Cuts and Wounds

The first thing to be said about this type of injury is that, with a little care, cuts and wounds can be avoided altogether.

Keeping knives sharp, out of the reach of children and safely stored are just a few of the precautions to apply. In the main common sense is the best guide but it's easy to overlook things when you're busy.

Do not, for example, leave kitchen knives in the sink where they may get covered by other items or immersed in soapy water. An invisible knife is a dangerous knife.

And beware the knife most people are not even aware of - the one that's attached to the box your plastic wrap comes in.

Personally I throw this box away immediately and cut my plastic wrap with a knife. That way I can see the blade at all times and in any case I find it much easier to do that than struggle with a box that the roll of wrap keeps trying to pop out of anyway.

But accidents do happen.

So let's first of deal with cuts and what to do about them.

Bleeding

Blood loss is something all cuts have in common and it needs to be controlled as quickly as possible, both for the health of the patient and the safety of others.

Blood contaminates, which is why you should always wash your hands both before and after treatment and preferably away from food preparation areas.

You should also wear disposable latex gloves which you discard after use - do not try to clean and retain them.

You can prevent bleeding simply by applying pressure to the cut and, where possible, elevating the affected limb.

Get the patient to apply the pressure themselves if they are able to, by first applying a clean wad of bandage yourself and then getting them to hold it in place.

Once you are reasonably confident the bleeding has stopped you can bandage the pad in position using a folded triangular bandage or a crepe roller bandage.

In the absence of anything else, get the patient to apply pressure using their own hand. Only apply direct pressure yourself as a last resort.

Monitor the patient for symptoms of shock.

If the initial application does not stop the bleeding, do not add more bandages. Instead remove the original pad, replace it with a fresh one and re-position it over the cut. Then repeat the above procedure.

Always check that circulation has not been restricted too much. If the victim complains of numbness, or color fails to return to fingertips after they have been pressed, ease the bandage a little until circulation returns to normal.

Under no circumstances should you apply a tourniquet. Any cut that serious requires immediate professional attention.

Don't forget to elevate the affected part, using a sling (in the case of a hand/wrist injury) if necessary.

Cuts to the palm

It's a fact that experienced cooks who should know better still manage to slice themselves across the palm of the hand by cutting through something they are holding and letting the blade slip.

Because of the complex nature of the nerves and tendons in the hand, anything but the most superficial cut in that area requires medical attention. Get the victim to a doctor.

But first control the bleeding by asking the patient to close their fingers around a sterile wad so that it's held firmly in place, then bandage the fist in that position using a roller bandage or anything else that's clean and available.

The patient could also use their free hand to hold the fist closed.

Elevate the affected arm in a sling, which can be improvised if necessary using the patient's own clothing.

Watch out for symptoms of shock and treat accordingly.

Infection

Cuts, if treated appropriately, are rarely life threatening. However they are susceptible to infection and great care must be taken, even with the most insignificant injury, to keep everything as clean and sterile as possible.

This does NOT mean using antiseptics of any kind, which can cause further tissue damage as well as unnecessary pain. Remember that pain is one of the factors in the onset of shock.

Simply follow basic hygiene. Treat the patient in an area that is clean and has running water available. This will usually be the bathroom.

If available - and only if necessary - clean any wound with nothing more than fresh water. You might want to do this, for example, to see if there is anything lodged in the cut which can be easily removed by flushing out.

Otherwise don't play with it. Content yourself with stopping the flow of blood and making the victim comfortable.

Finally, dispose of all used and soiled dressings. If you can burn them, fine. If not, try to place them in a sealed container of some kind, even if that is only a garbage bag that can be tied securely.

Do NOT flush them down the toilet and do NOT place them in the recycling bin.

Then clean all surfaces and any implements used with warm soapy water to remove all traces of blood. Only after you have done that should you use disinfectant.

If you have no disinfectant readily available, use vinegar which is a reasonable substitute. Do not, however use it or any form of alcohol on the patient.

Wounds

While a cut is caused by some object, such as a knife, slicing into flesh, a wound is caused by penetration.

I make this distinction because there is a difference in the way the two are treated.

With a wound, it's important to consider that something may still be lodged inside the injury. In fact, it may even be visible and protruding from the injury.

In such a case, unless it can be removed by simply wiping or flushing with water, leave the object where it is. There are two major for reasons for doing so.

Left in place, the object will help to control bleeding. Plus, removing it may cause further tissue damage and more severe blood loss.

Instead, bandage round the object, building up the padding to help hold it securely in place.

It is, of course, vital to seek medical help as soon as possible and equally important to expect the onset of shock.

Notice the difference in attitude here - treat for shock immediately, even though it is not yet evident. There may be internal bleeding which you cannot see, and the body has almost certainly gone into damage limitation control mode.

This is a dangerous state of affairs and almost certainly more serious than the original injury - so don't hesitate to take action. If in doubt, always follow the treatment for shock procedures. You can't do any harm and you may save a life.