Wound care

Skin wounds need to be cleaned and dressed.  Contrary to many myths, wounds that are kept moist heal better and faster than those exposed to the air. Protecting the wound with a dressing provides a moist environment that encourages the surface skin cells to migrate across the gap and join up. Put simply a ‘dry wound’ is a ‘dead wound’ and you don’t want a dead wound!

Letting a wound ‘breathe’ is a common cause of wounds failing to heal. This issue has been investigated scientifically, and it is conclusively demonstrated that a covered wound heals faster than an uncovered wound! This is because the dry scab actually slows the growth of new skin cells.

Because farmers often keep knocking their wounds on their hands and limbs they can take a long time to heal. Using a dressing will help the wound heal.  Other causes of wounds failing to heal are ongoing trauma, infection, deep burns, skin cancers or underlying medical conditions such as diabetes.

If you have a blister don’t pop the blister. Wounds covered by blisters heal better and more quickly when the blister remains intact, rather than broken. This is because the skin cover provides protection and a warm moist environment to allow for healing.

For more information on wound care visit Better Health Channel

Fast facts:

• Stop wounds bleeding by covering with a clean bandage and apply direct pressure.
• Clean wounds by washing with water. Don’t scrub. Use antiseptic and cover minor cuts with sterile bandage for 48 hours.
• Make sure any foreign material is removed.
• If you can’t clean the wound properly or, if it is deep or not healing, you will need medical help.

Snake bite

Australia has some of the world’s deadliest snakes, and snake bites in Australia most commonly happen in the warmer months when snakes are more active. They mainly live in rural and remote areas and are found out and about on farms looking for water or food.

Snake bites often occur if a snake needs to be defensive. Common sites to be bitten are hands, arms, feet and ankles. Medical assistance is required urgently after a snake bite.

Do not attempt to catch the snake. The snake may bite again if an attempt is made to catch it. Identification of the snake species can be obtained in the hospital through patient samples of blood and urine.

Symptoms of snake bite may include:

• pain
• local effects – swelling or bruising around the bite
• widespread effects – including abdominal pain, nausea, vomiting, blurred vision, slurred speech, muscle weakness and respiratory distress.

First aid for snake bite aims to stop the venom moving around the body. Depending on the volume of venom injected, research indicates very little venom reaches the circulation if pressure is applied over the site and the limb is immobilised. If the snake is angry and stirred up, it may release more venom when it strikes.

What you should do:

• Call an ambulance
• DO NOT wash the bite or attempt to catch/kill the snake.
• DO NOT apply a tourniquet or remove clothing.
• Apply pressure to the bite area.
• If a limb is bitten, bandage the area of the bite firmly with a broad (10-15cm wide) pressure bandage (as firmly as you would for a sprained ankle).
• Apply another broad bandage starting at the toes or fingers and bandage up the limb as far as possible.
• Crepe and compression bandages are ideal – but use anything available if no bandages are available. E.g., tearing up a shirt, towel or sheet.
• Splint limb to prevent any muscle, limb or joint movement.
• Mark the bandaged area over the snake bite with an X. This will allow health professionals to quickly locate the bite without removing the bandage.
• If the bite is to the trunk or torso still apply a firm bandage.
• If the bite cannot be bandaged then apply and keep constant firm pressure.
• Keep still, remain calm and try not to panic. Movement and panicking will cause the venom to circulate faster.
• Activate your emergency plan to get help and medical assistance urgently
• If the snake bite victim collapses or stops breathing, apply CPR (cardiopulmonary resuscitation) until medical help arrives.

Fast facts:

• Avoid being bitten by a snake.
• If bitten – don’t panic and don’t try to catch the snake.
• Follow basic first aid for a snake bite, even if you’re not sure if the snake was venomous.
• Don’t wash the skin, venom traces may help identify the snake.
• Send for help by calling triple (000) immediately.
• Remain still and calm until help arrives.
• Do not raise the limb.

Shock – physical

Medical shock is caused by not having enough blood circulating around your body. Reduced blood pressure decreases the flow of oxygen to vital organs and, unless attended to, is a life-threatening medical emergency.

