H e C> u H U I n j
7610-010-5*44
THE ELEMENTS
OF FIRST AID
WO Code No
9640
AM Pamphlet No
342
(Reprinted, Modified for Australia, 1959)
HOME OFFICE
SCOTTISH HOME DEPARTMENT
WAR OFFICE AND AIR MINISTRY
British Crown Copyright reserved. Reprinted with permission of
the Controller of Her Britannic Majesty's Stationery Office, London.
This booklet has been prepared by the ARMY MEDICAL
in consultation with the Home Office, the
Scottish Home Department, the Air Ministry, the Ministry
of Health, the Department of Health for Scotland, the
St John Ambulance Association, the St Andrew's Ambulance Association and the British Red Cross Society.
It is authorized by THE ARMY COUNCIL for use by all
military units and establishments.
SERVICES
HOME OFFICE
SCOTTISH HOME DEPARTMENT
WAR O F F I C E AND AIR M I N I S T R Y
The Elements of
First Aid
(Reprinted, Modified for Australia, 1959)
LONDON
HER MAIESTY'S STATIONERY OFFICE
1957
Amendments
Amendment
number
By whom amended
Date of
insertion
Contents
Foreword
Chapter I
II
III
IV
V
VI
VII
VIII
IX
X
XI
XII
XIII
INTRODUCTION
HOW THE BODY IS MADE
SHOCK
BLEEDING
How to apply a dressing
WOUNDS OF THE CHEST AND
ABDOMEN
UNCONSCIOUSNESS
Drowning
Poisons
Electric shock
Suffocation
Coal Gas Poisoning
ARTIFICIAL RESPIRATION
BROKEN BONES
Crush Injuries
Bandages and Slings
SPRAINS AND DISLOCATIONS
BURNS
NUCLEAR WEAPONS ....
WAR GASES
OTHER EMERGENCIES
CONCLUSION
INDEX
Page
1
1
7
8
11
12
16
19
25
26
27
27
29
31
32
Foreword
•
This book on First Aid is not meant for stretcher
bearers or medical orderlies alone. It is meant
for all ranks; read it. You never know, one day
it may save your life or your comrade's.
Remember, when a man is injured, either in
war or peace, there is rarely a doctor on the spot.
You must, therefore, be able to treat yourself or
one of your friends until medical help is available.
It is all very easy if you know how. This little
book tells you how.
If there is anything you don't understand, ask
your medical officer.
ii
I. Introduction
1. First Aid is simple. It means treatment on the spot
before the patient sees the doctor.
To be able to give adequate treatment you need a little
knowledge of the body and how it works.
You need to keep calm.
You need only to use your common sense.
You need to act.
Nothing more and nothing less.
You don't need fancy tools or fancy kit, but you DO
need to keep calm, to think, to use your common sense,
and then to act.
Don't be afraid of getting other people to help. Tell
them what to do. Send one off to get a doctor. Send
another for a bandage, and so on. Don't all stand around
talking.
Don't forget you can always improvise. A flat piece of
wood makes an excellent splint. A handkerchief a useful
dressing.
Above all don't forget the injured man. Talk to him.
Try and cheer him up. Ask him what happened. This
will help him and you.
But before learning treatment you must know a little
about the body.
II. How the Body is Made
and How it Works
2. The human body is built on a framework of bones.
This framework is the skeleton (fig 1).
The bones are joined together by joints. Joints are
made like door hinges, and they act like door hinges.
They allow the bones to move to and fro.
The main prop of the skeleton is the backbone. This
bone is made up of short sections and looks something
like a bamboo cane.
Fixed to the top of the backbone is the skull. This is a
box made of bone. Inside the backbone is the spinal
1
SKULL
JAW
COLLAR BONE
2 ® M
NECKBONES
tOWER
Fig 1.
The Human Skeleton
cord. Inside the skull is the brain. The spinal cord
connects with the brain through a hole in the base of
the skull. There is a hole in the skull for the nose.
There are two holes at either side for the ears. There
are two sockets for the eyes.
The jaw-bone is hinged at either side and swings underneath. The teeth are fixed into the jaw-bone below and
the skull above.
The ribs are joined behind to the backbones. In front
the ribs are fixed to the breastbone. There are twelve ribs
on either side. They move up and down when you
breathe.
The collar-bone is joined in front to the breastbone.
