How to know if a wound in the wilderness is worth the worry

You may know how to clean a wound, maybe even how to close a wound in the wilderness. But what about knowing the damage caused by the wound itself? When should you be worried?

For this we use something called CMS, which stands for circulation, movement, and sensation. If there is something wrong with any of these three things, then it means that major damage has occurred. It’s a serious problem because it can lead to more damage.

So for context: Your partner suffered a large cut to his hand. When you check to see if he has good circulation in that hand and if he can move and feel everything (CMS), you find that he can not move or feel his thumb and pointer finger. Now you know that he needs to go to the hospital right way, or he may forever lose function of his hand. Good thing you checked CMS!

To learn exactly how to check for CMS, watch the video below. Or keep reading. 

***Click Here To See More Videos About How To Treat A Wound In the Wilderness***

Assessing circulation, sensation, and movement gives us information about the extent of damage and seriousness of that damage. Lack of circulating blood will lead to tissue death or the eventual loss of limb. Lack of sensation and movement at the site of injury or below indicates nerve damage.

To assess circulation:

• Feel for a pulse below the injury site. No pulse is a very bad sign and means there is no circulation of blood in that limb.
• Assess skin: pink, warm skin is a positive sign of good circulation. Pale, blue, purple, or black skin, and swollen areas are a sign of poor circulation

To assess for sensation and movement:

• Gently pinch fingers or toes below injury and ask the person if they can feel it. If they can not feel the pinching or touching, then this is a sign that there is possible nerve damage
• Ask the person to slightly move or wiggle their toes or fingers. If they can not, be sure to determine if it because of pain or because they really can not move those digits.
• Ask the person if they feel any numbness or tingling sensations in the areas of the injury or below. If so, this is another sign of possible nerve or circulation damage. This may not develop until much later.

 
Check CMS before and after splinting or wound care, and periodically afterwards. 

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But of course, CMS troubles are not the only worry when it comes to wounds in the wilderness. Other cause for concern would be any wounds that have signs of infection like inflammation, fever, increased pain, pus, and redness or other discoloration. Or any large, complex wounds, open fractures, those with joint damage, and heavy bleeding. This also includes high risk infection wounds (like animal bites), wounds that can not be cleaned properly, and impaled objects.
 
By now, you have realized that most wounds in the wilderness are indeed worth the worry. For the wounds that have these red flags, seek help as soon as possible. Wounds in the wilderness have a nasty knack for progressing from minor to severe. 

For more information about wound care check out our online Outdoor Safety Awareness course. 

And if you are a WFA, WFR, and WEMT, recertify with us, 100% online.
 
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