First Aid: The Dos and Don’ts of Minor Injuries

firstaidcrossAuthor’s Note:  The following information is compiled from multiple sources including:  The Mayo Clinic, the American Medical Association, the American Red Cross, and the National Association of Emergency Medical Technicians.  The information included in this article is not meant to diagnose, treat, or cure any serious medical condition.  In the case of all emergency situations and medical conditions, it is absolutely essential to seek the advice of a licensed medical professional.  All opinions stated in the article are those of the author and do not necessarily reflect the opinions of GayFresno, its owners, entities, affiliates, or subsidiaries.


“Put a little butter on it!”  This phrase is commonly heard in the south just after someone has burned himself on a hot pan.  It’s just one of the many “old wives’ tales” associated with first aid.   In many cases, there tends to be some truth to the tales, and in others…well, they can do more harm than good.  Over the last few weeks, I’ve noticed a good deal of “first aid” advice flying across my Facebook feed in response to a few of my more accident prone friends hurting themselves.  Some of the advice was medically sound, but most of it wasn’t on par with current first aid standards.  Please understand that I’m not saying that someone must run to the emergency room for every scrape, cut, and burn, but what I am saying is that you can hurt yourself more if you don’t know what you’re doing.  There are many things you can do at home to handle minor first aid situations.  I’d like to take the time to address someone of those instances, dispel a few myths, and give people a better understanding of how to properly handle the situation.  And now, on with the show…

One of the most common first aid situations in the U.S. revolves around minor burns.  Whether it’s from touching a hot pan or oil splatter, people seem to burn themselves quite often.  An average of 3 million people seek medical attention for burns each year, but that pales in comparison to the number of people who treat burns at home.   In a recent poll, it was determined that, over the course of a year, 78% of the population of the United States will sustain a minor burn and will not seek medical treatment for it.  There are 2 problems with this. Most people don’t know when to seek medical attention and when to handle it at home, and most people do not know how to properly treat a burn.  A minor burn (one that does not require emergency medical attention) is less than 3 inches in diameter, does not break the skin, even if it blisters, and does not involve substantial portions of the hands, feet, face, groin, buttocks, or major joints.  If the burn covers a larger area or causes the skin to crack or slough off, seek medical attention immediately.  Do NOT pop “water blisters.”  If you determine this to be a minor burn, then move on to treatment.   Some of the myths surrounding first aid treatment for burns include:  butter, vegetable oil, egg whites, vasoline, frozen peas, and ice packs.  Stop for a moment and consider what happens when you heat butter or oil?  It melts.  We fry things in it.  Does it really make sense to use that on a burn?  Egg whites?   Do you know what happens when you heat up an egg? It cooks.  Vasoline is very oily and can fall into the same category as vegetable oils and butter.  Cellular degradation occurs faster below 90 degrees, so cooling the area with ice packs or other frozen materials is not recommended.   To properly treat a minor burn, place the burned area under RUNNING, cool (NOT cold) water for 10 to 15 minutes or until the pain lessens.  If it is impractical to use running water, then immerse the burned area in cool water for the same length of time.  Once the pain has lessened, gently blot the area dry.  You may now apply an over-the-counter burn cream, such as Aquafor (similar to vasoline, but not the same) or Bacitracin, and cover it with non-stick, sterile gauze.  Don’t use fluffy cotton or other lint-ridden materials. You should wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain, and protects damaged skin.  Most people don’t have burn creams in their medicine cabinets, and if you happen to be one of those people, there is something you can do.  Always begin with the cool water treatment.  Once you get to the burn cream and bandaging step, if you don’t have the proper first aid materials, you can apply a layer of common yellow mustard to the burns that DO NOT immediately blister.  The vinegar in the mustard will reduce bacteria of the affected area, and there are some natural pain relieving properties of mustard seed.  This should be temporary though and used as a secondary option.  Use the proper materials whenever possible.

