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The doctor, while heartily sympathizing with the machinist, felt that it would be unfair to send him home without some much needed advice, even though the advice itself should hurt. And this is what the doctor said:

“There is no good reason why you should have such a sore wrist; you have only yourself to blame for it.

“First of all, you were careless in leaving a wrench on top of the machine; hadit not been there you would not have been hurt.

“Then, when you did get hurt you should have gone to the first-aider or physician in your shop, who always keeps on hand some iodine and clean bandages to treat little cuts like this one was before you fooled with it. Your cut would then have healed so quickly that you could have kept right on at your work. But instead, you put into the wound some filthy tobacco, you bound it up with a dirty rag, and you made it a thousand times worse than if you had done nothing at all. The ointment your friend Frank recommended, made the sore still worse and it is now what is called a 'blood poisoned wound.'

“The next time you get hurt, don't try to nurse the injury yourself. See the first-aider or your foreman about it right away and save yourself all this suffering and the expense it makes."

Slight injuries like this and serious injuries too, are bound to occur from time to time in industry as well as out of it. For in spite of every safeguard that can be provided for prevention of accidents, even in spite the first-aider keeps on hand materials for of the exercise of personal

first-aid treatment of slight injuries caution—the most potent safeguard of all-people are times, somehow, sure to be hurt.

But as the physician pointed out, there is no good reason



why slight hurts should be allowed to develop into painful festering sores, for in nearly every case something can be done at once to relieve pain and to prevent infection. The question is, "What is the best thing to do?” The very best thing, of course, is to have a physician attend to the injury. But many injuries are so slight that it seems unnecessary to incur the expense or to take the time to go to a physician. Often too, injuries are quite serious and quick action is urgent, yet a physician may not be reached promptly. What then?

The most natural answer is: "Train people to do first-aid work.” But it should be kept in mind what an experienced surgeon once remarked: “I know that the first-aider can do valuable work. But you must remember that ordinary-looking injuries often involve extraordinary complications for the treatment of which the first-aider's limited knowledge and skill are by no means adequate. His treatment therefore must, absolutely must, be limited to strictly first-aid work or he will do more harm than good.”

The question “What is the best thing to do?” was referred to a body of surgeons and physicians who, through many years of extended experience in the treatment of work injuries, were in a splendid position to measure the value of first-aid as given by employees in work-shops.

“In our opinion,” they said, "first-aiders can do very efficient work if their efforts are properly directed. But they must be given brief, straight-forward instructions what to do; what not to do; how to begin; where to stop. There is great need for a set of such instructions. Many of those now published are quite voluminous and involve costly delays in finding out what is the right thing to do in an emergency. Some are adapted to special conditions only and omit important matters. Others recommend pet remedies which can be used to good advantage by skilled physicians but which are dangerous when used by the average person. Quite a number are published by patent medicine concerns to increase the sale and use of their nostrums.”

“We all recognize the need,” was the rejoinder, “but will you men of large medical and surgical experience prepare a guide that can be safely followed? Will you compile a standard set of simple, safe, effective first-aid instructions that ordinary persons can use with confidence?"

The question was asked nearly three years ago. It was immediately answered in the affirmative, for all were impressed with the necessity and value of standard and simple first-aid instructions. After several weeks of painstaking thought on the part of the individual physicians and surgeons and after much time spent by them in conference, first-aid instructions were agreed on. They were not, however, made public at once, for it was felt that their real value could only be measured by results secured when they were put into practice under largely varying conditions and in the hands of persons of largely varying intelligence.

So it was not until October, 1914, after these first-aid instructions had been in use under vigilant observation for more than six months, that they were approved and published. They have since been endorsed by industrial physicians quite generally and have become standard in thousands of shops and factories in the United States, in power houses, car barns, schools, homes, gymnasiums, construction camps, and wherever physical activity is apt to bring about physical injury. They have also formed a basis for the standard lists of first-aid materials required in industrial plants of industrial commissions, accident boards and similar bodies in various states.

They are reprinted in this bulletin and are recommended for general adoption, chiefly for these reasons:

They are brief.

They are written in words easily understood by anyone who can read the language.

They can safely be followed by persons who have no other knowledge of first-aid work.

They state clearly one right thing to do for each kind of injury, without useless, time wasting, confusion comment on why it is done or what other things the first-aider might choose to do.

They require use of only eight medicaments in all for firstaid treatment of the entire range of injuries that ordinarily occur.

None of the medicaments prescribed are poisonous except the iodine: its taste is so repugnant as to prevent its internal use in harmful quantities.

The purpose of first-aid treatment is commonly misunderstood. It is too often regarded as a substitute for treatment by physicians or trained medical attendants. As a matter of fact, it represents nothing more than the putting into practice of the old saying "A stitch in time saves nine." Its field should be limited to:

Anti-septic initial treatment of slight wounds, or simple initial treatment of slight disorders, in the absence of a physician or competent nurse;

Simple emergency treatment of serious injuries or disorders pending the arrival of a physician.

The first-aid instructions are intended to apply only to this limited field. They direct the first-aider to do strictly first-aid or emergency work only, based on the assumption that redressing of all wounds and after-care of the sick is to be in charge or under the supervision of a physician. For it should be recognized that most wounds that must be redressed, are beyond the first-aider's skill; and surely any disorder that does not readily respond to a first simple treatment may be too serious to be subject to an amateur's experimentation.

Indeed, it is even advisable that a competent person should in some way follow up the first-aider's treatment of injuries which appear to be slight, for it sometimes happens that the first-aider under-estimates the severity or consequences of an injury. A brief record immediately made by the first-aider on a card is the basis of a simple and inexpensive follow-up method. As these cards are promptly forwarded to the works physician or to the plant manager, they place him in a position to keep himself informed of the development of all injuries, and to guard before it is too late against harmful results.

In many cases the condition of an injured person requires that he be carried from one location to another or that he be placed at rest in a reclining position. For this purpose, it is advisable to have conveniently at hand one or more portable stretchers.

Everyone who has had experience in first-aid work realizes that quick treatment greatly speeds an injured person's recovery. Serious delays occur when the regular first-aider is ab


instructions cannot be found. A sufficient number

of persons should therefore LEGS TURNED DOWN FOR USE

be given a copy of the firstAS A COT

aid instructions and thorized and trained to do first-aid work. It is a good plan also to post the instruc

tions where they can be All metal sanitary stretcher and cot

read by persons in general,

so as to make many people able to render adequate first-aid in emergencies.

The medicaments called for in the first-aid instructions,


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A convenient and compact first-aid kit

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