!Deep Wounds

Leave deep wounds open
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Any deep wounds should be left open to heal. Wounds that are not closed 
properly can easily become infected. Rough, messy wounds and puncture wounds 
in particular should be cleaned twice a day with boiled water and kept open, 
or re‑opened, so they will heal from the inside.

Deep wounds can develop a tetanus infection. Unless the person had a tetanus 
vaccination within the last 5 years, they will need one now and also an 
injection of antitetanus immunoglobulin.

If you are not sure whether closing a wound is a good idea, it probably is 
not.

Never close animal bites, puncture wounds, or rough, messy wounds.

Animal bites
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Clean animal bites very well with soap and water for 15 minutes or more. 
Animal bites are likely to get infected, so give so give amoxicillin with 
clavulanic acid or another combination of antibiotics for animal bites.

For monkey, bat and raccoon bites, get a rabies vaccination and immunoglobulin 
immediately. Do the same for dog bites if the dog could have rabies.

Rabies is deadly. It affects the brain causing signs like confusion or 
paralysis. Then, in just a few days, the person becomes unconscious leading to 
death. Following a bite from an animal with rabies, it can take a month or a 
few months for signs to appear but by then it is too late to treat. If you 
think rabies is a possibility and do not have rabies vaccine or rabies 
immunoglobulin, contact your local health authority as soon as possible after 
the bite.

Even if there is no rabies immunoglobulin available, washing the skin 
thoroughly right away with soap and repeated rinsing, and giving the series of 
rabies vaccine as soon as possible can prevent rabies.

Knife wounds
------------
Deep knife wounds should usually be kept open and cleaned often. Give 
cloxacillin, clindamycin or cephalexin at any sign of infection.

Knife wounds to the chest or belly can be very dangerous. Get medical help. 
On the way to help, see Chest Wounds for what to do for a knife wound to the 
chest, or Abdomen Injuries for what to do for a knife wound to the belly.

Gunshot Wounds
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Get medical help as soon as possible for gunshot wounds. Use direct pressure 
to stop bleeding. Check both where the bullet entered and where it exited. If 
there is no exit wound, the bullet may have to be removed.

Gunshot wounds are likely to become infected. In all cases, wash the wound 
well and give one of these: cloxacillin, clindamycin, or cephalexin.

For a bullet in the head, on the way to get help, raise the head a little with 
folded blankets or pillows. Cover the wound with a clean bandage.

If there is any chance that the bullet hit a bone, the bone may be cracked or 
broken through. Splint the limb and do not use it for several weeks.

Fish hooks
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 1. Push the hook through the skin so it pokes out the other side.
 2. Cut off the barb or the shank. 	
 3. Pull the rest of the hook out.

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from NEW WHERE THERE IS NO DOCTOR ©
Hesperian Health Guides 1919 Addison St Ste 304 Berkeley CA 94704
1.510.845.1447 hesperian@hesperian.org
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