From: http://ririanproject.com/2006/10/25/10-useless-or-even-dangerous-first-aid-myths/

First Aid
We all know some remedy myths or old wives tales, but some of them have no effect on conditions, ailments, or illnesses of the human body. If you try any of these myths, you may run the risk of having an adverse reaction or the opposite result of what you would like to happen. So here are ten classic emergency fixes that definitely won’t do in a pinch:

1. Sucking Venom From a Snakebite

Cutting the skin of a snakebite victim to suck out the poison may be a classic first-aid technique, but doctors now say it’s useless and even dangerous. “Cutting and sucking, or applying a tourniquet or ice does nothing to help,” says Dr. Robert Barish, an emergency physician at the University of Maryland. The outdated measures “may do more harm than good by delaying prompt medical care, contaminating the wound or by damaging nerves and blood vessels,” Barish says in an article released by the university’s School of Medicine and the Rocky Mountain Poison Center.

“The victim should be moved out of harm’s way and transported to the nearest medical facility as soon as possible,” Barish advises. So the best cure for snakebite: a cell phone and a helicopter.

2. Peeing on a Jellyfish Sting

You’re far more likely to suffer a jellyfish sting than a shark bite, so here’s what you need to know:

First, don’t believe the rumors. Peeing on a stung bit of skin won’t do much to relieve suffering, and you’ll suffer some odd stares, too, doctors say.

“Urine has not been scientifically proven to help in jellyfish stings”, said Dr. Paul Auerbach, an emergency physician at Stanford University Hospital and an expert on jellyfish stings.

“Instead, vinegar is the best first treatment,” he said, when treating stings from North American jellyfish.

But the question still lingers, if no vinegar is in sight is urine better than nothing? While studies haven’t proven it, Auerbach admits he’s known a few people who said urine worked for them.

3. Drinking Booze to Ease a Toothache

“A shot of whiskey is not going to kill the pain of a toothache,” says Charles Wakefield, D.D.S., director of advanced education in general dentistry at Baylor University medical school. Instead of a whiskey on the rocks, just order the rocks: A Canadian study found that rubbing an ice cube on people’s hands killed tooth pain in 50 percent of them. Wrap the cube and rub it on the V-shaped soft spot of your hand, where the bones of your thumb and index finger meet. The cold, rubbing sensation travels on the same pathway to the brain as tooth pain, and by icing your hand, you override the signals from your mouth. When you’re finished, call a dentist. And pour yourself that whiskey.

4. Slathering Butter on a Burn

Putting butter, Crisco, or any other kind of grease on a burn can trap heat, cause scarring, and lead to infection. “When you’ve burned yourself, you’ve damaged the integrity of the skin, and butter is not the cleanest thing in the world,” says Ben Wedro, M.D., an emergency-room doctor at the Gundersen Clinic in La Crosse, Wisconsin. Your impulse to douse the burn in ice water is off base as well; the drastic temperature change can cause more pain. Instead, use cool water to soothe and clean the area.

5. Slapping a Raw Steak on a Black Eye

In the movies, you always see someone put a raw steak over their black eye. While it may feel good, the grease from the steak might get into the eye, causing more inflammation.

“The only medical merit this has is if it’s a cold steak,” says Flip Homansky, M.D., who’s seen his share of shiners in his work for the Nevada State Athletic Commission, which regulates Las Vegas’s boxing bouts. “The cold will decrease swelling, but there is no enzyme or anything else in a raw steak that will help otherwise.” The fact that the steak, compared with blocks of ice or ice cubes, can be formed to fit over the eye is another benefit, but a cheaper and less bacteria-prone solution is a bag of frozen peas, or crushed ice in a plastic bag wrapped in a towel. And remember, you will still end up with bruising.

6. Apply Peroxide to Cuts and Scrapes and Leave Open to Air

“I am not a fan of peroxide,” Richard O’Brien, MD, says. Some authorities even think it can kill the body’s cells that are rushing to fend off intruding bacteria and germs trying to enter the wound. O’Brien prefers soap and water - or just clean water - to flush out bits of dirt and irrigate the wound. Even hose water will do.

“We go by clean, treat, and protect,” he says. Clean a cut or scrape, apply antibiotic ointment, and bandage it. “Some people like to let wounds air, but I find they heal faster if they are protected. More importantly, if they are bandaged, the person, especially a child, will protect them better. You can’t imagine how many times people will reinjure the same place! I see it all the time. Bandaging makes it less likely the wound will be reopened.”

