Chapter XVIII: Section XI: The Scout Aide (4)

In carrying a weight in the water, carry it low on the body, close to the waist line, leaving one hand and both feet free for swimming. Or if for any reason it is necessary to swim on the back, it leaves both feet free to use as propellers.

ARTIFICIAL RESPIRATION

If the apparently drowned person is to be saved, no time must be lost in the rescue from the water or in getting the water out of him, and breathing re-established after he is brought to land.

If there is a messenger handy send for a doctor at once, but in the meantime lose no time in attempting restoration.

The best method for getting the water out of the lungs and breathing re-established is the _Schaefer Method_, because it is the simplest, requiring only one operator and no equipment. It can be kept up alone for a long time.

1. Every moment is precious. Immediately lay the patient face downwards, with the arms extended above the head and the face to one side. In this position the water will run out and the tongue will fall forward by its own weight, and not give trouble by falling back and closing the entrance to the windpipe. Be sure there is nothing in the mouth, such as false teeth, gum, tobacco, etc. Do not put anything under the chest. Be sure there is no tight collar around the neck.

2. Kneel astride of the patient facing toward his head.

3. Place your hands on the small of the patient's back, with thumbs nearly touching and the hands on the spaces between the short ribs.

4. Bend slightly forward with arms rigid so that the weight of your body falls on the wrists, and makes a firm steady pressure downward on the patient while you count one, two, three, thus forcing any water and air out of the lungs.

5. Then relax the pressure very quickly, snatching the hand away, and counting one-two--the chest cavity enlarges and fresh air is drawn into the lungs.

6. Continue the alternate pressing and relaxing about twelve to fifteen times a minute, which empties and fills the lungs with fresh air approximately as often as he would do it naturally.

It may be necessary to work for an hour or two before a gasp shows the return of natural breathing. Even then the rescuer's work is not over, as it will be necessary to fill in any gaps with artificial breathing. When natural breathing is established, aid circulation by rubbing and by wrapping him in hot blankets and putting hot bottles around him, being careful that they are protected to prevent burning the patient.

If at any time it is necessary to pull the tongue forward and to hold it to prevent choking, remember to put a wedge between the teeth to prevent biting. Do not give anything liquid by mouth until the patient is conscious and can swallow readily. Aromatic Spirits of Ammonia or Spirits of Camphor may be used on a handkerchief for the patient to smell. The patient should be watched carefully for an hour or two even after he is considered out of danger.

ICE RESCUE

Prevention: Below are two rules for preventing ice accidents:

1. Do not skate or walk on thin ice.

2. Watch for air holes.

Rescue: In trying to rescue a person who has broken through the ice, always tie a rope around your own body and have this tied to some firm object on shore. Do not try to walk out to the rescue as the ice will probably break again under the weight of your body on so small an area as the size of your feet. Always get a long board, ladder, rail or limb of a tree, and either crawl out on this, which will distribute the weight of your body over a larger surface of ice, or lie flat on your stomach and crawl out, pushing the board ahead of you so that the person in the water may reach it. If you yourself break through the ice in attempting a rescue, remember that trying to pull yourself up over the edge of the ice only breaks it more. If rescuers are near it is much wiser to support yourself on the edge of the ice and wait for rescue.

After getting the person out of the water use artificial respiration if necessary and bend every effort to get the patient warm and breathing properly.

ASPHYXIATION

Prevention: Below are seven rules for preventing asphyxiation:

1. When coal stoves and furnaces are freshly filled with coal, coal gas may escape if the dampers are not properly regulated. See that all dampers in coal stoves and furnaces are correctly arranged before leaving them for any long time, as for the night.

2. Do not go to sleep in a house or room with a gas jet or gas stove turned low. The pressure in the pipes may change and the flame go out, or a breeze may blow out the flame leaving the gas leaking into the room.

3. Do not blow out a gas jet.

4. Be careful to turn off gas jet completely.

5. Report gas leaks promptly.

6. Charcoal stoves and braziers are especially dangerous from escaping gas and should not be used in sleeping rooms.

7. Do not go into unused wells or underground sewers without first lowering a lighted candle which will go out at once if the air is very impure, because of lack of oxygen to keep it burning.

Rescue: 1. Remove the patient _at once_ to the fresh air. Gas is lighter than air, and therefore will not be found close to the floor and it will often be possible to crawl out when one would be overcome by the gas if he tried to walk out. For this reason it is sometimes best in trying to rescue anyone already unconscious from gas to tie the wrists together with a handkerchief, put his arms around your neck, and crawl out on all fours, dragging the insensible body with you, under your own body. If you attempt to walk out and carry the patient, cover your mouth and nose with a wet handkerchief, go very quickly, do not breathe until you reach the fresh air.

2. If there is a messenger handy, send for the doctor at once, but in the meantime if necessary, perform artificial respiration as outlined under the Schaefer System in the preceding paragraphs, until the patient is restored to normal breathing.

