PART I HOME NURSING (Part 12)

by caking upon the raw surface. As soon as the blisters Punctur- form they should be punctured at their base with a Misters large needle which has been held in the gas jet a moment in order to burn off inpurities and make it sterile. The serum that oozes forth can be gently mopped up with absorbent cotton. Boracic acid solution, or better still one made of a mixture of boracic acid and salicylic acid and known Thiersch's as Thiersch's powder, is cleaner to use than the oils powder r ' and ointments which were much in vogue at one time. If a burn is extensive or very deep, a doctor must give advice about its treatment, but for an ordinary small burn the solution made of Thiersch's powder will be found to keep the burn clean and cause it to heal ACCIDENTS AND EMERGENCIES 123 rapidly. The solution is made by adding half a tea- spoon of the powder to a pint of warm water and the dressing should be kept moist. This is best accom- plished by covering the dressing with oiled silk or firm rubber tissue and cutting holes here and there, through which to pour the solution. In dressing a burn, all the ordinary precautions of Absolute 7. 11 1 r i cleanliness absolute cleanliness are to be observed as tor the treat- ment of any wound. If a burn is severe, complications may be looked for. Brain disturbances, bronchitis, and pneumonia are Serious not uncommon sequelae, and ' if the alimentary tract J^ sburns has been injured the digestive process may be seriously impaired. The danger of shock is always great after a burn of any large extent, and the patient should be kept quiet and warm and stimulants given to keep up the heart's action. Great deformity sometimes results in the case of severe burns from the contraction of the skin in heal- J° Prevent deforming ing. Something can be done toward preventing this contraction by a wise adjustment of splints in order to keep the muscles parts in the best position. When the splints are re- moved for dressings the joints should be moved freely to guard against stiffness. The diet should be light and liberal in order to keep up the patient's strength, which is having a heavy drain iet upon it while the healing process is going on. There would be fewer grave results of accident by fire if more people realized how to act in an emergency, if your If one's own clothes catch fire, lie down instantly and Catch fire roll on the floor, remembering to keep the mouth closed in order not to inhale the flames. If a rug is at hand and can be reached that will help to smother the flames. The first impulse is very naturally to run and call for aid, but nothing that one could do would be more dis- 124 HOME NURSING If an- other's clothes catch fire astrous, since the current of air thus set in motion only serves to fan the flames. If another person is afire, do not hesitate a moment to knock him down and to wrap quickly about him whatever is at hand in the way of a rug, blanket, shawl, or overcoat, being careful to protect the head first. FOREIGN BODIES To float away for- eign body on the eyeball If a par- ticle is caught in the lid If a par- ticle is imbedded in the eyeball Any foreign body in the eye causes great pain and discomfort. If the particle is not imbedded in the eye- ball it can often be floated out and into the nasal pas- sage by lifting the lid of the eye outward and down- ward and holding it a moment. This causes the tear glands to secrete freely and also throws the lower eye- lashes against the eyeball in such a way that they act as a brush. If the nose is blown vigorously while the eyelid is being held, the offending particle will usually disappear. If a particle gets caught under the lower lid and can be seen there it may be wiped out with the fold of a soft handkerchief. If it is under the upper eyelid, the latter can be folded back over a small pencil or knitting needle, the patient directing his eyes to the floor while the particle is wiped out. The eyeball must always be treated very gently and never rubbed hard with the hand. When it is neces- sary to examine an inflamed eye let the index finger hang over the eyebrow and gently draw up the lid without touching the eye, If a particle is imbedded in the eyeball and can be plainly seen, it may some- times be removed, provided the patient is not nervous, by means of a small piece of rather stiff letter paper, creased to form a scoop. This can be used to pick out the particle and will answer very well if the latter is ACCIDENTS AND EMERGENCIES 125 not too deeply buried. If this is not successful, the services of a physician will be required. Sometimes a fragment of lime gets into the eye and burns into the eyeball. The eye should be bathed at When once in some mild acid, as vinegar or lemon- juice di- in the eye luted to about one teaspoon to a cup of water. This will neutralize the effect of the alkali. If it is necessary to put drops into another person's eye a medicine dropper is used for the purpose. If the Using a drops are to be warmed before applying them (and dropper the physician should state whether he wishes this done) the medicine dropper after it has been filled may be passed once or twice over the alcohol flame. The end of the dropper will need to be held up while doing this in order that the fluid may not escape as the glass expands. If some hard substance gets into the ear, there may be gentle syringing with warm water unless it is a pea To take or bean which obstructs and which would only swell substance with the water and add to the trouble. If the