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#199897 - 04/09/10 01:38 AM Re: FAK: Things your going to run out of #1 [Re: duckear]
nursemike Offline
Old Hand

Registered: 11/09/06
Posts: 870
Loc: wellington, fl
Originally Posted By: duckear
Originally Posted By: MDinana
A bit off topic here, but everyone that's carrying around betadine realizes that it needs to DRY before it's actually sterilized anything, right?






Uh oh. I have been scrubbing my hands with betadine before surgery for years and never let it dry.

I've run into the 'let it dry' approach before, usually applied to alcohol products. Would it be more palatable to assert that most disinfectants require some dwell time , wet or dry, to croak the more resistant organisms? probably more accurate, anyway. Regarding disinfection of intact skin, CDC research seems to identify chlorhexidine and povidone iodine (betadine) as the leading contenders. Quaternary ammonium salts like zephiran, were in vogue for this application in the seventies, not so much now.
Or there is the Arkansas orthopedics approach: make a paste of plaster dust and bourbon, and smear it on the infected part-the bacteria get drunk and stone each other to death.
_________________________
Dance like you have never been hurt, work like no one is watching,love like you don't need the money.

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#199902 - 04/09/10 03:13 AM Re: FAK: Things your going to run out of #1 [Re: nursemike]
JohnE Offline
Addict

Registered: 06/10/08
Posts: 601
Loc: Southern Cal
I'm glad I was only "a little confused" but I'll stick to using my BZK wipes and skip the alcohol wipes for any sort of cleaning in or near a wound and iodine or betadine for use in helping to keep bandaids stuck.




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JohnE

"and all the lousy little poets
comin round
tryin' to sound like Charlie Manson"

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#199919 - 04/09/10 01:18 PM Re: FAK: Things your going to run out of #1 [Re: JohnE]
Lono Offline
Old Hand

Registered: 10/19/06
Posts: 1013
Loc: Pacific NW, USA
Getting back to 'what can I expect to run out of first', based on exercises and feedback from folks who have been there patching others up from a kit post-earthquake, besides water I'll run out of burn dressings or anything to cover severe burns. And it doesn't fit in a FAQ, but I can also expect to run out of ground insulation below patients, ground around the PNW tends to be cool enough most of the year that if you can't get them up off the cold, wet moss, they will lose body heat. No solution for that so far, just scrounge what you can find.

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#199923 - 04/09/10 03:13 PM Re: FAK: Things your going to run out of #1 [Re: duckear]
MDinana Offline
Pooh-Bah

Registered: 03/08/07
Posts: 2208
Loc: Beer&Cheese country
Originally Posted By: duckear
Originally Posted By: MDinana
A bit off topic here, but everyone that's carrying around betadine realizes that it needs to DRY before it's actually sterilized anything, right?






Uh oh. I have been scrubbing my hands with betadine before surgery for years and never let it dry. I rinse my hands with water (tap water at that!), dry them, and then don gloves and gown. wink

Letting it dry is good because it leaves a bacteria resistant area, for lack of a better description, for hours, but iodine, wet or dry, will kill bugs.



No... you've been using the Betadine surgical scrub. Real/normal betadine you need to let dry (read the fine print in the instructions)

http://www.betadine.com/for_hospitals.aspx

Click the links for the package info - you'll see that the 10% solution they tell you to let dry; the scrub solution they say to keep wet. In fact, the last line in the scrub solution is essentially "if you add betadine, let it dry."

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#199941 - 04/09/10 07:46 PM Re: FAK: Things your going to run out of #1 [Re: MDinana]
Art_in_FL Offline
Pooh-Bah

Registered: 09/01/07
Posts: 2432
If you scrub an area with Betadine you're going to have to remove the Betadine before tape will stick. Or at least you will if you want it to stick for any period of time.

Try this experiment: Wipe some Betadine on your arm. Let it dry. Apply a band-aid over top of the dried Betadine. Betadine dries slightly tacky so it might feel like it is stuck on pretty well. Now try a little light exercise. Get out of the AC. Walk around the block a few times. Let it ride the rest of the day.

In my experience the dried Betadine absorbs sweat and softens. Band-aids and tape tend to fall off in a short time.

This may, or may not, be a consideration. If you're bandaging people up just to get them to a hospital a few minutes away it really doesn't matter what you do. You want to make a professional job of it but it is mainly out of pride instead of necessity. In short order the docs will remove the bandage. A carefully made field dressing is wasted if they are on their way to an ER or trauma center.

On the other hand, in a disaster, or austere field conditions, and certainly for minor injuries that won't see a doctor, wounds that account for the majority of what a FAK is used for, people will be wearing that bandage for a day or more. If you don't want to blow the contents of your FAK redoing one small injury you need to get it right the first time.

It also has to be noted that that time honored stickum, tincture of benzoin, is not entirely foolproof. I happen to love the smell. But I'm also mildly allergic to it. Anywhere it dries on my skin blisters in 24 hours. I had it used on me to anchor the ends of three Steri-strips. Next day I had six tight and round little blisters located directly under the ends of the strips. The laceration healed long before the six spots stopped their cycles of cracking and peeling. I now avoid the stuff.


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#199956 - 04/10/10 02:08 AM Re: FAK: Things your going to run out of #1 [Re: Art_in_FL]
nursemike Offline
Old Hand

Registered: 11/09/06
Posts: 870
Loc: wellington, fl
Originally Posted By: Art_in_FL
Band-aids and tape tend to fall off in a short time.

people will be wearing that bandage for a day or more


Band aids falling off is a good thing; wearing a bandage after it is wet, or soiled, or more than 24 hours old, I would assert, is a bad thing. Bacteria thrive in warm, dark moist environments-it is wise to get the dressing off once or twice each day to allow the wound to dry, check for infection, and change the layer of antibiotic ointment. Bad things happen under dressings: bad things I have found under older dressings include infection, tissue necrosis (destruction of tissue due to excessive tightness/compromised circulation), and maggots...tho the maggots did clean up the dead tissue quite admirably, the patient seemed offended by their presence. Dandy little protein source, too, I am told, tho the efficiencies involved in dining on something that is dining on you is problematical.
I understand that the problems of wound care in primitive circumstances requires compromise, but I'm just sayin'...
_________________________
Dance like you have never been hurt, work like no one is watching,love like you don't need the money.

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#199959 - 04/10/10 02:14 AM Re: FAK: Things your going to run out of #1 [Re: MDinana]
nursemike Offline
Old Hand

Registered: 11/09/06
Posts: 870
Loc: wellington, fl
Good link-thanks. I am not quite sure that they are saying that it is not bactericidal until it dries; they might be saying that, if it hangs around on your skin too long in solution, you will absorb it and suffer sensitivity and allergic reactions-then again, they might not mean that either: these words may have been written by marketers and lawyers, rather than pharmacologists and physicians,
_________________________
Dance like you have never been hurt, work like no one is watching,love like you don't need the money.

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