Doom and Bloom: Injuries to the Nail Bed

The Altons at Doom and Bloom Medical have an article about nail bed injuries and how to treat them. If you’re squeamish, there are a few bloody and/or squished finger photos in the article.

A fractured femur or a gunshot wound to the chest are major injuries that affect your chances of survival in disaster settings, but not all injuries are so extreme. “Minor” injuries can also impact the efficiency of a group member off the grid.  Of these, nailbed injuries are some you’ll commonly see.

You can imagine that nailbed injuries will be more common when untrained (and perhaps careless) people perform tasks to which they’re not accustomed. The failure to use work gloves and boots may also increase the risk of mishaps.

NAIL ANATOMY

Your fingernails and toenails are made up of protein and a tough substance called keratin. They are very similar to the claws of animals.  Any issue relating to nails is referred to as “ungual” ” (from the latin word for claw: unguis).

The nail consists of several parts:

The nail plate:  this is the hard covering of the end of your finger or toe; what you normally consider to be the nail.

The nailbed:    the skin directly under the nail plate.  Made up of dermis and epidermis just like the rest of your skin, the superficial epidermis moves along with the nail plate as it grows. Vertical grooves attach the superficial epidermis to the deep dermis.  In old folks like me, the nail plate thins out and you can see the grooves if you look closely.  Like all skin, blood vessels and nerves run through the nailbed.

The nail (germinal) matrix:  the portion or root at the base of the nail under the cuticle (the cuticle is also called the eponychium) that produces new cells for the nail plate.  You can see a portion of the matrix in the  light half-moon (the “lunula”) visible at the base of the nail plate. This is the germinal matrix (actively makes new nail cells) and determines the shape and thickness of the nail; a curved matrix produces a curved nail, a flat one produces a flat nail.

TYPES OF NAIL INJURIES

There are various types of nail injuries. Amputations and fractures may occur due to trauma, but more commonly you’ll see…

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American Partisan: Ditch Medicine – Projectile Injuries

The medical staff at American Partisan has a short article out, Ditch Medicine: Projectile Injuries, talking about the relative futility of treating gunshot wounds in an austere environment. There are many people in the preparedness movement who are counting on their military tactical training to equip them for any offensive or defensive violence that they may encounter in an extreme disaster situation. They may not realize that modern military tactics rely on the long logistical tail not only for materiel but for medical response. Some tactics are taught, knowing that they will cause some casualties, but relying on rapid self-aid and quick evacuation to medical hospitals to keep loss of life low. And the US military medical establishing has made great strides in saving lives on the battlefield which previously would have resulted in death.  However, in an extreme disaster/SHTF/WROL/TEOTWAWKI situation, that rapid medical treatment will probably not be available to you. Tactics should be adjusted accordingly where possible.

Projectile injuries commonly present as gunshot wounds or fragmentation injuries. All missiles destroy tissue through tearing a hole called the permanent cavity. Injury also occurs by displacing, or stretching, tissue away from the projectile path much the way water moves away from a rock thrown in it; it’s a temporary cavitation effect. Can they be treated with the simple supplies available in an austere situation?

Sadly, the answer is mostly “no.”

Click here to continue reading at American Partisan.