By Patricia Curtis
Update your first-aid kit and learn which common treatments can be dangerous to use in an emergency.
Today, Ann LaBelle admits that it was a stupid thing to do. But when she jumped off her boyfriend's motorcycle and burned her inner leg on the tailpipe, she didn't know how to treat the injury. "It burned a hole right through my jeans, about the size of a fifty-cent piece." Her boyfriend's mother suggested she clean the area and put butter on it. For the next several days, LaBelle repeated the process. "It kept getting redder and redder, and it really hurt." Two weeks later, when the burn wasn't healing, and she developed a 104 degree fever, LaBelle went to the hospital. There she was given antibiotics to fight the infection. But they didn't help. About a month later, she underwent surgery to close up the wound.
ComstockCompleteLaBelle made an all-too-common mistake -- she relied on an old wives' tale. First-aid treatment has evolved, and many of our mothers' remedies are no longer recommended. Take a look inside your first-aid kit: bandages, some gauze, painkillers, a tube of antibacterial cream, maybe iodine or hydrogen peroxide. We're all familiar with these tried-and-true solutions.
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They may be tried, but they're not all true. "Many people still use their mother's remedies, like putting peroxide on a wound," says Michael VanRooyen, professor of emergency medicine at the Johns Hopkins School of Medicine. "This, and other remedies are very common, but wrong." After years of research, experts are finding that your standard first-aid response may sometimes be the worst thing you can do in an emergency. Here's how to update your first-aid kit.
CUTS AND SCRAPES
Hydrogen Peroxide, Iodine, Rubbing Alcohol, Mercurochrome
When the skin isn't broken, it's hard to beat iodine for killing bacteria. That's why doctors use it to clean an area before surgery. But when there's a cut, says dermatologist Robert Kirsner, a spokesperson for the American Academy of Dermatology, full-strength iodine, hydrogen peroxide and rubbing alcohol can be toxic to skin cells, impeding healing. The chemical reaction (and bubbling) that occurs when hydrogen peroxide hits the skin isn't only cleaning the wound -- it's killing healthy cells. And that stinging from the rubbing alcohol? This stuff hurts because it's wiping out healthy tissue.
Putting iodine on cuts and wounds kills bacteria, says VanRooyen, but it won't clean the wound. "You want to protect the good tissue, and iodine doesn't do that." Mercurochrome also kills bacteria, but as the name suggests, it contains mercury, which is toxic, and not generally recognized as safe, says the FDA. Today, doctors don't use Mercurochrome.
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Remarkably, cleansing a wound has become much simpler: "The most effective way to get rid of debris and bacteria without damaging healthy tissue is flushing the wound out with water," says VanRooyen. Put the wound under a faucet, or spray it with the nozzle on the kitchen sink. Flush it with water to clear it of all debris. If you are worried about the bandage sticking to the wound, consider using an antibacterial ointment that contains bacitracin or neomycin to keep the area lubricated.
You burn your hand -- on the stove, an iron, or a hot plate. According to a popular old wives' tale, you should spread some butter on the burn to ease the pain. But that isn't a good idea, says VanRooyen. "Butter was thought to coat the burn, but it can cause infection and create an environment for bacterial growth."
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Run the burn under cool water immediately to help remove the heat and put an end to the damaging process. "The water will also clean the area, decrease the risk of infection, and make it feel better," says VanRooyen. Next, wrap the burn with sterile gauze or a nonadhesive bandage, and keep it clean and dry. If blisters form, don't break them -- the fluid inside is sterile, and it creates a natural bandage over the burn.
Syrup of Ipecac
When a child swallows anything that's poisonous, parents probably think they are well prepared if ipecac syrup is on hand. Wrong, says the American Academy of Pediatrics and the American Academy of Clinical Toxicology. If you have ipecac in your house, get rid of it. For years, ipecac was thought to be a good way to treat a child who had swallowed a toxic substance, but not anymore. Made from the root of a Brazilian plant, ipecac irritates the stomach to induce vomiting. But a recent study from the Cincinnati Children's Hospital Medical Center found that ipecac doesn't reduce ER visits or save lives. Maybe that's because it doesn't always remove enough of the toxic substance from the body, says American College of Emergency Physicians spokesperson Charles Pattavina, an assistant professor of emergency medicine at Brown University Medical School. Ipecac can leave 40 to 50 percent of the toxin behind. It can also lead to excessive vomiting, a problem that may cause dehydration and prevent doctors from giving other treatments. Another risk: If the poisonous substance is caustic, like lye, it burns the esophagus when swallowed, and can burn it again when it comes back up.
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Immediately call the national poison control hotline (800-222-1222), which will be answered by your local poison control center. (Paste the number on the back of your phone.) The experts will be able to tell you what, if anything, to do. If it's a true emergency, they may send you directly to the ER. There the treatment of choice is often activated charcoal (AC), a very finely ground charcoal powder. When the tasteless powder is swallowed (often it's mixed with soda), it can soak up the ingested substance like a sponge, preventing it from entering the bloodstream. The charcoal then passes through the digestive system and leaves the body.
It's important to move quickly, since AC is best taken within an hour of ingesting the poison. Some poison control centers recommend having AC on hand (you may find it in drugstores), but stress that you should never use it without expert guidance. The poison control center will tell you if it's necessary, and how much to use, which depends on the victim's weight. Look for AC in powder form, or pre-mixed with water (called a slurry), not capsules -- you'd need to swallow 50 of them to get the benefit, says Henry Spiller, director of the Kentucky Regional Poison Center.
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Once upon a time, every well-trained Boy Scout in America learned how to stop bleeding with a tourniquet. But studies show this method causes more harm than good. "Only in the most dire circumstances would you want to put a tourniquet on somebody," says Pattavina. Tourniquets can increase the risk of tissue damage or even the loss of a limb, and since there are other methods that can slow the blood flow -- and preserve life -- without the loss of the limb, tourniquets are out.
Apply direct pressure to the wound. This is what the Red Cross has always recommended and it's the best solution, says VanRooyen. Simply place a clean cloth on the wound and press firmly; don't remove the cloth, even if it gets saturated. If necessary, add more cloths right on top of the first. Applying direct pressure reduces blood flow to the wound. This should stop the bleeding and promote clotting, but still leaves blood circulating to the rest of the limb, says VanRooyen.
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If that's not enough, you can further slow the blood flow by applying pressure to the main artery of the upper arm or leg, depending on the site of the wound. You can learn about this procedure in a first-aid course or through the American Red Cross at redcross.org.
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