Some of the many causes of medical shock include uncontrolled bleeding, severe burns, dehydration, being crushed under heavy objects, and spinal injury. A range of factors influences the impact of shock, such as your health, age, personality, where on the body the injury occurs and the environment. Signs of medical shock may include clammy skin, shallow or difficult breathing, rapid or irregular heartbeat, anxiety, thirst, dizziness, nausea and confusion.

Shock can be particularly life threatening on farms where you may be a long way from help or emergency medical facilities. It is very important that everyone on the farm knows where you are going to be and when you will return. If you are working on your own on a farm, arrange a system of notifying a family member, colleague or neighbour about where you will be and commit to checking in by a certain time each day. It is also important for everyone on the farm to have some first aid training. If someone suffers a major injury, you must send for help and then try to stop any bleeding or treat wounds and burns.

Emotional distress or sudden fright in response to a traumatic event is also often called ‘shock’ but this is different from physical shock. More information about emotional shock can be found here: Better Health Channel – Trauma reaction and recovery.

Fast facts:

• Medical shock is when there is not enough blood circulating around the body.
• Shock is potentially fatal, making it a medical emergency.
• If you think someone is suffering from medical shock, ring an ambulance immediately and give first aid.

Poisoning

Poisoning can occur when a person ingests, inhales or has skin contact with household, agricultural and industrial chemicals or gas. Not only are farmers and agricultural workers at risk but also children or children visiting farms. Poisoning to stock, (sheep, cattle) and domestic pets, can also occur when exposed to waste such as broken vehicle batteries, chemical containers, snail and other vermin baits and general rubbish.

Reduce the risk of accidental poisoning by:

• Reading the instructions carefully on how to store, apply and the safety precautions required before using chemicals
• Keep and maintain an up to date written register of chemical and hazardous substances on the farm
• Wear appropriate Australian Standard levels of personal protective equipment when using chemicals and make sure areas are well ventilated
• Lock all chemicals and used chemical containers in appropriate storage facilities and out of reach of children, stock and pets
• Dispose of waste such as vehicle/truck batteries, or sump oils at appropriate refuse and recycling stations
• Dispose of agricultural containers through Drum muster centres
• Used chemical or expired chemicals can go through Chem Clear or phone 1800 008 182
• Also remember to keep medications in a safe place away from children

If you think someone has been poisoned, or has an unexplained illness, do not wait for further symptoms to develop.

Ring the National Poisons Information Centre on 13 11 26 immediately.

This is a 24 hour, 7 days a week service.

Do not try to make the person vomit, unless instructed to do so it may cause more injuries. Always call triple zero (000) in an emergency and have your address and location ready.

Fast facts:

• Farm chemicals, vehicle battery contents, solvents, cleaner, fumes and sprays can cause accidental poisoning.
• Poisoning may occur if chemicals are spilled on the skin, sprays are inhaled or splashed in the eyes or accidentally swallowed.
• If there’s a chance poisoning has occurred call the National Poison Information Hotline on 13 11 26
• If possible have name (and material data sheet) of the chemical the person has been exposed to.

First aid kits

First aid kits are essential on farms. Life on a farm comes with its own set of hazards and a first aid kit should be properly stocked and available at all times. It’s a good idea to keep a first aid kit in the home, car, ute, truck, shearing shed and workshop.

Well-stocked first aid kits should contain components to address: 

• Snake bites.
• Bleeding, wounds, lacerations and splinters. 
• Burns and scalds. 
• Stings and bites. 
• Eye injury. 
• Resuscitation. 
• Exposure to heat or cold. 
• Sprains, dislocations and fractures. 

Thes items will enable emergency care to be given to an injured family member or employee until medical assistance arrives. The isolation of many Australian farms means medical assistance may take time to arrive. Consequently, preserving life, preventing a condition from worsening and the promotion of recovery is more likely to occur with a well-stocked first aid kit.

Everyone living and working on a farm should know the location of all first aid kits and be trained in first aid; once a course is completed, refreshers are required every three years. To remain effective, first aid kits need to be maintained through regular component checks and used or expired stock replaced as soon as possible. 

