What to Do in Emergencies
Many books and pamphlets have been written advising the layman what to do in a case of emergency, and in the absence of a physician or surgeon.
Much of the information presented is altogether too technical, and is not likely to be understood by the public at large.
The author has attempted to cover, in a few pages, the fundamentals of first aid to the injured, and has carefully avoided technical and medicinal terms. No amount of information, no matter how carefully or plainly written, can take the place of the physician or surgeon. Self-doctoring and -dosing is, or should be, considered a crime, and no one is justified in attempting to relieve any one suffering from accident or any other ailment, if it is of possible seriousness, unless a good physician or surgeon cannot be procured.
First and always, keep your head, and keep cool. Don’t get excited. Work rapidly, but deliberately. If the injury or trouble is at all serious, summon a surgeon or physician immediately. If you are alone with the sufferer, it may not be safe for you to leave him, but unless he is in immediate danger, it is better to call a competent physician, even though you have to absent yourself from him for a few moments. If the accident occurs in a crowd, solicit some one who looks trustworthy, and request him to telephone or otherwise communicate with a doctor.
If you know the cause of the accident or trouble inform the physician in advance, so that he may be better prepared to meet it and bring with him instruments and remedies.
The patient or sufferer should be placed in a comfortable position, a doctor or surgeon summoned, and in the interval the layman may follow the instructions presented here. If he does so, no harm will be done, and in many cases suffering will be relieved, and death or serious illness prevented. But the author again, and most emphatically, urges the layman to send for a physician or surgeon, and to follow the instructions or information given in this chapter only as preliminary to the arrival of the doctor or surgeon, unless the injury be of slight consequence.
If possible, remove the patient to a quiet place, where there is plenty of air, and where the temperature is normal.
If there are many people about, request them to keep away.
Place the injured person in a comfortable position, usually upon his back, and straighten out his legs and arms. If the head is injured, better lift it above the level of the body; but if it is not, allow the body to lie on a level.
If the patient is breathing hard, it may be well to lift him into a sitting position. Loosen his collar, waist-band, and clothing. If he faints, his head should be slightly lower than his feet. If an arm or leg is injured, lift it slightly and place it upon a cushion, pillow, or other support.
If the one injured is unconscious, watch him very carefully. If he is vomiting, or that tendency is apparent, turn him over on one side so that the discharge will run out easily and not go into the lungs.
If he is wounded, cut away the clothing covering the wound, but don’t remove any more than is necessary. If he has been burned, pour lukewarm water, containing a little saleratus or bicarbonate of soda, over the clothing before you remove it. If he is bleeding severely, stop the bleeding before dressing the wound. After the wound is dressed there is nothing for the novice to do, except bring the patient to consciousness, if unconscious, and remove him to a place of safety and comfort.
If the accident or injury be serious, or the patient is unconscious, it is well to request more than one bystander to summon a physician, because the first one sent may fail, or the physician he telephones to or calls upon may be unavailable.
Use the telephone, if there is one at hand or nearby, and tell the physician what you think is the matter with the sufferer or what caused the accident, that he may be better prepared to bring with him the instruments necessary.
If you are alone with the patient, and cannot notify a physician or surgeon without leaving the patient, you must use your best judgment; but you should make every possible effort to reach a physician at the earliest possible moment. Remain with the patient long enough to place him in a comfortable position, and to stop the flow of blood, if bleeding; then make all haste to notify a physician or surgeon.
The author acknowledges his indebtedness to Johnson’s First Aid Manual, published by Johnson & Johnson of New Brunswick, N. J., and to Jay W. Seaver, M. D., of New Haven, Conn., and recently of Yale University.
Accidents.—Convey the sufferer to a place of safety, and give him plenty of air. If a shock follows, follow instructions given for shock. Do not touch the wound with the bare hand. Wear absolutely clean gloves or wrap the fingers in clean cloth or gauze. Do not attempt to cleanse the wound. Summon a surgeon immediately.
Apparent Death.—Never assume that a person is dead because he appears to be. Summon a physician. A fairly good test of death is to hold the hand of the person apparently dead before a candle or other light, with the fingers stretched out, each touching the other. Gaze intently between the fingers, and if the person is alive, a red or pink color will undoubtedly be seen where the fingers touch each other. Another method is to take a cold piece of polished steel, like a razor blade or table knife, and hold before the mouth or nose of the person apparently dead. If moisture does not gather on it, it may be safe to assume that breathing has stopped; but these tests are not infallible.
