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Monday, June 25, 2012

ACCIDENTS AND EMERGENCIES

How to Treat Bruises. Bruises are best treated either by holding the injured part under the faucet, or pump, if convenient, or by plunging it into very hot water and holding it there for ten or twelve minutes. Then if the bruise still continues to throb or ache, wrap it up lightly with a bandage of soft, loose cotton or linen cloth, and pour over it a lotion of water containing about one-fourth alcohol until the bandage is soaked, moistening it again as fast as it dries. This is also a useful treatment for wounds that have been made by a fall, or by something blunt and heavy, so that there is bruising as well as cutting. Most of the household applications for wounds or bruises, such as arnica, camphor, witch-hazel, etc., owe their virtues to the five or ten per cent of alcohol they contain, which, by evaporating, cools the wound and relieves inflammation, kills germs and so acts as an antiseptic, and cleans the wound and the skin around it very thoroughly and effectively.

Bruises of all sorts, however, unless very severe, are much safer than cuts or scratches, because they do not break the skin, and consequently no germs can get into the tissues of the blood. Our skin, as you remember, is one of the most wonderful water-proof, germ-proof, hot-and-cold-proof coatings in the world; and as long as it remains unbroken, none but a few of the most virulent disease-germs can get through it into the body.


Boils and Carbuncles, their Cause and their Cure. Boils and carbuncles are almost the only instances in which pus germs can get into the body without some actual cut, tear, or breaking of the skin. They come always from other boils or ulcers or discharging wounds and are caused by the pus germs in these either being rubbed into the skin until it is almost chafed through, or else being driven down into the mouth of one of the hair follicles, or "pores."

 Here they proceed to grow and form a little gathering, which soon turns to pus; and this stretches the skin and presses upon the sensitive nerves in it so as to cause much pain. The best way to treat them in the beginning is to give a thorough scrubbing with hot water and soap, and then to drop right over the point, or "head," of the gathering two or three drops of a strong antiseptic, like formalin or peroxide or carbolic acid. If this does not check them, then they had better be opened up freely with a sharp knife that has been held in boiling water, or a needle that has been held in a flame until it is red hot and allowed to cool. Then pour peroxide into the opening, put on a light dressing, and keep soaked with alcohol and water, as for a bruise. This evaporating dressing is far superior to the dirty, sticky, germ-breeding poultice. If this does not clear it up within twenty-four hours, go to a doctor and have him treat it antiseptically.

How to Stop Bleeding. If a cut should go deep enough to reach an artery the size of a knitting needle, or larger, then the blood will spurt out in jets. There is then some danger of so much blood being lost as to weaken one. Our blood, however, has a wonderful power of clotting, or clogging, round the mouth of the cut artery, so that the risk of bleeding to death, except from quite a large artery, like that of the thigh, or the armpit, is not very great.


For a wound in the hand or foot, that spurts in this way, it will usually be sufficient to grasp the arm firmly above the wrist or the elbow, or the ankle, as the case may be, with the thumb over the artery, or even to press directly over the wound, until the bleeding stops and the blood is thus given a chance to clot. If the wound is small and deep, like that made by the stab of a knife, or the slip of a chisel, then firm pressure directly over the wound itself with a thumb, or both thumbs, will usually be sufficient to stop the bleeding.
A TOURNIQUET
A TOURNIQUET A stone laid above the cut under the bandage will help to increase the pressure at this point.
Should, however, the spurting be from an artery like that of the pulse, or from that at the bend of the elbow or the knee, then the best thing to do is to tie quickly a handkerchief or strip of tough cloth loosely around the limb above the wound and, slipping a short stick or bar into the loop, twist upon it, as shown in the picture, until the blood ceases to flow from the wound. It is much better to use a handkerchief or piece of cloth than a cord, because the latter may cut into and damage the tissues, when drawn as tight as is needed to stop the circulation. It is not best to allow a bandage twisted tight enough to stop the circulation—called a tourniquet—to remain tight for more than half an hour at a time, as this may give rise to very dangerous congestion, or serious "blood starvation" of the tissues below it.