Any cut that goes beyond the top layer of skin might need stitches. Generally, the sooner stitches are put in, the lower risk of infection.

7. People May Swallow Their Tongues During a Seizure

It’s commonplace in movies. Someone has a seizure and a passerby sticks something in the patient’s mouth so they don’t swallow their tongue and block their airway. “People can control their own airway,” Richard O’Brien, MD, says. “Don’t stick anything in there.” If the person is outside, let him or her roll around on the ground. It’s OK.

When a person is having a seizure, don’t hold the person down as this can result in injury. Just remove sharp objects - glasses, furniture etc. - from around the person to prevent injury.

8. If You Get a Bee Sting, You Must Squeeze Out the Stinger

Never do this! Squeezing the stinger may allow venom still in the sac to get into your system. “Scrape the stinger out with a credit card,” Richard O’Brien, MD, says. “Even those acrylic nails work, if they are clean.” If the person is getting red or having trouble breathing, dial 911. This can be serious or even fatal.

Another bee sting remedy is putting baking soda on it. This one actually works. Mix baking soda with water to form a thick paste and slap it on ASAP. “The sting is produced by an acid, and if you put baking soda on as soon as you can, it neutralizes that acid,” says Stephen Purcell, D.O., chairman of the division of dermatology at the Philadelphia College of Osteopathic Medicine. If you don’t have baking soda, wet the affected area and rub it with an uncoated aspirin; the aspirin will help control swelling, pain, and inflammation.

9. Throw Your Head Back to Stop a Nosebleed

“Don’t put your head between your knees or tip your head back,” Richard O’Brien, MD, says. The latter is especially bad because you can breathe the blood into your lungs or get it in your stomach and vomit.

“Press the fleshy part of your nose,” O’Brien says, “and not the part where your glasses sit - lower than that - as if you are trying to stop a bad smell.” Now - and this is the important part - press firmly for a complete 10 minutes by the clock. “People don’t do that, they let up every three seconds to see if it stopped,” he says. Ten minutes! O’Brien says there are also medications and little nostril plugs for people who get frequent nosebleeds.

If a nosebleed lasts for more than 15 minutes, occurs following a serious injury, or is accompanied by severe blood loss, you should call your doctor or go to the emergency room.

10. If You Get Shin Splints, Running More Will Ease Them

Anyone who has run or hiked too much without conditioning has probably experienced shin pain. “This is really called medial tibial stress syndrome,” says Jim Thornton, MA, a certified athletic trainer and head trainer at Clarion University of Pennsylvania. Basically the muscle attached to the shinbone is tearing loose. The inflammation - or pain - is a response on the way to healing.

“If you continue to pound the tears,” Thornton tells WebMD, “it will not heal. The key is to have it evaluated because it means your muscles are out of balance. If you run again when the pain lets up, dial back the mileage, because shin splints can end up in a stress fracture.”

So, next time you have softball in the eye, don’t reach for a raw steak! You can make matters worse if you follow wacky, outdated advice and don’t know the correct steps to take.

I've used the baking soda on a bee sting for years and it really does work.

A couple of other myths that crop up: slugging somebody in the jaw to knock them out before setting their broken leg and plugging a gunshot wound with well-salivated chewing tobacco .

Even I see the flaws in these two.

I was reading some research article not long ago which suggests that it doesn't really matter how you get the stinger out, just that you get it out as fast as possible. They demonstrated that the time the stinger is left in correlates well with the amount of venom pumped into the skin, while there was no appreciable difference between pinching vs scraping the stinger out.

I've seen the article in various places on the Internet, but here is one link.

Thanks for the article. Yeat, many myths persist -- take a First Aid class and get caught up on what the latest thinking is.

Teacher

What, no tourniquet advice?

I watched an old John Wayne movie recently, Hatari! One of the characters gets gored in the leg by a rhino, they put a tourniquet on it, then drive for 5 hours to the nearest hospital.

Don't acquire your first aid information from Hollywood!

Sue

This one is true and I experienced it when I was a kid. I swallowed blood from nosebleeds so often, it's disgusting and you almost feel like you have a sorethroat. I used to have nosebleeds so frequently that a doctor finally burned the problematic vein. It fixed the problem.

