Luka Terbuka

Setelah sebelumnya kita membahas tentang pengertian Cedera Jaringan Lunak pada Pertolongan Pertama yang dibagi menjadi 2 (dua) kategori yaitu Luka Terbuka dan Luka Tertutup, maka kali ini saya akan berbagi lagi dengan teman-teman tentang jenis-jenis luka terbuka.

Untuk teman-teman ketahui, ada 7 jenis luka yang digolongkan ke dalam luka terbuka yaitu:

1. Luka Lecet2. Luka Sayat/Iris3. Luka Robek4. Luka Tusuk5. Avulsi / Sobek6. Amputasi 7. Cedera Remuk (Crush Injury)

Kali ini, saya akan jelaskan 3 jenis luka terbuka yaitu luka lecet, sayat/iris dan robek.

1. Luka Lecet.Tentunya hampir setiap manusia pernah mengalami luka lecet ini, bisa karena terjatuh atau penyebab lainnya. Secara umum luka lecet ini terjadi karena adanya gesekan antara permukaan kulit dengan sesuatu yang mengakibatkan permukaan kulit terkelupas dan tampak titik-titik perdarahan.

Luka ini terjadi hanya dipermukaan kulit namun menimbulkan rasa nyeri bagi korbannya, hal ini akibat ujung-ujung syaraf juga mengalami cedera dan  biasanya bentuk dari luka lecet tidak beraturan. 

Untuk jelasnya mari kita lihat gambar luka lecet berikut:

Gambar Luka Lecet

2. Luka Sayat/Iris.Jenis luka terbuka yang satu ini sering terjadi karena adanya kontak dengan benda tajam seperti pisau dan lain sebagainya namun berbeda dengan luka tusuk.Biasanya pada luka sayat/iris, permukaan kulit dan lapisan di bawahnya akan terputus sampai kedalaman yang bervariasi namun tepi luka teratur. Sebagai salah satu contoh adalah ketika seorang korban yang sedang mengiris bawang dan tiba-tiba salah satu jarinya ikut teriris...hehe.

Berikut gambar luka sayat/iris tersebut:

Gambar Luka Sayat/Iris

3. Luka Robek.Umumnya luka robek ini terjadi karena adanya benturan dengan benda keras yang tumpul. Karakteristik luka robek hampir sama dengan luka sayat namun ketidak teraturan tepi luka yang menjadi pembeda keduanya.

Kondisi yang tidak teratur ini menyebabkan sulitnya penolong untuk menilai kedalaman luka termasuk juga untuk menilai kerusakan bagian dalam. Perdarahan pada luka ini sangat sulit untuk diatasi dan dikendalikan apalagi jika mengenai pembuluh darah yang besar, kalau pun bisa dikendalikan hanya setengahnya saja. Untuk jelasnya lihat gambar luka robek berikut:

Gambar Luka Robek

4. Luka TusukLuka ini biasanya terjadi karena masuknya benda tajam dan runcing melalui kulit ke dalam tubuh dengan ciri khasnya luka relatif lebih dalam dibandingkan dengan lebarnya dan bentuk luka hampir menyerupai benda

yang menusuk. Luka tusuk sangat berbahaya karena dapat melibatkan alat dalam tubuh.

Gambar Luka Tusuk Kesulitan akan ditemui dalam penanganan luka jika benda yang menusuk masih tertancap. Perlu juga untuk dicari apakah luka tusuk ini menimbulkan luka tembus yaitu ada luka masuk dan luka keluar, karena biasanya luka keluar lebih parah daripada luka masuk. Contoh kasus dapat kita lihat pada kasus seseorang yang tertembak, luka masuknya hanya sebesar peluru namun luka keluarnya sangat besar.  Berat ringannya luka tusuk yang terjadi tergantung dari lokasi luka, panjangnya benda yang masuk dan besarnya gaya yang dialami.5. Avulsi / SobekLuka ini terjadi akibat terkelupasnya kulit dan sedikit lapisan dibawahnya, bisa saja kulit dan lapisan dibawahnya itu masih menempel atau sudah hilang sama sekali. Bila masih menempel, maka itu disebut dengan flap atau lembaran gantung. Ujung hidung yang terkelupas disebut Avulsi.

