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When any tissue in our body is torn or cut by injury a wound is caused. There are several types of wounds like Bruises, Lacerations, Contusions, Incised wounds, Punctured wounds and others.

  • Incised Wounds are caused by sharp instruments like knives, razor etc. The blood vessels are "clean cut" and so these wounds bleed extensively.

  • Contused Wounds are caused by blows from blunt instruments or by crushing. The tissues look bruised.

  • Lacerated Wounds are caused by fall on rough surfaces, pieces of shells, claws of animals, machinery etc. These wounds have torn or irregular edges and they tend to bleed less.

What are the dangers of Wounds?

The two major dangers of a wound are bleedingand infection. Bleeding is the immediate danger and should be dealt with as soon as possible.

Dealing with Bleeding

Bleeding is one of the commonest causes of death in accidents. It is caused by the rupture of blood vessels due to the severity of the injury. There are two types of bleeding: external bleeding which is obvious and apparent and internal bleeding where the bleeding is not apparent at the outset but may manifest itself later in the form of bleeding from the nose, ear, lungs or stomach.

Signs and Symptoms of Bleeding

  • The patient may feel faint and even collapse.
  • The skin becomes cold and clammy.
  • The pulse becomes rapid and weak.
  • Breathing becomes shallow and the patient may gasp for air and sigh deeply.

  • Profuse sweating may occur.
  • Thirst may be prominent.

Identifying the source of bleeding

Bleeding may occur from the arteries, veins or capillaries or from combinations of the three. It can be identified by the following characteristics:

  • Bleeding from the arteries is bright red and comes out in jets or spurts, which correspond to the beating of the heart. This kind of bleeding is very dangerous and may cause death quickly.

  • Bleeding from the veins is dark in colour and often flows out in a continuous stream.

  • Bleeding from capillaries is a steady, slow ooze. In an acute situation, especially if on the surface of the body, it is less worrying than an arterial or veinous bleeding.

How to manage External Bleeding?
  • Bring the sides of the wound together and press firmly.

  • Place the patient in a comfortable position and raise the injured part (if no bone fracture is suspected).

  • If you know the pressure points at the appropriate locations then press on them firmly for 10-15 minutes.

  • Apply a clean pad larger than the wound and press it firmly with the palm until the bleeding lessens and finally stops.

  • If the bleeding continues, do not remove the original dressing but add more pads.

  • Finally bandage firmly but not too tightly.

  • Treat for shock.

  • Shift the patient to a hospital as soon as possible.

How to manage Internal Bleeding?
  1. Lay the patient down with the head low. Raise his legs using pillows.

  2. Keep the patient calm and relaxed with reassurance. Do not allow the patient to move.

  3. Maintain the body heat with blankets, rugs or coats.

  4. Do not give anything to eat.

  5. Do not apply hot water bottles or ice bags to the chest or abdomen. This may make things worse.

  6. Arrange for the patient to be shifted to the hospital at the earliest.

Dealing with Infection

Infection in wounds is caused by dirt and any material contaminated with germs that get into the wound. These micro-organisms may come from:

  • The object that caused the wound
  • The skin of the person
  • The clothes of the person
  • The hands of the First-Aider
  • Dirty Dressings
  • Contaminated Water
  • Surrounding Air

How to prevent infections in wounds?
  • Wash your hands thoroughly with soap and water.

  • Clean the external wound with plenty of good clean drinking water.

  • Dry the area surrounding the wound gently with dry sterile gauze or freshly laundered handkerchief or dhoti.

  • Cover the wound with sterile gauze if available. Alternately a dry sterile gauze or freshly laundered handkerchief or dhoti may be used.

  • Do not let the cotton come into contact with the wound.

  • If you wish to spread antiseptic over the wound, ensure that it is not mixed with water.

  • Bandage the wound.


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