FIRST AID AND LIFE SAVING
_Major Charles Lynch, Medical Corps, U. S. A.
Acting for the American Red Cross_
PREVENTION OF ACCIDENTS
General
Considerably over a million persons are seriously injured in the
United States each year. The enormous loss of life and the great
suffering involved certainly demand that every boy scout do what he
can to improve conditions in this respect. Some accidents happen under
all circumstances, but, on the other hand a great many accidents are
avoidable and probably quite one half of the injuries which occur in
the United States yearly could be prevented if common care were
exercised.
Panics and Their Prevention
In case of a panic, at an in-door assembly, scouts, if they live up to
their motto, "Be Prepared," will be able to save hundreds of lives.
There is usually plenty of time for people to get out of a building if
the exits are not blocked by too many crowding them at once. One
should, if possible, try to arrange to have the performance go on, and
the others could reassure the people and get them to go out quietly
through the exits provided. Almost all scouts know how quickly and
safely our school buildings are cleared by means of the fire drill.
Fires
Fires constitute a danger as great as panics, and scouts should be
equally well informed what to do in case of fire. It is the duty of a
scout to know how to prevent fires. Many fires are caused by
carelessness. Never throw away a lighted match, for it may fall on
inflammable material and start a fire. Reading in bed by the light of
a lamp or candle is dangerous, for if the reader goes to sleep the bed
clothing is likely to catch fire. {256} A scout may often have to dry
his clothes before a fire and if so, they should be carefully watched.
Hot ashes in wooden boxes, or in barrels, are responsible for many
fires. In camp, dry grass should be cut away from the locality of the
camp fire; and not to put out a camp fire on leaving a camp is
criminal. Many of the great fires in our forests have been due to
carelessness in this respect. Fires also result frequently from
explosions of gas or gunpowder. A room in which the odor of gas is
apparent should never be entered with a light, and in handling
gunpowder a scout should have no matches loose in his pockets.
How To Put Out Burning Clothing
If your own clothing should catch fire do not run for help as this
will fan the flames. Lie down and roll up as tightly as possible in an
overcoat, blanket, or rug. If nothing can be obtained in which to wrap
up, lie down and roll over slowly at the same time beating out the
fire with the hands. If another person's clothing catches fire, throw
him to the ground and smother the fire with a coat, blanket, or rug.
What To Do in Case of Fire
A fire can usually be put out very easily when it starts, and here is
an occasion when a scout can show his presence of mind and coolness.
At first a few buckets of water or blankets or woollen clothing thrown
upon a fire will smother it. Sand, ashes, or dirt, or even flour, will
have the same effect.
[Transcriber's note: Flour dust suspended in air is explosive.]
If a scout discovers a building to be on fire, he should sound the
alarm for the fire department at once. If possible he should send some
one else, as the scout will probably know better what to do before the
fire-engine arrives. All doors should be kept closed so as to prevent
draughts. If you enter the burning building, close the window or door
after you, if possible, and leave some responsible person to guard it
so it will not be opened and cause a draught. In searching for people,
go to the top floor and walk down, examining each room as carefully as
possible. If necessary to get air while making the search, close the
door of the room, open a window, and stick the head out until a few
breaths can be obtained. Afterward close the window to prevent a
draught. If doors are found locked and you suspect people are asleep
inside, knock and pound on doors to arouse them. If this produces no
results, you will have to try to break down the door. While searching
through a burning building it will be best to tie a wet handkerchief
or cloth {257} over the nose and mouth. You will get a little air from
the water.
Remember the air within six inches of the floor is free from smoke, so
when you have difficulty in breathing, crawl along the floor, with the
head low, dragging anyone you have rescued behind you.
If you tie the hands of an insensible person together with a
handkerchief and put them over your head, you will find it fairly easy
to crawl along the floor dragging him with you.
[Illustration: Learning by doing.]
Never jump from a window unless the flames are so close to you that
this is the only means of escape.
If you are outside a building, put bedding in a pile to break the
jumper's fall, or get a strong carpet or rug to catch him, and have it
firmly held by as many men and boys as can secure hand holds.
In country districts, scouts should organize a bucket brigade which
consists of two lines from the nearest water supply to the fire.
Scouts in one line pass buckets, pitchers, or anything else that will
hold water from one to another till the last scout {258} throws the
water on the fire. The buckets are returned by the other line.
Drowning
Drowning accidents are very common. Every scout should know how to
swim and to swim well, but this is not all that is necessary. He
should also know how to prevent accidents that may result in drowning.
In summer, boating and bathing accidents are common. Remember a light
boat is not intended for heavy seas; do not change seats except in a
wide and steady boat; and above all things do not put yourself in the
class of idiots who rock a boat.
At the sea-shore, unless you are a strong swimmer, do not go outside
the life line, and if the undertow is strong be careful not to walk
out where the water is so deep it will carry you off your feet. Very
cold water and very long swims are likely to exhaust even a strong
swimmer and are therefore hazardous unless a boat accompanies the
swimmer.
Rescue of the Drowning
(_See pages 279 to 285_)
Ice Rescue
To rescue a person who has broken through the ice you should first tie
a rope around your body and have the other end tied, or held, on
shore. Then secure a long board or a ladder or limb of a tree, crawl
out on this, or push it out, so that the person in the water may reach
it. If nothing can be found on which you can support your weight do
not attempt to walk out toward the person to be rescued, but lie down
flat on your face and crawl out, as by doing this much less weight
bears at anyone point on the ice than in walking. If you yourself
break through the ice remember that if you try to crawl up on the
broken edge it will very likely break again with you. If rescuers are
near, it would be much better to support yourself on the edge of the
ice and wait for them to come to you.
