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A MANUAL OF ARTIFICIALRESPIRATION

A Manual ofArtificial RespirationWhat it is and How to Perform it to ResuscitateThose Included by That Class of EmergenciesWhich Cause the Victims to Stop Breathing andare Designated as “Apparently Dead!”

' Compiled by

Capt G. R. G. FISHERWith the American Red Cross overseasduring the World War; Director bureauof first aid, Northern Division A. R. C.;Formerly with the British Army MedicalCorps, and assistant instructor in ambu-lance work at Polytechnic, London, Eng-land; Present director of accident pre-vention and instructor in first aid toIndustries and Civic organizations (inaffiliation with the Manufacturers Asso-ciation, the Chamber of Commerce) ofthe City of Omaha, Nebraska.

*- — 1923

THE STRATFORD COMPANY, PublishersBoston, Massachusetts

Copyright, 1923

The STRATFORD CO., PublishersBoston, Mass.

The Alpine Press, Boston, Mass., U. S. A.

Dedicatedto those of my fellow-mortals, whoare employed Industrially, particu-larly those in electrical, telephone,gas making and mining hazards.Also to policemen, firemen and life-guards, and to all who ought to knowwhat to do in emergencies only toocommon.

I

PrefaceIV T 0 APOLOGY is made by the author and com-

I \ piler of this small and somewhat modest hand-book, since it was conceived and bom out of a

conviction due to the urgency of dire necessity,through daily contact with a profession which em-phasized only too keenly the appalling mortalityentailed through a class of accidents, which, to treatproperly, demands a working knowledge of artificialrespiration.

Recent official U. S. mortality statistics show thatabout 10,000 lives are lost annually. Of these, about6,000 are due to drowning, 3,000 to asphyxiation, and1,000 to electrocution. If we add to these figures the4,000 cases of suicides from drowning, asphyxiationand hanging — for many of these unfortunates arefound before life is extinct — we are at once con-fronted with an appalling thought as to what this lossmeans to us as a Nation.

One of our great industrial surgeons, commentingupon our losses from such emergencies, has this tosay: “If only the knowledge of artificial respirationwere more generally known, especially among workerswithin the industrial world, thousands of personswhich have been buried might be alive today!” Inview of these words, is it saying too much that inall industries where these hazards exist to a greater

Preface

II

degree than in some others, that it ought to be thehumanitarian duty, to say the least, that all such con-cerns ought to afford this positive instruction to theiremployees, so that any victim may be given thispeculiar form of first aid so that these lives be saved.

If some corporations are doing this very thing, andif numerous victims are being snatched from the veryjaws of death is attested by the fact, that at least7/10 of all these successful cases of resuscitationreported are performed, not by doctors, but by theworkmen themselves; it at once is an incentive toother concerns to do likewise and to all workmen tocovet this most invaluable knowledge.

For who can tell when the occasion may arise, whena fellow man’s life may be at stake, and how unspeak-ably worth while to be able to step in and thus ward ofTHE GREAT ENEMY, to say nothing of the joy ofrestoring that one to his or her loved ones.

Therefore there is the conviction that if the simplic-ity of the Schaefer method of artificial respiration inparticular could be taught clearly, so that immediateaction would be taken on such victims, who, in onlytoo many cases are beyond hope through the time lostwhile awaiting the coming of him who may know whatto do. It was this conviction which led the writer toframe this little manual in the hope and confidencethat this very thing might be accomplished and therebyaid in the stemming of this awful tide of lost lives,of which, according to our insurance authorities, sevenout of every ten lives lost ought to be saved.

III

Foreword

IT IS axiomatic that the price of human progress ishuman life. Fortunately this price is not con-stant; the factors making it variable are many,

but more prominently stand out the factors of Sanita-tion, Disease and Accident Prevention and First Aid.

This little manual by Captain G. R. G. Fishersuccinctly and, at the same time, amply deals withone measure of First Aid to accidents so common toindustrial life-. The application of the principles andpractices set forth herein will be a dependable factorin enormously reducing the present too high death tollclaimed by accidents which attack the centers andfunctioning organs of respiration.

It is unmistakably destined to be of inestimablevalue in reducing mortality price of human progress.

Delmer L. Davis, M. D.,Dept, of Surgery, University of Nebraska.

V

List of IllustrationsFour Positive Steps in performing Schaeffer

method. First Step 15Second Step . .... 16Third Step ....... 18Fourth Step and First Position performing

Schaeffer method 19Second position in performing Schaeffer method 22Third position in performing Schaeffer method.

Hands snapped off body . . . .24Inspiration movement in Sylvester method . 26Expiration movement in Sylvester method . 27Method of administering “Counter Shock” . 42The Assist 52The Coat Carry — First Movement . . .53The Coat Carry — Second Movement . . .54The Hip Carry — First Movement . . .55The Hip Carry — Second Movement . . .56Fireman’s Lift — First Movement .

. .57Fireman’s Lift — Second Movement .

. .59Fireman’s Lift — Third Movement . . .60Fireman’s Lift — Fourth Movement . . .61The Back Crawl Carry — Movement One . . 63The Back Crawl Carry — Movement Two . . 64The Back Crawl Carry — Movement Three . . 66The Back Crawl Carry — Movement Four . . 67

Contents

VII

CHAPTER PAGE

DedicationPrefaceForeword by Dr. Delmar Davis, M. D.

i The emergencies demanding artificial res-piration 1

ii What actually occurs in the body when oneis taken by any one of these emergencies 3

in What others have done, you can do . .6iv How does the diaphragm work ... 9v To know the position of the organs of the

body and the floating ribs is vital in per-forming the Schaefer method of artifi-cial respiration . . . . .11

vi A comparative chart of the Sylvester andSchaefer methods 13

vii The four positive steps to be taken pre-paratory to performing artificial respi-ration 14

vm The correct manner of performing theSchaefer or Prone method of artificialrespiration 21

ix The correct manner of performing theSylvester method of artificial respirationand some additional aids in securingsuccess with the movement . . .25

VIII

CONTENTS

CHAPTER PAGE

x General rules to be observed in performingartificial respiration . . . .29

xi Some vital “don’ts” to be kept in mindwhen artificial respiration has to be per-formed 31

xil The pulmotor and some important factsabout it 31

xiii The particular emergency, the particularthing to do and its peculiar treatment 38

xiv Transportation,— the knack of handling byone-man methods the injured or un-conscious 52

1

Chapter I

The Emergencies Which Demand Immediate TreatmentBy Rendering Artificial Respiration.

Drowning.

