Removal of Foreign Bodies From a Wound.—When the foreign bodies are large enough to be seen they may be picked out with the fingers after the hands have been rendered sterile. Smaller bodies may be picked up with forceps, or they may be washed out with water that has been boiled and cooled slightly, or a bichloride of mercury solution in the strength of 1 to 2000 may be used; or a normal salt solution may be used. As a general rule the physician should be allowed to undertake this procedure so that you may not be blamed for something that may come up later.
Cleansing a Wound.—The simplest way, and the most effective, to cleanse a wound, no matter how caused, is to procure a brush and paint it thoroughly with tincture of iodine. The iodine should be painted right into the raw wound, it is then bound up and left if it is small and does not need any stitching. When the physician comes he can attend to any further procedure that may be necessary.
Closing and Dressing Wounds.—If the wound is small, its edges may be drawn together with narrow strips of adhesive bandage after it has been painted with iodine. It is then bound up and kept at rest. It should be inspected the following day to see if it is healing properly.
If the wound is large or torn, it should be seen by a physician and dressed and closed by him. All wounds do better if they are kept at rest.
The Condition of Shock.—When a person suffers a serious injury, loses a large quantity of blood, or is subjected to a profound emotion, it affects the vital powers to such an extent that the individual is said to be suffering from shock. Shock expresses itself in varying degrees of apathy. The patient may or may not be conscious. If conscious he gives no evidence of feeling, he is silent and motionless although he will respond to directions and may answer questions. The eyes are dull and listless, the face pale and pinched, and the general expression is apathetic. The skin is cold and there may be perspiration; the pulse is feeble and irregular, and the breathing is shallow. The whole attitude of the victim is one of indifference and apparent inability to appreciate the seriousness of the situation and a seeming immunity to pain or discomfort.
When this condition exists it must always be regarded as serious because the patient may die as a direct result of the condition of shock. The various symptoms depend upon a temporary paralysis of the blood vessels which deprives the brain of blood. There is always a certain degree of shock with all injuries. Mothers should know what to do in these cases before the physician comes. The general treatment in all cases is to keep the patient warm and quiet, and to use stimulants carefully.
The patient should be put in bed or on a flat surface with the feet higher than the head. If raising the feet should cause the face to become blue it will be advisable to restore the patient to the horizontal posture. Artificial heat must be applied to the patient's body and extremities by means of hot water bags, bottles, bricks, plates, or any other handy device. Blankets should be put around the patient and every possible means resorted to, to maintain body heat. Mustard plasters may be put to the heart, spine and shins. Stimulants are necessary, such as hot black coffee if possible or hot water, in which a small portion of brandy may be put. If brandy is not obtainable the patient may take aromatic spirits of ammonia in hot water every twenty minutes for a number of doses. In every case of shock a physician should be sent for immediately.
Dog Bites.—When a child is bit by a dog every effort should be made to get the dog. It should be kept in a safe place for a week so that it may be definitely known whether it is sick or not. If the dog dies within a few days after biting anyone it may be assumed that he had rabies. Its head should be sent to the local health authorities who can tell after examination if it was mad. If there is any reason to assume that the dog was infected, the child should receive the Pasteur treatment. This treatment will, if conducted under favorable circumstances, absolutely prevent hydrophobia.
The mother should sterilize the wound as thoroughly as possible. This may be done by using pure hydrogen peroxide. A little piece of absorbent cotton is wound round the end of a tooth-pick or match, dipped in the peroxide and the incision thoroughly rubbed clean. This may be done a number of times to ensure thorough cleansing. No effort should be made to cauterize the wound. It is not considered proper to employ this method with dog bites. When the physician examines the wound he may or may not open it further for more extensive inspection and sterilization.
Mothers should remember that there are thousands of bites by dogs that never cause any trouble, and if it is known that the dog is healthy no worry need trouble the family. It is also wrong to inform the child of the probability of hydrophobia. The child may worry himself sick with fear and if the mother is nervous and excitable he is apt to be made sick with the dread of what may follow. It is better, therefore, to remain quiet, to keep cool, and not to excite the little patient at all.