Restoring the Drowning and Artificial Respiration
(_See pages 286 to 288_)
Electric Accidents
For his own benefit and that of his comrades, the scout should know
how to avoid accidents from electricity. The third rail is always
dangerous, so do not touch {259} it. Swinging wires of any kind may
somewhere in their course be in contact with live wires, so they
should not be touched.
A person in contact with a wire or rail carrying an electric current
will transfer the current to the rescuer. Therefore he must not touch
the unfortunate victim unless his own body is thoroughly insulated.
The rescuer must act very promptly, for the danger to the person in
contact is much increased the longer the electric current is allowed
to pass through his body. If possible, the rescuer should insulate
himself by covering his hands with a mackintosh, rubber sheeting,
several thicknesses of silk, or even dry cloth. In addition he should,
if possible, complete his insulation by standing on a dry board, a
thick piece of paper, or even on a dry coat. Rubber gloves and rubber
shoes or boots are still safer, but they cannot usually be procured
quickly.
If a live wire is under a person and the ground is dry, it will be
perfectly safe to stand on the ground and pull him off the wire with
the bare hands, care being taken to touch only his clothing, and this
must not be wet.
A live wire lying on a patient may be flipped off with safety with a
dry board or stick. In removing the live wire from the person, or the
person from the wire, do this, with one motion, as rocking him to and
fro on the wire will increase shock and burn.
A live wire may be safely cut by an axe or hatchet with dry, wooden
handle. The electric current may be short circuited by dropping a
crow-bar or poker on the wire. These must be dropped on the side from
which the current is coming and not on the farther side, as the latter
will not short circuit the current before it is passed through the
body of the person in contact. Drop the metal bar; do not place it on
the wire or you will then be made a part of the short circuit and
receive the current of electricity through your body.
What To Do for Electric Shocks
Always send for a doctor, but do not wait for him. Treatment should be
given even if the man appears to be dead. Loosen the clothing around
neck and body. Proceed to restore breathing by artificial respiration
as in drowning. (See pages 286, 287.)
Gas Accidents
The commonest gas encountered is the ordinary illuminating gas. To
prevent such gas from escaping in dangerous {260} quantities, leaks in
gas pipes should be promptly repaired. Be careful in turning off gas
to make sure that gas is actually shut off. It is dangerous to leave a
gas jet burning faintly when you go to sleep: as it may go out if
pressure in the gas pipe becomes less, and if pressure is afterward
increased gas may escape into the room.
Coal gas will escape through red-hot cast-iron, and very big fires in
such stoves are dangerous, especially in sleeping rooms. Charcoal
burned in open vessels in tight rooms is especially dangerous. In
underground sewers and wells other dangerous gases are found. If a
lighted candle or torch will not burn in such a place, it is very
certain the air will be deadly for any person who enters.
To rescue an unconscious person in a place filled with gas, move
quickly and carry him out without breathing yourself. Take a few deep
breaths before entering and if possible hold breath while in the
place. Frequently less gas will be found near the floor of a building,
so one may be able to crawl where it would be dangerous to walk.
What To Do for Gas Poisoning
Proceed to restore breathing by artificial respiration as in drowning.
(See pages 286, 287.)
Runaway Horses
The method for checking a horse running away is not to run out and
wave your arm in front of him, as this will only cause him to dodge to
one side and to run faster, but to try to run alongside the vehicle
with one hand on the shaft to prevent yourself from falling, seizing
the reins with the other hand and dragging the horse's head toward
you. If when he has somewhat slowed down by this method, you can turn
him toward a wall or a house he will probably stop.
Mad Dog
The first thing to do is to kill the mad dog at once. Wrap a
handkerchief around the hand to prevent the dog's teeth from entering
the flesh and grasp a club of some kind. If you can stop the dog with
a stick you should hit him hard over the head with it, or kick him
under the jaw. A handkerchief held in front of you in your
outstretched hands will generally cause the dog to stop to paw it
before he attempts to bite you. This will give you an opportunity to
kick him under the lower jaw.
{261}
Another way suggested is to wrap a coat around the left arm and let
the dog bite it; then with the other hand seize the dog's throat and
choke him.
FIRST AID FOR INJURIES
General Directions
Keep cool. There is no cause for excitement or hurry. In not one case
in a thousand are the few moments necessary to find out what is the
matter with an injured man going to result in any harm to him, and of
course in order to treat him intelligently you must first know what is
the matter. Commonsense will tell the scout that he must waste no
time, however, when there is severe bleeding, or in case of poisoning.
If possible, always send for a doctor, unless the injury is a trivial
one. Don't wait until he arrives, however, to do something for the
injured person. A crowd should always be kept back and tight clothing
should be loosened. If the patient's face is pale, place him on his
back with his head low. If his face is flushed, fold your coat and put
it under his head so as to raise it slightly.
In case of vomiting, place the patient on his side. Do not give an
unconscious person a stimulant, as he cannot swallow, and it will run
down his windpipe and choke him.
If the injury is covered by clothing, remove it by cutting or tearing,
but never remove more clothing than necessary, as one of the results
of injury is for a person to feel cold. Shoes and boots should be cut
in severe injuries about the feet.
Shock
For example, a scout is riding on a trolley-car. The car runs into a
loaded wagon. The wagon is overturned and the driver thrown to the
pavement. Part of the load falls upon his body and when you reach him
he is unconscious. So far as you can find out, nothing else is the
matter with him. This is called shock. It accompanies all serious
injuries and is itself serious, as a person may die without ever
recovering from shock. Of course, there are different degrees of
shock. In severe shock the person is completely unconscious or he may
be only slightly confused and feel weak and uncertain of what has
happened.
In shock always send for a doctor when you can. Before he comes, warm
and stimulate the patient in every possible way. Place him on his back
with his head low and cover him with {262} your coat or a blanket. Rub
his arms and legs toward his body but do not uncover him to do this.
