3.6 Wound Care, First Aid, and Emergency Response

Wound Assessment and Infection Signs

Wound care may use clean or sterile technique depending on the procedure and provider direction. The CCMA observes and reports rather than independently treating beyond scope. Assess and document bleeding, drainage (serous, sanguineous, or purulent), odor, the condition of surrounding skin, pain, swelling, redness, and warmth.

Reportable Signs of Infection

Secure dressings snugly but without impairing circulation — check that fingers or toes distal to a dressing stay warm, pink, and sensate.

First Aid Priorities

First aid follows a fixed priority order: ensure scene and patient safety, control bleeding, prevent falls and further injury, and activate the emergency plan when the situation exceeds routine care.

• Bleeding control: apply firm direct pressure with a clean dressing first; if it soaks through, add layers without removing the first, elevate the limb if no fracture is suspected, and apply a pressure dressing. Escalate uncontrolled bleeding immediately.
• Burns: cool a minor burn with cool (not ice-cold) running water; do not apply butter or ointments to severe burns.
• Falls: do not move a patient with a suspected spinal or head injury; keep them still and call for help.

Recognizing and Responding to Emergencies

These symptoms stop routine work and trigger protocol-based response and provider/EMS notification.

Seizure trap: restraining the patient or forcing an object between the teeth can cause injury and is wrong. Syncope trap: sitting the patient up too soon. Anaphylaxis trap: giving an antihistamine and waiting instead of recognizing that epinephrine is the priority.

Emergency Response Sequence

When an emergency appears, work this order: (1) stop routine work, (2) protect the patient from injury, (3) notify the provider or activate the emergency/EMS team per protocol, (4) document objective findings and actions taken with times, and (5) complete the incident or unusual-occurrence report when required. Common trap: finishing a dressing change or a chart note before responding to an emergency sign.

Emergency Supplies

The crash cart and first-aid/emergency supplies must be checked, fully stocked, unexpired, sealed, and documented on a regular schedule so that nothing is missing or out of date when needed. A broken seal means the cart was opened and must be restocked and re-verified. Knowing where the emergency equipment, oxygen, and AED are located before an emergency is part of the CCMA role.

Standard Precautions and Personal Protection

Every wound and first-aid scenario assumes standard precautions: treat all blood and body fluids as potentially infectious. Perform hand hygiene before and after patient contact and after glove removal, wear gloves whenever contact with blood, drainage, or non-intact skin is possible, and add a gown, mask, or eye protection when splashing is likely (for example irrigating a draining wound).

Remove personal protective equipment in the correct order to avoid self-contamination — gloves first, then eye protection, gown, and mask last in a typical doffing sequence — and dispose of contaminated dressings in a biohazard container, not the regular trash. A needlestick or splash exposure is reported immediately and follows the facility exposure-control plan, not handled quietly later.

Using an AED and Recognizing Cardiac Arrest

If a patient collapses, is unresponsive, and is not breathing normally, the response is to activate emergency services, begin CPR, and apply the automated external defibrillator (AED) as soon as it arrives. Turn the AED on and follow its voice prompts, place pads on the bare, dry chest as pictured, ensure no one is touching the patient while it analyzes the rhythm, and deliver a shock only when the device advises it. Resume chest compressions immediately after a shock or a 'no shock advised' message. The CCMA works within training and scope, but knowing the AED location and basic operation is expected.

Stroke signs (sudden facial droop, arm weakness, speech difficulty) and the importance of noting the time symptoms started are also testable, because time drives stroke treatment.

Worked Emergency Scenario

Minutes after receiving an IM injection, a patient develops hives, lip and tongue swelling, wheezing, and says the room feels like it is spinning; blood pressure is dropping. This is anaphylaxis, and the exam-correct response is to recognize it immediately, activate the emergency response, and follow protocol for epinephrine — not to give an oral antihistamine and wait, which is a classic distractor. Position the patient to support breathing and circulation, monitor airway and vitals continuously, prepare to assist with oxygen, and document the onset time, signs, interventions, and responses.

Throughout, you stop routine work, protect the patient, notify the team, document objectively with times, and complete an incident report afterward — the same five-step emergency sequence applies whether the trigger is anaphylaxis, syncope, a seizure, choking, or uncontrolled bleeding.