Myth #11: Don't do anything because you might get sued.

Do something. Anything. They are someone's son or daughter and they need your help. Of course you'll probably get sued anyway (yeah, I know about the good Samaritan laws), but you'll feel better about it.


Myth #12: Hard exercise will burn off a fever.

Yeah, right.


Myth #13: Its important to immobilize a broken bone.

Tell that to the person who is screaming in agony while you're trying to bind the arm of the person who's broken their collarbone, or while your fastening a log to someone's broken leg. Its best to leave them be and have professional help come to them.

One thing that I didn't know, but learned the hard way (I wasn't the victim though), is that it is common for a choking victim who's been Heimlich'ed and then spit out the foreign object to immediately vomit. I don't know why, but I've seen it happen and was told by a nurse that it is common.

After a serious traumatic injuries that you must repeatedly say to the victim. " Keep talking. Stay with me."

Don't ask a unconscious person to open their eyes, because a lot of unconscious people lay with their eyes open.

(got that one from a cpr-instructor)

Most of these legends have rational roots.
For example, just out of the top of my head:

1. What about snakes then? All those REI snake kits are complete trash with their suction caps? Poor Indians, they had no cellphones nor the helicopters...

4. Not every oil will help. The sea-buckthorn oil is the best heat/acid burns cure known for centuries in Russia. Far outperforming any over-the-counter synthetic stuff.

5. Raw Steak is the same thing as ice - for cooling. I doubt anybody thought of a hot steak for that. You'll get it from a freezer right? Your eye will swell while you'll be looking for ice, zip-lock, and towel and putting them together. The faster you get it cooled the better the results. I'm using a steel spoon quite effectively. And the bacteria story is some medieval fairy-tale.

6. I like peroxide! It seals the broken capillaries instantly. So no under skin bleeding occurs at all. And it definitely kills any germs faster than soap or any PG based ointment. Sure thing a small scratch doesn't even deserve such a treatment.

It's seems to me that above mentioned guide was cooked by a private clinic manager or a backyard hiker.

Very much true. This is a point used for thousands of years in Chinese medicine to treat any pain in the face, gums, headache and pain in general.

Here's a well known Army medical myth, even though all the medics believe it.

Motrin cures all ills. It will cure headaches, the common cold, reduce swelling, regrown severed limbs, and even decapitations.

Not really, but it seems that way sometimes.

As for bone "setting," don't do it. Immobilizing, please do! I've never seen anyone screaming in agony from a broken bone, and I've splinted A LOT. Moans, cursing, "owowow...." for a few seconds. There are a few fractures I hear that hurt like crazy: femur, pelvis, though the only femur I ever saw the kid was surprisingly calm. These folks might scream. The main reason to splint, though, is to keep the bone from moving. Why? Every time that bone moves, the jagged edges are ripping muscle, tendons, the periosteum (it's kind of a skin-like membrane that coats the bone, and full of pain fibers). Also, those edges can cut blood vessels. Did you know you can lose over 2 liters of blood in a femur fracture, and over a liter if you break your forearm? So, tell them to tough it out for about 2 minutes.

With wound healing, recent studies HAVE shown peroxide to kill fibroblasts, which are responsible for repairing the wound. Not sure how much it'll slow healing, but just a heads-up.

As for my top 5, seen over the past 10 years:
1) Black pepper in a wound just makes it dirty, not stops bleeding.
2) Don't ice burns. Cold water, compress, NO ice or butter!
3) People putting a tourniquet on a bleeding finger. Do NOT use below the elbow or knee!
4) Hyper-panic parents. Just plain annoying. If you kid was that bad off, why did you drive 10 miles to the hospital instead of calling 911? Or why did you wait a week before coming to the ER (my personal pet peeve)?
5) Yelling, "Damn it (fill in name), don't die on me!" while simultaneously slamming your fist into their chest is MUCH more effective than CPR, medications, or a defibrillator.

Which brings us to another first aid "myth":

Getting kneed or kicked in the groin DOES NOT make you forget about the original ailment; it simply adds to the misery.

Only if you don't manage to pinch the venom sack while doing it. Doing so will do in a hurry what its already doing slowly: Pumping the contents through the stinger into you. Tweezers, SAK pliers, real needle nose pliers, or any stiff object is better for getting them out.

