6 Deadliest First Aid Mistakes

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The chances that you'll find yourself responding to a medical or first aid emergency at some point in your life are close to 100 percent. Whether it's a fall, a drug overdose, or a home-handyman project gone wrong, all of us will at some point be faced with handling an emergency that could mean life or death.

Yet it's all too common for people to think they know what to do in an accident or other health emergency, then find themselves paralyzed with indecision when seconds count. It's also common for people to follow outdated information or advice that doesn't take into account recent medical advances, says William T. Durkin, Jr., a physician and president of the American Academy of Emergency Medicine. Here's how to avoid the scariest first aid mistakes, and what to do to save the lives of those you love.

First aid mistake #1: Assuming a burn is benign

Some burns can be treated at home, and some can't. Not going to the emergency room when a burn is serious can result in infection, complications, and even death. It's also important to remember that burns don't occur just from fire; they also result from electricity, chemical exposure, and hot liquids. Electrical burns, which can occur from power lines or electrical wires or cords, can cause serious but invisible injuries deeper inside the body that might go unrecognized.

What to do: Run cool water over the burned area or soak in a vat of cool water (without ice). Head to the hospital for any burns to the eyes, mouth, or genital areas, even if mild; any burn that covers an area larger than your hand; and any burn that causes blisters or is followed by a fever. In the case of electrical burn, go to the ER immediately.

What not to do: Don't apply ice, don't apply any ointments, and don't apply butter or any other type of grease to burns. Also, don't cover a burn with a towel, blanket, or other cloth, because loose fibers might attach to the skin. Never break blisters, and if clothing is stuck to the skin, don't try to pull it off.

First aid mistake #2: Mishandling a cut-off body part

Timing and how you care for the cut-off body part are the keys to a successful outcome. Make a few wrong choices and surgeons won't be able to reattach it, whether it's a finger, thumb, or hand -- frequently associated with Halloween pumpkin carving, fireworks, snowblowers, or the use of table saws -- or even a nose, ear, or penis.

What to do: Handle the body part gently, wrapping it in gauze dampened with saline solution if you have some on hand, water if you don't. Seal it in a watertight bag (still wrapped) and submerge it in ice water. Get it to the emergency room -- along with the accident victim, of course -- as soon as possible. A severed arm or leg must be reattached within 6 to 12 hours. A finger can survive for 2 days if refrigerated but only 12 hours or less in a warm environment.

What not to do: Don't assume the cut-off digit or limb can't be reattached, even if it's damaged. No matter how doubtful you are, protect what you can save and transport it. Don't place body parts directly on ice and don't submerge body parts in water, where tissues can suffer frostbite and other damage or be contaminated by bacteria.

First aid mistake #3: Waiting too long to report a drug overdose

It's often scary to take action when someone passes out or becomes seriously ill from a drug overdose, a combination of drugs, or drugs and alcohol. Fearing exposure, legal action, academic probation, or angry parents, many people wait until it's too late to call 911 or take someone to the emergency room. Another mistake: not recognizing that a synthetic version of a "less serious" drug, such as pot, can cause a deadly reaction. Beware, too, that the danger doesn't just come from street drugs; prescription drugs are now the number-one cause of fatal drug overdoses, responsible for more than 26,000 deaths a year.

What to do: If the person is unconscious or not breathing, call 911. Collect the drugs and medications the victim took and bring them with you to the hospital. If breathing is weak, start CPR if you know how, or find someone who does. If the skin has a blue tint, that's an additional indication that depressed breathing is serious. If the person is dizzy, nauseated, incoherent, or hallucinating but still conscious, take him or her to the emergency room.

Overdosing on methamphetamine, speed, or cocaine causes a different set of symptoms, which include rapid or racing heartbeat, rapid breathing or hyperventilation, excessive sweating, acute anxiety, and sudden fluctuations in blood pressure. The result can be a stroke or heart attack, so go to the emergency room if you suspect an overdose of one of these drugs. If the victim is conscious, alert, and relatively stable but you still suspect an overdose, call the poison control center to report what you've observed and ask what to do.

What not to do: Don't call on a friend or neighbor to check if the victim is OK. And don't assume that, just because someone is still conscious, he or she is going to be fine. Don't try to make the person vomit. Don't waste time making repeated attempts to wake an overdose victim, such as pouring cold water over him or her. Don't avoid telling the emergency team exactly what drugs the victim took, even if they were illegal. Misreporting decreases the chance the person can be treated successfully.

More deadly first aid mistakes

First aid mistake #4: Not taking head trauma seriously enough

Only in recent years have doctors begun to fully understand and appreciate the long-term effects of brain injury, on everything from physical mobility to personality. A typical survivor of a severe brain injury will require five to ten years of intensive services and rehabilitation. Someone doesn't need to be knocked out or lose consciousness to sustain a traumatic brain injury, either. And not all head injuries come from physical impact; shaking and whiplash can cause the brain to move around inside the skull, causing traumatic brain injury (TBI).

