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Why you shouldn’t soak a splinter and other ways first aid has changed

UPDATED: Wed., July 28, 2021

By Stacey Colino Special to the Washington Post

Now that we’re relishing our post-shutdown freedom, we’re making the most of the season of barbecues, picnics and other outdoor fun with friends and family members. That’s all good, but it also means that we’re at increased risk for summer bummers such as splinters, sprains and burns. When it comes to treating injuries like these, the strategies our parents used might no longer be the right things to do.

In some cases, old wives’ tales have been debunked; in others, doctors have found better, evidence-based treatments. “As we learn new things from science, the guidelines change – and that’s happening with first aid. We now have better evidence of what works,” says Sean McGann, a clinical assistant professor of emergency medicine at Thomas Jefferson University in Philadelphia and a spokesman for the American College of Emergency Physicians.

If your first-aid techniques aren’t on target, you could end up exacerbating an injury. In a study in which 654 adults took a multiple-choice test on recommended first-aid skills, not a single one answered every question correctly, and only half of the adults were familiar with 60% of the questions. It shouldn’t be that way. To make sure you’re up to speed on the latest in first aid, check out these do’s and don’ts for various situations:

You burned your finger while barbecuing

Do: Place the burned area under cool running tap water for at least 20 minutes to calm the area and stop damage to the skin. “A lot of people don’t realize the thermal damage is continuing even after they’re no longer in contact with the source of the burn,” says Matt Wilson, vice chairman of emergency medicine at MedStar Washington Hospital in Washington, D.C.

“Cooling that area immediately is the key to limiting the damage.” A 2020 study found that treating burns with cool running water for 20 minutes was associated with a decreased thickness to the burn and significantly lower odds of needing a skin graft to repair the damaged skin. If you don’t have access to clean running water, place a cold compress, such as ice wrapped in a towel, on the area for that long.

After cooling the burn, pat it dry. You can take ibuprofen to reduce discomfort and apply a soothing antibiotic ointment (such as bacitracin) to the area, which can help moisturize it, says Michael Carius, an emergency physician in Connecticut and past president of the American College of Emergency Physicians.

Don’t: Apply butter, egg white or vitamin E to a burn, as some people do, because these could introduce contaminants or irritate the raw skin, Wilson warns. Applying ice directly to a burn can lead to more tissue damage. And if a blister forms on the burn, don’t pop it because that bubble of skin provides a barrier that helps prevent infection; if it pops naturally, apply an antibiotic ointment and a clean bandage.

Seek medical attention: If you suspect it’s a deep burn because the skin looks intensely angry (like raw meat) or waxy, go to an emergency department, Carius advises.

You got a splinter in your foot while walking barefoot on a deck

Do: Grab tweezers or splinter forceps (if you have them), and gently but firmly pull out the splinter. “Make sure all of it is removed, otherwise it becomes a source for possible infection,” says Daniel Bachmann, an associate professor of emergency medicine at Ohio State University in Columbus. Then, wash the area with soap and water and keep it clean.

Don’t: Soak the splinter in water. This makes the wood more susceptible to breaking apart under the skin and less likely to come out as a single piece, Carius says.

Seek medical attention: If you can’t get it out on your own, go to an urgent care center or emergency department. “The splinter has to come out because it’s almost certainly going to become infected if it stays under the skin,” Carius says.

Your child fell off a bike and got a bad cut

Do: Wash the cut thoroughly with mild soap and water, making sure all dirt is removed, then apply direct pressure, using a clean towel, to the wound to stop the bleeding. Apply an antibiotic ointment, which helps keep the wound moist and facilitates healing, and cover the cut for the first 48 hours to prevent infection, McGann says.

Don’t: Use hydrogen peroxide to clean the wound. “In addition to being painful, (applying) peroxide can actually damage healthy tissue and slow down the healing process,” McGann says.

Seek medical attention: If the wound is gaping or really dirty, if there’s a foreign body embedded in the cut or if it’s longer than half an inch, head to the ER. Keep in mind: Timing matters. “A lot of physicians won’t close a wound after 24 hours because of the risk of infection,” Carius says.

You got whacked in the nose by a Frisbee and your nose starts bleeding – profusely

Do: Place a towel or wad of tissues under your nostrils, and apply pressure by pinching the nose tightly just below the nasal bone for 10 to 15 minutes nonstop. “Don’t keep checking to see if the bleeding stopped,” Wilson says. Lean your head forward to prevent the blood from going down your throat and into your stomach, which could trigger nausea and restart the bleeding.

Don’t: Put tissue, cotton or anything else into the nose to try to stop the bleeding because “this could introduce a source for infection or make the situation worse,” Bachmann says. Also, avoid blowing your nose for a few hours so you don’t restart the bleeding.

Seek medical attention: If you can’t stop the bleeding with nonstop pressure after 15 minutes. Keep in mind: If you have a bleeding disorder or you’re taking anticoagulant drugs, it might be more difficult to stop the bleeding; if you can’t, go to the ER, McGann advises.

You twisted your ankle and fell while playing tennis

Do: Elevate the ankle above your heart and apply cold or ice packs – or a bag of frozen peas – for 10 to 15 minutes at a time, every two to three hours, to reduce swelling. Resting the injured joint and taking ibuprofen can help ease inflammation and pain. “The goal is to keep the swelling down because that’s what causes most of the pain,” Carius says.

Don’t: Put ice directly on the skin because this could damage the skin, Wilson says. And don’t apply heat in the 48 hours after the injury; this can increase swelling – the opposite of what you want.

Seek medical attention: If you can’t bear weight on the injured ankle or it looks misshapen, go to an urgent care center or an emergency department. “Sometimes it’s hard for people to differentiate a sprain from something more serious like a fracture,” Bachmann says.

Someone is having a seizure

Do: Call 911 (or get someone else to), then clear the area around the person so that they won’t hit something. “The most important thing is to protect the person from being injured while having a seizure,” Bachmann says. If possible, help the person get on the ground and turn them on their side so that “secretions will leak out of the mouth and not into the airway,” McGann says.

Don’t feel bad if you didn’t know what to do before now: A 2021 study by researchers at the Centers for Disease Control and Prevention found that only 25% of adults in a national survey knew seizure first aid.

Don’t: Force anything (such as your fingers or a spoon) into the person’s mouth to try to prevent them from biting their tongue, Carius says. “That’s one of the more dangerous things you can do.” Doing so can cause the person to choke or chip their teeth.

Seek medical attention: Anyone who has a seizure should be evaluated in an emergency department so doctors can determine the cause and assess their health and mental status afterward, Bachmann says.

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