There have been many misconceptions and wives tales when it comes to how to properly care for a wound. One of the more dangerous is spreading butter or other grease on a burn to relieve the pain. In reality, any type of grease can cause more harm by trapping heat, suffocating the tissue and trapping any harmful bacteria against the burn. Another is pouring alcohol or peroxide directly into an open wound to cleanse it. Again, this practice causes further destruction of the tissue, and delays the healing process.

How to care for an open wound

To begin with, assess the wound. What type of wound is it- A puncture wound? A slice caused by a sharp object such as a knife or outdoor equipment? Is it a jagged, irregular wound such as a chainsaw injury, where a lot of debris is in the wound? A scraped knee with gravel embedded?

All wounds are a break in the integrity of the skin, the largest organ in your body. It is the first line of defense between you and the outside world. Once that defense has been breached, how you care for it will determine the outcome of the healing process.

Steps to care for a wound

Once you have assessed what type of wound you are dealing with take the following steps

1. Stop or control bleeding if excessive or not well controlled. A little bleeding helps clear out invading pathogens and debris.
2. Remove any obvious debris, gravel or other objects from the wound. Use tweezers, or manually pick out debris. Flush out with plain water. Tap water is fine.
3. Continue to flood the wound with water, further cleansing the area. Be sure to clean and rinse around and away from the wound. This will prevent bacteria from entering the wound. Rinse with copious amounts of water. If you have access to a syringe or any way to deliver water under pressure, use it. This will help flush out any debris, bacteria or other matter that may not be visible to the naked eye. DO NOT use rubbing alcohol or hydrogen directly in the wound. This can cause further destruction to the skin integrity and delay the healing process.
4. Once all debris has been removed, and area adequately flooded and flushed with water, pat dry with clean gauze if you have it. If not, a clean, free of lint piece of cloth will do.
5. Cover with dressing. Do not use specialized dressings, ointments or creams unless instructed by your care provider. Products such as Neosporin do not prevent cellulitis. In fact, there is some evidence emerging that use of Neosporin or similar products may slow the healing process.
6. If the wound is caused by an animal or human bite, seek medical attention as soon as possible. The mouth is full of pathogenic bacteria, and a prophylactic antibiotic may be necessary to prevent a systemic infection or cellulitis. This also goes for wounds that have been exposed to contamination and couldn’t be properly cleaned, puncture wounds and other wounds that you were unable to effectively clean.
7. Change dressing daily. There will be some clear or even discolored exudate- this is normal, your body is healing itself. However, if the wound smells, or is swollen, the surrounding skin is hot or red to the touch, any red lines traveling from the wound outward, excessive drainage (cloudy, yellow or grey) seek medical attention. Also seek medical attention if fever over 100.4 (see below-signs a wound needs an antibiotic)
8. If any of the above complications arise and you are unable to get to the doctor, there are two antibiotics in the Jase case that are effective in most cases of infected wounds or wounds that have a high likelihood of infection– One is amoxicillin clavulanate and the other one is doxycycline. The Jase case includes a booklet to help you identify when an antibiotic may be necessary. This is especially helpful when unable to seek medical care or medical care isn’t available.

How to tell if a wound requires an antibiotic

In many cases a wound will heal nicely on its own. The body is equipped with an amazing ability to heal itself. There are some instances, however when an antibiotic may be necessary, either to prevent infection in high-risk wounds or to treat active infections

Signs a wound needs an antibiotic

• The wound is red, swollen and hot to the touch
• The wound is substantially more painful than the initial injury
• Excessive drainage – foul smelling, yellow and/or grey
• Chills or fever over 100.4
• Red streak spreading from the wound

Antibiotics needed prophylactically

• Diabetic, heart valve disease or immune compromised- all are at high risk for infection
• Puncture type wounds from animal bites-cats, some rodents, etc. or human bites- These bites contain bacteria that is almost impossible to thoroughly clean with pressurized water.
• Other types of puncture wounds- nails, fencing, needles, garden tools and implements
• Contaminated wounds-wounds exposed to manure, feces, swampy or bad water
• Open fractures where bone breaks through the skin

Now that January is “in the bucket”, 2023 is well on its way to challenges never before encountered in recent history. The following is a list of healthcare predictions for 2023:

Telemedicine will continue steady growth

During the pandemic, telehealth came to the forefront for patients unable to visit their care providers in person. Remote visits ensured that patients were still able to receive non-emergency care without being exposed to pathogens in the waiting room.

Telemedicine will continue to see growth as technology becomes easier to interface with, and patients start to see the value of remote visits.

Telemedicine will never replace in-clinic visits; however, for routine screenings (blood pressure visits without complications, allergies, and chronic health conditions that require monitoring) the convenience of having your appointment with your practitioner from the comfort of your home will become more appealing. 

Some of these benefits include saving time in transit to the clinic, saving money on gas and transportation costs, limiting exposure to pathogens, and a more flexible schedule for both patient and practitioner. 

Digital health tools, such as blood pressure monitors, scales, respiratory monitors, and thermometers will continue to make their way into homes as this technology is embraced. In addition to monitoring equipment, mobile apps on phones where patient and care provider can communicate. One example is blood sugar readings via an app that can be sent directly to the care provider.

Continued medical supply chain disruption.

Healthcare worker shortage continues.