ELECTRIC SHOCK

This is caused by some part of the body coming in contact with a live electric wire. The seriousness of the shock depends on how heavy a charge of electricity the wire is carrying at the time.

The patient is usually unable to release himself from the wire. The first thing to be done, if possible, is to turn off the current by means of the switch, but if this cannot be done _at once_, the patient must be rescued by pulling him away from the wire.

Remember his body will easily carry the charge to yours while he is against the wire. Therefore you must "insulate" yourself--that is, put on your hands something that will not let the electricity into your body--or stand on something that will "insulate" you; for instance, rubber gloves or rubber tobacco pouches, dry silk handkerchiefs, other silk garments or newspapers used in place of gloves if necessary. Stand on a rubber mat or on _dry boards_, or glass, or in dire necessity _dry_ clothes can be used to stand on. They must not be wet as then they will carry the electric current through your body and you must also be rescued instead of rescuing.

Prevention: 1. Do not touch the "third rail" of electric railways.

2. Do not catch hold of swinging wires, they may be "live wires."

3. Report broken wires to the right authorities.

Treatment:

1. Get patient loose from the current.

2. Send for the doctor.

3. Lay the patient flat on his back.

4. Loosen the clothing, and perform artificial respiration according to the Schaefer method if necessary.

5. Give first aid treatment to the burns.

FIRE ACCIDENTS

The first thought about a fire is to get it put out before it spreads any further. There are methods which will do this work effectually and Girl Scouts should learn these methods beforehand thoroughly, in order that when the emergency arises they may act quickly, coolly and effectively.

FIRE IN CLOTHING

If this happens in your own clothing, do not run for help, as the draft made by the motion of your body will only fan the flames to burn fiercely.

Grab the nearest thing that will cover you; overcoat, blanket, rug, wrap it tightly around you at the neck first to prevent flames from burning the face and lie down and roll over and over. This will smother the flames quickly. If you can get nothing to wrap around you, lie down and roll slowly over and beat the fire with your hands covered by some part of your clothing not on fire.

If the fire is in the clothing of another, wrap him in the nearest thing available, lay him on the floor and roll him over, smothering the flames as described before.

Woolen material will not catch fire as easily as cotton, therefore, if you have a chance to choose, take woolen material for smothering the flames.

RESULTS

Results of fire in the clothing are sure to be more or less serious burns.

When you have discovered the extent of the burn, if it is at all serious, send for the doctor at once, and in the meantime treat the burn as you have already learned to do in minor burns.

FIRE IN BUILDINGS

Keep cool, in order to remember what to do, and do it quickly.

Turn in a fire alarm at once. Send some one else if possible who may not know what to do to the fire. The quickest way is by telephone call, "Fire Department," and tell them the exact address of the building where the fire is. Or you may go to the nearest alarm box, smash the glass, open the door, and pull down the hook that sounds the alarm. (Generally the directions are printed on the box.) If you cannot sound the alarm alone, call upon the nearest person to help you. _Wait there until the firemen arrive and direct them to the fire._ When the firemen come do just as they tell you, for they know exactly what to do.

People trying to escape from a burning building often get frightened and then there is a panic. Panic kills more people than fire. Keep cool, and others will follow your example.

Never jump from a window unless the flames are so close that it is your only means of escape. If outside a burning building put mattresses and bedding piled high to break the jumper's fall and get a strong hold on a rug to catch the jumper, and let many people hold the rug.

If the fire is just beginning, it can easily be put out by smothering it with a rug or blanket; sand, ashes, salt, or a few pails of water will answer the same purpose.

Keep the doors and windows closed if possible to prevent draughts from fanning the flames to fiercer effort.

Remember this point when you go into a burning building, and leave some responsible person guarding the door, in order that it may not be left open by some one in excitement and the flames fanned beyond control.

If you need fresh air in your search for people in a burning building, open a window, put out your head and draw your lungs full of fresh air and then close the window again. In any case it is best to tie a wet handkerchief or towel over the nose and mouth while in a burning building, as this will prevent you from breathing a good deal of smoke.

In searching for persons remember always to begin at the top of the building if possible, and search every room. When on stairs keep to wall side, where air is relatively free from flames and smoke. If a room is locked, try to rouse the people by pounding and calling and then break in the door if unsuccessful in rousing them, and you suspect there is some one there.

Remember, the air within six inches from the floor is usually free from smoke, and if the smoke makes breathing too difficult, you can still accomplish your end by crawling along the floor and dragging the rescued one with you as you learned to do in gas rescue.

Form a bucket brigade from the fire to the nearest water supply; passing the filled pails from one to another rapidly, the last throwing the water on the fire and passing the empty pails back along _another_ line to be filled again and passed on as before.

FIRES FROM KEROSENE, GASOLINE, BENZINE

_Prevention._--1. Do not light a fire with kerosene.

