Accidents And First Aid
( Originally Published 1917 )
What to Do When Some One is Hurt.-The two things to remember when some one is badly hurt are to keep cool and to send for the doctor. Often, however, before the doctor arrives, there are simple measures that may be taken to lessen the pain and perhaps prevent serious harm. Some of these simple first aids every one should know, so as to be able to do the right thing when the need arises. In bad accidents, prompt action of this kind may sometimes save a life.
Foreign Bodies in the Eye, Ear, Nose, and Throat.—One of the commonest of the lesser accidents is getting a sharp bit of dust or cinder into the eye. When this hap-pens, the eye should not be rubbed, for rubbing only makes matters worse. If the particle can be seen on the eyeball, it maybe removed with the corner of a clean, soft handkerchief. A speck on the lower lid often becomes visible, so that it may be removed, if the lid is pulled down with the finger. Some-times, if the eye is kept closed for a few minutes, the tears, which flow whenever the eye is hurt, will wash the speck out where it may be seen and removed. Blowing the nose may also help. Sometimes a particle on the upper lid may be removed by taking hold of the lashes of the upper lid, and pulling it down over the edge of the lower lid two or three times, while the patient looks downward. If this does not dislodge the speck, it must be looked for on the upper lid by taking hold of the eyelashes and rolling the eyelid back over some small object, such as the small end of a penholder. The speck may then often be seen clinging to the under side of the lid. (See Fig. 137.) If the object cannot be removed in this way, a doctor should be consulted, for a sharp particle may in time work in and do serious harm.
If anything gets into the ear, it is safest to send for the doctor at once, as an attempt to remove anything from the ear with pointed objects may be dangerous. In the case of a live insect in the ear, a few drops of castor oil or sweet oil may be dropped in; this will usually wash the insect out.
If anything sticks in a person's throat, nothing should be done until the doctor comes, unless the object can be seen on looking into the throat. If it can be seen and is not too firmly wedged in, it may be possible to remove the object. If the patient is trying to cough out the obstruction, it sometimes helps to slap him on the back while he bends his body forward. '
Nosebleed.—Nosebleed may be due to some slight injury, or, as often happens with children, it may come on without any injury at all. It is usually not serious. Slight nosebleed does not require any treatment, but if it continues, the patient should be put in a chair with his head hanging back and his collar loosened, and a cloth wrung out in cold water should be placed at the back of the neck. A plug of cotton inserted into the nostril affected will help to retard bleeding, and pinching the soft part of the nose is also effective in some cases.
Cuts and Wounds.—The principal danger in a wound is that it may become infected with bacteria. In very serious cases, there is danger from the loss of blood. In most wounds, however, bleeding is a good thing, because it tends to wash out dirt and germs.
Slight cuts and scratches should be washed free from dirt, then dried with clean gauze, and painted with tincture of iodine. More serious wounds should be dressed temporarily, until the doctor can attend to them, by covering them with surgeons' gauze fastened on with a bandage. A doctor should be consulted about even the slightest scratch if, after a few days, it is red, hot, or painful; and a deep wound, particularly if produced by a rusty nail or other dirty object, should always receive prompt medical attention. Any wound will heal without much pain or redness if there are no germs in it. Remember that germs get into a wound, not from the air, but from dirty things that touch it. A scratch or cut should never be touched with anything but sterilized surgeons' gauze, and above all should never be picked with the fingers. In connection with automobile accidents, it is well to remember that gasoline is a good disinfectant.
If the blood comes from a wound in jets or spurts, an artery is bleeding, and the result may be serious if the flow is not checked. Fortunately, at most parts of the body the arteries are deeply buried in the flesh. A severed artery calls for prompt action. Put firm pressure close to the bleeding part, between the wound and the heart. In case the wound is in the arm or the leg, the pressure is best applied by tying a knot in the center of a folded handkerchief, and laying this knot over the artery. Tie it loosely around the limb, but with a good knot. Place a stick under the bandage and twist it round and round until the bandage is tight enough to stop the bleeding (see Fig. 138).
Bruises and Sprains.—The pain and swelling of an ordinary bruise will be much less, if something cold is placed on the bruise at once to drive the blood away. Ice in a cloth may be used for this purpose, or simply a cloth wrung out in cold water.
