The first aid that did nothing

Half of what used to be taught as first aid has been removed from the courses, and the removals are more interesting than the additions.

Tilting the head back during a nosebleed was taught for decades. It redirects the blood into the throat, which is worse in every respect and feels like action. Butter on a burn was standard advice; it holds the heat in. Rubbing a frostbitten hand was recommended; it damages the tissue being rubbed. Each of these persisted because it had the shape of help: it required a trained person to do something visible, immediately, in front of a frightened bystander.

What replaced them is usually simpler and harder to perform. Cool a burn under running water for twenty minutes, which is far longer than anyone instinctively continues. Lean forward and pinch the soft part of the nose for ten minutes without checking. Keep a frostbitten limb still and get to warmth. The difficulty in each case is not knowledge but duration: the correct action is boring, and stopping early feels like a judgement call rather than a mistake.

First-aid instructors have adapted by teaching the clock rather than the technique. A twenty-minute burn is taught with a timer, out loud, because the number is the active ingredient and the water is not.

There is a general point about advice here. An instruction that is easy to remember and satisfying to perform will spread whether or not it works, and an instruction that is correct but tedious needs scaffolding to survive contact with a real emergency. Designing the scaffolding is part of giving the advice.