Question

An 11-year-old boy presents to the emergency room (ER) with a 4-inch laceration on his right arm. He was with his friends doing bicycle stunts when he fell off his bike and cut his arm on a rusty nail from the ramp. In addition, his wrist is swollen, bruised, tender to touch, and warm, with limited mobility. He will most likely need stitches to close the laceration and a splint for the sprain. a. After treatment, as he prepares to leave, you give him last-minute care instructions for laceration and sprain. What would be important for this boy to know to prevent further health concerns with his injuries? b. The boy concernedly asks you, “My uncle lost his foot because he got gangrene in it. Am I going to lose my arm if I get an infection in this cut?” How would you respond? c. How would you respond if this was an elderly man rather than an 11 year old boy? need answer in 300-500 words.

Answer 1

a. Lacerations that are sutured as well as splinting requires some aftercare instructions by the nurse. These are :

- Do not put excess pressure over the lacerated area and the splint. The sutures may come out and bleed.
- observe the site for signs of infection such as increased pain, swelling, redness and warmth and report immediately to the physician.
- observe the splint site for tingling or numbness and report immediately if any such signs are observed.
- wash the wound area gently with mild soap and water only.
- avoid unnecessary movement of the splinted area.
b. Gangrene is the dead of the tisdues due to lack of blood supply. The gangrene is more common in people with diabetes, old age, vascular diseases and tobacco smoking. As the boy is young and healthy and has been treated adequately chances of developing gangrene in his arm due to infection are very less. Educate the patient about proper caring of the wound and signs of infection to prevent risks of developing gangrene.
c. No, elderly people are at a higher risk of developing gangrene than younger ones. Elderly people have a poor vascular competence. The blood vessels becomes stiff and the circulation to the limbs is often compromised. Elderly people may also have secondary diseases such as diabetes that interfere with wound healing. These factors increases the risk of developing gangrene.