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Journal Jw rljc Ambulance attd pursing ^mrioss No 589, Vol. L ]
JULY, 1943.
U S lL J
A™"**"?,”
By Lt.-Com. F. A. M. EDEN, R.N. 2s., by post 2s. 2d. Instructor, Ministry of Home Security School, York
CIVIL DEFENCE: •
A BASIC TRAINING M ANUAL SECOND
EDITION
•
“ It not only brings together under one cover th e information contained in five o r six handbooks, but it includes also details difficult to get at present o th er than from a visit to a Home Security School.” — British Red Cross Society, C ounty of London Bulletin.
J O R D A N & S O N S , L IM IT E D , 116 C H A N C E R Y L A N E , L O N D O N , W .C .2 .
BIOLOGICAL M B I 3 PREPARATIONS A
N
T I P
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O
L
areSfSi
O
I N
T
M
E
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O n e o r o t h e r o r all o f the three races o f g e r m s , S t r e p t o c o c c i, S t a p h y lo c o c c i a n d B. p y o c y a n e u s a re f o u n d in e v e r y s k in in fe c t io n c o m m o n to this c o u n t r y , a nd A N T I P E O L O I N T M E N T co n tain s the antibodies (an tivirus) o f these g e r m s . H e a l i n g is e x p e d it e d b y the p r o v e d in gre d ie n ts o f the o in t m e n t , and se ptic d e v e l o p m e n t is s t o p p e d o r p r e v e n t e d b y its a n t iv ir u s ste rile v a c c in e fil trates. A N T I P E O L O I N T M E N T is u nsu rp ass ed f o r B U R N S a n d S C A L D S , f o r it is m ic r o b ic id e a n d n on -a d h e siv e , and d r e s s in g s d o n o t r e q u ir e to be c h a n g e d e v e r y d a y . W O U N D S , B U R N S , etc., W I L L N O T T U R N S E P T I C i f tre at ed w i t h A N T I P E O L O I N T M E N T .
O
P
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H
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is a sem i-fluid o in t m e n t , m o r e c o n v e n ie n t than the o r d in a r y A n t i p e o l o in t m e n t f o r o c u la r in fe ct io n s a n d lesion s. E y e s affected b y s m o k e and d us t are s o o t h e d a lm o s t im m e d ia te ly b y the appli ca tio n o f O p h t h a l m o - A n t i p e o l , and the a n t iv iru s p r e v e n t s g e r m s f r o m d e v e lo p i n g ,
R
H
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O
- A
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T I P E O
L
affords rapid re lie f o f C O M M O N C O L D S , I N F L U E N Z A , A N D C A T A R R H . C o n t a i n i n g the a n tib od ie s o f the g e r m s c o m m o n to infections o f the n o se and p h a r y n x (Staph ly lo co cci, S tre p to co cci, B . p y o c y a n e u s , p n e u m o c o c c i , p n e u m o b a c illi, e n t e r o c o c c i , M . cata rr h alis , B. Pfeiffer), R h i n o - A n t i p e o l is n o t just a pa llia tiv e, b u t is a r e m o v e r o f the couse o f the in fe ctio n . D u r i n g e p id e m ic s it is the ideal p r e v e n ti v e o f m i c r o b e d e v e lo p m e n t.
C lin ic a l S a m p le , o n r e q u e .t fr o m
M E D IC O - B IO L O G IC A L L A B O R A T O R IE S
L T D ., C arg ree n
Road
So u th
N o rw o o d , Lo ndon, S .E JS
BROOKS FOR S .J .A .B .
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T h e F irs t A id m a n ’s sk ill Is u n availin g If th e v ic tim ’s re sp ira tio n is a llo w e d to fail — p ro m p t a ctio n w ith th e S p a rk le ts R e su scita to r is v ita l to successful re c o v e ry .
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rbeAmbulance atib SRursing perukes Editor : WALTER SCOTT, J U L Y ,
N o . 5 8 9 .— V o l . L .
N O T IC E
TO
F.R.San.l.,
F.R.S.A. T E n te r e d a t 1 LS ta tio n e r s ' H a l l \
1943.
READERS.
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Its aim and object being the advancement o f A m b u lan ce W ork in all its branches, the E ditor invites Re ade rs to send Articles and Reports on subjects pertaining to the M ove m en t and also welcomes suggestions for Practical Papers. A l l Reports, & c ., should be addressed to the E ditor at the address below, and should reach him before the 8 t h of each month, and must be accompanied (not necessarily for publication) b y the name and address of the Correspondent. Subscriptions, Advertisements and other business Co mm unications connected with F I R S T A I D should be forwarded to the Publishers. D A L E , R E Y N O L D S & C o . , L t d .,
F ir s t A id in W a r tim e .
e v ils
are
p r e v a ilin g g lo o m
so
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NUM BER.
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E d ito r ial —
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St. J o h n A m b u l a n c e A s s o c ia tio n
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w h ich
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S .J .A .B . H e ad q u a rte rs an d D istrict R eports
3
b u t th e ig n o ra n c e
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in f a c t o r ie s a n d
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in th e
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C o-ordin ation of C ivil D e fe n ce S erv ices
any
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F i r s t A i d in W a r t i m e .
in th e
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Telegraphic Address—" Twenty-four, London." Telephone—City 3710 . OF
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46 , C a n n o n S t r e e t , L o n d o n , E . C . 4 .
CONTENTS
sig h t
a tim e , n o t so m a n y y e a r s a g o , w h e n “ first
upon
th at
streets,
w ere
fo r
a v a ila b le ;
m e a s u re s a m o n g th e
5
g e n e ra l p u b lic w a s la m e n ta b le a n d th o u s a n d s m u st
Im provisation s
5
h a v e d ie d w h ile a w a it in g th e a tte n d a n c e o f a d o c to r
Q u i c k T r e a t m e n t for B u r n s
5
A U n iv e rsa l F irst A id Sp lin t
6
R ev iew s
6
B ritish R e d C r o ss S o cie ty
6
L e tte rs to th e E d ito r
...
fo r la c k o f a k n o w le d g e o f th e v e r ie s t ru d im e n ts o f th e sc ie n c e .
A ll
is
changed
m em b ers of a gath ered o n e o r tw o w ith first and
a id
a d m in is te r to th e
T h e H o m e G u a rd a n d F irst A id
re sp o n s ib le fo r
P o i n t s t o R e m e m b e r in D e a l i n g w i t h C a s u a l t i e s
d itio n
now
tra in in g
su fferer.
b rin g in g
o f th in g s, and
and
am on g
w e
to c o m e
T h e
have
i n g b l i t z e s f o r a n e n o r m o u s i n c r e a s e in t h e
10
g a in e d
E xam in atio n H o w le r
10
m a in
at
le a st
a tten d ed
an
E sc a p e from D r o w n in g
10
critica l m o m e n t h a s
10
cess w h ic h
Idea l A ntisep tic
10 10
S c h a fe r a n d N ielsen
10
A c tio n of C o ffee
12
E p ilep tic F it a nd F ra c tu r e d L e g
12
has
m u ch -boo sted w ill be
num ber
cla sse s
k n o w led g e
and
of
th e
w e
person
do,
proved
lea d s
in v a lu a b le .
