the explorers journal the global adventure issue - The Explorers Club

Pressure dressing and elevation are important in this serious lower extremity laceration on a patient in rural Ethiopia, courtesy Jim Marinucciof motion after the first two days. Elevation isimportant for any extremity injury. There is noabsolute need to splint a joint with a laceration.MJM: What about wounds with a bone stickingout through the injury?JM: This is a compound fracture and you willneed to clean and dress the wound and splintthat area. These are risks for serious infectionsso antibiotics should always be given as soonas possible. Also you have to be careful aboutmoving the bony fragments, not only for the pain,but the sharp ends can lacerate vital structureslike blood vessels and nerves. This type of injurywill definitely need evacuation.MJM: How does one manage a burn in the field?JM: The first thing to do is to cool the area withclean water at room temperature or slightly lowerfor a minimum of 20 minutes. Remove jewelryand leave blisters intact. If you have specificburn wound dressings, they can be applied, butif not, a thin layer of antimicrobial cream can beapplied before the dressing. Remember thatanything you have to put on a burn will have to beremoved as well later. If you use an antimicrobialdressing with a sulfa antibiotic, it is very importantto ask about allergies to sulfa. Burns canbecome infected easily so antibiotic use wouldbe a good idea if you have damage to the skin.Pain medication and elevation again are veryimportant with this type of injury.MJM: There is much more to discuss but thecommon theme here for the explorer comingacross a traumatic wound is assessment followedby wound cleansing, jewelry removal,bandaging, pain medication, and elevation,and antibiotics when needed. Following theseconcepts will certainly diminish serious consequencesfor the victim. Thanks very much foryour time and insights.the explorers journal