6. AmputasiLuka ini terjadi akibat terpisahnya jaringan tubuh korban, paling sering terjadi pada alat gerak mulai dari jari sampai hilangnya seluruh alat gerak. Pada ujung luka mungkin terlihat lembaran kulit dan ujung tulang.

Gambar Luka AmputasiPerdarahan yang terjadi pada luka ini sangat hebat atau bisa juga sebaliknya karena pembuluh darah dapat menutup sendiri untuk membatasi keluarnya darah.

7. Cedera Remuk / Crush Injury

Luka jenis ini adalah gabungan antara luka terbuka dan luka tertutup, yang terjadi karena terjepitnya alat gerak korban dengan alat-alat berat. Hampir seluruh jaringan lunak dan jaringan keras seperti tulang dapat terlibat, tulang dapat patah dan pecahannya atau patahannya dapat menembus sampai keluar. Hal ini akan menimbulkan pembengkakan dan Perdarahan, baik Perdarahan Luar maupun Perdarahan Dalam.

Luka ini sangat bervariasi sekali bentuknya dan perlu untuk segera diberikan Pertolongan Pertama pada korban mengingat perdarahan yang terjadi sangat kuat.

http://rahmatalmalik.blogspot.com/2013/03/luka-terbuka.html

OPEN WOUND

Definition

A wound is an injury that causes either an internal or external break in body tissue. An open wound (as in a knife cut) is a break in the skin or mucous membrane.

Description

The most common accidents resulting in open wounds are falls, mishandling of sharp objects, accidents with tools or machinery, and car accidents.

A closed wound (a contusion or internal bleeding) is a bruise that damages the underlying tissue without breaking the skin (as in a black eye).

There are at least five different types of open wounds:

Abrasions

An abrasion is a skin wound caused by rubbing or scraping the skin against a hard, rough surface. Bleeding in this type of wound is usually limited, but it is important that the skin be cleaned in order to guard against infection.

Incisions

An incision is a cut caused by a knife, the rough edge of metal, broken glass, a razor blade or some other sharp object. This type of wound generally bleeds rapidly and heavily. If the cut is deep, muscles, tendons and nerves may be damaged.

Lacerations

A laceration is a jagged, irregular or blunt breaking or tearing of soft tissues, often resulting from mishandling tools and machinery and other accidents. Bleeding from a laceration may be rapid and extensive.

Punctures

A puncture is a piercing wound that causes a small hole in the tissues. Such objects as nails, needles, ice picks and other pointed objects can produce puncture wounds. Even if external bleeding is slight, there may be serious internal bleeding resulting from internal damage to an organ (as in a gunshot wound). All puncture wounds require the attention of a health professional because of the danger of tetanus.

Avulsions

An avulsion is a forcible tearing or partial tearing away of tissues. It occurs in such accidents as gunshot wounds, explosions, animal bites or other body-crushing injuries. Bleeding is heavy and rapid.

If a body part (a finger, tooth or toe, for example) has been torn away in an accident, it should always be sent along with the victim to the hospital (placed on moistened gauze and cooled), since there is a possibility that it can be reattached.

Treatment

First Aid

When a cut is located on a certain part of the body, such as the lips or eyelids, or a part of the body that bends and puts stress on the cut, a physician may need to place stitches or sutures to close the wound. In general, sutures are used to hold the two edges of a wound together so that healing can occur with a minimum of scarring. Also, they might be required if the wound is deep and tends to gape widely, or if the bleeding cannot be controlled after 20 minutes of direct pressure.

The physician will often inject some local anesthetic (numbing medicine) to the area around the wound so that suturing will be less painful. Generally, if a cut is less than one half an inch long, not deep, or the edges of the skin tend to fall together, then sutures may not be needed.

Some physicians may use a skin glue (DermaBond) to close small wounds, especially in children.

Puncture wounds that stop bleeding rapidly present special problems. Such wounds can become infected easily and may harbor tetanus bacteria (lockjaw).

