Can you see what is wrong with this picture

[straylogic]

I love this site, but as someone who has only a rudimentary understanding of first aid, IE- I can already name 3 things wrong with this picture, no offense is meant to the guy who originally posted it, but if you can't even put on a bandaid properly, how the heck am I going to ever trust you to run with me during the apocalypse.

Can you see what is wrong with this picture? (This is meant to be constructive criticism, and not a personal attack so I am leaving the names out of this.)

[ElevenBravo]

Looks more like a tourniquet than a band aid.
Leaked onto surroundings
Dont see any Neosporin
Finger still is bloody, should have been cleaned up better
Already cut the hand once, and *still* hasnt locked the blade back yet

Andrew

[straylogic]

Looks more like a tourniquet than a band aid.
Leaked onto surroundings
Dont see any Neosporin
Finger still is bloody, should have been cleaned up better
Already cut the hand once, and *still* hasnt locked the blade back yet

Andrew

Right on all counts especially the tourniquet method of applying that band-aid, I would only add that:

alcohol prep pads should not be used on open cuts or scrapes. The alcohol content in them is too high. Using these on open wounds could cause tissue damage and inhibit rather than aid the healing process. Their intended purpose is to clean the skin before inserting a needle or making a cut.

link

a wound cleanser is the correct item to use, not an alcohol prep pad.

[straylogic]

My three things are
1) improper cleaning- using a prep pad over a wound cleaner or straight soap and water.
2) Improper application- the band aid is too tight, cutting off circulation.
3) Improper aftercare- no neosporin or other antibiotic.

[Ech0Sierra]

Knife's a fixed blade (BLACKHAWK! Kalista II), so don't give him crap about not closing it. Right on all other counts.

[tookieblueeyes]

1. If he were going to clean his wound he shouldn't have used alcohol prep pads. He would have been better off with soap and water which is commonly used in any ER, bactine would also have been acceptable.
2. I don't see any antibiotic ointment in the picture which would be highly suggested he use for treatment of his cut.
3. It looks like he is trying to cut the circulation off to his thumb! Loosen up that Band-Aid! For God's sake!

[cbr900]

You guys are picky... hell at work if the cut is deep enough just grab some electric tape works like a charm, if its real bad and wont stop bleeding cut a piece of your shirt off then tape that over the cut. At least he was prepared.

[straylogic]

You guys are picky... hell at work if the cut is deep enough just grab some electric tape works like a charm, if its real bad and wont stop bleeding cut a piece of your shirt off then tape that over the cut. At least he was prepared.

That's fine honestly. We live in a world where antibiotics are readily available and this kind of thing won't hurt you one bit, (unless you are dumb enough to leave the band aid on that tight for a few days.) But this picture was posted on a zombie prep site. Post apocalypse and without even the most basic understanding of why this picture represents all kinds of stupid could get you killed.

I applaud the guy for having the equipment but he was missing the knowledge. And seeing as how some people carry military spec trauma kits here it is kind of frightening to think what kind damage one could do with their miss-application. Let me rephrase this, the dude couldn't put on a band aid. But he thought highly enough of his handiwork to post the results. Me, I might feel safer shooting that guy, post zed-day, ok that's an exaggeration. But in a world without medicine and healthcare providers, this would be much more dangerous. Get safe and get trained in basic first aid. And use this entire post an exercise in seeing something we take for granted (access to healthcare) as a higher priority.

[cbr900]

Sometimes you have to put the bandage on really tight at first to stop the bleeding then loosen it up after the bleeding stops. Antibiotics are over rated I cant count the number of times I have cut myself deep enough to need a stitch or two to close it up at work. I havent taken antibiotics in the last 10 years, your body natural fights off infection.

[ElevenBravo]

Knife's a fixed blade (BLACKHAWK! Kalista II), so don't give him crap about not closing it. Right on all other counts.

Had no clue, fixed my post.

[IANMCDEVITT]

Hey, not meant to be a personal attack, but, what's the deal with the thread ? What is your goal ? What possible learning point are you trying to make ? I'm game, teach me. I believe the guy used what he had on hand. The guy put the band-aid on too tight ? That's your point ? You say you have limited FA knowledge, but your ready to critique a picture?.......C'mon man.

[Kommander]

If all you have is an alcohol prep pad is that better or worse than using nothing?

[straylogic]

From my M.D. / flight surgeon family member.

The alcohol prep pad is better than nothing, to clean and get any debris out, it is not a good first choice for the reasons I pointed out.

The tourniquet band aid tightness should only be worn until the bleeding stops, elevation is preferred.

My goal is to take a moment to describe a problem indicative of people who depend on equipment to make up for a lack of skill. Skill and knowledge are more important than any bit of kit.

[hatchtrikk]

IIRC, the person who originally posted that is actually in a third world country with no readily available modern medicine.

If you work with your hands and get cuts on a daily, this is no big deal. My most common bandaid is a paper towel wrapped in masking tape. Wait till the bleeding stops then remove it.

[TacAir]

IIRC, the person who originally posted that is actually in a third world country with no readily available modern medicine.

If you work with your hands and get cuts on a daily, this is no big deal. My most common bandaid is a paper towel wrapped in masking tape. Wait till the bleeding stops then remove it.

I do the same, and a dab of superglue to keep it from reopening, but as of late I've seen plenty of flesh-eating bacteria incidents in the news, so I'm adding Neosporin

Ripped from the headlines the Web...

