Accidents And Emergencies


Categories: ACCIDENTS AND EMERGENCIES
Sources: A Handbook Of Health

Ordinarily, Accidents are not Serious. Accidents will happen--even in

the best regulated families! While taking all reasonable care to avoid

them, it is not best to worry too anxiously about the possibility of

accidents; for a nervous, fearful state of mind is almost as likely to

give rise to them as is a reckless and indifferent one. Fortunately,

most accidents, especially with growing boys and girls, are

comparatively trifling in their results, and to a considerable extent

must simply be reckoned as part of the price that has to be paid for

experience, self-control, and skill. To have keen senses, vigorous and

elastic muscles, and a clear head, is better protection against

accidents than too much caution; it is also the best kind of insurance

that can be taken out against their proving serious. The real problem is

not so much to avoid accidents as to be ready to meet them promptly,

skillfully, and with good judgment when they occur, as they inevitably

will. As the old masters of swordsmanship used to teach, Attack is the

best defense.



Luckily, healthy children are as quick as a cat and as tough as

sole-leather--if they weren't, the race would have been wiped out

centuries ago. Children in their play, on errands, going to and from

school, and in excursions through the woods and the fields, run, of

course, a great many risks. But in spite of all these dangers, the

number of children killed, or even seriously injured, in these natural

accidents, is not half of one per cent of those who die from disease or

bad air or poor food or overwork.



Another cheering thing about accidents is that ninety-nine out of every

hundred of them are not serious; and if you are only wise enough to know

what to do--and still more what not to do--in taking care of them, you

can recover from them safely and quickly. The bodies of healthy children

have an astonishing power of repairing themselves. Their bones are not

so brittle as those of grown-ups; and even when one of them is broken,

if properly splinted and dressed, it will heal up in a little more than

half the time required by the adult. And wounds and scratches and

bruises, if kept perfectly clean, will heal very rapidly.



Probably the commonest of all accidents are cuts and scratches. So

common is it for us to bark our knuckles, or our shins, or scratch

ourselves on nails and splinters and drive pins into ourselves, or let

our pocket knives slip and cut our fingers, that, if the human skin had

not the most wonderful power of repairing itself,--not merely closing up

the cut or the scratch, but making the place as good as new,--we

should be seamed and lined all over our hands, arms, faces, and limbs

like a city map, or scarred and pitted like a tattooed man, before we

were fifteen years old. But of course, as you know, the vast majority of

cuts and scratches and tears heal perfectly. They hurt when they happen;

and they burn, or smart, for a few hours, or hurt, if bumped, for a few

days afterward; but they heal soon and are forgotten.



On the other hand, some cuts and scratches will fester and throb and

turn to matter (pus) and even give you fever and headache and blood

poisoning. What makes the difference? It is never the size, or depth, of

the scratch or cut itself, but simply the dirt that gets into it

afterward. If a cut, or scratch, no matter how deep or ragged, be made

with a clean knife-blade or sliver and kept clean afterward, it will

never matter (suppurate) or cause blood poisoning. So if you know

how to keep dirt out of cuts and scratches, you know how to prevent

ninety-nine per cent of all the dangers and damage that may come from

this sort of accident.



Not more than one cut or scratch in a thousand is deep enough to go down

to an artery, so as to cause dangerous bleeding, or to injure an

important nerve trunk. So, though no one would by any means advise you

to be reckless about getting cut and scratched, yet it is better and

safer to run some risk of cuts and scratches in healthy play when young,

and learn how to keep them clean, than to grow up pale and

flabby-muscled and cowardly.



How to Prevent Infection in Wounds. It is not just dirt that is

dangerous,--although dirt of any sort is a bad thing to get into wounds

and should be kept out in every possible way,--but dirt that contains

those little vegetable bacteria that we call germs. The dirt most likely

to contain these germs--called pus germs, because they cause pus, or

matter in a wound--is dirt containing decaying animal or vegetable

substances (particularly horse manure, which may contain the tetanus, or

lock-jaw germ) and the discharges from wounds, or anything that has come

near decayed meat or unhealthy gums or noses or teeth. This is why a cut

or scratch made by a knife that has been used for cutting meat, or by a

dirty finger-nail, or by the claw of a cat, or by the tooth of a rat, is

often likely to fester and run. Animals like rats and dogs and cats

often feed upon badly decayed meat; and hence their teeth, or claws, are

quite likely to be smeared with the germs that cause decay, and these

will make trouble if they get into a wound.