In the article I referenced, the researchers mention this common advice as one reason to test out the difference between pinching vs scraping because they say that the anatomy of a stinger (including the attached venom sac) does not support this commonly held belief. Their results seem to confirm their skepticism that pinching and grabbing the stinger does not increase the amount of envenomization, so however you get the stinger out, do it as quickly as possible and don't waste time trying to find a credit card, tweezers, or other scraping tool.

Jellyfish and sting ray venom, from what I've heard (careful now) can be neutralized by immersion in very hot water. The proteins in the venom are denatured by the heat.

For bee/wasp stings, meat tenderizer, which contains papraine (sp), can take the pain away quickly.

So. What's the most readily available hot water at 100F on the wild beach?
Another "myth" turned to be a reality.
http://crc.hawaii.edu/studies/crc00-03.htm

Ok. Some more:

3. Drinking Booze to Ease a Toothache
...it'll ease everything almost the same way as any narcotic. Just take enough

7. People May Swallow Their Tongues During a Seizure
Someone has a seizure and a passerby sticks something in the patient?s mouth so they don?t swallow their tongue

...not SWALLOW, but BITE it off! So use a stick or something if possible.

Toothpaste is supposed to be good for bee stings. See eg http://www.slate.com/id/2088863/

Again, please don't use aspirin in any manner on a child. Reye's syndrome is rare, but very very bad. It can occur as a result of any form of aspirin exposure -- even topical. Reye's syndrome is usually associated with a viral syndrome, but there is way to know that a bee-stung child is not also brewing a cold.

I've been taught to use meat tenderizer for jellyfish. Mud also I've heard is good for bee stings.

As for sting rays, up and down the coast of Southern California, hospitals DO use warm water to help. Make it as hot as the person can tolerate (test it like you would a baby bottle, drop some on your inner wrist). Never been stung personally, but my patients seemed to tolerate it well.

Of course, by the time they get to us, I wonder how much of the venom is still in the affected area?

During a seizure it's virtually impossibe to do anything. It's very hard to put anything between their teeth and if they get a lock-jaw, it's just not possible.
You could also injure yourself or break the victims teeth.

The best thing to do is to make sure the victim doesn't hurt himself to objects aroud them, and wait for the seizure to stop.
Then you can put the victim into the recovery-position to prevent blood from going into the airway (if the victim remains uncounsious ) and try to stop the bleeding.

Back in '92 during my EMT classes we were taught that placing a stick or anything between the PTs teeth was more likely to cause damage. This damage to the teeth is caused when you have to pry open their jaws. If you have to pry open the jaw you are more apt to get your self bitten. I was speaking with the local fire marshal (who spent 20+ years driving the bus) and he has never seen or heard of someone in a seizure biting off their tounge. Car accidents yes, seizures no.

Can anyone actually working the streets in an EMS capacity comment?

Ok. I'll probably give up on seizure for now
http://www.epilepsy.com/epilepsy/firstaid_tonicclonic.html
But that's the official version. All these officials are too cautious for themselves, who wants to be sued for giving a not 100% safe advice to the not 100% normal people? But the real ill people are smarter:

"Hi mickey

in reading all of the accounts of tongue-destruction I was surprised to see that nobody had mentioned that "auras" before seizures often give enough time for the sufferer to put an appropriate-sized object in the mouth to save the tongue.

My husband suffers from epilepsy and had chomped his tongue repeatedly for years before he started carrying around a rolled up bandage in his pocket. He usually gets it into his mouth before the full-blown seizures occur.

Now, sometimes it doesn't do a perfect job and there are small pokes through the tongue. But the damage is nothing compared to what he was doing beforehand - a lot less blood!

Just make sure the roll of bandage you use is wide enough so you won't choke on it. We use a standard roll of gauze, about 6inches wide and 2 inches thick; then wrap in duct tape for durability (this was his idea, I thought it was softer without). He places it sideways, like a bar to bite down on; as the seizure takes hold, he grinds down on the bandage bar instead of his tongue. He carries it everywhere with him.

K"

More terrible stories about tongue biting are here:
http://ehealthforum.com/health/topic16513.html

BTW: It's very rare that people swallow their tongue (if you don't caunt a wrong guedel-airway insertion),
but a cause could be that the small piece of tissue under the tongue (we in The Netherlands call it the tongue-belt, but do't know how you call it in the US), that connects it to the bottom jaw tears off.
When that occurs, it's usually seen in soccer-matches when a player gets a very hard ball into his face, resulting in the tongue-belt breaking, not during a seizure.

