Major or Minor Injury ?

When to seek professional medical attention can be a difficult question for many, especially when money and distance from medical care are involved. Often it is obvious that certain injuries are major and require advanced medical treatment. But, when the injury is less severe, the question of when to seek medical care arises. We hope that this web page will be helpful in those cases.

We encourage everyone to keep a good first aid book on hand as a reference, and review it when necessary. We also encourage everyone to participate in basic First Aid, and CPR courses, whenever they are available. Often these courses are presented in the community schools, or by employers. EMT courses are also available. EMT's are also a great resource when further care or information is needed.

Our goal is to present information here that will help non-medical persons to appropriately treat injuries when they occur and help them to decide when further care is needed. If there are any doubts regarding any injury, please call or see a medical professional as early as possible rather than later. Medical professionals rely on both the history and the exam to determine how to appropriately care for any injured patient. We at the Girdwood Clinic are happy to discuss any problems with you. Please call if you have any concerns.

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Burns

All Chemical, electrical, radiation and large burns should be seen by a health care provider

The most important thing to do when someone is burned is to stop the burning. If the burn is a heat, or thermal burn, immerse or run cool water over the burn. Avoid direct ice contact as this may increase tissue damage. If the burn is a chemical burn, flush the area with copious amounts of cool water. If it is a lime burn, you should brush off the lime powder first, then flush copiously.

Do not apply ointments to fresh burns as they may trap heat in the burned tissue. Ointments are useful to keep the burn moist later when the burn is well cooled.

First degree burns are superficial minor injuries that only involve the top layer or epidermis of the skin. These burns cause redness and swelling of the top layer of skin. They are very sensitive to heat and light touch. They will usually heal by themselves without scarring within a few days. Extensive burns on very young or very old persons, or if the person is feeling ill should be seen by a health care provider.

Second degree burns involve the deeper layer of skin called the dermis. The skin will be blistered and may look moist or mottled. They are intensely painful. With good care they will heal with little scarring in about 3 weeks. These burns should be seen by a health care provider if they are aver 10% of the body surface area, if they encircle a body part, or pain control is needed. Young children, senior citizens, and ill patients should be seen by a health care provider.

Third degree burns are full thickness burns of the skin. The damage may extend into tissues below the skin surface. These burns look charred and blackened with areas of red and white within them. All third degree burns should be evaluated by a professional health care provider.

Other burns which should be seen by health care providers include burns to faces, genitals, hands, and feet. Burns to the face may affect breathing while burns to hands and feet may cause loss of function. Chemical, electrical, and radiation and all large burns should be seen.by a professional. Burns on young, old, and ill patients, or those with pre-existing conditions such as heart or lung disease, and diabetes should also be seen by a health care provider.

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Sprains, Fractures, and Dislocations

Without an X-ray it is difficult to determine if an injury is a sprain, fracture or a dislocation. When in doubt always treat as a fracture. Do not move the patient except to remove from immediate danger. Control any bleeding, and check the patients heart rate and breathing.

Splint the injury by immobilizing the joint above and below the injury. Rolled up newspapers and magazines make good wrist splints. Ankle and knee splints can be made from sticks padded with towels or clothing. Always splint in the position you find the injury. Leave shoes on with ankle injuries.

Elevate the injured area and ice pack the injury as soon as possible . Do not warm pack initially because this will cause increased swelling.

Check the area below the injury for sensation and pulses. If cold, tingling, or no pulses can be found call 911, or transport immediately to the nearest emergency room. All suspected femur (thigh), hip and pelvic fractures should be transported by EMS. All neck, back, and head injuries should also be transported by EMS. Please read the following section about the care of these specific injuries.

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Basic Wound Care

All Eye and Ear Injuries should be seen by a health care Professional

The most important aspect of wound care is thorough cleaning and assessment of the severity of a wound. This can be difficult if a wound is bleeding copiously. Direct pressure for 5 minutes will stop most bleeding. If a wound continues to bleed after a full 5 minutes of direct pressure consult your local health care person, or transport the person while continuing to apply pressure till appropriate medical care is obtained.

Wounds should be cleaned with a gentle soap and water then flushed with copious amounts of clean water. All dirt and debris must be cleaned from the skin to prevent infections and tattooing from imbedded dirt and gravel. Solutions such as hydrogen peroxide and betadine should be diluted before using. Alcohol is painful and not a particularly good cleaning agent. Remember to wash your own hands before and after caring for a wound . It is also important to clean the skin surrounding the wound.

Wounds that have objects imbedded or protruding from them should have the object stabilized then transported to the nearest health care facility.

Inspect all wounds daily. Any wound that is not healing as expected, or becomes more tender, becomes surrounded by redness, swelling, or develops red streaks, foul odor, or discharge should be evaluated for infection by a medical professional as soon as possible.

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Back, Head, and Neck Injuries

DO NOT MOVE VICTIM!!!

Check immediately for breathing, and signs of shock, such as restlessness, fast, or weak pulse, bluish color, moist clammy skin, or, nausea and vomiting.

Do not raise the feet. Do not allow the victim to move about. Try to keep the head, neck, and back in alignment. Immediately call EMS to evaluate, stabilize, and transport the patient to the nearest appropriate medical facility.

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Poisoning

Call Poison Control Immediately!
261-3193 or 800-478-3193

Any non food item, including all medications and large quantities of vitamins can be toxic. Call Poison Control for any suspicious ingestion. Do not induce vomiting unless specifically instructed by Poison Control. All homes with small children should have ipecac syrup available to induce vomiting. Ipecac syrup can be purchased over the counter at most pharmacies. All medications and chemicals should be placed far out of the reach of children and secured with child safe fasteners. However, many poisonings occur outside the child's home. Parents and caregivers should be alert for poisonings whenever a child is in an unfamiliar place.

Fumes, gases, and smoke are also poisons. Remove the person from danger and support breathing if necessary. Then call Poison Control or 911 for EMS.

Brush off any acids, lye, pesticides, or other potentially poisonous substance that come into contact with the skin using gloves . Remove any contaminated clothing. Flush with large quantities of clean water, or mild soap and water. Call Poison Control. If possible take the container with you if instructed to go to the emergency room.

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Nausea, Vomiting, and Abdominal Pain

Do not give the person anything by mouth. Wait till the nausea resolves, or for 4 hours after vomiting, before offering any fluids. Begin with small sips of water, flat soda, or half strength juice. If they can keep down small amounts of clear fluids, increase the frequency and amount as tolerated. If the patient is unable to tolerate small amounts of clear fluids or has not urinated for over 3 hours they may be need professional help and intravenous fluids.

Persons with severe, or progressively worsening, abdominal pain should be seen by a health care provider. Any person who vomits bloody or coffee ground appearing material, or who passes dark red, maroon or black or bloody looking stools should be seen immediately by a health care provider.

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Dental and Mouth Injuries

The face and mouth typically bleed and swell profusely when injured. This can make it difficult to assess the injury. If the jaw is possibly broken, or there is significant swelling around the mouth or neck ,EMS should be called quickly in case the patient’s airway becomes compromised.

If the patient has bitten his tongue or lip, apply steady firm pressure to the area with a clean cloth. You should wear disposable gloves whenever you are working with blood or wounds. If swelling is present, apply a cold pack as soon as possible.

If a tooth has been knocked out, find it and place it in a moist gauze pack, or plastic bag and take it with the patient to the dentist as soon as possible. Consider that the patient may have swallowed or inhaled it. A swallowed tooth is usually not a problem. However, if it it is inhaled and lodges in the lungs or the airway, it can create serious problems.

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