What To Do In Accidents - First Aid
( Originally Published 1938 )
In accident prompt "first aid" for a slight injury may often prevent a serious one, or save life.
First aid is not intended to take the place of a physician's services. Whenever there is a serious injury, a doctor should always be summoned. There are times when a few minutes' delay may mean the loss of a life.
To give first aid, first examine to decide what must be done, and to see if the injuries are serious. If conscious, this is easily ascertained. If unconscious, the nature of the accident will decide the seriousness. If in no danger, a more careful examination should be made as to location and nature of the injury. Make sure that no bones have been broken before moving. Often a glance will show. Undo the clothing to determine the amount and source of bleeding.
FIRST AID UNCONSCIOSNESS
If UNCONSCIOUS, note the color of face, and condition of skin, manner of breathing, nature of pulse and pupils. If bleeding is rapid stop it before making further examination. If not sufficient to place in immediate danger, proceed along these lines :
Make comfortable until a doctor arrives. Give messenger a complete description of the nature and extent of the injury. If in a dangerous place or exposed to severe weather, move, taking all possible precautions to avoid increasing the injury, especially if there are broken bones.
Loosen tight collars or belts. Keep lying down or resting comfortably in a sitting position. Lower the head and let lie horizontally for pale face. If the face is flushed, raise head on a folded coat. If vomiting occurs, turn the head to one side. Do not try to force unconscious persons to drink water or stimulants they cannot swallow.
In removing clothing, take off from the sound side first, and avoid the danger of disturbing a fracture. Cut clothing up the seams when necessary to examine an injured or crushed limb. Check all hemorrhages before attending to anything else. Keep warm (of great importance) and allow sufficient air. Keep the crowd back.
The following supplies should be included in the camp, home and first aid kit:
Aromatic spirits of ammonia, 2 oz. with a rubber cork. Antiseptic gauze, 4 small packages; absorbent cotton, 1/2 lb. Roller bandages, 8 (4 large and 4 small).
Iodine swabs (12) and Carbolized vaseline, 1 jar.
Pins, ordinary and safety; scissors, blunt and curved. Olive oil, 4 oz., lime water, 8 oz., and Mustard, 4 oz. Glass and spoon and Camel's hair brushes, (2).
Shock may be due to severe bleeding, abdominal injuries, fractures, burns and scalds, excessive cold, gun shot wounds, severe cuts and bruises.
FIRST AID - SOCK
Those suffering from severe shock lie in a drowsy condition but not totally unconscious. Limbs are limp and skin pale and cold; temperature below normal and barely noticeable; breathing shallow; often severe thirst, especially if caused by bleeding; usually accompanied by vomiting and hiccoughs. Shock is usually recoverable but in severe cases, death may result, as in extensive superficial burns of children or the aged. Shock may not be severe enough as to include all the symptoms mentioned. Unless slight, send for a doctor. Heat, position and stimulants are the first aid remedies.
Heat is the most valuable. Electric pads, hot water bags, and glass bottles are good. Hot bricks and flat irons are also useful but use so as to prevent burns. Test and cover with protective layers of cloth or paper. In applying, place between legs, at outer sides and between body and arms. A hot water bag over the heart acts as a special stimulant. Loss of body heat always increases shock. Never remove more clothing than is necessary. Rub the limbs toward the body. Place on back with head low so that the blood will run toward brain. Raise the feet. Never raise head. The best first aid stimulant is aromatic spirits of ammonia, a half teaspoonful in one-half glass of water, preferably hot. Other good stimulants are hot black coffee, hot tea, or hot water. Repeat in half an hour. Whiskey and brandy are injurious. Never give an unconscious person stimulant by the mouth. Aromatic spirits of ammonia, ordinary aqua-ammonia or smelling salts may be used. Strong ammonia should be diluted with water. An inhaled stimulant is particularly useful for the unconscious, because they are unable to swallow.
A severely shocked person should not be moved until recovered to some extent. First aid should be given before moving. Clothing should be loosened at neck, chest or abdomen during transportation. Do not remove clothing, as it increases shock, All serious cases should be carried on stretchers, which can be made with two or three coats and a pair of poles. Turn coat sleeves inside out and place on the ground with the lower edges touching. Pass the poles through the sleeves on each side and button, with the buttoned side turned down.
CARRYING A PERSON WITH POSSIBLE FRACTURES
In carrying the patient up hill, follow these rules: Feet first: After severe bleeding, fracture of lower limbs, fainting, shock, or if face is very pale. Head first: In cases of apoplexy, sunstroke, fracture of the skull, or if face is flushed. Keep stretcher as level as possible.
If able to sit up and steady himself by placing his arms around the bearers' necks, carry in the "lady's chair". Each bearer should grasp his left wrist in his right and the other bearer's right wrist in his left hand, knuckles uppermost. Then stoop and place the chair under person who steadies himself by placing his arms around their necks.