If you have ammonia or smelling salts, place them before the patient's
nose so he may breathe them.
This is all you can do when unconsciousness is complete. When the
patient begins to recover a little, however, and as soon as he can
swallow, give him hot tea or coffee, or a half teaspoonful of aromatic
spirits of ammonia in a quarter glass of water.
Warning: Remember always that a person with shock may have some other
serious injuries. These you should always look for and treat if
necessary.
Injuries in Which the Skin is Not Broken--Fractures
A fracture is the same thing as a broken bone. When the bone pierces
or breaks through the skin, it is called a compound fracture, and when
it does not, a simple fracture.
[Illustration: Splints for broken thigh.]
A scout is in the country with a comrade. The latter mounts a stone
wall to cross it. The wall falls with him and he calls out for help.
When the other scout reaches him, he finds the injured scout lying
flat on the ground with both legs stretched out. One of these does not
look quite natural, and the scout complains of a great deal of pain at
the middle of the thigh and thinks he felt something break when he
fell. He cannot raise the injured leg. Carefully rip the trousers and
the underclothing at the seam to above the painful point. When you
have done this the deformity will indicate the location of the
fracture. You must be very gentle now or you will do harm, but if one
hand is put above where you think the {263} break occurred and the
other below it and it is lifted gently you will find that there is
movement at the broken point.
[Illustration: Splints for broken leg.]
Send for a doctor first, if you can, and, if you expect him to arrive
very soon, let your comrade lie where he is, putting his injured leg
in the same position as the sound one and holding it there by coats or
other articles piled around the leg. But if the doctor cannot be
expected for some time, draw the injured limb into position like the
sound one and hold it there by splints. Splints can be made of
anything that is stiff and rigid. Something flat like a board is
better than a pole or staff; limbs broken off a tree will do if
nothing else can be found. Shingles make excellent splints. In
applying splints remember that they should extend beyond the next
joint above and the next joint below; otherwise, movements of the
joint will cause movement at the broken point. With a fracture of the
thigh, such as that described, the outer splint should be a very long
one, extending below the feet from the arm pit. A short one extending
just below the knee will do for the inner splint. Splints may be tied
on with handkerchiefs, pieces of cloth torn from the clothing, or the
like. Tie firmly but not tight enough to cause severe pain. In a
fracture of the thigh it will also be well to bind the injured leg to
the sound one by two or three pieces of cloth around both. The
clothing put back in place will serve as padding under the splint, but
with thin summer clothing it is better to use straw, hay, or leaves in
addition. Fractures of the lower leg and of the upper and lower arm
are treated in the same way with a splint on the inner and outer sides
of the broken bone. A sling will be required for a fracture of the
arm. This may be made of the triangular bandage, or of a triangular
piece of cloth, torn from your shirt.
{264}
The Red Cross First Aid Outfit is very convenient to use in
fractures as well as in other injuries. The gauze bandage may be used
for the strips to tie on the splints and the triangular bandage for an
arm sling; or, if a sling is not needed, for strips to fix the splints
firmly in place.
Compound Fractures
The edges of a broken bone are very sharp and may cut through the skin
at the time of an injury, but more often afterward, if the injured
person moves about or if the splints are not well applied so as to
prevent movement at the point where the bone is broken. If a compound
fracture has occurred, the wound produced by the sharp bone must
always be treated first. The treatment is the same for any other
wound.
_Warning_: You will not always be able to tell whether or not a
fracture has occurred. In this case do not pull and haul the limb
about to make sure, but treat as a fracture. There will always be a
considerable amount of shock with fracture and this must also be
treated.
[Illustration: Splints and sling for fracture of upper arm.]
Bruises
Everybody has suffered from a bruise at some time in his life and
knows just what it is. A slight bruise needs no treatment. For a
severe one, apply very hot or very cold water to prevent pain and
swelling.
Sprains
A scout slips and twists his ankle and immediately suffers severe
pain, and in a little while the ankle begins to swell. {265} The
sprained joint should be put in an elevated position and cloths wrung
out in very hot or very cold water should be wrapped around it and
changed very frequently. Movement of any sprained joint is likely to
increase the injury, so this ought not to be permitted. Walking with a
sprained ankle is not only exceedingly painful but it generally
increases the hurt.
[Illustration: Triangular sling for arm.]
Dislocation
A dislocation is an injury where the head of a bone has slipped out of
its socket at a joint. A scout is playing foot-ball. He suddenly feels
as though his shoulder has been twisted out of place. Comparison with
the other side will show that the injured shoulder does not look like
the other one, being longer, or shorter, and contrary to the case with
fracture there will not be increased movement at the point of injury
but a lessened movement. Do not attempt to get a dislocated joint back
in place. Cover the joint with cloths wrung out in very hot or very
cold water, and get the patient into the hands of a doctor as soon as
possible.
Injuries in Which the Skin is Broken
Such injuries are called wounds. There is one very important fact
which must be remembered in connection with such injuries. Any injury
in which the skin is unbroken is much less dangerous, as the skin
prevents germs from reaching the injured part. The principle to be
followed in treating a wound is to apply something to prevent germs
from reaching the injury.
{266}
All wounds unless protected from germs are very liable to become
infected with matter, or pus. Blood poisoning and even death may
result from infection. To prevent infection of wounds, the scout
should cover them promptly with what is called a sterilized dressing.
This is a surgical dressing which has been so treated that it is free
from germs. A number of dressings are on the market and can be
procured in drug stores. In using them, be very careful not to touch
the surface of the dressing which is to be placed in contact with the
wound. The Red Cross First Aid Dressing is so made that this accident
is almost impossible. In taking care of a wound, do not handle it or
do anything else to it. Every one's hands, though they may appear to
be perfectly clean, are not so in the sense of being free from germs;
nor is water, so a wound should never be washed.
