Although most of what has been said in pre-previous articles of this series can be applied to the nursing of children, there are many special points which require careful attention when the patient is a child.
The first thing to be done when one of the children falls ill is to procure the best room in the house in which to nurse him, if the illness is at all likely to be serious or prolonged. A ground-floor bedroom should never be chosen for a child, and low ceilings and insufficient ventilation are even more undesirable for child patients than for adults. The child must have fresh air in large doses, especially when ill.
During the acute stage of the illness two beds will be required in the room, one for the patient and one for the nurse, or mother, in attendance. If the child is quite young, the ordinary nursery cot can be used. In the case of older children, a narrow hospital or nursery bed is best for the purpose. Early attention to every case of illness in the nursery will go far to prevent serious ailments, and there is a good deal of truth in the old saying that to lose an hour in the treatment of an ailing child is as bad as to lose a day in the treatment of a man. A child very quickly succumbs to illness. Bright and well, fit and alert at ten in the morning, he may have a high temperature at four in the afternoon. Indeed, the first sign that a child is going to be ill is often that he will suddenly turn from his food in the midst of an apparently good meal, and refuse to eat another bite. Unnecessary anxiety, however, need not be harboured by the conscientious mother, as children's temperatures rise for very little cause, and if they succumb quickly to illness, they get better in the same rapid fashion.
When a child complains of pain, it is often exceedingly difficult to find out its exact locality. A baby of two or three years will say the pain is in his head, his stomach, or his arm when in reality it may be located in the ear. Lassitude, sickness, or pain are signs of illness in children which ought not to be neglected. The best thing is to take the temperature, and if this is raised above the normal (98.4 degrees), the child should be sent to bed, and the doctor summoned.
Children's summer ailments which the amateur nurse may have to undertake can be divided into two groups :
Summer chills, colds, and catarrhs may be contracted as a result of unexpected showers of rain wetting children when they are in thin clothing, which they cannot change until after they are thoroughly chilled.
Again, an afternoon's paddling, prolonged into the colder atmosphere of the evening until the child's feet are blue with cold, is responsible for many a summer chill in the nursery.
The weather in England is exceedingly uncertain, even at the hottest time of year, and unless mothers are very careful to change children into warmer underclothing on cold days, they are liable to catch a chill which may settle on the throat or lungs.
Yet another cause of colds at this season is brought about by over-exercising, when the children become hot and perspire, inducing chill from contact of the damp clothing against the skin.
On crowded beaches the germs of catarrh have an opportunity of travelling from an infected child to a playfellow whose vitality is diminished by chill.
Another cause of cold at this season is getting the feet wet by running about or sitting on wet or damp grass.
Now supposing a child has contracted a cold at this season, what is the best thing to do ? If he is acutely ill and has a high temperature, he ought to be put to bed, as many of such summer chills are complicated with bronchitis, which pulls the general health down to an alarming degree. Two or three days at the beginning would prevent such complication. See, in the first place, that the room is kept ventilated, and well supplied with fresh air. Put the child on light milk diet, and give a gentle purgative at the beginning of the illness. Cascara or syrup of figs is best for this purpose.
The next plan is to let him breathe medicated antiseptic air. This can be managed by giving inhalations of medicated steam. Fill a jug with boiling water, and add half a teaspoonful of Friar's balsam. Place a folded towel round the mouth of the jug, in order that the steam does not escape too freely, and let the patient inhale the medicated steam. Do this for about ten minutes thrice daily, and the child will quite enjoy the process once he has discovered that the steam soothes, and does not irritate his throat. As children dislike anything biting or irritating, it is best not to use eucalyptus oil for them, although it is excellent for adults.
If any symptoms of bronchitis appear, such as frequent coughing and rise of temperature, the air of the room ought to be moistened by the steam from a bronchitis kettle. The kettle of boiling water should be placed on a spirit lamp or on the fire, and a little Friar's balsam may be added to it. A good substitute for a steam kettle can be made by wringing a large piece of flannel out of a basin of hot water, and hanging it on a clothes-line in front of the fire. A few drops of eucalyptus oil may be sprinkled on this. No internal medicines should be given to a child, except a simple purgative, unless they are ordered by the doctor. He will probably prescribe a " feverish mixture " for the child's temperature. A linseed poultice is a most useful domestic remedy in children's chest ailments. The food must be fluid. Liquid arrowroot, liquid custards, and simple milk, with occasional beef-tea and broth, will be found most suitable sick-room diet for the child. Remember that a glass of milk is a meal, and that a child should not be allowed to have sips of milk to relieve thirst. The milk should be given perhaps a glassful at a time, and the child told to sip it slowly. Thirst can be allayed by home-made lemonade, barley-water, or albumen-water, the making of which was described in the article on "Nursing in Hot Weather " (see page 2299).
Digestive troubles are a frequent cause of illness amongst children, and they require careful nursing. The chief sources of sickness at this season are indigestible and unwholesome food. Sour fruit, for example, will bring on an attack of sickness and diarrhoea in children, whilst tainted food is responsible for a good many cases of mild poisoning. Meat, fish, and rabbit decompose very quickly in summer, and children should never be permitted to have any food that is not absolutely fresh and sweet. Even milk that is sour will bring on sickness, whilst bad fruit should never be allowed on the table.
The first thing in treating sickness and diarrhoea is to give the child a smart purgative - castor-oil or magnesia. If, however, the child complains of severe pain, with constipation and great tenderness if the abdomen is touched, no purgative should be given. Summon a doctor at once, as these symptoms are suggestive of intestinal obstruction. The most important thing for the amateur nurse to attend to is to keep the child in bed for a day or two, even if the attack is what mothers call a simple liver attack, and the child seems better in a day or two.
Such ailments bring down a child's vitality enormously, and no medicine or " mixture " will do real good unless it is accompanied by rest of the body. Another point is to wrap a flannel binder round the child's abdomen, and keep this on until cure is affected. Anything in the shape of meat must be rigidly excluded from the dietary at once. So long as acute sickness and diarrhoea are present, the child should have nothing but water, or albumen or rice-water.
The following is an excellent recipe for making rice-water :
Boil an ounce of ground rice and half a dessertspoonful of cinnamon in two pints of water for three-quarters of an hour. Add sufficient water to sweeten, and give it to the child warm. During the first twenty-four hours he gets albumen-water and rice-water alternately, During the second day he might be able to take milk and soda-water in equal quantities, alternately with rice or albumen water, then gradually pure milk can be given; later, bread-and-milk, arrowroot, milk-puddings, etc.
These illnesses are generally rather severe while they last. In a day the child probably will feel better and very hungry. But food should be given sparingly, although the child can quite well sit up and read a book, cut out pictures with blunt-pointed scissors, and otherwise amuse himself.
It is during convalescence that children are often very difficult to manage. They become irritable, object to staying in bed, and require a good deal of tact to manage them well. A bed-rest, such as that shown in the photograph, helps to make a child more comfortable in bed, and if a heavy book is placed against the feet, it prevents the little patient from slipping downward and getting into uncomfortable positions.
In a further article one or two other points in the nursing of children, such as pulse, temperature, bathing, etc., will be considered. To be continued.