If a joint has been sprained (which means that the ligaments that hold the bones together have been strained or torn), the same treatment with cold cloths is very useful, and should be kept up at intervals for twelve hours. In old and enfeebled patients, hot wet cloths are better. The injured part should be placed as high as possible, so as to keep the blood out of it. One should never walk with a sprained knee or ankle unless the doctor advises it, as pressure may do harm. Sprains are often very troublesome, and if a sprain is at all bad, the doctor should be sent for.
Broken Bones.—If a bone is broken, medical care is, of course, necessary. While waiting for the doctor, the only thing to do is to keep the broken limb in as comfortable a position as possible. Above all, do not let the limb bend at the place where the bone is broken, because that gets the splinters of bone out of place, and may drive them through the skin and lead to an infected wound. If you find it necessary to lift a broken limb, put one hand on each side of the break and lift with both hands at the same time.
Fainting.—Fainting, or growing dizzy and losing consciousness, is caused by a temporary failure of the circulation to send enough blood to the brain to keep it acting. People may faint from a great many causes, most of which, in the case of young people, do not indicate anything particularly serious. Fainting is often caused by the hot, stuffy air of a badly ventilated room. The two things to be done for a person who has fainted are to get him into a horizontal position so that the blood may go back to his head, and to cool off the skin, which tends to send the blood in-ward.
The person should, therefore, be placed in a current of air (outdoors, if possible) and laid on his back with his head flat, either on the ground or on a couch without a pillow. The clothing around the neck should be loosened.
ACCIDENTS AND FIRST AID 347
It often helps to sprinkle a little water over the face. Nothing should ever be poured down the throat of an unconscious person, except by a physician, as such an attempt by one who is unskilled may lead to choking.
Sunstroke and Heat Prostration.—A person who has become faint and dizzy from the direct effect of strong sunlight shining on the head, should be placed in a seated position in the shade. His clothing should be loosened, and cold water poured on his head, or his body rubbed with bits of ice. Cool drinks should be given, if possible.
Heat prostration due to excessive heat acting on the whole body, and not to the direct sun's rays, should be treated somewhat differently, on account of the fact that in such a case the blood vessels all over the surface of the body will be dilated. The patient should be laid flat on his back in a cool place, his clothing loosened, and his hands and feet rubbed to restore the circulation. The face and body should be bathed in warm water and warm drinks should be given.
Burning Clothing and the Treatment of Burns.—If the clothing catches fire, there is only one thing to do and it must be done quickly: smother the flame. Fire needs plenty of oxygen, and if a person whose clothing is on fire is quickly and closely wrapped in a coat, shawl, blanket, or rug, the fire will go out. It is important to remember to wrap the cloth from above down. If the wrapping is done from below, the flames may be driven up and inhaled into the lungs with very serious results.
If your clothing catches fire when you are alone, do not run for help, but lie down flat and roll over and over on the floor or on the ground, to smother the flames.
In the case of a slight burn which only reddens the skin without forming a blister, the pain will be lessened if the air is kept from the burned place. A paste of ordinary baking soda and water applied to the burn will do this, or carbolized vaseline or any grease, like lard, may be used instead. The burn should then be covered by tying a piece of cloth or bandage around it. If there is extensive blistering, the application of soda or vaseline may do harm; and severe burns should be treated like the open wounds discussed on page 344.
Frostbite.—If ears, nose, or fingers are frostbitten, the affected part should be rubbed with snow or very cold water until the blood has come back and the flesh begins to sting and burn. On no account should the person go into a warm room until this has been done, and until the frozen part has been gradually warmed by rubbing. Even after the circulation has come back, the patient should not be brought into a very warm place too soon.
Drowning and Suffocation.—When a person has been under water or in some suffocating gas for a long time, the breathing stops, and the patient becomes unconscious. If breathing can somehow be started again, recovery may follow. The starting of the breathing movements in a person who has ceased to make them for himself is called artificial respiration.
Artificial respiration should be begun by laying the patient face downward upon the ground. The feet should be raised to drain out any excess water from the air passages. Stretch the arms of the patient straight above his head and let them rest on the ground in that position. Turn his head a little to one side so that the air will not be impeded in entering the nose and mouth. Next stand astride of the patient, with your body directly over his hips and facing his head. Put your hands on each side of his back, below the shoulder blades. Your hands now rest upon the patient's lower ribs. The fingers are spread out, pointed toward the head and away from the spine.
