While you’re enjoying the last barbecues, picnics, Frisbee games and other summer adventures, it’s a good time to make sure your first-aid skills are current. After all, some of the guidelines for what to do and what not to do have changed in recent years.
“As our understanding of physiology and anatomy has evolved, strategies that may have been based on old wives’ tales have either been supported or changed by evidence-based medicine,” says Dr. Michael Carius, an emergency physician in Connecticut and past president of the American College of Emergency Physicians.
In some cases, the old-fashioned advice is still pretty solid; in others, not so much.
Here’s a look at the best (and worst) ways to treat various injuries:
Do: Apply ice right away.
Don’t: Take a hot bath or shower or apply a heating pad.
If you get whacked in the knee by a line drive during a softball game, fall on the pavement while in-line skating or suffer another blow to your body, applying ice to the area of impact will help constrict the blood vessels that are leaking and causing the bleeding under the skin that leads to a bruise, Carius says. For the first 48 hours, apply ice packs (or a bag of frozen vegetables) to the area for 20 minutes every hour; place a lightweight towel or cloth between your skin and the ice. It also helps to elevate the injured area above your heart to reduce swelling. “After 48 hours, you want to start the repair process, so that’s when you should bring heat in to stimulate circulation and promote healing,” Carius says.
Do: Place the burn under cool running water.
Don’t: Apply vitamin E, aloe vera or butter to a burn.
If you burn yourself while, say, grilling, your priorities are to a) stop the burning and b) cool the area, says Dr. Seth Podolsky, an emergency physician at Cleveland Clinic. “If the skin blisters or it’s a deep burn, see your doctor or go to the emergency room.” Otherwise, place the burned area under cool running tap water or apply ice wrapped in a towel to the area to decrease swelling and pain; continue this at regular intervals for 24 to 48 hours.
“Even if the heat source isn’t there anymore, the skin and tissues are still angry and inflamed – coolness will help,” Podolsky adds. After 48 hours, applying an antibiotic ointment to the burn can help moisturize the area, soothe damaged tissue and allow the skin cells to regenerate, Carius says.
Do: Use tweezers or a small needle to get it out ASAP.
Don’t: Ignore it or soak it in water.
That splinter is a foreign body that your body will recognize within minutes, Carius says. “White blood cells will be sent to fight off the invader, and the longer it stays in there, the more likely it is to get infected because of the bacteria that enter with it. You can get a pretty nasty infection with a splinter.”
If you can see the splinter, use tweezers to pull it out; if you can’t, see a doctor. (If you soak a wood splinter in water first, it can absorb water, become softer and break apart under your skin, which can lead to infection, Carius warns.) Once you get the splinter out, wash the area in soap and water and apply an antibacterial ointment.
Cuts and lacerations
Do: Wash them carefully with soap and running water.
Don’t: Use alcohol or hydrogen peroxide.
To prevent a cut from becoming infected, the most important thing to do is flush it out with running water to remove bacteria and dirt. “The act of irrigating it is more effective in preventing infection than what you actually use,” Podolsky says, so it doesn’t matter if you use tap water, sterilized water or a saline solution to wash it out. Alcohol can burn the injury, Carius says. And “hydrogen peroxide can actually inhibit some of the wound healing – it kills bacteria by rupturing the cell membranes; it can do the same to your cells,” warns Dr. Kurt Smith, an assistant professor of emergency medicine at the Vanderbilt University Medical Center in Nashville.
After rinsing the cut with soap and water, pat it dry and apply an antibiotic ointment; cover it with a bandage if it’s bleeding or oozing. If the cut is longer than half an inch, jagged or deep and bleeding a lot, “it may need to be closed with stitches, glue or staples,” Carius says, so go to the ER.
Do: Apply compression to stop the bleeding.
Don’t: Tilt your head back or shove a tissue into your nose.
If you get whacked in the nose by a Frisbee or badminton shuttlecock and it starts bleeding, you’ve probably ruptured blood vessels in the front of the nose along the cartilage. Your best bet is to grab some tissues or a paper towel, pinch the soft parts of your nose behind both nostrils, and lean forward to stop the bleeding. Keep the pressure steady for five to 10 minutes; applying ice also can help constrict the blood vessels and stop the bleeding.
It’s a mistake to lean your head back while applying pressure because this just sends the blood down your throat and into your stomach. “If you swallow enough blood, you’re going to throw up and that could make things worse,” Smith warns. Once the bleeding stops, allow the clot to remain in place (that means don’t blow your nose!) for a few hours. If you can’t stop the bleeding within 30 minutes, go to the ER, especially if you’re taking an anticoagulant drug, Carius advises.
Sprains and strains
Do: Apply ice and elevate the injured area.
Don’t: Put heat on it right away.
Whether it happened while you were playing a sport or you tripped while walking on the beach, spraining or straining your ankle or wrist hurts. And it’s because “you’ve stretched a muscle, tendon or ligament beyond its natural tensile strength and torn fibers in those tissues,” Carius explains. This can lead to some leakage of blood and fluid into the surrounding area, which can contribute to the swelling.
“You want to decrease the inflammatory response and leakage of fluid,” Carius says, and the best way to do that is to rest the injury, apply ice packs (keep a towel between your skin and the ice) and elevate the injured area above your heart at regular intervals for 48 hours. (Applying heat actually can increase inflammation in the short term – the opposite of what you want!) Taking an anti-inflammatory drug (such as ibuprofen) also can help reduce pain and swelling in the first 24 hours, Carius says. After that, resume normal activities as you feel up to it.