T h e
suc
th e
m in istra tio n s
of
th e
one
to
in
th e
hope
th at
p o s t - w a r d a y s th e s u b j e c t o f first a id
in c lu d e d
sh o u ld
th an
e le m e n ta ry
atten d ed
c o m p a r a tiv e ly few ,
W e
first-a id
p r in c ip le s o f th e s c ie n c e , a n d w h o s e a id a t th e
A p o p lexy and B le e d in g P alm
H u m o u r in F i r s t A i d
con
to t h a n k th e t e r r ify
of
A sp h y x ia w ith B le e d in g
been
a b o u t th is im p ro v e d
Q u e r i e s a n d A n s w e r s t o C o r r e s p o n d e n t s :—
have
fo rw ard
w ar has
G reat W estern R a ilw a y
th ose w h o
th e
c ro w d w ill a lw a y s b e fo u n d
in
e v e r y e d u c a tio n a l
c e rta in ly and
w e w o u ld
in a t h o u s a n d
H o m e G u a rd U n ifo rm
12
m e t a t a r s u s is s it u a t e d
T r e a t m e n t of F r a c tu r e d R ib s
12
a sim p le
F r a c tu r e s of P e lv is a n d F e m u r
12
sh o u ld
C o m p r e s s i o n of B r a i n a n d A p o p l e x y ...
12
of
fa in tin g
know
m ore
c u rric u lu m .
a b o u t o u r b o d ies
w arrant
th at
not
one
k n o w s w h e r e h is fe m u r o r h is or w hat
a tta ck .
to d o in t h e c a s e o f
T h in g s
such
b e w ith in th e k en o f e v e r y o n e , e v e n
c o m p a ra tiv e ly ten d er
years.
T h is
is
as
th ese
in t h o s e sp e c ia lly
2
F I R S T
s o in t i m e s s u c h a s t h e p r e s e n t w h e n th e
a ir
is
still
a
p ro m in e n t
b o m b in g from
featu re
of
advanced
c i v i l i s a t i o n a n d t h e c i v i li a n is o p e n to a t t a c k e q u a l l y w ith
th e m e m b e r s
le ss to h a r k bu t th ere
is
back
of
th e a rm e d
and
to
ce rta in ty th at
fo rces.
regret w h at u p to
I t is u s e
has passed ;
n ow , d u rin g
th e
w a r, th o u s a n d s o f liv e s m ig h t h a v e b een s a v e d a n d th o u s a n d s o f c a s e s o f m o re o r le ss p e r m a n e n t in ju r y m ig h t h av e
b e e n a v o id e d h a d first a id b e e n a m a tte r
>f c o m m o n
k n o w le d g e .
Co-ordination of Civil Defence Services. E x tr a c ts from SIR
H EN RY
L.
L e c t u r e s d elivered b y
M ARTYN,
K .C .V .O .,
( C o n clu d e d from p a g e
The
C a su a lty
in
j j j
F .R .C .S
.)
H o s p i t a l . — ( C o n tin u e d .)
T r a n s f u s i o n a s a m e a n s o f life s a v i n g , b o t h fr o m s h o c k a n d fro m h a e m o r r h a g e , h a s pro ved to be th e m e a n s by w h ic h m a n y a c a s u a lty w h ich o th e r w ise w o u ld h a v e been co n sid ered h o p eless h a v e been sa ved , a n d fe w th in g s a re m o r e d r a m a t i c t h a n to w a t c h th e h e a l t h y c o lo u r r e t u r n i n g to th e d e a d w h ite fa c e of th e p a tie n t a s th e n e w blood p a sse s in to th e v ein s. B y su ch m ea n s th en y o u r pa tien t w ill h a v e been b r o u g h t t h r o u g h th e p h a s e of im m e d ia te d a n g e r , a n d w ill n o w be re a d y for operation . I h a v e a l r e a d y s t r e s s e d t h e n e e d f o r s p e e d in t h e c a s e o f a b d o m i n a l i n j u r i e s a n d c e r e b r a l c o m p r e s s i o n , b u t it e x i s t s , t h o u g h t o a m u c h l e s s e x t e n t , in a l l w o u n d s . M a n y p eople h a v e th e im p re ssio n th at a w o u n d p ro d u ced b y h i g h e x p l o s i v e is e i t h e r s e w n u p a t o n c e o r , if l e f t a l o n e , w ill heal v ery rapid ly. T h e p o s i t i o n is v e r y m u c h m o r e c o m p l i c a t e d . For a l l p r a c t i c a l p u r p o s e s , e v e r y w o u n d c a u s e d in w a r i s c o n t a m i n a t e d — -t h a t is, i n f e c t e d — b y t h e p r o j e c t i l e w h i c h c a r r i e s w i t h it in to th e t is s u e s f r a g m e n t s ot c l o t h i n g , e q u ip m e n t a n d sk in . A ll these fr a g m e n ts h ave upon th em la rg e n u m bers of b acte ria , so m e of w h ic h m a y be of e x tr e m e v iru len ce. N o t o n ly a r e th e y c a rrie d d ee p into th e w o u n d , b u t th e fo rce e xe rcise d b y the b o m b fr a g m e n t d evitalises a n d k i l l s a l l t h e t i s s u e s w i t h w h i c h it c o m e s i n t o c o n t a c t . Y o u m u st pictu re, th erefo re, e v e ry in ch of th e w o u n d , w h e t h e r it b e a t h r o u g h a n d t h r o u g h o r a n o p e n l a c e r a t i o n , a s c o v e r e d w i t h d e b r i s o f a l l s o r t s a n d i m m e n s e m a s s e s of bacteria . T h e la tte r te n d to flo urish e x c e e d in g ly sin ce t h e y a r e in i d e a l c i r c u m s t a n c e s t o f a v o u r g r o w t h s u r r o u n d e d in m o i s t w a r m d e v i t a l i s e d t i s s u e s t o o d a m a g e d t o r e s i s t them . It is, h o w e v e r , n o w k n o w n t h a t a d efin ite la t e n t perio d o f t im e e la p s e s b e fo re th e h e a lt h y tissu e s s u r r o u n d in g t h e w o u n d t h e m s e l v e s b e c o m e i n v a d e d , a n d if, b y t h e c o o r d i n a t e d w o r k o f t h o s e in t h e f ie ld , t h e c a s u a l t y c a n r e a c h t h e s u r g e o n ’ s h a n d in a fit c o n d i t i o n t o b e o p e r a t e d u p o n befo re t h a t p erio d h a s p a ssed , in fin itely b etter resu lts c a n b e o b ta in e d a n d th e g r e a t e s t d a n g e r of blood p o is o n in g a vo id ed . D u r i n g th e la st w a r a v e r y l a r g e n u m b e r of m en w e r e lost a s a re s u lt of w o u n d s w h ic h b e c a m e g r o s s ly septic, a n d a lt h o u g h , t o w a r d s th e en d of the w a r, m o rta lity f r o m t h e s e c a u s e s w a s b e i n g c o n s i d e r a b l y r e d u c e d , it w a s l a r g e l y in S p a in th a t th e p r e s e n t m e th o d of w o u n d s u r g e r y w a s perfected.
