reventing ig b Lente aa ry i elt: LL HOME ACCIDENTS are the result of unsafe conditions or unsafe practices. The following questions and answers emphasize the impor- tance of hore safety, and indi- cate how some of the more frequent, types of home accidents can be prevented. Ceslions 10. a; 12. + “74 Which of the following classes of accidents results in the greatest number of deaths and disabling injuries—motor vehicle accidents, home accidents, public (not motor vehicle) accidents, or occupational accidents? In which room of the house do the greatest number of serious accidents occur? What are the chief precautions which should be taken to prevent injuries in the kitchen? = How can you prevent accidents on“-he stairs of your home? What type of accident results in one half of all home acciJen* deaths? inte What precautions should be taken when poisonous materials must be kept in the house? How can living-room accidents be prevented? How can you guard against fires, burns, and shock from electricity? What are the two most important causes of home accident deaths among children less than 5 years of age? How can you prevent the more common types of bathroom accidents? What precautions should be taken to prevent accidents due to the escape of illuminating gas? What can be done to prevent persons from being overcome by carbon monoxide gas? How can accidents in the cellar be prevented? How can the yard be safeguarded? 1 Motor vehicle accidents slightly exceed home ac- cidents as a cause of death in the United States as a whole, although in many cities the reverse is true. However, nearly four times: as many disabling in- juries result from home accidents as from motor vehicle accidents. In the kitchen. (The second largest number of serious accidents take place in the living room. But more accidents occur on the stairs than in any room in the house. ) Turn the handles of pots and pans on the stove out of reach of small children. Fasten curtains to prevent them from blowing into open flames. Before leaving the kitchen for any length of time pull out the plugs of portable electrical appliances. Keep matches in noninflammable containers where children cannot reach them. Use short ladders—not stools, chairs, or boxes—to reach upper cabinets or other high places in the kitchen. Immediately place broken glass or crockery in a dis- carded box or can with a cover, and wrap it in heavy paper before placing it in the rubbish container. Keep the floor clean of grease and other slippery substances. Make sure that handrails and stair treads are in safe condition. ee See that rugs and carpets on steps and landings are kept in repair and fastened securely and safely. Make it a practice to keep stairs and stair landings free of mops, brooms, soap, pails, toys, or any other objects which may cause a person to fall. If there are young children in the home, place a gate at the top of the stairs to prevent falls. Cbwers 5. Falls. (About 80 percent of the accidental deaths of 6. persons 65 years of age or older are due to falls.) Keep all medicines and cleaning substances in secure containers, out of reach of young children, plainly marked as to content, and preferably in locked cabinets. Never take medicine in the dark. Always make sure of the contents of the container before taking any medicine. Know the antidote for each poison kept in the house. Fasten rugs to prevent slipping, or use nonslip underpads. Before turning out the light, make sure that all articles of furniture are in their customary places to prevent stumbling over them in the dark. Extinguish cigars, cigarets, and matches after use, and place them in proper receptacles. Keep a screen in front of an open fireplace whenever a fire is burning. Keep draperies, decorations, and other inflammable materials away from open lights or from close contact with electric bulbs. Keep small objects such as buttons, marbles, and pins off the floor and away from small children. Make sure that household wiring is adequate for safely conducting the current to operate electrical appliances, and that circuits are protected with proper fuses. Use only “U L” approved outlets, fixtures, and cords; have repairs made promptly. Teach members of the family not to touch anything electrical when the hands are wet or lesioe any portion of the body is in water. Burns and suffocation. (About one third of the home accident deaths of children under 5 years of age result from burns and scalds; about one fifth from mechanical suffocation, chiefly smothering under bedclothes.) Cndwerd 10. 