TO PREVENT INFECTION OF WOUNDS
Severe wounds may cause considerable damage to the muscles, bones, blood vessels, or internal organs, with possibility of severe inflammation. Danger of infection exists, therefore all wounds must be handled carefully. Even a pin scratch has been known to result in death.
Heat kills bacteria. All dressings, instruments used in dressings, should be first heated, by boiling. If wound is deep, or of a considerable surface, send for a doctor. Look out for shock and treat. Do not touch the wound. Exposure to the air is much safer than application of anything which is not surgically clean. Apply a. sterile dressing at. once, and bandage firmly in place.
Water, unless boiled is apt to contain germs. Too strong a solution of mercury or carbolic acid will destroy the body cells which dispose of the pus germs before they kill the latter and should never be used. Hydrogen peroxide is not strong enough. Iodine is of value, if applied in a 3% solution immediately and not later than two hours after injury is received.
Never pour it into a wound. Use a camel's hair brush or a tuft of cotton on a stick. Never suck a. wound, as dangerous pus germs are always in the mouth. Squeeze well at the sides. Adhesive plaster is unsafe. With much bleeding put on a layer of absorbent cotton over the compress (pad) before bandaging. A first aid packet should always be used in preference to any-thing else. The next best is antiseptic gauze. If at all serious call a doctor. Always examine the article which inflicted the injury to determine if the end may have broken off in the wound.
While waiting for the doctor, twist a small amount of cotton around the end of a toothpick, dip in iodine and push down to the bottom of the wound and work the iodine thoroughly into it. Paint surface and apply a sterile dressing.
FIRST AID - HEMORRAGE
In bleeding or hemorrhage the blood is carried through the body by three blood vessels, which are divided into (1) arteries, (2) capillaries, (3) veins.
The most dangerous form of bleeding is when an artery is cut and red blood spurts. Unless checked promptly patient will bleed to death. This can be stopped temporarily by pressure on the artery between the cut and the heart, until a tourniquet can be improvised. In all cases of severe bleeding, secure a doctor at once, but do not delay treatment.
In a cut artery, remember the flow of blood is away from the heart and that it is necessary to apply pressure between the cut and the heart. PRESS ON THE ARTERY ON THE NEAR OR HEART SIDE AS CLOSE TO THE BLEEDING POINT as possible. In pressing it is necessary to select a point where a bone will give a hard surface to press against.
When a vein is cut there is a continuous flow instead of in spurts. Venous blood is a dark bluish red color easily distinguishable from the bright red arterial blood.
In wounds and severe bleeding, first check the bleeding. Lay patient down, raise wounded part and keep the head low so that brain will get as much blood as possible. Prevent violent movements. When bleeding has ceased, the injured person should remain quiet. Give plenty of fresh air, cover warmly and put hot water bottles around. Stimulants are undesirable. Do not give them until bleeding is checked.
In a state of collapse from loss of blood, death may often be prevented by forcing the blood into the body from the limbs, by raising feet and bandaging legs from toes to body and arms from tips of fingers to arm pits with roller bandages.
FIRST AID - BURNS
For slight burns, exclude air by thin paste of water and baking soda, starch or flour. Ordinary vaseline or carbolized vaseline, olive oil, fresh lard or cream may be used. Smear over burn and on cloth to cover it. Hold dressing in place with light bandage. In second and third degree burns, a doctor should always be called, as there is severe shock and pain. In removing the clothing care should be taken as the clothing is apt to stick to injured surfaces. Cut it away. The portions which remain fast may be softened later, with oil or warm water and carefully removed.
ACID TYPE BURNS
Acid burns should be washed under flowing water and neutralized with an alkali, or solution of baking soda or soap suds. Lime water is excellent. For acid in the eye, wash out as quickly as possible with water and follow with lime water or bicarbonate of soda. For carbolic acid burns, pour on alcohol freely. Wash off alkali burns as quickly as possible under running water. Neutralize with vinegar, lemon juice or cider. Eye burns should be washed with a weak solution of vinegar and water or olive oil. Treat like other burns. In severe burns always see doctor, particularly when it is an eye case.
FIRST AID ELECTRIC SHOCK
Great caution should be observed in approaching one who has received an electric shock and is still in contact with a live wire. Do not touch with bare hands. Rubber gloves are the best protection. Take hold of the coat or skirt with hands inside of sleeves of a coat and remove from the wire with a quick jerk, use rubber overshoes or rubber raincoat to insulate the hands. If the ground is wet, stand on a dry board or news-papers. If the wire is lying on the victim, brush away with a dry stick. Never use a wet stick or anything made of metal. Don't approach closer than 18 inches. When clear of wire start the prone pressure method of resuscitation at once. Delay may mean death. Electrical burns require a doctor. In the meantime use the first aid methods for burns.
FIRST AID HEAT EXHAUSTION
In heat exhaustion send for a doctor. Remove patient to a cool place and lay down in a comfortable position with clothing loosened. Do not apply cold externally, give small quantities of cold water. Stimulants such as tea, coffee or aromatic spirits of ammonia should be given. Keep up bodily warmth.
