First Aid to a Wound of the Leg
To the Editor:
One of the firemen in our company was badly cut in the leg recently at a fire, and had a very narrow escape from death, as he suffered great loss of blood before the arrival of a doctor. What should have been done for him to stop this bleeding? Can it be done by anyone not a doctor? I refer this to you, as I know you are qualified to answer just such a problem.
Yours very truly,
November 26, 1918.
Answer.—It can and should. It is, in fact, rather surprising that a fire department should not have at least one man in its membership who knows the rudiments of first aid treatment to the wounded. The necessity of the quick control of a hemorrhage (bleeding) is that of the preservation of the person’s life who is wounded. To do this a certain knowledge of the circulation of the blood in the human body is essential. The venous or impure blood after collecting the impurities of the body, is pumped to the lungs in vessels known as veins, by the action of the heart, where, after being purified, it is passed again to the heart, which organ forces the now bright red blood into the arteries, and thence, through them, to the capillaries, or minute blood vessels, which carry the nourishment to the tissues. The difference in bleeding from the veins and arteries is very readily distinguished, as the venous hemorrhage is of dark color, and flows sluggishly, while that from the arteries is a bright red and comes in spurts, owing to the pulsation that occurs in the sheaths of these vessels and to the stronger and more direct action of the heart upon them. Naturally an arterial bleeding is much more dangerous and hard to control. In the case of a wound in the leg, the procedure would be to find first if the hemorrhage is of a venous or arterial nature. If the flow of blood is of a bright red color and is rapid, action to control is quickly imperative. The line of the thigh or femoral artery is rather obscure and unless one knows just where to locate it, is baffling. This artery must be compressed to control all bleeding of an arterial nature in the leg. Its course is from the middle of the fold of the groin to the inside of the knee. In the upper part of the thigh the artery is in front, in the middle, in the inside, and in the lower part it penetrates to the back of the knee. The loss of blood can be controlled and arrested by compressing the main artery at the groin. Grasp the thigh, as shown at A in the illustration, with both hands, and place one thumb upon the pulsating vessel; reinforce the t ressure by placing the other thumb upon it. However, if the sufferer should be a long way from a doctor, it would be impossible to keep up this pressure indefinitely, or until he arrived. In such a case a simple device known as a tourniquet can be employed, which will set your hands at liberty. Wrap a stone or some other hard, round article in a good-sized handkerchief. This had best be done, if possible, by another member of the company, so that the pressure of your fingers be not relaxed until the tourniquet is ready to be applied. If nothing better is at hand a hard knot in the handkerchief will answer the purpose. Place this directly over the artery, and pass the handkerchief around the limb, tying it tight. Then insert the end of a wrench, the handle of an axe, or any available instrument, and twist the bandage tightly, until the flow of blood is stopped as shown at B in the illustration. When this is accomplished fasten the wrench securely with another bandage, to prevent the tourniquet from loosening. Of course, a surgeon should be summoned as quickly as possible.
Chief Bates and Mayor Jones, of Elyria, O., are co-operating in reducing fire hazards to the irreducible minimum. All factories have been asked to form volunteer fire-fighting units among their employees, so that one concern can help another in case of fire.