11. 12. 13. Use a rubber mat or other nonskid mat in the bathtub to prevent slipping, or else have a handhold on the wall. Place soap in a safe container instead of leaving it in the tub or on the floor. Place the electric heater so that no one can trip over the electric cord. Disconnect the heater before retiring or leaving the room for any length of time. Promptly replace broken faucet handles. To prevent scalds, test the temperature of the water before stepping into the tub or shower. NEVER LIGHT A MATCH OR TURN ON AN ELECTRIC SWITCH IN THE PRESENCE OF LEAKING GAS. Inspect gas equipment periodically, and have all de- fects repaired immediately by competent workmen. Promptly replace gas hose and all connections when worn, and use “U L” approved flexible tubes for portable gas burners and heaters. Completely turn off all gas-stove cocks. Make sure that gas flames cannot be extinguished by a draft of air or by liquids boiling over. When in doubt concerning causes of gas leaks, tele- phone the gas company. Always open the garage doors or windows before starting an automobile engine in the garage. Keep furnace and stove pipes clean and in good repair. Keep tools in good condition and in safe places. Prevent accumulation of rubbish, piles of old news- papers, oily rags, and other inflammable material. Always place ashes in metal containers. Always remove or flatten nails in scrap wood or when breaking up old boxes and barrels. : If the cellar stairways are dark, paint the top and bottom steps white and always use a flashlight. 14. Keep sidewalks, steps, and porches in good repair and free of ice and other slippery substances. Place sharp tools such as rakes, shears, and axes so that no one can step on the prongs or walk into the cutting edge. . If rubbish burning is permitted, use a wire or metal basket with a cover. When parking the car in a driveway, set the brakes or place a chock under the wheels, turn off the engine, and remove the ignition key. PROVIDE FOR EMERGENCIES Provision should be made for dealing promptly with emergencies in the home. Every adult and older child should know the location of the nearest fire-alarm box. In addition, at least one approved fire extin- guisher should be kept in a convenient loca- tion, particularly in a place where there is a fire hazard, such as the garage or basement. Although prompt medical attention should be obtained in case of personal injury, every home should be equipped with a first-aid cabinet for emergency use. Adults and older children, except those living in apartments or hotels, should know where and how to turn off the main supply of water, gas, and electricity in case of emergency. HAVE ALL INJURIES, EVEN MINOR CUTS AND SCRATCHES, TREATED PROMPTLY F par rer fs eer ft Flagt ee? ?, e METROPOLITAN LIFE INSURANCE COMPANY PRESS NEW YORK, U.S.A. (d) 518 L.W. FIRST AID le Which of the following classes of eceidents results in the greatest number of 2. In whieh room of the howe do the greatest nuiber of serious accidents cecurt 3. that are the chief precautions which should be taken to prevent injuries in the kitchen? oe 4. How can you provent accidents on the stairs of your home? S. that type of accident results in one half of all home accident deaths? 6. that precautions should be taken when poisonous materials must be kept in the house? 7. liow can livingeroom seeidents be prevented? 8. iow can you guard ageinst fires, burns, and shock from electricity? 9. that ore the two most important causes of hove eecident deaths sncng ohiléren less than 5 years of age? $0. aw eum you pecs the mere commen types Of Weltween cockilentet ll. should be taken to prevent accidents due w the escape of 12, Vint can be done to prevent persons from being overecme by carbon monoxide gas? 15. Yow cm accidents in the seller be prevanted? 1. Ze Se 4. Se FIRST AID What is meant by the Pasteur treatment? In what per cent of cases is the use of it effective? Name the best known poisonous snake groups in the United States. Discuss the prevention of snake bites. What are the symptoms of snake-bites? When may the greatest. severity of symptons be expected to occur? Discuss fully the treatment for snake-bite as outlined in ' your text. 6. Te 8. 