R I D It w a s v ery so o n foun d th a t even the m e c h a n ic a l c le a n s in g of a w o u n d u n d e r a n a n a e s th e tic of all fr a g e m e n t s o f e x t r a n e o u s m a t e r i a l w i t h i n it w a s q u i t e i m p o s s i b l e , sin c e m a n y w e r e a c t u a lly g r o u n d in to th e tis s u e s t h e m selves. T h e m e r e r e m o v a l of th e f o r e i g n b o d ie s d id not, m o re o ve r, e n su re the d isa p p e a ra n c e of th e in fe c tin g bacteria, s in c e — c o n t r a r y to p u b lic o p in io n — th e r e is n o k n o w n a n t i se p tic y e t in v e n te d w h ic h is c a p a b le o f k i l l i n g b a c t e r ia in a w o u n d w ith o u t a t th e s a m e tim e d e s tro y in g th e tissues th em selves. T h e p roblem of th e tre a tm e n t of w a r w o u n d s w a s t h e r e f o r e a n e x t r a o r d i n a r y d i f f i c u l t o n e , a n d it w a s n o t u n t i l d isco v ery w a s m ad e of a n e n tirely n e w g r o u p of d r u g s th a t it b e c a m e in a n y w a y s i m p l i f i e d . T h e s e d r u g s , k n o w n a s th e S u lp h o n a m id e s , w e re foun d to h a v e a m o st in te r e s tin g action , not e v e n y e t fu lly u n d e r s to o d , u p o n s o m e of th e m o r e d a n g e r o u s ty p e s of b a c t e r i a f o u n d in w o u n d s . I f m i x e d w i t h t h e s e b a c t e r i a in a g l a s s test tu b e no a c tio n w h a t e v e r re su lte d , a s w o u ld h a v e b e e n t h e c a s e h a d a s t r o n g a n t i s e p t i c b e e n u s e d , in fact, th e b a c te ria a p p e a r e d ra th e r to flo u rish th e m o re . If, h o w ever, the d r u g w a s tak e n b y the m outh, or even p o w d e re d o v er the su rfa c e of a n in fected w o u n d , n ot o n ly w e re th e b a c te ria ren d ered in active, b u t th o se w h ic h h ad g a i n e d a c c e s s to th e blood s t r e a m of the p atient w e re v ery so o n killed. U p o n this d is c o v e r y th e p r es en t m e th o d s of d e a lin g w ith w o u n d s h as b een based . G i v e n t h a t th e c a s e r e a c h e s t h e s u r g e o n ’s h a n d s w it h i n a b o u t s ix h o u rs of th e re ce ip t of the w o u n d th e en tire i n j u r y is e x c i s e d c o m p l e t e , i n c l u d i n g a l l t h e b r u i s e d a n d d e v it a lis e d tis s u e s a n d t h e f o r e i g n m a t e r ia l i n g r a i n e d in to them . T h e r e s u l t i n g r a w a r e a is c o v e r e d w i t h p o w d e r e d s u l p h o n a m i d e , a n d e i t h e r p a r t l y s e w n u p o r , if t h e s p a c e b e too la r g e , p a c k e d w it h g a u z e , a n d su lp h o n a m id e s a re g iv e n b y the m o u th . If a ll g o e s w e ll, h e a lin g w ill from n o w on b e v e r y rapid . T h e r e is n o d e a d tis s u e left w h i c h n a t u r e w o u l d o t h e r w i s e h a v e l a b o r i o u s l y to g e t rid of , a n d h e a l i n g is n o l o n g e r d e l a y e d b y t h e p r e s e n c e o f b acte ria , w h ic h m u s t b e d es tro y e d a n d e lim in ate d before repair ca n occur. I h a v e g i v e n y o u this d es c rip tio n of th e m o d e r n t r e a t m e n t o f w o u n d s n o t o n l y i n t h e h o p e t h a t it m a y m a k e y o u r w o r k in t h e fie ld m o r e v i t a l a n d i n t e r e s t i n g , b u t b e c a u s e it p r o v i d e s t h e r e a s o n f o r s o m e o f t h e d e m a n d s m a d e upon you. F ir s t ly , it e x p la i n s t h e n e e d f o r s p e e d ; s e c o n d ly , fo r p ro tectio n of the w o u n d w h ic h p r ev e n ts n eed le ss co n t a m i n a t i o n ; a n d , t h i r d l y , it a n s w e r s t h e n u m e r o u s q u e s tion s w h ic h a re a lw a y s a s k e d a s to w h y a n tis e p tic s of o n e sort or a n o th e r a re n ot p o u re d into th e w o u n d s . O n e last w o rd — n e ve r r e g a r d a n y case, no m a tte r h o w s e r io u s th e in ju rie s m a y a p p e a r to be, a s h o p e le s s . There is r a t h e r a t e n d e n c y a m o n g l e s s e x p e r i e n c e d p a r t i e s t o d o t h i s a n d , p e r h a p s u n c o n s c i o u s l y , t o d e v o t e t h e i r e n e r g i e s to th e less s e r io u s l y in ju r e d t h a n to th o s e w h o a r e o b v i o u s ly d esp era tely w o u n d e d . W h a t I h a v e a lr e a d y sa id to y o u u p o n t h e s u b j e c t o f p r i o r i t y o f t r e a t m e n t m a y g u i d e y o u in t h e m a t t e r , b u t , in a d d i t i o n , r e m e m b e r t h a t t h e r e s o u r c e s o f m o d e r n 's u r g e r y a re v e ry w id e. L a r g e a rea s of sk in destroyed by bu rn s m a y be covered b y g r a f t s b r o u g h t from o th e r p a rts of th e b o d y. P o r tio n s of b o n e w h ic h h a v e b een p u lv e rise d b y h ig h e x p lo sio n m a y be re p lace d b y p ieces c u t from oth er bones. A rib m a y be m a d e to d o se rv ic e a s p a rt of a lo w e r ja w , a p ie ce of the sh in m a y s tr e n g t h e n a w e a k e n e d spine. In a ll th ese th in g s th e C iv il D e fe n c e S e r v ic e s h a v e th eir p a rt, a n d u p o n t h e s k ill w it h w h i c h t h e y p la y it d e p e n d s th e sm o o th n e s s of th e road w h ic h the A ir R a id c a s u a lty w ill tre a d u p o n h is w a y to re c o v e ry . N o w o r k is m o r e v i v i d l y i n t e r e s t i n g o r d e m a n d s m o r e selfless d ev o tio n a n d c o n s ta n t tra in in g . F in a ll y , let m e d r a w y o u r a tte n tio n to o n e of th e b est b o o k s on the su b ject upon w h ic h I h a v e been s p e a k in g
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t h a t I h a v e y e t r e a d — “ F i r s t A i d in A i r R a i d s , ” b y M e r r i c k W in n a n d H u n t, of the H o lb o rn S tre tc h e r P a rty . It is r e m a r k a b l e f o r t h e c l a r i t y , b r e v i t y a n d c o m m o n s e n s e o f its t e a c h i n g , a n d I s h o u ld li k e to q u o t e fr o m it o n e p a s s a g e w h i c h y o u s h o u l d c a r r y in y o u r m i n d s t h r o u g h w h a t e v e r y o u
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m a y b e ca lle d u p o n to face. “ D o n o t be a s h a m e d to b e g e n t l e a n d k in d . . . E m u la te th e ten d ern ess of w o m e n . T r y to u n d e r s t a n d t h e p s y c h o l o g y w h i c h m a k e s a m a n in a g o n y c r y f o r h i s m o t h e r — n ot his f a t h e r — a n d b e p r o u d to c u lt iv a t e the fem in in e t o u c h .”
