Sovereignty Module: Heal the Wounded
Heal the Wounded
Complete Wound Care, Field Surgery, and Emergency Medical Treatment Guide
Complete Wound Care, Field Surgery, and Emergency Medical Treatment Guide
When hospitals don't exist, you must be the hospital. Infection kills more than injury. Clean technique, proper wound care, and knowledge of when to intervene saves lives. This campaign covers everything from cleaning cuts to emergency surgery.
Chapter 1: Wound Classification and Treatment Priority
| Wound Type | Severity | Immediate Action | Infection Risk | Healing Time |
|---|---|---|---|---|
| Abrasion (scrape) | Low | Clean, bandage | Low | 1-2 weeks |
| Laceration (clean cut) | Low-moderate | Clean, close, bandage | Low-moderate | 1-3 weeks |
| Puncture (deep, narrow) | Moderate-high | Clean, DO NOT close (drain) | HIGH (anaerobic bacteria) | 2-4 weeks |
| Avulsion (torn tissue) | Moderate-high | Control bleeding, clean, close if possible | Moderate | 2-6 weeks |
| Crush injury | High | Splint, elevate, watch for compartment syndrome | Moderate | Weeks-months |
| Burn (1st degree) | Low | Cool water, aloe, cover | Low | 1-2 weeks |
| Burn (2nd degree) | Moderate | Cool water, don't pop blisters, cover | Moderate | 2-4 weeks |
| Burn (3rd degree) | Critical | Cover, fluids, evacuate | Very high | Months (grafting) |
| Arterial bleeding | Critical | Direct pressure, tourniquet if needed | N/A (stop bleeding first) | After bleeding controlled |
Chapter 2: Wound Cleaning Protocol
| Step | Action | Details |
|---|---|---|
| 1 | Stop bleeding (direct pressure, elevation) | Pressure for 10-15 minutes minimum |
| 2 | Wash hands thoroughly (soap + water or alcohol) | YOUR hands are the #1 infection source |
| 3 | Irrigate wound with clean water (high pressure) | Syringe or squeeze bottle, 250-500ml minimum |
| 4 | Remove visible debris (tweezers, irrigation) | Foreign material = guaranteed infection |
| 5 | Apply antiseptic (dilute povidone-iodine, honey, or clean saline) | Full-strength iodine damages tissue |
| 6 | Assess: can wound be closed? (clean, <6 hours old, not a bite/puncture) | If yes: close. If no: pack open. |
| 7 | Close (if appropriate): butterfly strips, sutures, or staples | Approximate edges, don't overlap |
| 8 | Apply sterile dressing | Change daily or when soiled |
| 9 | Monitor for infection (redness spreading, warmth, pus, fever, red streaks) | Red streaks toward heart = EMERGENCY |
CRITICAL: Puncture wounds and animal bites should NOT be closed (sutured). They need to drain. Closing them traps bacteria inside = abscess or systemic infection. Pack open, change packing daily.
Chapter 3: Suturing (Wound Closure)
| Technique | Use | Strength | Difficulty |
|---|---|---|---|
| Butterfly strips (tape closure) | Small, clean cuts | Low (surface only) | Very low |
| Simple interrupted sutures | Most lacerations | Good | Moderate |
| Horizontal mattress | High-tension areas (joints) | Very good | Moderate-high |
| Figure-8 suture | Scalp lacerations | Good | Moderate |
| Continuous (running) suture | Long, clean lacerations | Moderate | Moderate |
| Deep (buried) sutures | Close dead space in deep wounds | Good (internal) | High |
Suture materials: Silk (non-absorbable, remove in 7-14 days). Gut (absorbable, dissolves in 1-3 weeks). Nylon/prolene (non-absorbable, strong, low infection). In emergency: clean fishing line, dental floss, or thread (boiled).