9. 10. Is there a serum on the market for the treatment of bites other than those of the coral snake? Name it. What do we mean by the skin irritation, “sea nettles"? What is the treatment ? | What treatment is suggested in your text for the treatment of poison ivy? In the “black widow" spider family, which gender of the species is relatively harmless? What are the symptoms of and treatment for "black widow" spider bite? Fe Ml 4 . O. | Oonrbaha tm atoccmed ance 22 Ae pce 3h, BABA pealck (berry stale tk oy atlas “be seinry ) thal, Kure Det tin fy Oer The me Annard thes chars Das - car That ash wlan lee ude psy Lae aus uct athe Hs gee a Oe eer ew the Ba bh rhs Hews teats & ope, ni Tegclt uaean ze Fw Wafer 1g AF ion prak- Oid qo! sees cement racecar lors 9 el Te. cae NEL 15 aR canine ee ce aes coareeae Bed serps ie oe a butdings , ther the th be eared or“ cred ribeing om th musth off ounces, wear of Hargtians/ eputemint are tagerhe tmnMtag ae Le ths Longe, Bothowgh, our health temict 0 fad fron a Fagan A Gebisnk AF Corth he ir prised wn prtntnt eck AMhnret? Bhat Cymte atert, Prtapee 0 Coukh Be ee Bs Cth FIRST AID 1. The Pasteur treatment: A preventive treatment for rabies. it is almost 100% effective. 2. The poisnous snake group in the United States are Coral snakes and the pit-vipers, which include the rattle snakes, coppesheads, and cotton-mouth moccasins. 3. 75% of snake bites are in the lower extremity. Wear high-topped shoes, poots, or heavy leggings. 22% occur on hands and arms, should be careful . about putting hands in places where you might be bitten. 4, Pain is severe, swellin ecurs rapidly. Symptoms of shock; weak pulse, nausea and aa ce weekness soon begin to develop. The greatest severity of the symptoms is not reached for several hours. 5, Have patient lie down and keep quiet. Tie a constricting bandages @round the limb just above the bite, make the veins standout, should be tight enough to prevent blood from flowing back in the veins, but not tight e: enough to prevent the blood from flowing through the arteries. About every ten minutes, realease one minute, then retighten. As swelling progresses, the bandage should be moved higher up the limb. Sterilize a sharp knife or razor blade. Make a cross shaped incision + bys inch at each fang mark. The cuts must be from 1/8 to + inch deep, deep enough to insure free bleeding. Apply suction for at least % hour. Suction may be applied by the mouth, »y a glass breast pump, or by a $mall funnel attached to a rubber. Heating a bottle or small elasen hot water or over a flame or by burnign a small piece of paper i it. Keep the patient quiet and give the usual treatment for shock. 6, Yes. The serium is called Antivénin. 7. It isa severe skin irritation and poisoning caused by coming in contact with the trailing tentacles of the "Portugese Man of War", "large jellyfish", or "Sea nettles." Tréatment-First rub the affected part with clean sand to remove the slime and parts of tentacles, Bathe the infected part with full strength ammonia water followed by a paste of bicarbenate of soda, or a good burn ointment. 8. Treatment for poison ivy-Make a paste by heating soap with a little water until about the consistancy of lard. Apply thickly over the part, allow to dry, leave over night. 2. Apply calamine lotion purchased from any drug store. At time of purchase, have the druggist add enough - earbolic acid to make a 2% solution. ‘Shake well, apply with cotton sponge and allow to dry. - 9. The male is relatively harmless. 10. Sometimes a slight local swelling and redness is seen as well as 2 tiny red spots. Pain, usually in the region of the bite, is felt almost at once. In short time , this pain spreads to the muscles of the back, shoulders, chest, abdomen, and limbs. The abdomen is hard as a board. ‘There is some feaver and profuse perspiration. ‘reatment-Keep patient quiet and warm and call a doctor at once. 11. Pois@nous drugs commonly taken. 1. Carbolic acid or phenol. 2. lysol. 3. bichloride of mercury. 4. jodine. 5. arsenic or parisrreen. 6. strychine. 7. acids. 8. alkilies-lye. 9. medicines used to induce sleep; opium, morphine, veronal, etc. 10. Kerosene. 