Swing your body forward, keeping your arms straight and allowing your weight to rest on the patient's back; then swing back, taking all your weight off the patient. Do this fourteen to sixteen times per minute, to imitate the motions of breathing. When you put your weight on the patient, you press his chest together and force the air from the lungs; when you release the pressure, the chest springs back into place, and the lungs expand and draw air into them.
Recovery may be very slow; keep up your work for at least two hours. While this process is going on, the patient's clothing should be removed. If necessary, he should be dried with a towel and then covered with a blanket. This work must not interfere with the operator who is carrying out the artificial respiration. Compel bystanders to stand back. The patient needs every bit of air he can get.
When the patient begins to breathe,—but not before,—he should have his legs and arms rubbed toward the body. This should be done without removing the blanket. The patient will not breathe well all at once, and it will be necessary to help him at first by continuing the artificial respiration every little while. Of course, if breathing stops at any time, the artificial respiration must be renewed.
After the patient is breathing well, put him to bed. Sur-round him with hot water bottles and cover him up well. As soon as he can swallow, give some hot coffee. Open the windows wide, and allow him to sleep quietly.
Electric Shock.—Cases of electric shock (from contact with live wires, for example) and cases of gas poisoning require the same treatment as drowning—artificial respiration—since the stoppage of respiration is the chief danger to be feared.
The first thing to do in a case of electric shock, however, is to rescue the person from the action of the electric cur-rent, since the danger increases greatly with the length of exposure. If the current can be shut off, this is, of course, the simplest procedure. A live wire may be flipped off the patient with a dry board or stick, or it may be cut with an ax or hatchet with a dry wooden handle. Dry wood is essential, because water is a good conductor of electricity and wet wood or metal would transfer the current to the rescuer.
If the injured person is to be removed from the wire, the greatest care must be taken to avoid the discharge of the current from the wire or from the body of the victim to that of the rescuer. In order to guard against this, the hands should be covered with a rubber cloth or with several thicknesses of ordinary dry cloth; silk is a good non-conductor. If possible, the rescuer should stand on a dry board or a thick piece of dry paper, or even a dry coat. The separation of the wire from the patient should be made with one motion, because rocking to and fro on the wire will increase shock and burn.
Poisons.—If some poisonous drug has been taken, the first thing to do is usually to get it out of the body again as quickly as possible by causing vomiting. This may be done by running the finger down the throat, by drinking a large quantity of warm water, or by taking some substance which will cause vomiting, called an emetic. A teaspoonful of mustard or salt in a glass of lukewarm water will serve as an emetic. Promptness is more important than an exact dose. After the emetic has been taken, large quantities of warm water should be drunk to dilute the poison that re-mains.
In the case of strongly corrosive poisons, such as strong acids (sulphuric, hydrochloric, nitric) and strong alkalies (caustic soda, potash, and lime), an emetic should not be given, but something should be used which will neutralize the poison. Plaster from the ceiling, magnesia, baking powder, or even soap may be used for this purpose, with acid poisons; and vinegar, lemon juice, or orange juice, with alkalies. To dilute such poisons and soothe the tissues, there should then be given large quantities of oil, such as olive, salad, sardine, castor, or cod liver oil, or milk and eggs beaten up. Finally, stimulants should be given, such as strong tea or coffee, ammonia, or alcohol.
Carbolic acid, or phenol, acts in a different way from the strong mineral acids, and the antidotes used for them will not serve in the case of this poison. The effective antidote for carbolic acid is alcohol. It should be used as follows: for an, infant under one year of age, 1/2 ounce alcohol in 2–3 ounces of water; for a child from one to seven years, 1-2 ounces to 3–4 ounces of water; for a child from seven to sixteen years, 3–4 ounces of alcohol to 4–5 ounces of water; for a person over sixteen, 4 ounces of alcohol to 4 ounces of water. If alcohol is not available, whiskey, brandy, rum, gin, or hard cider may be substituted, undiluted or slightly diluted for infants.
Immediately after the dose of alcohol, a tablespoonful of mustard in 6–7 ounces of water should be given as an emetic; and the dose of alcohol, followed by the emetic, should be repeated three or four times, or even six or seven times if the poisoning has been severe. After this treatment, Glauber's or Epsom salts should be given (2 teaspoonfuls to 2 tablespoonfuls in 4–8 ounces of water, according to age) followed by milk, white of egg, or thick gruel, to soothe the mucous membranes.