FIRST AID - FROSTBIT
For frostbite and freezing, rub frozen part with snow or cold water. Then use warm water gradually. Never apply heat immediately. It may result in mortification of the frozen part. In freezing, a condition similar to a local frostbite prevails over the greater part of the body. To treat take into a cold room, rub limbs toward body with cloths wet in cool water. Increase temperature of room gradually. Cloths should be wet in warmer and warmer water. As soon as conscious and can swallow give aromatic spirits of ammonia in water, or tea or coffee. It is dangerous to place before open fire or in hot bath until patient begins to recover. Increased pulse, better breathing and more warmth and color in skin show recovery.
TREATMENT FOR - BRUISES
Often a bruise is the least serious part of an injury. Make sure that there is no other injury, as broken bones. Bruises of the chest and abdomen often accompany internal injuries. These severe bruises require the immediate attention of a doctor. If shock is severe after a bruise of the abdomen or chest there is serious danger of internal injuries.
FIRST AID - BLACK EYE
A handkerchief wrung out in ice water or an icebag should be applied immediately in black eyes. The ice water constantly renewed, thus combining the effects of both cold and moisture. Keep up for an hour. It will prevent discoloration. If the flesh has become black, applications of hot water for half an hour, three times a day, are good. If there is pain, see a physician to make sure that there is no eye injury.
FIRST AID - BLISTERS
Wash blisters thoroughly in hot water, pass a clean needle through a flame and prick at the side, gently pressing out the fluid until flat.
FIRST AID FOR STRAINS
For strains use rest, and gentle rubbing with alcohol and water, equal parts, arnica, liniment or witch hazel. The rubbing should be vigorous. Later hot water bags will often give relief. When the pain is reduced, gentle movements should be practiced. Always call a doctor when severe or in doubt. Begin treatment at once. Rest in order not to do more damage by rubbing the injured joint surfaces together. Less blood will come to the part if elevated. Application of heat or cold will contract the blood vessels and limit the escape of blood. Cloths wrung out in very hot or very cold water should be applied. Place injured part under a cold or hot water tap. Use hot instead of cold water for children, or old people or when there is shock. Either heat or cold should be applied long enough to get the full benefit, that is 24 to 48 hours. A severe sprain, especially of the ankle, requires a physician. Under X-Ray they often prove to be fractures.
Do not try to put a dislocated joint back if a doctor can be reached. Cover with cloths wrung out in very hot or cold water. Apply pad under armpit and put arm in wide sling. Dislocation of the second joint of the thumb requires a doctor. Others are less difficult. A dislocated finger should be grasped firmly on the hand side. The end of the finger can then be pulled straight out away from hand and bone will usually slip into place.
FIRST AID - EYE AND EAR INJURIES
If cinder or any other object gets in the eye, avoid rubbing as it drives the object more deeply into the eye or lid and makes it harder to remove. First close the eye so that tears will accumulate and the object will be washed out or loosened and easy to remove. If this fails, turn up lid carefully over a match or toothpick and brush across it carefully with the corner of a clean handkerchief, or absorbent cotton. If this fails, see a doctor.
If a small object becomes wedged in ear, care must be taken not to push it in farther by awkward attempts to remove. Tweezers may succeed, otherwise see a doctor.
Children often get peas or beans in their noses. Try to dislodge by having them blow through the nose with the other nostril closed. If this fails, call a doctor before any swelling occurs, which will make removal difficult.
FIRST RESPONSE - POISON INGESTION
In carbolic acid, creosote, lysol and sulpho naphthol cases, give epsom salts, castor and olive oil, three or four eggs or alcohol which neutralizes it.
In corrosive sublimate (mercury, bichloride) give freely of whites of egg, beaten up in water, and then empty stomach and repeat the eggs.
For iodine cases give starch and water, bread and water, empty stomach and repeat milk, white of egg and stimulants.
Lye, caustic potash, caustic soda and ammonia cases, give olive oil followed by vinegar and lemon juice.
Ptomaine cases: Any emetic such as mustard or salt water. When stomach is empty large dose of castor oil and strong coffee. Keep warm and avoid food until recovery.
Phosphorus, matches, rat poison: Avoid oils, give emetics, clean out stomach, then give magnesia or chalk, and mucilaginous drinks.
Toadstools: Give emetics, castor oil, cathartics, stimulants, external heat.
Wood Alcohol: Use emetics and apply heat over heart and to hands and feet. Give strong coffee, inhale ammonia, and call a doctor.
Lead, paints, etc.: Empty stomach; give tablespoonful Epsom or Glauber salts in glass of water, raw white of egg and castor oil.
Arsenic, Paris Green :óGive emetics at once ; then 4 ounces hydrated oxide of iron and magnesia at one dose. Raw eggs, beaten up in sweet milk, freely followed by sweet oil. Keep extremities warm and use stimulants. Magnesia may be used.