Asphyxiation, such as from illuminating gas,mine gas, blast furnace gasses, sewer gas, coalgas, charcoal gas, etc. Monoxide gas, as thefumes thrown off from an oil stove in a bathroom with its window and door closed, or a gasstove in a small room with little or no ventila-tion, or the exhaust from a gasoline engine in asmall garage when the doors are shut. Dead airin a manhole, or one shut up in a bank vault,wherein he quickly consumes the little oxygenand is soon overcome by the carbonic acid gas hebreathes out.

Fumes, such as in dense smoke, acid, ammonia,chloroform, ether, etc.

Fumigating Agents, such as formaldehyde,sulphur, etc.

NOTE—Scientists report that there are over 40 non-respirable gasses, any one of which, if breathed for a fewminutes, will cause death.

A Manual of Artificial Respiration

2

Severe Electric Shock, including lightningstroke.

Cave-in. This is usually quite serious, owingto the weight of earth material on the body.

Poisons, such as laudanum, prussic acid,strychnine, etc.

Sunstroke. In severe cases the hard rapidbreathing may produce a clogging of lungaction.

Freezing. In extreme cases respiration ceases.

Hanging, Garrotting, Choking from food.

Knockout Blows, as being “beaned” by abaseball, severe blows on the head short of afractured skull, a blow at “solar plexus” orunder jaw.

Winded Athletes, as one exhausted from agrilling race, or one “knocked out” in a footballgame.

3

Chapter IIWhat Actually Occurs in the Body of One to Whom Any

of These Named Emergencies May Happen.

The average person thinks that all the breath-ing he or she does is carried on by the lungs,but, in reality, the most important part of thebreathing function is that of the diaphragm,and, to some extent, even by the very pores ofthe skin. This fact was more than demonstratedsome years ago in the south, when a little negroboy, who was selected to represent cupid, andwhom they had beautified (?) with a coating ofbronze paint, died from suffocation within twohours.

But let us deal a little at length with thislittle-known, and less understood muscle, thediaphragm. It is the muscular partition whichdivides the chest from the abdomen, the floor ofthe former and the roof of the latter. Its vitalimportance lies in the fact that, just as the heartis the organ of the circulation, so is the dia-phragm the organ of our respiration.

4


If you will attentively watch one in a soundhealthy sleep, you will be more than surprised tonote that there is comparatively little movementof the chest, while that of the abdomen is quiteconspicuous which rises and falls rhythmically15 or 18 times a minute; this is respiration.

So then, let any one of these emergencies occurwhich we have named, and at once that whichwe call the respiratory center in the brain, whichregulates the breathing, becomes temporarilyparalyzed, and at once the diaphragm stopsfunctioning; and following this, the lungs andthe heart.

Perhaps you will now understand the com-monly used term, “apparently dead.” Thevictim is not really dead because he or she hasstopped breathing, but they soon will be, unlesssome one performs artificial respiration, which isthe one and only thing to do, and to continue ituntil the respiratory center in the brain is re-stored, and with it, those of the heart and thelungs. But is quite evident that this alone ispossible to those who not alone understand thesefacts, but who also, know how to perform this


5

life-reviving movement; and to ‘‘carry on” thework patiently and hopefully— even though itmay take many hours to obtain results.

6

Chapter III

What Others Have Done You Can Do.

Ponder these quite recent verified reports ofsome interesting cases of resuscitation and pur-pose in your heart to acquire this life-savingknowledge so as to be prepared against the anymoment possibility of this emergency arisingwhen YOU may actually be enabled to save alife.

A boy of 11 was drowned; his body was notrecovered for fully 20 minutes. Two doctorsawaited its being brought to shore; they care-fully examined it, and pronounced the verdictthat there was no hope. They covered thecorpse (?) and went off to notify the coroner.All this time there stood by the chum of thevictim — a boy scout — bitterly weeping at thethought of what had occurred. However, assoon as the doctors were out of sight he snatchedoff the sheet and, actuated by mingled feelingsof despair and hope, proceeded to perform


7

artificial respiration, and within 45 minutesactually revived the dormant life.

A lineman of the Power Company was“hit” by 2300 volts, and pronounced dead by anattending physician, who also withstood thepleadings of his mates, because as he insisted“there was positively no hope.” Nevertheless,despite his verdict, to the no less disgust of thephysician, and even though they possessed butan elementary knowledge of the methods of re-suscitation, they did what they thought shouldbe done, and in about 35 minutes he was restored.

A baseball player in Iowa was “beaned”and pronounced dead, yet because one of histeam mates knew how to perform artificial res-piration and who also insisted that they do notsurrender his body until they had at least £ ‘ triedto do something,” they made the effort. Within45 minutes the ‘ ‘ apparently dead’ ’ was upon hisfeet and led home with no little joy and satis-faction.

Perhaps one of the most extreme cases ofwhich I have ever heard and one which certainlyought to have been hopeless, but which I dare tomention since it will prove an incentive to all my


8

readers so that they too “will take a chance.”It is that of a lumber jack in northern Minne-sota who fell through a log jam above a dam.They were nearly an hour in recovering his body,yet after four hours of persistent work, theyactually restored him.

Please permit me to add “a word in season,”on behalf of the medical profession, that when adoctor pronounces a verdict such as “beyondhope,” “dead,” remember that he is conscien-tiously acting upon the prescribed teachings ofmedical science; namely, that with the cessationof heart action, life is extinct. However, thereare numerous surgeons — especially among thosein the great industrial plants — who discard thestethoscope with all such victims, proceed to per-form artificial respiration, and who pronouncethe doleful verdict only after all has been donewhich ought to have been done. And for such asthese, let us fervently “give thanks,” and alsopray that the Good God may increase their kind.

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Chapter IVHow Does the Diaphragm Work?

First, permit me to say that this great muscleis attached to the lower ribs, which you caneasily feel in your own body, though there aretwo “floating ribs” on each side lower downwhich are practically free of the diaphragm ofwhich we shall speak later.

In answering the above question — when onebreaths in, this great muscle practically flattensdown (except at the front where the bottom ofthe breast bone can be felt, and where it isslightly concave.) This movement is called“inspiration.” When one breathes out, it risesdome-like on each side, a little higher on theright than on the left, which difference is due tothe facts that the apex of the heart protrudes alittle towards the left side and the liver ascendson the right side. Thus it rises and falls likepistons in their cylinders, about 18 times aminute; and this out-breathing is called “expira-tion.”