2. Do not clean gloves or clothing with gasoline or benzine in a room with a lamp or gas jet lighted.

3. Do not try to dry clothing that has been cleaned with gasoline or benzine near a hot stove or lighted gas jet.

_Extinction._--Do not use water to put out a fire of kerosene, benzine, or gasoline, as that only scatters the flames. Smother with blankets, rugs, sand, ashes, salt, or anything which is at hand and can be used; remember that woolen will not catch fire as easily as cotton.

COMMON POISON AND ANTIDOTES

_Poisoning_--Cases of poisoning happen most often because people do not examine the bottles before taking medicines from them.

_Prevention_--Disinfectants, liniments and medicines in bottles and boxes should be correctly and plainly labelled.

Bottles containing a poisonous substance should be rough outside, or with notched corks or marked with something beside the label stating that their contents are poison.

_Treatment_--1. _Send for the doctor at once_, telling him what kind of poison you think the patient has taken in order that he may bring the right antidote and the right implements to give the quickest and most effective relief.

2. Give demulcent or mucilaginous drinks, as for example, milk, raw egg, one or two tablespoonfuls of salad oil, sweet oil, or barley water--which can be obtained most readily.

3. Give something to produce vomiting, provided the lips are not burned or stained as they are with an acid or alkali. A simple but effectual emetic can be made by mixing two teaspoonfuls of salt or a tablespoon of mustard in a glass of lukewarm water. This may be repeated if necessary.

4. If the patient seems drowsy, suspect opium and keep patient awake at all costs till the doctor arrives.

5. If delirium threatens, dash cold water on the patient's head and face to try to prevent the fit from coming on.

6. When the poison taken has been acid, the antidote should be an alkali, but different poisons require different antidotes, and it would be unwise to trust to one's memory as to the proper one to take in each case. It would be well to have a list of the more common poisons and their antidotes attached to the First Aid Kit, but do not trust to the memory. If a Girl Scout does not know, and if the patient's lips are _not_ stained or burned, give an emetic.

Bandages

Bandages form the most convenient way of keeping dressings on wounds and for making pressure when necessary. They are also used to correct some deformities, but you will not need to concern yourselves with the latter, as this is in the province of doctors.

There are three varieties of bandages which you will need to use and with which you should be familiar: the roller, triangular and four-tailed. The materials used for bandages are absorbent gauze, muslins or flannels. The kind you will use most will be gauze and muslin. The gauze is best to use in dressing wounds because it is pliable and absorbent, and muslin, if you may choose, in applying pressure, because it is firm. In an emergency there will usually be little chance to choose. Anything at hand, as underclothing, sheets, blankets, etc., may be torn into strips or triangles and used. Have the material which is used clean if possible.

The width of the roller bandage depends on the part of the body to be bandaged, from one inch for the little finger to four inches for the body. They can be rolled very well by hand with a little practice, and every Girl Scout should learn to do this or to improvise a bandage roller by running a very stiff wire through a small wooden box and then bending one end on the outside of the box like a handle.

A bandage must be rolled sufficiently tight so that the center will not fall out. By folding one end back and forth a few times to make a core, and then laying the bandaging over one's knees lengthwise of the thigh with the core uppermost, it can be rolled quite tightly and answer every purpose for emergencies.

Learn to put on all bandages smoothly and securely, but not too tightly.

_Triangular Bandages_--These bandages have advantages for first aid work. They can be quickly made, easily applied and are not apt to be put on too tightly even by a beginner.

The size of the piece of cloth varies with the part to be bandaged. Take a square piece of cloth (it should not be less than 34 to 38 inches), fold it diagonally from corner to corner and cut across the fold, making two bandages.

The bandage may be applied unfolded or folded into a narrow strip, called cravat bandage.

To fold the cravat bandage, the point of the triangle is brought to the middle of the diagonal side and the bandage folded lengthwise to the desired width.

The cravat bandage is convenient to use in bandaging the hand, foot, head, eyes, throat and jaw; for tying on splints; for tying around the limb in case of snake bite, and in making a tourniquet.

Always tie the bandage with a square knot to prevent slipping. Care must be used in applying the triangular bandage to have it smooth and firm, folding the loose ends into pleats evenly.

_Bandage for Hand_--For wound of the palm, lay cravat in straight line, place palm across it at the middle. Fold ends over the back of hand, carry around wrist and tie. Reverse the order for injury to the back of the hand.

To cover entire hand, unfold cravat, lay flat with point of triangle beyond the fingers. Fold the point of the bandage over the fingers, cross the ends, and pass around wrist and tie at the back.

_Bandage for Foot_--Place foot on the smooth triangle with the point extending beyond the toes several inches. Fold the point back over the instep, cross the ends, carry around the ankle and tie.

_Bandage for the Head_--The bandage may be used flat or as a cravat, according to the nature of the injury and the part to be bandaged.

_For a cap bandage_, fold over the edge of the diagonal edge, place on the head with the folded edge just above the eyes; pleat the edges hanging down over the ears into small folds so that the bandage lies smoothly; carry the ends around the head; cross at the back, and tie in a square knot in front. The cravat bandage may be used to hold on small dressings where the whole head does not need to be covered.