11. wood alchol or denatured alchol. | 12. Prevention in case of poisonous drugs. Keep bottles labeled and never take medicine in the dark when you cannot see label on the bottle. Keep all poison drugs away from other medicines and safely locked up. Keep all mediéines and- poisons out of reach of children. 13. There may be no early symptons. Pain in the stomach, nausea, and vomiting and cramps. frequently occur. If a corrosive poison has been taken the mouth and tongue may be burned or stained. 14. Dilute 2. Wash out. 15. Emetics of poisoningri. Soapsuds, use any ordinary soap. &. Salt water. 3. Soda water(use ordinary baking soda). 4. Luke warm water 5, Dish water _. Milk(particularly in corrosive poisons. 16. Ptomaine poisoning is caused by poison foods. ™t is caused by eating food that has not been properly cared for+- food that has decayed. Symptoms-aniuncomfortable feeling in the upper abdomen, pain, cramps, nausea, and vomiting. Treatment is the same as for drug poisons. 17. Red. Unconsciouness. 18. If there is any doubt at all, always treat the patient for skull fracture or apoplexy--call a doctor. 19. In examining an unconscious patient always look carefully for : stopping of breathing, bleeding, poison or sun stroke. 20. Symptoms of Epileptic Fits--Face becomes pale, the eyes roll up, the patient falls forward, utters a hoarse cry, looses consciousness, bites tongue, and turns blue. The convubive muscular movements begin with the patient wildly throwing his arms and legs, and jerking his head. Convulsions cease and patient passes into a sleep. Treatment--Place a piece of wood in patients mouth to prevent bitting of the tongue. Put something under the head to prevent injury, don't try to prevent the convulsions of the patient. | 21. Throwing a cup of cold water in the face or holding spirits of ammonia under the nose. £2. Drowning may be prevented by: 1. Swim when lifeguard is on duty. 2. Do not swim alone. 3. Do not swim during a thunder storm. 4. In attempting to resuce a drowning person always use a boat. 25. A victim of submersion is usually blue and cold. Breathing may or may not have stopped. The pulse is weak or may not be found at all. 24, Get this out of books ‘ 25. A very sharp slap between the shoulder blades will often dislodge the object. Or open the mouth, pass 2 fingers over the tongue to the back of the throat and try to pull out the forign body. 26. Carbon monoxide causes most of the trouble. 27. %It is a colorless, odorless gas, slightly lighter than air. It is found in automobile exhaust gas, manufactured gas used for illuminating and heating, coke oven gas, blast furnace gas, and other minufactured gases. 28. Symptomgare usually yawning, headacke, dizzness, nausea, weariness, ringing in the ears, and later a fluttering or throbbing of the heart. The skin often is a peculiar cherry red color or it may be blue of other asphyxiation cases. Treatment--get patient into fresh air quickly. Start artificial respiration immediatly. Try and get some pure oxygen for the patient. 29 Four kinds of wounds: 1. Abrasions-Wounds made by rubbing or scrapping off the skin or mucous membrane. 2. Incised wounds--These are made by sharp cutting instruments. 5. Lacerated or torn wounds-These are made by blunt instruments. 4. Punctured Wounds--These may be caused by any penetrating instrument. 50. Wounds are subject to 2 dangers; infection and severe bleeding. 31. Definition of infection--Whenever the skin is broken, germs enter the wound, Often these germs grow not only in the wound, but also in the body tissue around the wound. Heat, pain, swelling, redness, and formation of pus result. S52. 1. Number of germs in wound. 2. Vitality or ability of germs to grow. 3. The body own resistance. 535. 1. Do not touch the wound. 2. Do not wash with soap and water. 5. Apply Iodine. 4. Do not disturb blood clots. 54. 1. Think first of pressure. 2. Do not put fingers on wound. 5. Apply pressure. 55. A tourniquet should be flat band at least 1 inch in width; never a rope, wire, or sash-cord. If blood cannot be checked withemt a tourniquet it should not be used, because it cuts off the circulation and the part is liable to die g@@@ gangrene will set in. 56. Place a pad over the artery, the pad should be firm. Be sure the pad is over artery and tighten. 57. Stimulates the heart and this will speed up the circulation. 