Boy Scouts Handbook Part 59

Unconsciousness may be due to so many causes that, in order to give the best treatment, the scout should first know the cause. Always try to find this out if you can. If you cannot do this, however, you should at least determine whether unconsciousness is due to poison, to bleeding, to sunstroke, or to freezing; for each of these demand immediate, special treatment. If it is not due to one of these causes, and the patient is pale and weak, have him placed with his head low, and warm and stimulate him in every possible way. If the face is red and the pulse is bounding and strong, that patient should have his head raised on a folded coat. No stimulants should be given him and cold water should be sprinkled on his face and chest.

The common causes of unconsciousness are shock, electric shock, fainting, apoplexy and injury to the brain, sunstroke and heat exhaustion, freezing, suffocation, and poisoning. The first two have already been described and the treatment of any form of suffocation in artificial respiration.

Fainting

Fainting usually occurs in overheated, crowded places. The patient is very pale and partially or completely unconscious. The pupils of the eye are natural, the pulse is weak and rapid. The patient should be placed in a lying-down position with the head lower than the rest of the body so that the brain will receive more blood. Loosen the clothing, especially about the neck. Keep the crowd back and open the windows if in-doors so that the patient may get plenty of fresh air.

Sprinkle the face and chest with cold water. Apply smelling salts or ammonia to the nose, rub the limbs toward the body. A stimulant may be given when the patient is so far recovered that he is able to swallow.

Apoplexy and Injury to the Brain

Apoplexy and unconsciousness from injury to the brain are due to the pressure of blood on the brain so that they {271} may be described together. Apoplexy is of course much harder to distinguish than injury to the brain as in the latter the scout can always see that the head has been hurt. With both, unconsciousness will usually be complete.

Pupils are large and frequently unequal in size, breathing is snoring, and the pulse is usually full and slow. One side of the body will be paralyzed. Test this by raising arm or leg; if paralyzed, it will drop absolutely helpless. Send for a doctor at once. Keep patient quiet and in a dark room if possible. Put in lying-down position with head raised by pillows. Apply ice or cold cloths to head. No stimulants.

Drunkenness is sometimes mistaken for apoplexy. If there is any doubt on this point always treat for apoplexy.

Sunstroke and Heat Exhaustion

Anyone is liable to sunstroke or heat exhaustion if exposed to excessive heat. A scout should remember not to expose himself too much to the sun nor should he wear too heavy clothing in the summer. Leaves in the hat will do much to prevent sunstroke. If the scout becomes dizzy and exhausted through exposure to the sun he should find a cool place, lie down, and bathe the face, hands, and chest in cold water and drink freely of cold water.

Sunstroke and heat exhaustion, though due to the same cause, are quite different and require different treatment. In sunstroke unconsciousness is complete. The face is red, pupils large, the skin is very hot and dry with no perspiration. The patient sighs and the pulse is full and slow. The treatment for sunstroke consists in reducing the temperature of the body. A doctor should be summoned whenever possible. The patient should be removed to a cool place and his clothing loosened, or better the greater part of it removed. Cold water, or ice, should be rubbed over the face, neck, chest, and in arm pits. When consciousness returns give cold water freely.

Heat exhaustion is simply exhaustion or collapse due to heat. The patient is greatly depressed and weak but not usually unconscious.

Face is pale and covered with clammy sweat, breathing and pulse are weak and rigid. While this condition is not nearly as dangerous as sunstroke, a doctor should be summoned if possible. Remove the patient to a cool place and have him lie down with his clothing loosened.

Don't use anything cold {272} externally, but permit him to take small sips of cold water. Stimulants should be given just as in fainting.

Freezing

The patient should be taken into a cold room and the body should be rubbed with rough cloths wet in cold water. The temperature of the room should be increased if possible. This should be done gradually and the cloths should be wet in warmer and warmer water. As soon as the patient can swallow give him stimulants. It will be dangerous to place him before an open fire or in a hot bath until he begins to recover. You will know this by his skin becoming warmer, by his better color, and by his generally improved appearance.

