For some people it is easier to handle a_Scouting For Girls, Official Handbook of the Girl Scouts

table than on one's lap, having under the child a soft bath towel or

canton flannel large enough to be wrapped around it. Its nose may be

cleaned with a bit of absorbent cotton rolled to a point, using a fresh

piece for each nostril. To bathe the eyes use fresh pieces of absorbent

cotton dipped in boric acid solution. Wash the baby's face carefully so

that the water does not drip into its ears. Dry the face carefully. Wash

the head gently and thoroughly with soap, being careful to rinse

completely. Soap the baby's body before putting it into the bath. As a

soapy little baby is difficult to hold, support him firmly all the time

he is kicking and splashing, by placing the arm or hand at the baby's

back between its shoulders. Wash particularly, under the arms, the

creases in the back of the neck, between the legs, fingers and toes. The

bath should be given quickly and the baby lifted out in the bath towel

or flannel, covered and dried quickly, using a soft towel. Rub the baby

very slightly. All the folds of the skin should be dried and well

powdered: under the arms, behind the ears, about the neck, legs, etc. Do

not put too much powder on, as it forms a paste. Dress the infant and

lay it on its crib while putting away all the things used for its bath.

It is perfectly proper for a baby to exercise its lungs by crying, so do

not be alarmed, but be sure that its clothing is comfortable and that

the child is clean. Garments worn at night should always be different

from those worn during the day. The garments next to the skin should be

of wool or part wool, except the diaper, which should be soft cotton,

and when new, washed several times before using. Wet diapers should be

rinsed in cold water and dried before using a second time; about every

twenty-four hours diapers should be washed, scalded, rinsed in cold

water and hung in the air to dry.

Daily Routine--Child Under Two Years of Age

6.00 A.M. Feed warm milk.

7.30 A.M. Seat on chair or hold over chamber not more than ten minutes.

If the child has no movement of the bowels at this time, try later.

9.00 A.M. Give bath, and immediately after, feed, then put to bed in a

well ventilated room, darkened, or out of doors in carriage or crib. Be

sure no strong light is in the child's eyes. Child should sleep until

one o'clock.

1.00 P.M. Take up, make comfortable, and feed.

2.00 P.M. Take child out of doors again, but do not stay after 3 P.M. in

winter time. Later in summer. Stormy days keep in house in crib or

carriage, well wrapped up in room with window open.

3 to 5 P.M. Hold child, or let it stay in crib and play or kick.

6.00 P.M. Undress, rub with soft, dry towel, put on nightclothes, feed

and put to bed in well ventilated room.

10.00 P.M. A young baby should be fed at this time, dried, and not fed

again until 6. A.M.

A baby needs to be kept quiet. Do not make loud noises near it. Do not

play with infant too much. Leave it to itself to grow. Keep the baby

clean, everything about it tidy. Do not give a child pointed toys or

playthings small enough to go into the infant's mouth. Tie toys to the

crib or carriage so that they do not fall on the floor.

Things to Remember

Emphasize "tidy as you go," sleep, water, bowel movements, exercise for

older children, especially in cold weather, nothing in mouth, do not use

pacifiers, tying toys to crib or carriage, a baby over two years of age

should not be fed oftener than every four hours.

Bowel Movements

At least once a day.

Should be medium soft, not loose, smooth, and when on milk diet, light

in color.

If child is constipated, give one teaspoonful of milk of magnesia clear,

at night.

See doctor if child is not well.

Feedings

Children from birth to five months should be fed every three hours.

Children over one and a half years old need three meals a day, dinner in

the middle of the day.

Little children need to be kept very quiet. No confusion or loud noises

around them. They will then grow better and stronger.

Colds

Never neglect a cold. Do not "pass it on" to a child by coughing,

sneezing, talking or breathing into its face. Do not kiss anyone when

you have a cold. Never allow the handkerchief used by a person with a

cold to touch a child. If you must handle a child when you have a cold,

wear a piece of gauze over your mouth and nose, and be sure to keep your

hands clean. Be very careful with the handkerchiefs used; see that no

one touches or uses them. It is preferable to use gauze or soft paper

for handkerchiefs and burn them. When a child has a cold put it to bed.

Keep quiet as long as there is any fever. Give a cathartic, such as

castor oil, as soon as cold appears. Reduce the child's diet and give

plenty of drinking water. Consult a doctor. Do not let the child go out

until thoroughly well.

3. THE FIRST AIDE IN ACCIDENTS AND EMERGENCIES

General Rules

The sorrow and unhappiness of the world is increased enormously every

year by injury and loss from accidents, more than half of which might

be prevented if someone had not been careless, or if someone else had

taken a little trouble to correct the results of that carelessness

before they caused an accident.

It therefore becomes the plain duty of Girl Scouts not only to be

careful but to repair, if possible, the carelessness of others which may

result in accident.

Let us review briefly some of the many small things in our daily lives

which cause accidents, and therefore suffering and loss.

1. _Carelessness in the Street._ As, for example, taking chances in

getting across in front of a car or automobile; running from behind a

car without looking to see of some vehicle is coming from another

direction; catching a ride by hanging on to the rear end of cars or

wagons; getting off cars before they stop; getting on or off cars in the

wrong way; being too interested to watch for open manholes, cellarways,

sewers, etc.; reckless roller skating in the street, throwing things

like banana peels on the street or sidewalk where people are likely to

slip on them; teasing dogs, or trying to catch strange ones; many dogs

resent a stranger petting them and use their only means of

defense--biting. Other examples will occur to you of carelessness in the

streets which space does not allow us to mention here.

Wait until the car stops before trying to get off. In getting off cars

you should face in the direction in which the car is going. A simple

rule is to get off by holding a rod with the left hand and putting the

right foot down first. This brings you facing the front of the car and

prevents your being swept off your feet by the momentum of the car.

If you see any refuse in the street which is likely to cause an

accident, either remove it yourself or report it to the proper

authorities to have it removed at once.

2. _Carelessness at Home._ As for example, starting the fire with

kerosene; leaving gas jets burning where curtains of clothing may be

blown into the flame; leaving clothing or paper too near a fire;

throwing matches you thought had been put out into paper or other

material which will catch fire easily; leaving oily or greasy rags where

they will easily overheat or take fire spontaneously; leaving objects on

stairs and in hallways which will cause others to fall; leaving scalding

water where a child may fall into it or pull it down, spilling the

scalding water over himself; leaving rags or linoleum with upturned

edges for someone to fall over; and innumerable other careless things

which will occur to you.

3. _Disobedience_, playing with matches; building fires in improper

places; playing with guns; trying the "medicines" in the closet;

throwing stones; playing with the electric wires or lights; playing

around railroad tracks and bridges: We could multiply the accidents from

disobedience indefinitely. Remember, a caution given you not to do

something means there is danger in doing it, which may bring much sorrow

and suffering to yourself and others.

It is a very old saying that "An ounce of prevention is worth a pound of

cure," but it is as true today as it was hundreds of years ago.

After the Accident

When the time for prevention is past, and the accident has happened,

then you want to know what is the best thing to do, and how best to do

it in order to give the most help and relief immediately, before expert

help can arrive, and to have the victim in the best condition possible

for the doctor when he comes, in order that he may not have to undo

whatever has been done before he can begin to give the patient relief

from his suffering.

1. Keep cool. The only way to do this effectually is to learn beforehand

what to do and how to do it. Then you are not frightened and can do

readily and with coolness whatever is necessary to be done.

2. Send at once for a doctor, if you have a messenger, in all except the

minor accidents. This book will help you learn to judge of whether a

doctor will be necessary. If in doubt send for a doctor anyway.

3. Prevent panic and keep the crowd, if there is one, at a distance. The

patient needs fresh air to breathe, and space around him.

4. Loosen the clothing, especially any band around the neck, tight

corsets or anything else that may interfere with breathing.

5. _Keep the patient flat on his back_ if the accident is at all

serious, with the head slightly down if his face is pale and he is

faint, or slightly raised if his face is flushed and he is breathing

heavily, as though snoring.

6. _If there is vomiting_, turn the head to one side in order that the

vomited material may easily run out of the mouth and not be drawn into

the windpipe and produce choking to add to the difficulties already

present.

7. _Remove clothing_, if necessary, gently and in such manner as to give

the patient the least amount of suffering. Move any injured part as

little as possible. At the same time, as a secondary consideration,

injure the clothing as little as possible. If, as often, it becomes

necessary to cut off the clothing, it may be possible to rip up a seam

quickly instead of cutting the cloth, but saving the clothing is always

secondary to the welfare of the patient. Little or no consideration

should be shown for clothing where it is necessary to keep the patient

motionless, or where quick action is needed.