For poisons that are irritant but not corrosive, such as tartar emetic, blue stone, Paris Green, lead, corrosive sublimate, and arsenic, an emetic should be given, followed by water and then by oils or milk and eggs, as above, and by stimulants.
For nerve poisons which produce sleep or nervous convulsions, such as opium, morphine, laudanum, paregoric, and soothing sirups, an emetic should be given promptly. If the patient is sleepy, every effort should be made to keep him awake by giving him strong coffee, shaking him, and slapping him with a wet towel. Artificial respiration may be necessary.
Ivy Poisoning.—Some people are very sensitive to ivy poisoning, while others may come in contact with the plants without suffering at all.
Ivy poison is in the form of tiny drops of oil, and if the first places affected are scratched, the infection may easily be carried to other parts of the body. One should, there-fore, avoid scratching. The itching parts may be soothed by a cloth moistened with alcohol, or washed off with a boracic acid solution, then dried gently and treated with carbolized vaseline. If the skin is washed thoroughly with soap and hot water after exposure to ivy poisoning, the danger from poisoning is often lessened.
Snake Bites and Insect Stings.—Most of the snakes found in the United States are harmless, but there are three—the rattlesnake, the copperhead, and the water moccasin—which are very poisonous. If a person is bitten by one of these snakes, a handkerchief should be tied between the bitten part and the heart, and twisted tight by means of a stick, so as to compress the blood vessels and prevent the poison from being carried to the rest of the body. Then as much as possible of the poison should be sucked out of the wound. This may be done with safety, as the poison will not injure the mouth if it is spit out at once, unless one has cuts or scratches in the mouth.
The stings of insects found in temperate climates rarely do any harm unless disease germs of some sort are carried with them. The pain of a bee sting may be relieved by applying some alkali, like soda or ammonia, and, to a considerable extent, by merely plastering a little wet mud on the place bitten.
QUESTIONS FOR DISCUSSION AND REVIEW
1. Why should every one try to keep calm after an accident? Why should a doctor be sent for at once?
2. What danger is there in allowing a foreign sub-stance to stay in the eye?
3. What is the best way to pick a particle of dust out of the eye, when it can be readily seen?
4. If anything lodges in the ear, is it safe to poke after it with a pin, hairpin, or other sharp-pointed instrument? Ex-plain.
5. What treatment may be given for nosebleed?
6. Why is it a good plan to cleanse and disinfect even the smallest scratch? What danger is there in scratches and "skinning" which does not exist in bruises?
7. In a Fourth of July accident, a boy's leg was badly torn by an explosion, and pieces of his stocking were carried into the wound. Was there danger of infection? Explain.
8. Give an example of an accident in which the use of a bandage would be necessary.
9. On a hike, a boy stepped into a hidden hole and turned his ankle. It began to swell at once. What would you have done for him? Should he have walked home, even if he could stand his weight on the ankle? Explain.
10. Find out what splints are. Why are they used in case of a broken bone?
11. If a person broke his leg when he was at some distance from medical aid, what would you do for his temporary relief? What means could you devise to carry him, without injuring the broken leg further?
12. What causes fainting? Under what conditions might you expect to have accidents of this kind? How would you revive a fainting person?
13. In case of fainting or accident, there is a tendency for crowds to gather. Why should this not be allowed?
14. What is fire? Why do things burn? What do we do when we smother a flame?
15. In wrapping a coat or rug around a person whose clothes are on fire, why should we begin at the top?
16. If your clothes were on fire, why should you not run for help?
17. Two boys had their ears frosted while skating. One of them rubbed snow on his ears and the other went into the house to thaw out at the stove. Which probably had the more painful time? Why?
18. What do we mean by drowning? In what way does drowning differ from suffocation by gas?
19. Explain in detail the method of artificial respiration. Illustrate with one of your fellow students.
20. Why do you repeat the process at the rate of sixteen motions per minute? How long would you continue the process before giving up hope?
21. Why should the patient be dried and covered with a blanket? Should this be done before the artificial respiration is started?
22. In what other accidents do we use artificial respiration?
23. What is a poison? What is meant by corrosive poisons? Irritant poisons? Nerve poisons? Explain what you would do for each and why.
24. Is ivy poisoning common? How should it be treated?
25. What danger is there in snake and insect bites? How are they treated?