For more information on first aid kits visit Better Health Channel.

Fast facts:

• First aid kits are an essential farm item.
• Ensure first aid kits are well stocked and comply with Australian standards.
• Keep several well-stocked kits around the farm.
• Ensure kit contents do not exceed the use-by date.
• Seek training in first aid and keep first aid knowledge and skills updated.

Eye injury – something in your eye? Don’t ignore it!

Eye injuries on the farm: What you need to know

Working on the land means you’re often exposed to dust, dirt, chemicals, metal, grain and machinery. All of these can lead to serious eye injuries, especially when you’re welding, grinding, fencing, spraying or working with animals. 

Between 2010 and 2015, agriculture, forestry and fishing were the second highest industry for work-related eye injuries in Australia. That’s a lot of farmers, fishers and forestry workers getting hurt on the job (AIHW, 2017). 

What is a foreign body in the eye? 

A foreign body is anything that gets into your eye and doesn’t belong there – like: 

• Wood chips, grain dust, or hay.
• Metal shavings from grinding.
• Insects, animal hair or wool fibres. 
• Sand, dirt or seeds. 
• Chemicals from spraying or cleaning.
• UV radiation from welding or long hours in the sun without protection. 

Even a tiny speck can cause big damage. Eyes are also highly vascular and will absorb chemicals into the bloodstream more rapidly than when splashed on the skin. 

Symptoms include pain, burning, irritation, a scratchy feeling, blurred vision, loss of vision, sensitivity to bright lights, bleeding into the white of the eye and a feeling that something’s still in it.  

What to do if you get something in your eye 

• DON’T rub it! It could scratch your eye or push the object in deeper. 
• Flush your eye straight away with clean water (from a tap, hose, or bottle) for at least 15 minutes. 
• If it doesn’t come out: 
  • Loosely cover the eye with a clean pad or cloth. 
  • Get medical help straight away – go to the GP, urgent care centre or clinic, or nearest Emergency Department. 

Do not try to remove the object yourself. You might make it worse. 

Complications with eye injuries

• Infection and scarring – if the foreign body is not removed from your eye, it may lead to infection and scarring. 
• Corneal scratches or abrasions – a foreign body may scratch the cornea, which is the clear membrane on the front of the eye. 
• Eye ulcer – sometimes a scratch on the cornea doesn’t heal and an eye (ulcer) may form in its place. This could affect your vision or lead to an abscess. 
• Penetrating eye injury – sometimes a projectile object (for example, a piece of metal from angle grinding) can pierce the eye and enter the eyeball, causing serious injury and even blindness. 

What causes eye injuries on farms? 

• Flying particles – metal, grain, wood chips, insects, hay. 
• Chemical splashes from spraying or cleaning. 
• Poor personal protective equipment (PPE) or no PPE.
• Rushing jobs, working tired, and not doing risk checks. 

Farm kids and eye safety 

Children on farms are often around workshops, machinery, animals and even chemicals. They may be helping or copying adults, or be nearby when you’re using tools and equipment. 

Eye injuries in kids can happen when: 

• Playing with sticks, wire, or tools. 
• Riding horses or motorbikes without eye protection. 
• Watching welding without a proper mask. 
• Getting chemicals in their eyes during cleaning or spraying or washing animals. 

When it comes to farm kids and eye safety, remember:

• Always keep chemicals and tools out of reach. 
• Make sure children wear sunglasses and safety glasses when appropriate. 
• Teach children not to rub their eyes and to tell an adult straight away if they hurt their eye. 

Prevention is better than a trip to emergency 

• Assess the job – is there a risk to your eyes?
• Eliminate or change the task if it’s too risky.
• Always wear Australian Standard safety glasses (with UV protection) and side protection.
• Use a proper welder’s mask when welding.
• Keep all PPE clean, dry and in good condition.
• Have your eyes checked every two years by an optometrist.
• Keep eyewash bottles handy in the shed and ute.

Find out more about this topic on Better Health Channel.

