Guest guest Posted January 23, 2012 Report Share Posted January 23, 2012 ok if ya have a scalping injury and the scalp is partially on do you a replace the scalp and bandage over it b place a bandage on the scull put the scalp back then bandage this was a recent topic of discussion and wanted to get people opinions here Lawrence Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2012 Report Share Posted January 23, 2012 Add to that you must never use hydrogen peroxide on anything that might be stitched as it ruins the skin for stitches. Doc Krin why is that? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Training Program Manager Fire & Safety Specialists, Inc. Typed by my fingers on my iPhone. Please excuse any typos. (Cell) (Office) (Office Fax) LNMolino@... Lou@... > we were taught in the military (and in the EMT-A course) to rinse the wound > out as best as possible, then replace the flap and apply a head dressing. > this is one place where knowing how to do cravat bandaging comes in handy, > as a cravat head bandage provides some compression of those nasty bleeding > scalp arteries! > > If bone is sticking out, or gray matter is showing....then most bets are > off...and I'd use a wet dressing and pad things extensively without putting > any pressure on the wound. > > ck > > > In a message dated 01/23/12 16:58:04 Central Standard Time, > lgverrett@... writes: > > ok if ya have a scalping injury and the scalp is partially on do you > a replace the scalp and bandage over it > b place a bandage on the scull put the scalp back then bandage > this was a recent topic of discussion and wanted to get people opinions > here > Lawrence > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2012 Report Share Posted January 23, 2012 Add to that you must never use hydrogen peroxide on anything that might be stitched as it ruins the skin for stitches. Doc Krin why is that? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Training Program Manager Fire & Safety Specialists, Inc. Typed by my fingers on my iPhone. Please excuse any typos. (Cell) (Office) (Office Fax) LNMolino@... Lou@... > we were taught in the military (and in the EMT-A course) to rinse the wound > out as best as possible, then replace the flap and apply a head dressing. > this is one place where knowing how to do cravat bandaging comes in handy, > as a cravat head bandage provides some compression of those nasty bleeding > scalp arteries! > > If bone is sticking out, or gray matter is showing....then most bets are > off...and I'd use a wet dressing and pad things extensively without putting > any pressure on the wound. > > ck > > > In a message dated 01/23/12 16:58:04 Central Standard Time, > lgverrett@... writes: > > ok if ya have a scalping injury and the scalp is partially on do you > a replace the scalp and bandage over it > b place a bandage on the scull put the scalp back then bandage > this was a recent topic of discussion and wanted to get people opinions > here > Lawrence > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2012 Report Share Posted January 23, 2012 I agree with both, the issue was the possible presents of debris and its cause of infection. I took the side that you can use sterile water to do a limited field cleaning and then bandage the wound, the other side stated that if you do that, then putting a sterile dressing over the bone then covering it with the scalp would be the best option. Subject: Re: bandaging scalp wound To: texasems-l Date: Monday, January 23, 2012, 9:03 PM Â we were taught in the military (and in the EMT-A course) to rinse the wound out as best as possible, then replace the flap and apply a head dressing. this is one place where knowing how to do cravat bandaging comes in handy, as a cravat head bandage provides some compression of those nasty bleeding scalp arteries! If bone is sticking out, or gray matter is showing....then most bets are off...and I'd use a wet dressing and pad things extensively without putting any pressure on the wound. ck In a message dated 01/23/12 16:58:04 Central Standard Time, lgverrett@... writes: ok if ya have a scalping injury and the scalp is partially on do you a replace the scalp and bandage over it b place a bandage on the scull put the scalp back then bandage this was a recent topic of discussion and wanted to get people opinions here Lawrence Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 interestingly enough, about 15 years ago now, UCSD Medical Center published a nice series showing that plain potable (tap) water was as good as sterile fluids for most irrigations in terms of preventing infections. now, you might need to take more steps if you are practicing expeditionary or other long term WEMS, but for the rural medic with an hour transport time, just cleaning out the gross gradeau will do nicely- the rest can come out in the ED or OR. City slicker street medics probably should just cover the wound and administer the usual 'Bolus of Diesel' treatment. ck In a message dated 01/24/12 05:33:40 Central Standard Time, lgverrett@... writes: I agree with both, the issue was the possible presents of debris and its cause of infection. I took the side that you can use sterile water to do a limited field cleaning and then bandage the wound, the other side stated that if you do that, then putting a sterile dressing over the bone then covering it with the scalp would be the best option. Subject: Re: bandaging scalp wound To: texasems-l Date: Monday, January 23, 2012, 9:03 PM we were taught in the military (and in the EMT-A course) to rinse the wound out as best as possible, then replace the flap and apply a head dressing. this is one place where knowing how to do cravat