Have a bed ready that is properly made and protected, to which she can be moved when the doctors allow it, and where she can be kept quiet. If there is nausea and vomiting, the effects of the ether, you may quiet it by letting her sip a little hot water or by putting a hot, dry cloth on her neck and chest. During the operation you had simply to wait on the surgeon, now the patient will be principally in your care.
You will receive instruction from the surgeon in regard to things needing peculiar watchfulness and every point must be carefully noted.
As the wound may need to be watched during the first twenty-four hours for hemorrhage, it must be so arranged that it can be looked at without waking the patient.
The danger to which surgical cases are liable are, 1. Shock; 2. Hemorrhage; 3. Erysipelas; 4. Pyemia; 5. Tetanus. If there is TRAUMATIC ERYSIPELAS the edges of the wound are red and swollen, the secretion of pus ceases, and by the next day the skin around the wound becomes of a peculiar red color. There will be fever, headache, nausea, and a coated tongue.
Erysipelas can be generated by inattention to sanitary laws. It is infectious and spread by fomites, and the virus of erysipelas may give rise to puerperal fever. It is not proper for a nurse that has had the care of a case of erysipelas, to soon be the nurse of a lying-in woman, even if she is careful about using disinfectants on her hands and changing her clothes.
Certain influences augment the susceptibility of the body to the agency of the poison. Among the influences are intemperance, low spirits, anxiety, insufficient nourishment, and foul air. There should be great care in regard to ventilation, and clearing and cleaning the room where it has been present.
The disease cannot be cut short by active remedies, but may be made to terminate favorably by the use of the perchloride of iron, &c. (F. 177.)
Tetanus (lockjaw) may follow slight wounds. At first the muscles of the jaw are rigid, but the rigidity or spasms may extend all over the body. It may result from exposure of the wound to cold, and some cases of tetanus in infants have been attributed to the funis, in instances where as much as three or four inches were left attached to the umbilicus. In a case of tetanus the patient should lie in a darkened room, and noise should also be excluded.
Incised wounds, made in the flesh by sharp cutting instruments, of course may be trivial cuts, or deep incisions, and may sometimes be treated by the nurse, either because they are slight injuries or because a surgeon cannot immediately be obtained.
If there is not much bleeding there will not be very much to do. It is well to have a little carbolic acid in the water with which it is washed. The bleeding will soon cease if only small vessels are divided. If there is any extraneous matter on the surface of the wound it must be removed. Then put the surface of the lips of the cuts together, and take measures to keep them in this state till they have become firmly healed. If sutures are necessary take one or more stitches. The most common method of keeping the surface of divided parts in contact is by strips of adhesive plaster. Apply them after having put the wounded parts in a position favorable for bringing the edges of the wound together, then while one holds the lips of the wound evenly together secure them in this position by strips of adhesive plaster applied across the line of the wound. Leave a little interspace between each two strips of plaster. It is not best to bind it up so that there is no passage or exit for blood. But slight wounds may become serious if some poison or virus gets into it; you may need to put on lint or a compress over the strips of plaster and then a roller or bandage.