Part 1: Non-emergency first aid

External wounds

1. Causes and characteristics of external wounds

In the case of an external wound, the skin is damaged. Sometimes, the tendons, muscles or bones may also be damaged. An external wound can take form of a:

• Graze: are superficial, but painful. There may be dirt in the wound.
• Cut: bleeds because blood vessels have been severed. A victim with a cut will experience less pain than a victim with a graze.  
• Stab wound: causes internal damage to the underlying tissue. 
• Laceration: occurs when the skin gets caught on something, such as a nail, a chisel or a sharp piece of steel sheeting. 
• Pinch: can be severe enough to tear off a finger(tip).

2. Assessing the victim

A victim with a wound will be bleeding and experiencing pain. The amount of blood lost and the pain depends on the type and severity of the wound. 

3. What the ERO should do

Usually you do not need to call the (internal) emergency number in the event of an external wound. Minor wounds are small, superficial and not too dirty. Severe external wounds are large, deep and/or dirty. Severe wounds should be treated by a professional after the ERO has administered first aid.

The victim must be treated by doctor in the case of:

• Large wounds
• Wounds that cannot be cleaned
• Visible bones, muscles or other subcutaneous tissues
• Objects stuck in the wound
• Wounds that will not heal

If the victim is going to be treated by a doctor, you only need to cover the wound.

You should also advice victims with small wounds to go to a doctor if they have not had a tetanus injection in the past ten years.

Treating a wound is in many cases the same at first:

• Get the victim to sit or lie down, and reassure him
• Raise the part of the body that is injured
• Ask the victim to remove any jewellery from fingers and wrists to prevent constriction; remove them yourself if the victim is unable to
• Fetch the first aid kit or have someone fetch it for you
• Put on gloves if desired

Treat minor external (not dirty or deep) wounds as follows:

• Clean the wound, if necessary by rinsing it in lukewarm flowing water
• Disinfect the wound using an antiseptic such as chlorhexidine
• Apply pressure to the wound, if necessary
• Cover the wound with a sterile dressing. This will protect the wound from further infection
• If necessary, get the victim to give the affected body part rest and support

Emergency dressing: used to cover an external wound and keep it sterile.

• Apply an emergency dressing. Step 1 | Step 2 | Step 3 | Step 4
• Apply a finger dressing. Step 1 | Step 2 | Step 3 | Step 4
• Apply a hand dressing. Step 1 | Step 2 | Step 3 | Step 4

Treating a torn-off or crushed finger(tip):

• Apply a pressure to the wound to stop the bleeding
• Apply a sterile gauze or a folded up emergency dressing around the fingertip and ask the victim to apply pressure
• Cover the fingertip with a sterile gauze and then with a small plastic bag, put the bag in another bag of melting ice (never allow the wound to come into contact with the ice!)