At the shoulder the collar-bone is joined to the shoulder
blade.
The shoulder blade is flat. It is slung to the backs of
the ribs by muscles. At the shoulder it forms a shallow
socket for the rounded end of the upper arm bone.
In the upper arm there is only one bone. In the
forearm there are two bones. The two forearm bones are
joined to the upper arm bones by the elbow joint. The
two forearm bones are joined by the wrist joint to the
hand.
The hand and wrist are made up of a lot of small
bones.
The hip bones form a girdle called the pelvis. This is
joined to the bottom of the backbone.
Hinged to the pelvis at each side are the thigh-bones.
They are the biggest bones in the body.
The thighbones are joined by the kneejoint to the two
legbones.
In front of the kneejoint is a small bone called the
kneecap.
The small bones which form the foot are joined to the
two leg bones by the ankle joint.
3
Fig 2. The Intestines
3. The muscles are fixed to the bones. They are the red
meat you buy at the butcher's. They provide the power
to move the bones.
The muscles are controlled by nerves. These nerves
look like white threads. The nerves go from the brain
down the spinal cord and then out to the muscles.
The muscles are covered by a layer of fat.
The layer of fat is covered by the skin.
4
All these bones and muscles must be supplied with
oxygen to keep them alive. This oxygen is carried
around to the various parts of the body by the blood.
The blood gets the oxygen from the lungs. The lungs
get the oxygen from the air. This is why we must breathe
air to keep alive.
4. The heart and lungs are protected by a cage formed
by the ribs. The rise and fall of the chest in breathing
enables air to pass in and out of the lungs. In the lungs
the oxygen of the air passes into the blood stream.
The liver, kidneys and bowels are protected by the
backbone behind. In front they are protected by the
abdominal wall, which is made of muscles (fig 2).
The pelvis, which is made of bones, protects the
bladder and the back passage (fig 1).
5. How the blood goes round (fig 3).
The blood travels round the body in tubes, or vessels.
It is pumped into the tubes by the heart. The tubes are
of two sorts.
The tubes carrying blood away from the heart are
called arteries. The tubes which take the blood back
to the heart are called veins.
The veins often run by the side of the arteries.
The small blood vessels joining the arteries to the veins
are called capillaries. They are present throughout the
body. The blood continually flows round the body in
these tubes, collecting oxygen as it flows through the
lungs.
The position of the arteries is very important. They are
quite easy to find and you can feel them thumping with
your finger. This thumping is caused by the blood being
pumped round by the heart. It is called the pulse and
can be felt at the wrist. Its normal speed is 60 — 80
beats per minute.
A pressure point is a place where an artery is near the
surface and passes over a bone. The blood flow in the
part may be stopped by pressing here (fig 3).
5
Fig 3.
The Circulation of
the Blood
The black spots denote
the Pressure Points
CAROTID
BRACHIAL I
BRACHIAL II
FEMORAL
III. Shock
6. Any injury to the body will cause shock of greater or
less degree. This can be a serious condition which by
itself may kill the patient.
Bad news or an unpleasant sight may also cause sb jck.
How to recognize a shocked patient:
(a) He will be pale and clammy.
(b) His pulse at first may be slow, later will be fast
and faint.
(c) He will look frightened and may be shivering.
TREATMENT:
(a) Remove him from danger.
(b) Rest him. Lay him down. Put something
under his head.
(c) Reassure him.
(d) Keep him comfortable. Put blankets or coats
above and below him and protect him from the
weather.
(e) Don't use hot water bottles.
( / ) Don't give him spirits.
(g) Don't give him fluids except in the case of
BURNS
CRUSH INJURIES
DELAY IN EVACUATION
(h) Take great care in handling him.
(/) Treat his injuries.
(*) Get him off to hospital as quickly as possible.
There are three things that kill:
1. STOPPAGE OF BREATHING.
2. BLEEDING.
3. SHOCK.
7
IV. Bleeding
7. A man with severe bleeding always suffers from
shock. Sometimes a man may bleed internally. He may:
(a) COUGH UP BLOOD;
(b) VOMIT BLOOD;
(c) PASS BLOOD BY THE BACK PASSAGE.
Blood may not appear externally. It is difficult in
these cases to stop the bleeding. The important thing
is to treat the shock.
8. How to stop external bleeding
(a) GRAZES or small cuts soon stop bleeding.
