Self Injury: First Aid for External Injuries, Scars

by LifeSIGNS

(Page 4 of 8)

First Aid for External Injuries

Recommended First Aid Kit

• Surgical Tape
• Bandages
• Scissors
• Saline Water
• Antiseptic
• Painkillers

Cutting

When you need to SI please find a safe place where you will not be disturbed and that you feel calm in, always use new blades where you can and have your first aid kit ready to hand. LifeSIGNS does not encourage the use of self injury, we simply accept that self injury is a coping method for some people at this time.

The main points when considering first aid after cutting is that you must control the bleeding and prevent any possible infection.

If you lose a great deal of blood, you can go into shock. This can get pretty serious as the brain and heart can be deprived of much needed blood.

Once the urge to cut yourself has passed and you can concentrate on treating your injuries you need to be sure to:

• Assess the damage. If blood is pumping out from the injured area, in time to your heartbeat then this means you have cut through an artery as blood is under high pressure when pumped from the heart.
• When the area of the wound is particularly large then try and press the edges together to prevent further damage.
• The bleeding needs to be controlled to make sure blood loss is minimal. Cover the wound with a clean dressing and apply direct pressure to prevent bleeding.
• When blood trickles or oozes out of a wound then it is a minor injury as it means that only blood capillaries have been broken.
• If the area of injury is on a limb then raise the limb to reduce blood flow to the area, reducing blood loss and allowing time for a blood clot to form.

Using indirect pressure through use of a tourniquet above the wound can reduce bleeding; this needs to be firm enough to prevent bleeding but not tight enough to prevent circulation. The way to test this is to check for a pulse, or if the injury is on a limb; press the nail of a finger or toe; this should make it go white. Once you remove pressure, the nail should return to a pinkish colour. If not and it remains white or blue, the bandage is too tight.

When To Seek Medical Attention

• If the wound continues to bleed heavily once you have carried out the above steps, including bandaging
• If the cut is deep and has exposed underlying muscle, this is dark red in colour and may look like a slab of meat.
• If you have lost sensation in the area of injury, or more widespread; you may have cut a nerve.
• If after a few hours or several days you can see the wound is infected; it could be red, sore, swollen or weeping.

Burning

If your method of SI is burning by scalding or using a heated object then the most important thing you can do is lower the temperature of the affected area. The tissue damage that has been caused can progress very rapidly so you must rinse the area in cold water for at least 10 minutes.

If there is any clothing surrounding the burn please remove this by either taking it off or cutting it away; this also applies to removing constricting objects such as rings, watches, bracelets; just take it off. This is done because once tissue has been burned or damaged swelling of the area will follow; also the tissue can become sticky and attach to clothes or other things. IMPORTANT If there is anything that is already stuck to the burn, DO NOT remove it, this could make the situation worse.

The skin can also be burned when it is exposed to certain chemicals. If the chemical you have used is liquid, wash this off with lukewarm water for at least 30 minutes. If the chemical is dry, then brush the chemical off before rinsing the area in water. Please do not try and neutralise the chemical; if you have used an acid DO NOT try and reverse it by adding an alkali.

All chemical burns should be referred to a Doctor.

References and Further Reading

Colins Gem: First Aid; Dr. R.M. Youngeon
Cutting the Risk; Self Harm Network

Scars

Self injury can result in scarring. Scars may fade within the first two years, but scars are permanent.

Scar Biology

The skin is made up of two layers, the upper (epidermis) and the lower (dermis) on top of the subcutaneous [under-skin] fat. When we damage the dermis, scar tissue is formed from collagen. Depending on the severity / depth etc. of the damage, and the subsequent treatment received in the critical 3 week healing window, the scar will be minor or hypertrophic.

It has been observed that deep cuts often cause raised, hard, itchy hypertrophic scars; often as wide as the cut was deep.

Scar Treatments

If you do have a fresh wound, do consider hygiene; an infected wound has a higher chance of greater scarring.

Clean the wound as First Aid information suggests, and bandage or use a plaster.

For wounds that you do not expect to 'close' on their own, we highly recommend 'skin closure' plasters, such as can be purchased from chemists in the highstreet, or from their websites.

For fresh scars or even older scars you may find that Scar Reduction Patches help reduce the scar. They can be expensive and may require a month of treatment.

Scar reducing creams may be sought from your Doctor.

Make up may also be used to hide scars. Specially designed make up is available.

About the Author

www.lifesigns.org.uk
LifeSIGNS (Self Injury Guidance & Network Support) is an Unincorporated Voluntary Organisation. That means that we are an organisation, run by directors who volunteer their time, and are responsible for their own individual actions.