Sunday, March 21, 2010

CPNE SIM LAB #4 Successful Wound Management

For successs at the Wound Station follow these steps:

ID patient against the treatment record - verbalize the patient's name, date of birth, and medical record number
Gather supplies
Ask where the location of the biohazzard container is - if possible make sure you will not have to cross your Sterile field to dispose of the drsg.
Tear tape - hang from the table edge - 3 or 4 strips
Label one end of tape with date, time, and your initials
Open all of the sterile supplies you will need
Open the Saline - do not set down the cap, pour a tiny amount in trash can
Keep label up pour saline over tub of 4 x 4 (not too much)
Don clean gloves
Loosen tape toward wound.
Remove drsg as one unit
State noting drainage
Apply sterile gloves
Obtain one 4x4, squeeze extra saline out and open all the way do not shake
  • Parachute Method -  grasp the 4x4 in the center and bring up each corner like a parachute scrunch into smaller form , place in center of wound and open carefully; do not touch the skin with the gloves or the gauze or
  • Ribbon Method - grasp one corner of the 4x4 , fan fold (do not twist or it will become a rope and that is forbidden) and go around edges of the wound ;do not touch the skin with the gloves or the gauze
If you contaminate the gauze change your sterile gloves; Show the CE to avoid having to remove the dressing at the end and risk moving out of place.

this one would fail the gauze is too close on the left upper aspect.

Place dry 4x4 on top
Place abd on top
Secure with tape
Clean area and remove gloves
Verbalize washing hands prior to picking up pen to document
Sign the treatment record
State patient tolerated the procedure without incident
Declare completion


  1. Hello

    Before putting on sterile dressing don't we have to wash hands or gel up??

  2. I'm sorry, I meant before putting on sterile gloves don't we have to at least gel up hands. thanks

  3. In a real situation yes. But this is for the Wound Simulation on an artificial wound.

  4. I help take care of my Uncle who has a pressure sore above the where the "crack" begins. I think they called it the saccrum (sp)? The wound care nurse visits every day and cleans it but at bed time it seems I'm always having to clean it up after his diaper is changed by the aide. I have to use saline to flush it out, then apply a swab of dermasyn, pack it with gauze and apply a dermaview bandage and then put gauze and tape over the dermaview (without touching it) to try (in vain) to keep it clean whenever my Uncle soils his diaper. There's got to be something that will protect the wound's bandages from fecal matter so I don't have to re-dress the wound again. Any thoughts? Tips? PLEASE???

  5. Neil,
    You may want to try to attach a plastic barrier (saran wrap, cut sandwich bag, or even a plastic grocery bag) with tape sealing the perimeter over the completed decubitus dressing. Of course check to see if that is acceptable with the nurse or doctor. Some dressings need to "breath". Then if your uncle is incontinent only the plastic barrier would need changed. I would think this would be better than having to disturb any granulation (healing) and would definately reduce the contamination from the feces. If you would like I wouldn't mind doing a short video to show you what I am thinking of. Your uncle is blessed to have you in his life. I hope this helps you.