8. _Transportation._ There are three methods for emergency

transportation of accident victims which can be used according to the

degree of the injury:

(a) _Fireman's Lift._ If it is necessary for one person to carry a

patient, it is easily possible to lift and carry quite a weight in the

following manner:

First, turn the patient on his face, then step astride his body, facing

toward his head, and, with hands under his armpits, lift him to his

knees, then clasp your hands over the patient's abdomen and lift him to

his feet; then draw his left arm around your neck and hold it against

the left side of your chest, the patient's left side resting against

your body, and supporting him with your right arm about the waist. Then

drop the patient's left hand and grasp his right wrist with your left

hand and draw the right arm over your head and down upon your left

chest; then stooping, clasp his right thigh with your right arm passed

between the legs (or around both legs) and with a quick heave lift the

patient to your shoulders and seize his right wrist with your right

hand, and lastly, grasp the patient's left hand with your left hand to

steady him against your body. (Work this out with a companion as you

read it.)

(b) A seat made of four arms and hands (which you have no doubt used in

your play), may be used for the lesser injuries. If the patient can, he

supports himself by putting his arms around the necks of his carriers,

each of whom in the meantime grasps one of his own wrists and one of his

partner's. This makes a comfortable seat for carrying. If the patient

needs supporting, a back may be improvised by each carrier grasping the

other's arm below the shoulder to form the back and their other hands

clasped to form the seat. A better seat may be made with three hands

clasping the wrists, while the fourth arm is used as a back, by one

clasping the other's arm below the shoulder. This does not provide a

very secure back, however, as it is not easy to hold the arm against

much of a weight from the patient's body.

unconscious, has a serious fracture of some bone or bones, has a serious

injury to any part of the body, or is bleeding excessively, he must be

carried lying down. It may be that there will be no regular stretcher at

hand. In that case one must be improvised. A serviceable one can be made

from ordinary grain or flour bags by cutting the two corners at the

bottom and running two poles inside the mouth of the bags and through

the holes.

A workable stretcher can be made from coats by turning the sleeves

inside out, passing the poles through the sleeves and buttoning the coat

over the poles. This brings the turned sleeves on the inside. A five-bar

gate or a door, if it can be gotten without delay, also make

satisfactory emergency stretchers.

A stretcher may also be made out of dress skirts, with or without poles.

Put the skirts together, bottoms slipped past each other, and slip the

poles through, as with the bags. If no poles are available, roll the

edges of the skirts over several times to form a firm edge, and carry

with two or four bearers, as the size and weight of the patient make

necessary.

Minor Injuries and Emergencies

Minor injuries may or may not need the aid of a doctor, and you must

learn to use judgment as to the necessity of sending for one. We will

consider these minor injuries in groups to remember them more easily.

1. (a) BRUISES; (b) STRAINS; (c) SPRAINS

(a) A _Bruise_ is produced by a blow which does not break the skin, but

does break the delicate walls of the capillaries and smaller veins, thus

permitting the blood to flow into the surrounding tissues, producing

the discoloration known as "black and blue."

(b) _A Strain_ is produced by the overstretching of muscles or

ligaments, or both, but not tearing them. It may or may not be

accompanied by breaking of capillary walls with discoloration. Any

muscle or ligament may be strained.

ligaments or both about a _joint_. There may also be some tearing of the

fibres or tearing loose from their attachments. This always breaks

capillaries or small veins, making the surface black and blue. This

discoloration usually appears some time after the accident, because the

broken blood vessels are far below the surface.

_Treatment_--For bruises and strains it is seldom necessary to call a

doctor. Apply cold, either by wringing cloths out of cold water and

applying, or by holding the injured part under the cold water tap. Do

this at intervals of several hours, until the pain is lessened. The cold

may be alternated with hot water which must, however, be quite hot, just

enough not to burn, as lukewarm water is almost useless. Some patients

will prefer to use only hot water. The water followed by applications of

tincture of arnica, witch hazel, or alcohol and water, half and half,

and bandaging will be sufficient.

If, however, there has been no black and blue at first, as in a bruise,

but it begins to show later, and the pain continues severe, and there is

a good deal of swelling, then you should send for a doctor, as more than

first aid is needed.

In case of _sprain_, send for a doctor, and in the meantime elevate the

joint and apply hot or cold water, or alternate hot and cold, as patient

prefers. This will give relief by contracting the blood vessels.

2. (a) BURNS; (b) SCALDS; (c) SUNBURN; (d) FROSTBITE

(a) _Burns_ are produced by dry heat, as a fire, acids, alkalis, etc.,

and may be of all degrees, from a superficial reddening of the skin to a

burning of the tissues to the bone.

(b) _Scalds_ are produced by moist heat, and may be of the same degrees

as those produced by dry heat.

may be quite severe.

(d) _Frostbite_ is produced by freezing the tissues and is usually not

dangerous. The more severe types will be treated later under Freezing.

_Treatment_--(a) _Burns_; (b) _Scalds_

1. Except in the minor burns and scalds, send for the doctor at once.

2. The first thing to do is allay pain by protecting the injured part

from the air.

3. For a burn produced by fire, cover with a paste made of baking soda

and water, or smear with grease--as lard, carron oil (mixture of linseed

oil and lime water--half and half) or vaseline or calendula cerate.

Cover with a piece of clean cloth or absorbent gauze and bandage loosely

or tie in place. Gauze prepared with picric acid, if at hand, is a most

satisfactory dressing. It can be purchased and kept on hand for

emergencies.

4. In burns from alkalis or acids, wash off as quickly as possible and

neutralize (make inactive the acids with baking soda, weak ammonia or

soapsuds; the alkalis with vinegar or lemon juice). Afterward treat like

other burns.

the sun's rays and may be prevented by gradually accustoming the skin

to exposure to the sun. It is treated as are other minor burns.

(d) _Frostbite_--_Prevention_--1. Wear sufficient clothing in cold

weather and keep exposed parts, such as ears and fingers, covered.

2. Rub vigorously any part that has become cold. This brings the warm

blood to the surface and prevents chilling.

3. Keep in action when exposed to the cold for any length of time. The

signs of danger are sudden lack of feeling in an exposed part, and a

noticeably white area. Chilblain is an example of frostbite.

_Treatment_--The circulation of the blood through the frozen part must

be restored gradually. This must be done by rubbing the part first with

cold water, which will be slightly warmer than the frozen part, and

_gradually_ warming the water until the circulation and warmth is fully

restored. Then treat as a minor burn. If heat is applied suddenly it

causes death of frozen parts.

3. SPLINTERS, SMALL CUTS, SCRATCHES AND PIN PRICKS

None of these injuries will usually require a doctor if properly treated

in the beginning. The bleeding from any of them is not sufficient to be

dangerous. But whenever there is a break in the skin or mucous membrane

there is danger of infection by germs, and this is what makes the first

aid treatment in these cases so important. A tiny scratch is sometimes

converted into a bad case of blood poisoning by not being properly

treated at first.

Splinters should be removed by using a needle (not a pin) which has been

sterilized by passing it through a flame (the flame of a match will do

if nothing better is at hand). After the splinter is out, the wound is

treated like a cut or scratch.

The germs which produce poisoning do not float in the air, but may be

conveyed by any thing which is not sterile, as, for instance, the

splinter or the instrument that did the cutting, scratching or pricking.

They may be carried to the scratch by our hands, by water, or cloth used

for dressings.

_Treatment_--Wash your own hands thoroughly with soap and water, using a

nail brush. Clean the injured part well with disinfectant, as, for

instance, alcohol and water, half and half, or peroxide of

hydrogen--paint the spot with iodine, and cover with sterile gauze (if

this is not to be had, use a piece of clean cloth that has been recently

ironed), and bandage in place. If the bleeding is severe, a little

pressure with the bandage over the dressing will stop it. Use the same

precautions if the wound has to be re-dressed.

4. STINGS AND BITES OF INSECTS

The poison injected by the sting or bite of an insect is usually acid,

and the part should be washed at once with a solution of ammonia or soda

(washing soda) to neutralize the poison. Then apply a paste of soda

bicarbonate (baking soda) or wet salt and bandage in place. If the sting

is left in the wound it must be pulled out before beginning treatment.

5. FOREIGN BODIES IN THE (a) EYE (Cinder) (b) EAR (Insect), (c) NOSE

(Button)

(a) _Eye_--If a cinder, eyelash, or any tiny speck gets into the eye it

causes acute pain, and in a few minutes considerable redness.

_Treatment_--Do not rub the eye, as this may press the object into the

tender cornea so that it can be removed only with difficulty and by a

physician. First close the eye gently, pull the eyelid free of the

ball, and the tears may wash out the speck. If this is not successful,

close the eye, hold the lid free, and blow the nose hard. You may then

be able to see the speck and remove it with a bit of clean cotton or the

corner of a clean handkerchief. If the object is lodged under the lid,

and the foregoing efforts do not dislodge it, proceed to turn the lid up

as follows:

Ask the patient to look at the floor, keeping the eyeball as stationary

as possible. Take a clean wooden toothpick or slender pencil, wrapped

with cotton, place on the upper lid about one-fourth of an inch from the

edge, grasp the eyelashes with the other hand, give a slight push

downward toward the cheek with the toothpick, a slight pull upward on

the lashes and turn the lid over the toothpick. Remove the speck and

slip the lid back in position. Wash the eye with boric acid solution.

If you are still unable to dislodge the body, discontinue any further

efforts, apply a cloth wet in cold boric acid solution and send for the

doctor. Anything done to the eyes must be done with the greatest

gentleness.

