Splinters are always a hot topic on first aid courses! Can we pull them out? Why? Why not? Who says?
BUT many schools have a policy that splinters must not be removed. So who is right?
A school policy stating that they will not pull out splinters over-rides the HSE position that splinters can be removed, and this is why the myth abounds that first aiders cannot pull out splinters .
Why do schools have this in their policy?
The most often cited reason is that we shouldn’t pull anything out of a wound in case it is ‘plugging’ a bleed, but in the case of a small splinter this is highly unlikely. Arteries are buried deep beneath the skin’s surface – far beyond the reach of a small splinter. Even though veins are nearer the surface (and can lead to significant bleeds) a splinter would not cause more than a drop of blood to be lost even if it was a very long splinter!
Another reason sometimes given is that first aiders cannot ‘dig’ to remove a splinter – and the HSE agree. An embedded splinter with no part exposed to be gripped by tweezers should be left to a parent or guardian to be removed, but this doesn’t stop us removing those which have an exposed section with tweezers.
So why SHOULD we pull out splinters?
On the flip-side, what happens if you leave a splinter in a child’s skin until home-time? A splinter is usually from something which may well be dirty, for example from a fence, the school playground, field or on a forest school activity which could then lead to infection. In addition, it can be jolly tender if left for a period of time!
But we cover it with a plaster – surely this will stop the infection?
Covering a splinter with a plaster will merely encourage the infectious cells to reproduce – the infected material is already inside the wound (so a plaster won’t protect from it) and the claggy, moist environment created with a plaster is perfect for the growth and spread of infection.
If the splinter has reached a capillary (blood vessel) there is now the potential for a infection through the blood – SEPSIS (you may have heard this referred to in the past as blood poisoning or septicaemia).
SEPSIS kills 1,000 people in the UK EVERY WEEK!
– more than the top three cancers combined. Leaving the splinter there rather than removing it and flushing the wound out is increasing the chance of sepsis – cuts and wounds are the 4th top cause of sepsis. The longer the splinter remains in the skin, the higher the risk.
So, what should we do?
My suggestion would be to amend the school policy to something similar to:
• ‘we will remove a splinter if the child wishes us to do so, and
• there is enough of the splinter exposed to enable it to be gripped by tweezers
In the event that splinter is firmly embedded and cannot be gripped by tweezers or the child does not wish us to pull it out we will telephone the parent to inform them that their child has a splinter and request they attend school to remove it.’
Having a stark policy of ‘we do not remove splinters’ cuts off any permission that may be given over the telephone or actions you can take in extenuating circumstances and may be detrimental to the health of the child.
What can a parent do that we can’t?
The parent can break the skin to remove the splinter, or administer antiseptic cream (which a school cannot do) and cover with a plaster which will help to draw the splinter out. If the splinter is still there at the end of the school day, they could soak the affected area of skin which will help to soften it to squeeze the splinter out.
If you would like more help or advice please do contact us at info@winterburytraining.co.uk.
You can find out more about sepsis from Sepsis Research
(www.sepsisresearch.org.uk) or the Sepsis Trust
(www.sepsistrust.org).