Most injuries are minor and can be treated without medical attention. Severe pain, swelling, fever, numbness or tingling, deep wounds, wounds over bones (such as over the shin), and/or the inability to use the injured area are signs of a possibly serious injury requiring medical attention.

Sprains, Strains and Bruises:

These injuries are caused by torn, stretched or damaged fibers in muscles, ligaments, tendons, blood vessels and/or the tissues between them. The first treatment is application of ice for 25 minutes per hour during the first few hours - which reduces pain and prevents swelling and inflammation. After 24 hours, moist heat (hot water or a moist heating pad) for 20-30 minutes 3-4 times daily can dramatically speed up healing. Ice for 5 minutes after the heat can reduce swelling further. When using moist heat, be careful to avoid getting a burn - moist heating pads without automatic heating controls are safest. Dry heating pads are essentially useless.

Burns:

First degree burns (sunburn) and second degree burns (blisters) should be treated with COOL compresses (not ice!!!). Anti-inflammatory medicine or acetaminophen can be helpful. I do not recommend breaking blisters, they are "nature’s dressing." Try to avoid topical sprays or creams containing numbing agents (like lidocaine) - they are of little value for pain relief and can cause severe allergic reactions. Third degree burns have extensive skin damage and may not be as painful as less severe burns - they require medical attention. All burns leak enormous amounts of fluid - try to drink as much fluid as possible after any burn.

Cuts, Abrasions and Scratches:

The first treatment for broken skin is washing the area thoroughly with soap and water. Band-Aids are usually adequate, and reduce the risk of infection - but care must be taken not to allow the wound to get moist with dirt under the bandage. Antibiotic creams can be helpful for dirty wounds or if redness or other early signs of infection develop. If the wound appears deep, wide, or very dirty, medical attention is necessary. Stitches can only be used during the first 8-12 hours after an injury. Animal or human bites can be very dangerous and require immediate medical attention.

Cracked skin:

Dry skin can crack - causing very painful tears in the skin, especially in the hands, feet, and occasionally the lips. "Superglue" is a fantastic treatment that literally glues the torn surfaces together. It is very dangerous, however, and should never be applied by yourself - and may require a physician to do it properly. If you get fingers or other body parts stuck together they will likely need significant, deforming surgery to separate them.

Tetanus Immunizations:

People still die of tetanus because they didn’t keep their tetanus shots up to date. Tetanus is caused by a poison produced by a bacteria that lives where no oxygen is present (such as on rusty nails). Children are immunized at 2 months, 4 months, 6 months, 18 months and 5 years of age. After age 5, tetanus boosters (along with a Diptheria booster) are required every 10 years, or between years 5 and 10 if an injury occurs. For those out of date for their tetanus shots, tetanus immune globulin (Hypertet) is also given in an attempt to get immediate immunity to tetanus.

Pain:

Narcotics are occasionally required to control pain, but for most injuries acetaminophen (Tylenol and others) is effective and safe as long as it’s not overdosed. Anti-inflammatory medicines such as Aspirin and Ibuprofen (Advil and others) can be of great help and can be taken with acetaminophen - but do carry risks, especially for intestinal bleeding. Ice can be very effective for eliminating pain, but don’t use it during the first 8 hours after a burn.

Antibiotics:

Creams such as Polysporin are great for scratches. Try to avoid the medication "neomycin" found in creams such as "Neosporin" - they frequently cause allergies. Oral or injectible antibiotics for injuries or infections should only be prescribed by a physician.

Ace Bandages:

They can be very helpful for sprains to keep down swelling, reduce pain, and increase function and mobility - don’t let them get too tight!!! They should not be placed in a circular wrapping pattern around the injured area, but in a "figure 8" pattern. Please ask me to demonstrate this technique if you need to use such a bandage.

1/29/97