1. Are you a current member with account or password issues?

    Please visit following page for more information

    Dismiss Notice

Antiseptic vs. Antibiotic?

Discussion in 'First Aid Station' started by Finnigan, Sep 17, 2010.

  1. Finnigan

    Finnigan Loaded Pockets

    Joined:
    Apr 20, 2009
    Messages:
    377
    Likes Received:
    48
    Hello all. To start off, I (and a couuple of other coworkers) just completed the 1 day certifications in First Aid, CPR and AED at our workplace. Since, I have been investigating what we have on site in the way of supplies. We have one First Aid cabinet that is refilled under contract. I found 2 other much older kits that have been pretty well stripped.

    One thing I have come across in abuncence is BZK antiseptic towelette packets. I remember in training discussing triple antibiotic ointments for minor wounds. I know these towelettes are for use on wounds. I was just wondering, what is the difference? What is preferred?

    PS. The BZK antiseptic towelette contains Benzalkonium Chloride.

    Edit: I also found a bunch of Povidone-Iodine Pads, and plain old Alcohol whipes. What's the story with these?
     
  2. JIM

    JIM Loaded Pockets

    Joined:
    Feb 12, 2009
    Messages:
    284
    Likes Received:
    150
    Great that you and your co-workers got your certs and also took the effort to look at the FAK's at work!

    About antibiotic ointment: because of the antibiotic overuse worldwide there are lots of problems with allergies and drug resistent bacteria, so I would suggest not using these. For burns, roadrash I would suggest you use a burngel instead.

    There are lots of antiseptics on the market. Unfortunately alcohol isn't really good for first aid use because its very irritating to a wound and is only effecive when it dries after application.

    A mix of povidone-iodine and BZK wipes will give you effective antiseptics, and when someone is allergic to BKZ, you can use PI and visa versa
     
  3. Finnigan

    Finnigan Loaded Pockets

    Joined:
    Apr 20, 2009
    Messages:
    377
    Likes Received:
    48
    Ah! But I would need to know if they were allergic, or they would need to know and be able to communicate it to me. Actually, if they are capble, I'm supposed to hand them the stuff and let them administer it. Now that I think about it though, I should probably just work to stop the bleeding and let the EMT's and Dr.'s worry about infection.

    I was told for burns to avoid any burn gel except what can be rinsed off with water (otherwise it has to be scrubbed off.) Actually, for in the office, I was told to keep the burned area under running water for 30 minutes.

    Edit: Also, I guess my original question really should have been "If I go into my kit here at work and find Alcohol, BZK, PI and Triple Antibiotic, which one do I want to slap on a cut before a bandage? I think I answered my own question with "None of them" though.
     
  4. StealthChaser13

    StealthChaser13 Loaded Pockets

    Joined:
    Nov 15, 2009
    Messages:
    472
    Likes Received:
    8
    THey are all made for "cleaning" a wound before bandaging it. Triple antibiotic is put on to keep the wound from getting infected. triple antibiotic also helps a wound heal better, and faster (compared to not using).
     
  5. smellypaddler

    smellypaddler Loaded Pockets

    Joined:
    Jan 15, 2010
    Messages:
    158
    Likes Received:
    79
    Unless you are in a remote area and medical services are going to be limited I would not try and prevent infection using antibiotics or PI. PI is cytotoxic and kills fibroblasts making the wound take longer to heal. Dressing wounds in hospitals we normally clean using normal saline and should infection be a concern AB's are prescribed per oral or IV. If an infection is already present or develops then a culture is taken so that the correct AB's can be administered.

    In a remote situation it all changes. I would clean small wounds with normal saline, keep them clean and monitor for signs of impaired healing or infection. Should you develop an infection in a remote area then a course of broad spectrum AB's such as Amoxycillin could be taken orally.

    Depending on the mechanism of injury and whether debridement of the wound is possible prophylactic AB's may be indicated. My tip for remote area first aid is to pack some Tegaderm or similar dressings that are transparent and waterproof. These can be left in place for a number of days making sure that the wound receives minimal exposure as well as allowing wound monitoring.
     
  6. Finnigan

    Finnigan Loaded Pockets

    Joined:
    Apr 20, 2009
    Messages:
    377
    Likes Received:
    48
    Great advice! Thanks!
     
  7. xbanker
    • Administrator

    xbanker Geriatric Admin
    Staff Member

    Joined:
    Apr 5, 2006
    Messages:
    5,465
    Likes Received:
    7,792
    Good, concise information!

    This is the advice I see given most often by those "in the know." Accordingly, for my small PSK -- with its space limitations -- I recently found these at local CVS store. Box contains 24 individually-wrapped wipes. $6.99. Now carry a couple in PSK with other first aid items.

