Paramedics debunk 12 first aid myths


Following is a transcript of the video.

Randy Li: “You should clean your wounds with rubbing alcohol.”

Lorena Concepcion-Martinez: Ouch!

Li: “Slap a choking person on the back.”

Concepcion-Martinez: Yeah, not really working.

Concepcion-Martinez: “After getting stabbed, take out the sharp object from the body.”

Li: This is from movies. This is stupid. Don’t do this.

Li: Hi, my name is Randy Li. I’m a paramedic here in New York City, and I’ve been working EMS for 11 years.

Concepcion-Martinez: Hi, my name is Lorena Concepcion-Martinez. I am a paramedic here in New York City also, with Randy, for the past 19 years.

Li: And today we’ll be debunking myths about first aid.

Concepcion-Martinez: Ready?

Li: Let’s go.

Concepcion-Martinez: “If someone gets a concussion, keep them awake.”

Concepcion-Martinez: This is a old wives’ tale. They associated someone having a concussion and going into a coma and not being able to wake up. So that’s why they used to say to keep everybody awake.

Li: Now, we have figured out that the sleeping does not cause the coma. When someone has a concussion, it is considered a type of TBI, traumatic brain injury. You do want to monitor them, though. You want to make sure there’s no deficit, no changes. So things you’re going to be looking out for would be slurred speech, vomiting, unsteady gait, which means you’re, like, wobbly when you walk.

Concepcion-Martinez: A little dizzy.

Li: Yeah. You don’t want any of that. So if you think that’s a problem and it’s not self-resolving, then, yeah, take them to the hospital. Let them do a CAT scan, let them make sure that the patient’s not having an internal bleed in their brain.

Li: “You should put something into the mouth of someone having a seizure.”

Concepcion-Martinez: Negative. This is a major no-no. This is another old wives’ tale of people thinking that the patient having the seizure was going to swallow their tongue. It’s more muscle spasms and clenching of the jaw. So you don’t really have to worry about the patient swallowing the tongue or anything along those lines.

Li: That whole time you were talking, I tried to swallow my tongue. I couldn’t do it. So it’s not true.

Li: When someone’s having a seizure, they’re having these fasciculations, this tightening of the muscles. What’ll happen is they’ll clench their jaw. And if you put something in their mouth, they’ll break their teeth, they’ll break their jaw.

Concepcion-Martinez: Bite your finger off.

Li: Yeah, don’t do it.

Concepcion-Martinez: You also want to let the seizure pass. You want to make sure once they’ve stopped, you can roll them on their side and just kind of be supportive until EMS arrives to help.

Li: Most seizures will resolve themselves after, say, 30 seconds to a minute. But if you have something called status epilepticus –

Concepcion-Martinez: The patient will end up having continuous seizures, which will affect their breathing. That point is where you need that advanced medical care, advanced life support, paramedics like Randy and I, to come in and give medications to actually try to subside the seizures and transport the patient to the hospital as quickly as possible.

Li: “Slap a choking person on the back.”

Concepcion-Martinez: This myth does come from how you treat an infant or a child that is choking, because we do backslaps, as we call them, in an infant or a child. But in adult, you want to emphasize on doing the Heimlich maneuver.

Li: Wait, hold on. I have a thing for this. So, imagine this guy’s choking. We’re gonna try the backslap thing.

Concepcion-Martinez: Yeah, not really working. If you come across a person choking, try to encourage them to keep coughing. So, Randy here is going to show you the universal choking sign, which is?

Li: But you wouldn’t be smiling, clearly. But, you know, they’d be like this.

Concepcion-Martinez: That’s the universal choking sign. Do not – I stress, do not – give them anything to drink. You want them to keep coughing until they clear that airway. And if it becomes completely obstructed that they can’t get any air movement, they can’t speak, and they start turning blue, it’s time for the Heimlich and definitely 911.

Li: Depending on who you follow, the protocol for treating choking is a little bit different. The American Red Cross recommends five back blows followed by five abdominal thrusts and repeat. But Lorena and I follow the American Heart Association protocols, so we go straight to the abdominal thrusts.

Li: When you’re doing the abdominal thrust, like the old name of the Heimlich maneuver, you’re going to make a fist. So this goes right to the navel, just slightly above. You’re going to do a pulling-up motion, like a J. And you’re going to squeeze with a lot of force. So, unlike the movies and stuff, this actually takes a lot of effort. You can’t just do it in one shot. You’re going to be really tired doing this, and it’s probably going to hurt the person as well, but it’s better than them choking to death. Oh, God. [pants] There you go.

