Figure 13-10. - Exposed intestine.
Fasten the bandage firmly so that the dressing will not slip around, but do not apply more pressure than is necessary to hold the bandage in position. Ideally, the dressing should be folded under and then over the intestines (envelope style).
3. Apply an occlusive material such as aluminum foil or plastic wrap over sterile dressing and secure in place with tape or other material. This will help keep the sterile dressing moist.
4. Treat for shock. The casualty must be taken to a medical facility at the earliest opportunity. Do not give the patient anything to eat or drink. If he/she complains of great thirst, moisten the lips with a small amount of water, but do not allow the patient to swallow.
Although it is not always necessary to know what agent or object caused a wound, it is often helpful because it may give you some idea of the probable size of the wound, its general nature, the extent to which it is likely to be contaminated with foreign matter, and what special dangers must be guarded against.
The emergency treatment for all wounds consists mainly of stopping the flow of blood, treating for shock, and preventing infection.
For a casualty with multiple wounds, first treat the wound that appears to be most life-threatening. Be sure to check all possible points of the body for injury.
Your first concern is to stop the bleeding, preferably by direct pressure, elevation, or the use of pressure points. A tourniquet should be used only if the other methods do not control the bleeding.
Do not spend undue time trying to clean a dirty wound. This will be done by medical personnel. But, apply a dressing to help prevent additional contamination of the wound.
If a foreign object is near the surface and exposed, you may remove it. But if the injury is caused by a knife or other object that is still embedded, do not remove the object. It may cause massive bleeding. Simply apply dressings around the object.
As already explained, the primary examination was to assess the site and the life threatening injuries to the casualties. The secondary examination is much more thorough and extensive. It includes a full-body assessment.
The secondary examination, a systematic full body survey from head to toe, is usually conducted in a relatively safe area. Be careful not to move the casualty unnecessarily until you are satisfied that there are no major injuries (e.g., neck or spinal injuries) not
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