Dealing with Medical Problems - Large and Small

Minor burns - These are generally first-degree burns in which only the outer layer of skin shows swelling, pain or redness. They not blister, they heal quickly and they leave no scar. If they involve large portions of the face, hands, feet, buttocks, or groin or a major joint, they do not fall into this category. In addition, if the second layer of skin or is burned and limited to an area of 2 to 3 inches in diameter, this kind of burn is also classified as minor, even if blisters develop and the skin becomes splotchy and intensely red.

To treat the problem, place the burned area under cold running water, immerse it in cool water, or use a cold compress, and then apply a lotion (preferably one containing aloe vera) or moisturizer to promote healing. Next, to reduce pain and protect the skin without using undue pressure, wrap the area loosely in a sterile gauze bandage or some other dressing that will not adhere to the burn.

A minor burn usually heals completely in a week or two and requires no further treatment. If you notice any increased pain, redness, swelling or oozing, which are signs of infection, you should seek medical attention immediately. Note also that applying ice directly to a burn may cause frostbite and further damage to the skin, and that any fluid-filled blisters you see will protect the skin from infection, so they should not be broken. If they happen to break on their own, use an antibiotic ointment and a gauze bandage, clean the wound with mild soap and water, and remember to change the dressing daily.

Serious burns - These burns involve all three layers of the skin, but they are generally painless. Some affected areas may seem to be a dry white or charred black, and fat, nerves, muscles and bones may also be damaged, along with the lungs and eyes. The health and age of the victim - and any other injuries sustained with the burn - will also affect the seriousness of the situation, and infection is a concern here as well.

Do not remove the burned clothing in such an emergency, but seek medical attention immediately and make sure that the victim is not in contact with any smoldering material. If the individual's air passage seems to be blocked or breathing has stopped, try to clear the air passage or administer CPR. Next, cover the burn with a cool, moist sterile bandage or a clean cloth, but do not use a towel or blanket because the lint may irritate the skin.

If you are dealing with chemical burn, which results from contact with industrial or household chemicals in a gas, liquid, or solid form, flush the chemicals from the skin's surface for 20 minutes or more, and if the burn was caused by a powdery substance, brush it away before you begin. An electrical burn may seem to be minor, but the damage from it may extend to the tissues under the skin, and if a large amount of current has passed through the victim's body, disturbance of heart rhythm, cardiac arrest or other internal damage may result Thermal burns are caused by steam, fire, hot liquids or hot objects, and radiation burns are caused by the sun, sun lamps, tanning booths, X-rays or radiation therapy for cancer treatment.

Open wounds - If you are treating a minor wound, cleanse the area and protect it from becoming infected. To begin, wash your hands with soap and water and rinse them thoroughly. As you gently scrub the area with mild soap and water only, be sure to remove all foreign materials, including dirt or gravel. A severe laceration, deep puncture wound, a wound with extensive skin loss or damage, or a wound with an exposed layer of fat, muscle or white tissue should be protected with a sterile covering and treated by a doctor.

In all cases, covering a wound with sterile, "breathable" material will protect it from bacteria and keep it from becoming infected, but it will not trap the normal moisture of the skin, which would delay the healing process. If you decide to use ointment, or it is recommended by your physician, apply a thin layer with a clean brush or swab, and clean the area prior to each new application. Since removing the bandage forcefully can reopen the wound, use clean, warm water or ½ strength hydrogen peroxide to soften the point of attachment. Also, once a scab has formed, be sure to avoid overuse of the ointment.

When medical attention is needed - If the individual being treated has a chronic medical condition, such as a bleeding disorder or diabetes, or is unsure of the status of his or her tetanus immunization, medical attention is needed for any type of wound. To stop the bleeding from grazes or small cut, lift the injured part and apply pressure to the cut with a sterile dressing. When the bleeding has stopped, and the wound is clean, apply an adhesive dressing and allow the cut to heal.

Always seek medical attention if any of the following factors are present:

● The bleeding continues after 10 minutes of applying pressure, indicating that some nerves or tendons may have been affected.

● Something is imbedded within the wound.

● The cut is the result of an animal or human bite, or punctured by an object that could cause infection.

● The wound involves the hand, face, mouth or genitals.

● You detect signs of shock - confusion, restlessness, signs of fear or rapid, shallow breathing.

Note that the face and scalp contain many blood vessels close to the skin's surface, and while minor cuts on the head may bleed profusely, the injury is often not serious. At the same time, medical treatment is obviously needed if the skull appears deformed or an eye has been injured.

When a wound appears to be minor, have the injured person lie down, remove any visible objects from the cut, and press firmly on it with the cleanest material you can find for 15 minutes. This may be repeated twice, and if the bleeding continues, you should continue to apply pressure and seek medical assistance as well. If swelling or pain persists after an injury or a bleeding abnormality is indicated, professional advice is also essential because a blood clot may not be noticeable until long after an injury has taken place.

Broken bones - While they are usually not life-threatening, broken bones always require medical attention. A simple fracture may not be visible through the skin, and the symptoms include intense pain that becomes worse when attempting to move the injured area, bleeding or swelling. A compound fracture is indicated by laceration of the skin, and in any case, a bone may be partially or completely fractured - length-wise, cross-wise, or in the middle. Frequently, the victim hears a cracking or snapping sound when the bone breaks, the affected area will be swollen and tender, or a limb may appear to be deformed.

The three main causes of fractures are the following:

● Some type of trauma, such as a fall.

● Osteoporosis, a condition marked by thinning of the bones.

● Overuse, a condition that is hard to diagnose and common among athletes.

When a bone is broken, the body acts to protect the injured area and forms a blood clot and fibrous tissue, new bone cell "threads" begin to grow toward each other, the fracture closes gradually, and the fibrous tissue is absorbed. Externally, slings casts, cast-braces, and other devices are used to hold the fracture in the right position as the bone is healing. Internally, this is done with the use of plates, pins or screws in surgery. Also, fractures may take several weeks or even longer to heal, but pain usually ends long before the fractured area can handle the stress of normal activity. For example, once the cast or brace is removed from the victim's arm or leg, the related ligaments and muscles will feel weak and stiff since they haven't been used in quite a while, and physical therapy will be needed.

Bruises - These are colorful areas of the skin where blood has leaked out of the blood vessels and then collected beneath it, known to doctors as "contusions." They are generally caused by trauma-a hard blow or twist of some kind - and related to injuries such as fractures, sprained ankles, concussions, and torn muscles. They can also be caused by the thinning of the skin related to normal aging, when there is decreased support of the veins, arteries and capillaries to circulate the blood, combined with the loss of collagen and fat.

Bruises may also be a side effect of some medications, including corticosteroids and blood thinners. Sometimes they are a sign of a low blood platelet count, a blood-clotting disease, or overdosing from a certain drug. When excessive bruising occurs, internal bleeding may also be present. As a rule, healing of a light bruise may take a week or two, but more severe or deeper bruises may last longer, and the age of the victim is also a factor here.