Apply a dry dressing.
(b) DEEP CUTS continue to bleed. The first thing
to do is to raise the part. For example, if the
finger is bleeding then raise the hand in the air.
This will stop or slow the bleeding. The next
thing to do is to put a standard dressing (a clean
cloth or handkerchief will do) on the wound
(fig 4). Now press on it firmly and bandage it
in place, but not too tightly. In most cases the
bleeding will stop. (If you have tied it too
tightly, the part below the bandage will go blue
and the man will complain of pins and needles
in the part.)
(c) IF THE BLEEDING CONTINUES, press on
the nearest pressure point above the wound
(fig 3). After 10 minutes stop pressing. The
bleeding by then may have stopped.
(d) IF ALL THIS DOES NOT WORK, and you
cannot stop the bleeding, then you will have to
put on a tourniquet. But remember this —
A tourniquet is a last desperate effort. Use a
tourniquet ONLY if you have tried everything
else and failed, or if the man has lost a limb.
9. To put a tourniquet on
(a) Use a handkerchief, bandage or any piece of
soft strong material. Tie it with a half-knot
8
fig 4. Applying a Standard Dressing to a Wound
9
just above the wound and over his shirt or
underwear if possible. Do not use a piece of
string which is narrow and cuts the flesh.
(Z>) Next put a stick over the half-knot. Then
complete the knot over that.
(c) Twist the stick round and round until the
bleeding stops — BUT NO MORE.
(d) Fix the stick in position with a bandage.
(e) Do not cover the tourniquet with anything.
( / ) Always tell stretcher bearers or doctor that the
patient has a tourniquet on.
(8) If you have a pen or pencil write a T on his
forehead and the time, eg, T 0940 hours.
Bleeding as a rule occurs straight away; but sometimes
especially after a serious wound, it may re-start several
hours later. Be on your guard for this.
10. Summary — How to stop bleeding
{a) Raise the part; apply a firm dressing to the
wound.
(b) Apply pressure to the nearest pressure point.
(c) In desperate cases use a tourniquet.
{d) In battle conditions the urgency of the situation
is such that once a tourniquet has been applied
it is safer not to loosen it — to leave it on. If,
however, the patient's removal to hospital is not
going to be delayed, it may be advisable
to loosen the tourniquet carefully for a few
seconds every 15 or 20 minutes if you have been
taught to do so.
11. Bleeding in Special Places
(a) WOUNDS OF SCALP — Apply pressure with
fingers and hands on the edges of the wound,
best of all over a dressing. Later a tight
bandage round the head will close the lips of
the wound. Sit the patient up.
10
(b) WOUNDS OF THE TONGUE AND LIPS —
Put the cut edges together and press them
between the finger and thumb.
(c) BLEEDING TOOTH SOCKETS — Pack a wad
of handkerchief inside the mouth over the
bleeding socket and make the patient bite on it.
(d) BLEEDING NOSE —
(i) Pinch the nose firmly between the finger
and thumb at the junction of the hard and
soft parts. If this does not work get the
patient to bite on a cork or rolled up
handkerchief while still pinching the nose,
thus breathing through the mouth.
(ii) Do not lay the patient down. Always sit
or stand him up.
V. Wounds of the Chest and Abdomen
12. Chest Wounds
Often in a battle a man has a hole blown in his chest.
Air is sucked through the hole into the chest. This is
most dangerous. These wounds are known as SUCKING
WOUNDS.
TREATMENT
Plug the wound with a shell dressing or anything
you've got. Even a piece of shirt will do. Don't
give the patient anything to drink. Put him in the
position in which he feels most comfortable. This
may be propped up or lying on his injured side.
Evacuate him quickly.
13. Wounds of the Abdomen
These are very dangerous wounds too.
TREATMENT
Raise the patient's knees. Cover the wound and any
protruding gut with a dressing. Do not give him
anything to drink. Just moisten his lips with water
or give him a wetted handkerchief to suck. Do
not try to push the gut back.
11
This injury, together with internal bleeding which may
occur, produces severe shock. Evacuate quickly.
VI. Unconsciousness
14. An unconscious man is in a state resembling sleep.
Sleep is a natural form of unconsciousness from which
one may be easily roused. In unnatural or dangerous
forms of unconsciousness a man may be completely
unrousable, or may be roused only with difficulty. A
man who is knocked out in the boxing ring is unconscious.