Another common injury, especially for those of us with children, is minor cuts and abrasions.  This is the most common type of minor injury.  My grandparents would swear by alcohol and a red liquid called Mercurochrome.  Those treatments burned like crazy, and quite honestly, I’d had rather just bled to death.  Then of course, there were always the “boil it out with peroxide” comments, followed by “Just let it breathe. It will heal faster.”  *BZZZZ* We’ve heard these things all of our lives, but there isn’t a lot of truth in them.  Before we get into the first aid, we need to define what a “minor cut or abrasion” is.  It’s not as clear cut as you would think.  Consult a physician for any cuts and abrasions near or on your eyes, nose, mouth, genitals, or feet (especially if you are diabetic.)  If the cut bleeds heavily, has jagged edges, gapes open, is more than ¼ inch deep, or reveals fat or muscle tissue, seek medical attention.  If you cannot adequately clean the wound (removing all dirt and debris) or the wound was caused by a rusted object, call your doctor.  Deep puncture wounds should always be looked at by a licensed medical practitioner, especially if you have not had a tetanus shot in the last 5 years.  If the wound was caused by an animal or human bite that breaks the skin or the injured area feels numb, go straight to the ER.  Now, I’m sure your thinking, “I’ve had injuries like that before, and I didn’t go to the doctor. It was just fine.”  That may be true, but that doesn’t mean it was the best course of action.  In most cases, the cut itself isn’t nearly as concerning as the related infections that can occur from improper treatment.  Nails, thorns, bites (animal or human), and cuts from household objects contain microbes (fungi, bacteria, parasites, etc.) that can cause SERIOUS and LIFE THREANTENING complications.  Don’t play with your health.  Now that we’ve established “minor,” let’s talk about those pesky myths.  Substances like alcohol, iodine, mercurochrome, and what not are painful and unnecessary.  Peroxide can actually damage healthy cells in the area of the wound, which will slow healing and could lead to other problems.  All of those chemicals are harsh and can irritate the wound.  First, flush the area with cool, running water removing as much dirt and debris as possible.  You may use a mild, anti-bacterial soap on the area as well, but be sure to rinse the area thoroughly afterwards.    Next, it’s time to stop the bleeding.  For minor cuts and abrasions, blood loss is inconsequential and is secondary to cleaning (First aid for more serious injuries with heavy bleeding is different.  For this article, we are only talking about minor issues.)  You do not want to apply pressure to minor cuts and abrasions that have not been properly cleaned, as you can cause debris (like gravel and glass) or metal shards to become further imbedded in the surrounding tissue.  A small amount of bleeding is necessary and helps to clean the wound.   Minor cuts typically will stop bleeding on their own, barring certain medical complications like hemophilia.  Small cuts to the head, hands, feet, and genitals will often bleed more than cuts to other areas of the body due to the number of blood vessels in those areas.  The face is the drama queen of the body.  It bleeds a lot.  If the bleeding does not stop on its own within a few minutes, apply gentle pressure to the CLEAN wound with a clean cloth or sterile gauze.  Hold the pressure steady.  Don’t raise the cloth or gauze to check on the wound, because that could cause the wound to start bleeding again. If blood seeps through the dressing, just put more on top and keep applying pressure.  It should stop bleeding in 2 to 3 minutes in most cases.   If the cut is on your hand or arm, you can help slow the bleeding by raising it above your head.  If it the blood spurts, go to the ER!  A squirty cut is not a happy cut.  Once the wound is clean and the blood has stopped, it’s time to cover it up.  Remove any dried blood around the wound (not on it) with a moist, clean cloth.  Don’t blow on it.  There are microbes in your breath.  Apply a thin layer of antibiotic cream (like Neosporin or Polysporin) to the area.  (Some of these can cause a rash.  If it does, remove the ointment and stop using it.)  Apply a clean, sterile bandage.  Make sure that the gauze or pad is large enough to cover the entire wound.  You don’t want adhesives sticking to the injury.  Change the bandage once per day.  Keep it covered.  Letting it “air out” can allow infections to set in.  Keeping it covered will reducing scarring, prevent infection, and allow the body to heal naturally.  Once there is no longer a risk of infection, you can stop using the bandages.  Be aware that some “pus” will occur, even without an infection.  Yellowish pus seen at the beginning stages of healing is normal and is a sign that the body is creating a scab to begin repairing the area.  Thick green pus or pus that has a strong, foul odor can be a sign of a serious infection, and you should seek advice from your doctor.  I will also add that ripping off tape or Band-Aids is NOT best.  This can reopen the wound.  Instead, rub the edge of the bandage with water to release the adhesive.  It will come off painlessly.  Most minor cuts will completely heal in 2 weeks (5 days for the face).  If a cut doesn’t scab over, becomes swollen, or does not show signs of healing in that time, you should see your doctor.