_For the eyes, jaw and throat_ the triangular bandage is used by folding smoothly into a cravat and tying securely over the part to be covered.

_Arm Sling._--The triangular bandage makes the best arm sling to support the forearm or for supporting injuries to the elbow or shoulder.

An arm sling is firmer and more satisfactory if the triangle is double; that is, simply fold over the square diagonally, but do not cut it along the fold. An arm sling will need to be about a yard square before folding.

To adjust the arm sling, put one end over the shoulder on the uninjured side; slip the point of the triangle under the injured arm, so that it will extend beyond the elbow a few inches; then take the end of the bandage over the arm, carry around the back of the neck on the injured side, meeting the other end; and tie securely. To prevent slipping, pin the point of the bandage around the arm just above the elbow.

A temporary sling can be made by pinning the sleeve of the injured arm to the dress or coat in such a way as to support the arm.

_The Four-tailed Bandage_--This bandage is useful for bandaging the head, and especially in fracture of the jaw. Use a piece of cloth about six or eight inches wide and a yard long. Cut each end into two equal parts, leaving about three or four inches in the middle uncut.

When the bandage is applied, the split ends are crossed so that they may be tied over different parts of the head and thus hold the bandage more securely in place. For instance, in the jaw bandage the uncut middle part is placed over and under the chin, the ends crossed, and two ends tied at the back of the neck and two over the top of the head.

_Roller Bandages_--Roller bandages are a little more difficult to put on so that they will stay on, and at the same time be smooth and have a uniform pressure on the part of the body bandaged. This last point is most important.

Rules for applying roller bandages:

1. Lay external surface of bandage against the part to be bandaged, holding the roll in the right hand, unless you are left-handed, unrolling it as a roll of carpet unrolls to show you a pattern in the shops.

2. Hold the loose end with the left hand and catch it with two or three turns of the bandage before beginning to put on the bandage. Never have more than four or five inches of the bandage unrolled at once.

3. Be careful to have the same pressure from every turn of the bandage. This is most important if the bandage is to stay on and be comfortable and not interfere with the circulation of the blood. Judgment of the pressure is only acquired by practice, and therefore you should practice enough to acquire this before the real emergency happens.

4. Do not bandage too tightly. Blueness of the skin above or below the bandage always means the bandage must be loosened. Remember in applying a bandage immediately after an injury that considerable swelling may occur later, and apply your bandage more loosely than if bandaging after the swelling has gone down. Always loosen a bandage that is tight enough to cause pain or blueness.

5. Bandage from below upward. That is, from the tip of a finger or toe toward the hand or foot. From the hand or foot toward the shoulder or groin. This is in the general direction of the return of the circulation.

6. Bandage over a splint and not under it.

7. Bandage arms, legs, fingers, etc., in the position the patient is to keep the part in when the bandaging is completed. For instance, bend the elbow to a right angle before putting on the arm bandage. This will be more comfortable for the patient, allowing him to carry the arm easily in a sling and also permit him to use the hand to some extent if the nature of the injury will permit. In bandaging a leg both above and below the knee, the bandage must be put on with a view to the necessary bending of the knee in walking and sitting, if the patient is expected to use the leg.

8. Never apply a wet bandage, as you cannot judge of just how much pressure will be exerted when the bandage dries, because of the shrinkage of cloth with drying; much greater in some cloth than in others.

Kinds of roller bandages:

1. Circular for parts uniform in size, as the body.

2. Spiral for conical surfaces, as fingers or toes.

3. Reverse for more conical surfaces, as arms and legs.

_Circular Bandages_--Any part of the body which is of uniform size may be covered with a circular bandage. Each turn covers about two-thirds of the previous turn. This holds each turn firmly and prevents slipping and exposing the dressing or wound underneath. Bandage in general direction of the return of the blood to the heart. Fasten the bandage with a strip of adhesive plaster or safety pin. If there is possibility of restlessness or much activity on the part of the patient, it is best to run several narrow strips of adhesive plaster along the whole width of the bandage when finished to prevent possible slipping of the turns of the bandage when the muscles move under it with the activity of the patient. This is especially true of a body bandage.

_Spiral Bandage_--A conical part, if not too conical, may be covered with a spiral bandage. Each turn ascends at a slight angle, with one edge of the bandage a little tighter than the other. In putting on this kind of bandage it is necessary to learn to have the tight edges all of a uniform pressure and each turn overlap the turn below in such a way that these tight edges make the uniform pressure without regard to the upper edge underneath, which is covered in each turn by the tighter edge of the turn above it.

_Reverse Bandages_--The reverse bandage is a modification of the spiral one, in order to cover the gapping between spirals which occurs when the surface is very conical, as, for instance, on the leg.

