LEARNING OBJECTIVE: Recall medical precautions and wound-treatment procedures for the following list of wounds: animal bites, eye wounds, head wounds, facial wounds, abdominal wounds, crushing injuries, and the removal of foreign objects.

As a Hospital Corpsman, you should find most general wounds very easy to diagnose and treat. There are other wounds, however, that require special consideration and treatment. They are discussed below.

Eye Wounds
Many eye wounds contain foreign objects. Dirt, coal, cinders, eyelashes, bits of metal, and a variety of other objects may become lodged in the eye. Since even a small piece of dirt is intensely irritating to the eye, the removal of such objects is important. However, the eye is easily damaged. Impairment of vision (or even total loss of vision) can result from fumbling, inexpert attempts to remove foreign objects from the eye. The following precautions must be observed:

DO NOT allow the victim to rub the eye.

DO NOT press against the eye or manipulate it in any way that might cause the object to become embedded in the tissues of the eye. Be very gentle; roughness is almost sure to cause injury to the eye.

DO NOT use such things as knives, toothpicks, matchsticks, or wires to remove the object.

DO NOT UNDER ANY CIRCUMSTANCES ATTEMPT TO REMOVE AN OBJECT THAT IS EMBEDDED IN THE EYEBALL OR THAT HAS PENETRATED THE EYE!
If you see a splinter or other object sticking out from the eyeball, leave it alone! Only specially trained medical personnel can hope to save the victim's sight if an object has actually penetrated the eyeball.

Small objects that are lodged on the surface of the eye or on the membrane lining the eyelids can usually be removed by the following procedures:

1. Try to wash the eye gently with lukewarm, sterile water. A sterile medicine dropper or a sterile syringe can be used for this purpose. Have the victim lie down, with the head turned slightly to one side as shown in figure 4-29. Hold the eyelids apart. Direct the flow of water to the inside corner of the eye, and let it run down to the outside corner. Do not let the water fall directly onto the eyeball.

2. Gently pull the lower lid down, and instruct the victim to look up. If you can see the object, try to remove i t with the corner of a clean handkerchief or with a small moist cotton swab. You can make the swab by twisting cotton around a wooden applicator, not too tightly, and moistening it with sterile water.

CAUTION: Never use dry cotton anywhere near the eye. It will stick to the eyeball or to the inside of the lids, and you will have the problem of removing it as well as the original object.

3. If you cannot see the object when the lower lid is pulled down, turn the upper lid back over a smooth wooden applicator. Tell the victim to look down. Place the applicator lengthwise across the center of the upper lid. Grasp the lashes of the upper lid gently but firmly. Press gently with the applicator. Pull up on the eyelashes, turning the lid back over the applicator. If you can see the object, try to remove it with a moist cotton swab or with the corner of a clean handkerchief.

4. If the foreign object cannot be removed by any of the above methods, DO NOT MAKE ANY FURTHER ATTEMPTS TO REMOVE IT. Instead, place a small, thick gauze dressing over both eyes and hold it in place with a loose bandage. This limits movement of the injured eye.

5. Get medical help for the victim at the earliest opportunity.

Head Wounds
Head wounds must be treated with particular care, since there is always the possibility of brain damage. The general treatment for head wounds is the same as that for other fresh wounds. However, certain special precautions must be observed if you are giving first aid to a person who has suffered a head wound.

NEVER GIVE ANY MEDICATIONS.

Keep the victim lying flat, with the head at the level of the body. Do not raise the feet if the face is flushed. If the victim is having trouble breathing, you may raise the head slightly.

If the wound is at the back of the head, turn the victim on his side.

Watch closely for vomiting and position the head to avoid aspiration of vomitus or saliva into the lungs.

Figure 4-29.-Irrigating the eye.

Do not use direct pressure to control hemorrhage if the skull is depressed or obviously fractured
.

Facial Wounds
Wounds of the face are treated, in general, like other fresh wounds. However, in all facial injuries make sure neither the tongue nor injured soft tissue blocks the airway, causing breathing obstruction. Keep the nose and throat clear of any obstructing materials, and position the victim so that blood will drain out of the mouth and nose.

Facial wounds that involve the eyelids or the soft tissue around the eye must be handled carefully to avoid further damage. If the injury does not involve the eyeball, apply a sterile compress and hold it in place with a firm bandage. If the eyeball appears to be injured, use a loose bandage. (Remember that you must NEVER attempt to remove any object that is embedded in the eyeball or that has penetrated it; just apply a dry, sterile compress to cover both eyes, and hold the compress in place with a loose bandage).

Any person who has suffered a facial wound that involves the eye, the eyelids, or the tissues around the eye must receive medical attention as soon as possible. Be sure to keep the victim lying down. Use a stretcher for transport.