Leaving the ER? Keep Your Wound Clean

Each year, more than 130 million Americans visit emergency rooms at hospitals around the country. Often these visits involve injuries with open wounds. 

These include lacerations (cuts), abrasions, burns and avulsions — traumatic injuries that involve severe tearing of skin and tissue. These wounds can be caused by any number of mishaps, including falls, mishandling sharp objects, dog bites and car accidents. 

Wounds Worth an ER Visit

Some wounds can be treated at home with a basic first aid kit, but you should head to the ER if you experience any of the following: 

●      Severe bleeding

●      Bleeding that lasts longer than 10 minutes after applying pressure

●      Any animal bite that punctures the skin

●      A cut or puncture more than a quarter-inch deep

●      Loss of mobility due to the injury

●      Skin puncture from a dirty or rusty object

●      Facial wound

●      A wound with jagged edges or edges that are far apart and will not be able to close on its own 

If you have diabetes or another chronic health condition, you may be more vulnerable to infection, so you should go to the ER right away.

Triage in the ER

Once you arrive at the ER, you will enter triage. This is where the team assesses your injury and asks questions about your medical history.

Different injuries require different types of interventions. The team will find the best way to treat the wound and reduce scarring. Depending on the severity and location of the wound, you may need to be transferred to the operating room for surgery or admitted to the hospital for intravenous fluids and antibiotics. 

If your wound can be treated in the ER, doctors and nurses will do everything they can to minimize your pain, prevent infection and restore normal function of the injured body part. They might: 

Numb the area. Topical and injectable anesthetics are commonly used to numb the area around the wound and reduce pain during treatment. A nerve block or sedation may be used in cases of intense pain. 

Clean the wound. One of the most important parts of treating a wound is cleansing and removing dirt and debris. The team may use alcohol, iodine or saline to wash and sterilize the wound. 

Wound repair. Depending on the location and type of injury, your wound may be closed with skin glue, staples, Steri-Strips (butterfly stitches) or sutures (stitches). 

Dressing. There are many ways to bandage a wound. Simple injuries may be left uncovered to help them dry and heal. Others need to be kept moist and covered for several days to promote healing. 

Antibiotics. You may be prescribed topical or oral antibiotics if your wound is at high risk of becoming infected. This is more likely if it’s a puncture wound or if you have a history of MRSA infection. 

Tetanus shot. If you have an animal bite, puncture wound or a burn that damages a lot of tissue, you may need a tetanus booster.

You’re Leaving the ER. Now What? 

Before you leave the ER, your doctor will give you verbal and written instructions on how to care for your wound at home and what to watch for regarding infection. The instructions will include: 

●      How to keep your wound covered

●      How often to change the bandage

●      How to clean your wound

●      How to use topical antibiotics

●      When to get sutures/staples removed, if needed 

Depending on the type and severity of the wound, you may also be given other guidelines, including: 

●      No swimming or bathing for 24 hours.

●      Keep the wound clean and dry for five days.

●      Do not go into a lake, river or ocean for at least two to three days due to the risk of bacteria entering the wound.

●      Take the full course of antibiotics as directed.

●      Take over-the-counter pain relief medication or prescribed pain medication. 

Follow these instructions carefully to reduce the risk of infection, minimize scarring and promote healing. The ER doctor may also recommend following up with your primary care physician or a wound specialist.

See These Signs? See the Doctor

Your wound should heal over time. If it begins to feel or look worse, it’s important to see your doctor since infection can lead to serious complications. Signs to watch for include: 

●      Redness or swelling around the wound

●      Heat around the injury

●      Red streaks in the area around the wound

●      Oozing yellow or green pus — clear fluid is normal

●      Fever and/or body aches 

Watch your wound closely and see your doctor if you are not getting better as expected.