In the practice of bloodletting, doctors drained patients’ blood in hopes that it would help them stave off illness. It was a dubious practice that was used to treat everyone from medieval peasants to George Washington, and suffice it to say, usually did little to help affected patients.
Thankfully, bloodletting has gone out of style, and most doctors and citizens are as well-informed about proper medical care as they’ve been at any point in history.
However, a number of misconceptions about what to do in medical emergencies or first aid situations still swirl around in the American consciousness. Put grease on a burn? Peroxide on an open cut? If someone has a seizure, should you be reaching for your wallet?
HealthyWay spoke to some experts who specialize in training professionals and average citizens in first aid and emergency medical services (EMS). They offered up some advice on what to do, what not to do, and a few hard and fast rules about facing medical emergencies.
1. Butter is for bread. Toothpaste is for teeth. Neither are for burns.
Robb Rehberg is the director of first aid training and program development at the National Safety Council (NSC), an organization that eliminates preventable death through education and advocacy. He meets with a wide range of Americans to train them about proper emergency medical procedures and is very familiar with the inaccurate treatments that are still rattling around out there.
Rehberg asserts that one of the most common misconceptions he’s encountered involve treatment of burns. Over time, some folks have believed that a bit of butter can help sooth a burn, but that’s just not true. Explains Rehberg on treating burned skin with some Land O’ Lakes: “We’re not trying to cook people. Not quite sure where butter came from, but I’ve heard it before. We certainly don’t want to put butter on a burn.”
The truth is this: Not only is butter not an effective burn treatment, but it can actually make the situation worse.
The first thing that must happen after a burn is cooling of the skin, but Rehberg says butter—or other home treatments—will not be helpful: “The skin has been burned and it needs to cool itself. Butter or any ointment is clogging up pores where heat dissipation occurs. We are hindering the body’s ability to cool itself.”
[pullquote align=”center”]“Most minor burns will heal on their own and can [be] treated by running cool water over them.”
—Andrew Berger[/pullquote]
First aid expert Andrew Berger, who is the owner and training site coordinator at Healthline First Aid, also warns against butter or other believed fixes for a burn, saying that it “can actually make the burn worse by slowing the release of heat from the skin.” Indeed, if butter is a no-go, why do some think that burns need to be treated like a piece of toast?
Berger calls butter an “old folk remedy.” An Australian medical report makes mention of an 18th century document from the Prussian Surgeon General that reads more like a recipe than an emergency procedure, saying that burns should be “painted over with grease or butter, or powdered with flour, starch or powdered charcoal to alleviate the pain.”
Rehberg also says that toothpaste is a common household burn remedy, mostly because it usually feels cool to the skin, but that the “cooling” is just a chemical reaction that is actually irritating the skin, the last thing you want to do to a sensitive burn area.
The best burn fix? A simple running of cool water for about 20 minutes. Berger explains: “Keeping in mind that there are several types of burns and several degrees of burns. Most minor burns will heal on their own and can [be] treated by running cool water over them.”
According to Rehberg, you could also treat the affected area with a burn-specific ointment or aloe vera gel. These substances will actually help cool the burn rather than gunk it up like a stack of pancakes at IHOP.
2. If you’re cleaning a wound, keep the peroxide away.
Another common misconception Rehberg hears from students he teaches at the NSC is the use of peroxide on a wound.
“Every medicine cabinet has peroxide. It’s not the best thing for an open wound,” states Rehberg about the all-too-familiar brown bottle of searing pain. While it may help sterilize a cut, the age-old favorite of teachers and moms could do plenty of damage as well. “You might be killing bacteria, but you’re also killing healthy skin cells,” explains Rehberg. Such an act could hamper the wound’s ability to heal or leave a more noticeable scar.
The best remedy for cuts and wounds of a manageable size is a simple one: soap and water. Berger claims you don’t need to get too complicated when treating a wound: “People always think you need ointments … for cuts and scrapes. Just wash it with antibacterial soap, it’s the best thing to clean a wound.” A deliberate wash in the sink followed by an appropriately-sized bandage will be more than enough medical attention to allow your body to do what it does best: heal itself.
This is all assuming, of course, that the cut is of a manageable size and won’t need stitches. In every true medical emergency, you should dial 911 for assistance. Or, if your injury isn’t quite so perilous, call your primary care physician for tips on how to handle a less severe medical situation
3. Don’t tip your head back for a bloody nose.
Nosebleeds are one of the most common minor injuries. Sometimes, they are a side effect of another injury, and other times, they just spontaneously show up. Because they happen frequently, nearly everyone seems to know the treatment. However, as you will see in the video below, the traditional nosebleed remedy is also one of the most common medical misconceptions.
4. The truth about frostbite and hot water.
There’s a belief that if any skin or limbs fall victim to frostbite, the affected area should be heated up as quickly as possible with hot water. However, this isn’t exactly what medical professionals recommend.
[pullquote align=”center”]“You may actually be causing more damage.”
—Robb Rehberg[/pullquote]
First of all, cold limbs don’t necessarily mean frostbite. Berger reveals that the term “is often used too broadly for skin exposed to cold. The first stage of frostbite is frostnip, which doesn’t cause permanent skin damage and should not be treated with hot water.”
