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General Wound Management

General Wound Management. Union Hospital Emergency Department. Specific Surface Trauma Emergencies. Assess-subjective- history, immunizations, medications, mechanism of injury Assess-objective – physical exam, inspection. Psychological . Social Environmental factors Exposure Socioeconomic

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General Wound Management

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  1. General Wound Management Union Hospital Emergency Department

  2. Specific Surface Trauma Emergencies Assess-subjective- history, immunizations, medications, mechanism of injury Assess-objective – physical exam, inspection

  3. Psychological Social Environmental factors Exposure Socioeconomic Pathophysiological disorders affecting healing Diabetes Steroids Immunocompromise Frequent Infections Poor Nutrition Medications

  4. Diagnostic Tests CBC Wound Culture and Sensitivity If bleeding profusely – PT PTT X-ray

  5. Equipment Wound prep tray Steri strips Dermabond Disposable suture trays Plastics Set Suture/Staple remover Dressing Ring Cutter Hexaclens Sterile Saline Sterile Water

  6. Policies See policy on wound infiltration

  7. Cleansing and Irrigation Policy: Nursing staff will perform wound cleansing/irrigation in the emergency department utilizing best practice guidelines Purpose: To provide standardized guidelines for local wound care to help optimize the healing environment and decrease the potential for infection

  8. Procedure: The wound shall be inspected by the physician and appropriate anesthetic shall be ordered. Wound cleansing and irrigation are a part of the orientation checklist for ED nursing staff After local anesthetic infiltration wound management/care shall be done

  9. General Information • Irrigation: Is fundamental to good wound care and should be performed on all patients requiring wound closure • 0.9% NS removes foreign bodies and dilutes bacteria thus reducing risk of wound infection. • High velocity stream of NS is obtained by using a 20 cc syringe with an 18-20 gauge angiocath. • The following formula can be utilized to calculate the amount of fluid for irrigation • 100 ml X inches in length X hours since injury = volume to irrigate • Example: 100 ml X 2 inches X 2 hours since injury = 400 ml Saline

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