What to do: Check for signs of concussion, which include confusion, lack of focus, sleepiness, headache, nausea and vomiting, memory loss, "seeing stars" or flashing lights, and loss of consciousness. In the case of suspected concussion, call 911 or go to the emergency room. Also call 911 if the person faints or is less alert, has convulsions or seizures, can't stop vomiting, has unequal pupils or unusual eye movements, or can't walk.

What not to do: Don't assume that because the injured person didn't lose consciousness, he or she is fine. Another common mistake is failing to watch carefully for 24 hours or more for symptoms that may develop later.

First aid mistake #5: Not responding to or reporting alcohol poisoning

There's a fine line between being extremely drunk and having a blood alcohol concentration high enough to kill you. And sadly, there's a great deal of mythology surrounding drinking and what works and doesn't work to "sober up." Very few people know the signs, symptoms, and potential damage that can result from alcohol poisoning. Yet more than 50,000 cases of alcohol poisoning are reported every year, and one in 1,000 of those reported results in death.

What to do: Call 911 if you think there's any chance the person you're worried about has drunk enough alcohol to be in danger -- or has drunk a great deal quickly, such as on a dare. Stay with a friend or family member who's "sleeping it off," checking their breathing regularly to make sure it's not depressed (less than eight breaths per minute.) Also check their body temperature and skin color: Signs of hypothermia include cold, clammy skin; bluish skin; and paleness.

What not to do: Don't try to sober someone up with coffee, a cold shower, or a walk in cold air. The only factors that affect the level of alcohol in the blood are time and the digestive process. The biggest mistake of all: leaving someone alone after he or she has passed out. A person's blood alcohol concentration can continue to rise even after losing consciousness, because the alcohol continues to enter the bloodstream from the stomach and intestines and then circulates throughout the body. Another serious threat is choking after vomiting while sleeping.

First aid mistake #6: Missing the signs of internal bleeding

Internal bleeding occurs when an artery or vein is damaged or leaks. Because it's inside the body or brain, there may be little or no sign that it's happening and, depending on the type of injury, the outside of the body may look fine.

What to do: Be familiar with the kinds of injuries and trauma likely to cause internal bleeding. These include:

  • A fall
  • A high-impact injury such as a car crash
  • Blunt-force trauma
  • A hit or impact in the lower back or hip, where the kidneys are located
  • Physical contact in sports, particularly to the abdomen
  • Impact from a falling object
  • A punch to the eye
  • A hit from a fast-moving ball, such as in baseball or volleyball
  • A "deceleration injury" from shaking, whiplash, or rebound from impact, which can cause organs to shift inside the body
  • An ectopic pregnancy, miscarriage, or retained placenta after birth

Call 911 or go to the emergency room if the impact was strong enough to knock someone out, knock the breath out of them, or cause them to be dizzy. If a woman is pregnant, any bleeding is reason to go to the doctor. And after birth, if a woman is weak, woozy, or doesn't seem like herself, ask the nurse or doctor to examine her for retained placenta or another source of internal bleeding.

What not to do: Don't assume that if someone "looks fine" after a fall, a hit in sports, a car accident, or other trauma, there's no need to go to the hospital. Be aware that people who are taking anticlotting medications such as warfarin, or those who regularly take aspirin or who have bleeding disorders, are more prone to any kind of bleeding, external or internal.


about 4 years ago, said...

This article was very informative with one key exception: ectopic pregnancy. Deaths from ectopic pregnancy are almost always the result of delay in getting treatment. I speak as a survivor ---someone who had lost more than half my entire blood volume by the time I reached an ER and survived surgery [miraculously] only because of a very strong heart due to being athletic at the time. People need to know the following: ANY severe or prolonged cramping in a woman of child bearing age MUST be checked immediately. Bleeding from a ruptured ectopic pregnancy can progress to fatal stages --as in my case--without a single drop of blood visible externally. It is all internal. You CANNOT rule out an ectopic pregnancy because you do not think the woman is pregnant -- even if she says she isn't---she may not know she is pregnant. Pain from ectopic pregnancy, particularly in its early stages, may be similar to other conditions even some that are relatively benign--e.g., digestive reaction to certain foods. I vomited in the early stages prompting my then husband to conclude it was "just something I ate". DON'T TRY TO TREAT SOMEONE WITH ABDOMINAL PAIN YOURSELF! YOUR TREATMENT CAN KILL! Examples : NEVER EVER try to treat someone with abdominal pain with laxatives. If it is appendicitis, it could cause a rupture. NEVER EVER try to treat someone with abdominal pain with a hot compresses or a hot water bottle or any kind of heat therapy. This was done in my case. Heat therapy causes the person to bleed internally at quicker and more intense rate. My then OB/GYN [later forced by the Medical Board to "retire] gave the instruction to apply hot compresses to my abdomen over the phone. I complied and later learned that in doing so, I was helping myself to bleed to death! LISTEN to the patient. In my case, my ex and even my OB/GYN at the time [who improperly "diagnosed" me over the phone as having a "stomach bug"] ignored or downplayed what I was saying about my symptoms, delaying treatment and nearly causing my death. I am alive only because I just "knew" something was really wrong and getting worse and I ignored their advice and called for help. If a woman has been pregnant before and tells you she doesn't feel the same as the first time --LISTEN . In my case--and in the case of a friend who also had an ectopic pregnancy --we both complained to our OB/GYNs that we didn't feel right with the second pregancy. We were ignored and treated like hysterical females. With any abdominal pain that persists, the person MUST be seen by a doctor . The underlying condition can be mild --"something they ate"---or potentially fatal.


about 4 years ago, said...