St. John Ambulance Association. B r is t o l C e n t r e . — T h e a n n u a l contests at the Z o o lo g ic a l G a r d e n s , la st a r r a n g e d in J u ly 1940, w e r e s u s p e n d e d a fte r the blitzes u n til a ft e r th e w a r . T h e C o m m i t t e e felt, h o w e ver, t h a t th e i n c r e a s i n g e n t h u s i a s m of th e j u n io r s s h o u ld be e n c o u r a g e d a n d th at th e y sh o u ld h a v e a c h a n c e to co m p e te for th e J u n io r ( W e b e r ) C u p b e fo r e s o m e of t h e m w e r e p r e v e n te d b y h a v i n g r e a c h e d th e a g e lim it of s ix te e n . E i g h t t e a m s (six of g ir ls , t w o of b o y s) c o m p e te d on S a t u r d a y , J u ly 3rd, t h e te s t c o n s i s t i n g o f p r a c t i c a l w o r k a n d an oral e xa m in a tio n . T h e ju d g e s w e re D o cto r H . G. K yle, the C h a ir m a n of th e B ristol C e n tre , a n d D o c to r C. C. L a v in g ton, a v ic e -p r e s id e n t. D o c t o r K y le presided o v er th e p ro
ceed in gs. A fte r a v e ry k e e n con test, th e w in n e r s proved to be the B risto l E a s t N u r s in g C a d e t s w ith 164£ m a r k s out of a possible 200, s e c o n d c a m e B r i s t o l S o u t h A m b u l a n c e C a d e t s w i t h 1 6 1 m a r k s a n d third w e r e th e M a r k s b u r y R o a d N u r s i n g C a d e t s w it h 15 8 p oints. T h e H o n . S e c re ta r y (M r. M . R . F air) exp lain e d th a t the o b ject of the a ft e r n o o n ’s a c tiv itie s w a s n o t so m u c h th e w i n n in g of a c u p b y a p a r t ic u la r te a m , a s the e n l a r g i n g of th e e x p e r ie n c e o f all th o s e c o m p e tin g . T h e H o n . T r e a s u r e r ( M r . W . C . H a w k i n s ) in a n n o u n c in g th e re su lts s a id th a t in a d d itio n to th e C u p g i v e n b y M r. W e b e r, e a c h m e m b e r of th e w in n in g te a m w o u ld receive a d ip lo m a. H e w a s v e r y g l a d to b e a b le to a n n o u n c e t h a t a n o ff e r h a d j u s t b e e n r e c e i v e d f r o m M r . H . T . J e f f e r i e s ( a n official of t h e C e n t r e ) to p r o v id e a c u p fo r th e r u n n e r s - u p . In a dd ition , b o th w in n e r s a n d ru n n e r s -u p w o u ld r e c e iv e a coin. D o cto rs K y le a n d L a v in g to n both s p o k e of the exc elle n ce of th e w o r k don e b y th e te a m s ; the e a rn e stn e ss of th e m e m b ers g a v e a g o o d a u g u r y fo r th e fu t u r e of t h e B r i g a d e , of w h ich these ca d ets w e re th e fu tu re m em b e rs. D octor K y le h a d p l e a s u r e in a s k i n g M r s . F a i r t o p r e s e n t t h e C u p a n d d ip lo m a s to th e w i n n e r s — th e C u p fo r th e r u n n e r s - u p to fo llo w later. L a d y C o r p s S u p t . M . S a r a h s p o k e of th e k i n d n e s s o f th e d o c to r s w h o h a d d e v o te d th e ir a ft e r n o o n to th e c a r e fu l j u d g i n g of th e c o m p e titio n a n d c a lle d for a vo te o f t h a n k s fr o m the g a t h e r in g .
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T h e S t a n d in g C o n fer e n c e of N a tio n a l Ju v en ile O r g a n i s a t io n s h a s u n d e r c o n s id e r a t io n th e c a u s e s a n d in c id e n t of in d u strial fa tig u e a m o n g s t y o u n g people, b e tw e e n th e a g e s o f 1 4 a n d 20, in r e g u l a t e d a n d u n r e g u l a t e d e m p l o y m e n t . T h e g r o u p s e t u p t o i n v e s t i g a t e t h i s q u e s t i o n is d e s i r o u s o f re c e iv in g evid e n ce from the V o lu n ta r y Y o u t h O rg a n is a tio n s , fr o m p e rs o n n e l m a n a g e r s , w e lfa r e officers a n d c lu b le a d e rs, a n d p a rtic u la rly from m ed ic a l p ractitio n ers. A n y d o c t o r s w h o a r e i n t e r e s t e d in t h i s q u e s t i o n , a n d w h o a r e w i l l i n g t o fill u p a v e r y s h o r t q u e s t i o n n a i r e , a r e a s k e d t o c o m m u n i c a t e in t h e f i r s t i n s t a n c e w i t h t h e S u r g e o n - in - C h ie f at 166, H a v e r s t o c k H ill, L o n d o n , N . W . 3 . N o.
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N o. 41 ( W e s t e r n P o s t a l a n d S t . M a r y l e b o n e ) C a d e t A m b u l a n c e D i v i s i o n ; N o . 7 2 ( S t . J o h n ’s W o o d ) G i r l C a d e t N u r s in g D iv is io n .— A very p le a sin g a n d su ccessfu l m e e t in g of th e a b o v e C a d e t D iv is io n s w a s h eld a t th e T r a i n i n g H e a d q u a r t e r s , 30 , G l o u c e s t e r P l a c e , W . l , o n T h u r s d a y , J u n e 24th. A m o n g the distin gu ish ed g u e sts present w e re S ir G e o rg e a n d L a d y A b b iss, V ic e P r esid e n ts of the b oy a n d g ir l c a d et D iv is io n s resp ectiv ely, w h o w e r e receiv ed b y D iv is io n a l S u p t. W . V . M . A llen a n d L a d y D iv isio n a l S u pt. M rs. M . M . A llen a t th e e n t r a n c e h a ll, w h e r e a G u a r d of H o n o u r of b o y c a d e ts stood s m a r t ly to a tten tion . A f t e r a n in s p e c t io n of th e t r a i n i n g h e a d q u a r t e r s , t e a w a s provid ed, then fo llo w e d th e p resen ta tio n of certifica tes an d th e e n ro lm e n t c e re m o n y of n e w g ir l c a d e t e n tra n ts, a n d Sir G e o r g e A b b iss c o n g ra tu la te d the n e w m e m b e rs a n d exp la in e d to all the b o y s a n d g ir ls th e j o y a n d s a tis fa c tio n of b e in g tra in ed to re n d er p u b lic service. T h e p resen ta tio n of co m p e titio n tro p h y sh ield s w a s th en m a d e , S i r G e o r g e A b b i s s p r e s e n t i n g to t h e b o y s a s h i e l d f o r ind ivid u al com petition g iv e n by Pte. L . R a b in , a n d L a d y A b b is s p r e s e n tin g to th e g ir ls a s im ila r sh ield g iv e n by the b oy c a d e ts to th e g ir l ca d ets. D i s t r i c t O f f i c e r T . M c B r i d e , in p r o p o s i n g a v o t e o f t h a n k s to S i r G e o r g e a n d L a d y A b b is s , s a id h e r e a lis e d t h a t a s a v e r y b u s y p u b lic official, S ir G e o r g e h a d v e r y g e n e r o u s ly fo u n d t im e to a tte n d th is i m p o r t a n t p a r t o f y o u t h t r a in in g . E n t e r t a in m e n t s fo llo w e d , a n d th e r e w a s a d is p la y of h o m e cra fts b y th e g ir ls a n d a n u m b e r of m o d el a irp la n e s m ad e b y th e boys. A b o u t 120 b oy s a n d g ir ls w e re p resen t of w h ic h w e r e a n u m b e r of p r o s p e c tiv e n e w m e m b e r s . G r e a t c r e d i t is d u e t o A m b . O f f i c e r E . F . M a s o n a n d C o r p o r a l s J. C . M a y e r s a n d E. E. T r ib e , a lso o th er m e m b e rs of th e p a re n t D iv isio n s w h o g a v e v e r y v a l u a b l e a s s i s t a n c e in t h e a r r a n g e m e n t s . I t is h o p e d t o a r r a n g e a n o t h e r s u c h m e e t i n g in t h e n e a r future. N o . 93 ( F i n c h l e y ) .— T h is D i v i s i o n o f t h e S . J . A . B . h a s h ad a very active m onth. O n J u n e 5th th eir S o c ia l C o m m i t t e e p r e s e n t e d t h e H a r r i n g a y D r a m a t i c S o c i e t y in “ Q u i e t W e d d i n g , ” w h e n o v e r j£ jl5 w a s r a ise d for th e F i n c h l e y “ A id to C h i n a ” f o r t n i g h t f u n d s . T h e M ay o r of F in ch le y and D is tric t O fficer C o llin s w e re present. O n J u n e 1 9 th , S u p t . W . A . W o o d a n d N . C . O . ’s of th e D iv is io n a c te d a s j u d g e s in c o n n e c tio n w it h th e first a id s e c tio n of a n in te r-p atro l c o m p e titio n o r g a n is e d b y F in c h l e y B o y S co u t A sso ciatio n . O v e r 35 t e a m s t o o k p a rt. M em b e rs of th e D i v i s i o n a ls o a s s is t th e s c o u t o r g a n i s a t i o n as A m b u lan ce B a d g e exam iners,
