(c) Improvised Stretcher. When the patient shows any sign of shock, is 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.
(c) A Sprain is produced by the overstretching of the muscles or 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.