If an acid has entered the eye, neutralize it with a weak solution of

soda bicarbonate in water. If an alkali (lime) is the offending

substance, neutralize by a weak vinegar solution. Follow in each case

with a wash of boric acid solution.

(b) _Ear_ (Insect); (c) _Button in Nose_--Foreign bodies in the ear and

nose are not very common.

But sometimes a child slips a button or other small object into these

cavities, or an insect may crawl in. Drop in a few drops of sweet oil

and if the object comes out easily, well and good. If not, do not keep

on trying to extract it, for fear of greater injury. Send for the

doctor.

6. IVY AND OAK POISONING

There is a poison ivy (or poison oak) which is very poisonous to some

people, and more or less so to all people. The poison ivy has a leaf

similar to the harmless woodbine, but the leaves are grouped in threes

instead of fives. The poison given off by these plants produces a severe

inflammation of the skin. In the early stages it may be spread from one

part of the body to another by scratching.

_Treatment_--Wash the irritated surface gently with soap and water, and

then apply a paste of soda bicarbonate or cover quickly with carbolated

vaseline. Another remedy is fluid extract _grindelia robusta_, one dram

to four ounces of water. Sugar of lead and alcohol have also been found

useful. For severe cases consult a doctor, especially if the face or

neck or hands are affected.

7. (a) FAINTING; (b) HEAT EXHAUSTION

(a) _Fainting_ is caused by lack of blood in the brain, and usually

occurs in overheated, crowded places, from fright or from overfatigue.

_Symptoms_--1. The patient is very pale and partially or completely

unconscious.

2. The pulse is weak and rapid.

3. The pupils of the eyes are normal.

_Treatment_--1. If possible put the patient flat on his back, with the

head slightly lower than the rest of the body.

2. If there is not room to do this, bend the patient over with his head

between the knees until sufficient blood has returned to the brain to

restore consciousness.

3. Then get the patient into the fresh air as soon as possible.

4. Keep the crowd back.

5. Loosen the clothing about the neck.

6. Apply smelling salts to the nose.

7. When the patient has recovered sufficiently to swallow, give him a

glass of cold water, with one-half teaspoonful of aromatic spirits of

ammonia if necessary.

(b) _Heat Exhaustion_ is exhaustion or collapse due to overheating where

there is not sufficient evaporation from the surface of the body to keep

the temperature normal.

_Symptoms_--1. The patient is usually very weak.

2. The face is pale and covered with a clammy sweat.

3. The pulse is weak and rapid.

4. The patient is usually not unconscious.

_Treatment_--1. Remove the patient to a cool place and have him lie

down.

2. Loosen the clothing.

3. Give him a cold drink to sip.

4. Put cold cloths on his head.

5. Send for the doctor.

6. If necessary, give stimulant as in fainting.

8. (a) CHOKING: (b) HICCOUGH

(a) _Choking_--Choking is produced by something lodged in the throat,

does not require artificial respiration, but a smart slap on the back to

aid in dislodging whatever is blocking the air passage. It may be

necessary to have the patient upside down, head lower than feet, to aid

in getting out the foreign body. This is a comparatively simple matter

with a child, but is not so easy with an adult. When the object is not

too far down the throat it may be necessary for someone to use his

fingers to pull out the offending substance to keep the patient alive

until the doctor can arrive. In this case wedge the teeth apart with

something to prevent biting before trying to grasp the object.

(b) _Hiccough_--This is usually due to indigestion or overloading of

the stomach. Holding the breath for one-half minute will usually cure

it, as it holds quiet the diaphragm (the large muscular and fibrous

partition between the chest and abdomen), and overcomes its involuntary

contractions which are causing the hiccoughs. A scare has the same

effect sometimes. If the hiccoughs still continue troublesome after

these simple remedies try to cause vomiting by drinking lukewarm water,

which will get rid of the offending material causing the hiccough, and

relieve the distress.

9. NOSE BLEED

The ordinary nose bleed will soon stop from the normal clotting of the

blood and does not require treatment.

(a) Keep head elevated, with patient sitting up if possible. Do not blow

the nose, as this will dislodge any clot which may have formed, and the

bleeding will begin again. Any tight collar around the neck should be

loosened.

(b) If the bleeding seems excessive, apply cloths wrung out of ice water

to the back of the neck and over the nose.

with a cotton or gauze plug. Pack tightly (with a blunt end of a pencil

if nothing else is at hand) _and send for the doctor at once_.

=Major Injuries and Emergencies=

1. (a) DISLOCATIONS; (b) FRACTURES

(a) _Dislocations_--In a dislocation the head of a bone is pushed or

pulled out of its socket. A person may be falling and in trying to save

himself catch hold of something in such a way that he feels a sharp,

sudden, severe pain, and may even feel the head of the bone slip out at

the shoulder or elbow.

_Symptoms_--1. When you looked at the injured part it does not look like

the other side.

2. If you attempt to move it you find it will no longer move as a joint

does, but is stiff.

3. There is great pain and rapid swelling usually.

4. There may or may not be black and blue spots around the joint.

_Treatment_--Send for a doctor at once. While waiting for the doctor,

place the patient in the easiest position possible, and apply hot or

cold cloths, frequently changed, to the injured part.

In dislocation of the jaw it may be necessary for someone to try to

replace it before the doctor arrives. The mouth is open and the jaw

fixed. The patient may even tell you he has felt the jaw slip out of its

socket. Wrap your thumbs in cloth to prevent biting when the jaw snaps

back in place. Place the thumbs on the tops of the lower teeth on each

side, with the fingers outside, and push firmly down until the head of

the bone can slip over the edge of the socket into place. As you feel

the bone slipping into place, slide your thumbs out to the inner side of

the cheek to prevent biting when the jaws snap together with the

reducing of the dislocation.

(b) _Fractures_--_Broken bones_--There are two classes of fractures:

1. _Simple_--In a simple fracture the bone is broken, but the skin is

not broken; that is, there is no outward wound.

2. _Compound_--In a _compound_ fracture not only is the bone broken, but

the jagged ends pierce through the skin and form an open wound. This

makes it more dangerous as the possibility of infection by germs at the

time of the accident, or afterward, is added to the difficulty of the

fracture.

_Symptoms_--As in dislocation, you should be familiar with the main

symptoms of a broken bone.

1. When you look at the injured part it may or may not look like its

mate on the other side. In the more severe fractures it usually does

not.

2. When you try to move it you find more motion than there should be, if

the bone has broken clear through; that is, there will seem to be a

joint where no joint should be.

3. The least movement causes great pain.

4. The swelling is usually rapid.

5. The discoloration (black and blue) appears later; not at once, unless

there is also a superficial bruise.

6. The patient is unable to move the injured part.

7. You may hear the grate of the ends of the bone when the part is

moved, but you should not move the injured bone enough to hear this,

especially if the limb is nearly straight; the detection of this sound

should be left for the doctor.

_Treatment_--Send for a doctor at once, and if it will be possible for

him to arrive soon, make the patient as comfortable as possible and wait

for him. However, if it will be some time before the doctor can arrive

you should try to give such aid as will do no harm and will help the

sufferer.

You must handle the part injured and the patient with the utmost

gentleness to avoid making a simple fracture into a compound one, or

doing other injury, and also to give him as little additional suffering

as possible. You will need to get the clothing off the part to be sure

of what you are doing. Rip the clothing in a seam if possible when the

fracture is in an arm or leg, but if this cannot be done, you will have

to cut the material. Do not try to move the broken bone trying to get

off a sleeve or other part of the clothing.

With the greatest gentleness put the injured part, for instance, the arm

or leg, as nearly as possible in the same position as the sound part,

and hold it in that position by splints. Do not use force to do this.

There is no great hurry needed to set a broken bone. The important point

is to get it set right, and this may better be done after complete rest

of several days, allowing for the passing of the inflammation.

_The Most Important "What Not to Do Points" for Fractures Are_:

1. If there is reason to think a bone _may_ be broken try in all ways to

prevent motion at _point_ of fracture lest it be made compound.

2. Do not go hunting for symptoms of fracture (such as the false point

of motion or the sound "crepitus") just to be sure.

3. The best treatment is to try to immobilize the part till the doctor

comes.

_Splints_--Anything that is stiff and rigid may be used for splints.

Shingles, boards, limbs of trees, umbrellas, heavy wire netting, etc.

Flat splints are best, however. All splints should be padded, especially

where they lie against a bony prominence, as for instance, the ankle or

elbow joint.

If the patient is wearing heavy winter clothing this may form sufficient

padding. If not, then other cloth, straw or leaves may be used. Cotton

batting makes excellent padding but if this is not to be had quickly,

other things can be made to do to pad the first rough splints which are

applied until the patient can reach a doctor or the doctor arrives on

the scene of the accident.

In applying splints remember they must extend beyond the next joint

below and the next joint above, otherwise movement of the joint will

cause movement of the broken part.

The splints are tied firmly in place with handkerchiefs, strips of

cloth, or bandages, tied over splints, padding and limb. Do not tie

tight enough to increase the pain, but just enough to hold the splints

firmly. Do not tie directly over the break. There must be an inner and

outer splint for both the arms and the legs.