4 N o.
F I R S T II D is tric t
C h e l t e n h a m . — T he a n n u a l c h u r c h p a r a d e of th is D i v i sio n , a c c o m p a n ie d b y D e t a c h m e n t s of the B . R . C . S . , to o k p la c e on S u n d a y e v e n in g , J u n e 20ih, a t A ll S a i n t s ’ C h u r c h . A b o u t 350 m e m b e r s to o k part. T h e p a ra d e w a s u n d e r the co m m a n d of C o rp s S u p t. L . M. Starr, a n d w a s h eaded by the D o w t y E q u ip m e n t B a n d . T a k i n g a s h is s u b je c t the p e r f o r m in g of a c ts of k in d n e s s , C a n o n P . M . C . J o h n s t o n e , th e V i c a r , e x p r e s s e d g r a t i t u d e to th e A m b u l a n c e B r i g a d e for th e ir d a ily a c t s of k in d n e s s w h ic h w e r e p e rfo rm e d w it h o u t p u b licity , a n d p aid trib u te to th eir u n t i r i n g efforts. B e fo r e th e p a r a d e w a s d ism isse d , A m b u l a n c e O fficer B a r n f i e l d w a s p r e s e n t e d w i t h t h e P a r c h m e n t o f E l e c t i o n to S e r v in g B ro th e r of th e O r d e r of St. John.
S a l is b u r y . — A p a ra d e of D iv ision and the G ir ls ’ N u r s in g h e l d in S a l i s b u r y a t t h e e n d o f d e ta c h m e n t in clu d ed b oys from b erlayne.
the B o y C a d e t A m b u la n c e D iv isio n of th e S .J .A .B . w a s la st m o n th . T h e S alisb ury B arford and C o m p to n C h a m -
T h e M a y o r ( C o u n c illo r S. C la rk e ) in spected th e p a ra d e in t h e f o r e c o u r t o f t h e i n f i r m a r y . H e w a s a c c o m p a n ie d by M r. T . H e rb e rt G r e y (P resid en t of th e D iv isio n ) a n d the L a d y C o u n ty S u p t., M rs. B attye. T h e p a ra d e w a s c o m m a n d e d b y C a d e t O fficer H . H o u n som e. A f t e r t h e p a r a d e t h e c a d e t s a t t e n d e d s e r v i c e in S t . P a u l ’s C h u r c h .
S a r i s b u r y . — T h e n e w S . J . A . B . h u t in H u n t s P o n d R o a d , S a r is b u r y , w a s op en ed on J u n e 22nd by the H o n . M rs. C u b itt ( L a d y C o u n t y S u pt.). L a d y D i v . S u p t . M rs . S c a t c h a r d s p o k e of t h e p rid e felt b y S a r isb u ry D iv ision a t h a v in g a cq u ire d the h ut, esp ecially a s it w a s e n t i r e l y p a i d f o r . M rs. C u b itt m en tio n e d th e n u m b e r of C a d e t N u r s in g D iv is io n m e m b e rs , h o p in g th e r e w o u ld be m o r e re cru its. C o l. M a r s h a ll ( A s s is ta n t C o u n t y C o m m is s io n e r ) referred to th e i m p o r t a n c e of th e C a d e t S e c tio n , w h ic h fo r m e d a n in te g ra l part of the B rig a d e. A n in sp ectio n of th e D iv is io n b y M rs. C u b itt follo w ed.
A l d e r s h o t a n d F a r n b o r o u g h . — P erson n el of these tw o D iv isio n s w e re in spected re ce n tly by th e C o u n ty C o m m is s io n e r (M a jo r H . T en n yso n -S m ith , O .B .E .) . T h e r e w a s a g o o d m u ste r of the F a r n b o r o u g h D iv isio n o n t h e R . A . E . s p o r t s f ie ld , w h e n t h e D i v i s i o n p a r a d e d u n d e r th e c o m m a n d of D iv is io n a l S u p t. L . C lifford. T h e in sp e c tion w a s fo llo w e d b y a m a r c h p a s t a n d p r a c tic a l d e m o n s t r a t i o n s in f i r s t a i d . T h e in s p e c tio n a t A ld e r s h o t t o o k p la c e in th e M a n o r P a r k , a d jo in in g th e F ir s t A id Post, w h e r e the p a ra d e w a s u n d e r th e c o m m a n d of C o rp s O fficer U . O s m o n d . A fter the in sp ectio n th e perso n n e l m a rc h e d past, M a jo r T e n n y s o n S m ith t a k i n g th e salu te. In a n a d d r e s s to th e D iv is io n , th e C o u n t y C o m m is s io n e r t h a n k e d t h e m fo r t h e ir s e r v ic e s a n d e m p h a s is e d th e n e e d for a l l r a n k s t o m a i n t a i n e f f i c i e n c y d u r i n g t h e w a r a n d in p r e p a r a tio n fo r th e p o s t- w a r p erio d.
N o.
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C o v e n t r y .— T he C o v e n try C en tra l C o rp s n o w h as a s t r e n g t h o f o v e r 3 ,0 00 a n d s e v e r a l n e w D i v i s i o n s h a v e rece n tly b een form ed . A le a g u e w e e k ly “ q u iz ” co m petitio n has been started, and is c r e a t in g g r e a t in terest an d e n t h u s i a s m , w h i c h i t is h o p e d m a y e v e n t u a l l y b e c o m e a r e g u la r c o u n ty feature. A n in spection b y th e C o m m is s io n e r, M a jo r E . S. Ph illip s, D . S . O . , w ill t a k e p l a c e o n A u g u s t 7 th to i n c l u d e t h e m e n ’s
A I D D iv isio n s a n d N u r s in g a n d C a d e t section s, u n d e r the d irec tion of C o r p s S u p t. L . T . M a rc h . T h e S t a n d a r d A e r o D iv is io n held th e ir i n a u g r a l d in n e r on J u n e 2 3rd , a n d m a n y fine t r ib u t e s w e r e m a d e b y t h e m a n a g e m e n t r e g a r d in g th e w o r k perform ed by the S .J .A .B . d u r i n g th e d a n g e r o u s d a y s of N o v e m b e r , 1940. T h e a m b u la n c e s, of w h ic h th ere a re e ig h t, h a v e a g a in re m o v e d a re c o rd n u m b e r of p atients. T h i s s e r v i c e is r u n in co n ju n c tio n w ith th e H o s p ita l S a t u r d a y F u n d , to w h o s e C o m m i t t e e t h e D i v i s i o n is g r a t e f u l in m a n y w a y s . A n y n e w m e m b e r s tr a n s fe r r in g to th is p a rt of th e c o u n try w ill a lw a y s be w elcom e, a nd ca n rest a ssu re d th at t h i s D i v i s i o n is v e r y m u c h a l i v e .