There’s no need to get the tea kettle whistling for a case of frostnip. Instead, says Berger, “it can be treated by gently rewarming the area with mild to warm water.”
When it comes to true frostbite, Rehberg says there is no better treatment than contacting the professionals: “If we’re in a situation where we have frostbite and we are close to medical help, we just want to make sure we activate the EMS system.” In certain frostbite cases, a form of reheating the body will include the use of very warm water—“about 110 degrees”—but that this practice is reserved for those with proper training to avoid further injury.
One of the dangers of treating frostbite on your own in the wild is the risk of the affected parts refreezing if subjected to the elements again: “You may actually be causing more damage,” warns Rehberg. For emergencies, there is a practice called wet-rapid rewarming that Rehberg states is “reserved for controlled environments like in a medical facility or advanced courses like wilderness first aid.”
5. Don’t heat up that sprained ankle.
Sprains and small fractures can run the gamut from inconvenience to serious hinderance. How they are treated can have a major influence on how quickly they heal.
One misconception is to add heat to a sprained area. That’s the wrong move, according to Rehberg, who gives an easy rhyme for sprain treatment: “Ice is nice, hot is not.”
Also, patients should follow the proper protocol when it comes to icing: just about 10 minutes at a time. Rehberg advises that people with a sprain should “not ice continuously,” adding that folks should avoid the inclination to “go big or go home.” When it comes to ice on a sprain, more is not always better.
RICE—rest, ice, compression, elevation—is usually the go-to guideline for muscle soreness and injury. However, the doctor that coined RICE, Gabe Mirkin, actually rescinded this acronym, writing that after years of recommendation by coaches, “now it appears that both Ice and complete Rest may delay healing, instead of helping.”
Mirkin, as well as a few studies, realized that while ice does keep inflammation down and numbs a bit of the pain, it also prevents that inflammation from fulfilling its original intent: healing. Long-term icing can be detrimental to the healing process by limiting the amount of muscle repairing cells that can access the site of the injury. Mirkin recommends something similar to Rehberg’s suggestion: It’s okay to ice an injury for 10 minutes once or twice with a waiting period between applications. However, icing should be avoided after this. Mirkin points out that there’s no benefit to applying ice six hours after the injury occurs.
6. If you witness someone faint or have a seizure, don’t worry about their tongue.
There’s an old belief that someone could “swallow their tongue” while passed out. Even Rehberg is familiar with this unique concern, saying he remembers being a kid and hearing rumors of someone passing away because they swallowed their tongue.
“That’s not what happens” asserts Rehberg, “what happens is that the soft tissue in our airway can close off if we’re not responsive.” In the event of an unresponsive individual, Rehberg says the first thing he teaches his students is “how to open the airway very easily by tilting their head and lifting their chin.” By positioning the head in this way, you can prevent the threat of suffocation.
Similarly, it was a long-held belief that someone experiencing a seizure could bite their tongue off, so people were advised to give those in a seizure state a wooden spoon or even a wallet to bite down on.
You might see where this is going: Rehberg advice is to “never put anything in the mouth of someone having a seizure.” The best protocol is to let the seizure pass, then assist with any injuries—putting your hands near the mouth of a seizure victim could be harmful to them, or as Berger says, “it’s a really good way to lose a finger.”
7. Don’t throw up poison until you’ve talked to the pros.
The swallowing of poison is an absolute emergency situation. And though many think that inducing vomiting will expunge the poison from the body, there are certain situations where that might not be the right move.
Bergen states: “Inducing vomiting is not recommended for certain substances which can cause more damage on the way back up. The most important steps to take are call 911 and contact the Poison Control Center.”
Rehberg points out that poison control—which is a hotline that can be reached 24/7 at 1-800-222-1222—may advise you to take other action depending on what kind of substance was swallowed. In the case of acidic toxins, explains Rehberg, “it may better to ingest something like milk to absorb some of it,” though he mentions that isn’t the only remedy that Poison Control recommends. Contacting Poison Control is critical in these situations because every substance could involve dramatically different symptoms and treatments.
8. “Grandpa’s Cough Medicine” has little application in emergency situations.
Over the course of human history, there have been a number of remedies or medical treatments that include drinking beverages that today are only found behind the bar.
A Johnson’s First Aid Manual from 1909 suggests that a sip of brandy could help “encourage circulation” in the case of a victim who has recently recovered from artificial respiration. It was long believed that such substances were stimulants, and, as a result, were recommended for a variety of medical professionals for use in certain situations.
Such usage has declined significantly over time.
Berger says he’s heard of stories of a little brandy to ease various pains, but in general it’s “not something I could recommend to anyone.” He says many people have the image of a dashing doctor taking a bottle of hooch from the bar to clean a wound, but dismisses such things as “very Hollywood.”
The biggest takeaway is that when it comes to any medical situation, you should first and foremost defer to the professionals.
That means, say, your primary care doctor or poison control—and 911 in emergency situations.
It is also extremely useful to get trained by professionals: CPR and first aid training classes are available in big cities and small towns from coast to coast. Large organizations like the NSC will often offer classes; you can find classes at local offices like Healthline First Aid, too. Berger stresses that while knowing what do with burns and sprains is beneficial, “learning proper CPR and how to use an AED [automated external defibrillator] is even more important, considering most cardiac emergencies happen at home.”