18 Jul 10 COMMON FIRST AID MYTHS – Learn the facts
Below are my top 10 common myths that my students usually come to the lesson stating what they have been told or learnt at school or their own society. I have put the name of the First Aid Emergency and the incorrect remedy in italics just to shock you into reading further!
Later, I have given the correct First Aid treatment or remedy, which must be administered by the First Aider, to relieve the victim quickly and efficiently.
BURNS: APPLY BUTTER
CHOKING: DRINK WATER
SEIZURES: PUT A PENCIL OR WALLET IN MOUTH
NOSE BLEEDS: PULL HEAD BACK & PINCH NOSE
BEE/WASP STINGS: USE CREDIT CARD TO REMOVE
BIKE ACCIDENT: REMOVE HELMET FROM INJURED
HYPERVENTILATING: BREATH INTO A PAPER BAG
TORNIQUET: IN ALL CASES OF SEVERE BLEEDING
TRACHEOTOMY: KNIFE & A PEN
10.JELLY FISH STING: PEE ON AREA AFFECTED
Burns First Aid MythsBURNS – Many people think that putting butter on a burn will relieve it, but this actually makes it worse, because it is like cooking your skin. The best treatment for all types of burns is to run the affected area under cold water, for at least 10 minutes. This is because, when we burn our skin, the burning process continues unless it is relieved. After the cold water, it is recommended to wrap the affected limb or area with Clingfilm in order to protect it from infection and from the environment. For more serious burns, which have blistered or gone deeper, apply cold water, but call an ambulance to take the victim to A & E for medical care. Most burns are caused by carelessness in the home, so make sure that you keep your home safe from danger, such as fitting smoke detectors or a visit from the Fire Brigade to help you put safety measures in place in order to prevent fire.
The photograph below clearly illustrates the three types of burns on an arm and hand, which are classified as follows: –
Superficial Thickness Burn – Red & hot to touch
Partial Thickness Burns – Pain and Blistering
Full Thickness Burns – Charred & waxy grey
13CHOKING – Some people think that you should give the victim sips of water to clear the food that they are choking on. This is incorrect and could be dangerous. Another dangerous practise is to push the choking object down the throat further: Wrong again! The best treatment for the choker is to lean them forward and administer 5 Back Slaps, firmly between the shoulder blades, in order to expel the foreign body. Follow this by placing a fist, covered by the other hand, under the Sternum bone (As illustrated below) and push in and upwards 5 times. If the choker is a child under the age of 2, never give Abdominal Thrusts, but give Chest Thrusts instead. Back Slaps are always recommended facing the child downward, in order to help relieve the blockage through gravity.
seizure first aid mythsSEIZURES – If somebody is suffering with a seizure, for example, during an Epileptic Fit, the victim may very well bite his or her tongue; it very rarely becomes an airway emergency. Seizures look very scary, but generally do very little harm. You are more capable to cause an airway blockage by stuffing a pencil or belt in the victim’s mouth, than by leaving the victim alone to have their fit. At most, I suggest to my students that after making the area around the victim safe try and place a pillow or coat under their head to prevent injury. It is recommended that, if a child has a fit for more than 5 minutes, the observer must call an ambulance to take the victim to A & E for observation. Never try and restrain the victim of a seizure, because you could be hurt through the force of their thrashing limbs.
There is a saying, which is:
‘Treat the seizure with less, rather than too much’
Noes bleeds mythsNOSE BLEEDS – The reason why it is recommended not to put the victim of a nosebleed’s head back, is because blood will be swallowed and cause them to be sick or even choke. The First Aider must lean the victim forward (see picture below) and squeeze the area below the bridge of the nose (known as the ‘Bundle of His’). Keep the pressure on for at least 10 minutes, whilst reassuring the casualty they will be ok. After 10 minutes, if the bleeding has stopped, the area can be cleaned and the person takes it easy. However, if bleeding continues, then they should see their GP or go to A & E for examination and investigations.
bee sting mythsBEE/WASP STINGS – Removing the Sting is terribly important as soon as you can, as opposed to searching for a credit card to scrape the sting off. Apply vinegar to the affected area and pay special attention to the victim presenting signs of Anaphylactic Shock. This means that they will show a massive allergic reaction, causing them to asphyxiate, if an EpiPen is not struck into the victim’s thigh, administering Adrenaline, in order to counter act the allergic signs, associated with Anaphylaxis.
Bike accident mythsBIKE ACCIDENT – This is often a contentious issue for my First Aid students, because it is frequently said that removing a motorbike helmet from the victim of traffic accident is not advised. The reason being, that they may have a head or spinal injury and removing their helmet may render them paralysed. However, it is suggested that if their breathing is affected and they are struggling to breathe, with the helmet on, then the helmet should be carefully removed, to enable the victim to breathe comfortably. Naturally, as in all First Aid emergencies, safety should be paramount to all concerned and making use of second and third aiders is advised.
Hypeventilation mythsHYPERVENTILATING – Hyperventilation syndrome (HS) is a non-medical cause of shortness of breath. It is very scary, but not life threatening. It can be hard to tell HS apart from othercauses of shortness of breath. If there is any doubt about the cause of difficulty breathing, call NHS 111 for advice on what to do for the victim of HS, or alternatively, dial 999/112 immediately. Talk to the victim calmly in a soft voice and tell them to take slow deep breaths, to calm them down. Other things, such as running, make you breath faster than normal.Pneumonia makes you breath quicker as well as situations involving Stress. In no case is a paper bag indicated as proper treatment for Hyperventilation, and may very dangerous, because the casualty could suffocate.