Infection

After an injury that causes a break in the skin or after an operation, various wound infections may occur. The wound may be red, tender, painful or produce pus.

One type of infection is cellulitis (inflammation of the skin caused by bacteria). Another is gangrene, which can result in death or decay of tissues.

Necrotizing subcutaneous infection is a severe infection caused by bacteria that infect the tissue through wounds. The primary symptoms are swelling, discoloration and death of the surrounding tissue. The skin around the wound becomes hot, inflamed, tender and red. If the infection worsens, the skin may become discolored and gangrene may develop.

"Gas gangrene" results when a wound becomes infected by certain bacteria, usually Clostridium. This infection causes sudden pain and swelling around the wound, moderate increase in temperature, decrease in blood pressure and rapid heartbeat. Skin around the wound becomes pale, due to fluid that builds under it and a watery, foul-smelling, brownish-red fluid may be released. The tissue changes from pale to dusky to highly discolored as the infection worsens. Treatment consists of penicillin given intravenously. Surgical removal of infected tissue is essential, and removal of surrounding tissue is usually necessary.

As with any wound, it is important to have a physician inspect the wound and help decide if sutures, antibiotics, tetanus therapy or other treatment is necessary.

Questions

What should the wound be cleaned with and should the cleansing process be repeated?

Are sutures necessary?

Should an antibacterial ointment be applied on the wound?

Will you be prescribing any antibiotics? What are the side effects?

Do I need a tetanus shot?

Should the wound be covered or left open?

How long will the wound take to heal?

Are there any signs or symptoms that should be watched for and reported to the doctor?

Self-Care

Allow the wound to bleed freely and clean itself out, unless there has been a large loss of blood or the blood is squirting out, in which case you need to apply pressure to stop the bleeding.

Cleanse the wound with soap and water (or hydrogen peroxide) as throughly as possible. You should also try to remove all particles or debris to prevent infection or scarring before applying a sterile dressing. Minor cuts, however, often heal more quickly if left uncovered.

http://www.healthcentral.com/encyclopedia/408/66.html

Wounds and bleeding

Any break in the surface of the skin (wound), will not only allow blood and other fluids to be lost, but allow germs to enter the body. If the wound is minor, the aim of the first aider is to prevent infection. Severe wounds may be very daunting to deal with but the aim is to prevent further blood loss and minimise the shock that could result from the bleeding.

Some closed wounds such as bruising could indicate an underlying injury and first aiders need to be aware of the cause of injury as this may alert you to a more serious condition, such as internal bleeding.

Any open wound is at risk of becoming infected, it is important to maintain good hygiene procedures to guard against prevent cross infection between yourself and the casualty.

http://www.sja.org.uk/sja/first-aid-advice/wounds-and-bleeding.aspx

Bleeding

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Summary

Bleeding is the loss of blood. The loss can range from minor bleeding (small cuts and abrasions, nosebleeds) through to severe external or internal bleeding. First aid for severe external bleeding includes applying direct pressure on the wound in the form of pads secured with bandages and raising the injured limb above the level of the heart if possible.

Bleeding is the loss of blood from the circulatory system. Causes can include small cuts and abrasions as well as deep cuts and amputations. Injuries to the body can also result in internal bleeding, which can range from minor (such as that caused by superficial bruising) to massive

(life threatening bleeds).

First aid for severe external or internal bleeding is critical in order to limit the loss of blood until emergency medical aid arrives. First aid actions to manage external bleeding include applying direct pressure to the wound, using pads and bandages, and raising the injured limb above the level of the heart if possible.

Minor bleeding

Small cuts and abrasions that are not bleeding excessively can be managed at home. First aid suggestions include:

Clean the injured area with sterile gauze soaked in normal saline or clean water. Do not use cotton wool or any material that will fray or leave fluff in the wound.

Apply an appropriate dressing such as a bandaid or a non-adhesive dressing held in place with a non-allergenic tape. This dressing must be changed regularly.

See your doctor if you can’t remove the dirt yourself. A dirty wound carries a high risk of infection.

If you have not had a booster vaccine against tetanus in the last five years, see your doctor.

