Revision 7T · Full Tutorial Edition · Updated 1 September 2026
PWR-037 · RESTRICTED full tutorial
Check a wound against its care plan and route warning signs without treating it yourself
Wound recovery is a clinical process, not willpower or a trainable personal Power. This lesson teaches the permitted method: identify the wound and care team, follow the written dressing and hygiene plan, observe only what the plan allows, compare redness, drainage, pain, temperature and function with the prior record, recognise emergency and same-day warning signs, and contact the accountable service with a clear report. It does not teach diagnosis, debridement, closure, antibiotics, negative-pressure treatment or improvised dressings.
What you will produceUsing the two supplied fictional scenario sets, the learner records only permitted observations and correctly chooses emergency, same-day, routine or continue-plan routing without opening, probing, cleaning or treating a wound.
Method8 numbered Power-specific steps
Practice authorityComplete safety and decision method; prohibited act excluded
Full step-by-step individual tutorial · TLU-PWR-037
Using the two supplied fictional scenario sets, the learner records only permitted observations and correctly chooses emergency, same-day, routine or continue-plan routing without opening, probing, cleaning or treating a wound.
Read and follow the named clinician's written dressing, hygiene and activity instructions.
Observe visible changes without touching or removing anything the plan says to leave in place.
Contact the care team or emergency service using the plan's warning signs and provide a factual timeline.
Qualified help is required for
Diagnosis, wound probing, debridement, closure, staple/suture/drain removal and treatment selection.
Choice or change of dressing, antiseptic, antibiotic, negative-pressure therapy or activity restriction unless already prescribed.
Interpretation of infection, circulation, tissue death, allergic reaction or healing failure.
Never do this from the page alone
Cut, scrape, squeeze, probe or attempt to close a wound.
Apply peroxide, alcohol, bleach, powders, oils, supplements, glue or another person's dressing/antibiotic unless the treating service prescribed it.
Delay urgent care because a photo, temperature or consumer app looks reassuring.
2 · Get ready
Gather what you need and check the starting conditions
What you need
The current written care plan and the named care-team and emergency contact numbers.
A clean observation area with good light and handwashing supplies.
Clinician-approved supplies only when the written plan explicitly directs their use.
A dated observation sheet and ruler or photograph reference only when the clinician permits measurement or photography.
Scenario A — emergency: The fictional plan says to use emergency help for bleeding that remains uncontrolled after the prescribed first-aid action or for fainting. The dressing is rapidly soaking with bright-red blood and the person feels faint.
Scenario B — same-day: Four days after lower-leg surgery, the fictional plan says to keep the dressing intact and contact the surgical service the same day for spreading redness, increased drainage, fever or worsening pain. Redness visible beyond the dressing has expanded from about 5 mm to 15 mm, pain rose from 3/10 to 6/10 and yellow drainage is visible on the outside.
Scenario C — routine: There is no new redness, drainage, pain, fever or function change. Only one prescribed dressing remains, the next planned change is tomorrow and the next delivery is due in three days. The fictional plan gives a routine clinic or supply contact for non-urgent supply problems.
Scenario D — continue the plan: The dressing is intact, the marked redness boundary is unchanged, pain fell from 2/10 to 1/10, there is no new drainage or fever and ordinary function is unchanged. The fictional plan says to continue the scheduled check.
Scenario E — emergency delayed card: The fictional plan says to use emergency help for uncontrolled bleeding or a cold, pale or blue hand. Prescribed pressure has not stopped the bleeding and two fingers have become pale and cold.
Scenario F — same-day delayed card: The fictional plan says to contact the team the same day if wound edges open, a drain leaks or pain worsens. The outer dressing has lifted over a newly opened edge, fluid is leaking around the drain and pain rose from 2/10 to 5/10.
Scenario G — routine delayed card: There is mild adhesive itching away from the wound, no spreading redness, swelling, breathing problem, drainage, fever, pain increase or function loss. The fictional plan says persistent non-urgent adhesive questions go to the routine clinic.
Scenario H — continue the plan delayed card: A small amount of clear drainage is unchanged and explicitly expected in the fictional plan. The dressing remains secure, pain is improving and there is no fever, spreading redness or function change.
Covered answer strip — reveal only after every decision is locked: A and E = emergency; B and F = same-day clinical contact; C and G = routine contact; D and H = continue the written plan.
Before you start
Identify the wound, procedure/injury date, responsible service and next planned review.