Necrotizing fasciitis (NF), commonly known as flesh-eating disease or flesh-eating bacteria syndrome, is a rare infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue.

Necrotizing fasciitis is a quickly progressing and severe disease of sudden onset and is usually treated immediately with high doses of intravenous antibiotics.

Type I describes a polymicrobial infection, whereas Type II describes a monomicrobial infection. Many types of bacteria can cause necrotizing fasciitis (e.g., Group A streptococcus (Streptococcus pyogenes), Staphylococcus aureus, Vibrio vulnificus, Clostridium perfringens, Bacteroides fragilis, Aeromonas hydrophila). Such infections are more likely to occur in people with compromised immune systems.

Further -
Over 70% of cases are recorded in patients with one of the following clinical situations: immunosuppression, diabetes, alcoholism/drug abuse, malignancies, and chronic systemic diseases. It occasionally occurs in people with an apparently normal general condition. So - stay healthy.

And this odd bit -
Some published case reports have implied a possible link between use of non-steroidal anti-inflammatory drugs and NF, though the evidence of the link was said to be weak because of a small number of case patients and it was unclear whether the drugs just masked the symptoms of a secondary infection or were a cause per se. I'm going to dig into this a bit later today - fiest I've seen any mention of NSADs and any disease...

Don't know if the antibiotic gel will help, but it can't hurt....

[DannusMaximus]

Hey, not meant to be a personal attack, but, what's the deal with the thread ? What is your goal ? What possible learning point are you trying to make ? I'm game, teach me. I believe the guy used what he had on hand. The guy put the band-aid on too tight ? That's your point ? You say you have limited FA knowledge, but your ready to critique a picture?.......C'mon man.

Concur with Ian, here. Dude cut his finger, cleaned the cut, put on a bandaid. Anybody who works with their hands or does any type of manual labor does the exact same thing about a dozen times per year with no worries. Not every injury requires advanced medical training, access to a full surgical suite, or $50,000 worth of fancy supplies to address...

[Doctorr Fabulous]

I'm with Ian. Bandaid "improperly attached?" whatever, They usualkly loosen on they own after you work with them a bit, and the initial tightness will not do damage, but will help stop the bleeding. I do it to keep them from falling off too quickly.

Alcohol pad: Very nitpicky. Hell, most of the time I skip steps 1 and 2 and just use direct pressure to stop the bleed, and maybe wrap it with electrical tape in a dusty/dirty environment. The alcohol pad seems overboard to me, unless there was debris in the wound.

Neosporin/bacitracin? Is that really necessary? I survived for 20 years without using it on anything that I could cover with a bandaid.

The mentuioend criytiques seem dickish, starting a new thread (rather than just pm'ing the poster or replying in the thread) is really dickish.

[duodecima]

Don't know if the antibiotic gel will help, but it can't hurt....

Unless you're allergic to it. Even then we're usually talking about a local contact dermatitis, not anaphlaxis, so it's rarely going to hurt. In terms of wound healing, there some petrie-dish evidence that the topical antibiotics might speed it up but no observed difference in the real world. Anyone aware of a difference in infection rate with topical neomycin/bacitracin? (I'm severed from my references for a while...)

But seriously, irrigation/cleaning with clean (ie not contaminated) water is probably the single most important thing for wound infection prevention.

[Blacksmith]

The mentuioend criytiques seem dickish, starting a new thread (rather than just pm'ing the poster or replying in the thread) is really dickish.

Dickish indeed. However proper wound care is extremely important in a less than sanitary environment especially if you are dealing with people who may not already be in the best of health. You should know that. Unless someone is shooting at us while someone else is patching me up I would much rather have the nit picky guy patching me up.

[Niblick]

I agree with Blacksmith on all counts except that this thread is dickish. Nitpicky sure, but I don't really see an attack here. OP maybe next time just grab a google image to convey your point so no feelings are unintentionally hurt.

[Doctorr Fabulous]

The mentuioend criytiques seem dickish, starting a new thread (rather than just pm'ing the poster or replying in the thread) is really dickish.

Dickish indeed. However proper wound care is extremely important in a less than sanitary environment especially if you are dealing with people who may not already be in the best of health. You should know that. Unless someone is shooting at us while someone else is patching me up I would much rather have the nit picky guy patching me up.

True, but the pic wasn't happening in the NAW. Do you want a critical thread everytime you do something that would kill you in the PAW? I mean, hell, I think I'm as close to a PAW as anyone here, and I still would have used duct tape and some kleenex for soemthing like that.

[Blacksmith]

Do you want a critical thread everytime you do something that would kill you in the PAW?

Yes.

You should have figured out by now that things slip. Standards are hard to meet under good circumstances and near impossible under distress. Your best chance of getting something right is in the classroom and in training. Teach someone the right way to do something the first time and you don't have to break bad habits.

Doing something wrong or incorrectly is unprofessional and sends a message to whomever you are trying to teach or instruct that whatever you are doing does not really matter. If it does not matter to you it will not matter to them either. If that turns into a critical mistake that kills them or gives them a nasty infection on their hand where they can not fight than you really screwed up. Defending something that was done wrong makes you look unprofessional.

Doing things right sends the opposite message. You are professional and not an idiot. You care about what you are doing and it is important.

People will notice either way.

[Doctorr Fabulous]

Whatever. I think you're taking things a bit too far, and I stand by my statement that this entire thread was dickish and pointless.

[Fletch]

What we have here is a picture taken out of context, and a whole lot of armchair quarterbacking.

We are better than this, gentlemen.