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R u d d in g t o n . — T h is D iv isio n of the S .J . A . B. h a s a proud re c o rd of s e r v ic e d u r i n g its sh o rt e x is te n c e o f th r e e y e a r s. I ts a m b it io n fr o m th e o u ts e t w a s to h a v e its o w n a m b u la n c e se rv ic e , a n d th is w a s re a lis e d o n S a t u r d a y , J u n e 26th, w h en a n e w a m b u la n c e w a s d ed icated a t R u d d in g to n P a rish C h u rc h b y the R e v . F. Potts. M r. j . W . N a a k e (ch a irm a n of th e R u d d in g to n S t. John A m b u la n c e C o m m itte e ) fo rm a lly h an d ed over the a m b u la n ce t o t h e C o u n t y C o m m i s s i o n e r , M r . S . J. VV. D o n a l d ( S e r v i n g B r o t h e r o f t h e O r d e r ) w h o r e c e i v e d it o n b e h a l f o f t h e R u d d in g to n D ivision . D u r in g the aftern oon the C o u n ty C o m m issio n e r in sp ec ted the R u d d in g t o n a n d v is it in g D iv isio n s a lo n g w ith the n e w l y fo r m e d local C a d e t D iv is io n .
N o.
V III
(D uke
o f C o n n a u g h t ’s )
D istrict
R a m s g a t e . — L a r g e ly b e c a u se the tim es preven t m a n y of its m e m b e r s b e i n g su p p lie d w it h u n ifo r m s , th e w o r k of th e b o y s’ C a d et C o rp s of the R a m s g a t e T o w n D iv isio n , S .J .A .B ., p a sse s m o r e o r less u n n o tice d . Y e t , b e h in d the scen es, th o se la d s a re d o in g a g r a n d job. S o m e of th e re su lts of th e b o y s ’ tu itio n w e r e seen at th e R a m s g a t e p o lice p a r a d e g r o u n d , w h e n th e a m b u l a n c e m e n of t h e f u t u r e w e r e i n s p e c t e d b y M r . J. B a k e r , C o u n t y O f f i c e r o f C adets. T h e p a r a d e w ^ s u n d e r t h e c h a r g e o f C d t . S u p t . W . W . J. N o rris , w h o a c c o m p a n ie d M r. B a k e r d u r i n g th e in sp ectio n . F o llo w in g th e in spection a p a rty of th e b oys g a v e a realistic d e m o n s t r a t i o n of first a id m e t h o d s . D u r i n g t h e a f t e r n o o n it w a s l e a r n t t h a t t h e a p p o i n t m e n t of M r. A r t h u r W i l l i a m s a s c a d e t officer h a d re c e iv ed official sa n c tio n . M r. W illia m s assisted th e R a m s g a t e D iv isio n d u r i n g t h e e v a c u a t i o n f r o m D u n k i r k , a n d w a s m e n t i o n e d in d e s p a t c h e s in c o n n e c t i o n w i t h a l a n d i n g o n t h e R e d S e a coast. S e v e r a l p r e l i m i n a r y f ir s t a i d c e r t i f i c a t e s w e r e p r e s e n t e d to m e m b e rs of th e C o rps. A d d r e s s in g a fe w w o rd s to th e boys, M r. B a k e r sa id he t h o u g h t th eir w o r k w a s w e ll ca rrie d ou t a n d he lo o k e d for w a r d to p e a ce -tim e w h e n co m p e titio n s cou ld be a rra n g e d .
N o.
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H a y l e .— T he a n n u a l m e e tin g of the H a y le A m b u la n c e D i v i s i o n w a s h e l d o n M o n d a y , J u n e 7 t h , in t h e A m b u l a n c e H all. A l t h o u g h v e r y la te in th e y e a r , th e a tt e n d a n c e w a s g o o d a n d the h all cro w d e d . M r. E . P. Lello , th e n e w ly e lected p residen t, to o k th e ch air. A m b . S u p t. J. R . B o n d w e lc o m e d M r. L e llo a s th e n e w p residen t, t h a n k i n g h im fo r a c c e p t in g the position, a n d h oped he w o u ld h a v e a p le a sa n t tim e w ith them . R eferrin g to th e past-p re sid e n t, M r. K . U r e n , L . D . S . , h e s ta te d h e h a d o n ly r e s ig n e d b e c a u s e his o th e r a c tiv itie s h a d so in c r e a s e d a s to o c c u p y to o m u c h t im e to s e r v e a ll fa irly . T h e ir relatio n s w e r e still c o rd ia l. H e th e n g a v e a r e p o r t of th e y e a r ’s w o r k in g , an d the s ta te of affairs w e re m o st s a tisfa cto ry . A ll
F I R S T
the m em b e rs w e re also m e m b e rs of the C ivil D e fe n c e C a s u a lty S ervice. T h e m o to r a m b u l a n c e h a d tra v e lle d o v e r 1,80 0 m i l e s in 1 9 4 2 , a t t e n d i n g 2 0 7 c a s e s in a l l , o f w h i c h 1 7 c a s e s h ad been road a icid en ts. H e r e fe r r e d to th e d e a t h of C o r p l. J a c k R ic h e tts a s b e in g a g r e v io u s loss to the B r ig a d e , a s he w a s o n e of th e e a r lie s t m e n to join th e D i v i s i o n , a n d o n e of its m o s t a c t i v e m e m b e r s . T h r e e o f th e old m e m b e r s w e r e p r i s o n e r s o f w a r , a n d a f u r t h e r 1 7 w e r e s e r v i n g in t h e F o r c e s . G r e e t in g a ll the n e w m e m b e rs a n d the n e w ly -fo rm e d C a d e t s ’ S ection , he e xp re sse d th e h ope th a t m o re m e m b e rs w o u ld join i n ' 194 3 . F in a lly , h e t h a n k e d a ll his officers a n d m e n for th eir w h o le - h e a r te d s u p p o r t a n d c o - o p e r a tio n t h r o u g h o u t the year. N e x t fo l l o w e d t h e t r e a s u r e r ’s r e p o r t b y A m b . O f f i c e r R . VV. W a k e f o r d , w h o s t a t e d t h e f i n a n c i a l p o s i t i o n t o b e s o u n d . It w a s th e te n th a n n u a l r e p o r t h e h a d p r e s e n te d , b u t th e fi r st t i m e h e h a d b e e n a b l e t o a n n o u n c e a c o m p l e t e c r e d i t b a l a n c e in a l l a c c o u n t s . M r . E . P . L e l l o s p o k e o f h i s p l e a e u r e in b e i n g a s k e d to b eco m e presiden t of su c h a n o rg a n isa tio n , an d re m a r k e d th at it w a s a w o r k a k i n t o C h r i s t i a n i t y , a n d w i s h e d t h e B r i g a d e co n tin u ed success. Cad et. Supt. F . W illia m s reported on the n e w C a d et section. H e w a s g l a d t o r e p o r t t h a t f u n d s w e r e c o m i n g in stead ily, a n d the y o u th s w o r th w h ile w e r e r a l l y i n g ro u n d sp len d id ly. H e h ad not anticip eted b e in g the S u p e rin te n d e n t w h e n a s k e d e a r ly on to h elp w ith the boys, b u t n o w he h a d a c q u i r e d t h e p o s i t i o n , h e w o u l d f u lf il i t t o t h e b e s t o f h i s ability. V o te s of t h a n k s w e re proposed b y S e r g t. J.
