Transcript MSU Wound Care PowerPoint and labx

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B/c of the close physical contact that occurs
through athletic participation, the potential for
spread of infectious diseases among fitness,
professionals, coaches, athletes, and sports
medicine personnel is of major concern.
Healthcare facility must be maintained as clean
and sterile to prevent spread of disease and
infection
Must take precautions to minimize risk and
prevent contaminations
Must be aware of potential dangers associated
with exposure to blood or other infectious
materials
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Pathogenic organisms, present in human
blood and other fluids, that can potentially
cause disease
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Cerebrospinal fluid, semen, vaginal secretion and
synovial fluid) that can potentially cause disease
Most significant pathogens are Hepatitis B, C
and HIV
Others that exist are hepatitis A, D, E and
syphilis
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You don’t want to get the
blood/fluid on you or in any
opening (cuts, eyes, nose, mouth,
etc)
In the field…latex, vinyl, or other
medical grade gloves will be what
you need (most of the time…)
The exception would be if blood
is flying everywhere. You really
need to wear goggles and/or an
impervious gown.
An exposure to someone’s blood
who is positive with something
that you really don’t want can
haunt you for the rest of your life.
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Preparing the Athlete
All open wounds and lesions should be covered with
dressing that will not allow for transmission
 Occlusive dressing lessens chance of crosscontamination
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 Hydrocolloid dressing reduces chance that wound will
reopen, maintains moist and pliable wound
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When Bleeding Occurs
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Athletes must be removed from participation and
returned when deemed safe
Bloody uniform must be removed or cleaned
Place all bloody items in a biohazard bag
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Personal Precautions
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Use appropriate equipment
 Latex gloves, gowns, aprons, masks and shields, eye
protection, disposable mouthpieces for resuscitation
 Emergency kits should contain, gloves, resuscitation masks,
and towelettes for cleaning skin surfaces
 Non-latex gloves can be used when long term exposure to
blood and bodily fluids is not likely
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Doubling gloves is suggested with severe bleeding
and use of sharp instruments
Extreme care must be used with glove removal
Hands and skin surfaces coming into contact with
blood and fluids should be washed immediately with
soap and water (anti-germicidal agent)
Hands should be washed between patients
First, carefully pinch the
flap on the underside of
one of your wrists.
 Second, role that glove
inside out, off of your
hand.
 Put the glove in the palm
of your other hand.
 Role that glove off too.
 Put the gloves in the
biohazard bag.
 Wash hands immediately
http://www.youtube.com/
watch?v=BmomTXux_L4
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Skin wounds are extremely common in sports
Soft pliable nature of skin makes it susceptible
to injury
Numerous mechanical forces can result in
trauma
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Friction, scrapping, pressure, tearing, cutting and
penetration
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Depends on the injury….
BBP (Bloodborne pathogens) prevention supplies
A cleaning agent (saline solution, good old soap and water, or
some other antiseptic cleaning substance)
Gauze (or something to help clean up)
Some kind of triple antibiotic, or other topical ointment
Wound Covering (Gauze and Tape, Band-Aids, Steri-strips, and
again any other coverings that you might have, such as Tefla
Pads)
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Should be cared for immediately
All wounds and the surrounding skin/area
should be treated as though they have been
contaminated with microorganisms
To minimize infection clean wound with
copious amounts of soap, water and sterile
solution
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Avoid hydrogen peroxide and bacterial solutions
initially
Clean wound from the inside out
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Dressing
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Sterile dressing should be applied to keep wound
clean
 Do not remove gauze if it bleeds through. Removal
will open clot . Apply more gauze on top.
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Occlusive dressing are extremely effective in
minimizing scarring
Antibacterial ointments are effective in limiting
bacterial growth and preventing wound from
sticking to dressing
 Apply ointment to dressing to avoid contaminating
the tube or use individual packets
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Saline solution is recommended for repeated
cleaning
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In the event that the wound is bleeding…apply direct pressure or
apply pressure to a pressure point.
If it squirts that is probably an artery…call 911
If you cannot stop the bleeding…call 911
If it is huge and you think that something else could be injured
(you can see bones)…call 911.
If you think that it could use sutures…cover it and send them to
the doctor.
