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and all other necessary first-aid materials, should be stored in a receptacle where they can be kept clean and in orderly, compact and convenient arrangement, and this first-aid kit should be of such size and shape that it can readily be picked up and carried to the injured when the injured cannot come to the kit. The instructions are printed on the inside of the cover of the jar-always at hand when needed.
Every employer is urged to adopt these first-aid instructions as standard in his plant, keeping in mind that every injury, whether slight or serious, causes least suffering and expense if it is treated right, right away. The instructions authoritatively point the first-aider in the direction of the greatest assistance to injured persons. As stated before, they are written in briefest form; they are explicit directions—not arguments. Yet for those who are interested to know the why and wherefore, some brief non-technical explanations are herewith given.
Among the most frequent injuries are open wounds, such as cuts, abrasions and punctures; if not properly treated, they may lead to serious consequences. Some bleed and some do not. Unless bleeding is severe, no harm is done by blood that comes out of a wound; the mischief is created by germs that enter it. These germs exist everywhere; on the hands, of course, and on whatever causes the wound. They do not harm the skin, which is the body's protective armor; but the moment this armor is pierced or broken, germs find entrance and are apt to cause what is commonly known as “blood-poisoning." Such wounds are not always "poisoned,” but no one can foretell which wound will be and which will not be. For that reason, each open wound should be treated as if it threatened to become a "poisoned” sore; so the germs in every open wound should be killed as soon as possible. It has been found that the best all-around germ-killer for open wounds is 3% alcoholic tincture of iodine. It acts instantly, dries and heals quickly. If a physician has to treat the wound afterward, his work is not hampered by iodine in it. After iodine is applied, the wound should be bandaged with dry sterile gauze (gauze that is free from germs) in order to keep other germs out. Dirty or greasy wounds may be cleansed by liberally flushing the wounds with gasoline or benzine before the iodine is applied. First-aiders should never scrub an open wound or the surrounding skin, nor use other harsh means.
Wounds that bleed a great deal may prove serious by weakening the injured person's resistance, causing long-continued faintness or illness. Loss of a pint or more of blood in an adult may cause shock, or even death. Many persons, however, are too easily scared by a moderate loss of blood; in their frantic efforts to stop its flow, they often use violent methods that do great harm. It is dangerous practice to apply a tourniquet and leave it bound very tightly for a half-hour or more. It is very rare that a wound bleeds so badly as to require the use of a tourniquet at all; tight bandaging will usually stop the flow of blood, and a tourniquet should be used only as a last resort when rapid flow of blood cannot be controlled in any other way. One of the safest tourniquets to use consists of a piece of strong cotton webbing one inch wide-no rubber whatever in it. The chief reason why rubber tourniquets are not recommended is that they become rotten and may break; they also are apt to pinch into the flesh too deeply.
Splinters and slivers imbedded in the flesh are not essentially different from other open wounds and must be treated as such. The splinter, sliver or nail may be removed by the first-aider, if it can easily be done, otherwise by a physician. Danger of infection is usually greater than in ordinary wounds because germs penetrate more deeply and are therefore harder to reach with iodine. Increased watchfulness for septic consequences is imperative.
Quite frequent injuries are bruises and sprains, which often stubbornly resist all treatment except long-continued rest. While the use of commonly recommended liniments and counter irritants may give a feeling of comfort and satisfaction, they do no real good. Very hot or very cold applications help somewhat, but their preparation involves loss of precious time. Tight bandaging is best; it restricts excessive blood circulation started by the injury, it can be done without delay. Even in severe cases bandaging helps, but the first-aider should not stop
at mere bandaging; he should elevate the injured part to decrease circulation of blood at the injury, make the patient as comfortable as he can and promptly send for a physician.
Certain classes of work may cause burns in various forms. The burn ointment prescribed is the best first-aid remedy. It is composed of 3% bicarbonate of soda in petrolatum, entirely mineral in character, and so remains pure indefinitely. It is cheap, can be procured anywhere, can be applied effectively to any kind of a burn, however caused, of whatever extent, wherever located. It should be applied quickly and freely, but any blisters that may have formed should not be opened by the first-aider. Burns caused by acid or alkali must of course be flushed first with plenty of water, followed in the case of alkali burns with white wine vinegar to neutralize the alkali. Even eye burns will yield to the same treatment, but after first-aid has been given, no time should be lost in getting the patient to an eye specialist. Carron oil is often recommended as a burn remedy; it is a compound of linseed oil and lime water, very helpful if used fresh, but undesirable for emergency service because it soon becomes putrid or rancid.
