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Accidents And Emergencies

Source: 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

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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