Read whether the dressing should stay dry/intact and whether it may be removed by the learner; if unclear, leave it in place and call.
Wash and dry hands before and after any plan-authorised contact; keep pets and shared surfaces away.
Know the emergency signs before beginning: severe bleeding, fainting/confusion, severe pain with rapidly worsening swelling, breathing difficulty or signs of severe infection.
3 · The method
Follow these steps in order
Check the written plan
Read today's dressing, cleaning, activity and contact instructions and confirm the responsible service.
Why: The correct action depends on the wound and treatment.
Check: The learner can state what may be touched and whom to call.
Screen emergency signs first
Before moving a dressing, look for uncontrolled bleeding, collapse/confusion, rapidly spreading swelling/redness with severe illness, breathing difficulty or a limb that is cold/pale/blue.
Why: Emergency problems should not wait for routine documentation.
Check: The learner routes emergency signs immediately without continuing the check.
Prepare clean observation
Wash hands, use good light and open only clinician-approved supplies. Do not place items on an unclean surface.
Why: Basic contamination control matters when a plan permits handling.
Check: The workspace follows the written plan and no unapproved item is present.
Leave protected items protected
If the plan says the dressing, steri-strips, staples, sutures, drain or negative-pressure seal stays in place, do not lift or adjust it. Observe the outside only.
Why: Disturbing treatment can cause bleeding, contamination or failure.
Check: All protected items remain intact; the visible 'Leave protected items protected' check is satisfied.
Observe the declared features
Record visible redness boundary, swelling, warmth as noticed without risky touching, drainage amount/colour/odour, pain trend, fever reading if already advised, and ability to use the area.
Why: Change over time is more useful than a vague 'looks bad'.
Check: The log uses factual descriptions and prior comparison.
Measure only if authorised
If the care plan permits, use the same ruler/photo distance and include a scale without exposing private identifiers; never probe depth or remove material to see more.
Why: Consistent external measurement can aid communication, while probing is clinical care.
Check: The measurement method matches the prior record.
Choose the route
Use the care plan: emergency services for emergency signs; same-day clinical contact for spreading redness, pus/foul drainage, fever/feeling unwell, worsening pain, opening edges or loss of function; routine contact for slower concerns.
Why: Routing is the safe skill this restricted lesson teaches.
Check: The decision matches the declared warning-sign table.
Give a concise handoff
State wound/procedure/date, what changed and when, measurements if authorised, pain/temperature/function, current dressing and what you have not done. Follow the service's next instruction.
Why: A complete handoff helps the accountable team triage.
Check: The receiving service has the facts needed and the learner records the advice.
4 · Worked example
See the whole method used once
Scenario
Scenario B: four days after lower-leg surgery, the written fictional plan says to keep the dressing intact and contact the surgical service for spreading redness, increased drainage, fever or worsening pain. Redness has expanded from about 5 mm to 15 mm beyond the dressing edge, pain rose from 3/10 to 6/10 and yellow drainage is visible outside the dressing.
Walkthrough
The learner checks first for uncontrolled bleeding, collapse, severe systemic illness or another emergency sign; none is present.
They wash their hands but leave the prescribed dressing, staples and wound untouched.
They record the redness boundary, pain change, visible drainage, temperature only if the plan already asks for it, and walking function.
They match those facts to the fictional plan’s same-day criteria and contact the surgical service instead of waiting for the next appointment.
They report the exact timeline and follow the service’s instruction. They do not open the dressing, apply antiseptic or claim that infection has been diagnosed.
Result
The correct result is same-day accountable clinical review with the prescribed dressing intact and a factual handoff. The exercise neither diagnoses infection nor chooses treatment.
5 · Right and wrong
Compare correct or safer execution with the common wrong version
Right and wrong comparison
Moment
Right / safer
Wrong / riskier
Why it matters
Dressing: Wound and tissue recovery checkpoint
Follow the written plan and leave it intact when instructed.
Peel it back to get a better photo.
Treatment may be disrupted or contaminated.
Observation: Wound and tissue recovery checkpoint
Describe change in redness, drainage, pain and function.
Label it infected from appearance alone.
Diagnosis requires clinical assessment. That changes correct observation completeness and routing of wound warning signs. It is no longer the same test.
Cleaning: Wound and tissue recovery checkpoint
Use only the prescribed method/supplies. It is correct when the workspace follows the written plan and no unapproved item is present.
Pour peroxide or alcohol on the wound by default.
Unprescribed agents can harm tissue or conflict with care.