Once again, don't place anything between their teeth, make sure they don't injure themselves to surrounding objects, and when the seizure is over, put the victim into the recovery-position.

That's about all you can do as a first-aid provider in a seizure... You could hurt yourself and the victim by inserting a bite-block during a seizure... If the victim does it himselve before a seizure, that's fine, but a first-aid provider shouldn't do it.

After the seizures end, place him into the recovery-position an when victim regains counciousness, you must have them lay down for about 10 minutes. If they stay uncounsignous for longer than 10 minutes, they have additional injuries or if a seizure is followed by another seizure (status epilepticus), you should call 911.

While maybe slightly off the topic of seizures, EMT's usually carry oropharyngeal airways to prevent the tongue from falling back and blocking the airway. Some refer to this as swallowing the tongue. Same result, compromised airway...

OBG, a oroharyngeal airway is the same thing as a guedel airway (their also called mayo-tubes). They prevent the tongue from falling down into the airway, but if you insert them in the wrong way, you block the airway even more.

"...but if you insert them in the wrong way, you block the airway even more..."

True, that is probably why we received a lot of training/re-training on measuring and inserting...

I'd have to agree; I've never even heard of it. The occasional bloody tongue, but never actually severed.

It's called the lingual frenulum.

Jim, are you saying that you would insert an OPA/NPA on a patient having a seizure?

Just wondering...

I have seen more than one bitten tongue from a Seizure. I have never seen a bitten tongue cause more than a bleeding problem. I have seen a few tongue tips bitten off, but again it is never more than a bleeding issue.

The absolute best thing to do for a patient that is seizing is protect them from doing any more harm to themselves from their surroundings. Don't put anything in their mouth while they are seizing... if you need to secure an airway while they are postictal then manual airway management (head tilt) is usually all you need.

Bee, an NPA would probably not hurt a seizing patient if you could actually get one in safely… but you would be wasting your time. It isn’t an airway issue that causes seizing patients to become hypoxic. Placing anything in a seizing patient’s airway is more likely to cause a foreign body airway obstruction then it is to do any good.

As OBG stated, “swallowing the tongue” isn’t actually that. It refers to the tongue relaxing a causing it to occlude the airway. Normally our gag-reflex prevents this, but an unconscious person’s gag reflex can be compromised. An OPA does help prevent this, but a proper head-tilt or modified jaw thrust method or manual airway management is the most effective basic airway management with an OPA or NPA as an adjunct after one of those airway maneuvers has been performed. OPAs and NPAs do require special training but are very simple and many area’s are including their training in first responder classes (a 40-60 hour course) if someone is interested in gaining that additional training.

As for tearing the lingual frenulum, it is very rare in adults… and usually the least of their worries.

OH, I do currently both work in the field on a busy paramedic unit and am the lead instructor of a paramedic training program.

As Col. Potter would say Buffalo Biscuits! It may not be scientifically proven... but it works (from personal experience). You can always go back into the surf to wash off (if you dare).



Best advice from this whole thread!

However... don't rule-out the usefulness of a tourniquet in the right situation. When needed, tourniquets SAVE LIVES and you will probably see an increase in their popularity in austere/remote medicine in years to come. Sure, pressure and shock management with a speedy trip to a surgeon is the preferred management of a major bleed… but the speedy trip to a surgeon isn’t always an option.

Disclaimer to all: DON’T DO ANYTHING YOU HAVEN’T BEEN TRAINED TO DO or ANYTHING THAT IS NOT WITHIN YOUR SCOPE OF PRACTICE!...

I didn't say that. I just mentioned that a swallowed tongue is rare, but it can happen when you insert a Guedel airway the wrong way.
Then OBG replied in his post:
After that I said that a Guedel airway is the same as a OPA.

Maybe it was a bit confusing, but I didn't say anything about inserting a OPA in a victim with a seizure..

Thanks for speaking up Allen, Always nice to hear from the pros!
Stay safe.

Yeah, OBG, we do. Mainly, though, OPA's are used as an adjunct during CPR. Though, yeah, they can be used as a bite block.


Jim... the tongue belt is the lingual frenulum. As opposed to the labial frenulums (the little pieces that connect your lips to your jaws).