Author Topic: Blister treatment  (Read 12391 times)

Hugh Westacott

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Re: Blister treatment
« Reply #15 on: September 25, 2013, 12:23:16 PM »
I think that, in this instance Lyle, you are in danger of being a little too dogmatic. I'm reminded of the famous duet in Gilbert and Sullivan's HMS Pinafore:

'What never?'
'No never!'
'What never?'
'Well, hardly ever!'

Suppose you were out alone on a Sunday afternoon stroll and you encounter someone who is bleeding profusely as a result of being gored by cattle. You have to staunch the wound asap and you suddenly remember that, quite by chance, you have in your pocket a small water bottle with some duct tape wrapped round it. Would you not tear a piece of clothing, wrap it round the wound and secure it with the tape? Or is it better to allow the patient to bleed to death for fear of them having an allergic reaction to the tape?

I readily concede that it is better to use proper bandages, dressings and surgical tape but if they are not available one has to improvise. It is clear that the use of duct tape to secure dressings is widely practised and I'd be interested to know if there is any convincing evidence that anyone has suffered as a result.

Is there a surgical tape that is as strong as duct tape? The stuff I see in pharmacies never seems broad enough and does not adhere well.

Hugh

Callum

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Re: Blister treatment
« Reply #16 on: September 25, 2013, 12:30:00 PM »
Dogmatic or pragmatic Hugh, I venture the latter.

Whether or not you ‘work for outdoor organizations’ it seems pretty much common sense that in first-aid use the correct medical materials.

captain paranoia

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Re: Blister treatment
« Reply #17 on: September 25, 2013, 12:49:38 PM »
For group work with third parties, sadly, I think the advice to stick to tested medical products is appropriate; as Callum says, it's a matter of legal pragmatism...

For personal use, do what you want...

Of course, even tested & approved medical products have known problems; zinc oxide and latex are two very common allergens, and yet also very common in many medical products.

Equally, the problem with saying 'use duct tape' is that there are so many variants, each with their own adhesive formulations (some of which include latex).

Interestingly, there is peer-reviewed medical use of duct tape to treat warts.

One alternative to duct tape discussed here is kinesio tape
The tape used for IV drips would probably make a very good blister hot spot reliever, as it's smooth and sticky.

There are plenty of google hits for duct tape medical, including 3M duct tape plasters...

I'll try emailing our first aid tutor and see if has any evidence to support use of duct tape in first aid.


captain paranoia

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Re: Blister treatment
« Reply #18 on: September 25, 2013, 12:53:11 PM »
In Hugh's example case, yes, I'd agree; the benefits of immediate life-saving potential of duct tape far outweigh the relatively minor problem of an allergic reaction; everyone will bleed to death from an untreated major bleed, but only a fraction of the population will have a fatal allergy.

adi

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Re: Blister treatment
« Reply #19 on: September 25, 2013, 12:59:57 PM »
Duct tape is indeed used heavily in first aid, particularly in outdoor first aid Hugh. You will see it written about in books, in forums, on blogs and on some very eminent websites. However as Lyle correctly pointed out best practice or current guidance must be used when treating others. What you do to yourself is up too you.

Zink Oxide tape is an allergen and can be very allergic to some people. I use it because I know it sticks better than most other tapes. When I teach I talk about Micropore tape this is safer than Zink Oxide tape. My medical kit is stocked with Micropore tape; my personal FAK has Zink Oxide tape.

From your comments, would you close a wound with super glue? There is loads of advice on the net that champions its use.

I am a huge fan of duct tape and have two roles of it in my medic kit. Note I said 2 roles, the first is excellent stuff the second is as sticky as a stick, it has no use what so ever, sellotape would be more effective.

I use duct tape for splinting, strapping limbs together, stabilizing the head, strapping people to back boards or trees. The only time I would seriously consider using duct tape on the skin would be to seal a chest seal for an open sucking chest injury. However If duct tape was all I had then I would use it.

I believe if you work or play in the ourdoors you should include duct tape in your kit because it has a lot of uses.             
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

adi

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Re: Blister treatment
« Reply #20 on: September 25, 2013, 01:01:44 PM »
In Hugh's example case, yes, I'd agree; the benefits of immediate life-saving potential of duct tape far outweigh the relatively minor problem of an allergic reaction; everyone will bleed to death from an untreated major bleed, but only a fraction of the population will have a fatal allergy.

That in law is described as 'Life over limb'
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

adi

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Re: Blister treatment
« Reply #21 on: September 25, 2013, 01:06:45 PM »
kinesio tape is bloody great stuff however it is too expensive to waste on blisters. Not a problem for personal use but for an organisation that has over 400 feet through its doors every year cost is a major concern. 
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

adi

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Re: Blister treatment
« Reply #22 on: September 25, 2013, 01:10:45 PM »
Another question. would you spray WD40 on your sore joints?
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

Pete McK

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Re: Blister treatment
« Reply #23 on: September 25, 2013, 03:43:12 PM »
Never thought I would see a debate on blisters :o My take is. if there is absolutely nothing else then use duct tape, but it begs the question why you are not readily prepared.

