CHAPTER XXXIX
ACCIDENTS AND EMERGENCIES
Accidents and Emergencies—Contents of the Family Medicine Chest—Foreign Bodies in the Eye—Foreign Bodies in the Ear—Foreign Bodies in the Nose—Foreign Bodies in the Throat—A Bruise or Contusion—Wounds—Arrest of Hemorrhage—Removal of Foreign Bodies from a Wound—Cleansing a Wound—Closing and Dressing Wounds—The Condition of Shock—Dog Bites—Sprains— Dislocations—Wounds of the Scalp—Run-around—Felon—Whitlow—Burns and Scalds
Contents of the Family Medicine Chest.—The family medicine cabinet should contain the following articles: a graduate, medicine droppers, hot water bags, a flat ice bag, a fountain syringe, a Davidson's syringe, a baby syringe, sterile gauze, absorbent cotton, gauze bandages of various widths, a yard of oiled silk, one roll of one inch "Z O" adhesive plaster, a bottle of Pearson's creolin, hydrogen peroxide (fresh), one ounce tincture of iodine in an air-tight bottle, a can of Colman's mustard, two ounces of syrup of ipecac, a bottle of castor oil (fresh), one pound of boracic acid powder, one pound of boracic acid crystal, a bottle of glycerine, a bottle of white vaseline, a bath thermometer, some good whisky or brandy, aromatic spirits of ammonia, smelling salts, pure sodium bicarbonate, oil of cloves for an aching gum or toothache, a bottle of alkolol for mouth wash and gargle, and one ounce of the following ointment for use in the various emergencies which occur in all homes,—
| Bismuth subnitrate | dram one |
| Zinc oxide | dram one |
| Phenol (95%) | drops twelve |
| Resinol ointment to make | ounce one |
This ointment may be applied to all cuts, bruises, skin eruptions, chafings and sores of minor importance. It is one of the best applications for chafing of the skin in babies.
The medicine chest should also contain a small jar of Unguentine for burns; one-tenth grain calomel tablets for a cathartic for baby to be used as explained in the text of the book, or as advised by the physician. It may also contain tablets for colds and for other purposes as suggested by the family physician. It should never contain medicines the use of which is not thoroughly understood by the mother. It is a wrong practice for mothers to keep medicines to use for the same ailment at a subsequent time. The ailment may not be the same and frequently the medicine itself deteriorates, or it may get stronger with age. Many medicines are made with alcohol in them. If kept for some time the alcohol evaporates and leaves a concentrated mixture which, if given in the dose meant for the fresh preparation, may poison a child. Such cases of poisoning are on record. The same argument applies to powders. Certain drugs lose their strength, some absorb moisture, others change their chemical strength if kept mixed with other chemicals. They should be thrown away after the case is over if they have not been used. It is a dangerous practice to keep medicines around if there are children in the family.
Foreign Bodies in the Eye.—Particles which accidentally lodge in the eye are usually located on the under surface of the upper lid. They are sometimes, however, found on the ball of the eye or on the inner aspect of the lower lid. Foreign bodies which are propelled into the eye with great force, as iron specks which railroad men frequently get sometimes imbed themselves into the eye-ball and have to be cut out or dug out. The entrance of the foreign particle is always accompanied by a flow of tears which is nature's way of removing them. The offending object may escape through the tear duct into the nose, or it may be simply washed out with the flow of tears. Rubbing the well eye will cause a flow of tears in both eyes and may facilitate removal of the foreign matter. Blowing the nose may force the particle into the tear duct. The use of the eye cup may help in ridding the eye of the body. The same object may be accomplished if the eyes are immersed in a basin of water and opened wide. Then by moving the eyes around the particle may be washed out. If the particle is located on the under surface of the upper lid it may be promptly removed by pulling the upper lid forcibly down and over the lower lid. The eyelashes of the lower lid act as a brush and as a rule quickly remove the irritant if the procedure is carried out adroitly. Everting the upper lid is a means of locating the body and in making possible its removal by a small camel's hair brush or corner of a handkerchief. To evert the upper lid it is necessary to employ a guide. A match stem may be used in an emergency. This is laid across the middle of the upper lid, the eye lashes are grasped with the fingers of the other hand and the lid is bent over the match stem and turned up thus everting or turning inside out the entire upper lid. The procedure may be facilitated if the patient is instructed to look down while the operator is drawing the eye-lid upward.
If the particle cannot be easily removed by any of the above methods it is not safe for an uninstructed individual to go any further. The eye is an exceedingly delicate organ and may be permanently injured by unnecessary irritation. It is always safer and it may be cheaper in the long run to consult a competent oculist in such cases.