Wednesday, May 12, 2021

Wednesday, May 12, 2021

daily actions toward becoming better prepared for societal

Using iodine, rubbing , peroxide, or whiskey to clean a wound makes
for good TV drama. Tough guys wince or swear, whimper and cry.
In reality, it makes for dead tissue which then has the potential to get infected and
create a whole other host of problems. And, on top of that, you are wasting
what may be very precious disinfecting agents. So let’s learn to clean a wound properly.

Assume
your teenage boy has come to you with a really nasty road rash. It’s
kind of sizable and extremely dirty–sand, mud, organic matter–all
kinds of grossness. And it’s bleeding a bit. What do you do first?

Stop
the bleeding. Right. Now it may be hard to tell whether the bleeding
has actually been stopped with all that gunk in the wound, so you may
have to use some water to wash it out so you can see better. If you’ve
washed it out and you now see that it’s still bleeding–oozing out and
pooling, then go back to lying pressure to stop the bleed. Only once
the bleeding has completely stopped do you go on to the next step.

Once
the bleeding has been stopped, it’s time to debride the wound, i.e.,
remove all the dirt, dead tissue, gunk, bacteria, etc. Clean water–it
doesn’t have to be sterile–is all you need. Tap water, bottled water, a
clean, clear mountain stream. Boiled water. Saline solution, sterile
or not. It all works. (If you’re really desperate, fresh from a
person without a UTI is said to be sterile. Let’s hope we don’t get
desperate.) Never use iodine, rubbing , peroxide, or any
used for drinking. That only works on TV, and you are not on TV. All
of those will kill healthy tissue (because those disinfecting agents are
being used to kill living things like bacteria) and make it dead tissue
that can create an infection. And then you’ll need to re-open the
wound, clean it out properly, waste supplies, and maybe even need to
start using some antibiotics. Just do it right the first time.

You
may need a whole liter of water, even for a small injury. It’s not an
exaggeron. And yeah, that’s not how they do it on TV. Back to our
teenage boy with the nasty road rash. You’re not simply pouring water
from a bottle or using a washcloth. You’re going to need to create some
pressure to dislodge that debris in the wound. Your best options for
doing this are a large syringe (without the needle), like around 60 ml.
A curved tip might be nice. Or you can use a perineal bottle (usually
simplified to peri bottle), the bottles given to new mothers in the hospital to rinse
with every time they use the toilet. Both of those will create nice,
gentle pressure for removing debris. You don’t want a fire hose that is
going to do more damage. And don’t be surprised if you need to refill a
few times. It would be nice to get it all done at once, but a larger
bottle or syringe may be more difficult to manage.

If
the wound is substantial, or if it has some larger contaminants that
irrigon alone can’t dislodge, you’ll need some tools. Doctors call
them forceps. The rest of us call them tweezers. Tweezerman point
tweezers are the way to go. Uncle Bill’s sliver gripper tweezers are
also nice. This is not an item you want to go cheap on.

Once
you have thoroughly debrided and irrigated the abrasion so that there
are no contaminants or dead tissue left inside the abrasion, it’s time
to clean around the wound. Now you can use iodine, rubbing
, peroxide, etc. Start at the edge of the wound and in a
circular motion work your way out. Take care not to make any contact
with the wounded tissue as you are doing this.

After the area
around the wound is dry, finish up your treatt with a bandage or
gauze (possibly spread with triple antibiotic) and tape to protect the
wound from getting contaminated and infected.

This is
probably where the doctor would stop, and hopey it’s all that is
needed. But what if things have really and truly fallen apart? What if
it’s only you providing care? What if you missed something? What if
there is no triple antibiotic to spread on the bandage? You might
consider covering the wound with sugar, granulated pure cane sugar.
It’s a natural antibiotic and provides some pain relief as well.

Links to related posts:
Sugar for Wound Care
Lacerations
Skin Preps and Washes

Would honey be ropriate instead of sugar?

Absolutely. Pure, raw honey is great. I just find it easier to use sugar. My honey is so old that it crystallizes quickly and is usually rather solid. Sugar is just always ready to use. But if honey was all I had, I’d definitely use it.

Wednesday, May 12, 2021


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