2. (a) SERIOUS WOUNDS; (b) SERIOUS BLEEDING

Send for the doctor at once, and then stop the bleeding and keep as

clean as possible till he arrives.

_Dangers_--1. In any wound with a break in the skin, there is the danger

of infection or blood poisoning, as you have already learned.

2. In serious wounds through the skin, flesh and blood vessels there is

also the danger of severe bleeding, with the possibility of the

patient's bleeding to death.

_Infection_--You already know how the germs which can cause the blood

poisoning get into the wound.

(a) by the object that makes the wound

(b) from the clothing of the patient through which the wound is made

(d) from the water which has not been sterilized used in washing the

wound

(e) from dirty dressings, that is, dirty in the sense that they have on

them germs which can get into the wound and cause infection or blood

poisoning.

The first two of these chances the Girl Scout will not be able to

control. The last three she can to some extent prevent. _Do not wash,

touch or put anything into a serious wound_ unless a doctor cannot be

found. Only this sort of thing justifies running risk of infection.

Otherwise just put on a sterile dressing and bandage. In reality washing

wounds only satisfies the aesthetic sense of the operator without real

benefit to the patient in many cases. If a wound has to be cleansed

before the doctor comes use boiled water; if this cannot be had at once,

use water and alcohol half and half.

1. Always wash your hands thoroughly with water, soap and a nail brush,

unless there is necessity for immediate help to stop bleeding which

admits of no time to clean one's hands. Be sure your nails are clean.

2. Try not to touch the wound with your hands unless it is absolutely

necessary.

3. Many wounds do not have to be washed, but dressing may be applied

directly.

4. Having cleansed the wound as best you can, or all that is necessary,

apply sterile cloth for dressing. This may be gotten at a drug store in

a sterile package ready for use immediately, and is very satisfactory.

If, however, these cannot be had, remember any cloth like a folded

handkerchief that has been recently washed and _ironed_ is practically

sterile, especially if you unfold it carefully and apply the inside

which you have not touched, to the wound. Bind the dressing on with a

bandage to keep in place until the doctor arrives.

(b) _Serious Bleeding_:

It is important that you should learn what is serious bleeding and this

will often help you to be cool under trying circumstances.

As you learned in your work in minor emergencies, the bleeding from the

small veins and capillaries is not usually sufficient to be dangerous,

and the pressure of the dressing when put on and bandaged in place will

soon stop it. It may sometimes be necessary to put more dressing outside

of that already on (called re-inforcing it) and bandage again snugly.

But if you have made sure first that there is no large vein or artery

cut, you need not be troubled for fear there will be serious bleeding

before the doctor arrives.

[Illustration: Tourniquet

Showing where stone for pressing against artery is placed

Loop through which stick for tightening is inserted]

_Bleeding from an Artery_: If an artery is cut the blood spurts out, the

size of the stream depending on the size of the artery cut. This is the

most serious bleeding because the heart is directly behind, pumping the

blood through the artery with all its power. If it is a small artery the

pressure with the finger between the cut and the heart for a few minutes

will give the blood time to clot behind the finger and form a plug. This

will stop the bleeding aided by pressure of the bandage. If it is a

larger vessel the force in the heart muscle pumping the blood will force

out any plug formed by the finger there, as the finger tires too easily.

_Tourniquet_: In this case it will be necessary to put on a tourniquet

to take the place of the finger until a clot can form in the vessel big

enough and strong enough to prevent the force of the blood current from

pushing it out. This of course can be used only on the legs or arms.

A tourniquet is something put on to make pressure on a blood vessel to

stop serious bleeding. There are five points to remember about a

tourniquet:

1. It must be long enough to tie around the limb--a big handkerchief,

towel or wide bandage.

2. There must be a pad to make the pressure over the artery greater than

on the rest of the limb--a smooth stone, a darning ball, a large cork,

cloth folded into a large pad or a rolled bandage.

3. The pad must be so placed that the artery lies between pad and the

bone on the limb, in order that the pressure may stop the flow of blood

by forcing the walls of the artery together between the pad and the

bone.

4. Unless the tourniquet is put on tight enough, its application

increases bleeding. It is extremely rare to find a tourniquet put on

tight enough. In almost every such case removing the tourniquet will

stop or partly lessen bleeding. A short stick or handle is needed, about

a foot long, with which to twist the tourniquet sufficiently to stop

the flow of blood. Usually it cannot be twisted tightly enough by hand

alone. Tie the twisted part firmly so it will not slip, after it has

been made tight enough to stop bleeding.

5. Remember, a tourniquet stops most of the circulation below it as well

as in the cut artery, and must not be left in place too long for fear of

injury to the rest of the limb by cutting off the circulation. _Usually

it should not be left on for more than an hour._

_Bleeding from Veins_--Bleeding from the veins is not so dangerous as

from an artery. The blood from the heart has to go through the little

capillaries before it gets into the veins, and therefore the force of

the heart muscle on the blood in the veins is not so great as in the

arteries. The blood does not spurt out, but flows out as it would from a

bottle tipped on its side.

You have already learned what to do to stop the bleeding from the

smaller veins, and that it is not serious. From the larger veins,

however, it can be very serious, and it may be necessary for you to put

on a tourniquet before the doctor arrives in order to save the patient's

life.

Almost always bleeding from a vein can be controlled by clean gauze or

handkerchief pad and pressure by hand directly over the bleeding wound.

Tourniquets are almost never needed in bleeding from a vein. If

necessary, it is wisest to apply them in the same way as for arterial

hemorrhage and stop the circulation in the whole limb.

It is important to know in a general way where the blood vessels are in

order to put the pad over them to stop the bleeding. Roughly speaking,

the artery of the arm runs down about in a line with the inner seam of

the coat. The large vein lies close beside it, carrying the blood back

to the heart. The artery and vein of the leg run about in a line with

the inside seam of a man's trousers.

_Stimulants_--In serious bleeding of any kind do not give stimulants

until the bleeding has been stopped, as the stimulants increase the

force of the heart and so increase the flow of blood. After the

tourniquet is on and bleeding is stopped, if the patient is very weak,

he may have a teaspoonful of aromatic spirits of ammonia in half a glass

of water.

(a) SHOCKS; (b) APOPLEXY; (c) CONVULSIONS

(a) _Shocks_--In any injury, except the slight ones, the ends of the

nerves in the skin are bruised or jarred. They send this jar along the

nerves to the very delicate brain. The blood is drawn from the brain

into the larger blood vessels, and the result produced is called shock.

If you have jammed your finger in a door sometime, perhaps you have felt

a queer sick feeling and had to sit down. A cold sweat broke out all

over you, and you were hardly conscious for a moment or two. This was a

mild case of shock. In more severe injuries a shock to the brain may be

very serious.

_Symptoms of Shock_--1. The patient may or may not be unconscious, but

he may take no notice of what is going on around him.

2. The face is pale and clammy.

3. The skin is cold.

4. The pulse is weak.

5. The breathing is shallow.

In any serious injury the shock is liable to be severe and will need to

be treated before the doctor arrives.

_Treatment_--Send for the doctor if serious.

1. Lay the patient flat on his back with head low, so that the heart can

more easily pump the blood back into the brain.

2. Cover warmly; if they can be gotten, put around him several hot water

bottles or bricks, being extremely careful to have them covered so that

they will not burn him. Persons suffering from shock are more easily

burnt than usual. Do not put anything hot next him unless it can be held

against your own face for a minute without feeling too hot.

3. Rub the arms and legs, toward the body, but under the covers.

4. Give stimulants only after the patient has recovered enough to

swallow, and when there is no serious bleeding.

_Stimulants_--Strong, hot coffee, or a half teaspoonful of aromatic

spirits of ammonia in a half glass of warm water. The latter may be

given if the coffee is not ready.

(b) _Apoplexy_--When a person has a "stroke" of apoplexy send for the

doctor at once.

This condition resembles shock only in that the patient is unconscious.

The blow to the delicate brain does not come from the outside along the

nerves, but from the inside by the breaking of a blood vessel in the

brain, letting the blood out into the brain tissue and forming a clot

inside of the brain, and thus making pressure which produces the

unconsciousness.

_Symptoms of Apoplexy_--1. The patient is unconscious.

2. The face is usually flushed--red.

3. The skin is not cold and clammy.

4. The pulse is slow and full.

5. The breathing is snoring instead of shallow.

6. The pupils of the eye are usually unequally dilated.

_Treatment_--1. Lay the patient flat on his back with head slightly

raised.

2. Do not give any stimulants.

3. Wait for the doctor.

apoplexy in that the patient is unconscious.

_Symptoms of Convulsions_--1. The patient is unconscious.

2. The face is usually pale at first, but not so white as in shock, and

later is flushed, often even purplish.

3. The skin is not usually cold.

4. The breathing may be shallow or snoring.

5. There are twitchings of the muscles of the face and body or a

twisting motion of the body.

6. The pulse may be rapid, but is usually regular.

7. The mouth may be flecked with foam.

8. The pupils of the eye may be contracted or equally dilated.

_Treatment_--Convulsions come from various causes, and are always

serious, therefore send for the doctor at once.

