Ever-increasing efforts are being made to spread the useful knowledge which goes by the name of First Aid to the Injured. The St. John's Ambulance and other similar societies have done good service by means of lectures and demonstrations to impart this knowledge to the general public as well as to those, such as police-men, railway-men, and firemen, who may be regarded as in the service of the public.
The work of rendering first aid is not confined to men. Those who in times of peace prepare for war train women and girls also to help the injured, and so alleviate the fearful suffering of war-time. The Women Yeomanry Nursing Corps, the Girl Guides, and similar organisations train their members to assist the injured, and the knowledge thus gained stands in good stead when members are engaged in the routine of everyday life-how to Learn First Aid
A course of training under qualified teachers is of inestimable benefit, but those who are not thus privileged can acquire definite serviceable knowledge from simple directions, clearly illustrated, provided only that frequent practice makes the details sufficiently familiar to become matters of routine.
It is not of much use to glance at a picture and see how a fractured limb should be bound up and how bleeding may be arrested and then to find at the critical moment that memory has failed. In first aid as in every other department of life it is practice that makes perfect.
It must be distinctly understood at the outset that first aid does not encroach on a doctor's province, and that those who go through a course of lectures, cither oral or in print, are not aiming to become doctors, or even nurses. Excepting in the case of trifling accidents a doctor's aid must summoned at once, and first aid, in filling up the time of waiting, lessens the suffering of the patient and prevents the injury from becoming more serious through neglect and delay. As soon as the doctor arrives, he takes charge of the case, and those who are allowed to assist him must obey implicitly all his orders and directions.
1. It is of great assistance to a doctor if the person who renders first aid can give particulars of the accident, but although the assistant should be observant, time must not be wasted in gleaning information.
2. Prompt action is the chief requirement, and particularly in cases where there is severe bleeding or where the injury is progressive, as in cases of poisoning, or where garments are alight, or where insensibility is becoming deeper.
3. The assistant's powers of observation must be brought into play so as to spare the patient the worry of thoughtless and tactless questions.
4. Fresh air for the patient is of groat consequence. When accidents occur indoors the windows should be set open, and in cases of street accidents the crowd must be kept from pressing round and preventing the circulation of air.
5. A patient must never be moved until the extent of the injury has been ascertained, then a restful position must be ensured and support given to the injured part.
6. Severe bleeding must be controlled speedily as possible. Poisons must be got rid of or neutralised. Clothing must not be unneces-sarily removed, but when it is necessary to take it away, remove it from the sound side first, and never hesitate to cut the garments which cannot be taken off without dragging the injured side.
7. Remember particularly that every injury gives a shock to the system, which is murked by a falling of temperature according to the severity of the accident. The patient feels cold. and really is cold. Cover the body with light, warm clothing, and if there is pallor in the skin and shivering, and coldness and blueness of the extremities, apply warm blankets or hot-water bottles, rub the extremities which are uninjured, using gentle friction, and if the patient is conscious give him a hot drink.
Hot tea, coffee, soup. or milk, or a teaspoonful of sal volatile in a wineglassful of cold water are safe restorative, but alcohol should only be given under a doctor's orders, unless the shock is very severe and life seems to be dipping away. Even
Medical then alcohol must not be given unless haemorrhage is under control. With an unconscious patient the lips and tongue should be moistened with the alcohol, but no attempt made to pour it into the mouth.
The resourceful person is the most helpful, for in rendering first aid homely articles which lie at hand must be utilised, since surgical appliances can hardly be expected in the house, street, or field. These articles will show presently that splints, bandages, tourniquets, and stretchers can be extemporised from quite unpromising materials, and that they can be used by any person who takes the trouble to learn how to turn them to account.
Most exercises in first aid involve the tying of knots. This seems such a simple matter that many pupils assume they can do it easily. It is well to make the test before passing on to other work. Fold a handkerchief diagonally and tie the two ends with a double knot. Pull the handkerchief and see what happens. If the knot tightens it is a reef knot and is well done, but if the ends slip free, it is a "granny" knot, and is of no use for first aid purposes. Study the illustration, and practise knot-tying until it can be done without having to stop to think about method. Take one end in each hand, pass that in the right hand over that in the left, and make a single knot. Take that now in the right hand and pass it under that in the left, draw the end of it through to the front and pull both ends. (See illustration.)
Roller bandages are rarely at hand at the time of an accident, and their application is not within the provinces of first aid. Bandages must be used in many cases, and these have to be extemporised. Pocket-handkerchiefs are usually forthcoming, and a large one folded cornerwise, or, better still, cut along this fold to make two, will prove serviceable. The short edge of the triangle should measure about 36 or 38 inches, but if less than this the bandage can be supplemented at the ends by lengths of tape or string. Even with such a simple thing as a triangular bandage there is only one right way of using it to many wrong ones, so the following directions must be observed:
1. To fold a triangular bandage, bring the point or apex over the middle of the base and crease the folded edge, bring the folded edge to lie along the base, and crease the new fold. This gives a wide bandage, and a narrow bandage is made by folding a wide bandage lengthwise to half its width.
2. Stand as nearly as possible in front of the injured part.
3. Place the middle of the bandage on the part to be bandaged.
4. Never cross the ends more than once, and see that each end is carried round to lie flat on its proper fold.
5. Tie with a reef knot, and see that the knot does not press on an injured part.
A triangular bandage makes an excellent arm sling of which there are two varieties - narrow and broad. A narrow arm sling should always be used when the arm is broken between the elbow and shoulder (see illustration), as the weight of the elbow pulls the fractured bone into position; also when a dressing is applied to the shoulder. Note carefully that in applying ,a narrow sling the end which passes over the uninjured side lies flat against the body and that the other end passes over the forearm to tie with the other on the shoulder.
A broad sling is used to give support to the forearm. Spread out a bandage, and pass one end over the uninjured shoulder to the other side, arrange the apex under the injured arm, a little higher than the elbow, bend the arm in position, carry the other end upwards, and tie it with the other in a reef knot. Take the apex, bring it forward over the elbow of the injured arm, and pin it to the front of the bandage. (See illustration.)
A triangular bandage is easily applied to the hand, and is useful for keeping dressings in place. Let the assistant spread out her hand to correspond with the patient's injured hand.. Place the bandage over the hand with the long edge just beyond the fingers and the apex towards the elbow. This covered hand makes a firm support for the patient's hand, which is placed as shown in illustration, while the assistant folds the apex over the patient's hand, arranges the sides in pleats, crosses the ends over, passes the ends round once, and afterwards, with both hands ties them with a reefknot. (See illustration.)
A Knee Bandage
The knee bandage is very useful when little folk fall and graze the knee. A folded piece of clean linen, dipped in cold water containing salt, or sanitas, or boracic acid, is spread over the injured part, the knee is slightly bent, the patient holds the point of the bandage well over the knee, the fulness is gathered in the hands and the ends are crossed behind the knee. One end is carried round above the knee and the other in a contrary direction below it, and when they meet behind they are tied with a reef knot. (See illustration.)
The chest bandage is of service for keeping a dressing or a poultice in position. The apex points upwards, the ends are crossed behind and carried over the shoulders, and pinned one to each side a few inches from the apex (see illustration), and thus when a poultice or dressing has to be changed, the triangular flap can be unpinned and turned back without disturbing the patient. If the poultice or dressing is required at the back, the crossing of the ends must be done in front.
The head bandage is often useful. Fold an inch or two of the long side upwards, and place the middle of the fold to the middle of the forehead with the apex hanging loose behind the head. Lightly gather up the fulness of the short sides, and carry the folded edge over it. Cross the ends behind, well under the prominence at, the back of the head, bring the ends to the front, tie with a reef knot and tuck the loose ends in the fold. Pull the apex firmly down, fold it over the bandage crossing, and pin it with a safety-pin to the single fold that covers the head. (See illustration.)