Hugh Westacott

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Re: Blister treatment
« Reply #24 on: September 25, 2013, 03:57:40 PM »
<Another question. would you spray WD40 on your sore joints?>

There would be no point, Adi, because I had lubrication nipples fitted to all my major joints years ago.

Hugh

Hugh Westacott

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Re: Blister treatment
« Reply #25 on: September 25, 2013, 04:41:47 PM »
<My take is. if there is absolutely nothing else then use duct tape, but it begs the question why you are not readily prepared.>

These are the circumstances, Pete, that impelled me to use duct tape on a blister. Last month, i took my twenty-one year-old son on a backpacking trip from Land's End to Falmouth. He was wearing boots that he'd had since his middle teens and he was carrying a heavy pack in temperatures hovering around 90°F and his feet must have swelled. I noticed that he was limping and when he took off his boot he had a large blister on his heel and an inflamed verruca on the sole of his foot. The blister was too big for even the largest Compeed dressing, so I cut a hole of the requisite size in a sheet of moleskin, covered the hole with gauze and secured everything with surgical tape. I protected the verruca with a corn pad and covered that with surgical tape.

Austin was comfortable for about an hour but the dressings shifted and he was was soon limping again. So I dressed his foot in exactly the same way but used duct tape instead of surgical tape. The dressings remained in place for three days and were only removed when we got home, by which time the blister was healing and the verruca was no longer inflamed. But for the duct tape, we would have had to abort the trip.

If anyone can recommend a surgical tape that is as tenacious as duct tape, I'll happily purchase some. I'd also be grateful if anyone can supply me with hard evidence, as distinct from what is accepted as best practice, that duct tape is harmful when used on human skin.

Hugh

Callum

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Re: Blister treatment
« Reply #26 on: September 25, 2013, 05:03:08 PM »
Ah Ha Hugh  :)

adi

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Re: Blister treatment
« Reply #27 on: September 25, 2013, 06:32:10 PM »
There is a tape that well out performs duct tape but I have forgotten its name and I can't find my role. It costs over £10 a role I think it is made by Leukopor. Moleskin and Standard tape will stick well if you dab some Tincture of benzoin around the area. I the UK the easiest way to by it is as a product called friars balm. It does a great job at making things stick. Some people just put Tincture of benzoin around the area effected by blisters and then smear Vaseline over it but that has never worked for me. 

Duct tape does not breath that well so it cause the skin to become weak and leaves the area prone to infection. Not good.

I have heard very good reports on Tesco own-brand "Sterile Blister Plaster" apparently they are thinner than the others, including Compeed. So are more comfortable and far cheaper than Compeed. 

Hugh I had those grease nipples inserted too ;)

Out of interest many sports therapists at the football matches spray WB40 on the players when they are down.  You will see them pulling a can out and spraying the injured leg and would you know it the footballers are up and running around as if nothing was ever wrong. A fine case of qualified persons not following the protocols.
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

adi

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Re: Blister treatment
« Reply #28 on: September 25, 2013, 06:39:58 PM »
Never thought I would see a debate on blisters :o My take is. if there is absolutely nothing else then use duct tape, but it begs the question why you are not readily prepared.

Pete on my very first post in this thread I said "here is another emotive subject". Sadly First aid is emotive because in most cases most things will work. If something works once people continue to do it use it and spread the word around. And there a lot of people that say they have done a course and they are experts or say my first aid instructor told me this, so it must be true. When actually all first aid instructors should be teaching the same protocols.   
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

captain paranoia

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Re: Blister treatment
« Reply #29 on: September 27, 2013, 01:25:43 PM »
I've been on one short first aid course.
I am most certainly not an expert.
The instructor did recommend using duct tape.
I've asked him if he can provide any clinical trials of duct tape for first aid use, and no, he cannot, merely what has worked for emergency medical teams, civil and military.

I'm not in the least bit emotive about the issue, but I am very much a pragmatist; "if it's stupid and it works, it isn't stupid".

> When actually all first aid instructors should be teaching the same protocols.

Well, there's first aid and there's first aid, and they're not always the same, so I'm not surprised that different things are being taught, depending on the intended deployed environment.  What is applicable in an office environment with a large, well-stocked first aid kit will be different from what is applicable in the wilds with a more limited (due to practicalities of carrying the thing) FAK.  A good example being CPR advice; urban FA 'best practice' is now not to breathe for the casualty (hence the BHF Vinny Jones advert "you only kiss your missus on the lips"), whereas remote FA advice is to continue breathing for the casualty, since it will be longer than the 8 minute target for an ambulance and paramedics to arrive.  A recent TV programme allowed two military medics to compare their small, personal FAKs, and they were different (and carried things unlikely to be required in a walker's FAK, such as tourniquet devices).  And a lot smaller than the large medic's more comprehensive backpack.

And there's also the issue that even things that are clinically tested and found to have adverse reactions are still used; drug side-effects, allergies to latex and zinc oxide, and even micropore tape.  And yet we knowingly use these items, and even suggest them as 'best practice'.

I'd actually suggest that blister treatment isn't really first aid at all, but palliative treatment...  In most cases, blister treatment is intended to allow someone to continue their activity, whereas the 'best practice medical advice' would be to stop whatever it is that's causing the damage; i.e. cease the activity.  "Doctor, it hurts when I <insert activity here>" "Well, stop doing it, then..."