FIRST AID for PERSONS OVERCOME BY GAS SIXTH EDITION FIRST AID for PERSONS OVERCOME BY GAS ooo SIXTH EDITION 090 Copyright 1905-1910-1914 1915-1921-1924 THE UNITED GAS IMPROVEMENT COMPANY Philadelphia ~RA/z+j ■QkS.U.5 \9 3 .+ ©C1A777250 FEB 23 1924 I 'VvO TREATMENT FOR THOSE OVERCOME BY GAS When persons are affected by illuminating gas, they are in one of three classes: CLASS I. Those slightly affected. CLASS II. Those seriously affected, but still breathing. CLASS III. Those apparently dead, — not breathing. To properly treat these three classes, it is im¬ portant to have on hand the following materials, contained in the Company’s Emergency Gas Kit, as shown in Figure No. 1 : (a) Effervescing phosphate of soda. (b) Aromatic spirit of ammonia. (c) Vaporole aromatic ammonia. (d) A drinking cup. (e) A pair of tongue-pliers. (f) A jaw-block. CLASS I (those slightly affected) Symptoms. —Headache, dizziness, nausea or vomiting, and great drowsiness, with relaxation of muscles, hurried breathing and rapid heart action. This condition is illustrated in Figure No. 2. Treatment.— Carry patient immediately into fresh air, preferably into a comfortably warm room, where there is a free circulation of air, and loosen his collar and neckband. Keep patient well covered to guard against a lowering of body tem¬ perature. Give him a dose of effervescing phos¬ phate of soda in a glass of water, following in five minutes with half a teaspoonful of aromatic spirit of ammonia in a third of a glass of water. This latter dose may be repeated at intervals of fifteen minutes to a limit of four doses. Effervescing phosphate of soda is given to over¬ come nausea, and to act on the patient’s bowels. However, if it is not obtainable, plain soda water will do. Aromatic spirit of ammonia is given as a stim¬ ulant to the heart, which is weakened by the effects of gas. 4 CLASS II (those seriously affected, but still breathing) Symptoms. — Semiconsciousness or uncon¬ sciousness ; patient is very weak and his breathing is rapid and shallow. Treatment. —Send for a doctor at once. Carry the patient immediately into fresh air, as stated in instructions pertaining to Class I cases. In this class of case he is too weak to stand and is unable to swallow. Place him on his back on a flat surface, with a coat rolled (not folded) under the shoulders, in such a way as to allow the head to fall backward far enough to straighten the windpipe, as shown in Figure No. 3; at the same time loosen the shirt at the neck, loosen* the trousers and drawers at waist, loosen garters, loosen or preferably remove shoes, and release any compression that might restrict a free circulation of blood through the arteries and veins or impede respiration, and have assistants rub his legs and arms. The sleeves and trouser legs should be loosely rolled up as far as possible, as shown in Figure No. 3, so that the rubbing may be done on the bare skin and from the extremities toward the body. Friction thus applied is a stimulus to blood circulation; during the rubbing process the flesh also should be gently kneaded. 5 If the patient is unconscious, open his mouth, forcing the jaw if necessary. Note. —If the jaw is rigid, force it open by placing the forefingers back of the bend of the lower jawbone and the thumbs of both hands on the chin, pulling forward with the fingers and pressing jaw open with thumbs, as shown in Figure No. 4. Place the jaw-block, or something similar, be¬ tween the teeth to keep the jaws open and to prevent the patient from biting his tongue, using an object large enough to obviate any danger of his swallowing it accidentally, and grasp his tongue and pull it forward with the tongue pliers, as shown in Figure No. 5, to open the air passage¬ way to the lungs. Then clear froth, etc., from the mouth by put¬ ting in your forefinger as far as possible and bringing up the froth with a scooping motion. Have the assistant who is holding the tongue, crush a capsule of vaporole aromatic ammonia and slowly pass it under the patient’s nose about once a minute as the patient breathes in, as shown in Figure No. 6. Help the patient to breathe by pressing the base of his .r.ibs together every other time he breathes out, as shown in Figure No. 6. Do not press vertically, but press on the patient’s sides (palms of hands over lower ribs), thereby forcing as much air as possible out of the lungs. You will carry out this pressing action most successfully if, on beginning, you rest your hands lightly over 6 the patient’s ribs and let them move inward and outward in unison with the patient’s breathing, and then begin to press hard with every other outgoing breath. Note.— The object of doing this is to strengthen breath¬ ing. By making the pressure every other time the patient breathes out, you give him an opportunity to take a breath himself. This natural effort to breathe is in itself strengthening to the action of the lungs. Continue this pressing action until the patient is conscious and breathing well by himself. The rubbing of the arms and legs, the holding of the tongue and the passing of the ammonia under the nose, all shown in Figure No. 6, should be continued as long as the patient is unconscious. After the patient is conscious, give him half a teaspoonful of aromatic spirit of ammonia in a third of a glass of water, as shown in Figure No. 7. Then shift the coat or pillow from under his shoulders to under his head, and surround him with bottles of hot water, as shown in Figure No. 8. Note. —Empty bottles are easily obtained and should be filled with hot water and covered with paper or cloth to avoid burning. Hot bricks, also covered, or gas bags filled with hot water, may be used. Then cover the patient with a blanket or coats, as shown in Figure No. 7, and watch him, as a relapse may follow, in which event the resusci¬ tation treatment should be repeated. 