Begin treatment in the open air as soon as you have brought the unfortunate ash.o.r.e. Meanwhile send for medical a.s.sistance, blankets and dry clothing. Expose the patient"s throat and chest to the wind, except in very severe weather. Remove all tight clothing from neck and chest.
Take off suspenders.
The points to be aimed at are: First and immediately the restoration of breathing, and, secondly, after breathing is restored, the promotion of warmth and circulation. The efforts to restore breathing must be commenced immediately and energetically, and persevered in for one or two hours, or until a medical man has p.r.o.nounced that life is extinct.
Efforts to promote warmth and circulation beyond removing the wet clothes and drying the skin must not be made until the first appearance of natural breathing, for if circulation of the blood be induced before breathing has recommenced the restoration of life will be endangered.
HALL"S METHOD IN RESUSCITATION
To clear the throat, place the patient on the floor or the ground with the face downward and one of the arms under the forehead, in which position all fluids will more readily escape by the mouth, and the tongue itself will fall forward, leaving the entrance into the windpipe free. a.s.sist this operation by wiping and cleansing the mouth.
If satisfactory breathing begins, use the treatment described below to promote warmth. If there be only slight breathing, or no breathing, or if the breathing fail, then, to excite breathing, turn the patient well and instantly on the side, supporting the head, and excite the nostrils with snuff, hartshorn, and smelling-salts, or tickle the throat with a feather, etc., if they are at hand. Rub the chest and face warm, and dash cold water, or cold and hot water alternately, on them.
If there be no success, lose not a moment, but instantly, to imitate breathing, replace the patient on the face, raising and supporting the chest well on a folded coat or other article of dress. Turn the patient very gently on the side and a little beyond, and then briskly on the face, back again; repeating these measures cautiously, efficiently and perseveringly about fifteen times in the minute, or once every four or five seconds, occasionally varying the side. (By placing the patient on the chest, the weight of the body forces the air out; when turned on the side this pressure is removed, and air enters the chest.)
On each occasion that the body is replaced on the face make uniform but efficient pressure, with brisk movement, on the back between and below the shoulder-blades or bones on each side, removing the pressure immediately before turning the body on the side. During the whole of the operations let one person attend solely to the movements of the head, and of the arm placed under it.
The result is respiration, or natural breathing, and, if not too late, life.
While the above operations are being proceeded with, dry the hands and feet, and as soon as dry clothing or blankets can be procured, strip the body and cover, or gradually reclothe it, but take care not to interfere with the efforts to restore breathing.
SYLVESTER"S METHOD
Rule 1. _To Adjust the Patient"s Position._--Place the patient on his back on a flat surface, inclined a little from the feet upward; raise and support the head and shoulders on a small, firm cushion or folded article of dress, placed under the shoulder-blades. Remove all tight clothing from about the neck and chest.
[Ill.u.s.tration: SYLVESTER"S METHOD--FIGURE 1]
Rule 2. _To Maintain a Free Entrance of Air Into the Windpipe._--Cleanse the mouth and nostrils; open the mouth; draw forward the patient"s tongue, and keep it forward; an elastic band over the tongue and under the chin will answer this purpose. (Fig. 1.)
Rule 3. _To Imitate the Movements of Breathing._--First, _Induce inspiration_. Place yourself at the head of the patient, grasp his arms (at the elbow-joints), raise them upward by the sides of his head, stretch them steadily but gently upward, for two seconds. By this means fresh air is drawn into the lungs by raising the ribs. (Fig. 2.)
[Ill.u.s.tration: SYLVESTER"S METHOD--FIGURE 2]
Secondly, _Induce Expiration_.--Immediately turn down the patient"s arms, and press the elbows firmly but gently downward against the sides of the chest, for two seconds. By this means foul air is expelled from the lungs by depressing the ribs. (Fig. 3.)
Thirdly, _Continue These Movements_.--Repeat these measures alternately, deliberately, and perseveringly fifteen times a minute, until a spontaneous effort to respire be perceived. By these means an exchange of air is produced in the lungs similar to that effected by natural respiration.
[Ill.u.s.tration: SYLVESTER"S METHOD--FIGURE 3]
When a spontaneous effort to respire is perceived, cease to imitate the movements of breathing, and proceed to induce circulation and warmth, as described on following page.
Rule 4. _To Excite Respiration._--During the employment of the above method, excite the nostrils with snuff or smelling-salts, or tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them. Friction of the limbs and body with dry flannel or cloths should be had recourse to. When there is proof of returning respiration, the individual may be placed in a warm bath, the movements of the arms above described being continued until respiration is fully restored. Raise the body in twenty seconds to a sitting position, dash cold water against the chest and face, and pa.s.s ammonia under the nose. Should a galvanic apparatus be at hand, apply the sponges to the region of the diaphragm and the heart.
_To Induce Circulation and Warmth._--Wrap the patient in dry blankets, and rub the limbs upward energetically. Promote the warmth of the body with hot flannels, bottles or bladders of hot water; heated bricks to the pit of the stomach, the arm-pits, and to the soles of the feet.
On the restoration of life, when the power of swallowing has returned, a teaspoonful of warm water, small quant.i.ties of wine, warm brandy and water, or coffee should be given. The patient should be kept in bed, and a disposition to sleep encouraged. During reaction, large mustard-plasters to the chest and below the shoulders will greatly relieve the distrest breathing.
NOTE.--In all cases of prolonged immersion in cold water, when the breathing continues, a warm bath should be employed to restore the temperature.
[Ill.u.s.tration]