock.2. Keep the victim warm and at rest.3. Replace lost fluids with a suitable blood volumeexpander. DO NOT give the victim anything todrink until the extent of the injury is known forcertain.4. Give oxygen, if available.5. Splint injured extremities.6. Apply cold compresses to identifiable injuredareas.7. Transport the victim to a medical treatmentfacility as soon as possible.SPECIAL CONSIDERATIONS INWOUND TREATMENTThere are special considerations that should beobserved when treating wounds. The first of these isimmediate treatment to prevent shock. Next, infectionshould be a concern: Look for inflammation and signsof abscess. Hospital Corpsmen should be aware ofthese conditions and have the knowledge to treat them.ShockShock is likely to be severe in a person who has losta large amount of blood or suffered any serious wound.The causes and treatment of shock are explainedearlier in this chapter.InfectionAlthough infection may occur in any wound, it is aparticular danger in wounds that do not bleed freely, inwounds in which torn tissue or skin falls back intoplace and prevents the entrance of air, and in woundsthat involve the crushing of tissues. Incisions (inwhich there is a free flow of blood and relatively littlecrushing of tissues) are the least likely to becomeinfected.Battle wounds are especially likely to becomeinfected. They present the problem of devitalized(dead or dying) tissue; extravasated blood (blood thathas escaped its natural boundaries); foreign bodiessuch as missile fragments, bits of cloth, dirt, dust; and avariety of bacteria. The devitalized tissue proteins andextravasated blood provide a nutritional medium forthe support of bacterial growth and thus are conduciveto the development of serious wound infection.Puncture wounds are also likely to become infected bythe germs causing tetanus.COMMON INFECTION-CAUSING BACTERIA.—There are two types of bacteria that commonly causeinfection in wounds: aerobic and anaerobic. Aerobicbacteria live and multiply in the presence of air or freeoxygen, while anerobic bacteria live and multiply onlyin the absence of air.Aerobic Bacteria.—The principal aerobicbacteria that cause infection, inflammation, andsepticemia (blood poisoning) are streptococci andstaphylococci, some varieties of which are hemolytic(destroy red blood cells). The staphylococci andstreptococci may be introduced at the time ofinfliction, or they may be introduced to the wound later(at the time of first aid treatment or in the hospital ifnonsterile instruments or dressings are employed).Anaerobic Bacteria.—Anaerobic bacteria arewidespread in soil (especially manured soil). Whilenot invasive, anaerobic bacteria contribute to diseaseby producing toxins and destructive enzymes, oftenleading to necrosis and/or gangrene of the infectedarea.M I N O R W O U N D C L E A N I N G A N DDRESSING.—Wash minor wounds immediately withsoap and clean water; then dry and paint them with amild, nonirritating antiseptic. Apply a dressing ifnecessary. In the first aid environment, do not attemptto wash or clean a large wound, and do not apply anantiseptic to it since it must be cleaned thoroughly at amedical treatment facility. Simply protect it with alarge compress or dressing, and transport the victim toa medical treatment facility. After an initial soap andwater cleanup, puncture wounds must also be directedto a medical treatment facility for evaluation.InflammationInflammation is a local reaction to irritation. Itoccurs in tissues that are injured, but not destroyed.Symptoms include redness, pain, heat, swelling, andsometimes loss of motion.4-35
Integrated Publishing, Inc. - A (SDVOSB) Service Disabled Veteran Owned Small Business