7 CLASS III (those apparently dead) Treatment.— Send for a doctor at once, in the meantime acting as follows: Carry the patient im¬ mediately into fresh air, as directed in Class I. Open his shirt wide at the neck, loosen his trousers and drawers at waist, and loosely roll up trouser legs and shirt sleeves so that the assist¬ ants can rub the patient’s bare legs and arms. Open his mouth, forcing the jaw if necessary, as shown in Figure No. 4, and insert a jaw-block. Grasp the tongue and pull it forward with the tongue- pliers, having an assistant hold it out, as shown in Figure No. 5. This is necessary on ac¬ count of the tendency of the tongue to swell in cases of gas poisoning. If without tongue-pliers, grasp the tongue between the index and second fingers after they have been covered with a towel or handkerchief. Clear froth, etc., from the mouth by putting in your forefinger as far as pos¬ sible and bringing it up with a scooping motion. Then.place the patient flat on his stomach, the head turned to one side and resting on the hand or forearm, and the other arm extended at right angle to the body, so that breathing through both the mouth and nose will not be interfered with, as shown in Figure No. 9. 8 ARTIFICIAL RESPIRATION After the patient has been prepared as directed, kneel across his back and place your hands over his ribs in such a way that the thumbs, when ex¬ tended, will be about six inches below his armpits and the “heel” of the hands about two inches from the spine. Then swing your body forward so as to allow your weight to fall vertically on your wrists, in this way compressing the body and forcing the air from the lungs, as shown in Figure No. 10. Then swing backward to an up¬ right position, releasing this pressure, as shown in Figure 11. This permits the chest to expand and the lungs to refill with air. Repeat this swinging motion slowly about 12 times per minute, exert¬ ing no more force than is necessary to cause a deep expiration, which can be determined by the sound made by the air escaping from the patient’s nose or mouth. (Be careful not to overdo in this motion. If the pressure is violent, there is dan¬ ger of internally injuring the patient.) Have the assistant holding the tongue slowly pass the vapo- role ammonia under the patient’s nose as the pres¬ sure over the ribs is released, as shown in Figure No. 11, and air is drawn into the lungs. When the patient has begun to breathe by him¬ self, place him on his back and press his sides every other time he breathes out, as described in Class II and shown in Figure No. 6. This should be continued until he breathes naturally. 9 The rubbing and kneading of the legs and arms should continue as long as the artificial breathing or pressing action is necessary, as should also the holding of the tongue and the passing of the am¬ monia under the nose as long as the patient is unconscious, as shown in Figures No. 6 and No. 11. After the patient becomes conscious, give him half a teaspoonful of aromatic spirit of ammonia in a third of a glass of water, as shown in Figure No. 7, and surround with bottles of hot water, as shown in Figure No. 8. Note. —Empty bottles are easily obtained, and should be filled with hot water and covered with paper or cloth, to avoid burning. Hot bricks, also covered, or gas bags filled with hot water, may be used. Then cover the patient with a blanket or coats, as indicated in Figure No. 7, and watch him. In the event of a relapse, repeat the treatment. In applying artificial respiration, if the pa¬ tient shows no signs of corning to life promptly, do not be discouraged, but continue the motions regularly for several hours, summoning such help as may be needed. Cases are known wherein patients showing no signs of life nor response to treatment after an hour’s work have recovered, and the recoveries were due to the persistence of those in charge. 10 Persons affected by gas must have fresh air. Therefore, bystanders should not be per¬ mitted to crowd around the patient, and no one should be allowed to approach him except those carrying out these instructions. Should the articles mentioned on page 3 not be on hand when needed, every effort should be made to revive the patient by following the course of movements described until the doctor arrives and the necessary articles are secured. 11 12 Figure No. 1 , See Page ■■ 13 14 15 Figure No. 4, See Pages 16 Figure No. 5, See Pages 17 Figure No. 6, See Pages 18 Figure No. 7, See Pages ••:v 19 20 Figure No. 9, See Page > > ) > ) > 4 ) ) Figure No. 10, See Page Figure No. 11, See Pages <-> y r »,;y •- •: v * „ . L -' li'.XN: :■ i,v' * ' •• ■ . 1 V ’ • t • - v ‘ v • ■ • • V >**■•■* y V>**‘V • V !