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FIrst Aid error in Scouting magazine


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#1 TAHAWK

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Posted 31 August 2016 - 01:48 PM

Not sure where to post this, but it deserves someone's attention.

 

Earlier this year, Boys' Life published an article on wound care.  In that article, it was pointed out that using alcohol (among other "antiseptics") on a wound was discouraged.  That advice is in accord with the advice of, among others, the Red Cross, Mayo Clinic, Cleveland Clinic, and Wilderness Medical Society, all of whom feel the chemicals do more harm than good.  It's not new learning.  It's decades old.

 

The BSA Wilderness First Aid course does not specifically discourage use of alcohol, but it does not teach its use,  Like the other authorities its basic advice IIRC is irrigation under some pressure with clean water. 

 

Now we have the latest (Sept-Oct) copy of Scouting which, on p. 54, twice advises using alcohol to clean out cuts, both shallow and "deeper" ones that keep bleeding.

 

Another error and another example of the lack of cross-bubble communication.  Left Hand, meet Right Hand.  You should talk now and then,

 

Isn't getting it right on first aid topics a safety issue?


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#2 qwazse

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Posted 31 August 2016 - 02:07 PM

A letter to the editor would be in order.

 

But, I'm glad you brought it up here. Decades old still is quite new to some clinical practices.

 

I myself haven't kept up with the regeneration literature. Lacking that, it's hard to balance the risks and benefits. In other words, what percentage of wounds fail to heal when cleaned with alcohol vs. those that fail to heal when cleaned with water. And what percentage get infected after being cleaned with alcohol vs. the percentage that get infected when cleaned only with water?

 

I know, I know, the numbers guy gives everyone else headaches. However; knowing that balance gives us an idea of how great a safety issue promoting an outdated strategy becomes.

 

The old "98% of body heat lost through your head" still sticks with me (be it true or false).


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#3 TAHAWK

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Posted 31 August 2016 - 02:22 PM

Sent letter to editor first.  Such measures have always been ignored previously.  We are, after all, only volunteers. (I recall the National guy arguing with a double Phd (public health and microbiology - later a WHO scientist) about safe dish-washing.

 

You can wonder about what science might show.  On the other paw, there are the authorities cited above who have already done the science.  Or there is the B.S.A. which has, several times, spoken on the subject, as recently as the Boys' Life article noted above and the current Wilderness First Aid Syllabus.

 

This is added to a distinguished list of such advice as :

Use cotton socks in Winter

Wool is the ideal outer layer in winter (in about 2011)

chlorine in the initial dish-washing rinse (It's BAAAACK!)

chlorine and iodine make wild water "safe to drink"

Don't drink water when hot; suck a pebble instead.

Annual troop program planning is by consensus of all the commissioned Scouters, the entire TC, the COR, the Unit Commissioner and - why not? - the PLC

Pocket knives don't rust so they can be washed in the family dish-washing machine.

The bowline won't slip.

 

... and other old favorites.


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#4 qwazse

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Posted 31 August 2016 - 03:10 PM

...

You can wonder about what science might show.  On the other paw, there are the authorities cited above who have already done the science.  Or there is the B.S.A. which has, several times, spoken on the subject, as recently as the Boys' Life article noted above and the current Wilderness First Aid Syllabus.

...

Yeah, reference, but extreme redaction leads to extreme reactions. Either a practice goes unchanged -- out of ignorance or to curb expense -- at great risk, or it is revised at great expense and little benefit.

 

Is this like those lean years where we all had to settle for margarine when it turns out that butter ain't all that bad? Or, is this like all those kidneys that are jammed due to chronic diet soda consumption?

 

Knowing how much good can come from best practice is a strong motivator. And, maybe in demanding that from reporters, we force them to more closely inquire of sources.


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#5 TAHAWK

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Posted 31 August 2016 - 07:15 PM

You are free to check my sources (Google is your friend.) or do your own research.  Fourteenth point of the Scout Law (after Hungry) is Doubting. (or is is "Doubtful"?)


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#6 TAHAWK

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Posted 12 September 2016 - 06:59 PM

The error regarding using chlorine in a first, cold rinse has been corrected in the Handbook.


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#7 Stosh

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Posted 12 September 2016 - 09:54 PM

Back when I was teaching CPR, it was taught to professionals by the American Heart Association and to the public by the American Red Cross.  The techniques were different.

 

The use of iodine was discouraged back when I was a kid in the 50's and 60's but it's still the pre-surgery antiseptic of choice..  Basic first aid says soap and water is enough for a cut.  I also wash with a alcohol wipe and as long as the pain is minimal and only temporary, I do enjoy not having infections in my cuts.  Every pre injection and post injection clinical procedure is marked with the use of alcohol.  Major clinical procedures include iodine.  So do what you want, nothing is right or wrong. 

 

If the cut is minor, soap and water should do it.

 

If the cut is major, pressure bandage and get increased medical attention.  If they want to use alcohol, that's their SOP. 


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Stosh

 

There's a reason why I don't always answer the phone, doorbell or comments on forums.  :)


#8 TAHAWK

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Posted 12 September 2016 - 11:00 PM

We are not talking about surgery in 2016.

 

My last stitches at Cleveland Clinic (four inside and six outside) involved saline under pressure before and WPJ after.

 

The article was about treating "cuts."

 

If someone wants to disagree with the Cleveland Clinic, Mayo Clinic, Red Cross, Wilderness Medical Society and the B.S.A., it's a free country.  We prove that here regularly.  But Scouting should not be doing the disagreeing with B.S.A.


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