Encyclopedia of Health and Medicine

Burns, Bleeding, Breaks
The most common types of injuries that require
emergency medical assistance are BURNS, LACERA-
TIONS (cuts) that result in external bleeding, BLUNT
TRAUMA that results in internal bleeding, and fractures
(broken bones). Many such injuries are mild
to moderate in severity; mild burns and lacerations
often require only self-care. Fractures and
moderate injuries may need medical attention to
assess their severity, especially burns and lacerations
that may extend deep into the tissues.
Burns and bleeding have the highest risk for
being life threatening. Traumatic injury to the
chest can result in the loss of 25 percent of the
body’s BLOOD supply within minutes. A second- or
third-degree burn that covers 36 percent of the
body’s surface results in extensive fluid and heat
loss. Both circumstances cause rapid SHOCK.
Though fractures are not as likely to be life threatening,
an open FRACTURE exposes body tissues to
high risk for INFECTION. As well, the BONE ends may
sever blood vessels, resulting in hemorrhage.
These types of injuries present the highest risk
of bloodborne infection, such as HEPATITIS and
HIV/AIDS, for first responders. Latex or latex-type
gloves are essential; the responder should be
wearing them before touching the injured person.
There is also the risk for injury to the responder,
such as in a fire or explosion or when injuries
result from VIOLENCE.
BLOOD vessels. Small abrasions are more nuisance
than health problem. Large, deep abrasions may
leave scars after they heal though most abrasions
do not damage the dermis, the innermost layer of
skin. Most abrasions require only minor first aid
and heal uneventfully within two weeks.
These are the recommended steps for treating
abrasions:
• Gently but thoroughly flush all dirt and debris
from the abrasion with normal saline or a
wound cleansing solution. Do not use soap and
water or hydrogen peroxide; these formerly
popular approaches delay scab formation and
HEALING.
• Apply a topical antibiotic ointment and cover
the abrasion completely with a bandage.
• Change the bandage daily or when it gets wet,
applying fresh antibiotic ointment with each
bandage change.
• Keep antibiotic ointment and a bandage on the
abrasion until it heals, typically 7 to 10 days.
A health-care provider should assess and
débride (clear away debris and damaged tissue)
large abrasions to minimize the risk of scarring
and INFECTION.
SCAR.
See also ANTIBIOTIC
MEDICATIONS; LACERATIONS;
abrasions Scrape wounds that remove the outer
layers of SKIN to expose the dermis and sometimes
the subcutaneous layer beneath. Abrasions are
common sports- and activity-related injuries
resulting from falling or sliding on hard surfaces
such as sidewalks, pavement, artificial turf, and
hard-packed dirt.
Abrasions often look raw and may bleed; they
usually hurt because they expose nerves and
361
avulsion An injury of force that tears away a
body structure such as a TOOTH, segment of finger or
toe, piece of tissue, or fragment of BONE. A major
avulsion may involve a limb. Avulsion may be,
though is not always, a type of TRAUMATIC AMPUTA-
TION. Surgeons can replant some avulsed structures,
such as teeth and bone fragments. The force
that creates the separation often causes significant
and irreparable damage to the tissues, however.