Fast facts:

• If you get something in your eye, don’t rub it as it may cause more damage. 
• Flush your eye out with clean water or eyewash for 15 minutes. 
• If it doesn’t come out, cover the eye with a loose pad and get medical help.
• Do NOT try to remove it yourself. 
• Act fast – this can save your sight. 

Electrocution

Electrocution on farms is often due to overhead power lines. You do not have to touch a power line to be electrocuted with overhead power lines as the power arcs. Harvest time on farms is particularly risky. Producers using large machinery such as harvesters and augers underneath overhead powerlines should take particular care. Moving large objects such as Windmills and silos can also be hazardous when there are power lines nearby.

Aerial power lines, defective wiring and extension cords are also common causes of electrocution.

If someone is electrocuted, it is vital to disconnect the power supply before you try to help them. After you disconnect the power source, give first aid and seek medical help.

Injuries and death from an electric shock can include burns and disturbances to heart rhythm (heart failure) that could be fatal.

Fast facts:

• Electrocution can be fatal.
• Ensure there is a safe clearance between you, the equipment you are using and overhead wires.
• Disconnect the power, if you can do so safely, before you touch or try to help a victim of electric shock.
• Call triple zero (Tel. 000) immediately if someone has been electrocuted.

Crush injuries

Crush injuries occur when a part of the body – such as a hand, arm, leg, foot or trunk is trapped, pinched or jammed under or between objects. The pressure can harm skin, muscles, nerves or bone, depending on the degree of force.  In some cases little damage is seen on the outside as the damage is hidden on the inside.

Crush incidents are often horrific events that result in death or life-long consequences for workers, their families and communities. Crush injuries range from hitting a finger or thumb with a hammer, to the deadly impact of unsafe use of modern machinery, falling hay bales, or quad bike rollovers. 

Crush injuries are common on farms, particularly those involving the hands. The most serious cases occur in agriculture where heavy machinery is used and people become trapped under them or in them. 

Crush injuries can happen: 

• During tractor and quad bike rollovers, with the main causes of death from quad rollovers being asphyxiation, crushing and head injuries. 
• While using heavy equipment. 
• When moving large hay or wool bales and they fall. 
• While dealing with large animals in yards or small spaces. 
• During logging or cutting firewood. 
• While moving farm equipment. 
• Operating vehicles without a driver (for example feeding out alone).  

Crush injuries can cause compartment syndrome or crush injury syndrome which both have serious consequences. Both require urgent medical attention.

Compartment syndrome

Compartment syndrome can occur when muscles inside the ‘compartment’ of a limb swell so much that blood flow is blocked. The fascia, which covers the muscles, is not very elastic and does not stretch, forcing the pressure from the swelling inwards, compressing nerves and blood vessels. This compression can damage nerves and muscles, causing chronic pain and mobility issues. Compartment syndrome can be caused by many things including being crushed under a heavy object.

Crush injury syndrome

Crush injury syndrome occurs when a large area of muscle is compressed and starved of blood flow over several hours. This causes the muscle cells to break down, releasing acids and other chemicals. When the pressure is removed these chemicals are released and can cause serious damage as they travel to the heart and kidneys.

First aid

First aid for crush injuries requires careful assessment. If the area has been compressed for a long time it may be best to wait for emergency services to arrive or seek advice when you call triple zero (000), before removing the crushing weight, as a tourniquet or intravenous fluids may be needed before the weight is released.

However, if the weight on the head, chest, neck or abdomen is not removed the casualty may die from breathing failure, heart failure or blood loss. Even if not apparently badly injured internal damage or rapid deterioration can occur. Seek medical attention.

Visit Better Health Channel for more information and suggestions to prevent crush injuries involving tractors, quad bikes, machinery, grain augers and livestock.

Fast facts:

• Crush injuries, where part of the body is squeezed between or under a heavy object, are common on farms and can be serious.
• Crush injuries can cause broken bones (fractures) bruising and bleeding.
• Crush injury syndrome occurs when a large area of muscle is squashed – this requires careful first aid. Call triple zero 000 immediately for advice before you ‘free’ the person.

Burns

There are many causes of burns on farms. These include burns from friction, heat, sun, chemicals, equipment and fuels.