10

Now while you are reading these words, willyou turn your thought in upon your own breath-ing and, in doing so, you will notice that youbreathe more deeply in than you do when youbreathe out; in other words, your inspirationsare about one-third longer than your expirations.This is an important point to keep in mind whenperforming artificial respiration, which showsthat the down pressure on the body of thevictim ought not to be so long as the off-pause,when the hands are snapped off the body duringthe operation of the Schaefer movement.

11

Chapter V

To Know the Positions of the Organs of the Body, as alsoThose of the “Floating Ribs” is Vital in Performing

the Schaefer Method of Artificial Respiration!

It is probably safe to assume that most per-sons have studied an anatomical chart and thatit might seem very unnecessary to waste time inspecifying the location of the organs of the body,but long experience as a teacher of physiologycompels me not to take things for granted.

The organs above the diaphragm in the chestare the lungs and the heart; those below are, onthe right side, the liver; on the left side thespleen; in the front and extending well to theleft, the stomach; and immediately behind andon either side of the spine, the kidneys. Theseall, in the main, are protected by the ribs, savepart of the stomach at the immediate front,which is known to most people as the region ofthe “solar plexus.”

Now, strange to say, at the lower parts ofthese organs, to the immediate right and left, lie

12


the 11th and 12th pair of ribs known as the“floating ribs;” just as if the All-wise Creatorhad purposely placed them there that they mightact as springs, so to speak, to the bellows we areto work in performing this wonderful Schaefermovement, which, without question, is the mosteffectual method of artificial respiration.

Consequently, when you straddle the body ofa victim, placing the hands as will be describedand illustrated later, the downward pressurewith rigid arms and inward pressure with fin-gers causes these organs to force up the dia-phragm and when this pressure is released bythe snapping off of the hands, the ribs springback, the diaphragm descends, creating a vac-uum which compels the air to rush in; so muchso, that one usually hears a gasping sound fromthe victim.

13

Chapter VISince the Methods Most Commonly Used Are the

“Sylvester” and the “Schaefer,” Possibly the Follow-ing Comparative Chart Will Prove of Some

Interest by way of Visualizing TheirRespective Points.

SYLVESTER SCHAEFERPosition of victim—on back.Tongue of victim must be

held so that it may not fallback over trachea.

If a drowning case, watercan not escape.

Movement calls for 2 or 3persons.

Victim’s arms have to beused in the movement, there-fore laborious.

Amount of air inspired andexpired by the victim in thismethod is 175 c. c. (spiro-meter measurement)

In severe electric shockcases, the muscles of thechest, shoulders, and the armsare usually rigid, hence butfew resuscitations are ob-tained; about 3 in 10.

Position of victim—on face.Victim’s tongue when once

brought forward remains sobecause of position.

If a drowning case, thewater will ooze out freely.

One person can carry onalone.

Pressure is at the small ofthe back with arms rigid,hence easy on operator.

Amount of air inspired andexpired by the victim in thismethod, is 520 c. c. (spiro-meter measurement).

NOTE—the advantage ofthis method in electric shockis only too evident; indeed, itis said that the very pressuremade by this movement, actu-ally helps to ease up thismuscular tensity. Resuscita-tions obtained 10 in 13.

14

Chapter VIIThere Are FOUR Positive Steps Which Must be Taken

Before the Actual Movement for Resuscitation isStarted, the Neglect of Any of Which May

Spell Failure for the Operator and Burialfor the “Apparently Dead.”

First Step. Loosen all tight clothing, espe-cially at neck and waist.

a. A man’s collar, and the suspenders overshoulders.

b. A man’s belt and trouser band.c. A woman’s skirt bands and corsets.

NOTE—Any tight waist clothing will positively impede thefree movement of the diaphram, the attachment of which is atthe waist line.

Study the accompanying cuts of these foursteps.

Second Step. Turn the body of the victimover, face down; stand over it astride, claspingthe hands under it at about the pit of stomach,jerking it up and holding it there for a few mo-ments by bracing the elbows on the thighs. Ifthe case is one of drowning, hold the body up a

15

ILLUSTRATIONNo.1

FirstStep

16

ILLUSTRATIONNo.2

SecondStep

17


little longer so as to allow the water in thestomach and breathing passages to drain out.If a suffocation ease, this jerking up of the bodywill help to clear the air passages and in suchcases to do it two or three times will be helpful.If the victim is a large heavy person, have someone assist in the lifting process by claspinghands while facing each other at opposite sides.Study illustration No. 2.

Third Step. Open the mouth, use a cleanhandkerchief or piece of gauze; insert one ortwo fingers; pull the tongue forward; removeany obstruction from mouth such as loose falseteeth, tobacco or chewing gum; if there is noneof these, there is usually some mucus. Of coursethe jerking up of the body does much to effectthis very thing, especially in drowning; never-theless, it is important that this step be takenso as to make quite sure that everything is clear.See illustration No. 3.

Fourth Step. Stretch victim’s arms straightout above head; flex left forearm, supportinghead thereon, with the face turned to the right,

18

ILLUSTRATIONNo.3

ThirdStep

19

FourthStep,andfirst

positionin

performingSchaeferMethod

ILLUSTRATIONNo.4


20

but see tliat there is no outside obstruction inthe way of the mouth. (This fourth step is onlyused when performing the Schaefer movement.)See illustration No. 4.

21

Chapter VIIIThe Schaefer or “Prone” Method of Artificial Respira-

tion, and How to do it Correctly for SuccessfulResuscitation—Following Instructions as to

the Four Necessary Steps.

Proceed as follows:—First. Straddle the body by kneeling a little

above the victim’s knees (a woman operator canspread the legs of the victim and kneel between) ;

this position is positively necessary, since in thisway only can equal pressure be made to causethe diaphragm to function successfully.

Second. Place the hands with thumbs close tothe fore-fingers on the small of the victim’sback, immediately above the hip bones, with thefinger tips out of sight. Make the arms rigidand throw the weight of your body forward withsteady pressure — there must be no jerking—

and, as this is done, squeeze in with the fingersthus forcing in the floating ribs.

While making this downward pressure, countdeliberately — one — two, then snap the hands

22

Secondpositionin

performingtheSchaeferMethod

ILLUSTRATIONNo.5


23

off the body onto the ground, continuing tocount — three— four — five, and resume themovement as above; thus carrying on until re-suscitation is achieved. Study illustrations Nos.5 and 6.

NOTE—The entire movement should not be less than fiveseconds, so that about twelve movements will be rounded outto the minute. This is the rate suggested by those who havehad much experience in reviving the “apparently dead.’’ Anaid could time the operator by holding a watch and calling theperiods.

24

Thirdpositionin

performingtheSchaeferMethod.Handssnappedoffbody.

