Part 37

SUSPENDED ANIMATION FROM NOXIOUS GASES.

Remove patient at once into the fresh air. Employ artificial respiration, apply heat, and stimulate hypodermically.

METHODS OF ARTIFICIAL RESPIRATION.

=Sylvester’s Method.=—Lay the patient upon his back; kneel above the head, take firm hold of the arms above the elbow, and move them horizontally—first away from the body, then over the head until the hands touch behind; pull them backward for a few seconds. This process expands the chest cavity, and the lungs are filled with air, inducing inspiration. Return the arms to the first position, and make strong pressure on the sides of the chest and epigastrium to expel the air and effect expiration. Movements should not be too rapid; they should be repeated about sixteen times a minute. In case of apparent want of success, persist in the treatment until it has been ascertained that the heart has ceased to beat.

=Marshall Hall’s Method.=—Roll the patient over on his breast, make gentle pressure on the back, then turn the body gently but completely on the side, and again make gentle pressure on the back. Repeat these movements fifteen times every minute.

Artificial respiration may be kept up for hours before the faintest symptoms of life are shown.

SUNSTROKE.

Two conditions result from exposure to excessive heat: thermic fever and heat exhaustion.

In =thermic fever=, after prodromal symptoms consisting of headache, nausea, and vomiting, there are stupor or coma, fever ranging from 105° to 110° F., flushing of the face, contraction of the pupils, a rapid, full pulse, and noisy respirations.

Management.—Pack the patient in ice, and rub with ice. Ice-water enemas may also be given. Bleeding and the subcutaneous administration of normal salt solution are sometimes efficacious.

In =heat exhaustion= consciousness is not lost; the skin is cold and moist; the respirations are shallow and rapid, but not noisy; and the pulse is feeble.

Management.—The patient should be covered with blankets and surrounded with hot bottles. Aromatic spirit of ammonia (30 minims), whisky, and black coffee are useful stimulants.

BATHS AND PACKS.

WARM PACK FOR PNEUMONIA PATIENTS.

Articles needed: 4 blankets. Foot-tub for hot water. 1 rubber and towel for head. Basin and ice. 1 long rubber sheet. 2 compresses for head.

Place under patient: First, blanket, then rubber sheet, covered with second blanket. Place small rubber piece, covered with the towel, under patient’s head. Third blanket put over patient. Leave patient on side while woolen blanket is wrung out of hot water. Place this blanket quickly under and about the patient, removing lower dry one at the same time. Leave feet out of wet blanket, wrapping them up dry, and use hot-water bottle if necessary. Cold compresses to head. Leave in pack 45 minutes. Wipe dry; give alcohol rub. Take temperature and pulse every half-hour after removing from pack.

COLD PACK TO REDUCE TEMPERATURE.

Articles needed: 1 long rubber sheet. Foot-tub. 3 blankets. Pitcher or sprinkler. Basin of ice. Rubber and towel for head. 2 compresses for head.

Place under patient: First, blanket, then rubber sheet, covered with second blanket. Have blanket over patient with patient on side. Wring a cotton blanket or sheet out of warm water to wrap about patient, leaving feet out, covering them with a dry blanket, using hot-water bottle if necessary. Compress on head. Sprinkle with tepid water. Use friction. Turn patient once in midst of pack and iron back with ice, and again just before he is removed. Leave in 30 minutes. Change compresses frequently. Give plenty of water to drink. Have sea sponge to take up water. Leave patient between blankets; give alcohol rub. Take temperature and pulse half an hour after removing the pack.

SPONGING TO REDUCE TEMPERATURE.

Articles needed: 2 blankets. Basin of ice. 3 towels. Basin of warm water. Rubber and towel for head. Compresses or ice-cap for head.

Place patient between blankets. Rubber and towel under head. Towel across loins. Wash face and apply cold compress to head. Sponge chest, arms, legs, and back with warm water. Cool water and sponge chest. Apply cold compress across chest. Turn patient on side. Sponge arms, leaving upper part of body exposed. Fold blanket up and sponge back. Change compresses frequently. Give plenty of water to drink. Continue sponging from 20 to 30 minutes. Rub with alcohol and put patient to bed. Take pulse and temperature half-hour after sponging.

HOT PACKS TO INDUCE PERSPIRATION.

Articles needed: 4 blankets. 1 sheet. 2 long rubber sheets. Basin of ice. 1 short “ sheet. Foot-tub of hot water. Rubber piece for head. Old woolen blanket. 2 towels. 2 compresses.

Place under patient: First, blanket, then rubber sheet, covered with the second blanket. Third blanket place over patient. Wrap feet up dry. Have patient on side. Wring fourth blanket out of hot water and place quickly about patient, bringing well up around neck and in between the arms. Wrap well about the legs. Bring under rubber sheet up about the neck well and place a long rubber sheet snugly over that. Wrap feet, then bring under blanket up over rubber sheet, and top blanket tucked over all, seeing that all folds of blankets are snug around the neck. Rubber and towel under head. Compress to head. Place sheet over patient not tucked in. Give hot drinks freely unless liquids are restricted. Take pulse before placing patient in pack and every 15 minutes while in. Leave patient in 45 minutes and then in dry blankets half an hour, Take out of pack, rub dry, and give alcohol rub.

TUBBING.

Articles needed:

1 long rubber sheet. 1 sea sponge. 2 blankets. 2 pails. 1 tubbing sheet. Basin of ice. 1 towel. Siphon. 2 compresses or ice-cap. Piece of rubber tubing. 1 bath towel.