1. Put a wedge of some kind between the teeth if possible, the handle of

a spoon protected by a cloth cover, or a rolled napkin does well. This

is to prevent biting the tongue, which the patient is apt to do in

unconsciousness with convulsive movements.

2. Lay the patient flat on his back, and prevent him from hurting

himself in his twisting, but do not try to stop convulsive movement. It

will do no good.

3. No stimulant is needed.

(a) SUNSTROKE; (b) FREEZING

(a) _Sunstroke_--Sunstroke is caused by too long exposure to excessive

heat, or to the direct rays of the sun, and is much more serious than

heat exhaustion, which you have already studied.

_Prevention_--Do not stay out in the direct sunlight too long on a hot

summer day. Wear a large hat which shades the head and face well, if

obliged to be in the hot sun for any length of time. Do not wear too

heavy clothing in the hot weather. Leaves or a wet sponge in the top of

the hat will help to prevent sunstroke. Drink plenty of cool water

between meals.

_Symptoms of Sunstroke_--1. The patient is unconscious.

2. The face is red.

3. The pupils large.

4. The skin very hot and dry, with _no_ perspiration.

5. The pulse is full and slow.

6. The breathing is sighing.

_Treatment_--1. Get the patient into the shade where it is as cool as

possible.

2. Send for the doctor.

3. Remove the greater part of the clothing.

4. Apply cold water or ice to the head, face, chest and armpits.

Often the patient recovers consciousness before the doctor arrives; give

cold water to drink; never stimulants.

(b) _Freezing_--This is a much more serious condition than frostbite,

which you have studied, but only because more of the body is frozen and

the tissues are frozen deeper. Much more care must therefore be taken to

prevent bad effects after the thawing-out process.

_Symptoms of Freezing_--1. The patient may or may not be unconscious.

2. The frozen parts are an intense white and are without any feeling or

motion.

_Treatment_--Send for the doctor at once.

1. Take the patient into a cold room.

2. Remove the clothing.

3. Rub the body with rough cloths wet in cold water.

4. Very gradually increase the warmth of the water used for rubbing.

5. Increase the temperature of the room gradually.

6. When the patient can swallow, give him stimulants.

7. When the skin becomes more normal in color and the tissues are soft,

showing that the blood is once more circulating properly through the

frozen flesh, cover the patient warmly with hot bottles or bricks

outside of the bed clothing, or wraps, and give hot drinks. In using hot

water be sure it is not too hot.

Dog Bite[3]

In the case of the dog bite we have a more or less extensive break in

the skin and sometimes a deep wound in the flesh, through which the

poison of hydrophobia, which is a living virus or animal poison, may be

introduced, to be taken up slowly by the nerves themselves, reaching the

central nervous system in about forty days. The slowness and method of

this absorption renders the use of a ligature useless and unsafe. The

treatment for dog bite is therefore as follows:

_Immediate._ Send for a physician, telling him the reason. While

waiting, treat as any similar wound from any cause. If the skin is not

penetrated, but scratched only, apply iodine and a sterile or wet

dressing. If the skin is penetrated, the treatment should be the same as

for a wound made by a dirty nail: that is, a small stick, such as a

match, whittled to a point, with a little cotton twisted on the point,

should be dipped into tincture of iodine, and twisted down into the full

depth of the wound, and then done a second time.

_Subsequent._ A physician should be consulted immediately, and if there

is any suspicion of the dog being sick it should be kept under

observation. The body of a dog that has been killed under suspicion of

rabies or hydrophobia, should be sent as soon as possible to the proper

authorities.

One of the greatest discoveries in medical science is the Pasteur

treatment for the prevention of hydrophobia after mad dog bite, and

fortunately, provision for this treatment is so widespread that

practically every one in civilized regions needing it, can have it, as

is well known to all physicians. The fact that the period of

development of the disease is so long makes the possibility of

prevention greater.

It is never proper to suck a dog bite, because the merest scratch or

break in the surface, even if too small to notice, will serve as a

portal of entry for the living virus of rabies.

_Snake Bite._ For treatment of snake bite see page 297.

WATER ACCIDENTS

When it is possible, Girl Scouts should learn to swim well. It is fear

when suddenly thrown into the water that causes so many of the deaths by

drowning, and learning to swim well takes away this fear. A Girl Scout

should also learn how to prevent accidents, and how best to help the

victims of accidents in the water.

PREVENTION

Below are five rules for preventing drowning accidents.

1. Do not change seats in a canoe or rowboat.

2. Do not rock the boat.

3. Do not go out alone in a canoe, rowboat or sailboat unless you are

thoroughly competent to manage such a boat, in a sudden squall or storm.

4. Very cold water exhausts a swimmer much quicker than warm water,

therefore do not take any chances on a long swim in cold water unless a

boat accompanies you to pick you up in case of necessity.

5. Be careful not to go too far out when there is a strong undertow;

that is, a strong current below the surface of the water flowing

relentlessly out to sea.

6. Always wade upstream.

RESCUE [Illustration]

When a person gives up the struggle in the water, the body goes down,

and then because of its buoyancy it comes to the surface and some air is

expelled from the lungs, making the body less buoyant. It immediately

sinks again, this time a little lower, and again comes to the surface,

and more air is expelled. This process may be repeated several times,

until sufficient water is taken into the stomach and lungs to overcome

the buoyancy of the body and it no longer appears at the surface; but

the buoyancy is barely overcome, and therefore the body will float

easily. This can easily be utilized in saving the drowning person by

making the water carry most of the weight of the body.

To do this, place the hands on either side of the drowning person's

head, and tow him floating on his back with the face above the surface

of the water, while you swim on your back and keep the body away from

you. Remember, if possible, to go with the current and thus save

necessary strength. In some cases it may be easier and safer to grasp

the drowning person by the hair instead of trying to clasp the head.

EMERGENCIES

_Grips_--A drowning person is always a frightened person, and is

governed by a mad instinct to grab anything which subconsciously he

thinks may save his life. Usually he is past any reasoning. He grabs his

would-be rescuer with a death grip that is hard to break, but remember

he instinctively grabs what is above the surface and will not try to

grab below the shoulders.

_Wrist Grip_--If the drowning person grasps the rescuer's wrists, the

rescuer 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 and breaks the grip.

_Neck Grip_--To release a grip around the neck and shoulders from the

front, immediately cover the mouth of the other with the palm of the

hand, holding the nose between the first two fingers, and at the same

time pull the other body toward you with the other hand, meanwhile

treading water. Then take a full breath and apply your knee to the

other's stomach quickly, thus forcing him to expel any air in his lungs

and preventing him from getting more air by the hand on mouth and

nostrils.

If the grip of the drowning person does not allow use of the arms, then

try to raise your arms to the level of the shoulder, thus slipping his

arms to the neck and leaving your own arms free to use, as described.

_Back Grip_--This strangle hold is perhaps the most difficult to break,

and it is necessary to break it instantly if the rescuer is not also to

be in the rescued class.

Grasp the wrists of the other and push sharply back with the buttocks

against the abdomen of the other, and thus make room to slip suddenly

out of the encircling arms.

If this is not successful, do not despair, but throw the head suddenly

against the nose of the drowning person and then slip out of the grip

before he recovers from his daze.

It is often necessary to dive from the surface in rescuing a drowning

person, and this requires practice, and should be learned thoroughly

before the necessity for saving a life is presented. Remember that to

dive from the surface to a depth of more than ten feet will usually

require a weight in addition to the weight of the body. Carry a stone or

other heavy object in diving. Then when wishing to rise to the surface,

drop it and push against the bottom with the feet. This will send the

swimmer to the surface in short order.

In carrying a weight in the water, carry it low on the body, close to

the waist line, leaving one hand and both feet free for swimming. Or if

for any reason it is necessary to swim on the back, it leaves both feet

free to use as propellers.

ARTIFICIAL RESPIRATION

If the apparently drowned person is to be saved, no time must be lost

in the rescue from the water or in getting the water out of him, and

breathing re-established after he is brought to land.

[Illustration]

If there is a messenger handy send for a doctor at once, but in the

meantime lose no time in attempting restoration.

The best method for getting the water out of the lungs and breathing

re-established is the _Schaefer Method_, because it is the simplest,

requiring only one operator and no equipment. It can be kept up alone

for a long time.

1. Every moment is precious. Immediately lay the patient face downwards,

with the arms extended above the head and the face to one side. In this

position the water will run out and the tongue will fall forward by its

own weight, and not give trouble by falling back and closing the

entrance to the windpipe. Be sure there is nothing in the mouth, such as

false teeth, gum, tobacco, etc. Do not put anything under the chest. Be

sure there is no tight collar around the neck.

2. Kneel astride of the patient facing toward his head.

3. Place your hands on the small of the patient's back, with thumbs

nearly touching and the hands on the spaces between the short ribs.

4. Bend slightly forward with arms rigid so that the weight of your body

falls on the wrists, and makes a firm steady pressure downward on the

patient while you count one, two, three, thus forcing any water and air

out of the lungs.

