Treatment for open wounds depends on the severity or nature of the injury. A simple cut or scrape will often stop bleeding on its own, but a deep arterial bleed can cause the person to lose consciousness and die within minutes. The first step in controlling bleeding is to apply firm pressure to the wound. Because diseases such as HIV and hepatitis B are found in blood, it is also important for first-aid providers to protect themselves with gloves or an appropriate barrier.
Clean and Cover a Minor Cut or Scrape
Even minor injuries can produce a lot of blood. The American Academy of Pediatrics recommends running cool water over the injury to clean off the blood to evaluate the extent of the injury. Minor injuries can be treated at home by cleaning the wound thoroughly with soap and warm water. The first-aid provider should apply a topical antibiotic cream and cover with a clean, sterile dressing or bandage. Even minor wounds can become infected so it is important to keep the area clean and dry and reapply sterile dressings until the open wound has healed. Punctures are especially susceptible to infection because they have little bleeding. Signs of infection include fever, oozing pus around the wound, redness, tenderness or swelling. At that point, a health-care provider should be consulted.
Cover and Apply Pressure
For larger wounds, the main priority is to stop or control the bleeding. The first-aid provider should consider wearing gloves or use some other appropriate barrier. The first step is to apply firm pressure using a sterile absorbent pad. A roller bandage will secure the dressing in place. Wrap the injury, using overlapping wraps, until the entire roll has been used. The wrap should be tight enough so it won't fall off but not so tight that it cuts off circulation. A finger should be able to slip under the bandage. If the bleeding continues, another roller bandage should be wrapped over the existing one. According to the American Safety & Health Institute, watch for signs of shock, which indicates severe blood loss. Advanced medical attention might be necessary if the bleeding continues and the person gets week, pale or dizzy. In this case, the injured person should lie down and the first-aid provider should monitor breathing and body temperature while keeping the person calm until emergency personnel arrive.
Immediately Apply Pressure
For wounds that are deep with blood spurting out or gushing, prompt action is crucial for survival. The first-aid provider needs to find the cleanest, absorbent item in the immediate area--such as a diaper, towel or piece of clothing--and place directly over the wound. The victim should lie down while the first-aid provider pushes firmly over the open wound, holding it in place until emergency personnel arrive. The first-aid provider should not release the pressure, but continue to hold the absorbent material firmly in place. This is a life-threatening condition.
Further Evaluation May Be Needed
If bleeding has been controlled, but the cut is deep or jagged, stitches might be required. Also, the wound should be evaluated if objects such as rocks or glass are embedded in the skin. If the cut was caused by a rusty or contaminated object, see a health care provider to prevent tetanus or infection. Animal and human bites should also be evaluated.
References
- Healthy Children: Acute Bleeding
- "Basic First Aid for the Community and Workplace"; American Safety & Health Institute; 2006
