John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
As I packed my bags, the excitement of a surf trip to Mexico filled my mind.
A good friend's birthday celebration and the X Games surfing competition being
held with predictions of a large south swell were just some of the highlights I
was looking forward to. Puerto Escondido, Mexico was the destination. It would
be my first time venturing down to this particular part of mainland Mexico that
has such powerful surf; it is known as the "Mexican Pipeline" because of its
similar treacherous conditions to the famous Pipeline on Oahu's North shore.
Despite the tales and warnings I received from other surfers about the place, I
was ready for an adventure. Little could I have predicted that I would receive
more "adventure" on this surf trip than I had anticipated.
With three boards in tow and a week's supply of bikinis and clothes for hot
humid weather, I set off to catch my flight to Puerto Escondido, Mexico. After a
full night and half a day's journey, I exited the Puerto Escondido airport. The
cab ride with other surfers, including even some pro surfers coming in to
compete in the X Games, only took a few minutes to reach the hotel that faces
the infamous beach break. As the luggage was unloaded, the sound of eight foot
surf turned my head, and I found myself in perfect viewing distance of hollow
beach break waves spitting surfers out right and left like baseballs in a
batting cage.
Cuts, scrapes (abrasions), and puncture wounds facts
Washing a cut or scrape with soap, and water and keeping it clean and dry is all that is required to care for most wounds.
Cleaning the wound with hydrogen peroxide and iodine is acceptable initially, but can delay healing and should be avoided long-term.
Apply antibiotic ointment and keep the wound covered.
Seek medical care within 6 hours if the affected person thinks they might need stitches. Any delay can increase the rate of wound infection.
Any puncture wound through sneakers has a high risk of infection and should be seen by
a health care practitioner.
Any redness, swelling, increased pain, fever, or pus draining from the wound may indicate an infection that requires
medical care.
What is the best way to care for a cut or scrape?
The first step in the care of cuts, scrapes (abrasions) is to stop the bleeding. Most wounds respond to gentle direct pressure with a clean cloth or bandage. Hold the pressure continuously for approximately 10-20 minutes. If this fails to stop the bleeding or if bleeding is rapid, you should seek medical assistance.
Next, thoroughly clean the wound with soap and water. Remove any foreign material
in the wound, such as dirt, bits of grass, which may lead to infection. Tweezers
can be used (clean them with alcohol first) to remove foreign material from the wound edges, but do not dig into the wound as this may push bacteria deeper into the wound.
The wound may also be gently scrubbed with a washcloth to remove dirt and debris. Hydrogen peroxide and povidone-iodine (Betadine) products may be used to clean the wound initially, but may inhibit wound healing if used long-term.
Cover the area with a bandage (such as gauze or a Band-Aid) to help prevent infection and dirt from getting in the wound. A first aid antibiotic ointment
(Bacitracin, Neosporin, Polysporin) can be applied to help prevent infection and keep the wound moist.
Continued care to the wound is also important. Three times a day, wash the area gently with soap and water, apply an antibiotic ointment and
recover with a bandage. Change the bandage immediately if it gets dirty or wet.
Who should seek medical care for a cut?
If you cannot control the bleeding from a cut or scrape (abrasion), seek medical attention.
Any cut that goes beyond the top layer of skin or is deep enough to see into might need stitches (sutures), and should be seen by a health care
practitioner as soon as possible. Generally, the sooner the wound is sutured, the lower the risk of infection. Ideally, wounds should be repaired within six hours
of the injury.
People with suppressed immune systems (including
people with diabetes,
cancer patients
receiving chemotherapy, people who take steroid medications, such as prednisone,
patients on dialysis, or people with
HIV) are more likely to develop a wound infection and should be seen by a healthcare
practitioner.
Any wound that shows signs of infection should be seen by a health care
practitioner (see
"What are the signs of a wound infection?").
Staphylococcus or Staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a Staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
A keloid is a scar that doesn't know when to stop. When the cells keep on reproducing, the result is an overgrown (hypertrophic) scar or a keloid. A keloid looks shiny and is often dome-shaped, ranging in color from slightly pink to red. It feels hard and thick and is always raised above the surrounding skin.
Tetanus is an often-fatal disease caused by nerve toxins produced by the common bacteria Clostridium tetani. In a seven-day period after infection, a person experiences muscle spasms, restlessness, headache, irritability, then lockjaw, and the lungs stop functioning. Tetanus is treatable with antibiotics and drainage. Sedation is often give to stop muscle spasms.
Necrotizing fasciitis is also known as a flesh-eating bacterial infection, Fournier's gangrene, suppurative fasciitis, and necrotizing cellulitis. The disease is occasionally caused by fungi, but most cases are caused by bacteria that enter the skin through insect bites, cuts, puncture wounds, or surgical incisions. Symptoms include pain, redness, swelling, fever, chills, skin ulceration, bullae formation, black scabs, gas formation, and fluid draining from the site of infection. Treatment involves hospitalization, the use of intravenous antibiotics, and debridement of the necrotic tissue.
There are millions of dogs living in the United States, and thus many cases of dog bites. Annually, hundreds of people seek emergency medical care for dog bites. Treatment for a dog bite depends on how deep the injury is and the amount of tissue damage. Dog bites can be prevented by employing preventative measures.
There are several bones in the foot, and these bones can be broken (fractured) in a variety of ways. Falling from heights, dropping heavy objects on the foot, or stress fractures from running or walking. Treatment of a broken foot depends on what bone in the foot is broken.
The hand has several bones to include the wrist, palm, and fingers. Fingers are the most commonly injured part of the hand. The most common causes of broken fingers are a traumatic injury to the finger or fingers such as playing sports, injury in the workplace, falls, and accidents. Treatment for a broken finger may be as simple as buddy taping the broken finger to the adjacent finger, or if the fracture is more serious, surgery.
The most common cause of a black eye is due to an injury to the face or head. Most black eye injuries are minor and heal on their own, however, some may lead to significant injury. In addition to trauma to the face, cosmetic surgery can cause a black eye(s) as a side effect. People should be aware of the situations in which medical care should be sought immediately for a black eye.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
Natural diasters such as a hurricane can take a toll on family, friends, and neighbors. Both physiological and psychological stresses can be devastating. Learn how to prepare for a hurricane like food storage, safe water, first aid measures, cleaning mold, wearing protective gear, preparing for electrical hazards, avoiding carbon monoxide, avoiding physical injuries and hazardous materials, preventing drowning, reducing the risk of thermal stress, and preventing fatigue related injuries.
The foot is designed to withstand the considerable forces
placed on it by walking, running, and jumping. The 26 bones of the foot are
connected by joints and supported by thickened ligaments to absorb the impact of movement. As well,
the joints of the foot are acted upon by tendons that allow flexing and
extending to permit walking and running to occur.
The bony anatomy can be described as follows:
The talus articulates with the
tibia (shin bone) to form the
ankle joint.
The calcaneus or the heel
bone is attached by ligaments to the tibia to
provide stability to the ankle joint.
The midfoot consists of the navicular, the cuboid, and the three cuneiform
bones. The midfoot is where inversion and
supination of the foot occurs. These
motions allow the sole of the foot to turn inwards and upwards.
The five metatarsal bones are connected to each toe.