58. Shock is a-eohdition in which all the activities of the body are greatly depressed. Symptoms are: pale face, weak and rapid pulse, great lowering of the blood pressure, irregular gasping .breathing, listlessness, dulling of sensibility and subnormal temperature. 59. L Results from injury. &- Fear will cause it. 5. Bleading and cold exposure. 4. Taking of poisons. Se following surgical operations. 40. lL Heat--keep the body warm. 2. Position--Lay patient on back with head down. 5. Stimulants--slight dose may bring them out of it. give 41. 1. Do notAstimulant in severe bleeding. 2. Dosnot give stimulant if skull is fractured or in case of strong pulse and red face. 42. Symptoms of electric shock--patient isn't breathing, is usually blue, although he may be white, pulse is weak or absent, complete unconsciousness, and burns may be present. 45. Turn off switch if it is possible. 2%. Use something dry and non- conducting. \ 44, Start artificial respiration immediately. 45. To prevent accidents. To equip the individual with sufficient knowledge to determine the nature and extent of an injury. To train the first aider to do the proper thing at the proper time. 46. Definition:-First Aid is the immediate, temporary treatment given in case of accident or sudden illness before the services of a physician can be secured. 47. To prevent accidents. To equip the individual with sufficient knowledge to determine the nature and extent of an injury. To train the first aider to do the proper thing at the proper time. 48. The need for First Aid is great because it would help to stop such accidents as automobile, home and industrial accidents that are caused from carelessness. 49, Place two men down the highway to prevent other accidents. Send for ambulance. See who was dead and who lived. Determine how bad persons were injured. | Apply First Aid in every possible way after making persons comfortable. oO. Anatomy and physiology. She 056 54. D5. D7» 58. 39. 60. 61. 62. 63. 64, 65. They give shape and support to the body. They form cavities which hold vital organs and protect them from injury. They afford attachment for muscles. They act as levers and make movement possible. Cranium. Skeleton of the face. Spinal column. Breast-bone. Ribs. Pelvis. Liver. stomach. Kidneys. Urinary bladder. Small intestines. Large. Collar bone. Shoulder blade. Arm bone. Bones of the forearm. : Bones of the palm. Bones of the fingers. Wrist bones. Thigh-bone. Knee-cap. Bones of the leg. Bones of the foot. Beneath the skin and between the muscles there is yellow or white the bones together. The blood is a red, sticky fluid that circulates through the arteries, capillaries and veins. It has a peculiar, faint odor and a salty taste, and varies in color from bright scarlet to a bluish red. The fluid part or plasma, also called serum. The red cells or corpuscles. The white cell or corpuscles. The average person weighing 150 lbs. should have 5 to 6 gts. The loss of 2 pints may be serious; loss of three pints may be fatal. The heart is a hollow, muscular organ that acts like a pump; this pump has two sides or "cylinders. The heart lies between the lungs, behind the breast bone, and more to the left side than to the right. The heart beats at an average rate of 72 beats per minute. Arteries are vessels that carry blood away from the heart. Only those from which serious bleeding is likely to occur. 66. Aorta 67. For the artery to the head and neck. 1. In the neck just to the side of the windpipe against the backbone. 2. Just in fromt of ‘the ear, against the skull. 3, About an inch forward from the angle of the jaw, where a large branch crosses the jaw bone.. B. For the artery to the shoulder and arm. 1. Behind the inner end of the collar bone against the lst. rib. 2, On the inside of upper arm, = way between the shoulders and elbow. C. For the artery to the lower limbs. 1. In the groin as it passes over the pelvis bone. 68. Capillaries. 70. Bleeding from capillaries is oozing and usually offers no serious problem in its control. 71. Veins which carry the blood back to the heart. 72. The veins are cut more frequently. 73. Blood from artery comes in spurts, and from a vein in a steady flow. 74. Veinous bleeding can usually be controlled by direct pressure, always first covering wound with compress. 75. 