Knowing when to see your doctor about a cut or a scrape can be challenging. If you are concerned about the severity of an extensive or deep injury, if it is difficult to control bleeding or if the wound is too painful to clean thoroughly, a visit to your family doctor or a hospital emergency room is in order. If skin edges gape around a cut, have it examined and treated by a doctor within a few hours.

The same basic guidelines apply to the care of any wound, no matter how serious it is. With these basics, you can provide proper first aid and know when a situation is serious enough to demand professional advice.

Bleeding

The body has natural defenses against bleeding. Damaged blood vessels constrict to reduce blood flow. If bleeding continues, blood pressure drops and blood flow is further reduced. Blood will clot as it is exposed to air, forming a seal at the damaged edge of the wound. This may take a few minutes. If bleeding is serious, apply pressure to the wound so it clots faster.

Steps to control bleeding

The following steps will control all but the most severe bleeding and help prevent the loss of too much blood. Often you can perform all three actions at the same time.

Direct pressure – Apply pressure directly to the wound to stop blood flow and allow clots to form. Once bleeding is controlled, continue to apply pressure while seeking medical help.

Elevation – Raise the injured limb above the level of the heart so gravity can reduce blood flow to the wound area. Elevate the limb as high as is comfortable.

Rest – Place the person in a comfortable resting position to reduce the pulse rate. Unless the head is bleeding, the preferred position is lying down with feet and legs elevated. Anyone with a head wound should be kept comfortable in a sitting position unless related injuries dictate otherwise.

It is easy to control slight bleeding from minor cuts and scrapes using these techniques. If the bleeding is profuse or does not stop quickly, blood loss can lead to shock. It becomes urgent to take the same steps of pressure, elevation and rest. Get medical help immediately.

Types of Wounds

Contusions or bruises are closed wounds, meaning there is no obvious bleeding caused by a fall or a blow from something blunt. Instead, the injury bleeds into the tissues under the skin, causing discoloration. Since there is no break in the skin, there is little chance of infection. A bruise may be a sign of a deeper, more serious injury or illness. If it does not go away within a few days or bruises appear too easily, see your family doctor.

Abrasions or scrapes are open wounds where the outer protective layer of skin and the tiny underlying blood vessels are exposed, but the deep layer of the skin is still intact. Abrasions usually appear when skin is scraped across a hard surface, as with a rug burn or road rash. Abrasions do not bleed very much but can be very painful.

Incisions are clean cuts in soft tissue caused by something sharp such as a knife or broken glass. They penetrate through the deep layer of skin. Although these wounds may not be as dirty as abrasions, they can contain fragments of glass or other material. Deep tissues like nerve tendons and blood vessels may be damaged.

Lacerations are tears in the skin and underlying tissue. The edges of the wound are jagged and irregular. The presence of dirt can increase the risk of infection. Often lacerations are caused by machinery, barbed wire or the claws of an animal. Deep tissue injury is also common.

Puncture wounds are open wounds caused by blunt or pointed instruments such as knives, nails or an animal’s teeth. The wound may have a small opening but often penetrates deep into the tissue. There may be contamination deep in the wound and internal organs may be damaged. Serious infection is an important risk in this case.

Avulsions and amputations are injuries that leave a piece of skin or other tissue either partially or completely torn away from the body. Amputations involve partial or complete loss of a body part and are usually caused by machinery or cutting tools.

Wounds to the scalp and face are also likely to bleed heavily and will often look much worse than they are. However, they can be very serious and should not be taken lightly. Medical assistance is usually required.

Putting together a first aid kit

A well-equipped first-aid kit is a must for home treatment
of minor injuries. This family kit is approved by St. John Ambulance and can add a feeling of security to work, home and recreational activities.

