The points to be aimed at are—first and immediately, the Restoration of Breathing; and secondly, after breathing is restored, the promotion of Warmth and Circulation. The efforts to restore Breathing must be commenced immediately and energetically, and persevered in for one or two hours, or until a medical man has pronounced that life is extinct. Efforts to promote Warmth and Circulation beyond removing the wet clothes and drying the skin must not be made until the first appearance of natural breathing, for if circulation of the blood be induced before breathing has recommenced the restoration to life will be endangered.
Turning on the Chest.
First: Roll the patient over on his chest, with one of the arms under the forehead, when the water will readily leave the mouth. Second: If breathing does not recommence then, place him on his face, supporting the chest on a roll of clothing. Turn the body gently on the side, then briskly on the face repeating these movements, about 15 times in the minute. (By placing him on his chest the weight of the body forces the air out; when turned on the side air enters the chest). Five minutes is the longest that can be afforded to this treatment. Third: Turn him on his back, draw his tongue forward, keeping it forward by a band passing over it and under the chin, placing the roll of clothing under the shoulder blades. Then, kneeling at his head, grasp the arms just below the elbows, draw them above the head, keeping them stretched for about two seconds. Then turn down the arms and press them firmly for two seconds against the sides of the chest. (The outstretched position allows air to be drawn into the lungs, the other position allows it to be pressed out.)
Arms extended.
When a spontaneous effort to respire is observed, proceed to induce Circulation and Warmth. This is accomplished by rubbing the limbs upwards with firm grasp and pressure underneath the warm blankets, or over the dry clothing which through bystanders or other means should have been already procured, apply hot flannels, hot water bottles, heated bricks, etc., to the pit of the stomach, the armpits, between the thighs and the soles of the feet.
Allow abundance of fresh air to play about the patient. Administer a teaspoonful of warm water, and then if the power of swallowing have returned, give hot milk, coffee, etc., in small quantities. The patient should be kept in bed and a disposition to sleep encouraged.
The above treatment should be persevered in for some hours, as it is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance, persons having been restored after persevering for many hours. The appearances which generally accompany Death, are: Cessation of the heart's action, eyes half-closed, pupils dilated, tongue approaching to the inner edges of the lips, lips and nostrils covered with a frothy mucus. Coldness and pallor of surface increase.
