First Aid for Wounds

The 3 most common questions I get asked about first aid for wounds are:-

Do they need a Tetanus vaccination?

Do they need stitches?

How do I know if it’s infected?

I’ve answered these questions below.  Please remember it’s impossible to give specific advice without seeing a wound so if you’re concerned you should always seek appropriate advice.

 

Do they need a Tetanus vaccination?

The short answer is usually ‘no’.  The long answer is ‘it depends’.

When assessing a wound it is decided if it is ‘tetanus-prone’.  This means there is a high chance that it has been contaminated with Tetanus spores.  The Department of Health produce guidance on the giving of vaccinations called ‘The Green Book’ you can find it here and on page 379 there is a list of tetanus prone wounds, I’ve listed these below:-

Tetanus-prone wounds include:
● wounds or burns that require surgical intervention that is delayed for
more than six hours
● wounds or burns that show a significant degree of devitalised tissue or a
puncture-type injury, particularly where there has been contact with soil
or manure
● wounds containing foreign bodies
● compound fractures
● wounds or burns in patients who have systemic sepsis.

Generally if they were born after the early 1960s they will have had at least 5 tetanus vaccinations in their lifetime.  This is considered sufficient unless there is a high risk of contamination, in which case they should receive the ‘human tetanus immunoglobulin’ which is designed to provide immediate protection.  The normal tetanus vaccination does not provide cover within the incubation period and is therefore not sufficient for a high risk wound.  There is a table in the same document on page 381 that shows what should be given.

 

Do they need stitches?

There is often an assumption that anything other than stitches is not good enough to close a wound.  There are lots of factors to consider when assessing a wound and how best to close it.

Stitches are not the best for every wound, especially if it’s in an area where the skin is thin, such as over the shin.  For every stitch that’s put in two more little wounds are created and if the skin isn’t thick enough this can lead to tearing.

Steristrips are a great way of closing a wound but they do require looking after.  They need to be kept clean and dry otherwise they will come off, they are also better covered to prevent the edges rolling back.  It’s important that the person follows the advice given in order that their wound heals well.

Tissue adhesive, also known as ‘glue’, is also used.  The cosmetic effect from using glue is often very good because it is best used on wounds that come together neatly.  Again they will be given advice to follow – strictly no picking!

 

How do I know if it’s infected?

As a First Aider someone may come with an injury that they’ve acquired at work or elsewhere because they’re concerned.  Specific things to consider when checking for signs of infection are:-

  • Slow healing and continued bleeding
  • Oozing or smell
  • Increased pain
  • Redness – looks ‘angry’
  • Feels hot
  • Any red lines travelling away from the wound towards the body, these can be faint
  • Any pain in the arm pit if it’s a wound on the arm, or pain in the groin if it’s on the leg
  • Any flu-like symptoms

Always seek advice if you’re unsure, it’s better to be safe.  When treating a wound I always warn people of the signs of infection and how and when to seek help.

 

Getting help

This blog is aimed to give general answers.  If you’re concerned about someone else or yourself always seek advice and help.

 

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