ILLUSTRATIONNo.6

25

Chapter IX

As it is Quite Possible That in Some Instances the “Syl-vester” Method Might Have to be Used, the Follow-ing Rules Ought to be Held to Faithfully if Success isto be Obtained. But of Course the Preparatory StepsMust be Taken Prior to the Movement Itself.

Proceed as follows:—

First. Place the victim on back, preferablyon a bench so that there will be more freedom inthe movement; have an aid hold the victim’stongue out, a small wooden paper clip or pieceof gauze will do for this purpose.

Second. Grip the victim’s forearms close tothe elbows, swinging outwards for the upwardmovement, doing so slowly while counting — one— two — three, this for inspiration. Then swingarms quickly back to the lower edge of ribs andpress in strongly with the victim’s elbows. Thismovement should equal about two moderatecounts; this is expiration.

NOTE—As an aid to the success of this movement, thehelper who is attending to the victim’s tongue, may also holda cloth to the nose on which a little aromatic spirits of

26

Inspirationmovementin

SylvesterMethod.Thelady

assistingis

readywith

clenched

fisttopressinatpitofstomach,whentheoperatorbringsvictim’s

armsdown.The

boyhasa

clothwith

aromaticspiritsof

ammoniaonitto

holdto

nostrilsinthismotion.

ILLUSTRATIONNo.7

27

Expirationmovementin

SylvesterMethod.Thelady

assistantquickly

removesfistas

soonasOperatorstrikeslower

ribswithvictim’selbows.

ILLUSTRATIONNo.8


28

ammonia is poured, while the inspiration movement is beingexecuted—but only for a moment. Further, he may also workthe tongue in and out; a ‘Laborde style, i. e. In for inspirartion, and out for expiration. Another helper can be of muchassistance by kneeling at the victim’s side and, with clenchedfist, press in sharply at pit of stomach when the operator’shands are brought down for the expiration movement; thusproducing a more positive stimulating effect upon the heart.This is a part of the method known as the “Howard.”

Study illustrations Nos. 7 and 8.

29

Chapter XA Few General Rules to be Observed During the Appli-

cation of Artificial Respiration.

1. Always send for medical aid, but do notwait for his coming, minutes are as hours inthese cases; proceed as has been suggested.

2. If cold weather, cover the body with ablanket; apply hot water bottles to the feet andsides — see that they are not too hot to hum.

3. In all cases of asphyxiation — except byammonia fumes — use aromatic spirits of am-monia to the nostrils momentarily while inhaling.

4. Always provide abundance of fresh air,which means that if there is any crowding ofspectators, that they be kept well back from thevictim.

5. When signs of reviving show themselves,have the helpers begin to rub the limbs towardsthe body; occasional slapping of the bare solesof the feet, or striking with a small club overthe soles of the shoes is often helpful.


30

6. If when applying the Schaefer method, theface becomes congested, quickly change over tothe Sylvester, but see that the body is kept on aslant — head slightly higher; when congestiondisappears change hack to Schaefer position.

31

Chapter XISome Vital “Dont’s” to be Rigorously Kept in View

When Artificial Respiration Has to be Given.

1. DON’T wait, not under any circumstances;if the body is where you can work on it, do it,and do it right away.

2. DON’T stop the application of the Schaefermethod to permit the use of a pulmotor or lung-motor, unless you know that the apparatus isactually in working order; and that, too, it isin the hands of a trained operator.

3. DON’T surrender the body to an ambu-lance unless you can accompany it and continuethe movement enroute to the hospital. Whenthis is permitted, there is usually a funeral, i. e.,short of the movement enroute.

4. DON’T desist, even if a physician pro-nounces the victim “dead;” there are so manycases in which this has been done, where, in theface of the verdict, a persistence in continuingthe movement has won out. No sane doctor will

32


resist you and all tlie friends of the victim willback you in your efforts, while, as for the rela-tives in their despair, nothing need he said.

5. DON’T allow the chafing of the limbs,until there are signs of reviving; it is ratherquestionable since it has the tendency to pushthe blood hack on the heart, which is dormantuntil revival sets in. There is an exception how-ever to this rule — see chapter 13 ‘ ‘ illuminatinggas.’ ’

6. DON’T turn the victim over on his backat first signs of reviving (when Schaefer methodis used) ; be patient and only do so when thelung action shows up positively. When turnedover, continue to keep the hands on the lowerribs to assist the labored breathing. See that thevictim is in a reclining position; he will breatheeasier this way.

7. DON’T allow the spectators to crowd inwhen he is reviving, that is, when necessary,insist that they be made to get away off, andespecially permit no hysterical relative to comenear him until he is getting well back to normal.

8. DON’T be too eager to give liquids, give

33


him a chance to breathe freely before this isattempted. When a stimulant can be given with-out fear of choking him, see that it is somethinghot, such as tea, coffee, or what is without ques-tion the best possible stimulant, aromatic spiritsof ammonia, *4 a teaspoonful in % a glass of hotwater; feed it to him in a spoon by sips.

9. DON’T fail to watch him for hours afterhe is revived; it is not beyond the possible forhim to stop breathing again and, in that case, goat it again. In such instances the victim quicklyresponds. A heart stimulant in the line of ahypodermic injection by the doctor will workwonders.

34

Chapter XIIThe Pulmotor—Some Facts to Keep in Mind in

Reference Thereto.

Most industrial surgeons condemn this methodof mechanical resuscitation.

One such authority has this to say relative toits use: ‘ ‘ Since the introduction of the pulmotor,thousands of persons have been buried thatought to he alive today.” It may be that hisconclusions are based upon the three reasonswhich I like to give for not using it.

1st. It is not always at hand, and to wait forit is fatal.

2nd. It may be out of order, and to use it, ifsuch is the case, must prove fatal.

3rd. If used by other than a trained operator,it is a risk which may also turn out fatally.

So then the moral is clear, do not depend uponthat which might prevent the resuscitation of thevictim, but go to it and use your hands (whichare always with you), just in the manner which

35


we have tried herein to make clear to you; andby all means stick to the Schaefer method.

It will be of much interest to my readers, asit was to the writer, to learn from the pages ofa government report devoted to the investiga-tions of a select committee upon this subject ofresuscitation of these victims, i. e., TechnicalPaper No. 77, Bureau of Mines, 1914, p. 25.Two very startling objections are therein raisedin reference to the use of a mechanical appara-tus such as the pulmotob.

First. “It is possible when using a mechan-ical apparatus to turn inspiration into expira-tion through a slight resistance in the air pas-sages of the victim.”

