Scrapes, Cuts, and Bruises

A look through any family photo album will reveal at least 1 picture of a child with a bandaged or scraped knee. Cuts, scrapes, and bruises are among the most common injuries, and no family member is safe from minor accidents. Fortunately, these injuries usually can be treated at home without a doctor visit. Pharmacists need to be able to advise patients on how to treat these injuries if medical attention is not necessary, as well as to counsel patients as to when they should seek medical attention.

Defining Scrapes, Cuts, and BruisesScrapes (or abrasions) are wounds in which layers of skin are scraped or torn. The most common sites for scrapes are the hands, elbows, and knees. These injuries often are the result of a fall. Although the scrapes may ooze blood, bleeding does not always occur. Objects penetrating the skin cause cuts (or lacerations). Depending on the depth, cuts often will bleed. Bruises are the result of hard contact with a person or an object. The impact causes an injury to the tissue beneath the skin, and blood from the injury settles near the skin. Bruises usually start out looking red, then within a few hours turn blue or purple, and finally appear yellow as they fade.

Treating Cuts and ScrapesMinor scrapes and cuts are easily treated at home with basic wound-care or first-aid supplies. Because cuts can happen at any time, every home should have tweezers, gauze pads, bandages, and antibiotic ointment. Here are some steps that pharmacists should tell patients to follow in treating cuts at home:Rinse a cut with cool waterWash around the cut with soap; avoid getting soap into the woundRemove dirt and debris from the wound with tweezers; clean the tweezers with rubbing alcohol before using themApply direct pressure with a clean gauze pad to a bleeding cutTreat the cut with antibiotic ointmentCover the cut with a bandage (deeper cuts may require a butterfly bandage)Do not pick at a scab while a cut is healingThe following are steps to follow in the case of a scrape:Cover a scrape with an occlusive or semiocclusive bandage if the scrape covers a large area, comes in contact with clothing or dirt, or oozes blood (a pharmacist can help identify an occlusive or semiocclusive bandage for the patient to use)Use ice packs and cool compresses to help reduce pain caused by scrapes (ice packs should not be applied for more than 20 minutes at a time to avoid frostbite; wrap the ice pack in a thin towel to reduce the risk of frostbite and discomfort from the cold temperature)Take acetaminophen or ibuprofen, if needed, for pain Here are signs that indicate that the cut or scrape needs medical attention:The cut cannot be closed?the edges do not come together, are very irregular, or have flaps of tissueThe wound will not stop bleedingThe cut is very dirty or contains foreign material that will not wash offNumbness or weakness occursSigns of infection develop, including fever, increased tenderness, swelling, redness, or drainageThe date of the patient?s last tetanus shot is unknown

Treating Bruises

Although bruises can be painful, treatment is limited. The best care for bruises involves rest and ice. Ice stops blood flow to the injury site, thus limiting the size of the bruise. Rest allows the site to heal. Here are some further guidelines for patients for treating bruises at home:

• Apply ice packs or cold compresses as soon as possible
• Reapply ice packs every hour for 10-15 minutes during the first day, if needed
• With bruised legs or feet, elevate the legs as much as possible during the first day
• Take acetaminophen, if needed, for pain; do not take aspirin
• With large bruises, limit activity during the first day
• Use heat packs after 48 hours to promote healing

Here are some signs that bruises need medical attention:

• The bruise swells
• The bruise does not start to fade within a week
• The bruise occurs easily or for no obvious reason