In putting on this bandage the loose end is caught by two or three turns first as in other bandages. Then start to make a spiral turn, but at the mid point of the front of the part being bandaged place the thumb of the left hand, and fold the bandage down so that it lies smoothly and continue the turn around to that same point. Repeat the process with each turn. (See illustration.) Each turn covers two-thirds of the one below in order to hold firmly. The pressure must be uniform when the bandage is finished. Fasten the ends as described under circular bandages, or divide the end of the bandage into two parts for several inches--long enough to wind around the part bandaged. Tie a single knot at the base to prevent further dividing, and wrap the ends around the part in different directions; tie in a hard knot to hold firmly.

_Bandaging Fingers and Toes_--In bandaging fingers and toes it is usually best to bandage the whole of the injured member. Cover the end of the finger, for instance, by passing the end of the half inch or one inch bandage several times the whole length of the finger, over the end and to the base of the other side. Hold this in place with one hand, start the spiral at the end of the finger, and bandage smoothly toward the hand. The spiral or the reverse spiral may be used.

_Bandaging Two or More Fingers or Toes_--It is sometimes necessary to bandage two or more fingers, for instance, at once, as in case of a burn, where it is necessary always to have the burned fingers separated while healing to prevent the raw places from growing together.

Pass a finger bandage twice around the wrist and pass obliquely to the base of the thumb. Carry to the end of the thumb and bandage as described above. When the thumb is bandaged, carry the bandage back to the wrist; pass around the wrist in one or two circular turns, and carry the bandage to the first finger and bandage as before. Repeat this until all the fingers are bandaged. Carry the bandage back to the wrist, after the last finger you wish to bandage is done; make one or two turns around the wrist and fasten.

In bandaging the foot, carry the bandage to the ankle to make secure and hold in place.

_Bandaging Arms and Legs_--The reverse spiral is usually best for bandaging these, because of the conical shape. Practice alone can teach you to put this on smoothly, firmly, not too tightly, and at the same time quickly. A reverse bandage will not stay in place on the leg of the person walking around unless pinned in many places or stuck by sizing in the cloth (which has been wet), plaster, etc. Only a figure eight caught over the top of the calf, in each alternate loop, will do so.

_The Figure Eight Bandage_--The figure eight is a modification of the spiral used in bandaging over joints in such a way as to permit some motion and at the same time keep the bandage firm and in place.

The bandage is carried first below and then above the joint; then below and then above, the turns overlapping the usual two-thirds of the width of the bandage, leaving the joint free until the last. Then it may be covered with two or three circular turns of the bandage. This admits of considerable motion without disturbing the bandage to any extent.

The National Red Cross and Girl Scout Instruction in First Aid

By special arrangement with the National Red Cross, it is possible for a Girl Scout completing satisfactorily the requirements for the First Aid Proficiency Badge to secure with slight additional work the Red Cross certificate in First Aid. Or the course may be taken entirely under Red Cross auspices, though arranged by Scout officials, in which case the Scout may receive both the Proficiency Badge and the Red Cross certificate. The conditions of this co-operation between the Girl Scouts and the National Red Cross are as follows:

Classes are to be organized with not less than four or more than twenty-five in a class. The best size is ten to fifteen. _Scouts must be at least sixteen years of age to be admitted to these classes._

The instructor must be a physician appointed by the Chairman of the First Aid Committee of the local Chapter of the Red Cross. He or she may be supplied upon request by the Chapter, or chosen by the class and the name submitted to the Chapter for appointment.

The Red Cross class roll must be sent in to the local Chapter early in the course.

A Secretary to handle the records should be chosen, and where the class is made up of Scouts, the officials should be preferably a Scout Captain or Scout Official.

The examiner must be a physician appointed by the local Red Cross Chapter and is preferably some one other than the instructor, but this is not necessary. Like the instructor, the examiner may be supplied by the Chapter or chosen by the class.

The Red Cross examination roll, which may be obtained from the Chapter, should be used in giving examinations and then returned to the Chapter, who will issue the certificates. Follow the directions on the roll carefully.

If a Scout holds a First Aid Proficiency Badge she may complete the course in seven and one-half hours. If she does not hold a Proficiency Badge in First Aid then fifteen hours will be required. A Girl Scout holding a Proficiency Badge in First Aid and taking a school course held under Red Cross auspices which she passes with a mark of at least seventy-five per cent, can, when the school principal certifies to this, get the Red Cross certificate without further examination by applying to the local Red Cross Chapter.

_Advanced Courses_

Advanced courses are open to those who have the Red Cross certificate. There must be an interval of at least six months after the elementary course before an advanced course can be taken, and the same interval between repetitions of it. The course of instruction is seven and one-half hours, mainly practical demonstrations. A Red Cross medal is given on completion of this course. Each time it is repeated, up to three times, a bar (engraved with year) is given to be added to the medal.

_Fees_

A fee of fifty cents is required for the elementary course. The local Red Cross Chapter has the right to reduce this fee.

The fee for the advanced course is one dollar, which covers the cost of certificate, examination and medal. The fee for bar and engraving is fifty cents. These fees cannot be reduced.

