To restore breathing, place the patient on the floor or ground with the face downwards, and one of the arms under the forehead, in which position fluids can more readily escape at the mouth, and the tongue will loll out, leaving the entrance to the windpipe free. The tongue may be easily kept extended by simply passing a small rubber band round it and the chin. The mouth and nose must be thoroughly wiped and cleaned from obstructions.
If breathing has quite or almost failed, means must be used to restore it; if not, proceed at once to promote warmth. There are several ways of inciting suspended respiration. The best, as requiring only one person, is Silvester’s method, as follows: Place the apparently dead person flat on his back, raising his head and shoulders slightly by means of a folded article of dress. Standing behind him, grasp his arms just above the elbow, and draw them gently and steadily upwards over the head, keeping them in that position for 2 seconds; by this means the chest expands and air is drawn into the lungs (Fig. 121). Then carry the arms back again in the same way and press them gently and firmly against the sides of the chest for 2 seconds; by this means the air is pressed out of the lungs again (Fig. 122). These movements are repeated carefully and perseveringly, about 15 times in a minute, till natural respiration begins. The first evidence of this is a sudden flush of colour in the face.
121. Inspiration (Silvester). 122. Expiration (Silvester).
When 2 persons are present, Francis’s plan may be adopted, thus: The body of the patient is laid on the back, with clothes loosened, and the mouth and nose wiped; 2 bystanders pass their right hands under the body at the level of the waist, and grasp each other’s hands, then raise the body until the tips of the fingers and the toes of the patient alone touch the ground; count 15 rapidly; then lower the body flat to the ground, and press the elbows to the side hard; count 15 again; then raise the body again for the same length of time, and so on, alternately raising and lowering. The head, arms, and legs are to be allowed to dangle down quite freely when the body is raised.
When 3 or more persons can assist, Marshall Hall’s method is available. To excite breathing, turn the patient quite on the side, supporting the head, and induce inspiration and expiration by alternately rolling the body over on its face, and back again, at 15 seconds intervals, as shown in Figs. 123 and 124.
123. Inspiration (Marshall Hall). 124. Expiration (Marshall Hall).
As soon as a natural effort to breathe is produced, endeavour to restore circulation and warmth. Wrap the body in dry blankets and commence rubbing the limbs upwards firmly and energetically under the blanket or over warm clothing, which can generally be got from bystanders. Then put the patient into a warm bed, and cover over with hot flannels, applying bottles or bladders of hot water, or heated bricks, to the pit of the stomach, the armpits, between the thighs, and to the soles of the feet. When the patient is able to swallow, give him warm fluids by spoonfuls—coffee, tea, brandy and water, wine—but not in too great quantities. Warm baths should never be used but when ordered by the doctor.
Choking.—When a person gets a fish-bone or other substance in the throat, at once insert a finger into the mouth and press upon the root of the tongue, so as to induce vomiting. If this fails, let the patient swallow a piece of soft bread. If the substance can be felt by the finger, insert 2 fingers into the mouth and bring it away, using the safeguard of putting some hard substance between the teeth. A medical man should at once be sent for. Repeatedly sucking lemons will help to dissolve the bone. A marble or similar article in a child’s throat may be dislodged by turning him heels upwards and shaking.