So is a man who faints on the parade ground.
There are many causes of unconsciousness. For
instance, a blow on the head, an epileptic fit, too much
beer or spirits or certain diseases.
TREATMENT
Lay the man down in the coma position as shown
in fig 5. This position is the best for all unconscious
people because it keeps the tongue from falling back
into the throat and prevents vomit from running
into the windpipe and causing choking.
Remove his false teeth, if any, tie them in a handkerchief and put them in his pocket. Loosen the
clothing around his neck and waist. Make him
comfortable. Do not try to give him drinks. Get
him to medical aid as quickly as possible. If his
breathing stops apply artificial respiration.
15. Drowning
When a half drowned man is taken from the water he
may seem to be dead. He may not be breathing. You
may not be able to feel his pulse. But, unless he is quite
stiff, you must try to revive him however hopeless it
might appear.
TREATMENT
Waste no time. Every second counts.
Lay him face down. Quickly remove false teeth,
or any other obstruction such as seaweed. Loosen
the clothing round his neck but don't bother to
remove clothing.
12
Fig 5. The Coma Position
Lift his hips from the ground for a few seconds to
drain water from his windpipe and lungs. Start
artificial respiration. Remember you may have to
keep this going for many hours. Meanwhile send
for medical aid.
(For details of Holger Nielson method of artificial
respiration see Chapter VII)
16. Poisons
Some poisons, for instance an overdose of sleeping
tablets, cause unconsciousness. Some, like strong acids or
alkalis, burn the stomach and intestines. In these cases
you may see burns round the mouth and there is a pain
in the chest and region of the stomach.
TREATMENT
If at all possible get the patient to a doctor quickly.
If he is conscious and has swallowed an acid or
caustic alkali, give him plenty of water or milk to
drink. In all other poisons make him vomit by
giving him two tablespoonsful of salt dissolved in a
cup or glass of water.
If he is unconscious do not try to give anything by
the mouth. If his breathing has stopped start
artificial respiration immediately. It is important to
keep any container which may have held poison
and send it to the doctor with the patient.
17. Electric Shock
An electric shock may kill a man. He may become
unconscious and stop breathing. Where the live wire
touches him he may be burnt. To remove a casualty
from a live wire act as follows:—
If you cannot switch off the current, INSULATE
YOURSELF FIRST.
If possible stand on some dry rubber, dry lino, dry
bricks, dry wood, or dry straw. You MUST protect
your hands. Use a folded newspaper, dry clothes or
a rubber raincoat or groundsheet and pull him away
from the current.
14
If you cannot do this then try and push him away
from the current with a stick.
DO NOT use anything made of metal or you will get
a shock too.
Once clear, if he is not breathing, quickly start
artificial respiration. Keep this up even if he seems
dead. It may take many hours to get him round.
After recovery treat for shock. Treat burns in the
usual way.
18. People struck by lightning
Treat as above but remember other injuries may be
present.
19. Strangulation — Suffocation
People who have been strangled or suffocated go blue
in the face. They may froth at the mouth. The veins
in the head and neck will stand out. The eyes may be
bloodshot.
Remove the cause, such as a cord around the neck.
Look inside the mouth, remove false teeth and pull the
tongue forward. Give artificial respiration. Treat for
shock.
20. Choking
If a man swallows a piece of food or foreign body
and it goes down the wrong way, it may stick in the
entrance to his windpipe and choke him. Children sometimes swallow boiled sweets and choke in this way,
TREATMENT
Quickly bend the patient over and thump him on the
back. The best thing to do is to lay the patient over
the seat of a chair. If a child, lift up by his heels —
the marble or sweet should fall out of the windpipe.
21. Coal Gas Poisoning or Carbon Monoxide Poisoning
Coal gas is used in domestic stoves and is often used by
people who want to commit suicide. To get a man out of
a gas-filled room you must be quick. Hold your breath
15
and run in as fast as you can, keeping low. Get the man
into the fresh air. His face may be a cherry-red colour.
Apply artificial respiration immediately. Treat for shock,
keeping the patient warm. Don't forget, your respirator
does NOT protect you from carbon monoxide.
VII. Artificial Respiration
22. How to do Artificial Respiration by the Holger
Nielson Method (Fig 6).