These fees cover the cost to the Red Cross of postage, certificates, medals, bars, and so forth, but do not cover that of instructor, examiner, or classroom supplies, which the Red Cross requires the class to take care of.

_Information_

Where there is no local Girl Scout organization refer to the local Red Cross Chapter; or if there is none, either to the Girl Scout National Headquarters, 189 Lexington Avenue, New York, N. Y., or to the Department of First Aid, American Red Cross National Headquarters, Washington, D. C.

4. THE HOME NURSE

The Girl Scout who has earned the Home Nurse Badge may be of great help where there is illness. But, she should remember that only such people as doctors and trained nurses who have knowledge and skill gained by special training and thorough practice are fitted to care properly for those who are very ill.

If the Scout with the badge keeps her head and shows herself steady, reliable and willing, when called upon for help in illness or emergencies, she proves herself a true Scout who is living up to the Scout motto of "BE PREPARED."

To earn the badge she should know:

How to keep the sick room clean and comfortable.

How to make a bed properly.

How to prepare for and help a sick person in taking a bath.

How to make a sick person comfortable in bed, changing position, etc.

How to take temperature, pulse and respiration.

How to prepare and serve simple, nourishing food for the sick.

How to feed a helpless person.

How to prepare and use simple remedies for slight ailments.

How to occupy and amuse the sick.

When helping about the sick, the Scout should wear a wash dress or an apron which covers her dress. She should be very neat and clean. She should wash her hands frequently, _always_ before her own meals, and after coming into contact with the sick person and after handling utensils, dishes, linen, etc., used in the sick room. Great cleanliness is necessary not only for her own protection but to prevent illness spreading.

She should move quickly and quietly, but without bustle or hurry, taking care not to let things fall, not to bump against the furniture, not to jar the bed, not to slam doors, in fact not to make any unnecessary noises, as sick people are not only disturbed but may be made worse by noises and confusion. If a door is squeaky the hinges should be oiled. Too much talking, loud talking and whispering are to be avoided. Only cheerful and pleasant subjects should be talked of, _never_ illnesses either that of the patient nor of others.

The best nursing aims not only to bring relief and comfort to those already sick, but to guard against _spreading_ sickness.

We know, now, that many diseases are spread by means of _germs_ which are carried from person to person by various means, such as air, water, milk, and other food; discharges from the mouth, nose, bowels, bladder, wounds; clothing; the hands; the breath, and so forth.

It has been found that great heat, intense cold, sunshine and some powerful drugs called disinfectants kill germs. Germs thrive and multiply in dirt, dampness and darkness. That is why it is important to have fresh air, sunshine and cleanliness in order to keep well, and to help in curing those who get sick.

The Room, Its Order and Arrangement

The hangings and furniture of a sick room should be of a kind that can be washed and easily kept clean. Plain wooden furniture is better than upholstered furniture which collects and holds the dust. If there is a rocking chair it should be for the use of the sick person only. Seeing and hearing other people rock may be very disturbing.

If carpets are movable, so much the better, as they can be taken out to be cleaned.

The room should be bright and attractive. Sick people like flowers and pretty things, but the flowers should not have a strong perfume, and there should not be too many ornaments around to collect dust and to take up too much room. Flowers should be taken out of the room every night and the water changed before being returned to the room in the morning. Never have faded flowers around.

The room should be kept neat--a place for everything and everything in its place.

Neatness and attractiveness are not only pleasing to the sick person and those who come into the room but may really make the sick person feel better.

Medicines should not be kept in sight. All dishes and utensils not in use should be taken away and should be washed immediately after use.

_Ventilating and Lighting the Room_

The room of a sick person should be so situated that it will get plenty of sunlight and be easily aired. A room that has two or more windows can be better ventilated than a room with only one. When there is only one window, it should be opened both top and bottom. If there is not a screen, one can be made by hanging a shawl or a blanket over a clothes horse or a high-backed chair, or over a line stretched across the lower part of the window. A fire place or a stove keeps the air circulating--the air being constantly drawn up the chimney--and so helps in ventilating a room.

When "airing" the room great care must be taken to keep the sick person free from draughts.

Unless special orders have been given to the contrary there should be plenty of sunshine let in. The eyes of the sick person should be protected from the glare by a screen.

If possible there should be a thermometer in the room. The proper heat is between 65 and 70 degrees. If the temperature of the room is as high as 70 degrees and the sick person is cold, it is better to give her a hot water bag and to put on more covers than to shut the windows, thus keeping out the fresh air. Cool air acts as a tonic for the sick.

Cleaning the Room

The carpet should be gone over every day to remove the surface dust. Use the carpet sweeper, being careful not to knock the furniture nor to jar the bed. Raise as little dust and make as little noise as possible. Torn-up wet paper scattered on a small part of the carpet at a time and lightly brushed up into a dustpan with a whisk broom, or a broom, cleans the carpet very well without raising dust.