Great stuff to remember and pass along. Thank you.


about 4 years ago, said...

What to do about burns to the body.


about 4 years ago, said...

Very informative; concise, to the point! Can you provide information about heat stroke and heat exhaustion? How to check for ticks and proper removal? Keep up your good work.


over 4 years ago, said...

Alot of the information was scary. I fall alot. At night. I'm 61 and I wake up falling,indifferent rooms of my apt. I go to sleep at night and just wake up falling. Most of the times backwards. it is terrifing. I have told my grown daughters and my doctors. But no one really seems concerned. Well if they are no one helps. Theu just say oh my god that is terrible. Or a doctor says I'm going to set you up with a sleep specialist.But I don't drive. I just haven't made an appt. No one follows us so I guess it's not that bad. I have broken a rib and I always have soooo many bruises. It looks terrible. I;;ve been falling like this for about 3 years. I am so scared to go to sleep. Martha Dunn


over 4 years ago, said...

The knowledge from this article could save a life and should be made available to the public by way of all Doctor offices visits,all emergency room visits, all Hospital waiting rooms and out patient buildings.Because things happen and people Need to Know what to do and what not to do when it does, after all they are the first ones on site when something happens right? If this information were made available to the public as a hand out sheet at all the above places just as much as the magazines lying on the tables (that people pick up and read while waiting),God knows how many life would have less harm or even be saved.


over 4 years ago, said...

Reinforcing things I already knew in the back of my mind. Re: the severed limb paragraph was very informative. This I knew nothing about.


over 4 years ago, said...

You failed to mention "not to move a person who has been injured in a fall or some such trauma".


over 4 years ago, said...

Lots of great info packed in this article! With Summer upon us, #2 was of particular interest as there are mowers, trimmers and lots of other yard chores that can cause serious trouble if not handled properly. Saline is great to have handy for people or pets. Remember, too, that insects (bees, spiders, ticks, snakes, etc.) can cause trouble. Love the EMTs and neighborhood store clinics but it's time to take a brush-up at the Red Cross!


over 4 years ago, said...

Other sources of internal bleeding can be aneurism or organ damage. Prolonged alcohol or drug abuse can cause liver damage, which can lead to serious internal bleeding. Also, CPR should not be started if someone is breathing. Only if heartbeat stops or is very irregular. Artificial respiration can be applied however.


over 4 years ago, said...

Especially true regarding the head trauma - someone can be conscious, speaking, and appear only slightly confused...and a few hours later, in coma or worse. If there's a cranial bleed, the subsequent swelling squeezes the rest of the brain against the skull - if the bleed pushes hard enough against the brain stem, you'll stop breathing.


over 4 years ago, said...

I believe the article is helpful if someone follows those rules.


over 4 years ago, said...

First aid mistake 1 & 2 were things I did not know. Very helpful.


over 4 years ago, said...

How to take care of a severed body part to increase the chances of successful reattachment. Now I know.


over 4 years ago, said...

Very helpful and educative!


over 4 years ago, said...

It's really, really siimple: OVER-REACT. CALL 911. I'm a volunteer EMT in a small town. Our elders generally understand that we're publicly spirited people who became EMTs out of a desire to serve the community. And what I tell them, at every opportunity, is this: I'd sooner come to your house ten times for a hang-nail than have you fail to call us when you're having deep sub-sternal chest pain, and tring to convince yourself that it must be something you ate. We've had elderly people lie in anguish for hours, because they didn't want to bother anyone in the middle of the night. If we had been allowed to treat and transport them five hours earlier, it would have made a world of difference. Over sixty percent of our pts. are elderly. So use your local EMS. That's what we're here for.


over 4 years ago, said...

Children should be taught this in school. I arranged for someone from the Red Cross to come to my children's school to teach First Aid to those adults who wanted to learn. I was amazed at how many parents didn't want to know! My Mom took several courses from the Red Cross during WW2 and taught me what she learned and it was much easier when I had my children (4). I also had a Pediatrician who taught me what to look for before I phoned him for help!


over 4 years ago, said...

Lots of stuff I had not thought of. I'm glad to have the new knowledge. Thank you for putting it into such understandable and practical language.!


over 4 years ago, said...

This helps with decision making.


over 4 years ago, said...

This article is excellent and worthy of sharing! Many lay people who have no experience will be helped by this guide. Thank you..


over 4 years ago, said...

helpful. esp part about amputated digits .thanks. patty b.R.N.