wounds management

Question 1

assessment of wound severity

Answer 1

presence of foreign body
limited rom of joint
penetration of underlying bone, joint, tendon
NV damage/involvement

Question 2

initial management of wound

Answer 2

clean + irrigate wound
remove foreign bodys/debris
elevate and immobilise extremity
analgesia - pndol +/-or nsaid
educate on sos infection to trigger review
poabx - for animal bite or clenched fist injury
**dont suture or glue animal bites

Question 3

assessment and management for animal bite RACGP

Answer 3

exploration of wound
document wound type 
foreign body 
assess penetration of bone and joint
assess nerve motor and vacs function
assess for established infection

Question 4

indication for hospital referral of wound/bite

Answer 4

multiple and severe injury
systemic sos infection
cellulitis - severe or spreading
bone/joint/tendon nerve involvement
refractory to POABx

Question 5

indication for hospital referral of wound/bite

Answer 5

multiple and severe injury
systemic sos infection
cellulitis - severe or spreading
bone/joint/tendon nerve involvement
refractory to POABx
wound requires surg intervention - debridement/drainage/reconstruction
significant bites to hand or scalp (closed fist)
human bites with puncture wounds
immunocompromised patient
social reasons