b. General Evaluation. Make a general evaluation of the patient. Take care of
him as a whole. Examine the patient from head to toe, checking for associated injuries.
Follow these guidelines:
Check his entire body for injuries.
Ensure the airway is secure, spinal injuries are immobilized, etc.
(3) If there is an injury in an extremity, check the distal pulse and sensation
in that extremity.
Obtain a history of how the wound occurred.
(5) Find out what medications the patient is taking: steroids,
chemotherapeutic agents, anticoagulants, anti-inflammatories.
(6) Ask if the patient has any illness or chronic diseases such as diabetes,
cancer, peripheral vascular disease (PVD), or anemia. (Wound healing may be difficult
for a patient with a chronic disease or illness.)
Ask if he has a current tetanus immunization.
Find out if the patient has any allergies.
c. General Wound Care (Not Life- or Limb-Threatening). Follow this
procedure to care for general wounds. Begin by removing foreign bodies, then cover
the wound with a sterile dressing. This is enough if immediate evacuation is possible. If
evacuation is delayed, follow the procedure given below.
(1) Cover the wound and clean the surrounding area with povidone-iodine
(2) Uncover the wound and irrigate it with a diluted solution: for example,
(3) Using sterile gloves and a gauze sponge, lightly scrub the exposed
tissues. Using instruments, remove all dead tissue and any foreign matter (mechanical
debridement) still in the wound.
Irrigate the wound with a large amount of povidone-iodine solution
Change gloves and blot the area dry with a sterile dressing.
Cover the exposed tissue with full strength povidone-iodine solution.