If it is on the face…you might want to send them anyway (sutures
can reduce scarring)
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How to clean a wound
http://www.youtube.com/watch?v=YXbsujadP8Y
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Are sutures necessary?
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Deep lacerations, incisions and occasionally
punctures will require some form of manual
closure
A wound that looks severe should be referred and
decision should be made by a physician
Recommend for face and high stress areas
(knee/elbow) or when underlying tissue (fat,
tendon, bone or vessels) are exposed or if
bleeding cannot be controlled.
Sutures should be used within 12 hours
Area of injury and limitations of blood supply for
healing will determine materials used for closure
Physician may decide wound does not require
sutures and utilize steri-strips or butterfly
bandages
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Signs of Wound Infection
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Same as those for inflammation
 Pain
 Heat
 Redness
 Swelling
 Disordered function
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Pus may form due to accumulation of WBC’s
Fever may develop as immune system fights
bacterial infection
Most wound infections can be treated with
antibiotics
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Contusion- a blow
compresses or
crushes the skin
surface, causing
bleeding to occur
under the skin
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Friction Blister- fluid
collects below or
within the
epidermal layer of
skin due to rubbing
or friction
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There shouldn’t be any fluid with
these unless it is popped.
In that case, observe universal
precautions
If it is popped, or you choose to pop
it, make a small hole in the surface
at one of the edges and apply
pressure to drain the blister.
Chances are that your athlete will be
looking for a little padding so that
they can keep playing
A Band-aid and second skin pad
work wonders.
Or you can use a thin piece of foam
cut into a small donut, put it over
the blister, and cover it.
Wounds with smooth edges;
sharply cut
Care
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Control bleeding.
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Practice Universal
Precautions
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Clean the wound. Going from
the inside-out.
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Pull the edges together and
close using Steri-strips or a
Band-aid.
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Apply Triple antibiotic
ointment.
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If they are going to play, then
it needs to be covered.
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Skin has been irregularly torn
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Blunt force delivered over a
sharp bone or a bone that is
poorly padded results in
wound with jagged edges
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May also result in tissue
avulsion
Care
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Control bleeding; Practice
Universal Precautions
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Clean the wound
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Try to close the edges with
gauze, Steri-strips, Band-aids
(if possible)
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Apply triple antibiotic
ointment
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Cover the wound for
competition
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Skin is torn from body; usually
results in major bleeding
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A lot of avulsions may require
more medical attention than you
can do in the field
Care
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If it is controlled and manageable,
Practice Universal Precautions,
clean the wound, replace the
displaced flap with Steri-strips or
band-aids, apply a topical
ointment, and cover.
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For large pieces that can be
reattached, place avulsed tissue in
moist gauze (saline), plastic bag
and immerse in cold water
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Take to hospital for reattachment
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Skin scraped against rough
surface
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Top layer of skin wears away
exposing numerous capillaries
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Often involves exposure to dirt
and foreign materials = increased
risk for infection
Care
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These are easy…no closure
needed!
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Practice Universal Precautions
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Clean, apply a topical, and cover
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Your athlete will be back into
competition and maybe a little
sore.
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Direct penetration of tissue by
pointed object
Can easily occur during activity
and can be fatal
Penetration of tissue can result in
introduction of tetanus bacillus to
bloodstream
All severe lacerations and
puncture wounds should be
referred to a physician
DO NOT REMOVE OBJECT
Attempt to stabilize the object
when wrapping
Small punctures can be taken care
of relatively easily, but should
still be seen by a doctor.
High risk of infection
Practice Universal Precautions,
clean, close if needed, cover, and
ship.
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http://www.youtube.com/watch?v=WK0z
Gx9DmLg
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You glove up!
You clean it and apply a topical ointment (all
occasions)
You close it (when the situation calls for it)
You cover it (on all)
ACTIVITY #1
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Pair up
One person play the patient.
Use makeup pencil to draw a
wound on your partners
arm/hand. Squeeze a little
ketchup over the wound to
imitate blood.
Practice cleaning a wound
Switch with your partner
and repeat.
ACTIVITY #2
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Each person will receive a
cherry tomato
Your partner will make an
incision on the tomato and
pack it w/coffee grounds,
imitating dirt inside the
wound
You must clean the wound
from inside out using a
water bottle as your
cleansing agent and gauze
Once clean, close the wound
w/steri strips