When a person is asphyxiated treat him instantly. Give all the fresh air possible; remove all light clothing from the chest and neck and face; try to restore respiration first; clear the throat by placing the patient on the face with one arm under the forehead; the tongue falls forward and leaves the windpipe free; then wipe and cleanse the mouth.
To excite respiration turn the patient on his side and apply some stimulating agent (as camphor or ammonia) near the nostrils, and dash cold water, or hot and cold water alternately on the chest, which may have been previously rubbed briskly. (The effort to promote warmth and circulation by rubbing should be kept up continuously as far as possible.) Should there be no respiration immediately you can use
Marshall Hall’s method to imitate respiration. “Turn the patient again on his face, raising and supporting the chest well on a folded coat or other article of dress; make gentle pressure on the back, after which turn him over on his side; then again on his face, and again press a little; repeat these motions at the rate of fifteen a minute. During the operation let one person attend to the movements of the head and the arm placed under it.” If there is respiration and consequent life, dry the hands, in cases of drowning; and as soon as you can, strip the body and gradually reclothe or cover it; but if the breathing is not satisfactory, after continuing these same efforts to restore respiration for about fifteen minutes, you may use
Sylvester’s Method. “Place the patient on the back on a flat surface, inclined a little upward from the feet; raise and support the shoulders and head on a cushion or a folded article of dress; draw forward the patient’s tongue, and keep it projecting beyond the lips, by having a band or string around the tongue and chin, or by raising the lower jaw so that the teeth retain it; standing at the patient’s head, grasp the arms near the elbows and draw them steadily upward above the head, and keep them stretched upwards for two seconds; then turn down the patient’s arms and press them gently and firmly against the chest for two seconds; repeat the movement alternately about fifteen times every minute until a spontaneous effort to inspire is perceived; then proceed TO INDUCE CIRCULATION AND WARMTH.” Rub the limbs upward with energy, and continue the friction under the blanket and over the dry clothing; promote the warmth of the body by applying flannels, bottles of hot water to the pit of the stomach, the armpit, the thighs, and the sole of the feet; then if the power of swallowing has returned, stimulants and coffee should be administered.
A STROKE OF LIGHTNING may cause immediate death by its effects on the nervous system. Sometimes it produces unconsciousness without being fatal. In attempting resuscitation employ artificial respiration, and if there are any signs of life treat as directed for shock. If there are burns complicating the case, of course the burns must be treated. When there is SHOCK the patient lies in an apoplectic state, the surface pale; there is faintness, trembling, cold perspiration, low temperature, feeble pulse, and probably nausea and vomiting. Keep the patient’s head low, give aromatic ammonia, and apply heat to the extremities and to the stomach. Strong beef tea should be given, and hot tea and coffee.
There are but few exigencies that generally occasion more alarm than CONVULSIONS. Fits may come on without premonitory symptoms; there is sudden loss of consciousness, accompanied by irregular and powerful contractions of the muscles. All the voluntary muscles may be affected, or there may be only spasm of the features, or of one side, or of a single limb. During a general paroxysm the countenance is distorted, and the face pallid or livid; generally there is stertorous breathing, and as the attack subsides a disposition to sleep. It is seldom fatal in adults, unless caused by brain or kidney disease.
Do not attempt too much treatment, but you may put the patient in such a condition as to help his recovery. His dress is to be loosened, and all clothing about his neck removed; place him where he can breathe pure and cool air, and you may prevent his falling out of bed; if the face is flushed, cold may be applied to the head and warmth and sinapisms to the extremities. If occurring in a young child you may give a warm bath, or a warm hip bath. If there is ability to swallow, give bromide of potassium, either alone or simultaneously with the administration of chloroform and ether.
GIVING ANESTHETICS.
If you give chloroform you may pour a few drops on a handkerchief and hold it an inch from the patient’s nose and lips. Ether and chloroform together may be poured, a teaspoonful at a time on a little cotton inside a cone of paper made large enough to fit over the mouth and nose, the air being nearly shut out. The head of the patient must be kept low while he is under the influence of it. Observe the pulse while giving it; a feeble pulse is a sign of danger, and if the pulse is growing weak, or the face is growing livid or pale, stop giving the chloroform; if the symptoms continue, and there is no natural respiration, draw the tongue forward so that it will not obstruct the trachea; have plenty of fresh air; apply friction by rubbing the limbs, and if necessary artificial respiration.