Considering the priceless value of the human eye, it is incumbent on every first-aider to use extreme care when called upon to attend to an eye injury. If it is an ordinary eye irritation, 4% boric acid solution freely applied to the eye by the eye dropper or direct from the bottle, will usually bring great comfort and float away any loose particles that may be in the eye; or the loose particles may be removed with absorbent cotton wrapped around the end of a match or toothpick and dipped in 4% boric acid solution. Foreign bodies embedded in the eye must never be removed by the first-aider. He should put a few drops of castor oil into the eye; this will make an oily film between the eye and eyelid that will prevent the foreign body from scratching and will afford great relief from the pain. The eye should then be bandaged loosely and the patient sent immediately to a physician or an eye specialist.
When workmen suffer dislocation or fracture of any member, the amateur first-aider usually acts on the belief that the more effort he puts forth to realign the joint or to set the broken bones, the better will be the result. But the physician who must tackle the job afterwards keenly realizes that such efforts usually harm more than help. In case of a slight dislocation, the first-aider should use only ordinary effort to replace the
joint; when this fails, he should call upon a physician to replace it. Fractured bones must be handled with great care, else further injury may be done. The first-aider's job stops when he has made the patient as comfortable as he can and has carefully applied a temporary splint in case the patient has to be moved. The doctor wll do the rest.
Splints made of wire
gauze are recommended for How the wire gauze splint may be arranged temporary use instead of for holding both lower and upper arm
splints made of wood. Wooden splints are likely to be utilized for all sorts of carpentry jobs and to be missing when most needed. The wire gauze splint takes but little space in a first-aid kit, can be cut with scissors into short lengths for arm fractures or used full length for immobilizing both joints of arm or leg. When required for holding both upper and lower arm in position the splint can readily be bent to a right angle. It is very comfortable, very light and can be so curved as to compress the limb uniformly and avoid interference with the circulation; yet it holds the limb rigidly.
The serious results that may follow heat prostration demand that not a minute be wasted in rendering emergency service, by the use of any cold applications available if the body is warm, in which case the cause is probably sunstroke; or warm applications if the body is cold and clammy, denoting heat prostration. In either case the first-aider must himself get
into action quickly and should as quickly start someone to bring a doctor.
Usually a person who has become unconscious from fainting responds readily when laid on his belly, his body freed from tight clothing, his head kept cool and his hands and feet warm. When unconscious, there is some danger that he may swallow any false teeth or tobacco that may be in his mouth, and these must promptly be removed. The first-aider should be on his guard to note whether the patient continues to breathe regularly, but even in case breathing should cease, the first-aider still has at hand an effective method of resuscitation, known as the Prone Pressure Method, a method which he can practice alone if he must. This is equally effective for restoring respiration to persons whose breathing has stopped, whether due to fainting, shock following injury, electric shock, or asphyxiation by gas, smoke or water.
The Prone Pressure Method is recommended because it is the best known, is most uniformly successful, can be memorized in a few minutes by persons of common intelligence, can be applied by one person alone, does not require use of any mechanical apparatus whatever. Even should effective mechanical resuscitating apparatus be available, it would nevertheless continue to be a matter of utmost importance to make firstaiders everywhere familiar with the few prone pressure motions and to require them to use this method; for a single minute lost in hunting or waiting for a mechanical apparatus may mean the loss of a life.
Again, it must be remembered that, though the first-aider may allay pain, prevent infection, lessen disability and even save life, he is not a physician; he is simply a first-aider. He must realize that it is his function to obey orders, orders written in explicit and authoritative form, or orders given verbally or otherwise by the physician in charge. Above all, first-aiders must not experiment with injuries of their fellows; the human system is too complicated for their intelligence, and the danger is too great. On the other hand, their loyal and prompt firstaid service is an invaluable benefit.
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