lobe of [n°mear the ear is gently pulled out and down, the canal is straightened so that the water has freer passage. A medicine dropper placed on the end of a fountain syringe is the best thing to use for ear-syringing. If an insect has gotten into the ear, turn the pa- tient on the unaffected side and fill the ear with warm When an oil or glycerine, which will catch the insect and float in the ear it to the outside. Another method is to saturate a piece of cotton with a strong solution of salt or vine- gar and placing it firmly in the ear, have the patient lie on the affected side. After a short time if the cotton is withdrawn the insect will probably be found upon it. The ear has a most intricate and delicate mechanism and serious injury, even permanent deafness, may re- ^eSme^t1 suit from careless treatment. The practice of thrusting of the ear remove abnormal wax 126 HOME NURSING hairpins and other articles into the ears is a very dan- gerous one, and nothing should ever be introduced further than it is possible to get the little finger. Sometimes the natural secretions of the ear fail A physi- in their normal function of keeping the wax moist, so that the latter collects into a hard ball and so obstructs the passage as to cause temporary deafness. This condition is easily recognized by a physician and with the proper instruments the wax can be removed with- out causing any distress to the patient. If a child gets something lodged in the nostril make To dis- him take a deep breath, close the mouth and unob- lodge a x foreign structed nostril and give a strong expiration. The the nostril force of the air which has been excluded from the other outlets will usually blow out the object. A foreign substance that has been swallowed, such as a button, coin, etc., usually passes through the in- testines and no harm results from it. It should always SSV ^e watched for in the stools. If a sharp object has substance been swallowed it is best not to give purgatives, but lowed. to restrict the diet to solid foods, so that the object may become imbedded in the food and carried along without causing injury. SUNSTROKE AND HEAT EXHAUSTION The danger of sunstroke is less in the country, what in- where the air is pure and where people live with less creases c r r danger of nervous tension, than in the overcrowded districts of the city, where the reverse is true. People also of intemperate habits are more liable to suffer from the excessive heat. The terms sunstroke and heat exhaustion are not Sunstroke synonymous, the effects being quite different in each and treat- J J _ , . , *>■} ' . . „ , ment case. In cases of sunstroke the patient usually be- comes suddenly unconscious and the fever runs ex- ACCIDENTS AND EMERGENCIES 127 tremely high.. The respiration is very labored, and the pulse rapid and weak. Prompt measures must be taken or the issue will be fatal in many cases. A doctor must be summoned at once, and treatment with ice baths will doubtless have to be kept up. In cases of heat exhaustion the onset is more gradual. The patient feels weak and dizzy. He is Heat ex- . haustion not necessarily unconscious, but shows signs of col- and its lapse. The temperature will be found subnormal, treatment i. e., below 980 Fahrenheit. The pulse is weak and rapid and the breathing much quickened. The treat- ment is the same as for shock, and the patient is kept in a darkened room or in a cool, shady place out of doors with the head low. Aromatic spirits of am- monia, one teaspoonful in a little hot water every half-hour for three or four doses, may be given until the doctor comes. Strong coffee may also be used. In convalescence from heat exhaustion great care, must be taken that there is no exposure to extreme heat. The direct rays of the sun are not necessary to produce heat exhaustion. It may follow exposure to intense heat of any kind, and persons who have once suffered are liable to another attack. ARTIFICIAL RESPIRATION In accidents from drowning, strangulation, or suf- focation, where the supply of air for any reason has when been cut off from the lungs, artificial respiration must respSon be resorted to, as it is often possible to force the is used lungs to act, and the effort should be kept up till it is evident that it is hopeless, and that conclusion should not be reached short of two hours of faithful work. There are several methods of establishing artifi- cial respiration, there being little difference in their value so long as the lungs are made to expand. In 128 HOME NURSING a first any case the tongue must first be fastened to keep tabHsStS" it from falling back upon the windpipe. This can respiration easity be done by holding it down to the chin by means of a rubber band. If the case is one of drown- ing or of strangulation the patient must be turned over on his face and the throat cleared of any col- lection of mucus that may be obstructing it. In the method known as Sylvester's the patient Sylvester's is ^jd on hjs back with the head and shoulders slightly raised and the clothing loosened. Standing at the patient's head and grasping his arms just above the elbows, bring them slowly out from the body and up- ward till they meet over the head. They are held there for two seconds and brought slowly back till the elbows come together on the chest with slight pres- sure. . These movements should be repeated steadily and not more rapidly than sixteen times a minute. INSECT BITES Mosquito or spider bites can be relieved by lotions Small bites of ammonia or salt. The sting of a wasp