1. Nose 2. Mouth 3. Throat 4. Windpipe 5. Bronchial tubes. 6. Lungs. 76. 1. Restlessness 2. Anxiety Se. THiPss These symptoms may accompany these; pallar, weak rapid pulse, and and weakness. 77. 1. Punctured wounds usually don't bleed freely, so the cleansing given by bleeding is not present. : 2. They are difficult to clean out. 3. It is quite difficult to apply antiseptic well down in wound. 4. Air cannot get to the wound. 78. Ina simple fracture the bone is broken, but there is no connecting wound from the break in the bone to the skin. In a compound fracture the bone is broken in the addition there is a wound from the break to the surface of the skin. 79, 1. Patient frequently hears it snap. 2. Pain and tenderness are present. 3. May be deformed. 4. Swelling and discoloration occurs. 1. Same as above. 2. End of the bone is often protruding. 3. Frequently severe bleeding. 80. Ae 1. To prevent further damage. 2. To make the patient comfortable. 3. To treat any shock that may be present. B. 1. Check arterial bleeding. 2. Apply a turniquet. 81. No, most First Aiders do not have enough experience to distinguish between the two. 82. Symptoms 1. Unconsciousness 2. Bump or cut on head 3. Pupils of the eyes may be unequal in size 4. Bleeding of ears 5. Face flushed Treatment . Le. Keep patient lying down--the head slightly raised if it is red or flushed--but level if face is pale. @. Avoid all unnecessary handling 3. do not give stimulant 4, Keep patient warm. 5. Treat all scalp wounds. 83. Symptoms. 1. pain, swelling, bleeding Treatment : 1. Do not attempt to splint. 2. If wound present treat wound. 84. Symptoms 1. pain in movement of jaw 2. Loose teeth 3. Difficulty in eating, drinking and swallowing 4, Bleeding of gums. 5. Mouth open with drooling saliva Treatment 1. Place palm of hand below the jaw «nd gently raise it. - Bring the lower teeth against the uppers. ©, Place bandage under the chin and over head. 85. Symptoms 1. General symptoms of fracture are present. 2. Fractured ends may be felt through the skin by fingers. 3, Person unable to raise arm above shoulder. 4. If arm is hanging one shoulder is lower than the other. Treatment. 1. But arm in sling. 2. Tie arm to side. 86. Symptoms 1. Severe pain @. Breathing or coughing heavily 3. Person may hold chest with hands to keep part hurt from moving. Treatment 1. Apply two or three broad craveats around the body. 2. Keep patient lying quietly. Gis 2» Brain 2. Spinal cord 88. Brain and spinal cord. 89. Sensations and movement. 90. Breaking might cut the spinal cord in two or bruise it s that nearve impulses could not be carried by it. 91. Because of the pain;that is present. Because of the fact that the nervous system is needed to through off injuries. 92. That material is applied directly over a wound or burn. 93. Gauge Square. 94. 1. Stickes like cotton. 2. Make small or large bandages out of same piece of material 95. 1. Iodine Ze Salve 5. Acids 4. Epsom salts DS» Alchol 96. 1. To hold dressing or compresses in place. 2- TO Keep splints in place. 53. To control bleeding by pressure. 4. As sling 97. Trangular 2. Roller or pleated gauge and four-tail. 98. Carries germs from soap and water to the wound. 99. Because he is giving treatment not first add. ‘100. Think first of pressure. One should not put fingers in wounds, but when other methods fail or compress is not available in case of severe “bleeding do not hesitat to apply pressure directly on bleeding point. CHOLASTIC MAY, 1943 The Schafer Prone Pressure Method of Resuscitation. RESUSCITATION AND FIRST AID By Dr. Thomas Kirk Cureton This article is condensed from the chapter on Resuscitation and Water First Aid in Dr. Thomas Kirk Cureton’s new book, ‘Warfare ‘Aquatics,’ and is reprinted with permission of the Stipes Publishing Co. A review of the book may be found on page 30. T THIS time there are four A methods of resuscitation in common use: 1. The Silvester method which is widely used by the United States Coast Guard operators and is in use by doctors and first aid workers when it is desirable to put the pa- tient on the back. 2. The Schafer method which is preferred by the American Red Cross in its first aid work. 3. The Nielsen method which has increased greatly in popularity.