[Illustration: Head bandage.]
It will be a good thing for a scout always to carry a Red Cross First
Aid Outfit, or some similar outfit, for with this he is ready to take
care of almost any injury; without it he will find it very difficult
to improvise anything to cover a wound with safety to the injured
person. If no prepared dressing is procurable, boil a towel if
possible for fifteen minutes, squeeze the water out of it without
touching the inner surface, and apply that to the wound. The next best
dressing, if you cannot prepare this, will be a towel or handkerchief
which has been recently washed and has not been used. These should be
held in place on the wound with a bandage. Do not be afraid to leave a
wound exposed to the air; germs do not float around in the air and
such exposure is much safer than water or any dressing which is not
free from germs. Of course you can bind up a {267} wound with a towel
not boiled or piece of cotton torn from your shirt, but you cannot do
so without the liability of a great deal of harm to the injured
person.
Snake Bites
While snake bites are wounds, the wounds caused by venomous snakes are
not important as such but because the venom is quickly absorbed and by
its action on the brain may cause speedy death. The rattlesnake and
the moccasin are the most dangerous snakes in the United States.
In order to prevent absorption of the poison, immediately tie a
string, handkerchief, or bandage above the bite. This can only be done
in the extremities, but nearly all bites are received on the arms or
legs. Then soak the wound in hot water and squeeze or suck it to
extract the poison. Sucking a wound is not dangerous unless one has
cuts or scrapes in the mouth. Then burn the wound with strong ammonia.
This is not aromatic spirits of ammonia, but what is commonly known as
strong ammonia in any drug store. Aromatic spirits of ammonia should
also be given as a stimulant.
If you have nothing but a string to tie off the wound, be sure to do
that and to get out as much poison as you can by squeezing or sucking
the wound. A doctor should of course always be sent for when
practicable in any injury as severe as a snake bite. Leave your string
or bandage in place for an hour. A longer period is unsafe, as cutting
off the circulation may cause mortification. Loosen the string or
bandage after an hour's time, so that a little poison escapes into the
body. If the bitten person does not seem to be much affected, repeat
at the end of a few moments, and keep this up until the band has been
entirely removed. If, however, the bitten person seems to be seriously
affected by the poison you have allowed to escape into his body, you
must not loosen the bandage again, but leave it in place and take the
chance of mortification.
Wounds Without Severe Bleeding
These constitute the majority of all wounds. Use the Red Cross Outfit
as described in the slip contained in the outfit. The pressure of a
bandage will stop ordinary bleeding if firmly bound into place.
Wounds With Severe Bleeding
A scout must be prepared to check severe bleeding at once, and he
should then dress the wound. Bleeding from an {268} artery is by far
the most dangerous. Blood coming from a cut artery is bright red in
color and flows rapidly in spurts or jets. As the course of the blood
in an artery is away from the heart, pressure must be applied on the
heart side just as a rubber pipe which is cut must be compressed on
the side from which the water is coming in order to prevent leakage at
a cut beyond. The scout must also know the course of the larger
arteries in order that he may know where to press on them. In the arm
the course of the large artery is down the inner side of the big
muscle in the upper arm about in line with the seam of the coat. The
artery in the leg runs down from the centre of a line from the point
of the hip to the middle of the crotch, and is about in line with the
inseam of the trousers. Pressure should be applied about three inches
below the crotch. In making pressure on either of these arteries, use
the fingers and press back against the bone. You can often feel the
artery beat under your fingers, and the bleeding below will stop when
you have your pressure properly made. Of course you cannot keep up the
pressure with your fingers indefinitely in this way as they will soon
become tired and cramped. Therefore, while you are doing this have
some other scout prepare a tourniquet. The simplest form of tourniquet
is a handkerchief tied loosely about the limb. In this handkerchief a
smooth stone or a cork should be placed just above your fingers on the
artery. When this is in place put a stick about a foot long under the
handkerchief at the outer side of the limb and twist around till the
stone makes pressure on the artery in the same way that your {269}
fingers have. Tie the stick in position so it will not untwist.
[Illustration: How to apply first aid dressing.]
_Warning_: When using a tourniquet remember that cutting off the
circulation for a long time is dangerous. It is much safer not to keep
on a tourniquet more than an hour. Loosen it, but be ready to tighten
it again quickly if bleeding re-commences.
Another method to stop bleeding from an artery when the wound is below
the knee or elbow is to place a pad in the bend of the joint and
double the limb back over it holding the pad in tightly. Tie the arm
or leg in this position. If these means do not check the bleeding put
a pad into the wound and press on it there. If you have no dressing
and blood is being lost very rapidly, make pressure in the wound with
your fingers. Remember, however, that this should only be resorted to
in the case of absolute necessity as it will infect the wound.
Blood from veins flows in a steady stream back toward the heart and is
dark in color. From most veins a pad firmly bandaged on the bleeding
point will stop the bleeding. If a vein in the neck is wounded, blood
will be lost so rapidly that the injured person is in danger of
immediate death, so you must disregard the danger of infection and jam
your hand tightly against the bleeding point.
Keep the patent quiet in all cases of severe bleeding, for even if it
is checked it may start up again. Do not give any stimulants until the
bleeding has been checked unless the patient is very weak. The best
stimulant is aromatic spirits of ammonia, one teaspoonful in half a
glass of water.
[Illustration: How to apply tourniquet to upper arm.]
{270}
Unconsciousness and Poisoning
Unconsciousness, of course, means lack of consciousness, or, in other
words; one who is unconscious knows nothing of his surroundings or of
what is happening. A person may, however, be partially, as well as
wholly, unconscious.
