Most first aid happens in kitchens and backyards, not emergency rooms — which means most people are treating cuts, burns, and sprains based on what their grandparents did. Some of that advice (butter on burns, hydrogen peroxide on cuts) is actively wrong. Here's a refreshed, evidence-based playbook for the three injuries that send the most people rummaging for a first-aid kit.
Cuts & Scrapes: Clean, Protect, Watch
- Stop the bleeding — apply firm, direct pressure with a clean cloth for 5–10 minutes without peeking.
- Wash with clean water and mild soap. This is the single most important step for preventing infection. Contrary to folklore, hydrogen peroxide and rubbing alcohol are not recommended for routine wound care — they damage healthy tissue and can slow healing.
- Protect the wound — a thin layer of petroleum jelly or antibiotic ointment plus a sterile dressing keeps it moist, which heals faster than air-drying.
- Watch for infection — increasing redness, warmth, swelling, pus, or red streaks within days means a clinician should look.
Seek care for: deep or gaping wounds, cuts over a joint, animal or human bites, signs of embedded debris, or heavy bleeding that won't stop. If your last tetanus shot was more than 10 years ago (or 5 years for a dirty wound), you may need a booster.
Burns: Cool, Don't Grease
For minor burns (first-degree and small second-degree), the evidence is clear: cool (not ice-cold) running water for about 20 minutes within the first few hours reduces pain and tissue damage. After cooling, cover loosely with a clean, non-stick dressing.
The "grandma rules" to skip: no ice (causes further damage), no butter, oil, toothpaste, or egg whites (they trap heat and invite infection), and do not pop blisters — intact blister skin is a natural sterile dressing. A tetanus booster may also be due after a burn.
Seek emergency care for: burns larger than the person's palm, full-thickness (white, waxy, or charred) burns, burns on the face, hands, feet, joints, or genitals, chemical or electrical burns, or burns with inhalation injury (singed nasal hair, soot, hoarse voice).
Sprains & Strains: The RICE Update
You probably learned RICE — Rest, Ice, Compression, Elevation. The modern version keeps the ice and elevation but softens the "total rest": early, pain-guided movement beats prolonged immobilization for most sprains. Ankle sprains treated with early protected movement recover faster and with less stiffness than those put in a cast.
- Protect and offload initially, but start gentle range-of-motion as pain allows.
- Ice 15–20 minutes every few hours for the first 1–2 days.
- Compress with an elastic bandage and elevate to limit swelling.
- Over-the-counter anti-inflammatories (NSAIDs) are reasonable short-term unless contraindicated.
Sprain or fracture? The Ottawa Ankle Rules help clinicians decide: if you can't bear weight for four steps right after the injury, or there's tenderness over the bones at the ankle or the base of the fifth toe, an X-ray is usually warranted. When in doubt, get it looked at rather than guessing.
The Bottom Line
Good first aid is mostly subtraction: plain water instead of peroxide, cooling instead of butter, early movement instead of a week of couch rest. Keep a basic kit stocked (bandages, sterile gauze, antiseptic, elastic wrap, a thermometer), know your tetanus status, and remember the threshold for escalation — anything deep, dirty, extensive, or accompanied by loss of function deserves a professional look. Old advice can be charming; it can also be wrong.