Some Thoughts on First Aid to the Injured

Some Thoughts on First Aid to the Injured

Physician Describes Proper Procedure in Cases of Burns and Asphyxiation—Three Classifications for Each—Treatment of Burns—Fresh Air Important in Asphyxiation

IN the following brief notes I shall endeavor to present to you, men of the “hose and nozzle,” the ways and means of relieving the burned and those overcome by smoke or other gases, always remembering that this paper refers to first aid only.

Burns and Their Treatment

Burns are caused by heat, either dry or moist, and are roughly classified into three divisions as follows: A burn of the first degree is a superficial burn which only reddens the skin; that of the second degree causes a blister to form; while the third degree or more destroys the skin by partial or complete carbonizing (charring) of skin and underlying muscles. All burns of the first and second degree involve the upper layers of skin and are more painful, as they expose the nerve ends.

In all treatment of burns exclude air as soon as possible. In burns of the first degree use cold cream, zinc oxide, vaseline and baking soda, one ounce to eight ounces of water. In burns of the second degree all blisters should be opened with a sterile needle and any dressing of the first degree applied. Third degree burns are best treated with salt solution or boric acid solution, saturating sterile gauze, applying and keeping the same constantly wet after applying. All clothing should be cut off. It should be thoroughly soaked with preferably hydrogen peroxide and then only a small area at a time removed, so as to avoid exposing a large surface to the air. Always give plenty of water to drink.

Acid and Alkali Burns

Acid burns should be treated with lime water or solution of baking soda.

Burns caused by alkalies, such as caustic potashsoda or ammonia should be treated with a weak solution of vinegar. Give ice for burns of the mouth. For burns of the eyes use boric acid solution (boric acid, 10 grains, distilled water, one ounce), and apply cold cream or sweet oil to eyelids.

Treatment for Asphyxiation

Gases, smoke and fumes of any character should come under Asphyxiation. There are, as in burns, three classifications of smoke asphyxia: In first stage a fireman staggers out of a building, his eyes are red, he coughs, has a throbbing headache, and his legs are weak; in fact has all the appearances of a drunken man. He should be taken away from all smoke into the fresh air. Clothing around neck should be loosened, and something wrapped around body to keep him warm. A seidlitz powder should be given in a glass of water or a teaspoonful of aromatic spirits of ammonia. He should immediately be sent to a hospital. In second and third stages the fireman is unconscious. In this case take him out immediately into fresh air and send to the nearest hospital. If a tank of oxygen is at hand the tube should be held near his nose, allowing him to breathe the oxygen. In the third stage, where he is not breathing, artificial respiration must be employed until respiration is re-established. Meanwhile the patient should be kept warmly wrapped up in blankets. Never attempt to give anyone who is unconscious anything to drink, as much harm can be caused by some of the fluid passing into the air passages, even causing death by suffocation.

Illuminating Gas Poisoning

A fireman overcome by gas (illuminating carbon monoxide) becomes dizzy, suffers headache and ringing of the ears, and after he gets out into the fresh air, in about five minutes, will fall unconscious. Clothing should be loosened at once, patient wrapped up in blankets and oxygen administered. Artificial respiration should be given if necessary, and patient immediately sent to nearest hospital and physician summoned. In cases of smoke containing gases of ammonia, in addition to rules for smoke treatment a cloth saturated in vinegar should be held over nose and mouth.

Of course, by all of the foregoing it is to be understood, as referred to above, that these treatments are only temporary and for the purpose of relieving the patient until a physician can be summoned. This should be done at once.

But, nevertheless, this paper will emphasize the necessity for all members of fire departments to have a working knowledge of First Aid to the Injured. This knowledge will in many instances, through the prompt and intelligent treatment of persons overcome or injured, be the means of saving lives that otherwise, if left without attention until the tardy arrival of a doctor, would probably be so far gone as to be beyond help through his ministrations. No one appreciates this fact more than the physician himself, who, no matter how promptly summoned, must consume valuable minutes in getting from his office or the hospital to the scene of the fire, knowing that without expert treatment the patient may be beyond his help before he arrives.

Recommendations for Equipment

In closing let me recommend that all fire departments equip their trucks with the following first aid necessaries: one package sterile gauze plain; bandages, 2-inch and 4-inch; a container with cold cream or zinc oxide salve; one bottle vinegar; one bottle aromatic spirits of ammonia; a small tank of oxygen, with attachments, and one bottle boric acid solution (10 grains to oz. of water). The above will meet all your first aid requirements in burns and smoke.

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Note—Paper read before the annual convention of the Illinois Firemen’s Association at Jacksonville.

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