bandaging comes in handy, as a cravat head bandage provides some compression of those nasty bleeding scalp arteries! If bone is sticking out, or gray matter is showing....then most bets are off...and I'd use a wet dressing and pad things extensively without putting any pressure on the wound. ck In a message dated 01/23/12 16:58:04 Central Standard Time, lgverrett@... writes: ok if ya have a scalping injury and the scalp is partially on do you a replace the scalp and bandage over it b place a bandage on the scull put the scalp back then bandage this was a recent topic of discussion and wanted to get people opinions here Lawrence [Non-text portions of this message have been removed] ------------------------------------ Yahoo! Groups Links [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] ------------------------------------ Yahoo! Groups Links Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 Peroxide (as well as alcohol and iodine for that matter) tend to kill off the delicate cells that speed healing (gee! D'oh!). a dilute solution of the pink stuff (chlorhexidine) or the white stuff (hexaclorophene) is probably OK for skin and most soft tissues but NOT directly on the brain!!! stick to plain water or saline in the field for most purposes...if you are going on a wilderness expedition or if you are *way* out in the rural areas, discuss the situation with medical control as to what your best options are. ck In a message dated 01/24/12 05:34:13 Central Standard Time, lnmolino@... writes: Add to that you must never use hydrogen peroxide on anything that might be stitched as it ruins the skin for stitches. Doc Krin why is that? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Training Program Manager Fire & Safety Specialists, Inc. Typed by my fingers on my iPhone. Please excuse any typos. (Cell) (Office) (Office Fax) LNMolino@... Lou@... > we were taught in the military (and in the EMT-A course) to rinse the wound > out as best as possible, then replace the flap and apply a head dressing. > this is one place where knowing how to do cravat bandaging comes in handy, > as a cravat head bandage provides some compression of those nasty bleeding > scalp arteries! > > If bone is sticking out, or gray matter is showing....then most bets are > off...and I'd use a wet dressing and pad things extensively without putting > any pressure on the wound. > > ck > > > In a message dated 01/23/12 16:58:04 Central Standard Time, > lgverrett@... writes: > > ok if ya have a scalping injury and the scalp is partially on do you > a replace the scalp and bandage over it > b place a bandage on the scull put the scalp back then bandage > this was a recent topic of discussion and wanted to get people opinions > here > Lawrence > > [Non-text portions of this message have been removed] > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 While a scalp lac even a small one is often an horrific looking wound rarely are they in and if themselves fatal. The bolus I'd diesel may be more life threatening than the reason fit the 9-1-1 call. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Training Program Manager Fire & Safety Specialists, Inc. Typed by my fingers on my iPhone. Please excuse any typos. (Cell) (Office) (Office Fax) LNMolino@... Lou@... > interestingly enough, about 15 years ago now, UCSD Medical Center published > a nice series showing that plain potable (tap) water was as good as > sterile fluids for most irrigations in terms of preventing infections. > > now, you might need to take more steps if you are practicing expeditionary > or other long term WEMS, but for the rural medic with an hour transport > time, just cleaning out the gross gradeau will do nicely- the rest can come > out in the ED or OR. City slicker street medics probably should just cover > the wound and administer the usual 'Bolus of Diesel' treatment. > > ck > > > In a message dated 01/24/12 05:33:40 Central Standard Time, > lgverrett@... writes: > > I agree with both, the issue was the possible presents of debris and its > cause of infection. I took the side that you can use sterile water to do a > limited field cleaning and then bandage the wound, the other side stated > that if you do that, then putting a sterile dressing over the bone then > covering it with the scalp would be the best option. > > > > > Subject: Re: bandaging scalp wound > To: texasems-l > Date: Monday, January 23, 2012, 9:03 PM > > we were taught in the military (and in the EMT-A course) to rinse the > wound > out as best as possible, then replace the flap and apply a head dressing. > this is one place where knowing how to do cravat bandaging comes in handy, > as a cravat head bandage provides some compression of those nasty bleeding > scalp arteries! > > If bone is sticking out, or gray matter is showing....then most bets are > off...and I'd use a wet dressing and pad things extensively without > putting > any pressure on the wound. > > ck > > In a message dated 01/23/12 16:58:04 Central Standard Time, > lgverrett@... writes: > > ok if ya have a scalping injury and the scalp is partially on do you > a replace the scalp and bandage over it > b place a bandage on the scull put the scalp back then bandage > this was a recent topic of discussion and wanted to get people opinions > here > Lawrence > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2012 Report Share Posted January 25, 2012 That's interesting! As I have used plain old bottled water many times in the field when nothing else was available for flushing out a wound. Good to know that I was correct in the line of thinking of " the solution to pollution is dilution " . > > > From: krin135@... > Subject: Re: bandaging