How To Dress a Wound And Basic First Aid

How To Dress a Wound And Basic Wound Care

What You Might Not Know About Basic First Aid

How To Dress a Wound And Basic Wound CareWhen it comes to being prepared, having a broad base of knowledge will help to keep you calm when unexpected things come up,  from water filtration to how to dress a wound and basic first aid. And let’s face it, unexpected things will come up on a daily basis, not only in a SHTF Scenario, But if you have the knowledge of how to handle that particular situation, then it will hopefully not seem as catastrophic.

When thinking about your preparedness skills, having a good basic understanding of first aid and basic wound care is absolutely necessary.

Knowing how to dress different types of wounds is invaluable, and can save life and limb in certain situations. There is a lot of information on the internet about first aid. And yes, I am going to add to that, but the difference is my background. I am a Registered nurse, specializing in advanced wound care. On a daily basis, I have the amazing opportunity to help those that have devastating wounds, to get better. I have been an orthopedic/wound care nurse for the last eight years, and the best part is…I get wounds to heal.

I want to share with you the knowledge that I have, so that you will have the knowledge in case you ever need to use it. I also wrote a post about what first aid supplies you need and some tips to save a few dollars, but not skimp on quality.

Important Items For A Good First Aid Kit

  • Different sizes of band aids
  • 4 x 4 gauze
  • 2 x 2 gauze
  • Different size ace wraps
  • Alcohol swabs
  • Silvasorb gel
  • Coban (or vet wrap)
  • ABD pads (or feminine maxi pads)
  • Saline
  • Nitrile gloves
  • Foam pads (I prefer Mepilex, and Mepilex AG)
  • Restore dressing (Silver Calcium Alginate dressing)
  • Medihoney Calcium Alginate dressing
  • Hypafix adhesive tape
  • Adaptic dressing
  • 3” Cling Gauze
  • Bandage scissors (not the cheap EMT plastic handle kind, solid steel is better for cutting through thick dressings.)
  • Medical tape

All of these items can be purchased online, or in a medical supply store. Some can be a little expensive – like Mepilex AG foam dressing, but if a $16.00 dressing could be the difference between life and death, I’m going to spend the $16.00 for the dressing. I am sure there are different brands that are cheaper that might work just as well, but these are the products I use, so I know them very well.

 Lets Dig a Little Deeper

So below you will find several basic dressings that you can do rather easily. Well the first time you do one it may not seem too easy, but after one or two dressings under your belt, you will be a pro! Also, please keep in mind this is for educational information, and should not replace professional medical advice.  Always seek professional medical advice in any medical emergency when you can.

Basic Dry Dressing

A dry dressing is exactly what it sounds like, a dressing that is dry. You could use this for minor cuts, and scrapes, or over an open blister. First things first, wash your hands and clean the wound (cut, or scrape, etc.) For a dry dressing, there should not be any depth to the wound, and it would be best of the bleeding has stopped.

Wipe the wound with an alcohol swab, and make sure it is clean. Pat it dry with 4×4 gauze, and use Silvasorb gel, and apply just enough to give it a shine. Not too much, because too much of a good thing is not better. Just a tiny amount is enough.

Silvasorb GelSilvasorb gel is an amazing product. It should be in everybody’s emergency first aid kit. If you are using Neosporin, stop. Replace your Neosporin with Silvasorb gel. Neosporin is so overused that as a result, our bodies become immune to it. And just like there are bacteria resistant to other antibiotics, I am sure there are those resistant to Neosporin. So if you are slapping that on every wound, bite, etc, you could be creating a perfect breeding ground for bacteria. Bacteria love damp and dark places, and when you slather an oozing wound with it, that is what you are creating, a perfect breeding ground for bacteria. And remember, bacteria = infection.

Ok, back to the basic dressing. After your wound is clean and dry, and has a shine of Silvasorb gel on it, you can now cover it to protect the area. If the cut is small, a Band-Aid will work fine. If it is larger, you can make your own out of a 2 x 2 or 4 x 4 gauze pad. This is what I prefer, because the gauze breaths, and does not trap moisture against the wound.

If you choose the gauze method, you can use medical tape or hypafix tape to keep it on. I like hypafix. It is breathable, and moves with the skin, but it is gentle. It will stay in place without leaving any residue when it is removed. And being on a roll, you can cut the amount you need, no matter how large your dressing.

For a small “Band-Aid” just make sure the gauze is completely covered with the hypafix. If you are dressing a large area, like a skinned knee, or road rash, cut four separate pieces of hypafix and attach them one at a time around the perimeter of the gauze. If you think the wound may still bleed a little, cover any open areas of the gauze with more tape.

Wet To Dry Dressing

A wet to dry dressing is best used in a deeper wound that you are not able to have stitched, If you do not have the skills to stitch a wound I suggest you don’t, you could make the problem worse.

Examples of a wound that would benefit from a wet to dry dressing would be a deep wound that will not heal, and is getting larger, and deeper or an incisional wound that has opened up (dehisced). That may sound gross, but it happens a lot. These wounds can progress and become infected easily if not managed properly. But if you are in a situation where you have a deep wound that cannot be stitched, a wet to dry dressing can actually work really well to help a wound heal.

It works by inserting damp gauze into the wound and then once a day the dressing is changed. The goal is for the gauze to dry out over 24 hours, and when the dressing is removed, the dry gauze will help clean out (debride) the wound bed. Hopefully it will take some of the yucky stuff out, and leave a nice and pretty red wound bed.

