Boy Scouts Handbook Part 58

A scout is in the country with a comrade. The latter mounts a stone wall to cross it. The wall falls with him and he calls out for help.

When the other scout reaches him, he finds the injured scout lying flat on the ground with both legs stretched out. One of these does not look quite natural, and the scout complains of a great deal of pain at the middle of the thigh and thinks he felt something break when he fell. He cannot raise the injured leg. Carefully rip the trousers and the underclothing at the seam to above the painful point. When you have done this the deformity will indicate the location of the fracture. You must be very gentle now or you will do harm, but if one hand is put above where you think the {263} break occurred and the other below it and it is lifted gently you will find that there is movement at the broken point.

[Ill.u.s.tration: Splints for broken leg.]

Send for a doctor first, if you can, and, if you expect him to arrive very soon, let your comrade lie where he is, putting his injured leg in the same position as the sound one and holding it there by coats or other articles piled around the leg. But if the doctor cannot be expected for some time, draw the injured limb into position like the sound one and hold it there by splints. Splints can be made of anything that is stiff and rigid. Something flat like a board is better than a pole or staff; limbs broken off a tree will do if nothing else can be found. Shingles make excellent splints. In applying splints remember that they should extend beyond the next joint above and the next joint below; otherwise, movements of the joint will cause movement at the broken point. With a fracture of the thigh, such as that described, the outer splint should be a very long one, extending below the feet from the arm pit. A short one extending just below the knee will do for the inner splint. Splints may be tied on with handkerchiefs, pieces of cloth torn from the clothing, or the like. Tie firmly but not tight enough to cause severe pain. In a fracture of the thigh it will also be well to bind the injured leg to the sound one by two or three pieces of cloth around both. The clothing put back in place will serve as padding under the splint, but with thin summer clothing it is better to use straw, hay, or leaves in addition. Fractures of the lower leg and of the upper and lower arm are treated in the same way with a splint on the inner and outer sides of the broken bone. A sling will be required for a fracture of the arm. This may be made of the triangular bandage, or of a triangular piece of cloth, torn from your shirt.

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The Red Cross First Aid Outfit is very convenient to use in fractures as well as in other injuries. The gauze bandage may be used for the strips to tie on the splints and the triangular bandage for an arm sling; or, if a sling is not needed, for strips to fix the splints firmly in place.

Compound Fractures

The edges of a broken bone are very sharp and may cut through the skin at the time of an injury, but more often afterward, if the injured person moves about or if the splints are not well applied so as to prevent movement at the point where the bone is broken. If a compound fracture has occurred, the wound produced by the sharp bone must always be treated first. The treatment is the same for any other wound.

_Warning_: You will not always be able to tell whether or not a fracture has occurred. In this case do not pull and haul the limb about to make sure, but treat as a fracture. There will always be a considerable amount of shock with fracture and this must also be treated.

[Ill.u.s.tration: Splints and sling for fracture of upper arm.]

Bruises

Everybody has suffered from a bruise at some time in his life and knows just what it is. A slight bruise needs no treatment. For a severe one, apply very hot or very cold water to prevent pain and swelling.

Sprains

A scout slips and twists his ankle and immediately suffers severe pain, and in a little while the ankle begins to swell. {265} The sprained joint should be put in an elevated position and cloths wrung out in very hot or very cold water should be wrapped around it and changed very frequently. Movement of any sprained joint is likely to increase the injury, so this ought not to be permitted. Walking with a sprained ankle is not only exceedingly painful but it generally increases the hurt.

[Ill.u.s.tration: Triangular sling for arm.]

Dislocation

A dislocation is an injury where the head of a bone has slipped out of its socket at a joint. A scout is playing foot-ball. He suddenly feels as though his shoulder has been twisted out of place. Comparison with the other side will show that the injured shoulder does not look like the other one, being longer, or shorter, and contrary to the case with fracture there will not be increased movement at the point of injury but a lessened movement. Do not attempt to get a dislocated joint back in place. Cover the joint with cloths wrung out in very hot or very cold water, and get the patient into the hands of a doctor as soon as possible.

Injuries in Which the Skin is Broken

Such injuries are called wounds. There is one very important fact which must be remembered in connection with such injuries. Any injury in which the skin is unbroken is much less dangerous, as the skin prevents germs from reaching the injured part. The principle to be followed in treating a wound is to apply something to prevent germs from reaching the injury.

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All wounds unless protected from germs are very liable to become infected with matter, or pus. Blood poisoning and even death may result from infection. To prevent infection of wounds, the scout should cover them promptly with what is called a sterilized dressing.

This is a surgical dressing which has been so treated that it is free from germs. A number of dressings are on the market and can be procured in drug stores. In using them, be very careful not to touch the surface of the dressing which is to be placed in contact with the wound. The Red Cross First Aid Dressing is so made that this accident is almost impossible. In taking care of a wound, do not handle it or do anything else to it. Every one's hands, though they may appear to be perfectly clean, are not so in the sense of being free from germs; nor is water, so a wound should never be washed.

[Ill.u.s.tration: Head bandage.]

