The roads are underwater. All lines are down. Cellphones aren't working. No medical expertise is available. What do you do?IN AN EMERGENCY: Treating a wound with no access to medical care right now? This is the post to read.
You can sometimes use duct tape to close a wound. (See step four.)
by James Hubbard, M.D., M.P.H.
You’re cleaning up after the big storm. You’re wearing gloves but grab a pile of rubble that contains some sheet metal. Next thing you know, your glove is red with blood. You cannot get medical help. What do you do?*
Basics for Treating All Cuts, Scrapes, Gashes and Stab Wounds:
1. Stop the bleeding.
Apply direct pressure. If it’s a cut finger, squeeze the wound with your other hand. With a larger area, push down with the base of your palm. Use a clean rag if available. Even if it’s a small artery, you can temporarily stop the bleeding by squeezing proximal (closest to the heart) to the wound. A tourniquet is a last resort. Direct pressure is always better if it works.
Be careful if you suspect a broken bone underneath. You don’t want to push too hard and move the bone out of place.
As a rule, sharp cuts bleed more than dull, at least at first. (Dull cuts pull more on the blood vessels, causing them to spasm and close more). This has nothing to do with the severity of the cut. Cuts on the face and fingers tend to bleed more (more dense blood supply).
2. Assess the damage.
For more details on how to assess a wound, click here.
If the blood is squirting out, you’ve cut an artery. Oozing usually means it’s a vein. Arteries are harder to stop bleeding and are more likely to supply blood the tissue cannot do without. Small arteries on the fingers usually quit bleeding after squeezing for 10 or 15 minutes. Veins take less time. If you’ve cut an artery, follow the instructions in this article. Then come back here and continue with these instructions.
To treat small cuts and nicks click here.
To treat stab wounds click here.
If the wound is deep and large and won’t stop bleeding without pressure, click here.
To treat other large cuts, gashes or stab wounds, go to step three below.
3. Clean the wound.
The cleaner a laceration is the less the chance for infection. Run it under tap water or use the cleanest water you have. If your tap’s not running, punch a small hole in the bottom of a full plastic jug for extra pressure. If water is scarce, use peroxide. Alcohol is okay, including liquor, but be aware it’s going to hurt worse.
If the wound is more of a scrape, pick out the debris, and wash it. If the dirt is ground in, you may have to scrub a bit.
4. If the cut gapes open, close it.
Cuts that gape open can sometimes be closed with tape. Duct tape works well. (If the gash can’t be closed, clean it and pack it with clean rags.) To close the cut, follow these steps:
- Dry the wound. If you have some glue apply it to the skin edges (not the actual wound).
- Apply a strip of tape to one edge, close the skin gap using your hand, and apply the other side of the tape tightly.
- Cover the wound with clean cloth, duct tape, or whatever you have to keep dirt out of it.
The bandage has to be loosened if the area distal (furthest from the heart) to the cut starts turning blue or dark. This discoloration may mean this area is not getting sufficient blood flow and could be permanently damaged. See an expert as soon as possible to try to save the tissue.
If you don’t have antibiotic ointment, you can use honey (just not on a baby).
5. Keep it clean and dry.
Add some antibiotic ointment if you have it. Cover it with Band-Aids, or cloth and tape, or wrap a cloth around it.
How to Treat Small Lacerations:
Small nicks or lacerations similar to paper cuts should be washed and bandaged. You can seal them with a little super glue if available. Keep clean and dry.
How to Treat Stab Wounds:
Stab wounds, or puncture wounds, are deeper than they are wide. They’re usually caused by a knife or a stick or something similar. You can’t see the whole damage.
If the chest or abdomen is stabbed, try to approximate the depth by the length of the stick or knife. If you think it may have punctured the chest or abdominal cavity, it becomes more important to seek expert care as soon a possible due to the risk of severe infection.
If the area begins to swell immediately, you may have hit an artery. Apply pressure.
If not severely bleeding, wash as best you can, apply ointment and cover. Keep it clean and dry.
If the wound is deep and large:
It may never stop bleeding without pressure. Pick out any noticeable debris, pack it with clean rags and cover with tape.
Questions and comments are appreciated.
[...] Wounds [...]
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Srividhya,
If you’re healthy, anytime is a good time for giving blood. The average blood loss during a menstrual period is about a tenth of a pint, so it’s not going to make any difference if you give while on your period on not. If you have heavy periods, you probably want to wait until mid-cycle. They’ll check your blood count before you give to make sure you’re not anemic.
In general people need to wait about two months between donations to give plenty of time for your body to replace the blood cells you lose.
Nice Mr.James, What is best time for blood donating? How long days should be to donate before or after periods.
Sridivhya,
Hemoglobin transports oxygen to your cells. You wouldn’t be bleeding more from that. In general fingers bleed more because they have more tiny blood vessels than most parts of the body. Also, when you get cut with a sharp object, everyone tends to bleed more. Getting more of a tear or cut with a dull object makes injured blood vessels spasm and close. Sharp object injuries don’t cause this reaction as much. Taking aspirin can make you bleed more. To be sure you’re okay you’ll need to see your doctor for tests such as a blood and platelet count and clotting times.
Thanks for the comment
When I cut my finger with a knife, it takes time to stop bleeding. why this happens? Some are saying that i have more hemoglobin. is that true? What is hemoglobin? If it is more what does it will do?
In A S.H.T.F. situation….what anti biotics should I keep on stock for Cuts.Gun shot,burns
ect.When no Doc. is around……Should I get A Gram (+ – )test kit. I’v also heard about a Nurse guide…what is that….
Rick
Rick,
If you’re not allergic to penicillin, maybe amoxicillin or amoxicillin/clavulanate (Augmentin). Ciprofloxin (Cipro) for anyone over 18 years old. If you can give injections, then Rocephin with lidocaine to mix it.
I’m thinking a nurse guide would be a book a nurse would use to learn the basics of his/her profession. I’m not an expert on which is best. Maybe a Merck Manual?
I’m also not familiar with the gram +/- kit. I would think that would be more for someone who wants to create a common, go-to medical facility.
Thanks for the questions.
Dr Hubbard,
You really help instill confidence by simplifying the procedures to basic first aid. As a physician, you can look at a wound, know the general ramifications and not panic. Blood is a scary thing to many of us. Wound care that can deal with extensive wounds to basic scapes or a paper cut should be taught in middle school. Thanks for being my 7th grade teacher.
William,
You’re so right about the panic. It can be hard for healthcare professionals also if they’re newbies or the trauma is out of the ordinary they see. Try to take a deep breath and think about what you’ve learned.
Merry Christmas, David. Thanks for the great tip.
Another way to irrigate a wound: get a zip-lock bag, fill it with tap water, and zip the seal tightly closed. Next, use a knife, scissors, nail clipper or whatever to cut off the tip of one of the bag’s corners. Now squeeze the bag firmly to produce a strong stream of pressurized water. Refill and repeat until the wound is clean. If you have no plastic bag you can use a toy balloon, condom, rubber glove, etc., but only if you are confident that the patient is not allergic to latex.
Merry Christmas Doc!
Thanks, Paul,
I plan on doing just that. I’ll have some tips on nutrition, foods, some that grow wild, sterilizing water, etc.
Hi Dr Hubbard,
This could well become a really important site for people interested in Survival skills and emergency preparedness. People tend to forget that they can have years worth of food stored; tons of survival equipment, but if they can’t deal with even minor medical problems – their chances of survival are severely reduced.
Have you thought about providing information on “how to stay healthy when…” such as basic survival hygiene, diet and nutrition?
Best of luck with your new project.
Paul.