Chapter 4: Natural Antiseptics and Medicines
| Substance | Use | Preparation | Effectiveness |
|---|---|---|---|
| Raw honey | Wound dressing, burns | Apply directly to wound, cover | Excellent (antibacterial, promotes healing) |
| Garlic | Antibiotic (internal + external) | Crush, apply to wound or eat raw | Good (broad-spectrum) |
| Turmeric | Anti-inflammatory, wound healing | Paste with water on wound, or eat | Good |
| Plantain leaf (Plantago) | Drawing poultice, insect bites | Chew or crush, apply to wound | Moderate-good |
| Yarrow (Achillea) | Stop bleeding, antiseptic | Crush leaves, pack into wound | Good (styptic) |
| Pine resin/pitch | Wound sealant, antiseptic | Warm and apply as bandage | Good (seals + antimicrobial) |
| Willow bark | Pain relief (contains salicin/aspirin) | Tea from inner bark | Good (anti-inflammatory) |
| Charcoal (activated) | Poison ingestion, wound odor | Powder mixed with water (drink) or poultice | Good (adsorbs toxins) |
| Salt water (saline) | Wound irrigation | 1 teaspoon salt per quart boiled water | Good (osmotic antimicrobial) |
| Alcohol (40%+) | Skin disinfection (NOT in wounds) | Apply to skin around wound | Good (skin prep only) |
NEVER pour alcohol INTO a wound: it destroys tissue and delays healing. Use alcohol on SURROUNDING skin only. Irrigate wound with clean water or saline.
Chapter 5: Fracture and Dislocation Management
| Injury | Signs | Immediate Treatment | Splinting |
|---|---|---|---|
| Closed fracture | Pain, swelling, deformity, crepitus | Splint in position found, ice, elevate | Immobilize joint above and below |
| Open fracture (bone visible) | Bone protruding through skin | Cover bone with moist sterile dressing, splint | DO NOT push bone back in |
| Dislocation (shoulder) | Arm held away from body, hollow in shoulder | Traction + rotation (Cunningham technique) | Sling after reduction |
| Dislocation (finger) | Obvious deformity, can't bend | Steady pull along finger axis | Buddy-tape to adjacent finger |
| Sprain (ligament) | Swelling, pain, instability | RICE (Rest, Ice, Compression, Elevation) | Wrap or brace |
| Rib fracture | Pain with breathing, point tenderness | Pain management, deep breathing exercises | DO NOT wrap chest (pneumonia risk) |
Splinting materials: Sticks + cloth, cardboard, SAM splint, pillow (for ankle), buddy-taping (fingers/toes). Principle: immobilize the joint ABOVE and BELOW the fracture. Check circulation (pulse, color, sensation) after splinting.
Chapter 6: Emergency Procedures
| Procedure | Indication | Technique | Risk |
|---|---|---|---|
| Tourniquet | Life-threatening limb bleeding | 2-3 inches above wound, tighten until bleeding stops | Limb loss if >6 hours |
| Chest seal | Sucking chest wound (penetrating) | Occlusive dressing taped on 3 sides (valve) | Tension pneumothorax if fully sealed |
| Needle decompression | Tension pneumothorax | 14g needle, 2nd intercostal space, midclavicular | Requires training |
| Cricothyrotomy | Complete airway obstruction | Incision through cricothyroid membrane, insert tube | Last resort, requires training |
| Wound packing | Deep bleeding wound | Pack gauze/cloth tightly into wound, direct pressure | Pain (necessary) |
| Reduction (fracture/dislocation) | Displaced fracture or dislocation | Traction along bone axis, realign | Nerve/vessel damage possible |
Reference Card
- Stop bleeding FIRST: direct pressure 10-15 minutes, tourniquet if life-threatening
- Irrigate wounds with clean water (250-500ml minimum): removes bacteria and debris
- Do NOT close puncture wounds or bites: pack open, change daily (must drain)
- Honey is an excellent wound dressing: antibacterial, promotes healing, reduces scarring
- Red streaks from wound toward heart = EMERGENCY (sepsis developing, need antibiotics)
- Splint fractures: immobilize joint above AND below break. Check circulation after.
- Never pour alcohol INTO a wound (destroys tissue). Use on surrounding skin only.
- Suture within 6 hours of injury (golden period). After 6 hours: leave open, pack, close later.
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