Unconsciousness may be due to so many causes that, in order to give
the best treatment, the scout should first know the cause. Always try
to find this out if you can. If you cannot do this, however, you
should at least determine whether unconsciousness is due to poison, to
bleeding, to sunstroke, or to freezing; for each of these demand
immediate, special treatment. If it is not due to one of these causes,
and the patient is pale and weak, have him placed with his head low,
and warm and stimulate him in every possible way. If the face is red
and the pulse is bounding and strong, that patient should have his
head raised on a folded coat. No stimulants should be given him and
cold water should be sprinkled on his face and chest.
The common causes of unconsciousness are shock, electric shock,
fainting, apoplexy and injury to the brain, sunstroke and heat
exhaustion, freezing, suffocation, and poisoning. The first two have
already been described and the treatment of any form of suffocation in
artificial respiration.
Fainting
Fainting usually occurs in overheated, crowded places. The patient is
very pale and partially or completely unconscious. The pupils of the
eye are natural, the pulse is weak and rapid. The patient should be
placed in a lying-down position with the head lower than the rest of
the body so that the brain will receive more blood. Loosen the
clothing, especially about the neck. Keep the crowd back and open the
windows if in-doors so that the patient may get plenty of fresh air.
Sprinkle the face and chest with cold water. Apply smelling salts or
ammonia to the nose, rub the limbs toward the body. A stimulant may be
given when the patient is so far recovered that he is able to swallow.
Apoplexy and Injury to the Brain
Apoplexy and unconsciousness from injury to the brain are due to the
pressure of blood on the brain so that they {271} may be described
together. Apoplexy is of course much harder to distinguish than injury
to the brain as in the latter the scout can always see that the head
has been hurt. With both, unconsciousness will usually be complete.
Pupils are large and frequently unequal in size, breathing is snoring,
and the pulse is usually full and slow. One side of the body will be
paralyzed. Test this by raising arm or leg; if paralyzed, it will drop
absolutely helpless. Send for a doctor at once. Keep patient quiet and
in a dark room if possible. Put in lying-down position with head
raised by pillows. Apply ice or cold cloths to head. No stimulants.
Drunkenness is sometimes mistaken for apoplexy. If there is any doubt
on this point always treat for apoplexy.
Sunstroke and Heat Exhaustion
Anyone is liable to sunstroke or heat exhaustion if exposed to
excessive heat. A scout should remember not to expose himself too much
to the sun nor should he wear too heavy clothing in the summer. Leaves
in the hat will do much to prevent sunstroke. If the scout becomes
dizzy and exhausted through exposure to the sun he should find a cool
place, lie down, and bathe the face, hands, and chest in cold water
and drink freely of cold water.
Sunstroke and heat exhaustion, though due to the same cause, are quite
different and require different treatment. In sunstroke
unconsciousness is complete. The face is red, pupils large, the skin
is very hot and dry with no perspiration. The patient sighs and the
pulse is full and slow. The treatment for sunstroke consists in
reducing the temperature of the body. A doctor should be summoned
whenever possible. The patient should be removed to a cool place and
his clothing loosened, or better the greater part of it removed. Cold
water, or ice, should be rubbed over the face, neck, chest, and in arm
pits. When consciousness returns give cold water freely.
Heat exhaustion is simply exhaustion or collapse due to heat. The
patient is greatly depressed and weak but not usually unconscious.
Face is pale and covered with clammy sweat, breathing and pulse are
weak and rigid. While this condition is not nearly as dangerous as
sunstroke, a doctor should be summoned if possible. Remove the patient
to a cool place and have him lie down with his clothing loosened.
Don't use anything cold {272} externally, but permit him to take small
sips of cold water. Stimulants should be given just as in fainting.
Freezing
The patient should be taken into a cold room and the body should be
rubbed with rough cloths wet in cold water. The temperature of the
room should be increased if possible. This should be done gradually
and the cloths should be wet in warmer and warmer water. As soon as
the patient can swallow give him stimulants. It will be dangerous to
place him before an open fire or in a hot bath until he begins to
recover. You will know this by his skin becoming warmer, by his better
color, and by his generally improved appearance.
Frost-Bite
Remember that you are in danger of frost-bite if you do not wear
sufficient clothing in cold weather, and that rubbing any part of the
body which becomes very cold helps to prevent frostbite, because it
brings more warm blood to the surface. The danger is when, after being
cold, the part suddenly has no feeling.
The object of the treatment is gradually to restore warmth to the
frozen part. To do this the part should be rubbed first with snow or
cold water; the water should be warmed gradually. The use of hot water
at once would be likely to cause mortification of the frozen part.
Poisoning
For all poisons give an emetic. Send for a doctor at once and if
possible have the messenger tell what poison has been taken so that
the doctor may bring the proper antidote. Do not wait for him to
arrive, but give an emetic to rid the stomach of the poison. Good
emetics are mustard and water, salt water, or lukewarm water alone in
large quantities. Never mind the exact dose and if vomiting is not
profuse repeat the dose.
Fits
A person in a fit first has convulsive movements of the body, then he
usually becomes unconscious. A scout should have no difficulty in
making out what is the matter with a person in a fit.
Put the sufferer on the floor or the ground where he can not hurt
himself by striking anything. Loosen tight clothing and do not try to
restrain the convulsive movements. A wad of {273} cloth thrust in the
mouth will prevent biting the tongue. When he becomes quiet do not
disturb him.
INJURIES DUE TO HEAT AND COLD
Burns and Scalds
For slight burns in order to relieve the pain some dressing to exclude
the air is needed. Very good substances of this character are pastes
made with water and baking soda, starch, or flour. Carbolized
vaseline, olive or castor oil, and fresh lard or cream are all good.
One of these substances should be smeared over a thin piece of cloth
and placed on the burned part. A bandage should be put on over this to
hold the dressing in place and for additional protection.