A. (a) Begin at once. Every second counts. Lay the
patient face downwards with arms bent and
forehead resting on his hands. Make sure the
patient's mouth and nose are free from sand and
other debris. To keep his mouth and nose free
from obstruction it may be necessary to turn his
head slightly to one side. If on sand or soft
ground put a handkerchief or other material
under the head and hands.
(6) Give one or two firm thumps with the flat of the
hand between the shoulders to bring the tongue
forward and clear the throat.
(c) Kneel at his head, placing one knee near the
head and the other foot alongside the elbow.
The operator's mid-line should be in line with
that of the patient.
From time to time this position can be altered
by changing the kneeling knee.
(d) Place your hands on his shoulder blades with
thumbs parallel to and touching on the mid-line
and fingers pointing towards the casualty's feet,
your arms being kept straight and the heels of
your hands over the tops of the shoulder blades.
B Bend forward with arms straight and apply light
pressure by the weight of the upper part of your body
while steadily counting "one, two and three". Time, 2i
seconds. This forces the air out of the lungs. (Expiration.)
16
C (a) Release the pressure gradually and slide your
hands to just above the elbows of the casualty,
counting "four." Time, 1 second.
(b) Draw his arms and shoulders towards you by
bending backwards with your arms straight till
you feel resistance and tension, without lifting
the chest off the ground, counting "five, six and
seven". Time, 2i seconds. This draws the air
into the lungs. (Inspiration.)
D Lay his arms down and replace your hands on the
shoulder blades counting "eight". Time, 1 second.
E Repeat the movement with rhythmic rocking at the
rate of approximately 9 times to the minute, counting as
follows:—
"One, two and three"', with hands on shoulder blades,
bend forwards and apply pressure (2i seconds);
"Four"-, slide hand on to elbows (1 second);
"Five, six and seven": bend backwards raising arms
and shoulders (2i seconds);
"Eight"-, lay arms down and place your hands on
shoulder blades (1 second).
F When breathing begins again stop the back pressure
and continue the arm raising and lowering alone at the
rate of 12 times to the minute, counting as folloWs:—
"One, two and three"-, arms raising (inspiration,
2i seconds);
"Four, five and six": arm lowering (expiration,
2i seconds).
G (a) If there are chest injuries, do the arm raising
and lowering procedure only, at the rate of 12
times a minute.
(b) If there are arm injuries, place arms at sides of
body. Press on shoulder blades in normal way
(expiration). Place your hands under casualty's
shoulders and raise (inspiration).
18
(c) If arms and chase are both injured, place your
hands under the casualty's shoulders and raise
and lower for inspiration and expiration.
H The amount of pressure you can safely put on the
shoulder blades varies. For an adult 24 to 30 pounds is
correct. For slender women, and half-grown children
12 to 14 pounds is enough.
For infants it is best to place the casualty on a table
with the arms by the side and stand at his head. Then
press on the shoulder blades with the thumbs and raise
the shoulders with the fingers. The speed should be 15
times a minute, and the pressure no more than 2 - 4
pounds.
It is essential to practise correct pressure by using a
weighing machine such as is found in a bathroom, or a
modified spring balance. It is very easy to press too
hard, and if you do, it may cause damage. Even 30
pounds does not require much pressure.
3 Never stop artificial respiration until the casualty has
started to breathe normally, or until a doctor says he is
dead. Go on for two hours or more if necessary.
After recovery transport him to hospital lying down.
t
VIII. Broken Bones and How to Treat
Them
23. How to tell when a bone is broken
A broken bone is a painful injury causing shock. The
man cannot usually move the injured part. The site of
the break will be painful to touch. The limb may be
crooked and swollen. Sometimes the skin over the break
may be torn, a jagged piece of bone may protrude.
GENERAL
TREATMENT
The first thing to do is to relieve the pain and so
relieve the shock. You can relieve a lot of pain by
good treatment. When you treat a broken bone you
must support it and stop the broken ends moving
about. Never try to set it, and move it as little as
19
possible. If you see a bit of bone pushing through
the skin, don't push it back. Just put on a dressing.
Be very gentle in handling broken bones. Movement
of the broken ends increases pain and shock.
24. Broken Collar Bone, Upper Arm Bone, Lower Arm
Bone and Broken Bones of Hand and Fingers
All these bones can be broken by direct blows with a
weapon, or by falling on the outstretched hand.