Bandaging.—There are two kinds of bandages,—the roller bandage or the triangular or handkerchief bandage. They may be purchased at any drug store or be made on the spot in an emergency. The purchased bandages are made of gauze, or muslin, crinolin, elastic webbing, rubber, or other material. The roller bandages are absorbent, and are very thin and pliable. They should be placed next to the wound and hold the fluids. Muslin bandages are stronger than those made of gauze, and should be used for pressure and outside bandages. Bandages should be kept in a perfectly clean place, and always covered, either by being enclosed in a box or wrapped in paper. If an improvised bandage is used, care should be taken to use a clean cloth. The triangular bandage is made by cutting a piece of cloth about 36 inches square into two pieces diagonally. It can be purchased at a drug store, or any clean cloth can be used if it is of firm texture.
Baths.—Cold baths may be taken to reduce fever and in sunstroke and other cases when the temperature is high. It is well to have the temperature in the bath at 70° or 80° Fahrenheit, and to reduce the water until it reaches 60° or 65°. Tepid baths have a temperature of 80° or 90°, and warm baths are of a temperature from 90° to a little less than 100°. Hot baths may be used in case of shock, apparent drowning, depression, and similar troubles. The temperature of the water should vary from 98° to 110°. When the patient leaves the bath, he should be dried quickly and put to bed. Hot baths may produce fainting, and should be taken in the presence of an attendant. Do not guess at the temperature of the water; use a thermometer.
Bleeding.—Arterial blood, or blood coming from the arteries, is bright red, and is discharged in spurts or jets. Such bleeding is very dangerous, and unless a physician arrives almost immediately the patient is not likely to survive.
Venous blood, which comes from the veins, is of dark purple color and flows freely and steadily.
Capillary bleeding comes from injured small veins. It flows slowly, and such bleeding is dangerous only if it continues. Always summon a surgeon or physician, and put in a hurry call for him. Force the patient to lie down in a level position, preferably upon his back.
If the leg or arm is wounded, elevate it. Cut away the clothing quickly, so that it may be exposed. Press the bleeding places, but cover your finger with gauze or a clean handkerchief, or compress the part by using a strong cloth bandage.
If the bleeding comes from an artery, cover your finger with a few thicknesses of gauze or clean cloth, and press hard upon the wound and maintain the pressure, which may stop the bleeding. If the wound is large, crowd a lot of gauze into it, and push it in, then press on the flesh a little distance above the wound, that is, between the wound and the heart. This can be done by winding a bandage, a piece of rubber tubing, string, or rope, or a pair of suspenders may be used, above the wound.
If the arm or leg is crushed, do not press on the wound, but bring pressure to bear above it.
Bleeding from the Veins.—Lay a piece of gauze over the wound and bind it on with a firm bandage. Be very careful not to apply your naked fingers or hand to the wound unless you have washed them in some antiseptic, but even then it is better to cover your fingers with clean gauze or cloth. If the bleeding is very severe, apply cracked ice wrapped in gauze, and hard pressure below the wound. Varicose veins occasionally bleed. Elevate the arm or leg and bandage it very tightly, the bandage to be placed directly over the bleeding spot.
Bleeding from Capillary Veins.—As the blood oozes, and does not flow rapidly, expose the wound to the air for a short time, which will usually check it. The application of hot water is advisable, but warm water should not be used. Extremely cold water or cracked ice will stop some bleeding. If copious bleeding occurs around a tooth, it may be stopped by packing the place with plaster of Paris, or absorbent cotton may be used. In every case, keep the places warm. After the bleeding is stopped, give hot drinks, like hot tea, coffee, or milk, if much blood has been lost.
Broken Bones.—Do not attempt to set the break. Handle the patient carefully. Place him in a comfortable position and undress him, removing the clothing by cutting it to save time. If it is necessary to carry him a distance, improvise a splint made of wood or heavy pasteboard and fasten it around the broken part with bandages. Carry him to a physician or summon one at once, but let him lie quietly if a physician can reach him. It is well to have two splints, one on each side, to be held in place by the same bandages. If the arm is broken, bandage it and place it in a sling. In every case, summon a physician or carry the patient to one.
Chilblains.—Keep the feet warm and dry. Don’t warm them at a fire or place them in hot water, but bathe them in cold water and rub with a dry towel. Apply turpentine, camphorated spirits, or oil of wintergreen.