scalp wound > To: texasems-l > Date: Monday, January 23, 2012, 9:03 PM > > > > > > > > we were taught in the military (and in the EMT-A course) to rinse the > wound > out as best as possible, then replace the flap and apply a head dressing. > this is one place where knowing how to do cravat bandaging comes in handy, > as a cravat head bandage provides some compression of those nasty bleeding > scalp arteries! > > If bone is sticking out, or gray matter is showing....then most bets are > off...and I'd use a wet dressing and pad things extensively without > putting > any pressure on the wound. > > ck > > > In a message dated 01/23/12 16:58:04 Central Standard Time, > lgverrett@... writes: > > ok if ya have a scalping injury and the scalp is partially on do you > a replace the scalp and bandage over it > b place a bandage on the scull put the scalp back then bandage > this was a recent topic of discussion and wanted to get people opinions > here > Lawrence > > [Non-text portions of this message have been removed] > > ------------------------------------ > > Yahoo! Groups Links > > [Non-text portions of this message have been removed] > > > > > > > > > [Non-text portions of this message have been removed] > > > > ------------------------------------ > > Yahoo! Groups Links > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 Also for consideration http://bja.oxfordjournals.org/content/88/4/597.long ________________________________ To: texasems-l Sent: Tuesday, January 24, 2012 6:52 AM Subject: Re: bandaging scalp wound Peroxide (as well as alcohol and iodine for that matter) tend to kill off the delicate cells that speed healing (gee! D'oh!). a dilute solution of the pink stuff (chlorhexidine) or the white stuff (hexaclorophene) is probably OK for skin and most soft tissues but NOT directly on the brain!!! stick to plain water or saline in the field for most purposes...if you are going on a wilderness expedition or if you are *way* out in the rural areas, discuss the situation with medical control as to what your best options are. ck In a message dated 01/24/12 05:34:13 Central Standard Time, lnmolino@... writes: Add to that you must never use hydrogen peroxide on anything that might be stitched as it ruins the skin for stitches. Doc Krin why is that? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Training Program Manager Fire & Safety Specialists, Inc. Typed by my fingers on my iPhone. Please excuse any typos. (Cell) (Office) (Office Fax) LNMolino@... Lou@... > we were taught in the military (and in the EMT-A course) to rinse the wound > out as best as possible, then replace the flap and apply a head dressing. > this is one place where knowing how to do cravat bandaging comes in handy, > as a cravat head bandage provides some compression of those nasty bleeding > scalp arteries! > > If bone is sticking out, or gray matter is showing....then most bets are > off...and I'd use a wet dressing and pad things extensively without putting > any pressure on the wound. > > ck > > > In a message dated 01/23/12 16:58:04 Central Standard Time, > lgverrett@... writes: > > ok if ya have a scalping injury and the scalp is partially on do you > a replace the scalp and bandage over it > b place a bandage on the scull put the scalp back then bandage > this was a recent topic of discussion and wanted to get people opinions > here > Lawrence > > [Non-text portions of this message have been removed] > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 Also for consideration http://bja.oxfordjournals.org/content/88/4/597.long ________________________________ To: texasems-l Sent: Tuesday, January 24, 2012 6:52 AM Subject: Re: bandaging scalp wound Peroxide (as well as alcohol and iodine for that matter) tend to kill off the delicate cells that speed healing (gee! D'oh!). a dilute solution of the pink stuff (chlorhexidine) or the white stuff (hexaclorophene) is probably OK for skin and most soft tissues but NOT directly on the brain!!! stick to plain water or saline in the field for most purposes...if you are going on a wilderness expedition or if you are *way* out in the rural areas, discuss the situation with medical control as to what your best options are. ck In a message dated 01/24/12 05:34:13 Central Standard Time, lnmolino@... writes: Add to that you must never use hydrogen peroxide on anything that might be stitched as it ruins the skin for stitches. Doc Krin why is that? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Training Program Manager Fire & Safety Specialists, Inc. Typed by my fingers on my iPhone. Please excuse any typos. (Cell) (Office) (Office Fax) LNMolino@... Lou@... > we were taught in the military (and in the EMT-A course) to rinse the wound > out as best as possible, then replace the flap and apply a head dressing. > this is one place where knowing how to do cravat bandaging comes in handy, > as a cravat head bandage provides some compression of those nasty bleeding > scalp arteries! > > If bone is sticking out, or gray matter is showing....then most bets are > off...and I'd use a wet dressing and pad things extensively without putting > any pressure on the wound. > > ck > > > In a message dated 01/23/12 16:58:04 Central Standard Time, > lgverrett@... writes: > > ok if ya have a scalping injury and the scalp is partially on do you > a replace the scalp and bandage over it > b place a bandage on the scull put the scalp back then bandage > this was a recent topic of discussion and wanted to get people opinions > here > Lawrence > > [Non-text portions of this message have been removed] > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
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