The simplest first aid treatment for all these is to put
the arm in a sling. Use a triangular bandage. Always
make sure the patient feels comfortable.
25. Broken Ribs
These are broken by a blow on the chest.
TREATMENT
Place the arm on the injured side in a sling. If blood
is coughed up it means the lungs have been injured.
Sit the patient up on a stretcher and take him to
medical aid.
26. Broken Backbone or Spine
The backbone is broken by a fall from a height or a
heavy blow on the back or neck. Sometimes the arms
or legs will be paralysed below the level of the injury.
TREATMENT
If you think a man has broken his backbone do not
move him unless it is absolutely necessary. Reassure
him. Call the doctor to him as quickly as you can.
But above all, do not move him unless you really
have to. If you must move him, do as follows:—
Remove all hard articles from his pockets. If you
have time strap the arms to the side. Place some
padding between knees and ankles and strap the
ankles, legs and thighs together (two or more
anklets joined together are useful for this).
The man with the broken back should be treated
and moved in the position in which he is found.
Place a rolled blanket on one side of him and very
20
Fig 7. The St John Sling. Used for broken collar-bone
Fig 8. The Greater Ann Sling
gently and carefully work or unroll it underneath
him. Use the blanket to lift him on to the
stretcher very carefully, as in one piece. DO NOT
BEND OR TWIST HIS BACK. If he is lying
on his face, place him on the stretcher on his face.
If he is on his back, place him on the stretcher
on his back.
If his neck hurts place him on the stretcher on his
back (carefully rolling him over in one piece if
necessary) and support his head on each side
with pillows or rolled-up clothing. If his neck
does not hurt, you can turn his head on one side.
27. Broken Thighbone
This bone is often broken in car accidents or by
awkward falls.
TREATMENT
First place the limbs together by pulling the ankle
gently downwards. Whenever possible move the
uninjured leg toward the broken one. Place padding
between the ankles and knees. Then tie the ankles
together. Put a long piece of wood on the outside of
the broken limb from the armpit to the heel. Then
tie both legs to the piece of wood with bandages
at the ankles, knees, thighs and chest. If you have
not got a piece of wood long enough tie the legs
together at the ankle, knees and thighs.
28. Broken leg bones
The leg bones are usually broken by direct blows, for
instance, motor cycle accidents. The prominent lower
ends of these bones form part of the ankle and are often
broken if the ankle joint is twisted.
TREATMENT
Place the legs together after padding between ankles
and knees, and then tie them at the ankles. Put a
piece of wood on the outside of the broken leg from
the heel to above the knee. Then tie both legs to the
piece of wood with bandages at the ankle, above and
below the break and above the knee.
22
If you have not got a piece of wood long enough tie
the legs together at the ankles above and below the
break and above the knee.
29. Injuries to the Knee
These may be due to blows on the knee, or awkward
falls without the knee being struck.
TREATMENT
If the knee straightens without pain place padding
between ankles and knees and tie the feet together.
Put a board behind the knees and fix it to the leg
with bandages at the ankle, above and below the
knee, and at the thigh.
If the knee cannot be straightened as above, fix it in
its position by bandaging a board or stick to the
side of the leg and thigh to prevent movement.
30. Broken Skull
Broken skulls often occur with head injuries.
A swelling or bruise on the upper part of the head may
mean a fracture of the bone underneath.
The brain rests on the base or bottom of the skull
which may be broken in very severe head injuries. Blood
may run from the nose, the ear holes or the mouth, and
the eyes may be bloodshot. A large bruise may develop
behind the ear.
A man with a head injury may be unconscious.
Unconscious patients require special treatment to be sure
that there is no obstruction to the breathing. An
unconscious man is placed on a stretcher in the coma
position and taken to medical aid. The coma position
was described in the Chapter on unconsciousness.
31. Broken Lower Jaw Bone
This bone may be broken by a direct blow or by a
missile. There will be a swelling of the jaw over the
break. The patient will have difficulty in moving his jaw.
There will be bleeding from the gums. The teeth may
be out of line. He may have difficulty in swallowing,
and blood and saliva may dribble from the mouth.
23
Whole-cloth
The Right Way
(Reef knot)
/
A
\
'
The Wrong Way
In severe cases the tongue may fall back into his throat
and choke him.
