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Writer's pictureMedicine Revision Crash Course

Wound Care

1. Introduction


  • Introduce yourself, check patient details

  • Explain examination

  • Ask if there could be any glass etc in it

  • Check for allergies

  • Position patient appropriately

  • Begin with observing the wound and think about what equipment is needed

2. Prepare and gather equipment


  • Gather tray and clean it

  • Wash hands


Gather equipment

o Saline water/ cleaning solution – check expiry date and place on tray standing up (open with alcohol swab)

o Wound pack

o Sterile gloves

o Apron

o Dressing

o Gauze

3. Return to patient


  • Open up wound care pack making sure not to touch the sterile field

  • Put dominant hand and open orange waste bag from pack

  • Remove the dressing with the waste bag and place between patient and trolley

  • Dispense the cleaning solution into the gallipot (container for holding liquid)

4. Sterile gloves


  • Open up the sterile gloves packet and place onto a clean surface

  • Wash hands (preferably with soap and water) and put on sterile gloves using ANTT approach

  • Wet the gauze by placing it into the liquid and squeezing it

5. Clean the wound:


  • Let the patient know that you are about to start cleaning the wound. Let them know that it shouldn’t be too painful but if it is then a painkiller can be used

  • Pick up wet gauze with “clean hand” – usually the left and transfer to right hand

  • Wipe down in one direction with one piece of wet gauze and dispose of in the waste bin using the right hand “dirty hand”

  • Pick up another piece of gauze and repeat until the wound has been cleaned – making sure you go in one direction with one sweep before disposing

  • Once clean dry the wound with dry gauze

  • Place dressing over the wound

  • Remove gloves

  • Secure the dressing


6. To finish:


  • Dispose of waste

  • Thank patient

QUESTIONS:

1. Name 3 different types of wounds

Answer

  • Abrasion = when skin rubs/scrapes against a rough or hard surface (e.g against a road)

  • Laceration = deep cut or tearing of the skin (e.g. accidents with knives/tools)

  • Puncture = small hole cause by a pointy object

  • Avulsion = partial or complete tearing away of skin and the tissue beneath. Occurs during major accidents (body-crushing, explosion, gunshots)

2. Other than cleaning the wound and dressing it, what else needs to be thought about (and possibly prescribed)?

  • Antibiotics if there are signs of infection or used prophylactically

  • Pain relief

3. What can be some complications of a wound if it gets infected?

  • Cellulitis – bacteria skin infection in which the skin is swollen and red and is typically painful and warm to the touch

  • Necrotising fasciitis – a severe soft tissue infection with a sudden onset caused by a variety of bacteria including Clostridium and Streptococcus. Failure of treatment can lead to sepsis, loss of limbs and death.

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