cleanup, puncture wounds must also be directed to a medical treatment facility for evaluation.
Inflammation
Inflammation is a local reaction to irritation. It occurs in tissues that are injured, but not destroyed. Symptoms include redness, pain, heat, swelling, and sometimes loss of motion.
The body’s physiologic response to the irritation is to dilate local blood vessels, which increases the blood supply to the area, which in turn causes the skin to appear red and warmer. As the blood vessels dilate, their injured walls leak blood serum into surrounding tissues, causing edema and pain from increased pressure on nerve endings. In addition, white blood cells increase in the area and act as scavengers (phagocytes) in destroying bacteria and ingesting small particles of dead tissue and foreign matter.
Inflammation may be caused by trauma or mechanical irritation; chemical reaction to venom, poison ivy, acids, or alkalies; heat or cold injuries; microorganism penetration; or other agents such as electricity or solar radiation.
Inflammation should be treated by the following methods:
1. Remove the irritating cause.
2. Keep the inflamed area at rest and elevated.
3. Apply cold for 24 to 48 hours to reduce swelling. Once swelling is reduced, apply heat to soft tissues, which hastens the removal of products of inflammation.
4. Apply wet dressings and ointments to soften tissues and to rid the area of the specific causal bacteria.
Abscesses
An abscess is a localized collection of pus that forms in cavities created by the disintegration of tissue. Abscesses may follow injury, illness, or irritation. Most are caused by staphylococcal infections and may occur in any area of the body, but are usually on the skin surface.
A FURUNCLE (boil) is an abscess in the true skin caused by the entry of microorganisms through a hair follicle or sweat gland. A CARBUNCLE is a group of furuncular abscesses having multiple sloughs, often interconnected under the true skin. When localized, there are several “heads.” Symptoms begin with localized itching and inflammation, followed by swelling, fever, and pain. Redness and swelling localize, and the furuncle or carbuncle becomes hard and painful. Pus forms into a cavity, causing the skin to become taut and discolored.
Treatment for furuncles and carbuncles includes the following:
1. DO NOT squeeze; this may damage surrounding healthy tissue and spread the infection.
2. Use aseptic techniques when handling.
3. Relieve pain with aspirin.
4. Apply moist hot soaks/dressings (110°F) for 40 minutes, three to four times per day.
5. Rest and elevate the infected body part.
6. Antibiotic therapy may be ordered by a physician.
7. Abscesses should be incised after they have localized (except on the face) to establish drainage. Abscesses in the facial triangle (nose and upper lip) should be seen by a physician.
EYE WOUNDS
Many eye wounds contain foreign objects. Dirt, coal, cinders, eyelashes, bits of metal, and a variety of other objects may become lodged in the eye. Since even a small piece of dirt is intensely irritating to the eye, the removal of such objects is important. However, the eye is easily damaged. Impairment of vision (or even total loss of vision) can result from fumbling, inexpert attempts to remove foreign objects from the eye. The following precautions MUST be observed:
1. DO NOT allow the victim to rub the eye.
2. DO NOT press against the eye or manipulate it in any way that might cause the object to become embedded in the tissues of the eye. Be very gentle; roughness is almost sure to cause injury to the eye.
3. DO NOT use such things as knives, toothpicks, matchsticks, or wires to remove the object.
4. DO NOT UNDER ANY CIRCUMSTANCES ATTEMPT TO REMOVE AN OBJECT THAT IS EMBEDDED IN THE EYEBALL OR THAT HAS PENENRATED THE EYE! If you see a splinter or other object sticking out from the eyeball, leave it alone! Only specially trained medical personnel can hope to save the victim’s sight if an object has actually penetrated the eyeball.