Some causes of burns include UV radiation (sunburn), flame, radiant heat, hot liquids or gases, electricity, fuels and certain chemicals. The cause of the burn will determine the category of the burn. Sometimes farmers use burning to  reduce pests in fields, get rid of stubble and snails. Carelessness is the most common cause and to avoid burns on the farm and in the home, proper safety precautions needs to be undertaken.

There are several categories of burns

• Dry/wet burns – flames & scalds
• Chemical burns – e.g. acid, alkaline (lime), or organic compounds
• Electrical burns
• Mouth/throat/inhalation burns
• Radiation burns
• Molten substances/plastics/metals and bitumen burns

All deep burns need emergency medical care and the management of the burn will vary depending on the category of the burn.

General management involves: Ensure you are no longer in contact with the source of the burn. Applying cool running water over the burn site for 20 minutes, or until the skin has cooled. Do not break blisters as these provide a sterile cover for the burn, do not apply ointments or oils. Cover the area with a sterile/ clean non fluffy dressing. Arrange urgent medical assistance.

Major burns are a medical emergency and require urgent medical attention. Do not remove burned clothing if it stuck to the burned area, rather cool it by continuously pouring water on it. In some cases, skin graft surgery is needed.

Always call triple zero Tel 000 for major burns. You will be given advice over the phone on how to manage the burn.

For more information on (Burns and Scalds) visit Better Health Channel

Immediate Burn Treatment – video

Fast facts:

• Major burns are a medical emergency, minor burns can be managed at home.
• Burns can be caused by sun exposure, fire, hot liquids, chemicals, electricity and lightning.
• Apply cool running water over the burn site for 20 minutes or until the skin has cooled.
• Call triple zero (000) for an ambulance immediately if someone experiences a major burn.

Bleeding

Farming men, women, children and agricultural workers are exposed to many hazards which can potentially cause trauma and injury, resulting in bleeding. Bleeding may present as minor bleeding from small cuts, abrasions and nosebleeds or severe external or internal bleeding caused by trauma. Bleeding always requires immediate attention and first aid.

• First aid for severe external bleeding includes applying direct pressure on the wound maintained by using preferably clean pads and bandages, and raising the injured area above the level of the heart if possible.
• First aid for internal bleeding assist into comfortable position. If suffering breathing difficulties – sit in an upright position. If no breathing difficulties raise legs above the level of the heart. Cover with a blanket but DO NOT overheat and protect from the external environment. DO NOT give food or drink.
• First aid for small cuts and abrasions can be treated at home. Clean the area of the wound, disinfect and apply a clean bandage or sticking plaster.
• Having a well-stocked first aid kit available is your responsibility. Keep several first aid kits around the farm, for example in the workshop, shearing shed and in the tractor.

To find out more on the different types of bleeding, treatment and management. Go to Better Health Channel

Severe bleeding, which doesn’t stop after 10 minutes of continuous pressure, requires urgent medical attention. Call triple zero (000).

Fast facts:

• First aid for external bleeding is critical to limit blood loss.
• Apply and maintain direct pressure on the wound. Use pads, bandages, or anything available like towels or a t-shirt if you are not near a first aid kit.
• For external bleeding – raise the injured area above the level of the heart if you can.
• For internal bleeding – place the injured in a comfortable position. Keep warm and DO NOT offer food or drink.

• If severe bleeding continues after 10 minutes of continuous pressure call triple zero (000) and give a clear description of your location and emergency situation. Remain calm, stay focused, and reassuring to the injured person.
• Always have more than one person trained in First Aid on your farm and family.

Bites and stings

Poisons Information Centre – 13 11 26

There are many Australian species that bite or sting, such as insects, bees, wasps, ants, mosquitos, ticks, scorpions, caterpillars, centipedes, spiders, snakes and sea creatures. Some bites and stings may be harmless and not require treatment, others may be venomous or cause a severe allergic reaction (anaphylaxis) and require medical treatment promptly.