Frost-Bite

Remember that you are in danger of frost-bite if you do not wear sufficient clothing in cold weather, and that rubbing any part of the body which becomes very cold helps to prevent frostbite, because it brings more warm blood to the surface. The danger is when, after being cold, the part suddenly has no feeling.

The object of the treatment is gradually to restore warmth to the frozen part. To do this the part should be rubbed first with snow or cold water; the water should be warmed gradually. The use of hot water at once would be likely to cause mortification of the frozen part.

Poisoning

For all poisons give an emetic. Send for a doctor at once and if possible have the messenger tell what poison has been taken so that the doctor may bring the proper antidote. Do not wait for him to arrive, but give an emetic to rid the stomach of the poison. Good emetics are mustard and water, salt water, or lukewarm water alone in large quant.i.ties. Never mind the exact dose and if vomiting is not profuse repeat the dose.

Fits

A person in a fit first has convulsive movements of the body, then he usually becomes unconscious. A scout should have no difficulty in making out what is the matter with a person in a fit.

Put the sufferer on the floor or the ground where he can not hurt himself by striking anything. Loosen tight clothing and do not try to restrain the convulsive movements. A wad of {273} cloth thrust in the mouth will prevent biting the tongue. When he becomes quiet do not disturb him.

INJURIES DUE TO HEAT AND COLD

Burns and Scalds

For slight burns in order to relieve the pain some dressing to exclude the air is needed. Very good substances of this character are pastes made with water and baking soda, starch, or flour. Carbolized vaseline, olive or castor oil, and fresh lard or cream are all good.

One of these substances should be smeared over a thin piece of cloth and placed on the burned part. A bandage should be put on over this to hold the dressing in place and for additional protection.

Severe burns and scalds are very serious injuries which require treatment from a physician. Pending his arrival the scout should remember to treat the sufferer for shock as well as to dress the wound.

Burns from electricity should be treated exactly like other burns. Do not attempt to remove clothing which sticks to a burn; cut the cloth around the part which sticks and leave it on the burn.

FIRST AID FOR EMERGENCIES

Besides the accidents which have been mentioned, certain emergencies may demand treatment by a scout.

The commonest of these are described here.

Something in the Eye

No little thing causes more pain and discomfort than something in the eye. Do not rub to remove a foreign body from the eye, as this is likely to injure the delicate covering of the eyeball. First, close the eye so the tears will acc.u.mulate, these may wash the foreign body into plain view so that it may be easily removed. If this fails, pull the upper lid over the lower two or three times, close the nostril on the opposite side and have the patient blow his nose hard. If the foreign body still remains in the eye, examine first under the lower and then the upper lid. For the former have the patient look up, press lower lid down, and if the foreign body is seen lift it out gently with the corner of a clean handkerchief. It is not so easy {274} to see the upper lid. Seat the patient in a chair with his head bent backward. Stand behind him and place a match or thin pencil across the upper lid one half an inch from its edge, turn the upper lid back over the match, and lift the foreign body off as before. A drop of castor oil in the eye after removing the foreign body will soothe it.

[Ill.u.s.tration: Eye bandage.]

Sunburn

This is simply an inflammation of the skin due to action of the sun.

It may be prevented by hardening the skin gradually. Any toilet powder or boracic acid will protect the skin to a considerable extent. The treatment consists of soothing applications such as ordinary or carbolized vaseline.

Ivy Poisoning

Poison ivy causes a very intense inflammation of the skin. Better avoid, even though it has not harmed you before. Baking soda made in a thick paste with water or carbolized vaseline are good remedies. In severe cases a doctor should be consulted.

Bites and Stings

Ammonia should be immediately applied. Wet salt and wet earth are also good applications.

Nosebleed

Slight nosebleed does not require treatment as no harm will result from it. When more severe the collar should be {275} loosened. Do not blow the nose. Apply cold to the back of the neck by means of a key or cloth wrung out in cold water.