Concepcion-Martinez: When you do this, please make sure to keep your head to the side. ‘Cause if not, the patient will bang you on your nose, and you might end up with a bloody nose.

Li: Boom.

Concepcion-Martinez: “Always suck the venom out of a snakebite.” I’m sorry. [laughs]

Li: I don’t know how to answer this properly. It’s ill-advised to ever have a answer in our life where sucking something out is, like, your go-to thing.

Concepcion-Martinez: If you drop food coloring into a cup of water, it’s very difficult to get it back together. It’s impossible to get it all out. So the same applies for venom on a snakebite. Once it’s in, it’s in the bloodstream, it’s going to circulate. So it’s really not going to do much. The other thing is, stay away from putting any kind of tourniquet. It’s going to create more damage than what it’s going to help.

Li: If someone’s going to be bit by a venomous snake, sucking on the wound, you’re going to get such a minimal amount out that it’s not going to do anything. And then you leave them exposed to infection, because your mouth is probably dirty.

Concepcion-Martinez: If you encounter someone who’s had a venomous – key word, venomous – snake bite, you definitely want to call 911 as soon as possible and get that patient to the hospital. You want to go to a venom center or a bite center. And it’s particularly a hospital that has all kinds of antivenoms, antidotes for this kind of incident.

Concepcion-Martinez: “CPR requires mouth-to-mouth.”

Li: CPR does not require mouth-to-mouth. There are procedures of just doing chest compressions that allow you to make sure that blood’s circulating through the whole body to get oxygenated blood to the brain. That’s the goal. It buys you time for us, paramedics, to show up.

Concepcion-Martinez: A couple years back, CPR was required mouth-to-mouth. But do you really want to put your mouth on a total, complete stranger? The American Heart Association and everyone else who teaches CPR have been doing a strong emphasis on hands only. It eliminates the transmissions of any communicable diseases or anything along those lines.

Li: To do CPR properly, you’re going to want to expose the chest down, so you have access to the bare chest. Palm of your hand, center of the chest, you’re going to wrap your fingers around each other. And then you’re just going to push straight down. For an adult, it’s about 2 inches (5cm) or so, but basically, just going to keep that going on for 100 beats per minute. There is a song that we utilize all the time. Historically, we use “Stayin’ Alive.” Ah, ah, ah, ah, stayin’ alive, stayin’ alive.

Li: So, when you’re doing CPR, the main thing you want to just maintain is that those compressions are going to be consistent. Anytime you stop, that threshold goes down. It causes a huge amount of detriments to the body. You got to start doing it immediately. You got, like, six minutes before you have irreversible damage to the brain. So start CPR quick. Give them a good shot.

Concepcion-Martinez: “After getting stabbed, take out the sharp object from the body.”

Li: This is from movies. This is stupid. Don’t do this.

Concepcion-Martinez: Do not remove it. You will cause a lot more tissue damage and cause a lot more bleeding. So, please, I stress this, please do not remove it. Leave it in place.

Li: You should stabilize it, so it doesn’t go wiggling around inside, because any kind of movement to the foreign object – Will create more damage. It’s great in movies though. It’s hysterical.

Concepcion-Martinez: Drama effect.

Li: It’s just like … [makes sound effect] [grunts]

Li: Why?

Concepcion-Martinez: No. I don’t get it.

Li: “You have to be medically trained to use a defibrillator.”

Li: It’ll make you feel more confident, but you really don’t. What you see out there, they’re not actually defibrillators like you see in the movies, paddles and all that craziness, they don’t do that.

Concepcion-Martinez: Well, let’s show them.

Li: OK. So, this is an AED. This is an automatic external defibrillator.

Concepcion-Martinez: A defibrillator basically shocks the heart. All municipal buildings have these in every location. So the best thing about defibrillators is that anyone can use them. All you have to do is open it up and press the power button, and it will literally tell you, step by step, what needs to be done.

Li: Open it up. [AED beeps] AED: Adult mode. Remove all clothing from patient’s chest.

Li: Can you pull the red handle?

Concepcion-Martinez: Sure. AED: Look at pictures on pads.

Li: There are photos to show you exactly where you’re supposed to put these things on.

Concepcion-Martinez: You want to use this as quickly as possible once you know the person is in cardiac arrest. If the person is unresponsive but you’re not sure, you still want to use this and put it on the patient’s chest. If the patient’s still alive, it will tell you not to shock. AED: Analyzing heart rhythm. Provide chest compressions to the beat.