For small wounds:
• Antiseptic cleaning towelettes (6)
• Elastic adhesive pads 5 cm x 11 cm (3)
• Elastic knuckle adhesive bandages 7.5 cm x 4 cm (2)
• Adhesive fingertip bandages 3.5 cm x 5.5. cm (2)

For medium wounds:
• Pressure dressing bandage (1)
• Sterile dressing 20 cm x 19 cm (1)
• Antiseptic cleansing towelettes (2)
• Gauze pads 10 cm x 10 cm (2 packs of 2 pads)

For large wounds (burns):
• Large dressings 20 cm x 10 cm (2)
• Gauze roller bandage (self-adhering) 10 cm x 4.5m (1)

Additional supplies:
• Rescue blanket - foil (1)
• Triangular bandages (4)
• Latex gloves (2 large pairs)
• Scissors (1)
• Tweezers (1)
• Safety pins (8)
• Waterproof adhesive tape 2.5 cm x 4.6 m (1 roll)
• Antiseptic cleansing towelettes (12)
• Foam splint padding 2.5 cm x 40 cm (1)
• Sterile dressing 20 cm x 25 cm (1)

- from First on the Scene,
the complete guide to first aid and CPR.

Minor wound care

All open wounds are contaminated to some degree. From the moment of injury, a risk of infection continues until the wound is completely healed. While your first priority is to stop the bleeding, do so using the cleanest materials available. Follow the guidelines listed below for cleaning a wound.

Wash your hands with soap and water and put on latex gloves if available.
Do not cough or breathe directly over the wound.
Fully expose the wound but do not touch it.
Gently wash loose material from the surface of wound. Wash and dry surrounding skin with clean dressings, wiping away from the wound. Baby shampoo can be used to clean an abrasion with little added discomfort. A thin film of antibiotic ointment can be applied to an abrasion that does not appear to need medical attention.
Cover the wound promptly with a sterile dressing. Tape the dressing in place. Choose an adhesive bandage appropriate for the cut. For example, a butterfly closure will help close a gaping cut, while a stretchy bandage will fit better over a knuckle.
Remove and dispose of gloves in the household garbage and wash your hands and any other skin area that may have been in contact with the person’s blood.

Tetanus infection

Any wound may be contaminated by spores of the bacteria that cause tetanus. This potentially fatal disease, commonly called ‘lockjaw’, is characterized by muscle spasms. Wounds caused by animal bites or those that may have been contaminated by soil, dust or animal feces are at especially high risk of tetanus infection. Clean these wounds immediately with soap and water.

Anyone not up-to-date with tetanus immunizations should seek medical treatment. To be up-to-date, you will have received at least three doses of tetanus vaccine with the most recent dose or ‘booster’ within the last five years. This protection is part of the routine childhood vaccination program.

Wound infection

Infected wounds should always be seen by a doctor. Suspect infection in a wound if it:

becomes more painful
becomes red and perhaps swollen
feels warmer than the surrounding area
shows the presence of pus (whitish fluid).

The advice in this article cannot, nor is it intended to, replace the first aid skills that can only be learned in an approved first aid course. Readers are encouraged to take a first aid course from their local St. John Ambulance Branch or other recognized organization.

Preventing injuries in the first place

Although cuts and scrapes are part of daily living, many need not happen. Protective gear, used for the activity for which it was intended, can prevent many injuries. If helmets, elbow or kneepads are recommended for a sport, there is a good reason. Provide a safe place and adequate supervision for young children when they play. As well, make your house and work areas safe by keeping knives, tools and sharp implements out of reach of children. If you are a gun owner, make sure all firearms are safely stored in a locked cabinet. They must be unloaded and the firing pin assembly removed. Lock ammunition in a separate storage area. A gunshot wound is not something anyone should experience.

Prevent injuries where possible and know to do if minor injuries do occur. You can attend to most first-aid needs you will meet.

Cuts and Scrapes First aid for controlling bleeding

Active children and scraped knees – such a common sight! The box of bandages is never far away as parents care for the cuts, scrapes and bruises that are part of a normal childhood. Most injuries are minor and can be treated easily at home. Some are more serious and require medical treatment.