TREATMENT
If his tongue is choking him pull it forward using
a handkerchief. Support his jaw with a bandage tied
over the top of his head. Make sure it does not slip.
Take him to the doctor as a walking case if he is
able to walk. The best way of doing this is to place
his hands on the shoulders of the man in front and
walk him with his head down.
24
If he cannot walk place him face down on a stretcher
with his forehead resting on a broad bandage or slig
tied between the handles of the stretcher.
32. Points to remember
Your aim is to relieve pain by stopping the broken ends
moving about.
BE GENTLE.
DRESS WOUNDS FIRST.
USE PADDING WHERE
NECESSARY.
TIE BANDAGES FIRMLY, WITH A REEF
KNOT.
GET THE AMBLUANCE TO DRIVE SLOWLY.
ADJUST BANDAGES IF THEY GET TOO
TIGHT.
33. Crush Injuries
These occur when casualties are pinned beneath heavy
objects (debris for example) for a long time. The
affected limb is swollen and bruised.
In these cases the general rule of "no fluids" should be
relaxed and provided the casualty has no abdominal
injury he should be given two pints of water to drink.
If you can get hot tea or coffee, this can also be given.
IX. Sprains and Dislocations
34. Sprains
Bones meet as points where movement occurs. The
bones at a joint are held together by tough bands called
ligaments. A sprain is a torn ligament. Sprained joints
are painful and swollen.
TREATMENT
It is difficult to be sure a bone is not broken. Treat
a sprain as you would a fracture, eg, sprained ankle:
apply a firm supporting bandage and transport on a
stretcher.
25
35. Dislocations
A dislocation occurs when the bones of a joint are out
of place.
Never try to put the joint back in place. This is a job
for the doctor. If the shoulder joint is dislocated apply
a sling to take the weight of the arm and forearm.
X. Burns
36. (a) Burns and Scalds. Burns are caused by dry heat,
for example fire. Scalds are caused by wet heat,
for example boiling water or steam.
TREATMENT
Burns cause severe shock. Treat the shock.
Cover the burn with a clean dry dressing.
Never apply ointment, oils, or lotions to
burns. If the burn is on the face, cover it
as far as possible to keep out dirt. Do not
touch the burn. Cut the clothing if need be.
Do not prick or burst the blisters. Get
medical aid quickly. Treat scalds in the
same way.
(6) Electric Burns. Treat as above. But remember,
if he is not breathing, give artificial respiration
FIRST.
(c) Phosphorus Burns. Phosphorus is contained in
incendiary bombs and is widely used in industry.
TREATMENT
Flood the burns with water. Remove the
pieces of phosphorus with a wet cloth. Place
a very wet cloth or dressing over the burns,
and keep it wet.
(d) Acid or Alkali Burns. Flood the burns with
water and apply a dry dressing.
26
XI. Injuries Due to Nuclear Weapons
37. Following a nuclear explosion four types of injuries
may happen. They are —
(a) Blast Injuries. Treat these in the normal way.
(Chapter XIII, para 49.)
(b) Ordinary Injuries. From falling buildings, and
so on, Treat these in the usual way.
(c) Burns. There will always be a very large
number of burn cases. They will be of two
kinds.
(i) Flashi Burns. These are caused by the
flash from the explosion, and like sunburn, may not appear until some time
after.
(ii) Flame Burns. These are caused by the
heat of the explosion or by fires started by
it.
TREATMENT is as for any burn.
(d) Radiation Sickness. This is caused by the
gamma rays given off by the bomb. It causes
diarrhoea, vomiting and headache. The patient
will feel unwell.
TREATMENT
If the patient feels able to carry on, then let
him. Severe cases should be treated for shock
and sent off to hospital.
Xn. War Gases
38. Choking gas
Chlorine and phosgene are examples of this type of
gas.
These gases cause running eyes and nose, irritation of
the throat with a painful cough, tightness of the chest
with hard and painful breathing. In severe cases the
patient will be very shocked and fighting for his breath.
27
He may cough up blood-stained or watery froth. With
proper treatment few cases will die from choking gas.
TREATMENT
Rest the patient and sit him up to help his breathing.
Keep him warm. Reassure him. Don't allow
smoking or spirits. Don't give artificial respiration.
Get him to a doctor quickly.
