Lower extremity injuries after the hurricane
We are all well aware that hurricanes can be incredibly damaging and dangerous, and many injuries occur before and after a hurricane. With the recent passage of Hurricane Dorian, this is more real than ever. Hurricanes are known to cause physical injuries either directly, often as a result of strong winds causing persons to fall or be hit with blown objects, or indirectly, when persons return to affected areas to clean up and repair. The most common types of hurricane-related injuries are cuts to upper extremities and back strain. Lower leg extremity injuries are also among the most frequent afflictions.
The degree of flooding in the home or surrounding area was directly related to the occurrence of injury, with 39 percent of those who evacuated by walking through water or swimming being injured and an additional 25 percent of those whose homes were flooded with more than three feet of water also being injured. These painful injuries can occur as residents clean up debris from their yards and roofs and remove shutters after the storm has passed.
Some common injuries in the lower extremity include lacerations (cuts, scrapes, wounds), puncture wounds, and sprains and strains from falls.
Lacerations account for 80 percent of injuries post-hurricane, after blunt trauma. Most occur in the post-hurricane, clean up phase. However, with a storm like Dorian where so many people were displaced and had to evacuate during the storm, a lot of people were also injured during the storm. Lacerations are deep cuts or tears in the skin where cuts are more superficial and wounds are deeper. These can easily occur from flying objects or being cut or scraped with sharp objects while running or moving during or after the storm.
A puncture wound is a very common injury seen in the foot especially after a disaster, flooding or a hurricane. It is actually the third most common injury after a storm. It usually occurs when walking barefoot and stepping on a foreign object such as a nail or other metal, glass, a splinter of wood or even plastic. This can be dangerous because of the high risk of infection. The object that caused the wound may be covered in bacteria (germs) which makes its way into your foot. Puncture wounds on the foot make the feet more vulnerable to infection because there may be fungus or bacteria on the foot as well, and sometimes the puncture extends through the shoes or other footwear. If the puncture occurs in water, especially stagnant water after a rainstorm or hurricane, this also increases the risk of infection because of all the bacteria in that water.
Sprains and strains can occur during or after the storm. Again, persons can sustain injury by twisting the ankle or part of the foot while walking or running for shelter or safety during the storm or while lifting or clearing debris after the storm, during the cleanup. Often because of fear or adrenaline, the injury or pain may disappear without being recognized until a long while later.
Caring for your injury
Stop the bleeding: If it is a minor wound it will usually stop bleeding on its own. If it does not, apply gentle pressure with a clean cloth or bandage. If the bleeding persists or if it is a heavy and continuous flow, seek emergency assistance.
Clean the wound: Rinse the wound well with clear water or saline.
Remove splinter(s): If you can see the splinter in your foot, use clean tweezers to remove it. Grab the protruding end of the splinter and pull it out along the same direction it entered the foot. Wash the area well with soap and water. If you can see more of the object in the foot but you cannot get it out, you will need to see your podiatrist.
Apply an antibiotic: Apply a thin layer of an antibiotic cream or ointment such as Neosporin or Polysporin to help keep the surface moist, clean, and to discourage infection while the wound heals more efficiently.
Cover the wound: Wounds need a moist environment to heal and exposure to air slows healing. Place a clean bandage over the wound to protect it and keep harmful bacteria out.
Change the dressing: At least once a day or whenever it becomes wet or dirty.
Watch for any signs of infection: See your doctor if the wound doesn’t heal a few days to a week or if you notice any redness, pus, warmth or swelling.
Soak the area in warm water: If you are not diabetic you may soak your feet in warm water and a tablespoon of baking soda which may help the splinter work its way out of the wound.
If you have or suspect you have an injury, seek healthcare services as soon as possible to prevent infection or more serious complications. You may go to a government clinic or the field hospital. They will treat the injury and give you an immunization shot if needed. They will also refer you to the hospital if needed.
When to see the podiatrist
If you sustain a foot or ankle injury, it’s important to seek medical attention from a skilled podiatrist who can properly treat these injuries before they lead to more severe health problems or complications. If the puncture or laceration is deep, bleeding a lot, not healing, or it appears infected, see your podiatrist right away. Any sign of infection is cause to see the podiatrist right away. For people with diabetes, it is very important that you never walk barefoot and prevent puncture wounds to your feet. If a puncture does occur, take out the splinter if you see it, clean the foot as best as you can with soap and water and put an antibiotic ointment and a dressing on the foot. Make a note of the object that punctured or cut your foot and see your podiatrist as soon as possible. Do not soak your feet or wait to see signs of infection before you see the podiatrist.
Avoid do-it-yourself projects, unless you’re skilled and have the right equipment.
Wear long-sleeved shirts; long pants or jeans; hard-soled, closed-toe shoes or boots; thick gloves; and to prevent injury, it is important to wear proper shoes and be cautious while standing on ladders or on roofs in order to prevent serious injuries.
Often after a storm, there may be lots of mosquitoes and other little bugs displaced by the storm. Wear insect repellent and be careful; pay attention for bites as well.
• For more information or to see a podiatrist visit Bahamas Foot Centre Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820 or email firstname.lastname@example.org or visit www.apma.org.