Routing: Wound and tissue recovery checkpoint
Call same day when the plan's signs appear.
Wait for a consumer app or social-media opinion.
Delay can worsen a serious problem.
Measurement: Wound and tissue recovery checkpoint
Use consistent external measurement if authorised.
Probe depth or squeeze drainage to measure more.
Probing/squeezing is prohibited clinical action. That changes correct observation completeness and routing of wound warning signs. It is no longer the same test.
6 · Common mistakes
Spot the error and apply the correction
Common mistakes and corrections
Mistake
Fix
The learner cannot name the responsible service.
Put service and emergency contacts at the top of the care plan.
A dressing is removed despite a keep-intact instruction.
Stop, leave protected items alone and call when the plan is unclear.
The log says only 'worse'.
Record when the change began and the exact visible/symptom/function features.
A normal single temperature is treated as proof of no infection.
Use the whole clinical pattern and care-plan routing signs.
An unprescribed antiseptic is added.
Use only prescribed supplies and tell the clinician exactly what has contacted the wound.
7 · Practice
Turn the steps into a usable skill
First session
Cover the answer strip. Read Scenarios A–D and highlight the exact sentence in each fictional care plan that controls routing.
For each card, complete the emergency screen before doing any other observation.
Write only the permitted facts: plan, visible change, symptom trend, function, protected-item status and what was not touched.
Lock one route for every card: emergency, same-day, routine or continue the plan.
Practise a 30-second handoff for Scenario B, then reveal the answer strip and correct every missed or overcalled route.
Repeat plan
After at least seven days without rereading the first answers, cover the answer strip and complete delayed Scenarios E–H in a shuffled order. Record the delayed result separately from the first session. Real wound checks, dressing changes and measurements follow only the treating service’s written schedule.
Progress when
All four first-session routes and all four delayed routes match the supplied fictional plans.
Every record separates observation from diagnosis and treatment.
No card causes opening, probing, squeezing, cleaning or use of an unprescribed product.
The handoff includes the timeline, objective change, symptoms, function, current plan and what was not done.
Do not progress when
A real emergency or same-day warning sign is present; route care instead of continuing the exercise.
The written real-world plan is missing, contradictory or the responsible service cannot be identified.
The learner intends to disturb a protected item or add an unprescribed product.
8 · Check the result
Measure what changed
Correct observation and care-plan routing across four immediate and four delayed fictional wound scenarios.
How: Score each card for plan/contact identification, emergency screen, factual description, protected-item rule, permitted measurement, correct route and complete handoff. Any probing, diagnosis, unprescribed treatment or delayed emergency route is an automatic failure for that card.
Good result: Scenarios A–D and, after at least seven days, Scenarios E–H are all routed correctly without opening, probing or treating anything. Immediate and delayed scores remain separate.
This does not prove: It does not prove wound healing, absence of infection, treatment competence or authority to manage any real wound without its responsible clinical service.
Self-check
What does the current care plan say may be touched or removed?
Which signs require emergency help and which require same-day contact?
Can you describe changes without diagnosing infection?
Did you avoid probing, squeezing and unprescribed products?
Can you give the care team the complete timeline and current function?
9 · Stop, adapt or get help
Keep the safety boundary practical
Stop and get help
Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
Seek same-day clinical advice for spreading redness/warmth/swelling, pus or foul drainage, fever/feeling unwell, opening wound edges, worsening pain or loss of function.
Stop handling and call if a drain, staple/suture, negative-pressure seal or dressing moves, leaks, breaks or the written instruction is unclear.
Accessibility and adaptations
Provide the care plan in large print, plain language, audio or symbols with one clearly labelled contact route.
Use a support person for photography/logging or dressing care only with consent and the same hygiene/plan boundaries.
Use colour-independent descriptions, tactile-safe external markers or clinician-led review when vision makes wound observation unreliable.
10 · Evidence and limits
Why these instructions are here
primary research
A large randomized trauma-surgery trial found incisional negative-pressure therapy did not significantly reduce deep surgical-site infection, so devices must not be presented as guaranteed recovery.
NICE guidance places prevention and treatment of surgical-site infection within defined clinical recommendations rather than improvised self-treatment.
Matthew L Costa; Juul Achten; Ruth Knight; Julie Bruce; Susan J Dutton; Jason Madan; Melina Dritsaki; Nick Parsons; Miguel Fernandez; Richard Grant; Jagdeep Nanchahal; WHIST Trial Collaborators · 2020 · Primary research
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Step-by-step learner mode
Each activity includes its success check, a nearby accessible alternative and an “I’m stuck” correction path. Alternatives preserve the target where possible; when they change the task, Titan labels them as related rather than equivalent.