Severe burns and scalds are very serious injuries which require
treatment from a physician. Pending his arrival the scout should
remember to treat the sufferer for shock as well as to dress the
wound.
Burns from electricity should be treated exactly like other burns. Do
not attempt to remove clothing which sticks to a burn; cut the cloth
around the part which sticks and leave it on the burn.
FIRST AID FOR EMERGENCIES
Besides the accidents which have been mentioned, certain emergencies
may demand treatment by a scout.
The commonest of these are described here.
Something in the Eye
No little thing causes more pain and discomfort than something in the
eye. Do not rub to remove a foreign body from the eye, as this is
likely to injure the delicate covering of the eyeball. First, close
the eye so the tears will accumulate, these may wash the foreign body
into plain view so that it may be easily removed. If this fails, pull
the upper lid over the lower two or three times, close the nostril on
the opposite side and have the patient blow his nose hard. If the
foreign body still remains in the eye, examine first under the lower
and then the upper lid. For the former have the patient look up, press
lower lid down, and if the foreign body is seen lift it out gently
with the corner of a clean handkerchief. It is not so easy {274} to
see the upper lid. Seat the patient in a chair with his head bent
backward. Stand behind him and place a match or thin pencil across the
upper lid one half an inch from its edge, turn the upper lid back over
the match, and lift the foreign body off as before. A drop of castor
oil in the eye after removing the foreign body will soothe it.
[Illustration: Eye bandage.]
Sunburn
This is simply an inflammation of the skin due to action of the sun.
It may be prevented by hardening the skin gradually. Any toilet powder
or boracic acid will protect the skin to a considerable extent. The
treatment consists of soothing applications such as ordinary or
carbolized vaseline.
Ivy Poisoning
Poison ivy causes a very intense inflammation of the skin. Better
avoid, even though it has not harmed you before. Baking soda made in a
thick paste with water or carbolized vaseline are good remedies. In
severe cases a doctor should be consulted.
Bites and Stings
Ammonia should be immediately applied. Wet salt and wet earth are also
good applications.
Nosebleed
Slight nosebleed does not require treatment as no harm will result
from it. When more severe the collar should be {275} loosened. Do not
blow the nose. Apply cold to the back of the neck by means of a key or
cloth wrung out in cold water.
A roll of paper under the upper lip, between it and the gum, will also
help. When the bleeding still continues shove a cotton or gauze plug
into the nostrils, leaving it there until the bleeding stops.
[Illustration: Position of hands.]
[Illustration: Chair carry.]
Earache
This is likely to result seriously and a doctor should be consulted in
order to prevent bad results with possible loss of hearing. Hot
cloths, a bag of heated salt, or a hot bottle applied to the ear will
often cure earache. A few drops of alcohol on a hot cloth so placed
that the alcohol fumes enter the ear will often succeed. If neither is
effective, heat a few drops of sweet oil as hot as you can stand, put
a few drops in the ear and plug with cotton. Be careful that it is not
too hot.
Toothache
Remember that toothache indicates something seriously wrong with the
teeth which can only be permanently corrected {276} by a dentist. In
toothache if you can find a cavity, clean it out with a small piece of
cotton or a toothpick. Then plug it with cotton, on which a drop of
oil of cloves has been put if you have it. If no cavity is found, soak
a piece of cotton in camphor and apply it to the outside of the gum.
Hot cloths and hot bottles or bags will help in toothache, just as
they do in earache.
Inflammation of the Eye
Cover with a cloth wrung out in cold water and change cloths from time
to time when they get warm. See a doctor in order to safeguard your
sight.
Cramp or Stomachache
This is usually due to the irritation produced by undigested food. A
hot bottle applied to the stomach or rubbing will often give relief. A
little peppermint in hot water and ginger tea are both excellent
remedies. The undigested matter should be gotten rid of by vomiting or
a cathartic.
Remember this kind of pain is sometimes due to something serious and
if it is very severe or continues for some time, it is much safer to
send for a doctor.
Hiccough
This is due to indigestion. Holding the breath will often cure, as
will also drinking a full glass of water in small sips without taking
a breath. If these fail vomiting is an almost certain remedy.
[Illustration: Arm carry.]
{277}
Chills
In order to stop a chill drink hot milk or hot lemonade and get into
bed. Plenty of covers should be used, and hot water bottles or hot
milk or lemonade help to warm one quickly.
[Illustration: Improvised stretcher.]
Carrying Injured
A severely injured person is always best carried on a stretcher. The
easiest stretcher for a scout to improvise is the coat stretcher. For
this two coats and a pair of poles are needed. The sleeves of the coat
are first turned inside out. The coats are then placed on the ground
with their lower sides touching each other. The poles are passed
through the sleeves on each side, the coats are buttoned up with the
button side down. A piece of carpet, a blanket, or sacking can be used
in much the same way as the coat, rolling in a portion at each side.
Shutters and doors make fair stretchers. In order not to jounce the
patient in carrying him the bearers should break step. The bearer in
front steps off with the left foot and the one in the rear with the
right. A number of different methods for carrying a patient by two
bearers are practiced. The four-handed {278} seat is a very good one.
To make this each bearer grasps his left wrist in his right hand, and
the other bearer's right wrist in his left hand with the backs of the
hands uppermost. The {279} bearers then stoop and place the chair
under the sitting patient who steadies himself by placing his arms
around their necks.
[Illustration: First position.]
[Illustration: Fireman's lift.]
