A Compendium of Useful Information for the Practical Man/Medical Emergencies
The patient is usually wholly insensible. The breathing may be very faint or have ceased entirely, the face is often purple and swollen, and the lips livid- Yet all these signs are not always present, especially in cases where the suffocation is due to exposure of gas.
WHAT TO DO
It is hardly necessary to say — first remove the cause of the suffocation. Take the person out of the water, cut the rope, remove the food item. Even if hours have passed, do not hesitate to act promptly, cases of resuscitation have occurred after the lapse of several hours, not only in apparent drowning, but when suffocation has been due to other causes. For any case of suffocation, proceed as follows:
Dash cold water into the face, give the patient a sudden slap on the pit of the stomach, and hold ammonia under the nose. If these simple means are not sufficient to restore breathing, try artificial respiration by the following method, known as Sylvester's, and usually regarded as the most successful.
The chest is first made to expand, causing the air to he taken in just on the principle that a pair of bellows fills with air when opened. Then the chest is made to contract, its capacity for holding air is reduced, and the air is forced out. By causing these two movements to be performed alternately, we have first inspiration and then expiration, the two together constituting respiration or breathing. Wrap the finger in one or two thicknesses of a handkerchief, and wipe out the mouth and back of the throat; then place the patient on his back with the shoulders resting on a roll of clothing, which should raise them sufficiently to let the head fall back and rest on the ground or floor. Then let some one seize the tongue with a dry handkerchief and draw it forward to leave the passage to the windpipe free. If there is no one to perform this office, draw the tongue well out and tie it against the lower teeth, by laying the centre of a dry strip of cloth on the tongue, crossing it under the chin, carryine the ends around the neck and tying them at the side of the throat. Or, if a rubber band is to be had, slip it over the tongue and under the chin.
Next kneel behind the unconscious person, grasp the arms just above the elbows, draw them up over his head, rather quickly, but steadily, until his hands touch the ground or floor above his head. This should be done in the time needed to count one, two. The movement expands the chest and permits the air to enter the lungs. Next lower them so that the elbows will come to the sides, and the hands cross on the pit of the stomach, and press them gently but strongly against the sides and chest. Do this in the time needed to count three, four. The movement forces the air out of the lungs. Continue these two motions—which constitute artificial respiration—very deliberately about twelve or fourteen times a minute. Do not stop until the patient breathes naturally, or until life is undoubtedly extinct.
If the patient makes an effort to breathe, even though only a gaep, wait a moment to see if he will breathe again, if not, renew the artificial respiration, but it should now be timed by his efforts to breathe. Also, when efforts at breathing commence, try putting hartshorn to the nose, dashing cold water on the patient, and slapping.
During the continuance of the movements to produce artificial respiration, the chest may be gently rubbed with warm flannel
Artificial respiration should be kept up for an hour and a half, even if there is no sign of life, or until a physician has pronounced that life is extinct.
Failure to detect any pulse at the wrist, or to distinguish the beating of the heart by inexperienced persons, gives no certain proof of the presence of death.
As soon as natural breathing is established, the patient should be placed in a warm bed, with hot water bottles or hot bricks at each side of the body, between the thighs, under the arm-pits, at the soles of the feet and on the pit of the stomach. Use friction and warmth of all kinds till the vitality is fully restored. As soon as possible—when the patient can swallow—give warm drinks—hot tea or coffee, or whiskey and water, one teaspoonful at a time. If difficulty in breathing obstinately continues, put a large mustard plaster on the chest.