01
Check the written plan
Read today's dressing, cleaning, activity and contact instructions and confirm the responsible service.
Why this step exists
The correct action depends on the wound and treatment.
Success check
The learner can state what may be touched and whom to call.
I’m stuck on this step
Reset: Re-read this authored instruction — “Read today's dressing, cleaning, activity and contact instructions and confirm the responsible service.” — and its success check, then attempt only this step.
Possible snag: The learner cannot name the responsible service.
Correction: Put service and emergency contacts at the top of the care plan.
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
02
Screen emergency signs first
Before moving a dressing, look for uncontrolled bleeding, collapse/confusion, rapidly spreading swelling/redness with severe illness, breathing difficulty or a limb that is cold/pale/blue.
Why this step exists
Emergency problems should not wait for routine documentation.
Success check
The learner routes emergency signs immediately without continuing the check.
I’m stuck on this step
Reset: Re-read this authored instruction — “Before moving a dressing, look for uncontrolled bleeding, collapse/confusion, rapidly spreading swelling/redness with severe illness, breathing difficulty or a limb that is cold/pale/blue.” — and its success check, then attempt only this step.
Possible snag: The result from “Before moving a dressing, look for uncontrolled bleeding, collapse/confusion, rapidly spreading swelling/redness with severe illness, breathing difficulty or a limb that is cold/pale/blue.” does not yet meet this declared check: The learner routes emergency signs immediately without continuing the check.
Correction: Return to the start of “Screen emergency signs first”, reduce complexity or pace, and repeat only the part needed to satisfy: “The learner routes emergency signs immediately without continuing the check.”
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
03
Prepare clean observation
Wash hands, use good light and open only clinician-approved supplies. Do not place items on an unclean surface.
Why this step exists
Basic contamination control matters when a plan permits handling.
Success check
The workspace follows the written plan and no unapproved item is present.
I’m stuck on this step
Reset: Re-read this authored instruction — “Wash hands, use good light and open only clinician-approved supplies. Do not place items on an unclean surface.” — and its success check, then attempt only this step.
Possible snag: An unprescribed antiseptic is added.
Correction: Use only prescribed supplies and tell the clinician exactly what has contacted the wound.
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
04
Leave protected items protected
If the plan says the dressing, steri-strips, staples, sutures, drain or negative-pressure seal stays in place, do not lift or adjust it. Observe the outside only.
Why this step exists
Disturbing treatment can cause bleeding, contamination or failure.
Success check
All protected items remain intact; the visible 'Leave protected items protected' check is satisfied.
I’m stuck on this step
Reset: Re-read this authored instruction — “If the plan says the dressing, steri-strips, staples, sutures, drain or negative-pressure seal stays in place, do not lift or adjust it. Observe the outside only.” — and its success check, then attempt only this step.
Possible snag: A dressing is removed despite a keep-intact instruction.
Correction: Stop, leave protected items alone and call when the plan is unclear.
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
05
Observe the declared features
Record visible redness boundary, swelling, warmth as noticed without risky touching, drainage amount/colour/odour, pain trend, fever reading if already advised, and ability to use the area.
Why this step exists
Change over time is more useful than a vague 'looks bad'.
Success check
The log uses factual descriptions and prior comparison.
I’m stuck on this step
Reset: Re-read this authored instruction — “Record visible redness boundary, swelling, warmth as noticed without risky touching, drainage amount/colour/odour, pain trend, fever reading if already advised, and ability to use the area.” — and its success check, then attempt only this step.
Possible snag: The log says only 'worse'.
Correction: Record when the change began and the exact visible/symptom/function features.
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
06
Measure only if authorised
If the care plan permits, use the same ruler/photo distance and include a scale without exposing private identifiers; never probe depth or remove material to see more.
Why this step exists
Consistent external measurement can aid communication, while probing is clinical care.
Success check
The measurement method matches the prior record.
I’m stuck on this step
Reset: Re-read this authored instruction — “If the care plan permits, use the same ruler/photo distance and include a scale without exposing private identifiers; never probe depth or remove material to see more.” — and its success check, then attempt only this step.
Possible snag: The result from “If the care plan permits, use the same ruler/photo distance and include a scale without exposing private identifiers; never probe depth or remove material to see more.” does not yet meet this declared check: The measurement method matches the prior record.
