Enquire Within Upon Everything Part 82

vi. Arrange the bed _after_ changing the dressings; but in some cases you will have to do so before the patient is placed on it.

vii. Never be in a hurry when applying dressings, do it quietly.

viii. When a patient requires moving from one bed to another, the best way is for one person to stand on each _side_ of the patient, and each to place an arm behind his back, while he pa.s.ses his arms over their necks, then let their other arms be pa.s.sed under his thighs, and by holding each other's hands, the patient can be raised with ease, and removed to another bed. If the leg is injured, a third person should steady it; and if the arm, the same precaution should be adopted. Sometimes a stout sheet is pa.s.sed under the patient, and by several people holding the sides, thy patient is lifted without any fatigue or much disturbance.

801. Lint, how made.

Lint, how made. This may be quickly made by nailing a piece of old linen on a board, and sc.r.a.ping its surface with a knife. It is used either alone or spread with ointment. Sc.r.a.ped lint is the fine filaments from ordinary lint, and is used to stimulate ulcers and absorb discharges; it is what the French call _charpie_.

802. Uses of Sc.r.a.ped Lint.

This is made into various shapes for particular purposes. When it is screwed up into a conical or wedge-like shape, it is called a _tent_, and is used to dilate fistulous openings, so as to allow the matter to escape freely; and to plug wounds, so as to promote the formation of a clot of blood, and thus arrest bleeding. When rolled into little b.a.l.l.s, called _boulettes_, it is used for absorbing matter in cavities, or blood in wounds. Another useful form is made by rolling a ma.s.s of sc.r.a.ped lint into a long roll, and then tying it in the middle with a piece of thread; the middle is then doubled and pushed into a deep-seated wound, so as to press upon the bleeding vessel, while the ends remain loose and a.s.sist in forming a clot; or it is used in deep-seated ulcers to absorb the matter and keep the edges apart. This form is called the _bourdonnet_. Another form is called the _pelote_, which is merely a ball of sc.r.a.ped lint tied up in a piece of linen rag, commonly called a dabber. This is used in the treatment of protrusion of the navel in children.

803. Carded Cotton

Carded Cotton is used as a dressing for superficial burns, and care should be taken to free it from specks, as flies are apt to lay their eggs there, and generate maggots.

804. Tow

Tow is chiefly employed as a padding for splints, as a compress, and also as an outer dressing where there is much discharge from a surface.

805. Ointments

Ointments are spread on calicoes, lint, or even thin layers of tow, by means of a knife; they should not be spread too thick. Sometimes ointment is applied to discharging surfaces on a piece of linen, folded over on itself several times, and then cut at the corners with scissors, in order to make small holes in it. The matter discharged pa.s.ses out freely through these holes, and is received in a layer of tow spread over the linen.

806. Adhesive Plaster

Adhesive Plaster is cut into strips, ranging in width, according to the nature of the wound, &c., but the usual width is about three-quarters of an inch. Isingla.s.s plaster is not so irritating as diachylon, and is more easily removed.

807. Compresses

Compresses are made of pieces of linen, calico, lint, or tow, doubled or cut into various shapes, according to the purposes for which they are required. They are used to confine dressings in their places, and to apply an equal pressure on parts. They should be free from darns, hems, and knots. Ordinary compresses are square, oblong, and triangular. Compresses are also graduated by placing square pieces of folded cloth on one another, so arranged that they decrease in size each time. They are used for keeping up pressure upon certain parts.

808. Pads

Pads are made by sewing tow inside pieces of linen, or folding linen and sewing the pieces together. They are used to keep off pressure from parts such as that caused by splints in fractures.

809. Poultices

Poultices are usually made of linseed meal, oatmeal, or bread, either combined with water or other fluids; sometimes they are made of carrots, charcoal, potatoes, yeast, and linseed meal, mustard, &c., but the best and most economical kind of poultice is a fabric made of sponge and wool felted together, and backed by Indian rubber, called "spongio piline."

The method of using this poultice is as follows:--A piece of the material of the required form and size is cut off, and the edges are pared or bevelled off with a pair of scissors, so that the caoutchouc may come in contact with the surrounding skin, in order to prevent evaporation of the fluid used; for, as it only forms the vehicle, the various poultices generally used can be employed with much less expenditure of time and money, and increased cleanliness.