R a d c l if if e ,
5
R I D
Letters to the Editor. W e a r e in n o w a y r e s p o n s i b l e f o r t h e o p i n i o n s e x p r e s s e d , o r the sta tem en ts m ad e, b y C o rre sp o n d e n ts .— E d it o r . TH E
HOM E
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FIR ST
A ID .
S i r , — In the Ju n e issu e of F ir s t A i d , S e r g t . S p r e a d b u r y q u o te s fr o m a letter I w r o t e h im d e s c r ib in g a m e th o d of stra p p in g a patient on a stretch er, u s in g th ree slin gs. I sh o u ld lik e to s ta te th a t th e m e th o d w a s n ot m y “ in v e n tio n ,” b u t w a s pa rt of an in te re stin g a n d in stru c tiv e d em o n stra tio n by an A r m y F ield A m b u la n c e w h ic h w a s g iv e n to a p a rty of H .G . M e d ic a l U n its. W i t h r e g a r d to M a j o r B o w m a n E d g a r ’s a r t i c l e , m e n t i o n is m a d e o f “ r e m o v a l o f t h e b e l t m e c h a n i s m , ” w h i c h , I t h i n k , s h o u l d r e a d “ bolt m e c h a n i s m . ” I n c i d e n t a lly , th e bolt, w h e n r e m o v e d , is v e r y u s e fu l to t i g h t e n th e im p r o v is e d to u rn iq u e t, m a k i n g a n o th e r p a rt of th e e q u ip m e n t u sefu l. I a g r e e w ith the M a jo r ’s s u g g e s t io n of a p a g e d ev o te d to H o m e G u a r d . I a m su re m a n y w o u ld fo r w a rd in te re st in g n e w s a nd v iew s of the “ trou b les a nd d isa p p o in tm e n ts ” o f t h e m e d i c a l u n i t s in t h e H o m e G u a r d . — Y o u r s ,
James E. R u sh ton , C o rp l. N o . 2 B a tt ., N o tts. H . G .
Improvisations.
s e c o n d e d b y M r . A . H i g g s . ____________________ N o.
X
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C a m b r id g e .— S ince J a n u a r y , 1943, th e S . J . A . B . h a s re g is te r e d o v e r 550 n e w C a d e t N u r s i n g D iv is io n s , a n d for th es e D iv is io n s , h a s fo u n d s o m e t h i n g li k e 1,000 n e w c a d e t officers. L a d y D u n b a r -N a s m ith , C h ie f O fficer for th e St. John N u r s i n g C a d e t s g a v e t h e s e f i g u r e s in C a m b r i d g e o n S a t u r d a y , J u n e 1 9 t h , w h e n s h e a t t e n d e d a c a d e t d i s p l a y in t h e H o u g h to n H a ll, w h ic h fea tu red St. Joh n A m b u la n c e and N u r s i n g C a d e t s fr o m all o v e r C a m b r i d g e s h i r e a n d th e Isle of E ly. T h e c a d e t d is p la y c o n s is te d of n o less t h a n 10 ite m s , e a c h c o n trib u ted b y m e m b e r s of different C a d e t N u r s i n g and C a d et A m b u la n c e D iv ision s. In c h a r g e of the p a ra d e w a s Co rps Supt. S. S. D ick e r. C o m m e n t in g on th e d isplay, th e C h a ir m a n (D r. K . S. M a u r ic e - S m it h ) w a s full of p r a ise , a s w a s L o r d F a ir h a v e n , w h o a ls o said a fe w w o rd s. L ie u t.-C o lo n e l A rc h e r(c o u n ty treasu rer)d e liv ered a short ad d ress on th e h isto ry of th e O r d e r of S t. John. N orth ern
Ire la n d
(U lste r)
A b o u t th re e m o n th s a g o m y p la to o n w a s t u rn e d into a c y c lis t p la t o o n , a n d th e m e d ic a l o r d e r lie s h a d to a d a p t t h e m s e lv e s . T h e first t i m e o u t w e h a d t w o S c o u t p o le s a n d s a c k i n g c a r r i e d on o u r cycles, bu t n o w , ou t of th e p la to o n fu n d s, w e h a v e b o u g h t so m e w ood a n d rope and h a v e m ad e a stretch er w h ich c a n b e t a k e n to p ie c e s a n d c a r r ie d o n o u r c y c le s . T h e la st t i m e w e h a d it o u t , w e d i s m o u n t e d , a d j u s t e d g a s m a s k s , a ssem b led the stretcher, a nd w ith o u t a n y u n d u e haste, w ere r e a d y to c a r r y th e p a tie n t in s id e s ix m in u te s . B y im p ro v in g th e stretch er a n d b y m o re p ra ctice th e tim e co u ld e a s ily be h alved. T h e p o l e s a r e 7 ft . 6 in . l o n g , w i t h s h a p e d h a n d l e s , a n d t h e t r a v e r s e s 2 ft . 6 in . ( t o a l l o w a 3 i n . o v e r l a p e a c h s i d e ) a r e d o v e -ta ile d in to the poles. T h e r o p e is t h r e a d e d c r i s s - c r o s s a c ro s s th e stre tc h e r fro m o n e co rn e r to th e o p p o site one, a n d then co m es b a c k a g a in fo rm in g a n etw o rk. O n e cy c le c a rrie s th e poles, a n o th e r th e ro p e a n d tra v e rs e s , w h ile a third, th e b la n k e t a n d w a te rp r o o f, l e a v in g N o. 1 to c a rry a n y e x t r a kit. If a n y on e w o u ld lik e fu rth e r d etails, I sh all b e p lea sed to fo r w a r d s a m e . — J a m e s E . R u s h t o n ( C o r p l N o . 2 B a t t ., N otts. H .G .) .
D istrict.
T h e a n n u a l co m p e titio n s for th e S . J . A . B . N o rth e r n I re la n d D is tr ic t, w e r e h e ld in B e lfa s t re c e n tly . E ig h t team s fro m N o rth ern Ire la n d a n d fo u r fro m E ire co m p eted . The B e lfa st C h a lle n g e C u p ( A m b u la n c e D iv isio n , sen ior m en ) w a s w on by B roadstone ( G .S .R .) . O t h e r r e s u l t s w e r e :— L o r d M a y o r ’ s C u p ( n o v i c e ) , G l e n a g e a r y ; W h i t t a k e r M e m o ria l C u p ( N u r s in g D iv isio n , sen io r w o m e n ), W e s t B e lfa s t ; W h i t t a k e r C u p (n o vice w o m e n ), H ow th and S iltto n tied w it h N e w t o w n a r d s ; D istrict S u r g e o n s ’ C u p , R o y a l C a d e ts ; C ity of D u b lin C u p presented b y M r. W . S tr a th a n , B r o a d s to n e ( G . S . R . ) . W a r w ic k sh ir e C ollie r ie s A mbulance L eague. — C o v e n try C o llie ry w o n th e tw e lfth a n n u a l com p etitio n of the a b o v e a m b u la n c e le a g u e , h eld re c e n tly a t the G r iff a n d C o to n Sports G ro un d , N u n ea to n . T e n t e a m s e n t e r e d , t h e first t h r e e p l a c e s b e i n g o c c u p i e d b y : 1 , C o v e n t r y C o l l i e r y , 2 02 m a r k s ; 2, K i n g s b u r y , 1 7 5 ; 3, A r l e y , 1 7 3 . T h e total n u m b e r of m a r k s po ssib le w a s 275.
