Mother, Nurse and Infant / A Manual Especially Adapted for the Guidance of Mothers and Monthly Nurses, Comprising Full Instruction in Regard To Pregnancy, Preparation for Child-birth, and the Care of Mother and Child, and Designed to Impart so Much Knowledge of Anatomy, Physiology, Midwifery, and the Proper Use of Medicines as Will Serve Intelligently to Direct the Wife, Mother and Nurse in All Emergencies.

by S. P. Sackett

These cases demand the services of a physician, and my design is only to instruct you what to do before the doctor arrives; or rather I should say, the instructions that I give are not intended to supercede medical advice, though some cases may be of a kind in which little or nothing can be done. These emergencies are of every variety, and I shall bring the different kinds before you as fully as I can. Ordinarily it is not at first apparent what the real malady is.

We will suppose that during the heat of summer a man drops down unconscious. At first no one knows whether it is apoplexy or SUNSTROKE. Do not get excited and do things that are rash; if you do not know what ought to be done, do nothing; if you are not excited you may at least use what knowledge you have acquired.

Send a message to the doctor, giving a description as far as you can of the case, so that he may come prepared to treat it. Secure plenty of fresh air and room, and get rid of those who are around, who cannot be useful; if respiration is suspended, and there is immediate danger, something may be done at once; at least to know if the man has merely fainted. Have him laid in a horizontal position; you may soon have him carried to the nearest house. For this something should be provided on which he can lie horizontally; instruct the bearers to avoid unnecessary jolting; have a bed ready to put him on; if the case is supposed to be fainting give aromatic ammonia or a little stimulant of some kind; do not raise the head, but keep it low as the feet. If it is a severe case of sunstroke, the skin is hot and the pulse weak and fluttering; there may be convulsions, but probably there will be no movement; remove the clothing with as little disturbance as possible; do not cut anything that can be ripped; throw cold water on the head and chest, or put the patient in a cold bath of about 70° at first, and gradually reduce the degree of cold; give a cup of good table tea; do not give alcoholic stimulants without medical advice. If consciousness returns and the temperature again rises, repeat the cold applications to the head, neck, and chest; give ice water or ice tea; it may be best to rub the head and body an hour longer, and to give stimulant enemata.

Apoplexy can be distinguished from syncope by the pulse, which beats perhaps with unnatural force; the face instead of being pale is generally flushed, and turgid, and the respiration goes on though it may be labored and stertorous. The condition of the sensorial functions is much the same as it is in narcotic poisoning, or when a man is dead drunk. The nurse should make all necessary enquiries so that she can furnish the physician with a full history of the case to help him in his diagnosis. In apoplexy the pulse is rather slow though full, and the pupils of the eyes, one or both, dilated. There may be paralysis of one side.

Loosen the clothes, elevate the head and chest, apply cold water to the head, and heat to the extremities, and perhaps sinapisms also. Giving physic may be deferred until the doctor arrives; and in general you may pursue a similar course whether the case is one of CONCUSSION OF THE BRAIN, or COMPRESSION or narcotic poisoning; cold may be applied to the head by means of pounded ice in a bladder; keep the head cool and the feet warm.

Many of this class of cases require still very careful nursing after the dangerous symptoms are relieved. The skin should be kept healthy by daily friction and bathing. The bowels must not be permitted to become costive; the diet should be light, the food well chewed, the mind kept cheerful and free from excitement.

POISONS.

In cases of poisoning no time is to be lost in administering relief, and it is important that the nurse should be familiar with all the usual antidotes.

Most commonly in a case of poisoning, speedy free vomiting should be induced by those articles that are at hand, and that are quick and prompt in their effects.

Even if the poison has been taken hypodermically, emetics may be given; these will do no harm: Sulphate of zinc (white vitriol), is very prompt in its action, and may be used when it can be procured (F. 134); and if vomiting be present, we may aid it by giving warm water, or perhaps pulv. ipecac, or some other vegetable emetic.