Disinfectant spray in first aid kit for cycling and hiking?

Question

On a recent bike trip I slipped on a gravel road and got abrasion around the knee. The wound was dirty with gravel dust and I instinctively cleaned it with water from my drinking bottle. Then I went to a pharmacy and got it disinfected (Octenisept, wound disinfectant) and then covered with a sterile patch. A few days later I want to my physician and she did the same thing again.

There are a lot of affordable first aid kits available in outdoor shops and I want to get one for the next trip. All of them contain various bandages and compresses. Disinfectant spray seems to be missing, though. My experience now is that the essentials for abrasions are spray and some bandage to keep out the dirt.

While trying to research this, I found a help page of the German Red Cross stating that it is forbidden to (a) touch, (b) clean, (c) apply powder, creams, sprays, disinfectants and (d) remove foreign matter. Exceptions are just thermal and acid burns as well as rabis bite wounds. Any wound must be treated by a doctor as soon as possible.

If I apply that to my case, I would have taken a bandage from my (to be purchased) first aid kit and wrap it around the wound with all the dust still in it. Then I would have to go to the ER of the next hospital.

In contrast, the manufacturer of the spray writes that it intended for small wounds like cuts and abrasions that happen during sports. And it gives instructions for usage, so this implies that a layperson should apply it to wounds.

Perhaps it is also a legal issue? The Red Cross addresses the general public which tries to help but sometimes overdoes it. So they just state that one should be very conservative when helping. Say one applies the wrong kind of disinfectant spray and it makes it just worse. In Germany you are not liable if you just try to help (to some extent). Perhaps this waiver stops right where you apply things and not just a sterile bandage? So even though in this particular situation it would be the right thing, a layperson would not know and therefore the general advice is conservative?

Please excuse my medical naivity, but isn't applying water and then desinfectant spray better than just wrapping up the dirt?

Answer 1

In Germany, first-aiders may not apply medication:

Medication in general mustn't be applied by first-aiders. This also encompasses cases in which a customer in a pharmacy suffers from an asthma attack. One may only hand the patient their asthma spray, but they need to apply it themselves.

^{Medikamente verabreichen dürfen Ersthelfer prinzipiell nicht. Das gilt auch für Fälle, in denen etwa ein Kunde in der Apotheke einen Asthma- oder Angina-pecoris-Anfall erleidet. Dem Betroffenen darf lediglich sein Asthma- beziehungsweise Nitro-Spray gereicht werden, anwenden muss es der Patient selbst.}

^{Source: Pharmazeutische Zeitung}

I think this is why the DRK page explicitly states that it is forbidden to (a) touch, (b) clean, (c) apply powder, creams, sprays, disinfectants and (d) remove foreign matter.

In my first aid training (which isn't as fresh as it should be), it was pointed out that giving patients one's own medication is an even bigger no-go, and disinfectants were explicitly included in that ruling. The workaround solution is to forget the octenisept® next to them and let them have it this way.

Even in the DRK Sanitätsdienst (basically volunteers with a broader first-aid training that will help the emergency services in large festivals), a protocol needs to be filled out when disinfecting wounds (formally, not many do).

The above is all about giving medicine to strangers, no one can prevent you from doing all that to yourself. The DRK page is a guide for first-aiders, hence it "forbids" applying medication to others...

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For wounds, applying water might not be the best idea. Usually the wound cleans itself through bleeding if dirt gets deep into the wound (and if it's only on top, it doesn't matter), but the water will delay the clotting process. For cleaning a rash, get a sterile compression, apply disinfectant and put it on top of the rash, while applying a little pressure. This way, the dirt will stick in the compression and the wound cleaned.