Fortunately, the care of a cut or scratch is very simple and practically

the same in all cases. Just make the wound thoroughly clean and keep it

so until it is healed. For a slight clean cut or scratch, a good

cleanser is pure water. Hold the hand or foot under the faucet or pump,

and let the cool water wash it out thoroughly. If you are sure that the

thing you cut it with was clean, let the blood dry on the cut and form a

scab over it. If the wound is large, or there is any danger of the water

of the well, or tap, having sewage in it (see chapter IX), it is better

to boil the water before using it. Unless the blood is spurting in jerks

from a cut artery, or bleeding very freely indeed, it is better to let

the wound bleed, as this helps to wash out any dirt or germs that have

got into it. When the bleeding has stopped, do not put on sticking

plaster, because this keeps out the air and keeps in the sweat of the

skin surrounding the wound, which is not healthful for the wound, and

may also contain some weak pus germs.



If the wound is small, the old-fashioned clean white rag that has been

boiled and washed is as good as anything that can be used for a

dressing. Tear off a narrow strip from one to two inches wide and as

many feet long, according to the position of the wound, roll it round

the finger or limb three or four times, and then take a turn round the

wrist or nearest joint, to keep the bandage from slipping off. If the

wound be likely to keep on oozing blood, put on first a thickness of

surgeon's cotton, or prepared cotton-batting, an ounce of which can be

purchased for ten cents at any drugstore. This is an excellent dressing,

because it not only sucks up, or absorbs any oozing from the wound, but

is a perfect filter-protection against germs of all sorts from the

outside. Ninety-nine simple wounds out of a hundred dressed in this way

will heal promptly and safely without danger of pus, or matter.



If the wound happens to have been made with a knife or tool that you are

not absolutely sure was perfectly clean, or if the wound gets manure or

road-dirt or other filth rubbed into it, then it is best to go at once

to a doctor and let him give it a thorough antiseptic dressing, which

consists of cleaning it out thoroughly with strong remedies, called

antiseptics,--which kill the germs, but do not injure living

tissues,--and then putting on a germ-proof dressing as before. This is

one of the stitches in time which will save not only nine, but

ninety-nine.



If you have a wound with dirt in it, and cannot reach a doctor, one of

the best and safest antiseptics to use is peroxide of hydrogen. This

is non-poisonous, and can be poured right into the wound. It will smart

and foam, but will clean out and kill most of the germs that are there.

Another safe antiseptic is pure alcohol. It is a good thing to have a

bottle of one of these in the medicine-closet, or in your war-bag when

camping out. A package of surgeon's cotton and two or three rolled

bandages of old cotton, linen, or gauze also should be on hand.



Dog-bites, rat-bites, or cat-bites should always be dressed by a doctor,

or made thoroughly antiseptic, mainly on account of the germs that swarm

round the roots of the teeth of these animals, and also because

treatment of this sort will prevent hydrophobia--although this danger

is a rare and remote one, not more than a few score of deaths from

mad-dog bites occurring in the whole United States in a year.



The wonderful progress made by surgery within the last twenty or thirty

years has been almost entirely due to two things: first, the discovery

of chloroform and ether, which will put patients to sleep, so that they

do not feel the pain of even the severest and longest operation; and,

second, but even more important, keeping germs of all kinds out of the

wound before, during, and after the operation. That sounds simple, but

it really takes an immense amount of trouble and pains in the way of

baking the dressings; boiling the instruments, and scrubbing with soap,

alcohol, hot water, and two or three kinds of antiseptics, or

germ-killers, the hands of the surgeon and of the nurse and the body of

the patient. How enormous a difference this keeping of the germs out of

the wound has made may be gathered from the fact that, while in earlier

days, before Lister showed us how to avoid this danger, surgeons used to

lose seventy-five per cent of their amputations of the thigh, from pus

infection, or blood poisoning, now they can perform a hundred operations

of this sort and not lose a single case. We can open into the skull and

remove tumors from the brain; open into the chest and remove bullets

from the lungs, and even from the heart itself; operate in fact upon any

part, or any organ, of the body with almost perfect safety and wonderful

success. Whereas, before, two-thirds of the patients so operated upon

would die, probably of blood poisoning.