It will sometimes be necessary for one scout to carry an injured
comrade. The scout should first turn the patient on his face; he then
steps astride his body, facing toward the patient's head, and, with
hands under his arm-pits, lifts him to his knees; then, clasping hands
over the abdomen, lifts him to his feet; he then, with his left hand,
seizes the patient by the left wrist and draws his left arm around his
(the bearer's) neck and holds it against his left chest, the patient's
left side resting against his body, and supports him with his right
arm about the waist. The scout, with his left hand, seizes the right
wrist of the patient and draws the arm over his head and down upon his
shoulder, then, shifting himself in front, stoops and clasps the right
thigh with his right arm passed between the legs, his right hand
seizing the patient's right wrist; lastly, the scout, with his left
hand, grasps the patient's left hand, and steadies it against his side
when he arises.
WATER ACCIDENTS
_Wilbert E. Longfellow,
United States Volunteer Life Saving Corps_
The scout's motto, "Be Prepared," is more than usually applicable to
the work of caring for accidents which happen in the water.
To save lives, the scout must know first how to swim, to care for
himself, and then to learn to carry another and to break the clutch,
the "death grip," which we read so much about in the newspaper
accounts of drowning accidents. By constant training, a boy, even
though not a good swimmer, can be perfectly at home in the water,
fully dressed, undressed, or carrying a boy of his own size or larger.
In fact two boys of twelve or fourteen years can save a man.
Swimming
For physical development the breast stroke is useful, for it is one
that is used in carrying a tired swimmer and is used to go to the
bottom for lost articles and to search for a person who has sunk
before help has reached him. It is possible, you know, to go to the
bottom and bring a body to the surface and swim with it to shore
before life is extinct and to restore consciousness by well-directed
efforts. The body of an unconscious person weighs little when wholly
or partially submerged and {280} in salt water weighs less than in
fresh water, and is consequently more readily carried. Training makes
a small boy the equal or superior of an untrained boy much larger and
of greater strength, and the way to learn to carry a drowning person
is to carry a boy who is not drowning to get used to handling the
weights. A little struggle now and then lends realism to the work and
increases the skill of the scout candidate for a life saver's rating.
Speed swimming for itself alone is a very selfish sport so that the
scout should develop his ability to make it generally useful to
others.
[Illustration: Breast stroke for tired swimmer.]
[Illustration: Under-arm carry.]
Floating
After the breast stroke is learned, floating on the back for rest and
swimming on the back, using feet only for propulsion, leaving the
hands free to hold a drowning person, should be learned. This can be
readily acquired with a little practice, carrying the hands on the
surface of the water, arms half bent, with the elbows close to the
sides at the waist line. To carry a man this way the hands are placed
at either side of the {281} drowning man's head and he is towed
floating on his back, the rescuer swimming on his back, keeping the
other away. It is well to remember to go with the tide or current, and
do not wear your strength away opposing it. Other ways of carrying are
to place the hands beneath the arms of the drowning man, or to grasp
him firmly by the biceps from beneath, at the same time using the knee
in the middle of his back to get him into a floating position, the
feet acting as propellers. Methods which enable the rescuer's use of
one arm in addition to the feet are known as the "German army" and the
"cross shoulder." In the first, the swimmer approaches the drowning
person from the back, passes the left arm under the other's left arm,
across in front of the chest, and firmly grasps the right arm, either
by the biceps or below the elbow, giving him control. This leaves the
right arm to swim with. The other one-arm hold mentioned is one in
which the rescuer passes an arm over {282} the shoulder of the one to
be carried, approaching from the back as before, and getting a hold
under the other's arm, which makes the drowning man helpless. The
breast stroke carry previously mentioned is used only for helping a
tired swimmer, and one in possession of his faculties who will not try
to grasp the rescuer. The tired swimmer lies on the back and,
extending his arms fully in front, rests a hand on either shoulder of
the swimmer who rests facing him in the regular breast position
allowing the feet of the other to drop between his own. Quite good
speed can be made in this way, and all of these methods are practical
as a trial will show. A little practice will enable the beginner to
see which he can do most readily and then he can perfect himself in it
for instant use.
{281}
[Illustration: Swimming on back without hands.]
[Illustration: Head carry-swim on back.]
[Illustration: Break for wrist hold.]
[Illustration: Breaking back strangle hold.]
{282 continue}
Breaking "Death Grips"
If one uses care in approaching a frightened or drowning person in the
water, there will be no use for the release methods; but the best of
swimmers get careless at times and all swimmers need to know how to
get clear when gripped.
Wrist Grip
Of these the simplest is the one where the wrists of the swimmer have
been grasped by the drowning man in his {283} struggles. The swimmer
throws both hands above his head which forces both low in the water
and then turns the leverage of his arms against the other's thumbs,
breaking the hold easily. It should be borne in mind that a drowning
man grasps what he can see above the surface of the water, so he will
not attempt to grasp his rescuer below the points of the shoulders.
Remember also that a tall man and a short man would have about the
same amount of their body projecting above the surface of the water.
[Illustration: Break for front strangle hold.]
Neck Grip
For the grip around the swimmer's neck from the front, for both arms
around the shoulders, and for a grip in which the drowning man had the
other over one shoulder and under the other arm, the break is much the
same. As soon as the rescuer feels the hold, he covers the other's
mouth with the palm of his hand, clasping the nostrils tightly between
his first two fingers, at the same time pulling the drowning man to
him with the left hand in the small of the back, treading water in the
meantime. Then, taking a full breath, he applies his knee {284} in the
other's stomach, forcing him to expel the air in his lungs and at the
same time preventing him from getting more by pressure on the nostrils
and mouth. Should the pressure of the grip around the body be too
great to allow freedom of the arms, the preliminary move in that case
would be to bring both arms to the level of the shoulder, thus sliding
the other's arms to the neck, leaving the rescuer's arms to cover the
nose.
Back Strangle
The back strangle hold is an awkward one to break and one which must
be broken without an instant's delay, or the would-be rescuer himself
will be in great need of help. In practice it will be found that, by
grasping the encircling arms at the wrists and pushing back with the
buttocks against the other's abdomen, room to slip out can be
obtained. In a life and death struggle, sharper measures are needed,
and if the rescuer throws his head suddenly back against the nose of
the drowning man, he will secure his freedom very readily and have him
under control by the time he has recovered from his dazed condition.
