The Latest First Aid for Wounds and CPR

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Most of us are concerned about the spread of bloodborne pathogens —such as the hepatitis B virus (HBV) and human immunodeficiency virus (HIV), the AIDS virus— and try to avoid exposing ourselves to this hazard. Health professionals and amateur first aiders like those of us in Scouting may find ourselves faced with special problems in this regard. We must therefore know how to act and how to instruct the youth we lead.

The First Aid merit badge pamphlet and other BSA handbooks used to advocate direct hand pressure to stop bleeding in injuries. However, this action could involve getting the victim’s blood on the rescuer’s skin. If the victim has HIV or some other bloodborne disease, the rescuer could be infected with the virus. If the rescuer has open wounds on or near his or her hands, there is the risk of exposure to the victim.

In rescue breathing there is the risk of passing airborne infectious diseases such as influenza from victim to rescuer. But Scout leaders, parents, and youth members should know that there is no evidence that a rescuer can be infected by the hepatitis B virus or HIV either through contact with human saliva or by giving rescue breathing. Studies show that both hepatitis B and HIV are bloodborne illnesses.

The BSA has checked with experts in the federal government's Center for Disease Control and Prevention and with the American Red Cross. These authorities suggest that we should:

  • Maintain the BSA’s tradition of rendering first aid to those in need.
  • Recognize that very often the victims we treat with first aid are friends and family members whose health we are familiar with. Therefore, in such cases, except when we know they have infectious diseases, we should not hesitate to render first aid.

The BSA Health and Safety Committee recommends the following.

Treat all blood as if it is contaminated with bloodborne viruses. Do not use bare hands to stop bleeding; always use a protective barrier; always wash exposed skin areas with water and soap immediately after treating the victim.

Have available and use personal protective equipment that helps prevent direct contact with infected materials. This equipment includes disposable, nonlatex gloves (nitrile or vinyl) and breathing barriers used when performing rescue breathing. To help reduce the risk of getting or transmitting infectious disease, follow these guidelines for the use of protective equipment:

  • Wear disposable, single-use gloves whenever giving care, particularly if there is risk of contact with blood or bodily fluids.
  • Wear protective coverings such as a mask, eyewear, or gown when you are likely to come in contact with blood or other bodily fluids that may splash.
  • Cover any cuts, scrapes, or sores prior to putting on protective equipment.
  • Use breathing barriers such as resuscitation masks or face shields when giving rescue breaths.
  • Remove disposable gloves without contacting the soiled part of the gloves, and dispose of them in a proper container.
  • Change gloves before you care for a different victim.
  • Remove jewelry such as rings, bracelets, and watches before putting on disposable gloves.
  • Do not clean or reuse disposable gloves.
  • Do not use disposable gloves that are discolored, torn, or punctured.

BSA literature to be issued from now on will reflect these changes in first aid. All BSA leaders are asked to correct literature that describes the old methods and to direct youth members to do the same.

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