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.





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.



If the pain should not go down under either of these treatments within

six or eight, certainly within ten or twelve, hours, it is far wisest to

call a doctor, because severe sprains very often mean the tearing of

some important tendon or ligament, and the partial fracture of one of

the bones of the joint. Unless these conditions are promptly corrected,

you may be laid up for weeks, and even months, and left with a

permanently damaged--that is, stiffened--joint. You will often hear it

said that a sprain is harder to heal than a fracture; but that kind of

sprain usually includes a fracture of some small portion of a bone,

which has escaped notice and proper treatment. If the sprain is mild, so

that it does not pain you when at rest, then the bandage should be

removed every day, and the joint gently rubbed and massaged, and the

bandage replaced again. Should there be any one in reach who understands

massage, a thorough massaging right after the accident is quite helpful;

but no amateur had better attempt it, as unskilled rubbing and

stretching are likely to do more harm than good.



What to Do in Case of Poisoning. Poisoning is, fortunately, a rare

accident; and the best thing to be done first is practically the same,

no matter what poison--whether arsenic, corrosive sublimate, or carbolic

acid--has been swallowed. This is to dilute the poison by filling the

stomach with warm water and then to bring about vomiting as quickly as

possible. This can usually be done by adding a tablespoonful of mustard

to each glass of warm water drunk. If this cannot be had, or does not

act within a few minutes, then thrusting the finger as far down the

throat as it will go, and moving it about so as to tickle the throat,

will usually start gagging; or a long feather may be dipped in oil and

used in the same way. It is also a good thing to add milk or white of

egg or soap to the water, or to mix a little oil or plaster scraped off

the wall with it, as these tend to combine with the poison and prevent

its being absorbed. If the poison happens to be an acid, like vitriol,

then add a tablespoonful or more of baking soda to the hot water; if an

alkali, like lye or ammonia, give half a glass of weak vinegar. The main

thing, however, is to set up vomiting as quickly as possible.





Another rather frequent and most disagreeable accident, which may happen

to you when out in the woods, is poisoning by poison ivy. This is due to

the leaves or twigs of a plant, which many of you probably know by

sight, touching your hands or face. If you do not happen to know what

poison ivy looks like, you had better get some one who knows to point

out the shrub to you the next time you go into the woods, and then you

should try to keep as far away from it as possible. It is sometimes

called poison oak, but both these names are incorrect, as the shrub is

really a kind of sumac. It takes its different names because it has the

curious habit of either climbing like a vine, when it is called ivy,

or growing erect like a bush, or shrub, when it is called oak.



All sorts of absurd stories are told about the leaves of the shrub being

so poisonous that it is not safe to go within ten feet of it, when the

dew is on it, or to walk past it when the wind is blowing from it toward

you. But these are pretty nearly pure superstitions, because it has been

found that the substance in the leaves or bark of the shrub which

poisons the skin is an oil, which is non-volatile, that is to say,

will not give off any vapors to the air and, of course, cannot be

dissolved in dew or other watery moisture. You must actually touch the

leaves in order to be poisoned; but, unfortunately, this is only too

easy to do without knowing it when you are scrambling through the woods

or hunting for flowers or picking berries.



The remedy for poison ivy is a very simple one, and within the reach of

anybody, and is as effective as it is simple. This is a thorough

scrubbing of the part poisoned, just as soon as it begins to itch, with

a nail-brush and soap and hot water. This makes the skin glow for a

little while, but it washes out all the burning and irritating oil and,

if used promptly, will usually stop the trouble then and there. It is a

good idea if you know that you have touched poison ivy, or even if you

have been scrambling about actively in woods or patches of brush where

you know that the ivy is common, to give your hands a good washing and

scrubbing with sand or mud, if there is no soap at hand, in the first

stream or pool that you come to. This will usually wash off the oil

before it has had time to get through the natural protective coating of

the skin.