    [​IMG]
     
  8. smellypaddler

    smellypaddler Loaded Pockets

    Joined:
    Jan 15, 2010
    Messages:
    158
    Likes Received:
    79
    They look pretty good. I haven't seen them before in Australia. In my large remote area kit I carry sterile dressing packs that contain some disposable swaps, forceps and a kidney dish as well as some saline to wet the swabs with. I might have a scout around for some of those wipes as they might take up less space.
     
  9. Rich

    Rich Loaded Pockets

    Joined:
    May 15, 2008
    Messages:
    36
    Likes Received:
    0
    Since all of medicine is evolving into evidence based practice the International Liason Committe on Resuscitation (American Heart Association and Red Cross) has been reviewing the literature to determine best practices for their 2010 guidelines. I've taken this directly from their worksheet on irrigation of a superficial wound:

    There are three fundamental questions regarding wound irrigation. 1) Is irrigation better than no irrigation? 2) What is
    the optimal irrigation pressure and volume? 3) What is the best irrigation solution to be used?

    Evidence from seven well designed animals studies (LOE 5),six clinical trials (LOE 1, 2), and one meta-analysis (LOE 1)
    of simple traumatic lacerations in the ED demonstrate that irrigation is better than no irrigation, that higher irrigation
    pressures are more effective than lower pressures, that higher volumes are better than lower volumes (within a range of
    100 to 1,000 ml), and that tap water is as good (or better than) any other type of irrigation solution in reducing infection
    rates. One small study suggests that body temperature saline is more comfortable than cold saline and an inanimate
    study suggests that soap and water is more effective than saline alone.


    In other words a liter of water directly out of the tap is the best way to cleanse most wounds.
    Obviously things change in the field when large amounts of city tap water are unavailable. At that point, if it was my wound, I would want saline/sterile water in a bottle to irrigate my wounds; I'd prefer not to use field filtered/treated water on my wounds. I don't use PI, BZK or alcohol on my cuts and scrapes.

    You can review other parts of the proposed 2010 first aid guidelines here.
     
  10. medic2807

    medic2807 Loaded Pockets

    Joined:
    Aug 20, 2010
    Messages:
    849
    Likes Received:
    649
    http://www.metromedicalonline.com/1212-89.html
    Because clean water is always a consideration, this stuff works good. I add a vial to a liter bottle of sterile saline before I irrigate wounds before I suture them. The vials are small. Alcohol and betadine are used for cleaning before you make a wound (before an IV start, surgical incision, etc.) and shouldn't be used on wounds.
     
  11. medic2807

    medic2807 Loaded Pockets

    Joined:
    Aug 20, 2010
    Messages:
    849
    Likes Received:
    649
    Oh, and topical antibiotic ointment is great. Ever laceration seen in an ER gets a healthy slathering of bacitracin. Stops infections before they start.
     
  12. ObiHann

    ObiHann Loaded Pockets

    Joined:
    Jun 23, 2009
    Messages:
    1,019
    Likes Received:
    16
    just get some mini tubes of saline, it is all you really need. As a MFR through St Johns Ambulance, it is all we carry.
     
  13. Dr Jekell
    • Administrator
    • In Omnia Paratus

    Dr Jekell I had fun once, It was awful.
    Staff Member

    Joined:
    Aug 30, 2006
    Messages:
    2,778
    Likes Received:
    1,268
    I have worked as a medic for over 12 years & have never had any use for antiseptics or antibiotics.

    70% of the wounds that I see (And I see a lot) will get a cleaning with normal saline and a gauze square (not any of the "saline" types with added components).

    15% get to go home & have a shower to clean the wound (this is what has been found to have the best cleaning action for gravel rash, grass rash, road pizza & the like, short of sending them to ED to have it scrubbed)

    The last 15% have difficult to clean or too large to deal with wounds and they get a free pass to ED.
     
  14. scottenlow

    scottenlow Empty Pockets

    Joined:
    Sep 29, 2010
    Messages:
    24
    Likes Received:
    0
    Earlier tonight I busted my head above the left eye while trimming a tree limb. I just happened to have read this thread an hour earlier without commenting. I washed it out with clean water and slathered on some triple antibiotic ointment. Thanks guys.
     
  15. Pineapple Devil

    Pineapple Devil Loaded Pockets

    Joined:
    Jul 30, 2009
    Messages:
    188
    Likes Received:
    26
    People need to quit being so complicated. Clean it with soap and water and put a dressing on it. Ointments like Neosporin are aimed for minor cuts, scrapes, and burns. Use it if you want but keeping it clean with soap and water will work better.