ABSCESS PREVENTION & MANAGEMENT

1. ABSCESS PREVENTION & MANAGEMENT

2. At the end of this session, the trainee will have learnt: • Definition of abscess • How abscesses are formed • Various stages of abscess development (Signs and symptoms of abscesses) • Basic Care and Management for abscess. • Basic preventive measures of abscess OBJECTIVES

3. A collection of pus anywhere in the body e.g. under the skin • May progress to being an open wound. In this case it is scientifically called as an ulcer WHAT IS AN ABSCESS?

4. May result from injecting non soluble substances, such as SP, which can remain trapped under the skin • May result from bacteria contaminating the site of an injection • May result from dead (necrotic) tissue at the site of an injection HOW DO ABSCESSES FORM?

5. STAGES OF ABSCESS DEVELOPMENT 1. May start off as a hard lump at an injection site

6. 2. Localized skin redness appears STAGES OF ABSCESS DEVELOPMENT

7. 3. Soft swelling appears Stages of Abscess Development

8. STAGES OF ABSCESS DEVELOPMENT 4. The area becomes tender

9. 5. A fever may or may not develop STAGES OF ABSCESS DEVELOPMENT

10. STAGES OF ABSCESS DEVELOPMENT 6. The abscess may go on to increase in size and discharge pus

11. 7. Abscess may progress to an open wound called an ulcer STAGES OF ABSCESS DEVELOPMENT

12. CARING FOR ABSCESS

13. To prevent increase in size and other complications through provision of early treatment • To heal the abscess as quickly as possible • To provide appropriate pain relief • To refer complicated cases for appropriate medical treatment AIMS OF ABSCESS CARE

15. Encourage injecting into sites far from the abscess area (at least 12 inches away from the abscess site) till the abscess is healed There may be need to cover the abscess area with a clean dressing to prevent it from being knocked If the abscess is discharging pus or other fluid it will require a daily dressing: Clean the area with water or saline and apply a clean gauze dressing CARING FOR ABSCESSES

16. Encourage early reporting of complications, such as increase in abscess size, black tissue around the area (necrosis,) or increase in pain Sometimes, the patient may have to be referred to a bigger hospital for management of complicated cases CARING FOR ABSCESSES (CONT’D)

17. Pain • Chronic, non healing ulcer • Tissue death (necrosis), or gangrene (may lead to amputation of the limb itself) • Spread of infection through the blood stream leading to infection of the heart valves, bone infection and other abscesses ABSCESS COMPLICATIONS

18. PREVENTION OF ABSCESS

19. Educate clients on safe injecting methods: • Always inject in veins and avoid arteries • Differentiation between arteries and veins • Rotation of injecting sites • How to inject safely • Sites where NOT to inject • Outreach staff should distribute alcohol (spirit) / betadine / savlon swabs along with needle / syringe to every injecting client PREVENTION OF ABSCESS CONTD..

20. Before injecting, clean the site with alcohol swab (with soap & water if swab not available) • Inject with the vein clearly visible (make the vein prominent with a tourniquet or with other hand) • Use clean equipment (Needle/syringe and other injecting paraphernalia) • Inject at a 45 degree angle with the bewelled edge pointing upwards • Use a small gauge needle to avoid puncturing the veins PROPER TECHNIQUE OF INJECTING

21. Never inject into an artery • If you hit an artery: • There will be excruciating pain in the area • Bleeding may not stop • You may need to see a doctor DIFFERENCE BETWEEN VEIN & ARTERY

22. These include • Groin • Heart • Neck • Forehead • Part of hand below wrist • Part of legs below the ankle SITES TO AVOID DURING INJECTING

23. RISK OF INJECTING LEVELS IN THE BODY

24. Abscesses are formed due to a variety of reasons • NSEP is an effective means of preventing Abscess • Clients should be taught to inject safely and to take care of their veins • Abscess once formed lead to a number of complications CONCLUSIONS