Second. “That the expiration (breathing out)movement by suction, as in the pulmotor, isvery harmful.”

I take time here to recall to the reader’s mindwhat wr e endeavored to show as to the move-ment of the diaphragm; that is, in normal res-piration, expiration is produced by muscularcontraction. Hence the conclusion reached inthe above quoted report is, “that the automatic


36

mechanism of the pulmotor, though an ingenioustechnical contrivance, instead of assuring arti-ficial respiration, may interfere greatly with itsefficiency, because the mechanism is likely to cutoff inspiration prematurely.”

This government report strongly commendsthe Schaefer method of artificial respiration.

"While representing the Bureau of First Aidof the American Red Cross at the South DakotaState Fair, just before the World War, I wasgiving demonstrations in first aid to very largecrowds whose interest was most compelling.In these demonstrations artificial respirationwas one of the most vital elements emphasizedand, as is my custom, I had warned my hearersas to the pulmotor (as per my threefold objec-tions.) One day as I closed the demonstrationsa gentleman accosted me, introduced himself andsaid that he represented the TJ. S. Department ofMines. lie took occasion particularly to com-pliment me upon the demonstration in resuscita-tion and added, ‘ ‘ what you said about the pul-motor was most timely and I wish to state afact which I shall be glad if you will be goodenough to repeat in connection with your re-


37

marks on the pulmotor. It is this; in most caseswhere the pulmotor is used, if the victim is notrevived, the post mortem usually reveals thatthe lungs are a mass of blood, the pulmotorhaving ruptured the lung tissue.” I am surethat you can now grasp the significance of thegovernment report, especially in the light of theshocking fact stated by this officer of the Bureauof Mines; the connection is clear, “it is possiblewith a mechanical apparatus to turn inspirationinto expiration.” In conclusion, as far as thissubject is concerned, hold to the use of thehands, and especially through the Schaefermethod, in the application of which you are atleast positive that, if you do not accomplish anygood, you certainly will do no harm; and yet,in the bulk of such cases, providing that theconditions are right, and that you follow thesuggestions herein given, success ought to crownyour labors.

38

Chapter XIII

The Particular Things to do, in the Particular Emer-gency Which May Demand its Own Peculiar Treat-

ment, Which if Followed Would SecureSpeedier Results.

In Case of Electric ShockThe question of high or low voltage in this

matter of electrocution is rather a puzzling one.A good authority on this subject cites the caseof a man who, while taking a bath, reached upto turn on the light, and who received sufficientshock to effect him for several days—the voltagewas only twenty-seven. Quite recently a ladywhile taking a bath, in some manner overturneda small electric heater into the tub. Upon thearrival of the physician he pronounced her dead— though no effort was made to resuscitate her.The voltage was 110.

In contrast with these we have cases of electricpower linemen being “hit” with as high as 6600volts and actually being revived. Some author-ities lay this fact to the higher voltage seemingly


39

only affecting the body surfaces; they name it“skin effect.” However, whether “high” or“low” let us not waste any time in debating thematter, especially in the light of one case wherea lineman was “hit” by such high voltage andfell 30 feet. Even though his left hand wasburnt off and the arm charred to the shoulder,still his mates actually revived him.

Of course if the victim is in contact with “alive wire,” the first work will be that of remov-ing him from that predicament; but you mustthink of your own safety; if you do not, therewill be two in the same fix and you will he oneof them. Either “short circuit” or sever thewire on the side from which the current iscoming, or have the current cut off; but what-ever you do, follow ‘ ‘ safety first ’ ’ rules.If a victim is “hit” on a pole or a cross-arm

and does not fall, tie a bowline around chestunder arm-pits and lower to ground. If you donot have a rope, tie the hands together, puttingyour head and one arm between, thus gettinghim on your hack. In that way one can easilybring him down to the ground. See this illus-trated in chapter on transportation.

40


If the victim is “hit” in a bath-tub, first cutoff current, or remove wire from the water orcontact with tub (if it is metal) with a dry stick.Then get him out of the water and proceed toresuscitate.

In all cases of electric shock, if the victimdoes not fall at least ten feet when “hit,” youmust administer COUNTER SHOCK.

Victims of severe electric shock who fall havealways been easily revived, and the medicalworld, especially the industrial, have decidedthat this falling of the body is the “savingclause,” inasmuch as it imparts a “countershock” and thereby reacts upon the temporaryparalyzed respiratory nerve center in the brain,which makes possible speedier resuscitation —

especially when the Schaefer method is em-ployed. Numerous cases of those thought to heelectrocuted, whose bodies were put into vehiclesfor conveyance to some undertaking establish-ment, have been revived by the very jolting ofthe machine.

Here is one practically fresh off the press:—Omaha Bee, September 6th. “Man thoughtdead, screams in hearse.” This victim was

41


“hit” by a live wire, pronounced dead by aphysician, no effort made to resuscitate, under-taker called, the corpse (?) was put into thehearse and, on the way to his home, the joltingbrought him to. That’s all and it is laughable,but when one consideres the distressing fact ofthe many such victims who are not only pro-nounced “dead” but in time actually buried,who ought to have been revived, what shall wethink of the ignorance which is responsible forthese tragedies ?

Indeed it is a mild form of culpable homicide,on the part of those who stand by and considera victim dead who is in point of fact only “ap-parently dead,” but who will soon be dead andultimately buried, if the bystanders, whethermedical or lay, do not know how to render arti-ficial respiration.

How then is “counter shock” administered?While the operator is going on with the resuscit-ating movement two helpers should kneel at thefeet of the victim, one on either side who, atintervals of say half a minute, lift up the footof the victim and hit smartly right over the soleof the boot ’twixt heel and toe, with a hammer

42

Methodof

administering“CounterShock”

ILLUSTRATIONNo.9


43

handle or the ‘ ‘ climbers, ’ ’ taking care to sustainweight of limb so that theknee is not on groundwhen the blows are administered. If the shoesare off, spank sharply with the hand, a paddle oranything which is narrow and flat. This then inhow “counter shock” may be given if the bodydoes not fall ten feet or more. Study illustra-tion No. 9.

In a recent case of severe electric shock treatedby the linemen of the Nebraska Power Companyand revived in 35 minutes, the men reported tome that, in addition to the hitting of the solesof the shoes with their climbers, they found thatthey made more positive progress by pausing inthe movement two or three times to jerk up onthe victim’s abdomen (step No. 2).

