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Oct 20, 2019 Dr Zulfikar Bux, Features / Columnists
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
We have all had our share of bruises and cuts that occur when we get injured. Bruises occur when a blow breaks blood vessels near your skin’s surface, allowing a small amount of blood to leak into the tissues under your skin. It can also cause a breach in your skin surface. Cuts occur when you get trauma from sharp objects that lead to a breach on your skin and sometimes your tissues. Cuts bleed more and can go deeper into your tissues. Often, they are both treated at home but some do need medical care to prevent complications that become life threatening if left unattended. Today we will discuss the basics of managing cuts and bruises.
What should you do if you have a cut or a bruise?
You should:
• Stop any bleeding before applying a dressing to the wound. Apply pressure to the area using a clean and dry absorbent material – such as a bandage or a towel – for several minutes.
• If the cut is to your hand or arm, raise it above your head to help reduce the flow of blood.
• If the injury is to a lower limb, lie down and raise the affected area above the level of your heart.
• Clean the wound and apply a dressing
• When the wound has stopped bleeding, clean it and cover it with a dressing to help stop it becoming infected.
• Take over the counter painkillers if needed
When should you seek medical help?
Visit your doctor or a medical facility if there’s a risk your wound could become infected, or you think it’s already infected.
A wound is at risk of infection if:
• it’s been contaminated with dirt, pus or other bodily fluids
• there was something in the wound before it was cleaned, such as gravel or a shard of glass
• it has a jagged edge
• it’s longer than 5cm
• it was caused by an animal or human bite
If you have a medical condition that weakens your body’s defense such as diabetes, HIV, Cancer etc., then you are at higher risk of developing infections from cuts and bruises.
What are signs of an infected wound?
The following are signs of an infected wound:
• swelling, redness and increasing pain in the affected area
• pus forming in or around the wound
• feeling generally unwell
• a high temperature (fever) of 38C or above
• swollen glands under your chin or in your neck, armpits or groin
An infected wound can usually be successfully treated with a short course of antibiotics.
When should you go to the Emergency Department?
Go to your nearest emergency department as soon as possible if:
• you can’t stop the bleeding
• you’re bleeding from an artery – blood from an artery comes out in spurts with each beat of the heart, and is bright red and usually hard to control
• you experience persistent or significant loss of sensation near the wound or you’re having trouble moving any body parts
• you have a severe cut to your face – you may need urgent treatment to prevent scarring
• you have a cut on the palm of your hand and it looks infected – these types of infection can spread quickly
• there’s a possibility a foreign body is still inside the wound
• the wound is very large or the injury has caused a lot of tissue damage
At the emergency department, your wound will be examined to determine whether there’s a risk of infection. You may need an injection to prevent tetanus (a bacterial infection), and your wound may be closed with stitches, strips or special glue before a dressing is applied. If there’s a risk of infection, the wound won’t usually be closed because this may trap any infection inside. Instead, it will be packed with a non-sticky dressing before being covered with a protective dressing until it’s safe to close.
As you can see, not all cuts and bruises can be treated at home. There are complications associated with some of them that should be treated by a medical professional before they become dangerous to you.
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