Workshop First Aid
Story by Raf Nathan
Despite your best care and intentions there is always a chance of injury in a workshop that is equipped with sharp and powerful tools and machines.
Minor can be major
It doesn’t have to be a big incident to get into trouble. A simple splinter is no problem when removed with a pair of tweezers. However, a very deep splinter that breaks off at the skin surface is more problematic. Applying pressure around the entry point can help to expose some wood for the tweezers to purchase on.
Certain woods, local and imported, have septic properties and even small slivers can lead to an adverse reaction. I know someone who got a splinter from a tropical wood in their thumb which turned septic and led to massive infection. Wearing good gloves will help prevent some hand injuries. Modern work gloves offer a close fit and some are labelled cut resistant.
For example, those containing Kevlar can to some extent protect you against knife cuts. Go for the highest resistance rating of 5.
Tetanus is potentially fatal so it pays to be up to date with immunisation shots, especially when you’re over 50 years of age. Penetration of foreign bodies even as small as splinters through the skin is a potential entry point for tetanus!
With bad injuries shock is a potentially dangerous outcome. Uncontrolled bleeding or a large loss of blood can drastically lower blood pressure, load the heart and reduce the flow of nutrients to vital organs. Shock is life threatening.
You may be focused on dressing a wound and not realise the patient is drifting off. Watch out for pale and clammy skin, low breathing, racing heartbeat, confusion or unconsciousness. Lay the patient down, raise their legs, reassure them and call an ambulance.
Grinding wheels used for sharpening planes and chisels can cause eye injuries because of metal particles being flung outwards. Always wear protective glasses when grinding or using power tools and machinery. Inspection of an eye injury will be difficult due to watering, spasm and possible swelling, or if the patient is unable to open the eye. Contact lenses need to be removed and if so ask the patient to do this, if possible. Warn them not to rub the eye even if there is an overwhelming desire to do so.
Small objects on the eyeball surface not embedded can usually be flushed out with tears and blinking. If tears don’t expel foreign particles check under the lids. A clean moist cloth or cotton bud gently touched on the object should remove it. If not successful wash the eye with a gentle stream of sterile saline solution or clean water.
An embedded metal or wood particle in the eye requires surgical intervention. Don’t try and remove it, rather cover the injured eye with a sterile pad but do not apply direct pressure to the eye. A clean paper cup can also be positioned over the eye and very gently bandaged in place (or fixed with masking tape at a pinch). Cover the other eye to limit eye movement. Reassure the patient and attend a surgery.
The most common injuries that can occur in a workshop or building site are incisions and lacerations where the skin is cut or torn. Small cuts and abrasions of course can be covered with common plasters.
With incisions there may be damage to blood vessels and muscle structure. A bruise or contusion is a closed wound caused by a blow or fall. A bad hammer hit on a thumb is a common example. All these are classed as minor wounds and can be treated on site, usually.
Attending to a wound
Check for any embedded wood or metal in the wound and if clear apply gentle pressure to the wound site with a sterile pad. Applying a pad is usually sufficient.
It’s critical to stop the bleeding. A clean cloth can be used, or pressure applied with even a hand if nothing else is available. Next, gently draw the edges of the wound together and apply a pad. Elevate the wound and monitor the patient. You will need to decide whether a doctor should attend the wound. Small cuts will heal well, particularly in young people. Longer cuts may need stitches. Take care with older people in poor health.
A puncture wound is penetration of the skin by a sharp or blunt object, think of spindle moulder knives flying through the air or someone else falling on a chisel. Although external bleeding may not appear bad, internal bleeding may be more severe and not immediately noticeable.
Impaled objects like knives may again present minimal external bleeding as the object seals the wound to an extent, again internal bleeding may be severe. For these injuries first call an ambulance. Do not remove an embedded object as it may open the wound to significant bleeding.
Reassure the patient and remove clothing near the site and stop any bleeding. Apply pressure around an object or directly to a puncture with preferably a sterile pad or clean cloth. A doughnut shaped pad can be placed over an embedded object. Assume the patient may suffer shock and lay them down and elevate legs and wounded area.
An avulsion is when skin and other tissue is partly or completely torn away. Bleeding may be significant. This could happen with a sander. Again a pad over the area is needed to control bleeding. If severe, medical support will definitely be needed. Reassure the patient and watch for shock.
Control bleeding by direct pressure with a pad on the wound and elevate it. Place a bandage over the pad to secure it. Call an ambulance.
Collect the missing part but do not wash it. Rather place it in a clean plastic bag and seal the bag. Put the bag in a container of water with ice in it. Don’t let the ice touch the amputated part to avoid damaging nerves. Reassure the patient and lay them down with the injured limb elevated. Watch for shock.
Life threatening bleeding occurs when blood gushes or squirts from a wound and your efforts to control it with direct pressure are not working. Apply another pad and a tighter dressing. Elevate the part, assure the patient that remaining at total rest is the best activity.
Last resort is to apply a torniquet. Ideally a bandage around 50mm wide is wrapped tightly above and away from the wound on an arm or leg. The tightness should just stop the bleeding. Record the time of application and write this on the skin near the wound.
Can occur from exposure to moulds, fumes and wood dust. A severe reaction can be fatal with a sudden drop in blood pressure and impaired breathing. Allergies can build over time and in rare cases your favourite wood could one day become an enemy. I heard of one guy who collapsed after getting a mouthful of everyone’s favourite, blackwood!
Early signs of an impending problem can be mouth tingling, swelling of part of the face, rash and nausea. If this progesses to wheezing and a drop in consciousness, seat yourself or the patient and call an ambulance (lying down is worse for breathing). If you have an asthma puffer take four puffs.
The information above covers some of the problems that can arise from injury in the workshop. Safe practices and safety gear are our best means of prevention, however should injury arise some forethought and access to first aid supplies will be a great help.
A basic first aid kit for the workshop may include the following:
• Band aids, adhesive dressings and also non-adherent dressings as these don’t stick to skin and can be easily removed
• Combine and BPC dressings have bandage, pad and dressing as one unit and are ideal for deep wounds as they absorb blood and fluids.
• Triangular bandage, use as sling or a pad
• Roller bandages can be used to apply pressure to control bleeding, keep dressings in place, support injured parts
• Tweezers, cotton buds, Panadol, sealable plastic bags
Raf Nathan is a woodworker and also has a Bachelor of Health Science.