120. Forming a seat.
(b) By Stretcher.—To place an injured person on a stretcher and convey him properly requires 3 bearers, unless the distance be very great; 2 carry the stretcher, and a third attends to the patient, and changes place with one of the bearers if necessary. To lay a patient on it, put the foot of the stretcher at his head in a line with his body; 2 bearers then place themselves one at either side, join hands underneath the back and hips of the patient, raise him up, lift him backwards over the stretcher, and lower him on to it. The third bearer takes charge of the injured portion (limb or head), and steadies it with a hand on either side. The two bearers now take their places at the head and foot of the stretcher, lift it up, and carry it off; while the third walks at the side of it, as a safeguard to the patient. Observe the following rules in carrying a stretcher: (1) Carry it with the hands, or suspended by straps over the bearers’ shoulders, never place it on the shoulders, because the patient might fall off, or even die, without the bearer observing it. (2) Do not keep step, i.e. do not put the same foot forward, then the motion of the stretcher remains even. The pace must be short (about 20 in.) and without a spring; the knees must be rather bent, and the hips moved as little as possible. Jolting, hurrying, crossing ditches, &c., are to be avoided. Choose bearers of the same height, arrange the shoulder-straps so that the head may be carried a little higher than the feet.
Convulsions.—Till medical aid can be procured, put the child into a warm bath, in which you can bear your elbow. Sponge him well over, and put a sponge of cold water on his head.
Cuts and Wounds.—Wounds may be “incised” (made by a clean-cutting instrument), “punctured” (when the depth exceeds the breadth, as in stabs), “lacerated” (torn, and the lips of the wound irregular), and “contused” (effected by bruising). The chief points to be attended to are:—(a) Arrest the bleeding. (b) Remove all foreign bodies as soon as possible. (c) Bring the wounded parts in apposition, and keep them so, best done by means of strips of adhesive plaister, first applied to one side of the wound, and then secured to the other; these strips should not be too broad, and space must be left between the strips to allow any matter to escape; wounds too extensive to be kept together by plaister, must be stitched by a surgeon. For punctured and severely lacerated or contused wounds a surgeon should be sent for.
For washing a wound, to every pint of water add either 5 gr. corrosive sublimate or 2½ teaspoonfuls carbolic acid. If the acid is used, add 2 tablespoonfuls glycerine, to prevent its irritating the wound. If there is neither of these articles in the house, add 4 tablespoonfuls borax to the water. Wash the wound, close it, and apply a compress of a folded square of cotton or linen. Wet it in the solution used for washing the wound, and bandage down quickly and firmly. If the bleeding is profuse, a sponge dipped in very hot water and wrung out in cloth should be applied as quickly as possible. If this is not available, use ice, or cloths wrung out in ice water.
Wounds heal in two ways.—(a) Rapidly, by primary union without suppuration, and leaving only a very fine scar; this only when the sides of wound can be accurately brought together, are not displaced by bleeding or exudation of matter, and when the wound is left quiet, protected from outward injury, and kept perfectly free from impurity. (b) Slowly, with suppuration, and the formation of granulations, and leaving a large red scar, as when so much skin has been destroyed that the edges of the wound cannot be brought together, or so lacerated and bruised that life is destroyed in them, or separated by blood or exudation of matter, or if the injured parts have been disturbed, or the wound has not been properly cleaned and disinfected. Want of cleanliness leads to putrefaction and the formation of matter, which separates the sides of the wound.
Drowning, Choking, and Suffocation.—The fatal termination to be avoided in all these cases is suspension of breathing, hence they may be classed under one head.
Drowning.—This is perhaps the most common, and embraces in great measure the remedies adapted to the other forms of suffocation. The first step is to send immediately for medical assistance, blankets, and dry clothing; but proceed to treat the patient instantly on the spot, in the open air, with the face downward, whether on shore or afloat; exposing the face, neck, and chest to the wind, except in severe weather, and removing all tight clothing from the neck and chest, especially the braces.
The points to be aimed at are—immediately the restoration of breathing; and, after breathing is restored, promotion of warmth and circulation. Efforts to restore breathing must be commenced immediately and energetically, and persevered in for 1-2 hours, or until a doctor has pronounced life extinct. Efforts to promote warmth and circulation, beyond removing 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.