Wound dressing with bleeding as the main symptom
In the case of bleeding, the application of wound dressing must be based on hemostasis. If the bleeding is not stopped in time, it will cause serious blood loss, shock and even life-threatening.
Sometimes, dressing itself is a measure to stop bleeding. For example, capillary bleeding caused by tissue injury, when bleeding, blood flows out of the wound like water drops, which can stop bleeding with a little compression, and sometimes it can automatically coagulate to stop bleeding. For this kind of bleeding, it is often only necessary to put a hemostatic patch on the wound, or cover the wound with sterile gauze, and then apply a little pressure to bandage it, thus completing the dual tasks of hemostasis and bandaging. However, for "arterial bleeding" caused by arterial vascular injury and "venous bleeding" caused by venous vascular injury, simply compressing and dressing the wound often cannot achieve the purpose of hemostasis.
When arterial bleeding occurs, the bleeding is pulsating and jet-shaped, and the blood color is bright red, which can cause a lot of blood loss in a short time and endanger life; When venous bleeding occurs, the bleeding flows out slowly and continuously, and the color of blood is purple. These can be temporarily stopped by emergency measures such as "acupressure" and "tourniquet", and then sent to the hospital or invited ambulance personnel to come for treatment.
Finger pressure to stop bleeding is to find the beating blood vessel above the wound, that is, near the heart end, and press it tightly with your fingers. It should be noted that this method can only be used to control blood flow for a short time, and the "tourniquet" method should be used to stop bleeding immediately.
The tourniquet is an elastic rubber band (dressing should be placed between the band and the skin), and it can also be replaced by a cloth band, towel or tie with a width greater than 3cm, and the upper arm or thigh should be tied at the junction of 1/3 (note: the upper arm should not be tied too low, otherwise the nerves will be easily damaged). The tightness of the tie should be based on the fact that there is no blood flow from the wound. In addition, be sure to mark the time when the tourniquet is attached in a prominent position and loosen the tourniquet for a few minutes every hour. Tie it again.
Improper dress can lead to serious consequences.
Someone fixed the forearm and the upper arm in a straight line for a long time when dressing the child's elbow injury. As a result, the child's elbow joint lost its due bending function and was disabled. The reason is that Liu readers don't know that the joints should be fixed in the "functional position" when dressing. Even if the joint can't move after injury, it can retain some physiological functions of the original joint to the maximum extent.
For the upper limbs, the most important thing is to ensure the function of the hand; For the lower limbs, it is mainly to ensure the function of bearing weight and walking. Therefore, the functional position of elbow joint is flexion of nearly 90 degrees, the functional position of knee joint is slight flexion 10 degrees, and the functional position of finger joint of hand is flexion of 45 degrees. The functional position of ankle joint is 90~95 degrees.
Take traumatic fracture as an example: loose dressing and no fixation are important reasons for abnormal healing or pseudoarthrosis. As we all know, the reduction of fracture and dislocation depends on fixation. If the dressing is loose and cannot be fixed, there may be danger of bleeding, pain and shock in the near future, and abnormal healing and pseudoarthrosis may be caused in the long term.
On the contrary, wrapping too tightly may cause new harm to the body. Tight dressing affects blood circulation, and may also cause limb swelling, pallor, cyanosis, chills, numbness and other manifestations. If it is not relaxed in time and properly bandaged again, it may cause limb ischemia and necrosis.
In addition, improperly moving the patient to dress the wound can also cause irreparable damage. For example, the fracture end of patients with complete long bone fracture stabbed important blood vessels and nerves, and the spinal cord of patients with spinal fracture was injured and paraplegia occurred. Therefore, dressing must pay attention to skills.
2. What are the methods for dressing wounds?
(1) Bandage ring method This is the most basic and commonly used bandage method, which is generally used for dressing small wounds after cleaning.
It is also suitable for neck, head, legs, chest and abdomen. The method is: the first ring is slightly inclined, the second ring and the third ring are annular, and the inclination angle of the first ring is pressed in the annular ring, so that the fixation is more secure.
Finally, fix the tail with adhesive, or cut it into two knots. ② Bandage snake method is commonly used to fix splint.
The method is as follows: firstly, the number of bandages wound by ring method is fixed, and then the bandages are wound obliquely upwards or downwards at intervals according to the width of the bandages. That's it.
③ Spiral bandage method is mostly used in places with similar thickness. The method is as follows: firstly, it is wound and fixed several times according to the ring method, and then it is wound upwards to cover one-third or two-thirds of the front ring to form a spiral shape.
(4) Wrap the triangular head with a bandage. First, fold the bottom of the triangle on your forehead, pull both sides to the back of your head and tie a half knot with the bottom, and then tie a knot around your forehead to fix it.
3. How to dress the hand after cutting it?
Step one, stop the bleeding.
For general bleeding, it is effective to press the bleeding part with clean gauze or handkerchief or towel, or to press the injured hand with the other hand or others, and will not cause adverse consequences. If the hand artery injury leads to massive bleeding, the upper arm can be tied with tourniquet or elastic hose 1/3 to stop bleeding.
However, when being sent to a large hospital for surgery, the tourniquet should be loosened for 5 ~ 1 0 minutes every10 hour to avoid hand ischemia and necrosis. Be careful not to tie your wrist or upper arm with nylon rope or iron wire, otherwise it will not stop bleeding, but will aggravate bleeding, and some even cause finger necrosis.
The second step is to prevent further pollution. Don't apply purple potion and other drugs to the wound, so as not to affect the doctor's judgment on the injury.
The third step is to prevent the damage from getting worse. If the finger is broken and not completely broken, it should be temporarily fixed with small wooden boards and iron sheets, which can also relieve the pain.
If you have a broken finger or hand, don't throw it away at will. Wrap the severed finger with sterile gauze, wrap it in a plastic bag, put some ice cubes or sorbet outside the bag, and transport it as soon as possible so that replantation can be carried out within 6~8 hours. Never immerse the severed finger in alcohol, disinfectant, salt water and other liquids for transportation, so as not to destroy the tissue structure of the severed finger and affect the survival rate of replantation.
In addition, for some minor hand injuries, if you have a standing first aid tool at home, you can handle it yourself. If the hand is squeezed by a heavy object, most of the skin will not be broken, but there will be subcutaneous bruising or hematoma. At this time, use a cold towel or cold water bag for external application for about half an hour to prevent hematoma from increasing and relieve pain.
If there is a hematoma under the nail, you can use a red-hot needle to vertically puncture a small hole in the nail hematoma, so that the accumulated blood can flow out of the hole, and then stick adhesive tape to relieve the pain and prevent the nail from falling off. If your hand is stabbed, first check whether there is a puncture object. If there is a puncture, try to pick it out. The method is: pinch the wound, poke the skin with a sterilized needle and pick out the foreign body.