 It should be gently untwisted every half hour until the arm, or limb, below it reddens up again, and then, if the spurting begins, should be tightened as before. There is, however, a good chance that if the cut artery is not too large, the blood will have clotted firmly enough in this time to stop the bleeding; though the tourniquet had better be left on the arm, ready to be tightened at a moment's notice, until the doctor comes.
The Treatment of Burns. Burns require more careful treatment on account of the wide surface of the skin usually destroyed. The layer of the skin that is most alive and most active in the process of repair is the outer layer (the epithelial, or epidermis).

 A burn, or scald, if at all severe, is likely to destroy almost the entire thickness of this, over its whole extent. This gives both a wide surface for the absorption of pus germs and a long delay in "skinning over," or healing. As the same heat that made the burn has usually destroyed any germs that may be present, it is not necessary to wash or clean a burn, like a wound, unless dirt has been rubbed or sprinkled into it after it has been made. The first thing to be done is to coat it over so as to shut out the air; and this, for a slight burn, can be very well done by dusting it over with baking soda or clean flour or with one of the many dusting, or talc, powders on the market, containing boracic acid, or by laying over the burn a clean cloth soaked in perfectly clean olive oil or vaseline. If the oil or vaseline is not perfectly clean, put it on the top of a stove and heat it thoroughly before using. Dress with soft, clean cotton rag or lint as before, keeping wet with the alcohol lotion (one part of alcohol to eight of water) if there be much pain, or throbbing.

If the burn is deep or the pain at all severe, it is best to call in a doctor, as bad burns are not only agonizingly painful, but also very dangerous on account of the wide, raw surface that they leave open to entrance of pus germs for days and even weeks. Until a doctor can be secured, coat it over with some non-irritating powder or oil, as for lighter burns, or hold it in warm water to exclude the air. Do not try to clean a burn. You only increase the pain of it and probably add to the risk of infection.


If your clothing ever catches fire, wrap yourself up at once in a blanket or rug to smother the flame. Remember that running will supply more air to the flame and cause it to do more damage. If you have nothing at hand in which to wrap yourself, lie down on the floor, or ground, and roll over and over until you have smothered the flame.

What should be Done in the Case of Broken Bones, or Fractures. Broken bones, or fractures, as they are called, are more serious, but fortunately not very common. They should, of course, always be treated by a doctor, to prevent shortening of the limb, or to prevent the bones from growing together at an angle, or in a bad position, so as to interfere with the use of it. Where a doctor cannot readily be had, or the patient has to be taken to him,—as, for instance, where the accident occurs out in the woods,—take two light pieces of board, or two bundles of straight twigs, or two pieces of heavy paper folded fifteen or twenty times—two folded newspapers, for instance—and, wrapping them in cloth or paper, place one on each side of the broken limb, at the same time gently pulling it straight.

Then take strips of cloth, or bandage, and bind these splints gently, but firmly and snugly, the length of the limb, so that it cannot be bent in such a way as to make the ends of the bone grate against each other. The patient can then be lifted, or carried, with comparative comfort. Most fractures, or broken bones, in children or young boys or girls, heal very rapidly; and if the limb be properly straightened and splinted by competent hands, it will be practically as good and as strong as before the accident.

Sprains. Sprains are twists or wrenches, of a joint, not severe enough to "put it out," or dislocate it, or to break a bone. A mild sprain is a very trifling affair, but a severe one is exceedingly painful and very slow in healing. The best home treatment for sprains is to hold the injured joint under a stream of cold water for ten or fifteen minutes and then to bandage it firmly and thoroughly, but gently, with a long "figure-of-eight" bandage, wound many times, and to keep this moist with an alcohol lotion. Then keep the limb at rest. If the cold water does not relieve the pain, plunge the joint into water as hot as you can comfortably bear it and keep it there for ten or fifteen minutes, adding fresh hot water to keep up the temperature; then bandage as before.

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