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The Pamphlet Collection of Sir Robert Stout: Volume 9

Treatment for the Restoration of the Apparently Drowned

page 13

Treatment for the Restoration of the Apparently Drowned.

Send immediately for medical assistance, blankets and dry clothing, but proceed to treat the patient instantly on the spot, in the open air, whether on shore or afloat.

The points to be aimed at are, first and immediately, the restoration of breathing and the prevention of any further diminution of the warmth of the body; and, secondly, after breathing is restored, the promotion of warmth and circulation.

The efforts to restore breathing, and to prevent any further diminution of the warmth of the body, must be commenced immediately and energetically, and must be persevered in for several hours, or until a medical man has pronounced life extinct. Efforts to promote warmth and circulation must be deferred until natural breathing has been restored.

To Restore Breathing.

To Clear the Throat.

1. Place the patient on the floor or ground with his face down wards, and one of his arms under his forehead, in which position all fluids will escape by the mouth, and the tongue itself will fall forward, leaving the entrance into the windpipe free. Assist this operation by wiping and cleansing the mouth.

2. If satisfactory breathing commences, adopt the treatment described below to promote warmth and natural breathing. If there be only slight breathing or no breathing, or if fail then—

page 14

To Excite Breathing

3. Turn the patient well and instantly on the side, and—

4. Excite the nostrils with snuff, heartshorn, smelling salts, or tickle the throat with a feather, &c., if they are at hand. Rub the chest and face warm, and dash cold water on the face.

5. If there be no success, lose not a moment, but instantly

To Imitate Breathing

6. Replace the patient on the face, rising and supporting the chest well on a folded coat or other article of dress.

7. Turn the body very gently on the side and a little beyond, and then briskly on the face, back again; repeating these measures deliberately, efficiently, and perseveringly about fifteen times in the minute, or once every four 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.]

8. 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.

[The first measure increases the expiration, the second commences inspiration.]

∵ The result is—respiration or natural breathing; and, if not too late, life.

Cautions.

1. Be particularly careful to prevent persons crowding round the body.

2. Avoid all rough usages and turning the body on the back.

3. Under no circumstances hold the body up by the feet.

To Prevent Further Diminution of Warmth.

N.B.—These efforts must be made very cautiously, and must not be such as to promote warmth and circulation rapidly; for, if page 15 circulation is induced before breathing has been restored, the life of the patient will be endangered. No other effect, therefore, should be sought from them than the prevention of evaporation, and its result, the diminution of the warmth of the body.

1. Expose the face, neck, and chest, except in severe weather (such as heavy rain, frost, or snow).

2. Dry the face, neck, and chest, as soon as possible with handkerchiefs or anything at hand, and then dry the hands and feet,

3. As soon as a blanket or other covering can be obtained, strip the body; but if no covering can be immediately procured, take dry clothing from the bystanders, dry and re-clothe the body, taking care not to interfere with the efforts to restore breathing.

Cautions.

1.Do not roll the body on casks.
2.Do not rub the body with salts or spirits.
3.Do not inject tobacco smoke or infusion of tobacco.
4.Do not place the patient in a warm bath.

Treatment after Natural Breathing has been Restored.

To promote Warmth and Circulation.

1. Commence rubbing the limbs upwards, with firm, grasping pressure and energy, using handkerchiefs, flannels, &c., (by this measure the blood is propelled along the veins towards the heart.)

[The friction must be continued under the blanket, or over dry clothing.]

2. Promote the warmth of the body by the application of hot flannels, bottles, or bladders of hot water, heated bricks, &c. to the pit of the stomach, the armpits, between the thighs, and to the soles of the feet.

3. If the patient has been carried to a house after respiration has been restored, be careful to let the air play freely about the rcom.

4. On the restoration of life, a teaspoonful of warm water should be given; and then, if the power of swallowing have re- page 16 turned, small quantities of wine, warm brandy and water, or coffee, should be administered. The patient should be kept in bed, and a disposition to sleep encouraged.

General Observations.

The above treatment should be persevered in for several hours, as it is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance, cases have been successfully treated after persevering for many hours.

Appearances which generally accompany Death.

Breathing and the heart's action cease entirely, the eyelids are generally half-closed, the pupils dilated, the jaws clenched, the fingers semi-contracted, the tongue approaches to the under edges of the lips, and these, as well as the nostrils, are covered with a frothy mucus. Coldness and pallor of surface increase.

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Mills, Dick and Co., Steam Printers, Stafford Street, Dunedin.