NOTE—In all cases of severe electric shock, because of thefact that the “juice” causes the muscles of the shoulders,chest and arms to become tense or rigid; it is NOT possible toget results if the Sylvester method is used; therefore alwaysresort to the Schaefer or prone method.

Study illustration No. 9 for the method ofgiving “counter shock.”

NOTE—The Nebraska Power Co. of Omaha, reports thatit is not uncommon for a victim who has suffered from lowvoltage shock to have violent convulsions when coming out ofthe dormant stage. If the surgeon is present a hypodermicinjection is administered to relieve the pain. It is evidentfrom this, that the low voltage must go to the heart, probably


44

that helps to explain why it is more difficult to resuscitatethese cases; while those suffering from the high voltage (espe-cially if the victim falls) are revived within a few minutes.But let no one despair in performing artificial respiration onone who may be “hit” with low voltage. Use the Schaefermethod and follow these instructions herein given; since theyare the tried methods which have proved successful in num-erous eases and they will always bring results—provided thereis a ghost of a chance.

In Case of Drowning

If the body is taken out of the water somedistance from shore, at once follow STEPS 1, 2and 3. Place the victim on his back over thethwart or seat of the boat and apply the Syl-vester method, while others are pulling ashore.This is the only method which one could use inthis peculiar instance, and is at once a strongreason for a working knowledge of this methodof resuscitation also. When on shore, however, Ishould resort to that of the Schaefer method.

NOTE—Don’t try to apply any method if you are in acanoe; quickly get the body to shore and there set to work.

In Cases op Asphyxiation from IlluminatingGas

If the victim lies in a closed room, endeavorto have the gas shut off at the meter, and, if it isnecessary, break the windows so as to let in air;lots of it is vitally necessary. In all cases, get

45


the victim out into the open air, hut avoid thisif it is frosty; in that case seek a moderatelywarm room. In slight cases, where they are notentirely overcome, give a goodly draught ofeffervescing phosphate of soda; if you can getit; by all means induce vomiting; keep themwalking, and while doing so, have some one holda cloth to their nose upon which aromatic spiritsof ammonia has been sprinkled — but don’t holdit too long at a time as it will be apt to suffocatethem.If helpless but still breathing turn over on

stomach, jerk up on clasped hands under pitof stomach (step No. 2). Do this two or threetimes, as this will help rid the air passages ofany gas; hold aromatic spirits of ammonia tonostrils; and, as soon as it is possible for himto swallow, give the effervescing salts. Try toinduce vomiting. When he is able to stand,assist him to walk up and down.

If the victim has stopped breathing, rush med-ical aid and "proceed as has been suggested forthe work of resuscitation. But in addition, applyheat to the body, have the muscles of the limbs

46


vigorously rubbed, as such friction is a decidedhelp in these peculiar cases.

NOTE—This is the one exception in performing artificialrespiration, where rubbing of limbs should be permitted beforethe victim revives; in this case it is really friction to helprelax the muscles.

In many gas plants, oxygen is kept on handfor the treatment of such cases and hypodermicinjections are administered. In the hospitaltreatment, much success has been achieved bythe use of normal saline solution and even byblood transfusion in the saving of these victims.

In the Case of One Overcome by GasolineFumes

First get the victim up off the floor and into thefresh air, as the fumes are heavy and hug theground. Even if he is not quite overcome turnhim face downwards and clasp hands under theabdomen and jerk up two or three times to helprid the air passages of fumes. If you can inducevomiting, that will be even better than the jerk-ing up method. Use plentifully aromatic spiritsof ammonia for inhaling, and when able to swal-low give some internally — % teaspoonful in

47


1/2 glass of water. If entirely overcome followthe general rules for reviving, preferably by theSchaefer method.

In Cases of Hanging or Choking from

Food, etc.

If strangulation from food, bend the body for-ward; slap hard on the back. If that does notdischarge the mass, run the finger around theoutside of back teeth, and in that way you maysucceed in getting the finger behind it and thuseject it. If the victim stops breathing, quicklyremove the obstruction, and proceed to performartificial respiration.

If hanging, and you discover that the victimhas not hung for more than say twenty minutes,and that there is no evidence that the neck isbroken (most cases of this nature merely strangleto death), get help, cut the body down, jerk upon the stomach as in “step No. 2,” and at onceproceed with the artificial respiration movement.If after faithful and persistent effort you do notsucceed, then call for the coroner.

NOTE—According to the dictates of the Law you aresupposed to first call the coronor, but that would mean loss oftime, therefore FIRST try to resuscitate if there is but a ghost


48

of a chance; and if you should succeed, even the Law will com-mend you for your ignoring its mandate. Even the poormortal whom you snatched from the jaws of death, may havegood cause to be grateful also.

In Case of Ammonia Asphyxiation

Quickly remove the victim from the area ofthe fumes; it is quite possible that to do thisyou may have to crawl on your hands and kneesto where he is. In that case soak a handkerchiefin vinegar or diluted acetic acid, tying sameover your nose and mouth; this will enable youto breathe in the midst of the ammonia fumes.—See chapter on transportation for methods ofrescuing.

When you have him at the place wdiere theair is good, proceed with the general rules ofresuscitation. But instead of using aromaticspirits of ammonia — this is the exception tothe rule — in these cases you substitute a clothsoaked wr ith good vinegar or diluted acetic acid,and see that it is so held to the mouth and nosethat he inhales its fumes. Ammonia is a strongalkali and must be overcome with a weak acid assuggested.

When he is revived and can swallow, a goodstimulant would be a cup of hot lemonade.

49


In Case of Suffocation from Smoke orAcid Fumes

Get the victim out into the open air; try toinduce vomiting — this is the method usuallypracticed by firemen who are so effected. Holda cloth with aromatic spirits of ammonia to thenostrils so that he may freely breathe it; whenable to swallow give V2 teaspoonful in y<% cup ofwater. If entirely overcome, proceed with arti-ficial respiration as per the rules given.

In Case of Prussic Acid Poisoning

The action of this poison is exceedingly rapid,unconsciousness usually setting in within two orthree minutes; and one of the distressing symp-toms is that of the swelling of the throat causingsuffocation.If possible quickly neutralize the effect of the

poison by getting the patient to rinse out mouthand gargle throat with an alkali, i. e., purealcohol, lime water or a mixture of strongsaleratus water; and have him also slowly swal-low some. Hot cloths should be applied to theneck, especially to the windpipe; also give


50

chipped ice to suck; in this manner the swellingmay be reduced. If there is difficulty in breath-ing he may be materially aided by performingartificial respiration and since it will be easierfor him to remain on his back, resort to theSylvester method.