or bee, if left in the flesh, may set up considerable irritation. It can be removed by making firm pressure around it, BITES OF SNAKES AND RABID ANIMALS Prompt action and heroic treatment are demanded Speedy when dealing with the bite of a venomous snake or of otTZTo- a mad animal. The bleeding of the wound should rabid Mte ^e encouraged. If it is on an arm or leg this should be firmly bandaged at once above the point of injury, in order to cut off circulation for the time being. The wound must then be sucked or cupping glasses applied before the poison is taken into the system. Finally it must be deeply burned with a hot iron and poulticed. If more than half an hour has elapsed ACCIDENTS AND EMERGENCIES 129 since the bite the method of burning out the wound is useless. Pasteur's treatment by inoculation of virus made from emulsions of dried spinal-cord, not only secures Pasteur's immunity but has also proved itself a curative measure. Both in the Pasteur Institute in Paris and in New York this treatment is being carried out daily with marvelous success. POISONS Poisons are known either as irritants, substances which corrode the tissue, or narcotics, those which cause insensibility by directly affecting the brain. Xo time should be lost in giving emetics when a Treatment poison has found entrance into the body. A table- Jlnt^S-1 spoon of salt or of ground mustard stirred into a cup sonsna^ed of tepid water rarely fails to produce vomiting, and this dose should be given repeatedly till free vomiting is secured. After this it is always well to give a pur- gative enema to remove any trace of the poison that may have traveled as far as the bowel. Large draughts of water, milk, white of egg, or flour and water should be given to soothe the injured membrane of the alimentary tract if the poison is of an irritating character. For all alkaline poisons acids should be given to neutralize their effect, and vice versa for acid pois- oning. The treatment necessary for narcotic poisoning in nar- is strong stimulants (black coffee freely administered), poisoning cold effusions and mustard foot-bath. Above all, the patient must be kept awake, and will probably have Have to be walked about the room vigorously. Poisoning advice case of milk, or cheap ice cream. Emetics and purgatives may follow the use of tainted meat, mushrooms, fish, pc 130 HOME NURSING must be used freely, and a physician should be sum- moned at once in all cases of poisoning. An antidote is a remedy used to offset the effect Definition of a poison in one of three ways. First, mechanically dotes by emptying the stomach and bowels to prevent ab- sorption; second, chemically, by combining with the poison to form a harmless compound ; and third, physiologically by counteracting the effects of the poison on the system. VIII INFECTION AND CONTAGION Micro-Organisms and Disease— Transmission of Disease— The Protozoa- Disinfectants — Methods of Disinfection — Typhoid Fever- Erysipelas— Malarial Fever— Dysentery MICRO-ORGANISMS AND DISEASE IN any discussion on the subject of transmissible disease we have to consider the methods by which it is communicated before we can understand the Science has proper precautions necessary in its care. Science om^view has advanced and is advancing so rapidly in its in- of dlsease vestigations that each year adds to our knowledge and equips us with more effective weapons both in the prevention of disease and in its cure. We are only in the A B C's in our knowledge of the cause of disease, but in so many instances the use of what science has offered us will prevent it, and save life, that we should try to understand some of the scien- tific phraseology and follow the discoveries of the investigators as far as may be. The terms microbes, micro-organisms, germs, and bacteria are all used to indicate the microscopical ^Hv°ng0p" living bodies which are now held responsible for bodies many diseases. The bacteria are not animal organisms, but are the lowest form of plant life, and though invisible without high magnifying power, are near relatives of the sea-weeds. They are very complex and wonder- ful in their variety of shape and in the work they do in life, which is by no means exclusively the produc- er) 132 HOME NURSING tion of disease. This making of disease is confined to a comparatively small class, bacterial work in gen- eral being of great service to mankind. The decomposition and hence the disposal of Work of waste animal and vegetable material is largely carried bcictcrict on by bacteria. They make possible the renewal of worn-out soil by what is known as "rotation of crops," - and their presence in our bodies often saves us from disease by rendering harmless poisonous matter which would otherwise act as an irritant. In short, life on the earth would be impossible without this form of micro-organism. Many of the disease-producing forms have been Disease recognized, and the method of destroying them or bacteria^ rendering their poisons harmless is the subject of investigation, and has led to the modern method of fighting tuberculosis, to the antitoxin treatment of diphtheria, and to other results which we will discuss later. At the same time that scientists were pursuing The pro- their studies of bacterial life in relation to disease, the cause of certain disorders was traced to another source. This was another micro-organism, the pro- tozoon, which is the lowest form of animal life. The protozoa have long been the object of microscopical study, because most of them are much larger than the