First Aid for Scratches, Scrapes, and Shallow Cuts

Scratches, scrapes, and shallow cuts can happen during hikes, campouts, service projects, and other Scouting activities. Most of these wounds are minor, but they still need prompt care. Good first aid controls bleeding, removes dirt, protects the wound, and reduces the chance of infection.

This article covers open wounds with mild or moderate bleeding. Life-threatening bleeding requires immediate emergency action and is beyond the scope of routine wound care.

• Recognize the Injury
• Step 1: Check the Scene
• Step 2: Examine the Wound
• Step 3: Control the Bleeding
• Step 4: Clean the Wound
• Step 5: Protect the Wound
• Watch for Infection
• When to Get Medical Help
• Remember Tetanus Protection
• Be Prepared
• A Trail Example
• Check, Call, and Care

An open wound occurs when the skin is broken. Common minor open wounds include:

• Scratch: A narrow, superficial break in the skin.
• Abrasion: An area where the skin has been rubbed or scraped away. Abrasions are sometimes called road rash, rug burns, or turf burns.
• Laceration: A cut or split in the skin. A shallow laceration may be treated with basic first aid, but a deep or gaping cut needs medical care.

Before treating the wound, look at the amount of bleeding. Blood that flows continuously, spurts, or collects rapidly may indicate life-threatening bleeding. Call 911 and follow your first-aid training for severe bleeding.

Make sure the area is safe before approaching. Look for hazards such as traffic, broken glass, sharp tools, falling rocks, fire, or unstable terrain. Do not become another injured person.

Introduce yourself and ask permission to help. If the injured person is a youth, notify the responsible adult leader. A Scout should get an adult whenever an injury is more than a very small scratch or scrape.

Put on disposable non-latex gloves before touching the wound. If gloves are unavailable, avoid direct contact with blood and use an appropriate barrier while help is obtained. Wash your hands before and after providing care whenever possible.

Ask the injured person what happened. Check the wound’s location, size, and depth. Look for dirt, gravel, glass, splinters, or other material.

Also check how the person feels. Pale, cool, or clammy skin; weakness; confusion; rapid breathing; or unusual thirst can be warning signs of shock. Call 911 if the person shows signs of shock or appears seriously ill.

Do not remove a deeply embedded object. Removing it could cause additional damage or severe bleeding. Keep the person still, protect the area, and get medical help.

Cover the wound with sterile gauze. If sterile gauze is unavailable, use a clean cloth folded into a pad.

Press firmly and steadily on the wound. Keep applying direct pressure until the bleeding stops. Do not repeatedly lift the dressing to check the wound because this can disturb clotting and restart the bleeding.

If blood soaks through the first gauze pad while you are applying pressure, leave that pad in place and place another pad over it. Continue direct pressure.

Once the bleeding has stopped, secure the dressing with tape or a roller bandage if the wound cannot be cleaned immediately. A bandage should be snug enough to remain in place but not so tight that it interferes with circulation. Check beyond the bandage for normal warmth, color, and feeling.

If steady direct pressure does not control the bleeding, get emergency medical help.

After the bleeding has stopped, rinse the wound thoroughly with clean running water. On a hike or campout, use water that is safe to drink. Rinsing helps remove dirt and lowers the risk of infection.

Wash the skin around the wound with soap, but avoid putting soap directly into the injured tissue. Do not scrub the wound aggressively.

Small pieces of loose debris may be removed carefully with tweezers that have been cleaned with alcohol. Stop if the material is embedded, difficult to remove, or causes renewed bleeding. The injured person should receive medical care if dirt or another object remains in the wound.

Do not pour hydrogen peroxide or iodine into an open wound. These products can irritate tissue and may slow healing.

After cleaning the wound, apply a thin layer of petroleum jelly or an appropriate first-aid ointment. When helping another person, use medicated ointment only with permission and after checking for allergies.

Cover the wound with a sterile dressing or an adhesive bandage. Covering is especially helpful during outdoor activities because it protects the wound from dirt, friction, and further injury.

Change the dressing at least once each day and whenever it becomes wet, dirty, bloody, or loose. Wash your hands and put on clean gloves before changing another person’s dressing.

Do not share ointment applicators or touch the container directly to the wound. Place used gloves, gauze, and other bloody materials in a sealable bag for proper disposal.

Continue checking the wound over the next several days. Warning signs of infection include:

• Redness that spreads or becomes more intense
• Increasing pain or swelling
• Warmth around the wound
• Pus or cloudy drainage
• Red streaks spreading from the wound
• Fever
• A wound that is not healing normally

Tell a parent, guardian, or leader if any of these signs appear. The injured person should be evaluated by a healthcare professional.

Even if the bleeding is controlled, obtain medical help when:

• The wound is deep, gaping, or has uneven edges.
• Fat, muscle, bone, or another deep structure can be seen.
• The wound is on the eye, face, hand, or over a joint.
• Movement, feeling, or circulation appears affected.
• Dirt or another object cannot be removed.
• An object is embedded in the wound.
• The injury was caused by an animal or human bite.
• The injury is a puncture wound.
• The wound is badly contaminated with soil or saliva.
• The cut was caused by a rusty, dirty, or contaminated object.
• The wound continues bleeding despite steady direct pressure.
• Signs of infection develop.
• You are uncertain whether the wound can be safely treated in the field.

Call 911 for bleeding that is life-threatening, an unresponsive person, signs of shock, or any immediate threat to life.

Tetanus bacteria can enter the body through a wound. A parent, guardian, or healthcare professional should check the injured person’s vaccination history.

According to the Centers for Disease Control and Prevention, people who completed their primary tetanus vaccination series may need a booster if their last dose was 10 or more years ago for a clean, minor wound. For a dirty or major wound, a booster may be recommended if the last dose was five or more years ago. Anyone whose vaccination history is unknown or incomplete should contact a healthcare professional.

Do not try to make the vaccination decision in the field. Report how the injury happened and allow a healthcare professional to evaluate the wound and vaccination history.

A patrol or troop first-aid kit should include supplies for treating minor wounds:

• Disposable non-latex gloves
• Sterile gauze pads
• Adhesive bandages in several sizes
• Roller bandages
• Medical tape
• Clean water or wound-rinsing solution
• Tweezers
• Petroleum jelly or approved first-aid ointment
• Sealable bags for contaminated materials

Inspect the kit before outings. Replace expired, damaged, wet, or previously used supplies.

Read more about first aid kits.

A Scout slips on a rocky trail and scrapes a knee. The patrol stops in a safe place, and an adult leader is notified. A trained helper gets permission to provide care, puts on gloves, and checks the injury.

The scrape is shallow and bleeding slowly. The helper applies gauze and direct pressure until the bleeding stops. The wound is rinsed thoroughly with safe water, and loose grit is carefully removed. The helper covers the clean abrasion with a sterile dressing and records the treatment according to the unit’s procedures.

The Scout and leader continue to monitor the wound. If bleeding begins again, pain increases, or signs of infection appear, they seek additional medical care.

When someone is injured, remember three basic actions:

• Check the scene and the injured person.
• Call for adult, medical, or emergency help when needed.
• Care for the person within the limits of your training.

Reading about first aid is useful, but it does not replace hands-on practice or professional medical advice. Scouts and leaders should maintain current first-aid training and follow their organization’s procedures during every activity.