Concepcion-Martinez: And continue CPR. Don’t be afraid to ask someone to go get the defibrillator or the AED.

Concepcion-Martinez: “Put butter on a burn to heal it.”

Concepcion-Martinez: What are you, a piece of toast? That would be a no. You do not put butter on a burn. It’s going to trap the heat, and, ultimately, the heat is going to keep radiating. So it will continue to burn.

Li: Basically, you want to stop the burning process, no matter what it is. It could be a first-degree burn to a third-degree burn. You want to just eliminate that, right? So just cool water.

Concepcion-Martinez: Key word, cool. Not cold. You just want to keep it clean, sterile, and cool it down. Seek medical care.

Li:“If you get frostbite on your hands, rub them together to warm them up.”

Concepcion-Martinez: Ooh, I would say you don’t want to do that.

Li: We went from hot to cold.

Concepcion-Martinez: Yeah, we did go from hot to cold. If you do have frostbite on your fingertips or toes, which is usually where it starts, you never want to rub them. The friction will cause more damage to the skin tissue and the cells below it. So you want to warm them up slowly, coming into a warmer environment, taking off any wet clothing on it, and just gradually warming it up.

Li: So, how do you know the difference though, between just being cold and having frostbite? You’ll have this waxy-type deal on your hands. Your hands are going to be a little more puffy. Basically, you’re going to be blistered up. Imagine, like, just a really bad burn, except the opposite, ’cause it’s cold.

Concepcion-Martinez: Once you cross that frostbite threshold, it’s something that you definitely need to go to the emergency room to be treated by a physician, because the amount of damage that can be done by treating it incorrectly can be irreversible.

Li: “You should clean your wounds with rubbing alcohol.”

Concepcion-Martinez: Ouch! I’m sorry. This is painful just to think about it. And that would be a no.

Concepcion-Martinez: Rubbing alcohol is going to be very painful. So please stay away from rubbing alcohol. Just simple soap and water. If you have antibacterial soap, even better.

Li: It cleans it, sure. But why go through the trouble of, like, actually hurting yourself, essentially? You also want to make sure that the wound stays moist, and alcohol has this drying property that’s not going to be conducive to healing anyway.

Concepcion-Martinez: Keep it simple. Soap and water. If it’s an abrasion, a simple cut, a day or two with a Band-Aid is always good, just to control whatever bleeding you have. That’s the main key. You want to do the triple antibiotic and let it get free air. The air will actually help stimulate scabbing, and scabbing is a natural barrier that the body creates so it can heal and regenerate.

Concepcion-Martinez: Wow. “Cardiac arrest and a heart attack are the same thing.”

Li: They’re not the same thing. Cardiac arrest means that your heart stopped.

Concepcion-Martinez: They are no longer conscious, they are no longer breathing, and their heart is no longer beating. So this is where CPR comes into play.

Li: Heart attack, you have an occlusion in your heart.

Concepcion-Martinez: The heart is starving for air, causing the chest pain. You have the ability to get to the hospital. You’ll have shortness of breath, you’ll be diaphoretic, which means really, really sweaty, all classic signs of a heart attack. Not everyone will have the same symptoms. So remember, call 911 for either one.

Li:“If you witness a drug overdose, put the person in the shower or bath.”

Li: Um, no. Because, one, you have no idea what the person overdosed on. Any kind of dramatic change to someone’s temperature will throw the homeostasis of the body all out of whack. What does that mean? Your body has a regulation of temperature. You can’t go into any extremes quickly.

Concepcion-Martinez: Yeah. It just makes getting the patient out and treated a lot more difficult if they’re, like, in a bathtub and wet. And we as paramedics carry stuff such as Narcan to help counteract any narcotic overdoses.

Li: Specifically for opioid overdoses.

Concepcion-Martinez: But we also have other drugs that help with other types of overdoses. So please make sure, don’t lie about what you took.

Li: That makes it way harder for us. Because if you took drug A and you tell us it was drug B, we’re going to go the wrong route, and the treatment will get skewed, and then we’ll figure it out eventually, but then we have to backtrack and then go that route. It’s very dangerous.

Concepcion-Martinez: So no shower. This is debunked.

Li: Look at all these myths. The intention is there. Everyone wants to help somebody else. That’s great, but you’re going to want to get a little education on your backend. Take a first aid class. You don’t have to go to the level of EMT and paramedic.

Concepcion-Martinez: And, who knows, you might be somebody’s hero one day.