When venturing into extreme environments, being prepared for medical emergencies is crucial. Among the many challenges you may face, the ability to effectively manage wounds stands out as a vital skill.
In this blog post, we will explore the 7 goals of wound management in expedition medicine taken from our comprehensive downloadable guide, ‘Wound Management in Extreme Environments’.
You can grab your free copy here:
In extreme environments, where immediate medical assistance may be limited, it is essential to have the skills to control bleeding. The first goal of wound management is to identify and treat catastrophic bleeding during the primary survey or address it during the secondary survey. Following a stepwise approach to haemorrhage control is crucial for effective management.
2.Minimise the Risk of Infection
Preventing infections in remote locations is of utmost importance. Thorough wound cleaning, removal of foreign bodies, and appropriate dressing application are key strategies to minimise the risk of further microbial contamination. The use of antibiotics, along with tetanus or rabies immunisation/immunoglobulin, can further reduce the chances of infection.
3.Promote Optimal Healing
Facilitating optimal wound healing is another goal of wound management. Using dressings that maintain a moist wound healing environment, ensuring adequate nutrition, and reducing pressure, friction, and shearing are essential strategies. These measures help create the ideal conditions for the wound to heal efficiently, even in extreme environments.
4.Reduce Discomfort and Minimise Disability
Managing wounds in extreme environments often involves dealing with discomfort and potential disability. Anesthesia and/or analgesia may be necessary for wound assessment, closure, or dressing changes. It is important to consider interventions that are compatible with continued performance on the expedition. Balancing protection and functionality is crucial when making decisions regarding wound management.
5.Minimise Loss of Function
To minimise the risk of function loss, it is essential to assess underlying structures beyond the wound itself. Additionally, removing jewellery near the affected area is important to prevent complications and ensure proper healing. By addressing these factors, you can help preserve the overall function of the affected area.
6.Optimise Cosmetic Outcomes
While cosmetic considerations may not be the highest priority in extreme environments, optimising cosmetic outcomes can still play a role in wound management. Reducing the risk of scarring, especially around joints, and maintaining flexibility are important considerations.
7.Implement Definitive Care (if possible)
Definitive care refers to advanced treatments and interventions that may not be readily available in extreme environments. These may include wound closure techniques, surgical debridement, and access to necessary vaccinations or immunoglobulin. The availability of definitive care depends on various factors, such as the type of wound, environmental conditions, risk assessment, evacuation times, and the capacity of the medical team and equipment.
In the expeditionary setting, the availability of medical resources and supplies is often limited. Wound care items can be bulky and quickly exhaust available supplies, especially when medical kits have size or weight limitations. The focus should be on adaptable wound care items that can treat multiple wound types effectively.
In order to dive deeper into the intricacies of wound management in extreme environments, we invite you to our comprehensive downloadable guide, ‘Wound Management in Extreme Environments’ or join us for an Expedition & Wilderness Medicine Courses.
These courses provide hands-on training, expert guidance, and practical scenarios to prepare you for the challenges you may face. With specialised instruction and real-world experience, you’ll develop the confidence and competence needed to handle wound management in extreme environments and much more.
Other expedition medicine blogs that may be of interest, include: