Raise the body, with the back upwards, so that the bead is considerably below the chest level (this position is best attained by laying the body on its abdomen over a barrel). This allows the water to run out of the lungs. Another method is to hold the body up by its feet and attempt to get the water not only out of the lungs, but out of the stomach, if any has been swallowed, as is probable. Then lay the body on its back, cleanse the nose and month of mucus with the fingers and a handkerchief, loosen the clothing, and immediately begin, if there is no breathing, artificial respiration. To be sure that the glottis is open it is well to place the neck on a small roll of blanket, or other substance, with the head dropping over back, which will extend the neck. The tongue should be caught with tongue forceps and brought forward, and if it tends to fall back should be held by an assist-ant, or even a thread could be passed through it to retain it in position.
There are several methods of doing artificial respiration, the best known of which are the Sylvester method, and the Marshall Hall method, the former being the better.
The Sylvester method is done by bringing the arms, fully extended, upwards and backwards over the head until they meet, grasping the forearms near the elbows, the operator standing or sitting back of the patient. The arms are then brought downwards, folded at the elbows, and pressed firmly upon the sides and front of the chest, the elbows meeting in the upper part of the abdomen. An assistant can, at the time of compression of the chest, by the arms, press with his hands upon the abdomen, thus causing upward movement of the diaphragm at the time of the artificial expiration. The rate of this artificial respiration should be about fifteen times a minute.
This operation should be occasionally stopped to ascerlain if the patient will voluntarily make the attempt at respiration, and if the heart is still beating. If attempts at respiration are made, the rhythmical pulling forward of the tongue, about fifteen times a minute, seems to cause respiratory stimulation. If the patient attempts to breathe and he is to be helped with artificial aid, be sure to follow the rhythm of his attempts, and not compress the chest when he is about to inspire.
While artificial respiration is being done, assistants should rub the legs and feet to aid circulation and to keep the extremities warm, and the physician in attendance should give hypodermics of strychnia, whiskey or brandy, camphor, or nitroglycerine, or all, as his judgment decides.
Positive signs of death are absolute cessation of respira-tion, as shown by a polished, cold mirror held over the mouth and nostrils showing no befogging. Also, the absence of heart-beat as decided by the ear over the bared chest. Still, even with death apparent, artificial respiration should be done for a short time, as the heart may have but just ceased to beat.
To further decide that circulation has positively ceased, a string may be tied about the finger and if circulation is at all taking place the end of the finger will become dark red and slightly swollen. Also a drop of 1 per cent, atropine sulphate solution placed in an eye should dilate the pupil in a few minutes if there is still life.