It will be a good thing for a scout always to carry a Red Cross First Aid Outfit, or some similar outfit, for with this he is ready to take care of almost any injury; without it he will find it very difficult to improvise anything to cover a wound with safety to the injured person. If no prepared dressing is procurable, boil a towel if possible for fifteen minutes, squeeze the water out of it without touching the inner surface, and apply that to the wound. The next best dressing, if you cannot prepare this, will be a towel or handkerchief which has been recently washed and has not been used. These should be held in place on the wound with a bandage. Do not be afraid to leave a wound exposed to the air; germs do not float around in the air and such exposure is much safer than water or any dressing which is not free from germs. Of course you can bind up a {267} wound with a towel not boiled or piece of cotton torn from your shirt, but you cannot do so without the liability of a great deal of harm to the injured person.

Snake Bites

While snake bites are wounds, the wounds caused by venomous snakes are not important as such but because the venom is quickly absorbed and by its action on the brain may cause speedy death. The rattlesnake and the moccasin are the most dangerous snakes in the United States.

In order to prevent absorption of the poison, immediately tie a string, handkerchief, or bandage above the bite. This can only be done in the extremities, but nearly all bites are received on the arms or legs. Then soak the wound in hot water and squeeze or suck it to extract the poison. Sucking a wound is not dangerous unless one has cuts or sc.r.a.pes in the mouth. Then burn the wound with strong ammonia.

This is not aromatic spirits of ammonia, but what is commonly known as strong ammonia in any drug store. Aromatic spirits of ammonia should also be given as a stimulant.

If you have nothing but a string to tie off the wound, be sure to do that and to get out as much poison as you can by squeezing or sucking the wound. A doctor should of course always be sent for when practicable in any injury as severe as a snake bite. Leave your string or bandage in place for an hour. A longer period is unsafe, as cutting off the circulation may cause mortification. Loosen the string or bandage after an hour's time, so that a little poison escapes into the body. If the bitten person does not seem to be much affected, repeat at the end of a few moments, and keep this up until the band has been entirely removed. If, however, the bitten person seems to be seriously affected by the poison you have allowed to escape into his body, you must not loosen the bandage again, but leave it in place and take the chance of mortification.

Wounds Without Severe Bleeding

These const.i.tute the majority of all wounds. Use the Red Cross Outfit as described in the slip contained in the outfit. The pressure of a bandage will stop ordinary bleeding if firmly bound into place.

Wounds With Severe Bleeding

A scout must be prepared to check severe bleeding at once, and he should then dress the wound. Bleeding from an {268} artery is by far the most dangerous. Blood coming from a cut artery is bright red in color and flows rapidly in spurts or jets. As the course of the blood in an artery is away from the heart, pressure must be applied on the heart side just as a rubber pipe which is cut must be compressed on the side from which the water is coming in order to prevent leakage at a cut beyond. The scout must also know the course of the larger arteries in order that he may know where to press on them. In the arm the course of the large artery is down the inner side of the big muscle in the upper arm about in line with the seam of the coat. The artery in the leg runs down from the centre of a line from the point of the hip to the middle of the crotch, and is about in line with the inseam of the trousers. Pressure should be applied about three inches below the crotch. In making pressure on either of these arteries, use the fingers and press back against the bone. You can often feel the artery beat under your fingers, and the bleeding below will stop when you have your pressure properly made. Of course you cannot keep up the pressure with your fingers indefinitely in this way as they will soon become tired and cramped. Therefore, while you are doing this have some other scout prepare a tourniquet. The simplest form of tourniquet is a handkerchief tied loosely about the limb. In this handkerchief a smooth stone or a cork should be placed just above your fingers on the artery. When this is in place put a stick about a foot long under the handkerchief at the outer side of the limb and twist around till the stone makes pressure on the artery in the same way that your {269} fingers have. Tie the stick in position so it will not untwist.

[Ill.u.s.tration: How to apply first aid dressing.]

_Warning_: When using a tourniquet remember that cutting off the circulation for a long time is dangerous. It is much safer not to keep on a tourniquet more than an hour. Loosen it, but be ready to tighten it again quickly if bleeding re-commences.

Another method to stop bleeding from an artery when the wound is below the knee or elbow is to place a pad in the bend of the joint and double the limb back over it holding the pad in tightly. Tie the arm or leg in this position. If these means do not check the bleeding put a pad into the wound and press on it there. If you have no dressing and blood is being lost very rapidly, make pressure in the wound with your fingers. Remember, however, that this should only be resorted to in the case of absolute necessity as it will infect the wound.

Blood from veins flows in a steady stream back toward the heart and is dark in color. From most veins a pad firmly bandaged on the bleeding point will stop the bleeding. If a vein in the neck is wounded, blood will be lost so rapidly that the injured person is in danger of immediate death, so you must disregard the danger of infection and jam your hand tightly against the bleeding point.

Keep the patent quiet in all cases of severe bleeding, for even if it is checked it may start up again. Do not give any stimulants until the bleeding has been checked unless the patient is very weak. The best stimulant is aromatic spirits of ammonia, one teaspoonful in half a gla.s.s of water.

[Ill.u.s.tration: How to apply tourniquet to upper arm.]

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Unconsciousness and Poisoning

Unconsciousness, of course, means lack of consciousness, or, in other words; one who is unconscious knows nothing of his surroundings or of what is happening. A person may, however, be partially, as well as wholly, unconscious.