Official Medical Doctrine is famously riddled with fallacies and discredited practices. Some of those practices, like medicinal blood-letting that was prevalent in the Middle Ages and was only discontinued in 19th century, are mind-boggling. Nowadays only a willfully ignorant witch-doctor would consider taking a person wracked with fever and draining a pint of blood from him, supposedly to make him better. But this is exactly what had been going on for centuries. It was taught in Universities by professors. This in not to be confused with the use of medicinal leaches today. Leaches release a natural blood thinning agent into the blood that improves circulation that can help with a variety of conditions. Leaches can also help to drain a haematoma. This current practice has nothing in common with a “doctor” cutting into a vein in a person’s hand and deliberately draining a certain measure of perfectly normal blood.
For most of the 20th century it was considered necessary to keep the systolic blood pressure of a gun-shot victim at 120. This figure happens to be an ideal systolic blood pressure for a healthy person. Later somebody noticed that wounded who had not been given adrenaline and not put on saline drips, and whose blood-pressure plummeted as a result, had bled less. The medical doctrine had been reviewed and now the target systolic pressure is 60. This is the lower limit that allows the body systems to function without going dangerously into shock. Internal bleeding had been reduced significantly. Survival rate of the wounded went up. But why had it taken so long? Even Napoleonic doctors noticed that the wounded further away from a bonfire were more likely to survive. This is because they bled less. I hope that in near future gun victims are also cooled down, as well as systolic blood pressure kept at a 60. Of course blood pressure dropping too low can be fatal, so a careful balance must be kept. As always, moderation is the key.
A more modern fallacy in contemporary British medicine is that first aid kits do not include tourniquets. First aid classes teach that the road accident victims only need a pressure bandage and no tourniquets to stop blood-loss. Yes, even in a case where a limb had been completely severed... Whoever had endorsed this advice had either never seen a person with a freshly severed limb, never read case histories or is not particularly intelligent. The highly-paid public health managers simply decided that tourniquets are not needed in the first aid kits. This is because they apparently do more harm than good. This is because a tourniquet most likely will be left in place and forgotten for many hours and the nerve damage would occur. Never mind that a person with a severed leg has practically a zero chance of survival if no tourniquet is used. The official medical doctrine in Britain is that a tourniquet should not be used for more than 15 minutes otherwise an irreversible nerve damage will occur. In truth, it is 4 hours at the average room temperature. This time could be extended by the use of ice-packs. I objected that a pressure bandage is not sufficient for a gushing leg or arm stump, but my concerns had been dismissed with a flippant observation that the streets in UK are not a battlefield, and everything I have been taught in a Soviet Medical school is wrong. Yes, some of what I was taught there may have been outdated, but the logic tells me that in this case it the smug National Health Service managers with degrees in business instead of medicine, who are wrong. By applying logic it would appear there is little difference between cases of a person who had a leg cut off at a train crossing and one who had a leg torn off by a landmine, or a 12.5 caliber round. Tourniquet is a must if you want the patient to survive. Indeed there are documented cases of people dying within minutes of a bullet or a piece of shrapnel severing femoral artery. This begs a question – have the fat-cat NHS managers who endorsed removal of tourniquets from first aid kits, actually read any cases notes of real persons who had lost their limbs? The only possible explanations is that an average UK hospital reminds the Third World so much, that it is cannot be reasonably expected that the A&E staff can be relied on to notice that a patient has a tourniquet in place. It is possible that statistically a lot of damage has been done by applying tourniquets needlessly for minor injuries causing varying degrees of local nerve damage. Of course, for the NHS system it is cheaper to have a person die from a bleeding leg wound than to treat nerve damage with physiotherapy for years afterwards.
But there is no need for the nerve damage to occur. The old Soviet School required to attach a note to a patient, even write it on his forehead that a tourniquet is placed and the time it was placed. Obviously the smug overpaid health service bosses would find such a low-tech solution hilarious.
One more example of modern fallacy is the first aid advice for drowning victims. Veterinary guidance requires that a drowned cat or a dog be lifted by the hind legs to let the water drain from the airways. The advice for helping humans omits this crucial step. The victim is laid on the back and CPR is started. Much good will it do with the airways filled with water… When I raised this issue I was looked upon as if I were a Martian. What, lift a child by his legs upside down? Treating children like dogs? Little wonder that there are regular reports in the press that a child had been pulled out of water within a minute of drowning and still could not be saved. Actually a person not breathing for up to 5 minutes can be saved with no permanent brain damage. In cold water this figure rises – there have been cases of humans and pets drowned for hours in icy water and being saved. The old school East European first aid for drowning specified lifting children by the legs, and lifting adults over your knee to drain water from the airways.
Filed under: medical myths, medical fallacies, medical malpractice, trauma medicine, first aid for drawning, first aid for bleeding, gun-shot wounds first aid