By John McElligott, MD and Donna Kennedy, PhD, MS
Wounds? I know a bit about them. Wounds and caring for them in the field launched my medical career. I was a corpsman attached to the U.S. Marine Corps Fleet Marine Force 1965-1968. In Vietnam, I treated wounds 24/7 and even tended my own.
Those were the best days and the worst days of my life. My motto was “nobody bleeds to death in my chopper.”
But I’m not going to tell you how to bind and cover sucking chest wounds in this column. Instead, I’m going to give you some basic instruction on wound care in the cab of your truck and when you should abandon that plan and get yourself to a medical clinic.
Truck driving is a job that exposes you every single day to cuts, scrapes, punctures and more.
Proper wound care is necessary to prevent infection, to ensure there are no other associated injuries, and to promote healing of the skin.
Wound care in your truck
Most wounds can be cared for on the road or at home. Superficial abrasions and lacerations can be cleaned, an antibacterial ointment applied, and then covered with a Band-Aid or light bandage.
Bleeding can often be controlled with direct pressure to the wound. If possible, elevate the bleeding site above the level of the heart. This allows gravity to help decrease blood flow to the injury. Most bleeding will stop within 10 minutes, at which point a dressing can be placed over the wound.
If bleeding is not a problem, the wound can be cleaned using tap water to wash out any debris to decrease the risk of infection. Keep in mind that even if it looks clear, river and lake water can contain many types of bacteria that can cause significant infection.
Deeper wounds are painful, and scrubbing can aggravate them.
When you are evaluating how bad the wound is, steps can be taken right away to clean and dress it. Serious injuries, of course, can be an exception. So let’s talk about that a minute.
When to seek medical care for a wound
Most wounds can be treated at home or in your truck with routine first aid, including thorough washing and dressing to prevent infection, but sometimes that is not enough.
Here are some reasons medical care should be obtained for a wound:
- If the wound is due to significant force or trauma and you have other injuries as well.
- If bleeding cannot be stopped even with persistent pressure and elevation.
- If there is concern that the wound requires repair with sutures (stitches). The size and location of the wound are important considerations. Most facial wounds may need to be repaired for cosmetic reasons, especially if they involve the lip or eye.
- If the wound is caused by an animal bite. At least 50 percent of dog bites, 80 percent of cat bites, and a large percentage of human bites become infected. Rabies immunizations may need to be considered.
- If the wound is very dirty and cannot be easily cleaned.
- If there is evidence of infection including redness, swelling, increased pain, and pus at the wound.
Have you had a tetanus shot in the past 10 years? If tetanus immunizations are not up to date, then a booster is needed within 48 hours. If you have never been immunized, you should get the initial tetanus prevention with immunoglobulin immediately. LL