NOTE: These first-aid tips are taken from the Red Cross guide to first aid and from personal experience. I am not a doctor and, although this page was checked over by a registered nurse, I am not liable for any damage claimed to result from this information. In all cases of serious injury, seek medical attention. This information is provided as a service only.The most important thing, and the hardest to remember when dealing with the consequences of self-injury, is to refrain from judging yourself. Do NOT invalidate yourself. You're a human being who made a mistake and did something you'd rather not have done, just like thousands of other human beings. The fact that most people don't understand self-injury does not make you bad or evil or hopeless or stupid; it makes you misunderstood. Accept this and move on. Don't deny yourself medical attention you may vitally need.
Sometimes the results of self-injury can be safely treated at home. However, if you show symptoms of infection or your self-care doesn't seem to be adequately healing the wound, do NOT hesitate to seek professional medical attention. It can be annoying trying to explain what's happened to a doctor, but it's not worth dying to avoid embarrassment. What to expect in the emergency room and this ER/A&E checklist can help you get effective emergency treatment.
Shock
Severe cuts and burns can cause your body to go into physiological
shock. Fluid loss causes the body to reduce blood flow to the
extremities in order to protect vital organ systems. Basically, your
body starts shutting down -- untreated shock can kill you.
Second-degree burns cause reddening and blistering of the skin. If they are moderately large, they require medical attention.
Third-degree and worse burns involve charring or whitening of the skin. The burn has penetrated through the entire thickness of skin layers. These burns should always be treated professionally; they often require grafting or become infected. The layer of dead skin and nerves is called "eschar," and the process of removing it is known as "debridement." Having burns debrided hurts like hell, even with drugs, but it can be necessary to prevent infection. Let your doctor make the call on whether grafts or debridement are needed.
Burns are nasty, disfiguring, painful, and far more trouble than they're worth. If you burn yourself severely enough to require grafting, the surgeons will put you under general anesthesia, take an instrument that's kind of like a carpenter's plane or a cheese slicer, and peel a section of skin from an unburned part of your body to graft onto the damaged site. It hurts, it's boring, and if it gets infected you have to do it all again. And few things in life have hurt me as much as a healing donor site did. You don't wanna deal with it.
Once more, with emphasis, if you have a bad second or a third-degree burn, get your ass to an emergency room. Immediately.
Most cuts, even ones a doctor might suggest stitching, can be dealt
with at home. There are two exceptions to this:
If you can't
stop the bleeding, or
If you're going into shock.
It's important to maintain direct pressure for ten minutes without peeking. If you're pressing a cloth or bandage against the wound and the blood soaks through before ten minutes are up, just put another one on top of it. After you stop the bleeding, place a cold pack on the wound for ten minutes. Then wash with Betadine and apply an antibiotic ointment or spray (to keep the wound moist and minimize chances of infection) and a bandage. Change the bandage twice daily, and rotate the direction of the bandage tape to keep the skin around the cut from becoming too irritated. Bandages should be large enough that they extend an inch beyond all edges of the wound.
Watch for redness or heat spreading outward from the wound; these are signs of an infection and should be treated by a doctor. Other signs of infection include swollen lymph glands, increased pain, and fever. If you start running a fever, go to the doctor immediately.
Why bother about bandaging? Well, properly bandaged cuts heal faster and are less likely to scar. If the wound is small enough, the new Advanced Care Band-Aid is a good idea. You apply it and leave it on for several days as the wound heals underneath; it's made from a special material that turns fluids from the wound into cushioning or lets them evaporate. The tight seal means no bacteria can get in. If you choose to use a product like this, be sure to read the package directions. Closing the wound with Steri-Strips is also a good way to minimize scarring; the closer the wound edges are as they heal, the less scar tissue the body has to produce to join them.
Drink lots of fluid to make up for any blood you've lost. If you do this and you're still dizzy on standing (postural hypotension -- your blood pressure is dropping when you stand), see your doctor. Also, if you lost a lot of blood or are extremely fatigued, have your blood hematocrit (iron levels) checked -- you might have made yourself anemic.
If it's been more than 8-12 hours since the wound, most doctors won't stitch it. If you absolutely refuse to go to a doctor, at least get some Steri-Strips (or similar product; you can find them in pharmacies) to close the wound yourself. Wounds are stitched mainly to stop bleeding and to reduce scarring.
Silvadine is first choice for burns. The real trouble in recommending Rx's for infections is that the person has to decide if it is "serious" and requires MD attention. The patient usually doesn't have the experience to make this decision safely (e.g., all diabetics' wounds are "serious").