In all emergencies one of the chief requisites is coolness. Do not get excited, or you will be perfectly useless. When the doctor's services are necessary send him a written statement of the case, that he may come prepared with the proper appliances. Severe injury of any kind is apt to be followed by that complete prostration of the vital powers known as "shock." Therefore, after such, the patient should be put into a warm bed, and hot water bags applied to the feet and over the heart.
Scalds and Burns. In the treatment of scalds and burns the first object is to allay the pain by excluding the air. This is done best by the application of clean, soft, white linen or cotton cloths wrung out in a solution made by dissolving a tablespoonful of bicarbonate of soda (baking soda) in a pint of boiled water. This treatment can be continued for the first few days; afterwards boric acid ointment spread on lint or soft sterile cotton will be found healing. Do not try to treat a burn of any extent without a doctor's advice, as many complications are likely to ensue. In fact, in such cases, it is always best to send for the doctor immediately, as many people have died from shock after comparatively small burns.
Frost Bites. Rub with snow, or cloths wrung out in ice-water. The rubbing must be very light at first, and the patient kept away from the heat.
Syncope or Fainting. Place the head lower than the feet if possible; give plenty of fresh air. Ammonia may be given by inhalation, but it should not be very strong, as it is irritating to the bronchial tubes. If these measures are not successful treat as in case of shock.
Exclude the Air
Shock. Put the patient into a warm bed; undress and roll in blankets; apply heat to the extremities and over the heart; raise the foot of the bed, so that the patient's head will be considerably lower than the feet. If possible avoid giving stimulation till the doctor arrives; if, however, he cannot be found, and the case is urgent, give a rectal injection of whisky 1 oz., water 5 ozs. (1050 F), salt 5 grains. Coffee may be used instead of water and salt.
Drowning. In cases of drowning where a person is apparently lifeless, efforts to restore life should be commenced at once by loosening all tight clothing around neck, chest, and waist. Turn the patient over quickly on his face, raising the body slightly at the waist to allow any water in the throat or air passages to run out. Wrap a handkerchief or a towel around the forefinger and gently cleanse the mouth. All this should take only a minute or two. Place the person upon his back with a folded coat or a firm pad of any kind under his shoulders to raise them a little. Be careful that the tongue does not slip back and shut off the air from the trachea. If it shows any tendency to do so, have some one hold it out, or tie a hand' kerchief around it and then around the neck.
Now artificial respiration should be produced until the natural breathing is restored. To do this kneel behind the patient and grasping his arms just below the elbows, draw them slowly upward above his head until they nearly touch. Give a firm pull for a moment. This movement tends to fill the lungs with air by raising the ribs and increasing the chest cavity.
Then carry the arms slowly back to the sides of the body and press them against the ribs. This movement forces out the air which was drawn into the lungs and makes artificially a complete respiration. These two movements should be repeated slowly and steadily about sixteen times in a minute, until respiration takes place naturally. This may require an hour or more.
Asphyxiation, Caused by Gas, Smoke, etc. Remove the patient into the fresh air, loosen the clothing, throw cold water in the face, neck, and chest; apply heat to the feet and over the heart. If respiration is shallow, artificial respiration should be performed, and, if necessary, treat as for shock.
Contusions, or Bruises, are best treated by rest and cold applications.
Wounds. When there is a cut, the first procedure, provided there is no hemorrhage, is to wash out the wound well with bichloride, 1-5000, and bind it up with sterile gauze. A wound will heal without the formation of pus if all bacteria are killed or kept out. When the cut is long, or the ends of the wound do not come together well, the doctor should be summoned, as putting in a few stitches may prevent an unsightly scar. (Having bichloride and sterile gauze always in the house would save many a case of blood poison, infected ringers, etc.) Collodion is useful in keeping bacteria out of small cuts and in applying absorbent cotton over wounds in places where bandages cannot be used.
Hemorrhage. Elevate the affected part; make compression over the wound by applying clean compresses and bandaging tightly. If this does not check it, and you do not know the course of the arteries well enough to make compression upon the required one, tie on a bandage very tightly above the wound. A pencil or a piece of wood stuck under this, and turned around, will act as a tourniquet. When possible, in addition to this it is always better to place a hard pad over the course of the artery. A doctor's aid must be sought immediately, for if the blood is shut off in this manner longer than an hour gangrene is likely to set in.
Epistaxis (bleeding from the nose) Make the patient stand or sit erect; throw the head back and elevate the arms, while you apply ice or ice-cold compresses to the forehead and back of neck. If the bleeding still continues the nostrils should be syringed with salt and water, ice cold. Avoid blowing the nose, and so disturbing the formation of clots.
Hemorrhage from the Lungs. Keep the patient quiet, give crushed ice, and put ice-cap on chest. Salt solution made by dissolving a teaspoonful of salt in a small cup of water may also be given.
Artificial Respiration (First Movement)
Sprains occur most frequently at the wrist and ankle joint. Soak the affected part in hot water, or apply hot compresses. The joint should then be supported by strapping, and given moderate use. A surgeon should do the strapping, for if it is not properly done serious trouble may result.
Artificial Respiration (Second Movement)
Fractures. It is a mistaken impression that a fracture must be set immediately. It will do less harm for it to be left a day or two without splints than for them to be applied awkwardly. Handle the injured limb as little as possible, and keep the patient quiet until a competent surgeon can be obtained. Temporary splints made of pasteboard, shingles, etc., may be bound on to prevent the spasmodic twitching of the muscles; cold or hot compresses applied will keep down the swelling and relieve the pain.
Dislocations should be reduced as soon as possible, but only a surgeon can do this properly.
Expelling The Air (Third Movement)
Fractures Need Not Be Set At Once
Manner of compressing an artery with a handkerchief and stick