By Patricia Curtis and Peter Wisniewski, August 2007

7 first aid standbys you should never use

Today, Ann LaBelle admits that it was a stupid thing to do. But when she jumped off her boyfriend's motorbike and burnt her inner leg on the tailpipe, she didn't know how to treat the injury. "It burnt a hole right through my jeans," she remembers. Her boyfriend's mother suggested she clean the area and put butter on it. For the next several days, LaBelle repeated the process. "It kept getting redder and redder, and it really hurt." Two weeks later, when the burn was not healing and she developed a 40-degree fever, LaBelle went to hospital. There she was given antibiotics to fight the infection. But they didn't help. About a month later, she underwent surgery to close the wound.

LaBelle made an all-too-common mistake – she relied on an old wives' tale. First aid treatment has evolved, and many of our mothers' remedies are no longer recommended. Take a look inside your first-aid kit: bandages, some gauze, painkillers, a tube of antibacterial cream, maybe iodine or hydrogen peroxide. We're all familiar with these tried-and-true solutions.

They may be tried, but they're not all true. "Many traditional home 'remedies' may do more harm than good by further damaging the affected area," says Dr Walter Kloeck, president of the College of Emergency Medicine of South Africa. After years of research, experts are finding that your standard first aid response sometimes may be the worst thing you can do in an emergency. Here's how to update your first-aid kit.

Cuts and scrapes
Hydrogen Peroxide, Iodine, Rubbing Alcohol, Mercurochrome
When the skin isn't broken, it's hard to beat iodine for killing bacteria. That's why doctors use it to clean an area before surgery. But when there's a cut, says Cape Town dermatologist Dr Lionel Krause, full-strength iodine, hydrogen peroxide and rubbing alcohol can be toxic to skin cells, impeding healing. The chemical reaction (and bubbling) that occurs when hydrogen peroxide hits the skin isn't only cleaning the wound – it's killing healthy cells. And that stinging from the rubbing alcohol? This stuff hurts because it's wiping out healthy tissue.

Putting iodine on cuts and wounds kills bacteria, but it won't do much else for the wound. "Full strength iodine may damage the good tissue," warns Krause.

Mercurochrome also kills bacteria. But, as the name suggests, it contains mercury, which is toxic and not generally recognised as safe. Today, many doctors don't use Mercurochrome.

Better bet: Remarkably, cleansing a wound has become much simpler. The most effective way to get rid of debris and bacteria without damaging healthy tissue is flushing the wound out with water, says Kloeck. Don't use ice, he warns, as this could damage the tissue. Put the wound under a tap or spray it with a hand-held showerhead. Run the water over it until all debris is cleared. If you are worried the bandage may stick to the wound, use an antibacterial ointment that contains bacitracin or neomycin to keep the area lubricated.

Burns
Butter
You burn your hand – on the stove, an iron, a hot plate. According to a popular old wives' tale, you should spread butter on the burn to ease the pain. But that isn't a good idea. "Butter can mask the injury," warns Kloeck. There's no evidence of benefit, he says, and it also can create an environment for bacterial growth.

Better bet: Run the burn under cool water immediately to help remove the heat and put an end to the damaging process. The water will also clean the area, decrease the risk of infection and make it feel better, says Kloeck. Next, wrap the burn with sterile gauze or a non-adhesive bandage and keep it clean and dry. If blisters form, don't break them – the fluid inside is sterile and it creates a natural bandage over the burn.

Poisoning
Syrup of ipecac
For years, ipecac syrup was thought to be a good way to treat a child who had swallowed anything poisonous and well-prepared parents kept it on hand. Today, the type of treatment would depend on what has been ingested, says Dr Allan Puterman of the South African Paediatric Association.

Made from the root of a Brazilian plant, ipecac irritates the stomach to induce vomiting. But it can lead to excessive vomiting, a problem that may cause dehydration and prevent doctors from giving other treatments.
Other risks: if the poisonous substance is caustic, like lye, it burns the oesophagus when swallowed and can burn it again when it comes back up. And if the toxic substance is paraffin, as so often is swallowed in South Africa, vomiting can cause a severe inflammation of the lung tissues.

Better bet: Immediately call the poison control hotline (021) 931-6129. The experts will be able to tell you what, if anything, to do. If it's a true emergency, they may advise you to go directly to the casualty department of your nearest hospital. There, the treatment of choice is often activated charcoal, a very finely ground charcoal powder. When swallowed, it can soak up the ingested substance like a sponge, preventing it from entering the bloodstream. Although best taken within an hour of ingesting the poison, doctors warn that activated charcoal should not be used without expert guidance.

Excess bleeding
Tourniquets
Once upon a time, every well-trained Boy Scout learnt how to stop bleeding with a tourniquet. But studies show this method causes more harm than good. "A tourniquet should never be used by an ordinary member of the public," says Kloeck, "except where a limb has been totally severed." Tourniquets can increase the risk of tissue damage or even the loss of a limb. Since there are other methods that can slow the blood flow – and preserve life – without the loss of the limb, tourniquets are out.

Better bet: Simply place a clean cloth on the wound and keep pressing firmly; don't remove the cloth, even if it gets saturated. If necessary, add more cloths on top of the first. Applying direct pressure reduces blood flow to the wound. This should stop the bleeding and promote clotting, but still leave blood circulating to the rest of the limb.

If that's not enough, you can further slow blood flow by applying pressure to the main artery of the upper arm or leg, depending on the site of the wound. You can learn about this procedure in a first-aid course, offered by such organisations as St John Ambulance ( www.stjohn.org.za).