To do this, again, wash your hands first and put on some gloves. Gather a 2×2, 4×4, alcohol swabs, saline bullets, or just saline solution and tape. And depending on where the wound is and personal preference, a roll of cling gauze (conform) and an ace wrap.

After you have gathered your supplies and washed your hands, wipe around the wound area with the alcohol swab. I would not advise wiping in the wound itself, because alcohol will sting, and not make this a pleasant experience for your patient.

After the wound area has been cleaned open the 2×2 but leave it in the package. Take a saline bullet (these are wonderful, and have about 3mL of liquid, you can find them with nebulizer treatments) and squirt some saline onto the 2×2 gauze pad. You want it to be damp, but not dripping. If it is dripping wet, squeeze out some of the excess liquid.

Open the 2×2 gauze pad fully, and make it skinny. You are then going to pack it into the wound. That means you are going to have the 2×2 “stuffed” into the wound. When I say stuffed, I don’t mean push it into the wound. The wound bed can be very sensitive, and painful for the patient, so you will gently fill the void area with gauze. Do not force the gauze in, this should be done gently.

You should not see any of the wound bed, and should only see the white gauze. Once the wound has been packed, cover the white gauze with a regular 2×2 or 4×4 depending on the size of the wound, and adhere it with your hypafix tape. If the wound is on an arm, hand, leg, or foot, you could cover the 2×2 gauze with cling wrap gauze, and then an ace wrap if you have the supplies. But that may be overkill, especially as you will be changing this dressing daily.

I only like to change these dressings once every 24 hours because I want the packed gauze to dry out. You can change it every 12 hours, but if the gauze is not allowed to dry out the wound will get soupy, and slough tissue (dead tissue) can cause an opportunity for bacteria to grow. This is why I prefer to change it one time every 24 hours.

Dressing Burn Wounds

Minor burns do very well with a thin film of Silvasorb gel applied to them and covered with regular mepilex foam. Mepilex foam adds some protection to the wound, and with the Silvasorb directly on the burned area you only have to change the dressing every three days. This can help give the area time to heal on its own without being disturbed.

Just like every other dressing change, always wash your hands, and put on gloves. If the burn is blistered, try to leave the blisters intact and cover with Silvasorb gel. You do not need to wipe the area with an alcohol pad first. Just apply the Silvasorb gel (remember just a little bit) over the affected area, and cut a piece of the mepilex foam larger than the area.

The mepilex foam has a backing you need to remove. Once the backing is removed, apply the sticky side down, toward the wound. Don’t worry, it doesn’t hurt.

After you have applied the foam, cut your hypafix to secure over the foam which will keep it in place. Again, this type of dressing can be changed daily, but you don’t need to. Changing it every three days is ok, unless you are having a lot of drainage that is noticeable on the outer foam. If this is the case, change the dressing every day.

Dressing Foot Wounds

Foot wounds really need to be taken care of, because all of your weight is on your feet. No matter what you do, you have to walk on your feet. Which is why a wound on the foot is serious, and needs to be managed appropriately in order to have a positive outcome (meaning, the wound heals!)

Depending on what type of wound it is will determine the type of dressing. But in almost all foot wounds, having foam over the wound is a good idea. If it is a popped blister, or a superficial wound Silver foam (foam impregnated with silver like mepilex AG) work great. But the dressing is only one part of getting the wound to heal. The most important thing in order to get the wound to heal is to stay off of it.

With the foot being so far away from the heart, it takes longer for a wound on the foot to heal. So giving that wound every advantage to heal is critical.  Think about it, if you have a wound on your arm or hand, it heals pretty fast. And how often do you walk on your hands? Probably not very often. Now think about a time where you had a blister, or wound on your foot. How long did that take to heal? I would be willing to bet it took longer.

By keeping the wound covered and protected along with staying off of that foot you can get the wound to heal. The length of time it takes to heal will be determined by your general health, but regardless, it is not worth the risk of what can happen. Trust me, I have seen a simple blister on the bottom of a foot end up becoming a wound that wound not heal, and it turned into a bone infection, which the turned into a blood infection. I cannot tell you how many of those little blisters have ended up in a person having a below the knee amputation, all from a blister on the bottom of the foot.

So, after you have dressed the foot wound, have the patient stay off of it. If this means they are on crutches, or a walker or even in a wheelchair until the wound heals.

An Ounce Of Prevention Is Worth a Pound Of Cure

There are so many wound products, and so many different types of dressings that can be used for different types of wounds. However, the most important part of treating a wound is simply that, treatment.

If something happens, you need to know how to react. This doesn’t have to be in a SHTF scenario, it could be something that happens when you are on vacation or a long hike. Knowing  how to dress a wound and basic first aid is just a important as water filtration and building the perfect bug out bag. Just by having the right tools in your first aid kit you can treat many smaller emergencies that may happen until you are able to seek out professional help. But in the instances that help isn’t coming, you will have a good basic knowledge of wounds, and how to care for them.

1 Comment

  • Marie

    Reply Reply February 3, 2014

    Thank you very much for posting all this helpful info! I’ve already shared it with friends.

    Excuse what may sound like a dumb question… I’m wondering if you could, in a pinch when you don’t have real first-aid supplies available, use some hand sanitizer to disinfect a surface wound? (I was once staying in a hotel late at night, and faced with this question in a minor skin-scrape situation–and I didn’t know what to do.) Not exactly sure what’s in that stuff, but it supposedly kills germs, right? If you were out in the forest somewhere and didn’t have anything else at hand, would it be better than nothing, or could you actually do serious damage by putting it on a wound?

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