NOTE—Whatever causes a swelling of the tissues of thethroat, always resort to the use of hot applications to thethroat say from the top of the breast bone to the chin andaround the neck, also give chipped ice to suck; and olive,sweet, or any good oil may be given in dessert spoonfuls.Often a bee sting, particularly at the temple produces thesesymptoms. Remove sting and follow this treatment.

51

Chapter XIVTransportation, or the Knack of Handling the Injured,

Helpless or the “Apparently Dead”—by“One Man” Methods.

AH persons, especially those employed in ourindustries, particularly where the “hazards”exist, ought to know how to be able to takeproper care of their fellows when taken by someemergency, to the extent of their either assisting,or lifting, or carrying them. This whole matterof so doing is just “a hit of science,” and theseinstructions, together with their accompanyingillustrations, will make it easy for the reader toacquire the knack — if only he will practicethem a little.

1. The Assist is the easiest method of helpingone either with an injured ankle or knee, or inthe case of one being shakey from gas, fumes,etc. Be sure to hug the patient close to you. Seeillustration No. 10.

2. The Coat Carry. If the patient can standjust long enough so that a few turns to the tail

52

ILLUSTRATION No. 10

The Assist

53

TheCoat

Carry—First

MovementILLUSTRATIONNo.11

54

TheCoatCarry

—SecondMovement

ILLUSTRATIONNo.12

55

TheHipCarry—FirstMovement.

ILLUSTRATIONNo.13

56

TheHip

Carry—SecondMovement

ILLUSTRATIONNo.14

57

Fireman’sLift—FirstMovement

ILLUSTRATIONNo.15


58

of his coat can be given, then turn quickly,bringing the twist well over on to your shoulder,then stoop, pulling tightly so as to have him wellup on your back; and in that manner you willeasily carry him. Be sure that you bend yourbody well forward in lifting and carrying.Study illustrations Nos. 11 and 12.

3. The Ilip Carry. This is another quickmethod of carrying one out of a dangerous place— providing you can get him to stand whilemaking the hold. Stand to the front of thepatient, run your hand over the near shoulder,around the neck, catching him under the furtherarmpit, stoop down with bent knees, catch yourfree hand around the patient’s limbs; and liftover onto your hips. Follows illustrations Nos.13 and 14.

4. The Fireman’s Lift. Without question,this is the best of all methods to lift and carrythe helpless or unconscious. It is not a questioneither as to size or weight, providing you do itas illustrated. Roll the patient over face down,lift him by his armpits on to his knees, clasphim around the body in a tight embrace and rise,

59

ILLUSTRATION No. 16

Fireman’s Lift —Second Movement

60

ILLUSTRATION No. 17

Fireman’s Lift—Third Movement

61

ILLUSTRATION No. IS

Fireman’s Lift—Fourth Movement


62

bringing him to his feet. As you do this, placeyour left knee against his knees so as to keep himerect. Hold him tightly with the left arm, griphis left wrist, stoop so as to thrust head under theleft arm, pulling the body over your back withthe bend of his body pressed against yourshoulder, at the same time drop the left handover the buttocks to about the knees. Then braceyourself thoroughly for the lift and, as you rise,pass his left hand to your left, grasping stronglyat the wrist; and if he is not quite well balancedupon your shoulder throw his body into correctpoise by a hitch of your shoulder.

NOTE —-The firemen always place the lifting arm betweenthe legs. They do so as to bring the body across the shouldersand that the feet will be out of the way of the ladder in des-cending. But for surface work the above is by far the best asit gives one a more secure hold of the body.

Study illustrations Nos. 15, 16, 17 and 18.5. The Back Crawl Carry. This method will

he found very useful in rescuing a victim froma gas-filled room, or where fumes demand greatcare on the part of the rescuer.

If smoke with acid fumes or illuminating gas,wet a handkerchief with diluted aromatic spiritsof ammonia; if ammonia fumes, wet with good

63

TheBackCrawl

Carry

—MovementOne

ILLUSTRATIONNo.19

64

TheBackCrawlCarry

—MovementTwo

ILLUSTRATIONNo.20

65


vinegar and tie over mouth and nose, then whenyou near the point for the dash to rescue, getdown on hands and knees so as to avoid thefumes, because the air is purer near the ground.When you reach the victim see that he is on hisback, quickly tie his hands together at wrists —

be sure you tie a square knot. Lie on him faceup, bring his tied hands over your head, griphis pants tightly at either hip, holding taut.Roll over onto your chest, this movement willbring him on to your back and under him.Spread his legs so that they will liange one oneither side of yours; then rise to your knees andcrawl back to where the air is good and therefinally rising to your feet so that you may runto safety. Study illustrations Nos. 19, 20, 21and 22.

NOTE—With this “carry” the rescuer may descend aladder or fire escape, providing that when he rises to his feetthat he thrust one arm through the (bight of) the victim’s tiedarms: this will prevent the possibility of his arms choking oneas his weight hangs on the neck.

As a further word of exhortation,— he surethat for all rescue work where it is necessaryeither to use a rope in lowering a body, or to tiethe hands as in this latter “carry,” that you

66

TheBackCrawlCarry

—MovementThree

ILLUSTRATIONNo.21

67

ILLUSTRATION No. 22

The Back Crawl Carry—Movement Four


68

know how to tie a bowline with a rope for theformer, and a square knot for the latter. Andbe sure that you can even do it in the dark, sothat you do not endanger your victim whom youare trying to rescue. A ‘ ‘ granny knot ’ ’ will nothold, and a slip knot tied with a rope arounda man’s body, owing to his own weight, maycause injury of a serious nature.

71

IndexPAGE

AAbdomen, movement of, in respiration

. . 4Acid fumes 1Acetic acid. Necessary in cases of ammonia

fumes 48Ammonia asphyxiation 1“Apparently dead” is really suspended anima-

tion 4Arms, position of, in performing the Schaefer

method ........17Aromatic spirits of ammonia. How to use as a

stimulant ....... 29Asphyxiation. Its causes ..... 1Assist, the. For the injured . . . .51