* 4. Mechanical resuscitation with the E & J or McKesson equipment. Modern workers in resuscitation should be trained in all of these methods because they will all be ‘found in use and each one of them has advantages under certain condi- tions. N iahen Method This method was devised by Colo- nel Nielsen in charge of the Danish Life Saving work where it is gen- erally considered superior to the Schafer method. The physiological evidence has been interpreted by Colonel Nielsen and others in favor *Lt. Col. Holger Nielsen and the Danish Resuscitation Commission: Dr. H. Bendlsen (Chairman), Dr. Svend Hansen, Dr. Paul Guildal, C. Holstein-Rathlou, Prof. August reel ‘Dr. J; imdhard, & B. Pederson, Dr. . Svendsen. -; ' we eT he) of this method because it more near- ly corresponds to natural deep breathing and offers greater stimu- lation to circulation. It also decreases the potential danger of causing in- ternal injuries by great pressure on the abdominal organs. It affords an easier position from which to op- erate than the Schafer method. It also leaves the greater part of the body free to be worked upon with massage. The operational instruc- tions are as follows: 1. The side of the face is placed on the back of one or both hands which are bent at the elbows and crossed under the face. The body is freed as quickly as possible of tight gar- ments and the nose and mouth are checked to see that they are perfect- ly free to breath. A slap on the back is given to help open the mouth and make the tongue fall forward. 2. The operator kneels on one knee at the head of the victim and presses downward on the shoulder blades with the palms of the hands and with fingers widely separated. Pressure is exerted evenly and smoothly in the downward direction for about 2% seconds. 3. The operator relaxes the pres- sure and seizes the upper arms just above the elbows and lifts them vig- orously upward for 4 or 5 inches to assist the expiration of the chest and the inspiration of the air. This is a unique feature of the Nielsen method. The arms are lowered and the cycle is repeated at a rate of ap- proximately 2% to 3 seconds relaxa- tion and stretching on the chest. The Silvester Method of Resuscitation (victim supine). 4. During the application of the movements supplemental treatment is applied in the way of hot pads or stones, vigorous rubbing of parts of the body toward the heart, slapping the bottoms of the feet and other methods of reflex stimulation. 5. A change of operators is made whenever needed without interfer- ing with the respiratory movements. Silvester Method A brief description of the Silvester method of resuscitation is given as follows: 1. The subject is placed upon the back and the mouth is cleaned and the tongue pulled forward. 2. The operator works from the head end and places his hands over those of the subject. The subject’s arms are raised sideward and up- ward to an overhead position for 2 ‘seconds. This movement assists the inspiration. 3. The hands are placed back on the chest over the lower ribs and pressure is exerted downward for about 3 seconds until as much air has been forced out of the chest as pos- sible. 4. The movements are continued at a rate of about 12 to 15 per minute. 5. Supplemental treatment is ap- plied by an assistant. It may be nec- essary to tie the tongue forward or to hold it. It can easily be deter- mined from this position whether the subject is breathing or not. If the cheek is lowered to a position direct- 10 ly over the nose and mouth, any ex- pired air can be easily detected. Massage, heat and stimulation of re- flexes should be applied. If an as- sistant operator is available he should call the doctor and apply sup- plemental treatment. Schafer method A brief description of the Schafer method of resuscitation is given as follows: 1. The subject is placed in the prone position with the head turned to one side and placed over the back of the hand or over a handkerchief or other garments. The mouth should be cleaned and the tongue pulled forward. 2. The operator kneels astride one or both legs so that his knees are about even with the subject’s knees. The hands are placed on the body about 4 inches apart with the fingers together and following the line of conformation of the lower ribs. 3. The pressure is forward and downward with straight arms for about 3 seconds, followed by a quick removal of the hands and relaxation on the part of the operator for 2 sec- onds. This alternation of pressure and relaxation is continued at 12 respirations per minute. 