As an instance of successful unprofessional help, take the following case of a man who was seen by a policeman to fall against an iron railing with such force as to completely sever an artery. The policeman, a pupil of one of the St John Ambulance classes, so cleverly extemporised a compress and bandages that the bleeding was entirely arrested. On the temporary appliance being removed at one of the London hospitals, the hemorrhage returned with so much violence, that the surgeon in attendance declared that nothing but the prompt aid rendered by the policeman could have averted speedy death.
But even when the accident is not so serious as to involve the question of life or death, much needless suffering is often caused by the roughness or carelessness of unskilled handling, and recovery is in consequence greatly retarded. The following instance, both of this and of the advantages of skilled assistance, is taken from the Register of the Association. It is the case of a carter who had his leg broken by a fall whilst at work and at a distance from medical help. Two successful candidates of an ambulance class extemporised splints, bandages, and a stretcher, and conveyed the wounded man to a doctor’s house. As a consequence of the injured limb having been properly supported, the patient was able to get out of bed in three weeks’ time, and in less than two months was walking about with ease. Five years previously he had met with a similar accident under corresponding circumstances: but no skilled help being at hand, he was conveyed home somewhat roughly, a proceeding which revenged itself by sixteen weeks of helplessness and suffering.
Such cases are of daily, almost hourly occurrence in our large towns, whilst in mining or manufacturing districts, the risks to life and limb are even more serious and frequent; so that any agency which provides the needed help to such sufferers cannot but be looked upon as a boon to humanity. Now, it is just this first prompt aid that the Association seeks, through its pupils, to place within the reach of all those who are overtaken by sudden accident or injury; and in order to disseminate the necessary knowledge, classes for instruction are held wherever the requisite number—twenty to thirty—of pupils are found willing to prepare themselves to be in readiness to give help in case of need. The course of instruction is limited to a series of five lectures, according to a syllabus drawn up by a Committee of medical men of eminence. It consists of a general slight outline of the structure and functions of the human body, including particular notice of the principal arteries and of the different forms of hemorrhage, with the various extemporary means for its arrest, including the use of bandages. Fractured bones also receive a considerable share of attention. The fourth lecture is devoted to the consideration of insensible patients, the treatment of the apparently drowned, and of the victims to burns, scalds, and various smaller ills. So far, the instruction is the same for male and female pupils; but in the last lecture the lines diverge; and whilst women receive some hints on home-nursing, men are instructed as to the best methods of lifting and carrying the sick and injured, with or without stretchers. The last half-hour of each lesson is devoted to practice by the pupils of such arts as the application of splints and bandages, and the conveying from place to place of patients pro tem.
For ladies’ classes, a small boy is hired as dummy, and is put through such a series of possible accidents as ought to sober the most reckless of mortals into a cautious habit of life. The sight of a group of eager watchers for a vacant limb is decidedly entertaining; and it is curious to notice the contrast between the utter want of comprehension of some aspirants, and the quickness with which other deft fingers carry out an idea once grasped.
Pupils who pass an examination, partly written and partly practical, which is held at the end of each course of lectures, are presented with certificates of proficiency; and for women only, there is a second course of instruction in the elements of hygiene and home-nursing.
A record, well worth studying, is kept by the Association of cases successfully treated by its pupils; and a list is also kept of those holding certificates who would be willing to join an ambulance train in case of war.
It need scarcely be said that the work of the Association in no sense seeks to supersede or interfere with the doctor’s help; and it is pleasing to find that in no case has complaint been made of over-officiousness or presumption on the part of any one pupil. Indeed, the little knowledge so conveyed would be more likely to have a contrary effect, and to make the amateur pause and consider, before venturing to trifle with such a wonderful and intricate piece of mechanism as the human body. Few of us are without at least one ‘friend’ who is ready at a moment’s notice to prescribe some quack remedy, from the deadly poison of soothing sirup, to the comparatively harmless ‘globule’ of the homeopathist, and to do so with an air of profound conviction, even in cases where the doctor of learning and experience hesitates to give an opinion.
Now, anything that would tend to foster ignorant presumption is carefully avoided in the ambulance class, the instructor and examiner of which are invariably medical men; and only that amount of knowledge is imparted which will enable pupils to give help of the right kind, until the doctor arrives. Pupils in a position to do so, pay a small fee; but as the work of the Association increases rapidly amongst miners, colliers, railway-porters, policemen, and others, who cannot afford to contribute towards the necessary working expenses, whilst they constitute just the class to whom instruction is most valuable, increased support from those who have it in their power to give is very greatly needed; and as the work is undertaken, in great part, as a labour of love, donors may have the satisfaction of feeling that their gifts go directly towards the formation of new centres of usefulness.
In order to complete the work of the Association, a varied stock of matériel has been prepared and widely distributed by means of the Store Department. Of the first Handbook prepared for the use of classes, no fewer than fifty thousand copies have been issued, as well as a large number of special Manuals for the advanced or nursing class. It was also found necessary to supply the classes with diagrams for the use of lecturers, and with an assortment of such articles as bandages, splints, &c. The Association has also prepared a small portable hamper in a waterproof case, fitted with those ‘First Aid’ appliances, the use of which is taught in the classes. Much time and thought has been expended on the production of a stretcher at once light, easily managed, and comfortable; the result has been a small vehicle known as the ‘Ashford’ litter, consisting of a covered stretcher moving on two wheels, which can in ordinary cases be managed by one person. Such a hamper and litter have, during the past year, been placed in two lodges of Hyde Park; and it needs little prophetic insight to predict that in a short time our public buildings will boast a supply of the wherewithal for dealing with cases of accident or emergency.
The latest idea, which awaits full organisation, is the formation of Ambulance Corps for the transport of sick (non-infectious cases) and injured in large towns, where the distance is of necessity great. In London, there are no proper arrangements for the removal of the infirm, the few vehicles to be had being unsuitable for the purpose and costly to hire; facts which show the need of help, such as an organised Ambulance Corps would be able to give at a moment’s notice.