Snake-bite is one of the rarest of all accidents and not one-fiftieth as

dangerous as usually believed. Not more than one person in twenty bitten

by a large rattlesnake will die, and only about two in a hundred bitten

by small rattlers or by copperheads. The average poisonous snake of

North America cannot kill anything larger than a rabbit, and any

medium-sized dog can kill a rattlesnake with perfect safety. Our

horror-stricken dread of snakes is chiefly superstition. Of those who

die after being bitten by North American snakes, at least half die of

acute alcoholic poisoning from the whiskey poured down their throats in

pints; and another fourth, from gangrene due to too tight bandaging of

the limb to prevent the poison from getting into the circulation, or

from pus infections of the wound from cutting it with a dirty knife.

Alcohol is as great a delusion and fraud in snake-bite as in everything

else; instead of being an antidote, it increases the poisoning by its

depressing effect on the heart. If you should be bitten, throw a bandage

round the limb, above the bite, and tighten as for a cut artery. Then

make with a clean knife two free cuts, about half or three-quarters of

an inch deep, through the puncture, one lengthwise and the other

crosswise of the limb, and let it bleed freely. Then throw one or, if

there be room, two or three other bandages round the limb, three or four

inches apart, and tighten gently so as to close the surface veins by the

pressure, without shutting off the flow in the arteries. After thirty or

forty minutes loosen the first bandage to the same tightness and leave

it so unless the heart weakens or faintness is felt, in which case

tighten again. If this be done, there isn't one chance in a hundred of

any serious result.



How to Avoid Drowning. In case of falling into the water, the chief

thing to do is to try to keep calm and to keep your hands below your

chin. If you do this and keep paddling, you will swim naturally, just

as a puppy or a kitten would, even if you have never learned to swim. It

is, however, pretty hard to remember this when you go splash! into the

water. Everyone should learn to swim before he is twelve years old; and

then in at least nine times out of ten, he will be safe if he fall

overboard. Remember that, if you keep your mouth shut and your hands

going below your chin, you can keep floating after a fashion, for some

time; and in that time the chances are that help will reach you. If you

can reach a log or apiece of board or the side of a boat, just cling

quietly to that with one hand, and keep paddling with the other. Even if

you can get hold of only quite a small limb or pole or piece of a box,

by holding one hand on that and paddling with the other and kicking your

feet, you will be able to keep floating a long time unless the water be

ice cold. If you can manage to keep both your feet splashing on top of

the water and both hands going, you can swim several hundred yards.





You may sometime be called upon to save another person from drowning. In

such a case, as in every emergency, a cool head is the chief thing. Make

up your mind just what you are going to do before you do

anything,--then do it quickly! If no one is near enough to hear your

shouts for help, and no boat is at hand, if possible throw, or push, to

the one in the water a plank or board or something that will float, and

he will instinctively grasp it. If you are thrown into the water with a

person that can't swim, grasp his collar or hair, and hold him at arm's

length, to prevent his dragging you under, until help arrives, or until

you can tow him to safety.



Boys and girls, after they have learned to swim, may well practice

rescuing each other, so as to be prepared for such accidents.



Artificial Breathing. The best way to revive a person who has been

under water and is apparently drowned, is to turn him right over upon

his chest on the ground, or other level surface, turning the face to one

side so that the nose and mouth will be clear of the ground. Then,

kneeling astride of the legs, as shown in the picture, place both hands

on the small of the back and throw your weight forward, so as to press

out the air in the lungs. Count three, then swing backward, lifting the

hands, and allow the lungs to fill themselves with air for three

seconds, then again plunge forward and force the air out of the lungs

and again lift your weight and allow the air to flow in for three

seconds. Keep up this swinging backward and forward about ten or twelve

times a minute. This is the newest and by far the most effective way--in

fact the only real way--of keeping up artificial breathing. It is very,

very seldom that any one can be revived after he has been under water

for more than five minutes,--indeed, after three minutes,--but this

method will save all who can possibly be saved.



So perfect a substitute for breathing is it that if any one of you will

lie down in this position upon his face, and allow some one else to

press up and down on the small of his back after this fashion, ten or

twelve times a minute, he will find that, without making any effort of

his own to breathe, this pumping will draw enough air into his lungs to

keep him quite comfortable for half an hour.



Don't waste any time trying to pour the water out of the lungs. As a

matter of fact there is very little there, in drowned people. Don't

waste any time in undressing, or warming or rubbing the hands or feet to

start the circulation. Get this pendulum pump going and the air blowing

in and out of the lungs, and if there is any chance of saving life this

will do it; then you can warm and dry and rub the patient at your

leisure after he has begun to breathe.





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