If the carpet cannot be taken out to be swept or beaten but requires thorough sweeping, an umbrella with a sheet over it may be hoisted over the head of the sick person to keep the dust from her nose and nostrils. The bare parts of the floor should be gone over with a damp duster or a damp mop.

The dusting should be done with a damp or oiled duster also, so that the dust may not be scattered. A basin of soapy water should be at hand and the duster washed in it frequently while dusting, so that the dust collected on it from one surface will not be carried to another. While dusting special attention should be paid to the doorknobs and that part of the door around them.

When the dusting is finished the dusters should be thoroughly washed and scalded and hung out of doors to dry.

The Bed

A metal bedstead is better than a wooden one, as wood holds odors and moisture, and is apt to have more cracks and crevices for germs or bugs to lodge in. It should be white, for then it shows when it needs cleaning and bed bugs keep away from white surfaces which show them up easily.

If possible, have the bed in a part of the room, where the drafts will not strike the patient every time a door or window is opened, and where the light does not shine in the eyes. If it can be placed so that the patient can see from the window so much the better.

To Make an Unoccupied Bed

Remove pillows and bedclothes, one at a time, being careful not to let corners drag on the floor, and put to air. Turn the mattress over from end to end one day, and from side to side next day. If the patient does not have to return to bed at once leave to air for at least half an hour.

An old blanket, old spread or a quilted pad, spread over the mattress not only protects the mattress but prevents the sheets from wearing out, and may make the bed more comfortable. These should be kept clean.

The bed for a sick person is frequently made with a rubber sheet and a draw sheet. The draw sheet is so called because its proper use is to be drawn through under the patient without greatly disturbing her and give her a cool fresh place to lie on. Therefore it should be long enough to tuck in sufficiently under one side to allow of this being done. An ordinary sheet folded in two from top to bottom and placed with folded edge toward the head of the bed may be used. It should entirely cover the rubber sheet, which is usually put on between the bottom and the draw sheet.

When the mattress is sufficiently aired, put on the protective covering. Over this spread the lower sheet so that the middle fold of the sheet lies up and down the centre of the mattress from head to foot. Keep perfectly straight. The sheet should be long enough to have at least fourteen inches over at ends and sides to tuck in. Tuck ends under mattress at head and foot drawing tightly so that it will be smooth and firm. Now tuck under at one side, folding neatly at corners, so that they will be mitred when finished. If there is no rubber nor draw sheet to put on, go to the other side of the bed and tuck in firmly at corners. Then, pulling the middle of the sheet very tightly with one hand, push the mattress with the other and tuck the sheet under. This under sheet should be very smooth without a wrinkle in it. If it is not long enough to tuck in well at both head and foot, leave plenty at the head to tuck in securely and tuck in at the sides tightly rather than risk having it come loose at the head. Be sure, however, that the mattress is entirely covered.

When Rubber and Draw Sheets Are Used

Before going around to the other side, lay the rubber sheet over the bed, so that the top edge will be well above where the lower edge of the pillow will come. Put the draw sheet over it. Tuck both well under the mattress on that side. Then, go to the other side and tuck in the corners of the lower sheet as directed, then stretching draw, rubber, and under sheet very tightly, tuck in separately.

Next spread the upper sheet, wrong side up, leaving as much at the head to turn back over the blankets as you left in the under sheet to tuck in. Have the middle fold over that of the lower sheet. Spread the blankets so that their upper edges will be even with the upper edge of the mattress. If the blankets are not long enough to reach as far up as they should, and yet tuck under firmly at the foot, place the lower one as directed, and the upper one so that there will be enough to tuck under at the foot, and hold the others in place. Tuck in all at once the foot and lower corners, mitring the corners as you did those of the lower sheet. Pull and straighten the sheet at the top and turn back smoothly over the blankets. If the bed is not to be occupied right away, tuck in both sides, stretching well so that it will have a smooth surface. Put on the spread, having the top edge even with the top of the covers. Tuck in neatly at foot and lower corners, letting the sides hang. Shake and beat the pillows thoroughly, make smooth and even, and put in place.

To Change the Under Sheet When the Patient Is in Bed

Loosen the bedclothes, without jarring the bed. Take off covers one at a time, until only one blanket and sheet remain. (If the patient feels cold, leave as many blankets as necessary to keep her warm.) Holding blankets with one hand or having patient hold it by the top, draw off the upper sheet, being careful not to uncover the patient. Remove the pillows. Have the patient as near the side of the bed as is safe, on her side, and facing the side on which she is lying. Roll the under sheets on the side of the bed close to the patient's back, making them as flat as possible. Pleat about half of the fresh under sheet lengthwise, and place close to the soiled sheets. Tuck in the other half, at the head, foot and side, draw the rubber sheet back over this fresh sheet, arrange the fresh draw sheet in place, tuck both in at that side and roll the free part close up to the patient's back. Now lift the patient's feet over the roll of fresh and soiled linen to the freshly made part, then have her roll her body over that side. Going to the other side of the bed, remove all the soiled linen and tuck the fresh sheets in, pulling tightly, being sure that there are no wrinkles under the patient. All the time keep the patient well covered. Now, spread the upper sheet and blankets over the covering the patient has had on while the lower sheets were being changed and, having the patient hold the coverings you have just put on, draw off the others, just as you took off the top sheet at first. Finish making the bed as you would an unoccupied one.