5. Then relax the pressure very quickly, snatching the hand away, and

counting one-two--the chest cavity enlarges and fresh air is drawn into

the lungs.

6. Continue the alternate pressing and relaxing about twelve to fifteen

times a minute, which empties and fills the lungs with fresh air

approximately as often as he would do it naturally.

It may be necessary to work for an hour or two before a gasp shows the

return of natural breathing. Even then the rescuer's work is not over,

as it will be necessary to fill in any gaps with artificial breathing.

When natural breathing is established, aid circulation by rubbing and by

wrapping him in hot blankets and putting hot bottles around him, being

careful that they are protected to prevent burning the patient.

If at any time it is necessary to pull the tongue forward and to hold it

to prevent choking, remember to put a wedge between the teeth to prevent

biting. Do not give anything liquid by mouth until the patient is

conscious and can swallow readily. Aromatic Spirits of Ammonia or

Spirits of Camphor may be used on a handkerchief for the patient to

smell. The patient should be watched carefully for an hour or two even

after he is considered out of danger.

ICE RESCUE

Prevention: Below are two rules for preventing ice accidents:

1. Do not skate or walk on thin ice.

2. Watch for air holes.

Rescue: In trying to rescue a person who has broken through the ice,

always tie a rope around your own body and have this tied to some firm

object on shore. Do not try to walk out to the rescue as the ice will

probably break again under the weight of your body on so small an area

as the size of your feet. Always get a long board, ladder, rail or limb

of a tree, and either crawl out on this, which will distribute the

weight of your body over a larger surface of ice, or lie flat on your

stomach and crawl out, pushing the board ahead of you so that the person

in the water may reach it. If you yourself break through the ice in

attempting a rescue, remember that trying to pull yourself up over the

edge of the ice only breaks it more. If rescuers are near it is much

wiser to support yourself on the edge of the ice and wait for rescue.

After getting the person out of the water use artificial respiration if

necessary and bend every effort to get the patient warm and breathing

properly.

ASPHYXIATION

Prevention: Below are seven rules for preventing asphyxiation:

1. When coal stoves and furnaces are freshly filled with coal, coal gas

may escape if the dampers are not properly regulated. See that all

dampers in coal stoves and furnaces are correctly arranged before

leaving them for any long time, as for the night.

2. Do not go to sleep in a house or room with a gas jet or gas stove

turned low. The pressure in the pipes may change and the flame go out,

or a breeze may blow out the flame leaving the gas leaking into the

room.

3. Do not blow out a gas jet.

4. Be careful to turn off gas jet completely.

[Illustration]

5. Report gas leaks promptly.

6. Charcoal stoves and braziers are especially dangerous from escaping

gas and should not be used in sleeping rooms.

7. Do not go into unused wells or underground sewers without first

lowering a lighted candle which will go out at once if the air is very

impure, because of lack of oxygen to keep it burning.

Rescue: 1. Remove the patient _at once_ to the fresh air. Gas is lighter

than air, and therefore will not be found close to the floor and it will

often be possible to crawl out when one would be overcome by the gas if

he tried to walk out. For this reason it is sometimes best in trying to

rescue anyone already unconscious from gas to tie the wrists together

with a handkerchief, put his arms around your neck, and crawl out on all

fours, dragging the insensible body with you, under your own body. If

you attempt to walk out and carry the patient, cover your mouth and nose

with a wet handkerchief, go very quickly, do not breathe until you reach

the fresh air.

2. If there is a messenger handy, send for the doctor at once, but in

the meantime if necessary, perform artificial respiration as outlined

under the Schaefer System in the preceding paragraphs, until the patient

is restored to normal breathing.

ELECTRIC SHOCK

This is caused by some part of the body coming in contact with a live

electric wire. The seriousness of the shock depends on how heavy a

charge of electricity the wire is carrying at the time.

The patient is usually unable to release himself from the wire. The

first thing to be done, if possible, is to turn off the current by means

of the switch, but if this cannot be done _at once_, the patient must be

rescued by pulling him away from the wire.

Remember his body will easily carry the charge to yours while he is

against the wire. Therefore you must "insulate" yourself--that is, put

on your hands something that will not let the electricity into your

body--or stand on something that will "insulate" you; for instance,

rubber gloves or rubber tobacco pouches, dry silk handkerchiefs, other

silk garments or newspapers used in place of gloves if necessary. Stand

on a rubber mat or on _dry boards_, or glass, or in dire necessity _dry_

clothes can be used to stand on. They must not be wet as then they will

carry the electric current through your body and you must also be

rescued instead of rescuing.

Prevention: 1. Do not touch the "third rail" of electric railways.

2. Do not catch hold of swinging wires, they may be "live wires."

3. Report broken wires to the right authorities.

Treatment:

1. Get patient loose from the current.

2. Send for the doctor.

3. Lay the patient flat on his back.

4. Loosen the clothing, and perform artificial respiration according to

the Schaefer method if necessary.

5. Give first aid treatment to the burns.

FIRE ACCIDENTS

The first thought about a fire is to get it put out before it spreads

any further. There are methods which will do this work effectually and

Girl Scouts should learn these methods beforehand thoroughly, in order

that when the emergency arises they may act quickly, coolly and

effectively.

FIRE IN CLOTHING

If this happens in your own clothing, do not run for help, as the draft

made by the motion of your body will only fan the flames to burn

fiercely.

Grab the nearest thing that will cover you; overcoat, blanket, rug, wrap

it tightly around you at the neck first to prevent flames from burning

the face and lie down and roll over and over. This will smother the

flames quickly. If you can get nothing to wrap around you, lie down and

roll slowly over and beat the fire with your hands covered by some part

of your clothing not on fire.

If the fire is in the clothing of another, wrap him in the nearest thing

available, lay him on the floor and roll him over, smothering the flames

as described before.

Woolen material will not catch fire as easily as cotton, therefore, if

you have a chance to choose, take woolen material for smothering the

flames.

RESULTS

Results of fire in the clothing are sure to be more or less serious

burns.

When you have discovered the extent of the burn, if it is at all

serious, send for the doctor at once, and in the meantime treat the burn

as you have already learned to do in minor burns.

FIRE IN BUILDINGS

Keep cool, in order to remember what to do, and do it quickly.

Turn in a fire alarm at once. Send some one else if possible who may not

know what to do to the fire. The quickest way is by telephone call,

"Fire Department," and tell them the exact address of the building

where the fire is. Or you may go to the nearest alarm box, smash the

glass, open the door, and pull down the hook that sounds the alarm.

(Generally the directions are printed on the box.) If you cannot sound

the alarm alone, call upon the nearest person to help you. _Wait there

until the firemen arrive and direct them to the fire._ When the firemen

come do just as they tell you, for they know exactly what to do.

People trying to escape from a burning building often get frightened and

then there is a panic. Panic kills more people than fire. Keep cool, and

others will follow your example.

Never jump from a window unless the flames are so close that it is your

only means of escape. If outside a burning building put mattresses and

bedding piled high to break the jumper's fall and get a strong hold on a

rug to catch the jumper, and let many people hold the rug.

If the fire is just beginning, it can easily be put out by smothering it

with a rug or blanket; sand, ashes, salt, or a few pails of water will

answer the same purpose.

Keep the doors and windows closed if possible to prevent draughts from

fanning the flames to fiercer effort.

Remember this point when you go into a burning building, and leave some

responsible person guarding the door, in order that it may not be left

open by some one in excitement and the flames fanned beyond control.

If you need fresh air in your search for people in a burning building,

open a window, put out your head and draw your lungs full of fresh air

and then close the window again. In any case it is best to tie a wet

handkerchief or towel over the nose and mouth while in a burning

building, as this will prevent you from breathing a good deal of smoke.

In searching for persons remember always to begin at the top of the

building if possible, and search every room. When on stairs keep to wall

side, where air is relatively free from flames and smoke. If a room is

locked, try to rouse the people by pounding and calling and then break

in the door if unsuccessful in rousing them, and you suspect there is

some one there.

Remember, the air within six inches from the floor is usually free from

smoke, and if the smoke makes breathing too difficult, you can still

accomplish your end by crawling along the floor and dragging the rescued

one with you as you learned to do in gas rescue.

Form a bucket brigade from the fire to the nearest water supply; passing

the filled pails from one to another rapidly, the last throwing the

water on the fire and passing the empty pails back along _another_ line

to be filled again and passed on as before.

FIRES FROM KEROSENE, GASOLINE, BENZINE

_Prevention._--1. Do not light a fire with kerosene.

2. Do not clean gloves or clothing with gasoline or benzine in a room

with a lamp or gas jet lighted.

3. Do not try to dry clothing that has been cleaned with gasoline or

benzine near a hot stove or lighted gas jet.

_Extinction._--Do not use water to put out a fire of kerosene, benzine,

or gasoline, as that only scatters the flames. Smother with blankets,

rugs, sand, ashes, salt, or anything which is at hand and can be used;

remember that woolen will not catch fire as easily as cotton.

COMMON POISON AND ANTIDOTES

_Poisoning_--Cases of poisoning happen most often because people do not

examine the bottles before taking medicines from them.