The last of the more common minor injuries are those involving muscles and joints.  We’ve all had them.  Shin splints, twisted knees, sprained ankles, jammed fingers, and stubbed toes.  There are TONS of myths surrounding these types of injuries:  everything from “COLD ONLY!!!” to “Just yank it lose” and “Keep running!”  Since these injuries involved the musculoskeletal structure, continued use of the affected limb or joints with only make it worse.  Jerking and yanking on joints is not a good idea for non-medical folk.  Broken bones should always be treated by a physician.  Don’t, for the love of all that is good, try and set a bone yourself.  You can break it worse, set it wrong, or push bone fragments into the tissue, and possibly perforate an artery.  Just don’t do it.   Let’s take a moment and define some things.  A sprain involves the ligaments of the joints that hold one end of a bone to another.  A strain involves the muscle tissue and tendons (the connective tissue that holds muscle to bone).  Twisted knees and ankles are sprains, while shin splints and pulled muscles are strains.  Believe it or not, jammed fingers and stubbed toes also fall into the category of sprains, though they are typically caused by impact injuries that compress the joints.   In the cases of sprains and strains, the average person is more concerned as to whether or not the bone is broken.  The truth is, unless it’s a compound fracture and you can see the broken bone, you really can’t tell without an X-ray.  Suspected broken bones can be determined by answering the following 3 questions.

                1.  Did you hear or feel a snap/pop in the injured area?

                2.  Are you having extreme difficulty moving the injured limb?

                3.  Does the injured part move in an unnatural way?

If you answer yes to any of those questions, GO TO THE ER.  The pain from sprains and strains can mimic the signs of a broken bone, but it’s always best to be safe.  If however, you are certain you are dealing with a minor strain or sprain, we treat them all the same way—with RICE!  Not rice like the grain though.  RICE is an acronym used for the treatment of strains and sprains: Rest, Ice, Compression, Elevation. Rest the injured area for a minimum of 24 hours.  Apply ice for 20 minutes at a time with 20 to 40 minute breaks between icings.  LIGHTLY compress it with an elastic bandage (like an ACE bandage) for a minimum of 2 days.  Elevate the injury above the level of the heart.  All of these things help to reduce swelling and pain.  You should NEVER apply heat to a sprain or strain during the first 24 hours.  Heat will cause an increase in swelling and pain.  If after the first 24 hours, the swelling is gone, but you are still experiencing discomfort, you may alternate between heat and ice for a few hours.  For impact injuries like jammed fingers and stubbed toes, it is best to wrap the finger or toe to an adjacent finger or toe to help with stability.  Don’t yank on it or try to “pop it” back into place.  It will do that on its own.  Expect bruising to occur with these types of injuries.  In the case of shin splints, DO NOT keep running.  Shin splints are caused by the muscle tearing.  If you keep running, you will only make it worse.  If you cannot stand or walk, if the pain and swelling persist longer than 48 hours, or if you lose feeling (goes numb), seek medical attention immediately.

So folks, save the butter for biscuits.  Remember to CTC! Cut the crap, and “Clean! Treat! Cover!”  Use RICE: Rest, Ice, Compression, Elevation.  And seek medical attention if you have any doubt about your health or injuries.

As an addendum to the article, I’d like to offer some advice on home first aid kits.  Cheap kits are available at most major stores, though they can sometimes be lacking in their overall supply.  While many of them will have bandages, gauze, ointments, and swabs, they often do not contain cold packs, syringes, elastic bandages, or anti-bacterial soap.  You can make your own first aid kits for a little more money, and tailor them to your needs.  You can make them for your vehicle and home.  Purchase a small Rubbermaid tote or Lock-Tite box from your local department store.  They come in a variety of sizes.  Fill them with items that can help you treat minor injury and store them in an easily accessible place that everyone in your family knows about.  Items to include are: elastic bandages (ACE bandages) of varying size, a variety pack of Band-Aids, Bacitracin, Neosporin, Aquafor, anti-bacterial soap, non-stick gauze rolls and pads, self-adhering medical tape, a 10 mL syringe without the needle (for flushing), a small bottle of artificial tears, saline solution, a cold pack, a small pair of scissors, tweezers, and latex gloves.  You’ll be better for it!  Be safe!


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