In good times or bad, families may face any number of events where trauma causes injuries. In the United States alone, there are over 37 million emergency department visits annually due to injuries. In austere settings, many of these become infected. Failure to act can lead to headaches (and heartaches) for the family caregiver, especially off the grid.
What happens if we’re thrown back to a bygone era where modern medicine is not an option? The bad news: Expect civil war-era statistics with regards to major abdominal and chest trauma outcomes. The good news: We’ll still be ahead of our ancestors because of knowledge of antiseptic techniques.
The word antiseptic comes from the greek words “anti” (against) and “septikos” (putrid or rotten). Antiseptics are substances with antimicrobial properties applied to living tissue to reduce the possibility of infection.
Antiseptics are not the same as disinfectants
Antiseptics are different from disinfectants, which destroy germs found on non-living objects. Antiseptics are, also, not antibiotics. Antibiotics are meant to destroy bacteria within the body. Antibiotics are most commonly ingested by or injected into a patient, something you don’t want to do with either disinfectants or antiseptics. All of these, by the way, are important supplies for the survival medic.
COMMERCIAL ANTISEPTICS
Let’s discuss the most popular types on the market that might be candidates for your survival medical kit.
Iodophors: Iodophors like Betadine contain iodine, a substance that can also be used to purify water, but is combined with a solubilizing agent, povidone, which makes it, unlike pure iodine, relatively nonirritating and nontoxic to living tissue.
Iodophors work against a broad array of microorganisms and don’t need to be heavily diluted. I’ll admit that I do dilute Betadine if I use it on open wounds for regular dressing changes. Iodophors are effective in killing microbes within just a few minutes.
Chlorhexidine Gluconate: This substance, better known by its brand name “Hibiclens”, is helpful against many types of germs, although it’s not very effective against fungal infections. It’s relatively long-lasting, however, compared to some other antiseptics. For this reason, Hibiclens is popular as a way to prepare areas for surgery and for healthcare providers to scrub their hands before patient encounters.
Alcohol: Ethyl Alcohol (also called ethanol) is another tried and true antiseptic product. It, along with isopropyl alcohol, kills many different types of microbes and is fact acting and inexpensive. The problem is that alcohol has a drying effect on skin, the oral cavity, and vagina. It has a tendency to inhibit the development of new cells, so use it for an initial wound cleaning but not for regular care.
Benzalkonium Chloride: BZK is a mild antiseptic and is easily tolerated by most people. One of the most popular first aid wipes or sprays, some say that it has a special effect against the rabies virus, but there’s little hard data supporting this claim.
Hydrogen Peroxide: Hydrogen peroxide is used to clean wounds and reacts with blood to form an impressive foam. This is because blood and most cells contain an enzyme called “catalase.” Catalase reacts with hydrogen peroxide, converting it into oxygen and water. This effect makes it popular for household first aid in common mishaps like abrasions, but not a great candidate for regular dressing changes due to its drying effect on new cells. It can be used as a mouth rinse in the oral cavity, however, making it a candidate for a survival dental kit.
PCMX (Parachlorometaxylenol or chloro-xylenol for short): Available in more brand names than you can count, this substance is effective against most germs. It’s less potent, though, than chlorhexidine and iodophors, although the antiseptic effect lasts longer. PCMX can be irritating, so don’t use it on mucous membranes like the oral cavity and vagina.
Bleach: Bleach can be found as either a sodium hypochlorite (Clorox) solution or can be improvised with calcium hypochlorite granules, also known as “Pool Shock”. Used more as a disinfectant than an antiseptic, bleach in very dilute solutions (0.5% or less) can make Dakin’s solution, a time-honored method to clean wounds.
Silver compounds: Although not used for surgical procedures, topical silver solutions are known to be effective against various types of wounds. Indeed, before there were antibiotics, silver compounds were applied to skin lesions.
I’ll bet you know of more products that have served as time-honored antiseptics for your family sick room. Armed with these items, your chances of succeeding when everything else fails go up exponentially.
Next time, we’ll discuss plant-based and other natural substances that have antiseptic actions. You’ll need to know these for when you run out of commercial products if (when?) the you-know-what hits the fan.
Joe Alton MD
Dr. Joe Alton
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