Elicit, Document and present history in a patient presenting with wounds..pptx

Description of Initial assessment of wound, Medical history, Pain and symptoms and treatment attempts in patients presenting with wounds.

1. Elicit, Document and present a history in a patient presenting with wounds.

2. Initial assessment: Location and Description: Ask where the wound is located and what it looks like. Is it on the arm, leg, face, etc.? Is it a cut, abrasion, puncture, or other type of wound? Mechanism of Injury: Inquire about how the wound occurred. Was it from a fall, accident, animal bite, or something else? Time of Injury: Determine when the injury happened. Was it recent, or has it been present for a while?

3. Pain and Symptoms: Ask about any pain associated with the wound. Are there any other symptoms like bleeding, redness, swelling, pus discharge, foul smell Associated with fever Not able to move the affected area

4. Medical History: Gather information about the individual's medical history, including any chronic illnesses, medications, allergies, and previous surgeries. Tetanus Vaccination Status: Determine if the individual is up to date on tetanus vaccination, especially for puncture wounds or those with a high risk of contamination. Underlying Conditions: Inquire about any underlying health conditions that may affect wound healing, such as diabetes, vascular disease, or immunocompromised status.

5. Treatment Attempts: Ask if any home remedies or over-the-counter treatments have been tried, such as cleaning the wound, applying ointments, or taking pain relievers. Social History: Explore the individual's lifestyle factors that may impact wound healing, such as smoking, alcohol consumption, or living conditions.

6. Who is at higher risk? Age –Older people are at high risk Anemia Poor general health Steroid use Radiation & chemotherapy Diabetes , CAD, Peripheral vascular disease, Congestive heart failure, cancer, HIV/ AIDS etc. Smoking

7. Detailed history taking of the wound: 1.How long have you had the wound? a wound that develops slowly on the lower leg maybe caused by venous insufficiency and may take a long time to heal. This knowledge may help you to determine what therapy may be needed and may also guide testing and referrals.

8. Have you had any tests done since developing the wound? Blood tests may reveal poorly controlled diabetes(HgbA1C), anemia (CBC), issues with oxygenation (pulmonary function tests, oxygen saturation), heart disease (high blood pressure, high serum cholesterol), poor nutrition (protein and albumin levels) or the presence of infection in the wound (wound cultures)

9. Have you had any wounds previous to this one? These patients will require all of your talent and skills to heal. Obtaining written or recorded notes related to previous wounds may help you determine a course of action for the current wound

10. Phases of wound healing For soft tissue wound healing : 1. Inflammatory phase: It can be broken down into further A) Clot formation B) Early inflammations C) Late inflammation 2.Proliferative phase 3.Maturation phase/ Remodeling phase

11. Inflammatory Phase After tissue injury, a coagulation cascade is initiated to stop bleeding. In the presence of infection, the neutrophils increased. Late-Inflammatory Phase The macrophages stimulate angiogenesis and re-epithelialization. Fibroblast activated to deposit excessive amount of collagen for wound repair. Proliferation Stage Granulation tissue begins to form and is a loose network of collagen, fibronectin and hyaluronic acid.

12. Thank you