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First aid attendants play a crucial role in workplace safety, and one of their key responsibilities involves the assessment and treatment of wounds. This article provides a comprehensive guide to wound assessment and treatment, drawing from the WorkSafeBC Basic First Aid Participant Guide.
Initial Steps: Safety First
Before approaching a worker with a wound, it’s important to conduct a scene assessment to ensure there is no further danger to yourself or other workers. You should also use appropriate personal protective equipment (PPE), such as gloves, to prevent the transmission of infection.
Modified Primary Survey
For a worker who walks into the first aid area, a modified primary survey can be conducted. This involves:
- Airway Assessment: Is the worker talking in a clear voice?
- Breathing Assessment: Is the worker talking normally?
- Circulatory Assessment: Look to see if the skin color is normal. Conduct a rapid body survey and ask if the worker hurts anywhere else.
Detailed Wound Examination
After a modified primary survey, the wound itself needs a detailed examination:
- Expose the wound by removing clothing and other obstructions to the area of injury.
- Look at the entire area for wounds, discoloration, swelling, or deformities.
- Feel the entire area to determine the extent of the injury.
- Examine the wound for extent of damage, contamination, or foreign material.
Wound Cleansing
After examining the wound, you should cleanse it:
- Flush the wound with clean tap water or sterile saline for a prolonged period.
- Dry around the wound with sterile gauze.
Wound Dressing and Bandaging
Once the wound is cleaned, you can dress and bandage the wound. Here are some general steps:
- Apply skin closures if the wound is slightly open.
- Cover the wound with sterile gauze.
- Add extra layers of gauze or an absorbent dressing.
- Use a crepe roller bandage or roller gauze, if available, to secure the dressing.
Follow-Up Care
If a worker is treated and returned to work, the attendant should provide a patient handout and discuss its content with the worker. Follow-up care includes:
- Discussing wound care and follow-up treatment with the worker.
- Advising the worker to keep the bandage clean and dry, and to report back to first aid if it becomes wet, dirty, or starts to come off.
- Instructing the worker to return for follow-up care in 24 hours or at the start of their next shift.
- Completing the first aid record.
Wounds Requiring Medical Referral
Not all wounds can be treated by a first aid attendant. Some wounds will need to be referred to medical aid. These include:
- Wounds longer than 3 cm through the full skin thickness
- Wounds to hands in areas of joints or tendons
- Wounds that require sutures, such as those with jagged edges, a flap of full-thickness skin, those that are gaping or difficult to close, areas where skin is under pressure, and facial wounds
- Significant partial thickness (second-degree) burns
- Any full thickness (third-degree) burns
- Chemical or electrical burns
- Wounds that are very dirty, including human or animal bites
- Wounds with embedded materials
- Any sign of infection
- Soft tissue strains, i.e., sprains or strains if there is no improvement or there is a suspected underlying problem
Additional Considerations
- Tetanus Immunization: Advise injured workers to ensure their tetanus immunization is up to date.
- First aid record: Document all findings, actions, and recommendations in a first aid record.
By following these guidelines, first aid attendants with OFA Level 1 certification can effectively assess and treat wounds, ensuring the well-being of workers in the workplace. For those looking to gain these essential skills, enrolling in a first aid course in Vancouver—such as the ones provided by Fundamental First Aid or the Canadian Red Cross—is a great way to meet regulatory requirements and foster a safe work environment.