4. Supplemental treatment should be applied by an assistant operator, who telephones the doctor, secures warm clothing and a blanket, cuts off the wet clothing, assists with massage and stands by to change po- sition with the operator performing the resuscitation. Mechanical methods Doctor C. K. Drinker and Doctor Lewis A Shaw of Harvard Univer- sity constructed a heavy resuscitator (1929) about six feet in length and two and one-half feet in width and a depth which accommodates the body with the exception of the head, which is exposed and insulated from within by a collar. It was considered the first satisfactory appliance for administering artificial respiration over long periods. A regular rhythmic respiration is produced at about 15 to 25 breaths per minute by air pressure which is alternately fed in and forced out in imitation of the act of breathing. The incoming air current bears down on the chest and abdomen of the pa- tient and causes him to exhale, and the diminished pressure causes his ~ lungs to inflate. Mechanical resusci- tators of a much improved form for portable use have been introduced by the E & J Manufacturing Com- pany and the McKesson Appliance Company. These are widely used in American hospitals and are abso- lutely approved. An excellent technical report has been prepared by Dr. Coryllos* who maintains that the apparatus is easily effective in the hands of non-med- ical rescue squads. These new com- bination inhalators and resuscita- tors have been subjected to exacting experimental investigation with fa- vorable results. It is maintained that in the presence of apnea and begin- ning relaxation of the muscular sys- tem that only the mechanical meth- ods of forcible insufflation of oxygen into the lungs can produce success- ful resuscitation. The modern meth- ods permit forceful mechanical in- sufflation-suction until respiratory movements begin. Then the device is changed by a valve to a steady stream as an inhalator. Supplemental treatment Steinhaus has pointed out that the circulatory system has a great deal to do with the chances of recovery. When the heart is beating feebly the pressure in the capillaries is less than 10 per cent of the original pres- sure imparted to the blood by the heart (5 to 10 m.m. Hg.). It is high- ly important to do anything possible to aid the return flow of blood to the heart. The two principal methods are (1) the contracting and relaxing of skeletal muscles and the (2) forceful respiratory movements. Steinhaus recommends exercising __ *P. N. Coryllos, “Mechanical Resuscitation in Advanced Forms of Asphyxia,” Surgery, foe ee & Obstetrics, 66: 698-722 (April, SCHOLASTIC COACH the arms and the legs and exerting pressure on the abdomen during the inspiratory phase of respiration. The arm exercise involved in the Sil- vester method is possibly helpful and in addition, the legs may be ex-_ ercised by pushing the knees up to- ward the chest a number of times while holding the feet. This circu- latory viewpoint of resuscitation in- dicates that it is highly important to have the subject placed so that the head is downhill and gravity assists the return flow of blood to the heart. Another point is that pressure should be gradually applied to mini- mize the effect of increasing the in- - tra-thoracic pressure and checking the return flow of blood to the heart. With the patient on the back the legs may be lifted or exercised as sug- gested. This is the strong reason for methods which use the supine po- sition. Circulation may be assisted by massage toward the heart. The rub- bing should be over the big veins by stroking movements continuously applied in the direction of the heart. A strong slap should be given on the back before starting pressure in the prone position. It may also be help- ful to slap the bottoms of the feet and the face, pull the hair and apply rectal dilation. Colonel Nielsen em- phasizes that it is better to rough up the body and it should never be al- lowed to lie quietly. Vibratory tapping (100 times per minute) over the heart area may provide stimulation to the heart. Re- (Continued on page 24) Nielsen Resuscitation Method, arms bent at elbows, hands crossed under face.