Wound Cleaning (HB)

Wound Cleaning (HB)

Wound cleaning is one of the extended transport protocols. It can make the difference in a wound that is manageable in the field and one that needs an emergency evacuation.

We do not perform wound cleaning on any wound that we have controlled a massive hemorrhage on (with a tourniquet or wound packing). If you have downgraded a tourniquet to a pressure dressing (you just used the tourniquet to “buy time”), and you are confident that the bleed is controlled and not serious, you can clean the wound. You may need to consider cleaning the wound anyway if you will be stuck with the patient for an extended period of time.

Wound cleaning is pretty simple—you just need a few basic tools and plenty of clean water.

You should also take precautions to protect yourself from the fluids—water and wound stuff will be spraying about if you do this right. You should wear gloves and some kind of eye protection at the very least.

Tools needed:

  • Irrigation syringe (60ccs is best so you don’t have to refill it often) with an irrigation tip or cannula.
  • Tweezers.
  • Forceps.
  • Toothbrush.
  • Magnifying glass (can help to see small bits of debris).
  • Copious amounts of clean water (does not need to be sterile or saline, etc.).
  • Headlamp, on your head and turned on before you start.

Steps:

  1. Clean the area around the wound. Cleaning helps prevent recontamination of the wound.
  2. Remove Impalements and any large debris from the wound.
  3. Flush the wound with high-pressure water. The pressure from the irrigation tip or cannula is the right amount. Punching holes in the top of a water bottle will not generate enough pressure.
  4. Pick out any debris you find. You can use the forceps to hold the wound open.
  5. You can use the toothbrush to gently loosen debris in the wound.
  6. Continue flushing the wound and removing debris until it is clean.
  7. Dress and bandage the wound.

Cleaning the wound will take a lot of water and be somewhat messy. You should plan for this and have a way to catch all of the wastewater that comes from the process. The plan might be to let it soak into the ground. But if you are in a tent or something, you may want to try and catch the fluids and debris in a trash bag or something. This fluid can also be used as the base for a soup; however, it is not vegan friendly.