Nosebleeds

Bleeding from the nose is usually not severe. First aid suggestions include:

Sit the person upright and ask them to tilt their head forward. Using the thumb and forefinger, squeeze the nostrils shut. Hold for at least 10 minutes. Release the hold gently and check for bleeding. If the bleeding has stopped, avoid blowing your

nose or picking at it for the rest of the day. If bleeding continues beyond 20 minutes, see your doctor.

Severe external bleeding

Even a small cut can result in severe external bleeding, depending on where it is on the body. This can lead to shock. In medical terms, shock means the injured person no longer has enough blood circulating around their body. Shock is a life-threatening medical emergency.

First aid management for severe external bleeding includes:

Check for danger before approaching the injured person. If possible, send someone else to call triple zero (000) for an ambulance. Lie the person down. If a limb is injured, raise the injured area above the level of the person’s

heart (if possible).

Get the person to apply direct pressure to the wound with their hand or hands to stem the blood flow. If the person can’t do it, apply direct pressure yourself.

You may need to pull the edges of the wound together before applying a dressing or pad. Secure it firmly with a bandage.

If an object is embedded in the wound, do not remove it. Apply pressure around the object. Do not apply a tourniquet. If blood saturates the initial dressing, do not remove it. Add fresh padding over the top and

secure with a bandage.

Internal bleeding – visible

The most common type of visible internal bleed is a bruise, when blood from damaged blood vessels leaks into the surrounding skin. Some types of internal injury can cause visible bleeding from an orifice (body opening). For example:

Bowel injury – bleeding from the anus Head injury – bleeding from the ears or nose Lung injury – coughing up frothy, bloodied sputum (spit) Urinary tract injury – blood in the urine.

Internal bleeding – not visible

It is important to remember that an injured person may be bleeding internally even if you can’t see any blood. An internal injury can sometimes cause bleeding that remains contained within the body; for example, within the skull or abdominal cavity.

Listen carefully to what the person tells you about their injury – where they felt the impact, for example. They may display the signs and symptoms of shock. In the case of a head injury, they may display the signs and symptoms of concussion. Therefore, it is important to ask the right questions to collect the relevant information.

Symptoms of concealed internal bleeding

The signs and symptoms that suggest concealed internal bleeding depend on where the bleeding is inside the body, but may include:

Pain at the injured site Swollen, tight abdomen Nausea and vomiting Pale, clammy, sweaty skin Breathlessness Extreme thirst Unconsciousness.

Some signs and symptoms specific to concussion (caused by trauma to the head):

Headache or dizziness Loss of memory, particularly of the event Confusion Altered state of consciousness Wounds on the head (face and scalp) Nausea and vomiting.

Internal bleeding is a medical emergency

First aid cannot manage or treat any kind of internal bleeding. Prompt medical help is vital. Suggestions include:

Check for danger before approaching the person. If possible, send someone else to call triple zero (000) for an ambulance. Check that the person is conscious. Lie the person down. Cover them with a blanket or something to keep them warm. If possible, raise the person’s legs above the level of their heart. Don’t give the person anything to eat or drink. Offer reassurance. Manage any other injuries, if possible. If the person becomes unconscious, place them on their side. Check breathing frequently. Begin

cardiopulmonary resuscitation (CPR) if necessary.

Spread of disease through bleeding

Some diseases can be spread through open wounds.

If possible, wash your hands with soap and water before and especially after administering first aid. Dry your hands thoroughly before putting on gloves

First aid kits contain gloves. Always put on gloves beforehand if available. If not, improvise. Do not cough or sneeze over the wound.

Where to get help

In an emergency, call triple zero (000) Emergency department of the nearest hospital Your doctor For first aid training, St John Ambulance Australia (Victoria) Tel. 1300 360 455 For first aid training, Australian Red Cross Tel. 1300 367 428

Things to remember

Always call triple zero (000) in an emergency.

First aid for severe external bleeding includes direct pressure on the wound, using pads and bandages, and raising the injured area above the level of the heart if possible.

First aid for internal bleeding includes lying the person down, raising their legs above the level of their heart and not giving them anything to eat or drink.