If the Bed Is to Be Occupied at Once

If the bed is to be occupied at once the coverings should be tucked in only at foot, corners and one side, then turned back diagonally from the head to foot.

The bed clothes should never be drawn too tightly over a person in bed, or they may irritate the skin, especially at the knees and toes. Bed sores may be started in this way. Perhaps the commonest cause of bedsores is from wrinkles in the under sheets. If the spread is heavy it should not be used over a patient. Use a sheet instead to protect the blankets.

Bathing

Bathing is more important for the sick than for the well. It not only keeps the skin clean and in condition to do its work, but it is soothing to the nerves, makes the sick person rest better and is refreshing.

If the room is the right temperature and the bath is carefully taken there is no danger of a sick person taking cold. On the other hand bathing helps to keep people in condition to _avoid_ taking colds. (See Red Cross Text Book on Home Hygiene and Care of the Sick, page 156.)

When a patient is very sick or helpless, the bath should be given by someone who is able to do it deftly and quickly, with the least exertion to the patient.

Very often, however, a person in bed is quite able to bathe herself, with a little help, if the necessary things are brought to her.

To Prepare For a Bath in Bed

Have the room warm and free from draughts. A good temperature is 70 degrees. An old person or a baby may have it warmer.

Bring into the room everything needed. This will include:

An extra blanket to wrap around the sick person.

Two or more bath towels.

Two wash cloths--one for the face and another for the rest of the body.

Soap--Ivory or castile are good.

Pitcher of good hot water, and slop jar.

Alcohol and toilet powder if you have it.

Nail file and scissors.

Comb and brush.

Clean bed linen and nightgown. In cold weather these may be hung near the fire or radiator to warm.

A basin of water of a temperature that the sick person finds comfortable.

When everything is ready the Scout can help by loosening the bedclothes, arranging the extra blanket, removing the nightgown, and in holding the basin and towels, in changing the water or in any way that will make the bath easier for the sick person, perhaps washing the feet and back, being careful to keep all the rest of the body covered and warm, and in protecting the bed by bath towels spread under the part being washed. When doing this the wash cloth should not be so wet that it will drip and wet the bed. It should be held so that the corners do not touch against the bedclothes. There should not be too much soap used as it makes the skin feel sticky. Every part should be rinsed and dried thoroughly. Warm towels are a great help in this.

When the bath is finished alcohol or witch hazel may be used to rub the parts where there is most pressure as the back, shoulder blades, hips, buttocks, elbows, knees and ankles. This not only gives comfort but it prevents bedsores.

If a sick person gets a bath, so that it does not disturb nor tire her nor make her chilly she will usually enjoy it. By getting everything ready, by helping where needed, and by clearing up nicely the Girl Scout may make the bath a pleasure instead of something to be dreaded.

Sometimes sick people are able to go to the bathroom to take their own baths, if everything is gotten ready for them beforehand, so that they will not get tired doing so. People who are not well should never be allowed to lock themselves in the bathroom alone.

Getting Ready a Tub Bath

The bathroom should be well aired but warm. The water in the bath tub helps to warm it up. A bath towel or bath mat should be spread beside the tub on the floor and a chair with a blanket and a bath towel on it for the person to sit on while she is drying herself. The water should be about 105 degrees or a temperature that the person finds comfortable. Always let a patient try it herself with her hand and arm before getting in. Five to ten minutes is long enough to stay in the water. The towels should be within easy reach and the bathrobe, night gown and slippers placed ready to put on.

The bed should be put to air and left as long as possible, but if the patient has to get back in it immediately after her bath, it should be made--care being taken that it is warm enough. If necessary put in hot water bags and spread a blanket over the under sheet to wrap around her if she needs it. People chill easily after a bath if they are exposed to sudden cold.

Foot Baths

Foot baths are often used in the home as remedies for colds, headaches, sleeplessness and to give relief at the monthly period.

If there is not a regular foot tub a pail that is large enough to put the foot in is better than a basin as it lets the water come up around the ankles. A person may sit in a chair or on the side of the bed. Have tub about half full of water and at first of a heat that feels comfortable, putting more hot water in from time to time, until it is as hot as it can be stood. When adding hot water the feet should be away from the part of the tub where the water is poured in, and it should be added slowly to prevent possibility of burning. A person getting a foot bath should be kept very warm. Wrap a blanket around the knees so that the legs will be protected front and back. After fifteen or twenty minutes the feet should be removed from the water and dried without rubbing. They should be kept well covered for an hour or more. No one should go out immediately after a foot bath.