Tourniquet mythsTORNIQUETS – Is a constricting or compressing device, specifically a bandage type material, which is usedto control venous and arterial circulation to an extremity, for a period of time, in order to prevent blood loss and ultimately, death. There is no doubt that Tourniquets provide an efficient method to stop ‘Serious Haemorrhage’ – very serious bleeding wounds to the extent that death is pending, due to more than 30% blood loss. Tourniquets are commonly used in the army, worldwide and by Emergency Services in the USA and to a lesser extent, in the UK. My First Aid learners often ask the question about whether to use a Tourniquet on a bleeding wound and I usually tell them not to use this method to stop bleeding from a wound, namely a leg or arm.
There are many negative consequences of inappropriate or prolonged use of Tourniquets, which include, nerve damage, tissue death and blood clots leading to death. The person applying the tourniquet must have a basic understanding of what they are doing, how to do it and the reasons why they are doing it. Using a Tourniquet has caused more harm than good, because they were either applied incorrectly or left on too long, causing death to the victim. The photograph below is from 1918, the end of the First World War and depicts the use of a Tourniquet (AKA a Garrot), explaining that it is a beneficial blood stopper and saved many lives. Attending a First Aid course will educate the learner into the importance of stemming bleeding through applying pressure with your fingers, for at least 10 minutes, to ensure that the bleeding will stop, after which, dressing and bandaging a wound will protect it and prevent the casualty from getting a bacterial infection. If infection is not treated, this could lead to septicaemia (blood poisoning) and ultimately, death.
Tracheotomy mythsTRACHEOSTOMY – Only the other day in my Paediatric First Aid class, learners were practising how to relieve the choking baby. They gave Back Slaps and were also shown how to perform Chest Thrusts, as opposed to Abdominal Thrusts (which is prohibited on under 2’s who are choking). At One Day Courses, we always suggest 3 sets of each of the above are performed. However, the big question my learners always ask me is ‘What if the child is not saved through the First Aid methods taught in class?’ If a child turns blue (cyanotic), they may have to perform a Tracheotomy?
A Tracheotomy may have to be performed. The actual term “Tracheotomy” refers to the incision into the trachea (windpipe) that forms a temporary or permanent opening, which is called a “Emergency Tracheostomy, It can be done, but only if you feel confident enough and all else has failed. The casualty should be placed on their back and a rolled-up towel or something similar should be positioned under their shoulders to stretch out the neck, making it easier to see the structure of the throat.
A cut should be made in the skin of the neck and underlying tissue. The shell of a Bic Pen should be inserted into the hole to create an airway, enabling them to breathe again. This is much easier to perform on an adult, because their windpipe is easier to manipulate and insert the knife, in order to find the wobbly bit half way down the windpipe to make the breathing hole (See illustration below). I am certainly not suggesting that this should be performed by anyone on any victim who is choking, but if the choker is not relieved quickly, they will die of asphyxiation and I wonder how you might feel if you may have saved his/her life with a Tracheostomy!
Jelly fish mythsJELLY FISH STING – Jellyfish cause painful stinging by leaving Nematocysts (tiny stingers) behind, when they are touched through contact with our own skin. Nematocysts, once activated, inject venom into the victim. Nematocysts, affect the bare skin, often leaving a tentacle or two behind.
The treatment is mainly about relieving the painful affects of the sting, initially removing the Nematocysts, without triggering them to inject the venom. Pressure is the main thing, which triggers them, as well as fresh water and also some chemicals. Jellyfish Sting Treatment involves removing and cleansing, but not urinating on the area! Apart from being physically awkward, unless it is someone else’s urine! It is also not effective, unless the urinating person has acidic urine!
Use sand or a towel to remove the tentacles, without actually touching them. If you happen to touch them with your bare hands, this will result in additional stings. Next, try and rinse away the sting area, in order to remove the Nematocysts
Some of the things that are suggested to apply to the stinging area are, vinegar, vodka, alcohol, water and sometimes urine. At the end of the day, there is no perfect cure for jellyfish stings. It really depends on the extent of the stings over the body and the site of them too, whether it is the arms, legs, chest etc.
Research has suggested that Vinegar (5% Acetic Acid) has been shown to be the best form of rinse for the deadliest type of jellyfish known as Box Jellyfish. This is because it neutralizes the unfired Nematocysts, so that they cannot inject venom into the skin. Of course, if you are on a beach with no resources, then seawater may be used to rinse away the remaining Nematocysts. Fresh water is not recommended, because it triggers Nematocysts to inject venom.
It must be also be noted that studies suggest that vinegar actually makes the pain worse, especially from stings from Portuguese Man of War (see photograph below), Jellyfish and bluebottle variety. These creatures are dangerous look-alikes to jellyfish.
Another point about the use of urine as a treatment for Jellyfish stings: Urine consists of water and waste products of the body’s blood stream, which includes ammonia. Depending on the person providing the urine, take into consideration whether they are dehydrated, diabetic, on a protein diet, or have other medical conditions. Since I have explained that we know that fresh water will often make Nematocysts fire, the logical conclusion is that urine will do exactly the same thing to a stinging jellyfish wound! A lesson to be learned here is to ensure that your First Aid Box is well-stocked with the necessary items to treat stings and burns, this will mean less tears and better healing time.
On another level, avoid swimming in the sea and you will always be the First Aider and never the casualty from a Jelly Fish Sting!
I hope you enjoyed this Blog; it still surprises me when my First Aid students come out with bogus remedies and silly ‘Old Wives Tales’ to treat wounds and deal with the Epileptic casualty who is having a fit. My advise to everyone is to sign up for a One Day Emergency First Aid at Work course so that you can learn the skills and dispel the myths!