Allergies to venoms from stinging insects (bees, wasps and ants) are one of the most common causes of severe allergic reactions (anaphylaxis) in Australia. Symptoms of anaphylaxis include:

• A widespread rash, or severe itching.
• Swelling of the tongue or throat.
• Coughing, wheezing, or trouble breathing.
• Abdominal pain.
• Diarrhoea.
• Vomiting.
• A drop in blood pressure (shock) or fainting.

Anaphylaxis from stinging insect allergy results in an average of three deaths per year in Australia. Those with a known allergy should be seen by a medical specialist (clinical immunology/allergy specialist) to develop a strategy for managing subsequent bites or stings and have two adrenaline auto-injectors (e.g. EpiPen®, AnaPen®) readily available to treat anaphylaxis.

People at greater risk of severe reactions to spider venom include babies, young children, the elderly and people with an existing heart condition.

In the event of a venomous bite or sting:

• Call triple zero (000) for an ambulance in an emergency.
• Reassure the person and keep as still as possible.
• Determine the appropriate first aid action for the type of bite or sting: 
  • Pressure Immobilisation Technique (PIT) for funnel web and mouse spiders, land snakes, sea snakes, blue ringed octopus and cone snails.
  • Ice/cold packs (not directly on the skin) for red back spiders, other spiders (except funnel webs), wasps, scorpions, bees (remove the stinger), ants, leeches (once removed), centipedes and caterpillar stings.
  • Hot water immersion (not scalding) for stingrays, stonefish, cobblerfish, and bluebottles (after tentacles are removed).
  • Vinegar for tropical jellyfish such as Box and Irukandji.
• When using the PIT, apply pressure to the wound with a firm (10-15cm wide) elasticised bandage – use a second wide bandage starting at the toes or fingers and bandage up the limb as far as possible. 
• Do not remove the bandage at any stage and mark the bandage at the site of the bite or sting. This will enable medical staff to locate the site for inspection without removing the bandage. 
• Do not apply a tourniquet. 

If the person collapses or stops breathing, you will need to apply CPR (cardiopulmonary resuscitation) until medical help arrives. Remember – CPR takes precedence over other first aid if the person is not breathing.

If you need more information call the Poisons Information Centre on 13 11 26 – seven days a week, 24 hours a day.

Important note: NEVER apply the pressure immobilisation technique to a red back spider bite; it will increase the severity of the pain and cause more damage to the tissue around the bite site. First aid is to wash the area and apply a cold pack for 20 minutes ensuring it doesn’t come into direct contact with the skin, and to seek medical help. 

For more information on bites and stings first aid, visit Better Health Channel.

Fast facts:

• Many Australian species can bite or sting, some may be harmless, and others may be venomous or cause allergic or anaphylactic reactions.
• If you’re known to have a severe allergy to the bite or sting of a species – have a management plan and carry an adrenaline auto-injector (EpiPen® or AnaPen®).
• Do not use tourniquets, cut the puncture site or try to suck the venom from a bite.
• Seek medical assistance immediately
• Call triple zero (000) for an ambulance in an emergency.

Ambulance – when to call one

Farmers, who often work alone, need to be as self-reliant in an emergency as possible. First aid skills are essential for all farm workers and people living on farms.  Knowing what to do in an emergency could save a life, and that life could also be your own.

It is important to know when to call for help. Your first reaction in an emergency may not always be the best course of action.

Even if you think it will take too long for help to arrive, always call triple zero (000) in an emergency as the operator may provide you with life-saving advice and obtain/take note of the details of your location.

If you are working outside of mobile phone range, always make sure there is someone who knows where you are going and what time you expect to return.

Emergencies – calling an ambulance

In a medical emergency call triple zero (000) from any phone within Australia – even if you don’t have any phone credit. Don’t hesitate to call if you’re not sure if the situation is an emergency. If in doubt, call 000 anyway. Calling an ambulance can be the difference between life and death.

Find out more about this topic on Better Health Channel

Fast facts:

• If in doubt, always call triple zero (000).
• Ambulance staff can give lifesaving advice over the phone; don’t hesitate to call in an emergency.
• Give an accurate location so the ambulance gets there ASAP.
• Don’t hang up until you are told to do so.