_Prevention_--Disinfectants, liniments and medicines in bottles and

boxes should be correctly and plainly labelled.

Bottles containing a poisonous substance should be rough outside, or

with notched corks or marked with something beside the label stating

that their contents are poison.

_Treatment_--1. _Send for the doctor at once_, telling him what kind of

poison you think the patient has taken in order that he may bring the

right antidote and the right implements to give the quickest and most

effective relief.

2. Give demulcent or mucilaginous drinks, as for example, milk, raw egg,

one or two tablespoonfuls of salad oil, sweet oil, or barley

water--which can be obtained most readily.

3. Give something to produce vomiting, provided the lips are not burned

or stained as they are with an acid or alkali. A simple but effectual

emetic can be made by mixing two teaspoonfuls of salt or a tablespoon of

mustard in a glass of lukewarm water. This may be repeated if necessary.

4. If the patient seems drowsy, suspect opium and keep patient awake at

all costs till the doctor arrives.

5. If delirium threatens, dash cold water on the patient's head and face

to try to prevent the fit from coming on.

6. When the poison taken has been acid, the antidote should be an

alkali, but different poisons require different antidotes, and it would

be unwise to trust to one's memory as to the proper one to take in each

case. It would be well to have a list of the more common poisons and

their antidotes attached to the First Aid Kit, but do not trust to the

memory. If a Girl Scout does not know, and if the patient's lips are

_not_ stained or burned, give an emetic.

Bandages

Bandages form the most convenient way of keeping dressings on wounds and

for making pressure when necessary. They are also used to correct some

deformities, but you will not need to concern yourselves with the

latter, as this is in the province of doctors.

There are three varieties of bandages which you will need to use and

with which you should be familiar: the roller, triangular and

four-tailed. The materials used for bandages are absorbent gauze,

muslins or flannels. The kind you will use most will be gauze and

muslin. The gauze is best to use in dressing wounds because it is

pliable and absorbent, and muslin, if you may choose, in applying

pressure, because it is firm. In an emergency there will usually be

little chance to choose. Anything at hand, as underclothing, sheets,

blankets, etc., may be torn into strips or triangles and used. Have the

material which is used clean if possible.

The width of the roller bandage depends on the part of the body to be

bandaged, from one inch for the little finger to four inches for the

body. They can be rolled very well by hand with a little practice, and

every Girl Scout should learn to do this or to improvise a bandage

roller by running a very stiff wire through a small wooden box and then

bending one end on the outside of the box like a handle.

A bandage must be rolled sufficiently tight so that the center will not

fall out. By folding one end back and forth a few times to make a core,

and then laying the bandaging over one's knees lengthwise of the thigh

with the core uppermost, it can be rolled quite tightly and answer every

purpose for emergencies.

Learn to put on all bandages smoothly and securely, but not too

tightly.

_Triangular Bandages_--These bandages have advantages for first aid

work. They can be quickly made, easily applied and are not apt to be put

on too tightly even by a beginner.

The size of the piece of cloth varies with the part to be bandaged. Take

a square piece of cloth (it should not be less than 34 to 38 inches),

fold it diagonally from corner to corner and cut across the fold, making

two bandages.

The bandage may be applied unfolded or folded into a narrow strip,

called cravat bandage.

To fold the cravat bandage, the point of the triangle is brought to the

middle of the diagonal side and the bandage folded lengthwise to the

desired width.

The cravat bandage is convenient to use in bandaging the hand, foot,

head, eyes, throat and jaw; for tying on splints; for tying around the

limb in case of snake bite, and in making a tourniquet.

[Illustration]

Always tie the bandage with a square knot to prevent slipping. Care must

be used in applying the triangular bandage to have it smooth and firm,

folding the loose ends into pleats evenly.

_Bandage for Hand_--For wound of the palm, lay cravat in straight line,

place palm across it at the middle. Fold ends over the back of hand,

carry around wrist and tie. Reverse the order for injury to the back of

the hand.

To cover entire hand, unfold cravat, lay flat with point of triangle

beyond the fingers. Fold the point of the bandage over the fingers,

cross the ends, and pass around wrist and tie at the back.

_Bandage for Foot_--Place foot on the smooth triangle with the point

extending beyond the toes several inches. Fold the point back over the

instep, cross the ends, carry around the ankle and tie.

_Bandage for the Head_--The bandage may be used flat or as a cravat,

according to the nature of the injury and the part to be bandaged.

[Illustration]

_For a cap bandage_, fold over the edge of the diagonal edge, place on

the head with the folded edge just above the eyes; pleat the edges

hanging down over the ears into small folds so that the bandage lies

smoothly; carry the ends around the head; cross at the back, and tie in

a square knot in front. The cravat bandage may be used to hold on small

dressings where the whole head does not need to be covered.

_For the eyes, jaw and throat_ the triangular bandage is used by folding

smoothly into a cravat and tying securely over the part to be covered.

_Arm Sling._--The triangular bandage makes the best arm sling to support

the forearm or for supporting injuries to the elbow or shoulder.

An arm sling is firmer and more satisfactory if the triangle is double;

that is, simply fold over the square diagonally, but do not cut it along

the fold. An arm sling will need to be about a yard square before

folding.

To adjust the arm sling, put one end over the shoulder on the uninjured

side; slip the point of the triangle under the injured arm, so that it

will extend beyond the elbow a few inches; then take the end of the

bandage over the arm, carry around the back of the neck on the injured

side, meeting the other end; and tie securely. To prevent slipping, pin

the point of the bandage around the arm just above the elbow.

A temporary sling can be made by pinning the sleeve of the injured arm

to the dress or coat in such a way as to support the arm.

_The Four-tailed Bandage_--This bandage is useful for bandaging the

head, and especially in fracture of the jaw. Use a piece of cloth about

six or eight inches wide and a yard long. Cut each end into two equal

parts, leaving about three or four inches in the middle uncut.

[Illustration]

When the bandage is applied, the split ends are crossed so that they may

be tied over different parts of the head and thus hold the bandage more

securely in place. For instance, in the jaw bandage the uncut middle

part is placed over and under the chin, the ends crossed, and two ends

tied at the back of the neck and two over the top of the head.

_Roller Bandages_--Roller bandages are a little more difficult to put on

so that they will stay on, and at the same time be smooth and have a

uniform pressure on the part of the body bandaged. This last point is

most important.

Rules for applying roller bandages:

1. Lay external surface of bandage against the part to be bandaged,

holding the roll in the right hand, unless you are left-handed,

unrolling it as a roll of carpet unrolls to show you a pattern in the

shops.

2. Hold the loose end with the left hand and catch it with two or three

turns of the bandage before beginning to put on the bandage. Never have

more than four or five inches of the bandage unrolled at once.

3. Be careful to have the same pressure from every turn of the bandage.

This is most important if the bandage is to stay on and be comfortable

and not interfere with the circulation of the blood. Judgment of the

pressure is only acquired by practice, and therefore you should practice

enough to acquire this before the real emergency happens.

4. Do not bandage too tightly. Blueness of the skin above or below the

bandage always means the bandage must be loosened. Remember in applying

a bandage immediately after an injury that considerable swelling may

occur later, and apply your bandage more loosely than if bandaging after

the swelling has gone down. Always loosen a bandage that is tight enough

to cause pain or blueness.

5. Bandage from below upward. That is, from the tip of a finger or toe

toward the hand or foot. From the hand or foot toward the shoulder or

groin. This is in the general direction of the return of the

circulation.

6. Bandage over a splint and not under it.

7. Bandage arms, legs, fingers, etc., in the position the patient is to

keep the part in when the bandaging is completed. For instance, bend the

elbow to a right angle before putting on the arm bandage. This will be

more comfortable for the patient, allowing him to carry the arm easily

in a sling and also permit him to use the hand to some extent if the

nature of the injury will permit. In bandaging a leg both above and

below the knee, the bandage must be put on with a view to the necessary

bending of the knee in walking and sitting, if the patient is expected

to use the leg.

8. Never apply a wet bandage, as you cannot judge of just how much

pressure will be exerted when the bandage dries, because of the

shrinkage of cloth with drying; much greater in some cloth than in

others.

Kinds of roller bandages:

1. Circular for parts uniform in size, as the body.

2. Spiral for conical surfaces, as fingers or toes.

3. Reverse for more conical surfaces, as arms and legs.

_Circular Bandages_--Any part of the body which is of uniform size may

be covered with a circular bandage. Each turn covers about two-thirds of

the previous turn. This holds each turn firmly and prevents slipping and

exposing the dressing or wound underneath. Bandage in general direction

of the return of the blood to the heart. Fasten the bandage with a strip

of adhesive plaster or safety pin. If there is possibility of

restlessness or much activity on the part of the patient, it is best to

run several narrow strips of adhesive plaster along the whole width of

the bandage when finished to prevent possible slipping of the turns of

the bandage when the muscles move under it with the activity of the

patient. This is especially true of a body bandage.