For example,--a _vinegar_ poultice is made by moistening the fabric with distilled vinegar; an _alum_ poultice, by using a strong solution of alum; a _charcoal_ poultice, by sprinkling powdered charcoal on the moistened surface of the material; a _yeast_ poultice, by using warmed yeast, and moistening the fabric with hot water, which is to be well squeezed out previous to the absorption of the yeast; a _beer_ poultice, by employing warm porter-dregs or strong beer as the fluid; and a _carrot_ poultice, by using the expressed and evaporated liquor of boiled carrots.

Spongio-piline costs about one farthing a square inch, and may be obtained of the chemist. As a fomentation it is most invaluable, and by moistening the material with compound camphor liniment or hartshorn, it acts the same as a mustard poultice.

[TO-MORROW, DIES IN ANGUISH AND DESPAIR.]

810. Mustard Poultices.

These may be made of the mustard powder alone, or in combination with bread crumbs, or linseed meal. When mustard only is used, the powder should be moistened with water, and the paste thus produced spread on a piece of linen, and covered with muslin to intervene between the mustard and the skin. When mixed with linseed the powder and the meal may be incorporated before water is added, or the meal may be moistened and spread on linen for application, and the mustard be then strewn on the surface, more or less thickly according to the age of the patient. Rigollot's Mustard leaves, which can be procured from any chemist, are now much used in the place of mustard poultices. They only require wetting before application, and are both clean and economical.

811. Bandages.

Bandages are strips of calico, linen, flannel, muslin, elastic webbing, bunting, or some other substance, of various lengths, and from one to six inches wide, free from hems or darns, soft and unglazed. They are better after they have been washed. Their uses are to retain dressings, apparatus, or parts of the body in their proper positions, support the soft parts, and maintain equal pressure.

812. Simple and Compound Bandages.

Bandages are simple and compound; the former are simple slips rolled up tightly like a roll of ribbon. There is also another simple kind, which is rolled from both ends--this is called a double-headed bandage. The compound bandages are formed of many pieces.

813. Bandages for Different Parts of the Body.

Bandages for the Head should be two inches wide and five yards long; for the neck, two inches wide, and three yards long; for the arm, two inches wide, and seven yards long; for the leg, two inches and a half wide and seven yards long; for the thigh three inches wide, and eight yards long; and for the body, four or six inches wide and ten or twelve yards long.

814. To Apply a Single-Headed Bandage,

To apply a single-headed bandage, lay the _outside of the end_ near to the part to be bandaged, and hold the roll between the little, ring and middle fingers, and the palm of the left hand, using the thumb and forefinger of the same hand to guide it, and the right hand to keep it firm, and pa.s.s the bandage partly round the leg towards the left hand.

It is sometimes necessary to reverse this order, and therefore it is well to be able to use both hands.

Particular parts require a different method of applying bandages, and therefore it is necessary to describe the most useful separately; and there are different ways of putting on the same bandage, which consist in the manner the folds or turns are made. For example, the _circular_ bandage is formed by horizontal turns, each of which overlaps the one made before it; the _spiral_ consists of spiral turns; the _oblique_ follows a course oblique or slanting to the centre of the limb; and the _recurrent_ folds back again to the part whence it started.

815. Circular Bandages

Circular bandages are used for the _neck_, to retain dressings on any part of it, or for blisters, setons, &c.; for the _head_, to keep dressings on the forehead or any part contained within a circle pa.s.sing round the head; for the _arm_, previous to bleeding; for the _leg_, above the knee; and for the _fingers_, &c.

816. To Confine the Ends of Bandages

To confine the ends of bandages some persons use pins, others slit the end for a short distance, and tie the two strips into a knot, and some use a strip of adhesive plaster. Always place the point of a pin in such a position that it cannot p.r.i.c.k the patient, or the person dressing the limb, or be liable to be drawn out by using the limb; therefore, as a general rule, turn the head of the pin from the free end of the bandage, of towards the upper part of the limb. The best mode is to _sew_ the bandage on. A few st.i.tches will hold it more securely than pins can.