Pete:<br><br>I went through my old course material but was unable to find the specific info (Its been about 12 years).<br><br>As I recall, the study was performed because a patient had blood drawn and the resulting analysis indicated alcohol in the bloodstream. It was then determined that the patient had not consumed any alcohol for an extended period prior to the draw.<br><br>The hypothesis that was tested and subsequently proven was that the the cathether had been contaminated with the isopropyl alcohol during insertion. This, in turn, caused the incorrect results<br><br>I believe, but I am not 100% sure, that the original patient took legal action against the involved hospital because of the erroneous results.<br><br>I remember this study because I was part way through my EMT-I training when our hospital suddenly mandated the use of Betadine for all IV starts.<br><br>

In theory, I guess it would be possible to contaminate the blood collection tube. Our jurisdiction has been using isopropyl alcohol pads for starting IV’s for many years, even if the blood draw is used for drug/alcohol levels. Maybe it is one of those urban legends that get started based upon one study or observation. Pete

hypothetical guessing that might explain the apparent volume contradiction:<br><br>1) The needle or catheter that was used to sample the blood alcohol level was directly contaminated with pure isopropyl during insertion and sampling. <br>combined with<br>2) isopropyl alcohol reacts more strongly by a factor of 10 with whatever reagent is used to test for ethanol levels in the blood.<br><br>If either or both of the guesses is correct then the concern with the minute amounts of isopropyl in an alcohol swab might make for an innaccurate reading of blood alcohol levels in a large individual.

OK you guys are starting to get a little too technical for me :)<br><br>So in short, should I ditch my alcohol wipes for some Betadine instead?<br><br>Also, how do you organize your 1st aid kit? There are loose items floating around the tiny pouchie everywhere!!! Aaauggh! I put them in plastic baggies within the 1st aid pouch, but still a mess and a pain to get to what I need.<br><br>I may pick up some of those jumbo paper clips (the black clamps with the metal rings) and hold bandage type-X, bandage type-Y, etc. together with them.

If you have room, carry both. The alcohol pads are great for removing dirt and body oils (around the wound) and finish with the Betadine . I personally like the use of Benzalkonium Choride wound cleansing pads (from Bound Tree http://www.boundtree.com/home.asp) They are $2.50 for a box of 100. I am not sure you should ask me about organizing into kits, I probably have far too many “medical kits” around the house and vehicles. Many of the companies that sell EMS equipment have great empty kits to which you can add your own supplies. I have made up kits to supply to Red Cross, Civil Defense and Fire departments in Ecuador using backpacks I picked up at a Eddie Bauer outlet store for under $10.00 and bought zippered pencil pouches, made of clear vinyl on one side so you can see what is in the pouch and nylon on the other side for $1.00 at our local dollar store. There are both expensive and cheap options, but the more organized and familiar with how you packed your gear the easier it to deal with an emergency. Remember all these products have a shelf life on should be rotated on a regular basis. Pete

Roger that Pete, I will carry both.<br><br>So what is the neosporin for? Does it help wounds heal faster? Prevent Bad Things from growing on your boo boo? Should I just save the space and ditch it?

Neosporin, is the brand name for an antibiotic ointment, generic or store brands should be just as effective. The Bound Tree (or anyone of the other ems suppliers should work as well) web site likely has their own brand, cheaper. One could argue either way if it is worth the space or not. If the wound is cleaned well, in the short run the ointment may not be necessary. If medical care is not available in a reasonable amount of time, a very dirty wound or if the person has some other type of medical problem (like diabetes) the ointment may prevent an infection. I would not tie up space in a PSK, but if you have an additional medical kit/bag and you have the space, it could not hurt to include some packages. Keep in mind they will have an expiration date.

Pete,<br><br>I had a few packs of the smaller antibiotics, but they burst in my pocket. Not good I like the Neosporin tubes, so I referred it as that though I shouldn't have (like Kleenex).<br><br>I guess I'll leave it behind. Kind of bulky, but better than those little bursting ketchup packets.<br><br>Finally, do I need those rolls of tape and gauzes? I use the gauzes for cleaning, but otherwise don't know what else to do with them.

An interesting link: everything you ever wanted to know about Betadine™. Stain info is #6, most of the way down. Right at the top it also mentions that it's formulated to be timed release, who knew!<br><br>http://www.woundcare.org/newsvol2n2/ar1.htm<br><br>And if you can stand one more EMT(B, Wilderness) opinion on this topic, it's my understanding that alcohol is fine for cleaning INTACT skin. Less optimal on mucus membranes and not at all good for any open wounds. Its lysing action kills OUR exposed cells, including nerve cells as mentioned above, just as readily as it lyses microbes.<br><br>With regard to Betadine™ application, I was taught to dilute it to the color of extremely strong tea (slightly transluscent through a small quantity) and use an irrigation syringe to rinse wounds under a bit of pressure. The advantages of this are better flushing and debriding of debris and less irritation and stinging from full-strength Betadine™ solutions and it goes little farther. And you can use even somewhat non-sterile water as long as it's clear-running with no debris, just make the dilution a bit stronger.<br><br>Also if you're gearing up for extended wound care, I'd recommend taking some triple antibiotic of some type after all; if you're daytripping leave it. Betadine™ is good for flushing and short term antiseptic use but antibiotic jelly stays put better long term and somewhat physically excludes recontamination and resists washing off by sweat or in water environments when properly covered and dressed. Plus when you have a leg full of road rash, the mild anesthetic they add to some of the triple antibiotic formulations feels really good!

Irrigation of a wound with plain water (or sterile saline if you want to be fancy) is the best course of action......dilution is the solution to pollution.<br>Chris is correct, alcohol and peroxide are quite injurious to tissue and should not be applied to a wound. <br>Betadine solution is the least toxic antiseptic to use on wounds that I am familiar with. I prefer not to use neosporin in my practice and use plain bacitracin ointment simply because a large number of people are allergic to the neomycin in neosporin