FIRST AID TO THE INJURED.
(Concluded.)
CHAPTER X.
DISLOCATIONS AND SPRAINS
are produced by over-exertion or violent strains or twists of the smooth and elastic cartilages which cover the rounded ends of the bones. A fluid which is maintained by a membrane near the joint keeps these wounded ends oiled (so to say), while tough ligaments—retainers allow these ends to move only within certain limits. If these ligaments are torn, strained or inflamed by any extra force or violence—not sufficient to cause dislocation—they are sprained, the membrane alluded to becoming filled with blood and the oiling fluid being exuded in excessive quantities, the joint becoming swollen and discolored. Movement, also, is very painful, as the inflamed ligaments are thereby stretched. To treat a sprain, the joint must have complete rest, and water as hot as can be borne be applied freely round it, the heat being increased gradually and the application kept up as long as it can be borne—half an hour will generally suffice. At the expiration of that period, let ordinary hot, moist fomentations be employed for another half hour. The joint must then be bound up in a wet bandage and kept well elevated. If the ankle, wrist or linger is sprained, let the whole foot, ankle, wrist and hand be plunged into water as hot as can be borne, the heat being gradually increased to the extreme point of endurance for half an hour or an hour. Then let the foot be placed on a chair in an elevated position, or the wrist or hand in a sling, and swathed in hot wet cloths. It will be very painful for a day or two, when the pain will lessen. As soon as that is the case, let the joint be gently moved, rubbed with soap liniment, vaseline or oil and softlv kneaded at intervals. It also strengthens the joint to place it under the tap and let a stream of cold water run on it two or three times a day before beginning to use it fully in walking or working.
CHAPTER XI.
BURNS AND SCALDS.
Burns are caused by the application to the body of hot solids; scalds, arise from fluids, such as steam or gases coming in contact with the person. Each differs in gravity and intensity, according to the location of the injury.
The least to be regarded is one of the first degree. It consists of a mere reddening of the skin— a scorch.
When a burn is of the second degree, blisters are found, and should be carefully handled as the skm that covers them is very tender and may easily be torn open by being handled roughly, whereby a bad and possibly a dangerous sore may result, especially if a large portion of the skin is involved—one-third or one-half. In that case serious, if not fatal results may ensue.
A burn or scald of the third degree involves the charring of a superficial layer of the skin to suc*h an extent that it is dead. This layer must slough away before there can be any recovery and the surface so left is extensive and ulcerating. Severe shock accompanies such burns, often causing death within forty-eight hours. Such burns on recovery always leave a bad scar, even deformity behind them.
TREATMENT OK BURNS.
The first things to be observed are to keep the air from the part affected and also keep it perfectly clean. In order to do this apply to burns of the first and second degree vaseline, olive oil or sweet oil. A very common application is that of Carron oil—a mixture of equal parts of linseed oil and lime water. The objection to it is that it is a filthy mixture and liable to produce sores, sometimes fatal sores at that. Avoid it as well as alt poultices or water dressings, or dusting with flour.
If the patient is badly shocked, artificial respiration (Sylvester’s method; Howard’s if the arms are injured), or inhalation of oxygen.
The clothing must ni’ver be dragged off. Cut it off, and, if any of it sticks to the affected part, cut round it with a pair of sharp scissors, and let it remain.
Xezer puncture blisters of whatever sort, nor expose the burned part to the heat of a fire, as is often done, under the mistaken idea that such a course alleviates the pain. It does not; on the contrary, if that is done, a slight bum—one of the first degree may be thereby changed into one of the second. Keep a perfectly clean dressing on, so as to give neither germs nor poisons any chance to infect the burn. Be careful about using a carbolic lotion, or, although that acid forms an excellent dressing, yet, as a burned surface very quickly absorbs anything that comes in contact with it, poisoning may be the outcome of such an application.
If a patient’s clothing is actually alight, be careful to throw or lay the person down zvith the burning surface uppermost; then throw on the body a rug carpet blanket or something that will stifle the flames—whose tendency is always upwards.
In case of a bad burn of the second degree, and always when it is one of the third degree or if there is an extensive burned surface, send for a doctor at once, or take the patient to one, or the nearest hospital.
