Estimated reading time: 8 minutes
Stab wounds are potentially life-threatening injuries that require immediate attention. These deep wounds can result in various complications, such as internal organ damage, significant blood loss, and a high risk of infection.
In this article, you'll learn how to assess a stab wound, implement basic first-aid procedures, and understand when to seek emergency medical assistance. This knowledge is meant to be as basic as possible but still could make a difference in a critical situation, potentially saving a life.
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Assessing the Scene Before You Rush In
Before proceeding, your safety should take priority, even when your instinct is to immediately assist the wounded individual. Take a deep breath and take 10-20 seconds to remain calm and assess the entire scene.
An unsafe environment can turn you from a helper to another victim, escalating the emergency. Observe your surroundings and consider the potential risks before approaching.
Here is a checklist of things to carefully look out for:
- Are there any indications of ongoing danger like an active assailant, traffic, or fire?
- Look for hazardous materials that may be present or involved in the incident.
- Is the environment stable? Check for threats like falling objects, collapsing structures, or electrical hazards.
- Notice if there are bystanders who might be able to help or, conversely, create additional hysteria or interference.
- Survey the victim from a distance for any obvious signs of aggression or violent behavior that may require de-escalation or law enforcement.
Only once you have ascertained that the environment is secure should you move in closer to offer help to the injured person.
Where to Begin When You Encounter a Stab Wound
Upon ensuring that the scene is safe, the next step is to assess the victim's condition. Approach them calmly, introduce yourself, and let them know you're there to help. The majority of the time the victim will be alert and conscious, but in pain and shock.
You'll need to perform a quick assessment using the AVPU scale, which stands for Alert, Voice, Pain, and Unresponsive:
- Alert: Is the victim fully awake and aware of their surroundings?
- Voice: Does the victim respond to your voice by opening their eyes or speaking?
- Pain: Does the victim respond to pain by moving or making a noise?
- Unresponsive: Is the victim not responding to your voice or pain stimulus?
After determining the level of consciousness, proceed with the ABCs – Airway, Breathing, and Circulation:
- Airway: Ensure the airway is clear. If the victim is talking, their airway is likely clear. If they're unconscious, you may need to clear the airway.
- Breathing: Look for the rise and fall of the chest, listen for breathing sounds, and feel for breath on your cheek.
- Circulation: Check for bleeding and signs of shock. Bright red blood spurting out indicates an arterial bleed, requiring immediate pressure to control.
You should immediately call for emergency medical help if the person:
- Has trouble breathing or is not breathing at all.
- Is bleeding heavily or do you suspect severe internal bleeding (dark bruising)?
- Can't be awoken or is unresponsive.
- Is in extreme shock (pale, cold, clammy skin, rapid heartbeat, weak pulse, etc).
While waiting for medical help, talk to the victim to keep them calm and apply pressure to the wound to slow bleeding.
Monitoring their condition throughout for any changes is critical, and be prepared to provide the emergency dispatcher with all your observations when they arrive.
Treating a Stab Wound with the Object Still Inside
When faced with a stab wound where the object is still inside, do not remove it. The object may be acting as a plug, preventing excessive bleeding by sealing the wound and the blood vessels it has damaged. Removing the object can lead to a rapid loss of blood and can make the injury worse.
If you encounter such a situation, follow these steps to stabilize the object and the person:
- Call for emergency medical help immediately. Quick professional intervention is critical.
- Do not remove the object. It might be tempting, but doing so can cause further damage and increased bleeding.
- Stabilize the object. If the object is stable and not moving, leave it as is. If it is loose, you can use bandages or cloth to keep it from moving without applying pressure directly to the object.
- Control external bleeding. Apply pressure around the object, not directly over it, to control any bleeding. Use a clean cloth or bandage to press firmly around the margins of the wound.
The most you will be able to do at this time is comfort the person further until help arrives. For most situations just having someone to talk to is enough to distract someone distracted.
Treating a Stab Wound After the Object Has Been Removed
If you're faced with a stab wound where the object has already been removed, immediate action to stop the bleeding should be your first train of thought after assessment.
Here are some steps to follow:
- Call for emergency medical help immediately. Even if you can manage the bleeding, professional medical care is necessary.
- Apply direct pressure to the wound. Use a sterile cloth, scarf, or gauze to press down firmly on the wound. This helps control bleeding by compressing the blood vessels.
- Elevate the injured area above the heart level if possible. This can decrease blood flow to the wound, thus reducing bleeding.
- Use a clotting agent if available. Hemostatic agents or clotting powders can be applied to the wound to promote rapid coagulation. These are especially useful in situations where pressure alone is not sufficient to stop the bleeding.
- Monitor for signs of shock. While tending to the wound, keep an eye out for symptoms such as shallow breathing, cold and clammy skin, and rapid pulse, which can indicate shock.
- Do not attempt to suture the wound. Suturing is a medical procedure that should only be performed by a trained professional. Improper suturing can lead to infection and other complications.
If you have the training the situation is life-threatening, and emergency services are not immediately available, you may consider advanced treatments such as wound packing with sterile materials.
The priority is to get the victim to professional medical care as quickly as possible. While, with training, you can provide first-responder care, hospital management is necessary to assess, treat, and monitor for any complications such as internal bleeding or organ damage.
Keeping the Wound Clean If Help Is More Than an Hour Away
Begin by using clean water to gently rinse the wound, which can help wash away debris and bacteria. Avoid using river or pond water; instead, aim for bottled or boiled and cooled water if possible.
If the wound is bleeding, let it do so briefly; a small amount of bleeding can help cleanse the wound naturally. After rinsing, pat the injured area dry with a clean cloth. Do not rub it, as this could cause further injury to the tissue.
Once clean, keep the wound covered with a sterile dressing to protect it from contaminants. Change the dressing regularly, at least once every few hours, or if it becomes wet or dirty, to maintain a clean environment conducive to healing.
Natural Remedies for Bleeding and Pain
Various materials and plants have been traditionally used to manage and assist in the healing of deep wounds. Yarrow tops and leaves, for example, are used for stopping bleeding. It's believed that yarrow's ability to constrict blood vessels can help in keeping a wound from bleeding excessively. Grind the yarrow leaves into a paste, and apply directly onto the wound for its astringent effects.
Mullein and Goldenrod are also used in herbal medicine for their wound-healing properties. These plants have anti-inflammatory benefits which may assist in reducing pain and swelling. Mullein can be used as an infused oil to soften the skin around the wound and promote healing, while goldenrod has been historically used in a poultice to support the healing process.
In a pinch, cattail fluff can serve as an improvisational bandage. The fluff is highly absorbent and can be used as batting to help manage bleeding and protect the wound. Pack it lightly onto the wound before securing it with a cloth or bandage. Naturally, this method is not sterile, but it can be beneficial in emergencies where traditional medical supplies are unavailable.
Conclusion
Stab wounds can be frightening and it's natural to experience anxiety. Having a plan and being prepared with these tips can help alleviate stress and ensure more effective initial wound management.
While it may seem that you can do very little in this situation, simply being there with the person is often enough to keep spirits high. I recommend you take an appropriate training session before attempting anything in this article. However, this essential information can be summarized onto a handy reference card, laminated for durability and quick access.
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