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#28857 - 07/05/04 05:01 AM Re: First Aid Kit: Which Betadine?
JohnN Offline
Old Hand

Registered: 10/10/01
Posts: 966
Loc: Seattle, WA
Quote:
Betadine (a.k.a. 10% Povidone-Iodine sol) should never be used "full strength" from the bottle into an open wound. In clinics and hospitals, it is always diluted further. The reason this is done is because "full strength" is still considered caustic to tissue. The only time it can be used directly is when the skin is still intact,


Hmm. I had just read this Betadine FAQ which lead me to think that using it "full strength" was not only OK, but recommended:

http://woundcare.org/newsvol2n2/ar1.htm

"
Q. Does Betadine Solution "dry" or "blister" wounds?
..............................

A. No. Betadine Solution does not dry or blister skin or wounds. Betadine Solution is film-forming and leaves a protective antiseptic film over wounds and skin which decreases microbial counts and subsequently provides excellent antimicrobial substantivity for several hours.

Q. Should Betadine Solution ever be diluted when treating wounds?
..............................

A. The use of full-strength Betadine Solution on wounds has been proven to be safe and effective.

[...]

We therefore recom- mend the use of full-strength Betadine Solution on wounds and skin injuries.
"

Hmm.

-john

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#28858 - 07/05/04 05:07 AM Re: First Aid Kit: Which Betadine?
JohnN Offline
Old Hand

Registered: 10/10/01
Posts: 966
Loc: Seattle, WA
Quote:
The comment of having a bottle to just "pour it on" is rather telling. We have this idea wounds should be dressed in ointments and then bandaged. A small amount of controlled bleeding will naturally flush any debri. Betadine and a loosly fitted bandage ( air circulation) are a good followup. I've seen to many horses ( and people) with injuries smothered in ointments not unlike cement repairs. The doctors/staff usually have to remove this stuff to see the extent of the wound, causing further pain and tissue injury.


Considering Betadine has the approximate viscosity of water, I don't see why this should be a huge issue. You can pour the stuff on or over the wound, dab or let the excess run off and you are set. It seems the really cool part here is that it is not a paste.

-john

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#28859 - 07/05/04 05:08 AM Re: First Aid Kit: Which Betadine?
Trusbx Offline
addict

Registered: 01/16/02
Posts: 397
Loc: Ed's Country
As has been stated many times in this forum before:

Irrigate all wounds copiously - water, normal saline solution, chlorhexidine. We don't really irrigate a wound with betadine unless you had a lot. The key here is volume to wash out the dirt and gunk. Of course if you had lots and lots of betadine..... If you had only one bottle, it would be better to dilute wht amount in a larger amount of water to get more bang for your buck.

Don't induce more bleeding. Water is cheap, blood is not.

Don't close any dirty wounds in the field. If you can get it clean with irrigation and you are trained, you do so at your own risk.

DO NO HARM, to your wound, yourself or others!



Edited by Trusbx (07/05/04 06:31 AM)
_________________________
Trusbx


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#28860 - 07/05/04 05:16 AM Re: First Aid Kit: Which Betadine?
JohnN Offline
Old Hand

Registered: 10/10/01
Posts: 966
Loc: Seattle, WA
I just thought I should clear something up. I tried to set the context up in this post, but I realized I didn't link that post here. While it is obviously an importaint issue, I'm not really thinking of what you should do for wound care when professional help is imminent. In those cases I would be just peachy doing the minium needed and letting the professionals take over. I'm more thinking about in a disaster or remote emergency when it is likely that I'm the best that is available for some time.

Thanks,

-john

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#28861 - 07/05/04 07:56 AM Re: First Aid Kit: Which Betadine?
dave750gixer Offline
journeyman

Registered: 03/17/04
Posts: 60
Loc: UK
There is a fourth possibility ...I carry a 50 ml dry powder spray can of povidone/iodine. Dont know if its available where you are though.

For cleaning out wounds I carry 500 ml of clean water and a 20 ml tube of sterile saline. Plus the usual wipes. The povidone/iodine spray is for treating the dogs as it is much easier to get to awkward fur covered wounds with it in the field.

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#28862 - 07/05/04 05:24 PM Re: First Aid Kit: Which Betadine?
Anonymous
Unregistered


Very good advice, stargazer... you sound like you'd be a good person to have along in a pinch. I was going to ask your background, but after a quick look at your bio, I saw that you'd already answered that for anybody curious enough to look. You sound like you'd be a good bug-out buddy.

Troy

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#28863 - 07/05/04 05:47 PM Re: First Aid Kit: Which Betadine?
stargazer Offline
Enthusiast

Registered: 03/05/02
Posts: 224
Loc: Idaho, USA
John:

I recently reported that Betadine straight from the bottle into a wound was considered caustic to tissue and should therefore be diluted. Well, today (July 5, 2004 at 0100 MST) I spoke with the Doc at the ER and learned the "old school" of thought were along those lines. Seems in the late 1980's a series of anaphylactic reactions to iodine were noted. This subsequently led to an investigation by the FDA. The hospitals and clinics were quick to adopt the idea of diluted Betadine. In about 1998 it became recognized through product research to return to using Betadine full strength. Now a wound is irrigated (depending on the need and amount of debris) and just prior to closure about 10cc of Betadine is literally dumped in and after about 2 minutes it is rinsed out and the wound closed. CAUTION: Be sure your patient is not allergic to iodine, or shellfish, as this may cause problems.

I learned two things today…

One: I was still under the “old school of thought” and should therefore consider full strength Betadine in wound irrigation. About 10cc should work, anymore and you need professional help.

Two: When you are in the ED at 0100 with a heart attack (transported by ambulance) and the Doc is getting ready to suture a wound closed, you can learn something from them while they suture if they know you and are willing to instruct. BTW I observed the doc literally flush the wound with Betadine and then flush with sterile water.

Hope this clears the air yet again and the Doc did refer me to the website as you have. HMMMMMMM

I apologize to you (and all) if I caused any confusion and gave incorrect information.

Stargazer

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#28864 - 07/05/04 05:51 PM Re: First Aid Kit: Which Betadine?
stargazer Offline
Enthusiast

Registered: 03/05/02
Posts: 224
Loc: Idaho, USA
Thank you, I enjoy good comments like that.

Stargazer

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#28865 - 07/05/04 08:23 PM Re: First Aid Kit: Which Betadine?
bountyhunter Offline


Registered: 11/14/03
Posts: 1224
Loc: Milwaukee, WI USA
Stargazer:

To paraphrase the bank robber in "Dirty Harry", "I gots to know".

Was the heart attack you?

Was the sutured wound you?

Did the wound induce the heart attack, or vice a versa?

Bountyhunter

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#28866 - 07/05/04 08:28 PM Re: First Aid Kit: Which Betadine?
bountyhunter Offline


Registered: 11/14/03
Posts: 1224
Loc: Milwaukee, WI USA
Trusbx:

I was just kidding about cutting an opening for flushing an abrasion.

Water may be cheaper than blood, but you can't always get safe water.

Since you are medical professional, I wonder if you can tell me wheather urine is really a good antiseptic? I used to hear stories about it being used by some soldiers when medical supplies ran low or out, but since a lot of these stories came from friends, I never knew if they were kidding or not.

Bountyhunter

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