BBack crawl carry ...... 62“Beaned” by a baseball 2Bee stings. The treatment for all cases of

swollen throat ....... 50Blast furnace gas ......1Boat, rescue of the drowned in a. What method

to use ........44Breathing and how it is carried on . .3

INDEX

72

PAGEc

Carbonic acid gas ......1Cave-in 2Chafing of the limbs in artificial respiration . 32Charcoal gas 1Choking from food ......2Choking from food. How to treat same . . 47Chloroform .......1Clothing must be loosened before performing

artificial respiration . . . . .14Coat carry, the 51Cold weather, what to do when performing

artificial respiration in . . . .29Congested face in victim being operated on by

Schaefer method ...... 30Convulsions when reviving from electric shock 43Corporations active in teaching artificial respir-

ation to employees .....PrefaceCoroner, calling the ......47Corsets. Necessity of loosening before perform-

ing the movement ......14Counter shock. Why necessary in all cases of

severe electric shock . . . . .38Counter shock. How to perform if the body

does not fall 40

DDead air ........1Dense smoke .......1

73

INDEX

PAGE

Diaphragm. Its importance in the organism . 3Diaphragm. Its attachments. How it functions

in breathing 9Diaphragm. How it is made to function in per-

forming Schaefer movement . . . .10Doctor, the, who pronounces a victim dead . 31“Don’ts” to be observed in performing arti-

ficial respiration 31Drowning 1Drowning, points for treatment in . .44

E

Effervescing salts, need of, in caring for thoseovercome by illuminating gas ....45

Emergencies calling for artificial respiration . 1Ether asphyxiation 1Expiration. What it is . . . .9Exhaust from gasoline engines—monoxide gas 1

F

Face. If congested must change from Schaeferto Sylvester 30

Feet, slapping the soles of the . . . .29Fireman’s lift, the. How to do it right and

easily ........58

Formaldehyde 1

INDEX

74

PAGE

Four steps to be taken before performing arti-ficial respiration 14

Fractured skull 2Fresh air vital in performing artificial respira-

tion 29Freezing may cause one to stop breathing . . 2Friction of limb muscles in treating illuminat-

ing gas victims 45Fumes causing asphyxiation 1Fumigating agents 1

GGarrotting 2Gas stove dangerous in badly ventilated room 1Gas, blast furnace 1Gas, charcoal 1Gas, coal 1Gas, illuminating 1Gas, mine 1Gas, monoxide 1Gas, sewer 1Gasoline engine exhaust and its possible dan-

gersGasoline fumes victims and how to treat . . 46General rules to observe in performing artificial

respiration 29

INDEX

75

PAGEH

Hanging ........2Hanging, treatment for 47Head, position for, in performing Schaefer

method 17Heart, position of the- 10Heart, apex of the 9Hip carry. The quick method of removing the

helpless 51Hot cloths to the windpipe. For prussic acid or

bee sting cases 49Howard method as an aid in the Sylvester

movement 28Hysterical relatives 32Hypodermic injections necessary in certain

cases 33,46

IIce to suck in cases of swollen throat . . 50Illuminating gas 1Illuminating gas treatment 44Industrial surgeon’s testimony to need of this

practical knowledge ....PrefaceInteresting cases of resuscitation are an incen-

tive to learn “how” .....7Inspiration. How it is accomplished ... 9

INDEX

76

PAGEJ

Jaw, knock-out blow on the ....2Jerking up body of the apparently drowned

most important 14Jerking up body in electric shock and gas as-

phyxiation cases 45

KKidneys, position of 11Knock-out blows should be given artificial res-

piration ........2

L

Laborde method an aid in the Sylvester move-ment ........28

Labored breathing when reviving. How to assist 32Laudanum poisoning 2Lightning stroke ......2Limbs. When and when not to rub in artificial

respiration .......29

Lime water as an antidote in certain cases . 40Liquids. Great care must be exercised in ad-

ministering 32Live wire with victim on it. How to proceed to

rescue ........38Loosening tight clothing in performing artificial

respiration 14Lungs, position of the 11

77

INDEX

PAGEM

Man-hole, dead air in 1Medical aid, always call for, but don’t wait,

begin the movement . . . . .29Mine gas ........1Monoxide gas 1Mortality statistics of victims (U. S.) . PrefaceMouth must be cleaned out in performing arti-

ficial respiration 20

NNeed of haste in handling “apparently dead”

cases 8,31Need of long patience in performing artificial

respiration .......31Non-respirable gases 1

0

Obstructions must be removed from mouth whenperforming the movement . .

. .20Oil stoves dangerous in poorly ventilated rooms 1Oil and aid in treating certain cases . . .50Organs of respiration. The diaphragm . . 3Organs of body and their positions ...9Oxygen necessary in some cases . . . .40

78

INDEX

PAGEP

Poisons Avhich cause asphyxiation ...2Position. The correct position in performing

the Schaefer method . . . . .23Prussic acid treatment .

.. . .49

Pulmotor, some points which need emphasizingin relation to the ......34

Pulmotor, a government report on the . . 36

RRespiratory nerve center. How it enters into

the subject of resuscitation ....4Resuscitations obtained through workmen ex-

ceed those by doctors .... PrefaceRibs, some facts relative to the “floating” . 11Rules to strictly follow in performing the move-

ments ........ 29

S

Saleratus (carbonate of soda) as an antidote . 49Schaefer method, the wonderful . . . .11Schaefer method compared with that of the

Sylvester 13Schaefer method, how to perform the . . .14Severe electric shock ...... 2

How to treat .......38Lower body of . . . . . . .39

79

INDEX

PAGE

Sewer gas ........ 1“Skin effect,’’ so-called, in explaining the ac-

tion of high voltages . . . . .39Slapping the soles of the feet for electric shock

treatment ........43Solar plexus, a blow over the .... 2Spleen, position of the . . . . .11Stethoscope, some doctors discard the . . 8Stimulant, the best . .

.. . .33

Stomach, position of the . . . ..11

Strangulation from food ..

.. .47

Strychnine poisoning ......2Suicides. Some attempted suicides might be

saved .......PrefaceSulphur fumes ....... 1Sunstroke cases in some instances need artificial

respiration ...... 2Surrendering the body of a victim to be taken to

an hospital .......31Swelling of the tissues of the throat. What to

do 50

TTime an important factor in performing artifi-

cial respiration ......13Tissues of the throat, if swollen .

. . .50

INDEX

80

PAGE

Tongue of victim must be brought forward be-fore applying movement . . . • .25

Transportation. How to handle if alone, thehelpless or unconscious 51

V

Vacuum created by descent of diaphragm whenmovement is performed ..... 2

Vinegar. Its use in ammonia asphyxiation . 48Voltage, the question of high and low . . 38Vomiting as a help in case of gas or smoke

victims ........46

W '

Walking a victim partially overcome by gas . 45Watching a case which has been resuscitated . 33Water in the stomach—lungs . . . .17Why doctors usually pronounce a victim of as-

phyxiation as dead beyond hope ...8Winded athletes may need artificial respiration 2

Documents

A manual of artificial respiration