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TYPES OF OPEN WOUNDS
Abrasion
Abrasions, also known as scrapes, can be superficial or deep usually involving minimal bleeding. This type of wound is usually painful, but not severe.
Avulsion
Avulsions are wounds where skin has been torn from the body during an accident or injury. This type of wound is usually painful, but rarely severe.
Laceration
Lacerations are wounds characterized by a deep cut or tearing of soft tissue. This type of wound is sometimes severe.
Puncture
Punctures are wounds characterized by a deep penetration of soft tissue. This type of wound is frequently severe.
BLEEDING - MINOR EXTERNAL
Minor bleeding is usually capillary bleeding. This type of bleeding can usually be controlled by applying pressure to the wound site.
Common Symptoms: Small amount of blood, Trickling blood, Surface level bleeding
First Aid Steps:
1. Ensure scene safety
2. Dial 911 if needed
3. Get PPE and first aid kit
4. Apply direct pressure until bleeding is controlled
5. Clean the wound with water and an antiseptic wipe
6. Place antibiotic salve on the wound
7. Elevate and apply an ice pack (place gauze or bandage on it first if the wound is open)
Special Note: If the bleeding is from the nose (Epistaxis): pinch the nose, tilt the head forward and apply an ice pack to the bridge of the nose.
BLEEDING - SIGNIFICANT EXTERNAL
Significant external bleeding is usually venous or arterial bleeding. Though arterial bleeding is more dangerous, anytime the bleeding results from damaged blood vessels, the bleeding might require more than direct pressure to control.
Common Symptoms: Large amount of blood, Spurting blood, Bleeding that is not easily controlled
First Aid Steps:
1. Ensure scene safety
2. Dial 911
3. Get PPE and first aid kit
4. Apply direct pressure
5. Consider using a tourniquet
6. If a tourniquet is used, place it approximately 2 inches above the wound site, avoiding joints
7. Tighten the tourniquet until the bleeding has stopped
8. Note the time the tourniquet was placed
9. Perform CPR if necessary
SHOCK EMERGENCY
Shock is an acute condition induced by a loss of blood pressure and blood flow throughout the body.
Common Symptoms: Cool, clammy and pale skin, Rapid pulse, Rapid breathing, Nausea, Enlarged pupils, Weakness, Dizziness
First Aid Steps:
1. Ensure scene safety ( assign a person to secure horse and control traffic)
2. Dial 911
3. If a wound is present, control the bleeding by applying pressure (while wearing PPE)
4. Perform CPR if necessary
ALLERGIC REACTION & BREATHING EMERGENCIES
Allergic reactions are common. Allergic reactions can be caused by stings, bites, food, injections and more. Severe allergic reactions can cause anaphylaxis, a life-threatening acute response to an allergy. An allergic reaction can also trigger a breathing emergency such as an asthma attack. Many asthmatics carry an inhaler to help treat a potential breathing emergency.
Common Symptoms: Rash, Hives, Itching or tingling in the mouth or skin, Swelling of face/tongue, Wheezing, Headaches, Fever, Muscle spams
First Aid Steps:
1. Ensure scene safety ( traffic and horses under control) Assign a person to this task
2. Dial 911
3. Use an epinephrine pen if available (usage directions are on the packaging)
4. If a breathing emergency starts, loosen tight clothing around the neck and ask if the victim needs any medication (ie: inhaler)
5. Perform CPR if necessary
BONE, MUSCLE AND JOINT INJURIES
The most common bone and joint injuries are: Fractures, Dislocations, Strains/Sprains.
Common Signs and Symptoms: Deformity, Bruising, Swelling, Bone fragmentation, Lack of range of motion, Hearing a snapping or popping sound at the time of injury
First Aid Steps:
1. Ensure scene safety
2. Dial 911 if needed
3. Get PPE and first aid kit
4. Clean and dress any open wound without moving a deformed limb
5. Immobilize a fracture or dislocation by using a sling or padding to secure the affected area
6. Compression wrap a sprain/strain and apply ice if available
7. Elevate the sprain/strain if not painful
Special Note: While fractures and dislocations should be immobilized without moving them, sprains and strains should be treated with R.I.C.E. (Rest, Ice, Compression and Elevation).
BURNS
A burn is an injury caused by exposure to heat or a flame. Burns can be caused by a flame, chemicals, electricity and even friction. There are three classifications of burns.
Common Symptoms:
First Degree Burn (Superficial): Affects the outer layer of skin, are painful and cause reddening
Second Degree Burn (Partial Thickness): Affects lower layers of skin and cause reddening, swelling and blistering
Third Degree Burn (Full Thickness): Affects all skin layers and can cause the skin to turn white or black and numb
First Aid Steps:
1. Ensure scene safety
2. Get PPE and first aid kit
3. Any burn that is in flame should be doused with water or smothered with a blanket
4. If the person is on fire, yell STOP-DROP-AND-ROLL
5. Call 911
6. Remove clothing that is not affixed to the burn
7. Wash and clean wound with cool water (1st and 2nd degree)
8. Place a burn dressing (non-adhesive) with topical antibiotic ointment on the burn
9. Perform CPR if necessary
SPECIAL CONSIDERATIONS FOR PREGNANT OR OBESE VICTIMS
Abdominal thrusts are not recommended for pregnant women. The Heimlich maneuver can be modified upward so that the victim receives chest thrusts instead. Chest thrusts should be delivered over the sternum, avoiding the xiphoid process (a small extension on the lower part of the sternum). Also, in the case of obese individuals, chest thrusts are preferred if the rescuer cannot fully reach around the abdomen.
First Aid Steps:
1. Ensure scene safety ( traffic and horses under control) Assign a person to this task
2. Ask the victim, "Are you choking?"
3. If there is no answer or an affirmative nod, instruct the victim to forcibly cough
4. If the victim cannot breath or need further assistance, perform with the Heimlich maneuver (or, chest thrusts for pregnant or obese victims)
5. If the victim becomes unresponsive, lower him/her to the ground and check his/her airway and remove the foreign body if easily viewable and removable (never perform a blind finger sweep)
7. Dial 911 and Perform CPR if necessary