Correction: Return to the start of “Measure only if authorised”, reduce complexity or pace, and repeat only the part needed to satisfy: “The measurement method matches the prior record.”
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
07
Choose the route
Use the care plan: emergency services for emergency signs; same-day clinical contact for spreading redness, pus/foul drainage, fever/feeling unwell, worsening pain, opening edges or loss of function; routine contact for slower concerns.
Why this step exists
Routing is the safe skill this restricted lesson teaches.
Success check
The decision matches the declared warning-sign table.
I’m stuck on this step
Reset: Re-read this authored instruction — “Use the care plan: emergency services for emergency signs; same-day clinical contact for spreading redness, pus/foul drainage, fever/feeling unwell, worsening pain, opening edges or loss of function; routine contact for slower concerns.” — and its success check, then attempt only this step.
Possible snag: A normal single temperature is treated as proof of no infection.
Correction: Use the whole clinical pattern and care-plan routing signs.
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
08
Give a concise handoff
State wound/procedure/date, what changed and when, measurements if authorised, pain/temperature/function, current dressing and what you have not done. Follow the service's next instruction.
Why this step exists
A complete handoff helps the accountable team triage.
Success check
The receiving service has the facts needed and the learner records the advice.
I’m stuck on this step
Reset: Re-read this authored instruction — “State wound/procedure/date, what changed and when, measurements if authorised, pain/temperature/function, current dressing and what you have not done. Follow the service's next instruction.” — and its success check, then attempt only this step.
Possible snag: The result from “State wound/procedure/date, what changed and when, measurements if authorised, pain/temperature/function, current dressing and what you have not done. Follow the service's next instruction.” does not yet meet this declared check: The receiving service has the facts needed and the learner records the advice.
Correction: Return to the start of “Give a concise handoff”, reduce complexity or pace, and repeat only the part needed to satisfy: “The receiving service has the facts needed and the learner records the advice.”
Stop / get help: Call emergency services for uncontrolled bleeding, collapse/confusion, severe systemic illness, breathing difficulty, a cold/pale/blue limb or rapidly worsening severe symptoms.
Correct versus incorrect execution
These accessible process diagrams are built from the tutorial’s own right/wrong teaching. They are not anatomical illustrations and do not add technique beyond the canonical tutorial.
Dressing: Wound and tissue recovery checkpoint — Treatment may be disrupted or contaminated.
Correct / safer
Follow the written plan and leave it intact when instructed.
Wrong / riskier
Peel it back to get a better photo.
Observation: Wound and tissue recovery checkpoint — Diagnosis requires clinical assessment. That changes correct observation completeness and routing of wound warning signs. It is no longer the same test.
Correct / safer
Describe change in redness, drainage, pain and function.
Wrong / riskier
Label it infected from appearance alone.
Cleaning: Wound and tissue recovery checkpoint — Unprescribed agents can harm tissue or conflict with care.
Correct / safer
Use only the prescribed method/supplies. It is correct when the workspace follows the written plan and no unapproved item is present.
Wrong / riskier
Pour peroxide or alcohol on the wound by default.
Routing: Wound and tissue recovery checkpoint — Delay can worsen a serious problem.
Correct / safer
Call same day when the plan's signs appear.
Wrong / riskier
Wait for a consumer app or social-media opinion.
Measurement: Wound and tissue recovery checkpoint — Probing/squeezing is prohibited clinical action. That changes correct observation completeness and routing of wound warning signs. It is no longer the same test.
Correct / safer
Use consistent external measurement if authorised.
Wrong / riskier
Probe depth or squeeze drainage to measure more.
Method-structure checklist
10 of 10 structural checks present
✓ Ordered, Power-specific instructions — present
✓ Every activity has a success check — present
✓ Materials or supplied records are declared — present
✓ Measurement or assessment rule is present — present
✓ Tutorial-specific troubleshooting is present — present
✓ Stopping or escalation boundary is present — present
✓ Every activity has an adjacent alternative — present
✓ Correct-versus-incorrect comparison is present — present
✓ Evidence context is bound to the Power record — present
✓ Planning metadata is present — present
The method-readiness band and presence checklist assess tutorial presentation and are separate from evidence quality for the underlying Power. They are automated editorial aids, not human approval.
Manual editorial sign-off: Pending. This tutorial must not display a human-approved state until an identified editor signs the exact content hash.