Prior to 2020, the trend of healthcare workers- doctors, nurses, techs and aides leaving the workforce was already in progress. The covid 19 pandemic escalated the numbers. An aging workforce, job burnout and employees leaving healthcare altogether have added to the burden hospitals and clinics face. A recent (September 2021) Mercer study of healthcare workers found that 49% of healthcare professionals surveyed cited burnout due to workload as a primary reason they would consider leaving their current employer. Since 2021 the shortage has escalated. 

A September 2022 survey of 673 respondents done by the Medical Group Management Association reported healthcare worker shortage as its primary concern (58% respondents) heading into 2023. This shortage is already being felt by patients- staffing shortages lead to not enough available hospital beds, and longer ER wait times. 

Escalation of Russia-Ukraine conflict affecting US healthcare and supply chains, and possibility of nuclear war

According to Becker’s hospital review, the Russia-Ukraine conflict has and will continue to compromise US healthcare and supply chains by:

• Increase in transportation costs-tensions in the area of conflict have caused some ships to avoid the area altogether. The result is a potential delay /backlog of supplies at ports.
• The US has very limited manufacturing of healthcare products- we rely on other countries to provide medical supplies, instruments and medications, political tensions and sanctions continue to compromise the supply chain

The escalation of the Russia-Ukraine conflict has also brought the possibility of nuclear war to the table. Potassium iodide, Prussian blue and EDTA are treatments for certain radiation exposure. Prussian blue, a prescription drug, and potassium iodide (over the counter but experiences waves of shortages) are taken by mouth and EDTA is given by intravenous delivery. 

Drug shortages continue into 2023

 The National Community Pharmacists Association indicates that many independent community pharmacies are experiencing ongoing drug shortage issues and difficulty filling open staff positions.

Two antibiotics, Amoxicillin powder is still in shortage and Augmentin (amoxicillin and clavulanate)was recently reported in shortage. The prescription drug Ozempic, an injectable drug indicated for type 2 diabetics has been in short supply in various pharmacies. 

In a report by the Pharmacy Checker titled “Not Made in the USA” 78 percent of active pharmaceutical ingredients for brand name pharmaceuticals are sourced out of the country. China, India, and Mexico lead the way in terms of volume of ingredients. It is estimated the number is even higher for generic drugs.

Get prepared NOW

Given the precarious situation overseas with global instability on the rise, our medical supply chain and medicines are teetering on the verge of collapse. There is no time better than now to stock up on your prescription medicines, get any medical supplies you and your family need, and order a Jase Case.

With emergency room department waiting times ranging from just over one and a half hours (North Dakota) to just under 4 hours, (Maryland) the likelihood that you will be exposed to contagious diseases in crowded waiting rooms is almost certain.

 From urinary tract infections to respiratory infections (pneumonia, covid, influenza and others) to gastrointestinal illnesses (diarrhea and vomiting) to hospital acquired infections,  the waiting room in the emergency department is a cesspool of infectious agents.

It is estimated that up to one in four ER visits are unnecessary or could be handled via doctors office or urgent care visits. In addition, the CDC estimates that 42 percent of the US population visits the ER annually. Given the long wait times in the ER waiting rooms, this is a massive number of potentially unnecessary exposures to infectious diseases.

 To put this in perspective, this calculates to approximately 3.48 million ER visits that could be handled by urgent care or doctor’s office visit Even with shorter waiting times (average wait time in doctors waiting room is 18 minutes) you are still exposed to other sick people for an extended period of time.

The most common reasons for an ER visit as of 2020 are:

• Abdominal pain
• Chest pain
• Fever
• Shortness of breath
• Cough
• Pain, non-specific
• Psychiatric disorders
• Back pain
• Accidents

While many of these visits are true emergencies, a sizeable number are preventable.

Healthcare worker shortage

Along with extended wait times, the US is facing an unprecedented healthcare worker shortage.

The pandemic put a tremendous strain on the healthcare population, many report burnout as a factor for leaving. In addition, the workforce is aging faster than the replacement rate of qualified workers.

• Nearly one in 5 healthcare workers quit their job during pandemic.
• According to a 2021 report by AAMC, in 2019. there was a national shortage of 19,858 physicians and this number is projected to climb over the following decade.

Both these statistics point to compromised patient care, The remaining workers are stretched to their limit, working long hours, leaving them exhausted both mentally and physically.

A viable and highly effective option to non-emergent in person visits is telemedicine

Telehealth — sometimes called telemedicine — lets your health care provider care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone.

Telehealth visits can range from:

• Strains and sprains
• Allergies and asthma management
• Flu symptoms
• Diarrhea
• Vomiting
• Monitor chronic health conditions such as arthritis, and blood pressure.
• Medication refills
• Order labs and x rays as necessary
• The telehealth provider can triage and advise if an ER or in-person visit is warranted.

Cons of telehealth

• Should never be used as emergency care
• Should not be used in place of in office visits
• Some populations may not be familiar with digital access and how to use. There can be a learning curve.

There are several ways to utilize telehealth care:

• Speak to your health care provider live over the phone or video chat.
• Send and receive messages from your health care provider using secure messaging, email, secure messaging, and secure file exchange.
• Use remote monitoring so your health care provider can check on you at home. For example, you might use a device to gather vital signs to help your health care provider stay informed on your progress.

Advantage of telehealth visits

• Avoids exposure to infectious diseases by avoiding waiting rooms.
• Saves transportation costs and time traveling.
• Can save time accessing medical care.
• Many health insurance plans now cover these types of visits.

Your healthcare provider may already be providing telehealth services. Check with them and see if this is an option. In addition, check with your healthcare insurance provider and inquire if they cover telehealth visits.