Sylvester’s Method
Rule 1. To Adjust the Patient’s Position.—Place the patient on his back on a flat surface, inclined a little from the feet upward; raise and support the head and shoulders on a small, firm cushion or folded article of dress, placed under the shoulder-blades. Remove all tight clothing from about the neck and chest.
Rule 2. To Maintain a Free Entrance of Air Into the Windpipe.—Cleanse the mouth and nostrils; open the mouth; draw forward the patient’s tongue, and keep it forward; an elastic band over the tongue and under the chin will answer this purpose. (Fig. 1.)
Rule 3. To Imitate the Movements of Breathing.—First, Induce inspiration. Place yourself at the head of the patient, grasp his arms (at the elbow-joints), raise them upward by the sides of his head, stretch them steadily but gently upward, for two seconds. By this means fresh air is drawn into the lungs by raising the ribs. (Fig. 2.)
Secondly, Induce Expiration.—Immediately turn down the patient’s arms, and press the elbows firmly but gently downward against the sides of the chest, for two seconds. By this means foul air is expelled from the lungs by depressing the ribs. (Fig. 3.)
Thirdly, Continue These Movements.—Repeat these measures alternately, deliberately, and perseveringly fifteen times a minute, until a spontaneous effort to respire be perceived. By these means an exchange of air is produced in the lungs similar to that effected by natural respiration.
When a spontaneous effort to respire is perceived, cease to imitate the movements of breathing, and proceed to induce circulation and warmth, as described on following page.
Rule 4. To Excite Respiration.—During the employment of the above method, excite the nostrils with snuff or smelling-salts, or tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them. Friction of the limbs and body with dry flannel or cloths should be had recourse to. When there is proof of returning respiration, the individual may be placed in a warm bath, the movements of the arms above described being continued until respiration is fully restored. Raise the body in twenty seconds to a sitting position, dash cold water against the chest and face, and pass ammonia under the nose. Should a galvanic apparatus be at hand, apply the sponges to the region of the diaphragm and the heart.
To Induce Circulation and Warmth.—Wrap the patient in dry blankets, and rub the limbs upward energetically. Promote the warmth of the body with hot flannels, bottles or bladders of hot water; heated bricks to the pit of the stomach, the arm-pits, and to the soles of the feet.
On the restoration of life, when the power of swallowing has returned, a teaspoonful of warm water, small quantities of wine, warm brandy and water, or coffee should be given. The patient should be kept in bed, and a disposition to sleep encouraged. During reaction, large mustard-plasters to the chest and below the shoulders will greatly relieve the distrest breathing.
Note.—In all cases of prolonged immersion in cold water, when the breathing continues, a warm bath should be employed to restore the temperature.