Using Ice for First Aid

Over the past few years, as changes continue to be brought about through the programs offered by the Red Cross and Lifesaving Society, people continue to be confused with the use of Ice in first aid. the use of ice can be beneficial in a number of first aid scenario’s, however, it if is used in the wrong scenario it can do more harm than good. This post will hopefully clear up some of the confusion with the use of ice during a first aid emergency.

For decades first aider’s have been using ice to treat sprains, strains and other bruises. When applying ice to a sprain, strain or bruise you reduce the blood flow to the area, which in turn reduces the swelling and limits the bruising and recovery time for the injury. I definitely promote the use of cold for these scenario’s. However, prior to applying ice it is important for the rescuer to first immobilize or limit the use of the area affected by the bruise, sprain or strain. Without limiting the movement of the area ice will serve a limited purpose if the victim continues to move the injured area and cause further injury.

Many first aid and CPR scenario’s have acronym’s associated with the rescue. The acronym “RICE” is a popular acronym for treating sprains, strains and bruises. The letter “R” is for rest, the letter “I” is for ice and immobilize, the letter “C” is for compression and the letter “E” is for elevate.  To elevate an injury a rescuer would help the victim move into a position or move the injured area so that is above the heart. I will not go into detail on how to apply first aid to a bruise, sprain or strain, however, I want to focus on rescuers removing the “E” from this rescue. Unfortunately, removing the “E” would probably ruin the acronym. Elevating the affected area has the potential to cause more injury and the cost / benefit of elevating makes it not worth attempting. When a victim has a bruise, strain or sprain it can be very painful to move the area and other injuries associated with the major injury can make it unbearable. Imagine an individual with a bruised elbow

, who also has a swelling rota-tor cuff (think shoulder injury),  is now being told to elevate the arm to reduce the swelling on the elbow. Attempting to elevate the shoulder will likely cause unbearable pain in the shoulder and possible cause further injury to the shoulder. Furthermore, the benefits to elevating the elbow is very limited. In other words, it is not worth elevating the injury.

Applying cold to a bleeding wound can be beneficial to the patient. Cooling the wound can reduce the blood flow to the area and promote clotting. However, it is important for victims to place cooling the wound near the bottom of the priority list. The main focus for a bleeding wound is to apply pressure and wrap the area in sterile gauze, and abdominal pad. The word “RED” is a common acronym used for treating bleed wounds. However, just like the acronym for sprains, strains and bruises, candidates should not use this acronym. The “R” is for rest and reassure, the “E” is for elevate and the “D” is for direct pressure. Rescuers should help the victim rest and apply direct pressure, however, elevating the wound is no longer part of the procedures for treatment. Elevating the wound, as mentioned previously, can aggravate the injuries surrounding the area and for bleeding wounds, make it very difficult for the rescuer to apply pressure. Imagine being a rescuer and having to hold a victims wrist in the air with both hands and apply pressure. After a few minutes, the little pressure that you can apply to the wrist will have you exhausted. Applying pressure is one of the most important procedures for the rescuer to do and it is compromised by the need to elevate. This is why elevating the wound is not part of the procedures for rescue any more. However, once the victims wound is wrapped properly with sufficient pressure the use of ice can be beneficial.

With continued changes to the first aid program by the Red Cross, Lifesaving Society and Heart and Stroke Foundation, more focus has been placed on treating for anaphylaxis and using Epipen’s and Twin-jets. However, through years of re-certification I have noticed a significant number of rescuers applying ice to the area which the epinephrine had been injected. Applying ice to the area is counter-productive and will only reduce the circulation of the epinephrine. Do not apply ice to the injected area!

To learn how to treat all of the mentioned injures and first aid situations take a standard first aid class or emergency first aid course. These courses focus on teaching candidates how to treat patients with these injuries. Candidates will receive hands-on experience from trained first aid instructors. The material posted in this blog on using ice for first aid is for information purposes only. Learn all the skills by taking a Red Cross course. If you have any questions or concerns or if you would like to register for a standard first aid or emergency first aid course please call at 778-709-9180 or email at .

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