_Spiral Bandage_--A conical part, if not too conical, may be covered

with a spiral bandage. Each turn ascends at a slight angle, with one

edge of the bandage a little tighter than the other. In putting on this

kind of bandage it is necessary to learn to have the tight edges all of

a uniform pressure and each turn overlap the turn below in such a way

that these tight edges make the uniform pressure without regard to the

upper edge underneath, which is covered in each turn by the tighter edge

of the turn above it.

_Reverse Bandages_--The reverse bandage is a modification of the spiral

one, in order to cover the gapping between spirals which occurs when the

surface is very conical, as, for instance, on the leg.

In putting on this bandage the loose end is caught by two or three turns

first as in other bandages. Then start to make a spiral turn, but at the

mid point of the front of the part being bandaged place the thumb of the

left hand, and fold the bandage down so that it lies smoothly and

continue the turn around to that same point. Repeat the process with

each turn. (See illustration.) Each turn covers two-thirds of the one

below in order to hold firmly. The pressure must be uniform when the

bandage is finished. Fasten the ends as described under circular

bandages, or divide the end of the bandage into two parts for several

inches--long enough to wind around the part bandaged. Tie a single knot

at the base to prevent further dividing, and wrap the ends around the

part in different directions; tie in a hard knot to hold firmly.

_Bandaging Fingers and Toes_--In bandaging fingers and toes it is

usually best to bandage the whole of the injured member. Cover the end

of the finger, for instance, by passing the end of the half inch or one

inch bandage several times the whole length of the finger, over the end

and to the base of the other side. Hold this in place with one hand,

start the spiral at the end of the finger, and bandage smoothly toward

the hand. The spiral or the reverse spiral may be used.

_Bandaging Two or More Fingers or Toes_--It is sometimes necessary to

bandage two or more fingers, for instance, at once, as in case of a

burn, where it is necessary always to have the burned fingers separated

while healing to prevent the raw places from growing together.

[Illustration]

Pass a finger bandage twice around the wrist and pass obliquely to the

base of the thumb. Carry to the end of the thumb and bandage as

described above. When the thumb is bandaged, carry the bandage back to

the wrist; pass around the wrist in one or two circular turns, and carry

the bandage to the first finger and bandage as before. Repeat this

until all the fingers are bandaged. Carry the bandage back to the wrist,

after the last finger you wish to bandage is done; make one or two turns

around the wrist and fasten.

[Illustration]

In bandaging the foot, carry the bandage to the ankle to make secure and

hold in place.

_Bandaging Arms and Legs_--The reverse spiral is usually best for

bandaging these, because of the conical shape. Practice alone can teach

you to put this on smoothly, firmly, not too tightly, and at the same

time quickly. A reverse bandage will not stay in place on the leg of the

person walking around unless pinned in many places or stuck by sizing

in the cloth (which has been wet), plaster, etc. Only a figure eight

caught over the top of the calf, in each alternate loop, will do so.

_The Figure Eight Bandage_--The figure eight is a modification of the

spiral used in bandaging over joints in such a way as to permit some

motion and at the same time keep the bandage firm and in place.

The bandage is carried first below and then above the joint; then below

and then above, the turns overlapping the usual two-thirds of the width

of the bandage, leaving the joint free until the last. Then it may be

covered with two or three circular turns of the bandage. This admits of

considerable motion without disturbing the bandage to any extent.

The National Red Cross and Girl Scout Instruction in First Aid

[Illustration]

By special arrangement with the National Red Cross, it is possible for a

Girl Scout completing satisfactorily the requirements for the First Aid

Proficiency Badge to secure with slight additional work the Red Cross

certificate in First Aid. Or the course may be taken entirely under Red

Cross auspices, though arranged by Scout officials, in which case the

Scout may receive both the Proficiency Badge and the Red Cross

certificate. The conditions of this co-operation between the Girl Scouts

and the National Red Cross are as follows:

Classes are to be organized with not less than four or more than

twenty-five in a class. The best size is ten to fifteen. _Scouts must be

at least sixteen years of age to be admitted to these classes._

The instructor must be a physician appointed by the Chairman of the

First Aid Committee of the local Chapter of the Red Cross. He or she may

be supplied upon request by the Chapter, or chosen by the class and the

name submitted to the Chapter for appointment.

The Red Cross class roll must be sent in to the local Chapter early in

the course.

A Secretary to handle the records should be chosen, and where the class

is made up of Scouts, the officials should be preferably a Scout Captain

or Scout Official.

The examiner must be a physician appointed by the local Red Cross

Chapter and is preferably some one other than the instructor, but this

is not necessary. Like the instructor, the examiner may be supplied by

the Chapter or chosen by the class.

The Red Cross examination roll, which may be obtained from the Chapter,

should be used in giving examinations and then returned to the Chapter,

who will issue the certificates. Follow the directions on the roll

carefully.

If a Scout holds a First Aid Proficiency Badge she may complete the

course in seven and one-half hours. If she does not hold a Proficiency

Badge in First Aid then fifteen hours will be required. A Girl Scout

holding a Proficiency Badge in First Aid and taking a school course held

under Red Cross auspices which she passes with a mark of at least

seventy-five per cent, can, when the school principal certifies to this,

get the Red Cross certificate without further examination by applying to

the local Red Cross Chapter.

_Advanced Courses_

Advanced courses are open to those who have the Red Cross certificate.

There must be an interval of at least six months after the elementary

course before an advanced course can be taken, and the same interval

between repetitions of it. The course of instruction is seven and

one-half hours, mainly practical demonstrations. A Red Cross medal is

given on completion of this course. Each time it is repeated, up to

three times, a bar (engraved with year) is given to be added to the

medal.

_Fees_

A fee of fifty cents is required for the elementary course. The local

Red Cross Chapter has the right to reduce this fee.

The fee for the advanced course is one dollar, which covers the cost of

certificate, examination and medal. The fee for bar and engraving is

fifty cents. These fees cannot be reduced.

These fees cover the cost to the Red Cross of postage, certificates,

medals, bars, and so forth, but do not cover that of instructor,

examiner, or classroom supplies, which the Red Cross requires the class

to take care of.

_Information_

Where there is no local Girl Scout organization refer to the local Red

Cross Chapter; or if there is none, either to the Girl Scout National

Headquarters, 189 Lexington Avenue, New York, N. Y., or to the

Department of First Aid, American Red Cross National Headquarters,

Washington, D. C.

4. THE HOME NURSE

The Girl Scout who has earned the Home Nurse Badge may be of great help

where there is illness. But, she should remember that only such people

as doctors and trained nurses who have knowledge and skill gained by

special training and thorough practice are fitted to care properly for

those who are very ill.

If the Scout with the badge keeps her head and shows herself steady,

reliable and willing, when called upon for help in illness or

emergencies, she proves herself a true Scout who is living up to the

Scout motto of "BE PREPARED."

To earn the badge she should know:

How to keep the sick room clean and comfortable.

How to make a bed properly.

How to prepare for and help a sick person in taking a bath.

How to make a sick person comfortable in bed, changing position, etc.

How to take temperature, pulse and respiration.

How to prepare and serve simple, nourishing food for the sick.

How to feed a helpless person.

How to prepare and use simple remedies for slight ailments.

How to occupy and amuse the sick.

When helping about the sick, the Scout should wear a wash dress or an

apron which covers her dress. She should be very neat and clean. She

should wash her hands frequently, _always_ before her own meals, and

after coming into contact with the sick person and after handling

utensils, dishes, linen, etc., used in the sick room. Great cleanliness

is necessary not only for her own protection but to prevent illness

spreading.

She should move quickly and quietly, but without bustle or hurry, taking

care not to let things fall, not to bump against the furniture, not to

jar the bed, not to slam doors, in fact not to make any unnecessary

noises, as sick people are not only disturbed but may be made worse by

noises and confusion. If a door is squeaky the hinges should be oiled.

Too much talking, loud talking and whispering are to be avoided. Only

cheerful and pleasant subjects should be talked of, _never_ illnesses

either that of the patient nor of others.

The best nursing aims not only to bring relief and comfort to those

already sick, but to guard against _spreading_ sickness.

We know, now, that many diseases are spread by means of _germs_ which

are carried from person to person by various means, such as air, water,

milk, and other food; discharges from the mouth, nose, bowels, bladder,

wounds; clothing; the hands; the breath, and so forth.

It has been found that great heat, intense cold, sunshine and some

powerful drugs called disinfectants kill germs. Germs thrive and

multiply in dirt, dampness and darkness. That is why it is important to

have fresh air, sunshine and cleanliness in order to keep well, and to

help in curing those who get sick.

The Room, Its Order and Arrangement

The hangings and furniture of a sick room should be of a kind that can

be washed and easily kept clean. Plain wooden furniture is better than

upholstered furniture which collects and holds the dust. If there is a

rocking chair it should be for the use of the sick person only. Seeing

and hearing other people rock may be very disturbing.

If carpets are movable, so much the better, as they can be taken out to

be cleaned.

The room should be bright and attractive. Sick people like flowers and

pretty things, but the flowers should not have a strong perfume, and

there should not be too many ornaments around to collect dust and to

take up too much room. Flowers should be taken out of the room every

night and the water changed before being returned to the room in the

morning. Never have faded flowers around.

For some people it is easier to handle a baby when laid on a bed or