Can you just butterfly it yourself?

August 10, 2018 Allan Brettman

Let’s say, hypothetically, you’re hiking the Timberline Trail on Oregon’s Mount Hood in early September.
And let’s say — again, hypothetically — you decide it is a good idea to leap onto a rock in the middle of a raging mountain creek, then leap onto another, while carrying a 40-pound pack. Why? Because you’re trying to keep up with your daughter and her dog. Hypothetically.
And then your foot slips on one of those rocks and you come crashing to the surface, your forehead smacking a rock in a quite real fashion.
A gash opens over your right eye, bleeding ensues.
What then?
Like many things, it depends. But when it comes to cuts, there are four steps that should be followed whether the cut is barely perceptible or has sliced through skin and muscle. 

1. Stop the bleeding. In the example above — OK, it really happened — bleeding stopped remarkably quickly with continuous pressure applied to the gash above an eye with a bandana soaked in glacier-fed creek water. The frigidness of the water was a plus and the fact infection did not result from the untreated wilderness water was another plus. Cuts that continue to bleed after continuous pressure applied for 15 minutes will typically require sutures.

2. Wash the wound. That river water didn’t clean the wound. Use soap if available, even if it’s a painful scrape that may be even more painful to clean. In an emergency first aid kit at home or one on the trail, it’s valuable to have a syringe with an 18-gauge catheter tip to create a high-pressure irrigation stream. The goal is clear residual dirt or blood. An alternative is to pluck debris with tweezers. In this example, the high-pressure irrigation was used with a syringe, but emergency medical professionals still found dirt later. More on that in a moment.

3. Apply ointment. Neosporin or a generic triple antibiotic ointment will do. In addition to its germ-fighting properties, the ointment will prevent the wound from sticking to the bandage.

4. Protect the wound. In many cases, this will be done with a simple adhesive bandage. For wounds that are deeper — where muscle tissue can be seen, for example — butterfly bandages can be used as a temporary closure technique. In this example, three butterfly bandages were placed perpendicular to the cut. Gauze was then placed over the bandages and the gauze was secured to the skin with surgical tape. If stitches are required, it is important to get to emergency care within six to eight hours, which will reduce the risk of serious infection and help the stitches hold better.

In the example here, the patient walked eight miles to a trailhead, got a ride from a stranger for 20 miles to his car, then drove nearly 50 miles more to a medical center emergency room. There, medical staff thoroughly scrubbed the wound after applying local anesthetic injections, and a physician sewed 13 stitches. The patient said his thanks for a well-stocked first aid kit and the skilled work of an emergency department staff.

When you need fast care for cuts and scrapes you can’t treat at home, come see us at your neighborhood Providence Express Care Clinic or Urgent Care Clinic.

Recommended for you:

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Back to nature: What you need to know before you go

Parents, here’s your back-to-school first-aid kit


This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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