Rescue From Shore or Boat
It is not always necessary to go into the water to attempt a rescue,
and in many cases, when some one has fallen off a bridge or dock, a
line or buoy or boat can be used to advantage without placing more
lives in danger than the one in the water. Discretion in such matters
is worthy of recognition rather than too much recklessness in swimming
out. Use a boat when possible. Practice in throwing a life buoy should
be indulged in where possible, and a good scout should always leave
the line coiled over pegs and the buoy hanging on top to bind it in
place for instant use in an emergency.
Diving From the Surface
When a bather or victim from a boating accident sinks to the bottom of
a river or pond of from seven to twenty feet in depth, prompt rescue
methods may bring him to the surface, and resuscitation methods,
promptly applied, will restore breath. If there is no current in the
pond or lake, bubbles from the body will indicate its whereabouts
directly beneath the place where it sank. Should there be tide or
currents, the bubbles are carried at an angle with the streams and the
searcher must go from the spot where the person disappeared and look
along {285} the bottom going with the current. When a drowning man
gives up his struggle and goes down, his body sinks a little way and
is brought up again by the buoyancy within it and the air is expelled.
It sinks again and next rises less high and air is again expelled.
This happens several times until enough water is taken into the
stomach and air passages to offset the floating capacity. The floating
capacity is barely overcome, so the body weighs but little. It is very
simple, as almost any youthful swimmer knows, to go to the bottom if
one can dive from a float, pier, or boat, but to be able to dive down
ten feet from the surface requires practice. In most cases to go
deeper would require a weight after the manner of the Southern sponge
and pearl fishers. Grasp a ten or fifteen pound stone and dive in; to
come up the swimmer lets go and rises to the top.
[Illustration: Throwing feet for dive from surface.]
Diving For Lost Objects
In covering a considerable area in search for bodies or lost objects,
several ropes can be anchored with grapnels or rocks in squares and a
systematic search thus maintained by divers. Going down from the
surface is not so simple and the knack is attained by practice,
especially by athletic lads. The secret is to swim to a point where a
sounding is to be made, and to plunge the head and shoulders under,
elevating the hips above the surface to drive the shoulders deep and
give chance for a few strokes--breast stroke preferred--until the
whole body in a vertical position is headed for the bottom. The
elevation of the feet and lower legs in the air gives the body
additional {286} impetus downward, and when the object is attained a
push-off from the bottom with both feet sends the swimmer to the
surface in quick order. To carry any weight ashore, it is necessary to
carry it low on the body, hugged close to the waist line, allowing one
hand and both feet for swimming, or if on the back, hold by both hands
using the feet as propellers.
[Illustration: Artificial respiration (a)]
[Illustration: Artificial respiration (b)]
Restoring Breathing
Knowledge of resuscitation of the apparently drowned is an important
part of the equipment of a first-class scout, and a great many lives
could have been saved had it been more general. To be effective no
time must be lost in getting the apparently drowned person out of the
water and getting the {287} water out of him. The Schaefer or prone
method requires but one operator at a time and no waste of time in
preliminaries.
When taken from the water the patient is laid on the ground face
downward, arms extended above the head, face a little to one side, so
as not to prevent the free passage of air. The operator kneels astride
or beside the prone figure and lets his hands fall into the spaces
between the short ribs. By letting the weight of the upper body fall
upon his hands resting on the prone man, the air is forced out of the
lungs; by relaxing the pressure, the chest cavity enlarges and air is
drawn in to take the place of that forced out. By effecting this
change of air--pressing and relaxing, twelve to fifteen times a minute
(time it by watch at first, and then count) artificial breathing is
performed. Sometimes it is necessary to work an hour or two before the
flicker of an eyelid or a gasp from the patient rewards the life
saver's efforts, and then he must carefully "piece in" the breathing
until natural breathing is resumed. When breathing starts, then
promote circulation by rubbing the legs and body toward the heart. Do
not attempt to stimulate by the throat until the patient can swallow.
Give a teaspoonful of aromatic spirits of ammonia, in half a glass of
water.
_Remember that by laying the patient face downward fluids in the air
passages will run or be forced out and the tongue will drop forward,
and require no holding, always an awkward task_.
Treatment After Respiration Begins
The after treatment is important. Put the patient to bed, keep quiet
and warm. Always get the services of a physician as soon as possible,
but do not wait for him to come. Start work instantly. The patient
needs oxygen, so keep spectators away. They are robbing the man of the
life-giving properties of the air. For this reason, in all but the
most severe weather, it is well to work on the patient in the open.
Life Buoys
If one is to place a life buoy for instant use in emergencies it
should be hung upon four pegs driven into holes in two pieces of wood
nailed together in the form of the diameter of a two-foot square or
three pegs in strips of wood arranged in the form of a T, about
eighteen or twenty inches high, the two pegs at either side of the top
bar of the T and the other one on the upright near the bottom. Most
life buoys used on shore have fifty or seventy-five feet of light line
attached to draw the {288} rescued person ashore or to recover the
buoy after a faulty throw. Commencing at the free end of the line,
where a small wooden float is often attached, the rope should first be
coiled on the pegs, hanging the buoy outside the coil to bind it in
place so wind or jars will not loosen it. Then, when the buoy is
needed, the ring is grasped by the throwing hand which clasps the buoy
itself, and the coil is clasped in the free hand, the end of the rope
being secured ashore by standing upon it with one foot. After each use
or practice the buoy line should be restored to its pegs for instant
use.
[Illustration: Life buoy and ice ball/]
{289}
Notes
{290}
Notes
{291}