39. Blister Gas
Mustard gas is a blister gas. It smells of onions. It is
a liquid which gives off a vapour. The vapour makes the
eyes sore and the eyelids swell. A gassed man will have
a painful cough. Skin exposed to liquid or vapour will
turn red and will blister.
TREATMENT
Remove the liquid from the skin with cotton wool
or a cloth.
Rub anti-gas ointment on the skin — or if no ointment is available, wash the skin with soap and water.
Don't puncture the blisters. Cover them with a dry
dressing or cloth. Carry out. personal cleansing
measures.
If liquid blister gas enters the eye — rapidly wash out
with plenty of water. Put on a bandage. If the eyes
have been affected by blister gas vapour don't wash
them out. Put on a bandage. Reassure the patient
and get him to the doctor.
40. Nerve Gas
These gases are colourless liquids and have no smell.
They are quick-acting deadly poisons. They cause headache and running nose and affect the sight. A large dose
will cause sickness and stop breathing by paralysing the
muscles.
TREATMENT
Apply the respirator. Inject Atropine (if it has been
issued to you) into the outside of the thigh. Give
artificial respiration if breathing stops.
28
41. Tear Gas
The eyes and nose run; in fact, is just makes you cry.
TREATMENT
Flush the eyes with water. Put on the respirator.
XIII. Other Emergencies
42. Pain in the Abdomen
A very bad pain in the region of the stomach may be
caused by appendicitis, ulcers and the like.
TREATMENT
Lay the man down. Apply a. covered hot water
bottle to the abdomen but be quite sure that it isn't
so hot that it will burn him. Do not give drinks
or food. Do not give any opening medicine. If he
is thirsty moisten the mouth with sips of water only.
Raise his knees — this may help to relieve the pain.
Get him to a doctor quickly.
43. Burns and Scalds of the Eye and grit in the eye
Burns and scalds of the eye can cause blindness. They
are very serious.
TREATMENT
Wash out the eye thoroughly with clean water, with
the patient seated, tilt the man's head backwards and
gently pour water into the eye at the edge nearest
the nose.
Next cover the eye with a pad or clean handkerchief
and bandage and get him off to a doctor. Warn the
patient never to rub his eye as this will make it
worse.
44. The Ear
If a man gets something solid in his ear never try to
get it out. This is a job for the doctor.
If he has an insect in the ear, put in several drops of
any pure oil (but not paraffin oil). This will kill it and
may float it out of the ear hole. If it does not, get the
patient to a doctor.
29
Index
para
para
4 Insensibility, see
Abdomen
'Unconsciousness'
13
wound of
34
Ankle
31
Jaw,
broken
24
Arm, broken
34, 35
5 Joints, injuries of
Arteries
28
2 Leg, broken
Backbone
26 Muscles
Back, broken
3
....
. 46, 47
Bites
7 Neck, broken, see
Bleeding
8
control of
'Back, broken'
5
Blood, circulation of ...
11
bleeding
36 Nose
Burns
37
Nuclear weapons
21 Pelvis
Carbon monoxide
2
12 Poisoning
Chest, wounds of
16
24 Pressure points
Collar-bone, broken ...
10
Convulsion, see 'Fits'
37
Cranium, see 'Skull'
Radiation injuries
Respiration, artificial .... 22
39
Decontamination
25
35 Ribs, broken
Dislocation
8 Scalds
36
Dressings
15 Shin-bone, see 'Leg'
Drowning
6
44 Shock the
Ear
2
45 Skeleton,
rupture of eardrum ..
30
Skull,
broken
17
Electrocution
Spine, see 'Back*
Epilepsy, see 'Fits'
34
43 Sprains
Eye
Stomach, see 'Abdomen'
Stroke,
see
14
Fainting
'Unconsciousness'
14
'Fits'
28 Thigh-bone, broken
Foot, broken
27
24
Forearm, broken
9
....
48 Tourniquet
Frost Bite
14-21
Unconsciousness
... 38-41
Gas, War Gases
21 Veins
5
Coal gas .... '
Vertebral column, see
Haemorrhage, see
'Back bone'
'Bleeding'
Hand, broken
24 Wounds, bleeding
.... 7-10
Head Injury
30
chest or abdomen .... 12-13
Heart
5
dressing of
8
Hip, broken
27 Wrist, see 'Arm'
Hydrogen Bomb, see
'Nuclear weapons'
32
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