Quick Treatment for Burns. R . A . F . c r e w s w ill so o n c a r r y a s m a ll firep ro o f a n d w a t e r pro o f first a id p a c k c o n t a i n i n g m a t e r ia l fo r th e m o s t m o d e r n te a tm e n t for b u rn s. B y t h e a d a p t a t i o n o f t h e S t a n n a r d a n t i - b u r n g l o v e first aid tre a tm e n t for b u rn s on th e h a n d s w ill be a v a ila b le w ith in a few seconds. T h e a d a p t a t io n o f th e g l o v e to first a id ap p lica tio n fo llo w s the su cce ss of tre a tm e n t w o r k e d out b y the R . A . F . m ed ica l a u th orities. T h e g l o v e is m a d e o f o iled silk w h ic h e x c lu d e s the a ir a n d co n ta in s a n tisep tic a nd cu rative pow ders. M r . W i l l i a m S t a n n a r d , a s i l k m e r c h a n t a n d a p ilo t of the la st w a r , h a s co -o p era ted w ith th e R . A . F . m ed ica l a u t h o r i t i e s in p e r f e c t i n g t h e g l o v e a n d t h e p a c k c o v e r , w h i c h co n tain s the g lo v es, m o rp h ia, w o u n d -d r e ssin g , a nd a tube of a n ti-b u rn jelly.
6
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A Universal First Aid Splint. D r . F . O ’S u l l iv a n ( H a r r o w ) se n d s u s p a r t ic u la r s of a n e w t y p e of first a id s p lin t w h i c h h e d e s i g n e d re c e n t ly , a n d w h i c h m a y , h e t h in k s , h e lp to fa c ilita te th e t r e a t m e n t of c e rta in types of fractu res of the lo w e r a nd u pper lim b s ; also a copy o f a l e t t e r h e w r o t e t o t h e B r itis h M e d ic a l J o u r n a l a n d w a s p u b l i s h e d in t h e i s s u e o f t h a t J o u r n a l o f A p r i l 1 0 t h l a s t . T h e sp lin t c a n b e e m p lo y e d fo r first a id t r e a t m e n t of f r a c t u r e s o f th e f e m u r (u p p er, m id d le a n d lo w e r thirds), th e n e c k o f th e f e m u r — a c t i n g a s a m o d ified l o n g L i s t o n — the p a tella, fib u la a n d tibia, a n d th e ta r s u s a n d m e ta ta r s u s . It is p o s s i b l e t o d i s a r t i c u l a t e t h e s e c t i o n s f o r t r e a t m e n t o f fr a c tu re s of th e h u m e ru s, th e ra d iu s a n d u ln a, a n d the carpu s and m etacarpus. T h e s p l i n t m a y b e e m p l o y e d a l s o in c e r t a i n c a s e s a s a tou rn iq u et ; w ith su itab le p a d d in g , no b a n d a g e s a re needed fo r its a p p lic a t io n , v a l u a b l e t im e t h u s b e i n g s a v e d . Its use d o e s n o t in te r fe r e w i t h X - r a y s , so t h a t d i a g n o s i s c a n be v erified w it h o u t r e m o v a l. A n o th e r a d v a n t a g e of th is typ e of
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g i v e firm a d ju s t a b le su p p o rt, la t e r a ll y a n d a n te rio r ly . The a r t i c u la t i n g e n d s o f th e sp lin t h a v e c la m p s c r e w s a n d pins f o r t h e a d j u s t m e n t o f a n g l e s . T h e s p l i n t is q u i c k a n d s i m p l e i n a p p l i c a t i o n , a n d i t s t e c h n i q u e c a n e a s i l y ’ b e l e a r n e d b y f ir s t aid stu den ts. H is g r a t e fu l t h a n k s a re d u e to M r. K e a r s e y , ch ief e n g in e e r to H . M . S ta tio n e r y O ffice, w h o k in d ly c o n stru c te d th e first m o d e l fo r h im , a ls o th e d r a w i n g d e ta ils of th e sp lin t itself. T h e im p ro v e d m o d e l h as b een m a d e b y M essrs. D o w n B ro s. L td , w h o h a v e k in d ly su p p lied the illu stration s.
Reviews. N u rses'
P h a r m a c o p e ia . By H. L. H eim an n , M .D ., M .R .C .P ., and D o r a W ilso n , S .R .N . London : B ailliere, T in d a ll & C o x . P r i c e ys. 6d. net.
T h i s u se fu l little b o o k , w h i c h c a n b e c a r r ie d c o n v e n i e n t l y in t h e a p r o n p o c k e t , h a s b e e n c o m p i l e d t o h e l p s t u d e n t n u r s e s in t h e i r s t u d i e s a n d f o r u s e in t h e w a r d s a n d in t h e i r p r a c t i c e o f n u r s i n g a f t e r t h e y l e a v e h o s p i t a l . It w a s first p u b lis h e d in 1 9 3 3 ; a n d th is, its fo u r t h e d itio n , h as been revised a n d b r o u g h t u p -to -d ate by the a d d itio n s of n e w sectio n s w h ic h w e re s u g g e s t e d by readers. I n its n e w form the b o o k sh o u ld ob tain a w id e r circu latio n .
230 N . F . S .
Q u estio n s A n s w e r e d . B y J. M . C a r r i c k , I n stru ctor, N . F . S . , R . D . W o r m a ld , L .A . R . P ., an d j . M . Y ou n g, L .A .R .P . L o n d o n : Jordan & Sons. P r ic e
2s. n e t ; by p o st 2s. 2d. T h i s b o o k ( w h i c h a l s o c o n t a i n s SO Q u e s t i o n s A n s w e r e d for F ire G u a r d s ) w ill be u sefu l to N . F . S . p erson n el and m e m b e r s of W o r k s F ir e B r ig a d e s a n d a lso to F ire G u a r d s a n d W a r d e n s w h o a re t a k i n g c o u rses on use of trailer p u m p s. I t w i l l s u r e l y p r o v e i t s u s e f u l n e s s in t h e a d v a n c e m e n t o f k n o w l e d g e b e c a u s e it is b a s e d o n a m e t h o d w h i c h is w e l l re co gn ised . W e f o r e s e e a s u c c e s s f u l c a r e e r f o r it.
British Red Cross Society.
s p l i n t is t h a t it c a n b e f o l d e d w h e n n o t in u s e . T h e splin t m a y be ap p lied o u tsid e th e cloth es, a n d h a s b een proved effective fo r m o s t s ta n d a r d sizes. T h e a p p lia n c e is c o n s tr u c te d of li g h t w o o d , c o n s is t in g of r ig id b a c k p ieces w ith t a n g ib le h in g e s , w h ic h ca n a ls o be lo c k e d . T h e sid e s a r e fo r m e d of strip s of s t r o n g , r o u n d ed la th , a tt a c h e d to firm s tr ip s of c a n v a s , r e s e m b l i n g c r i c k e t e r s ’ le g - p a d s , w h ic h c a n be rolled, a n d at th e s a m e tim e
C e n t r a l H a c k n e y D e t a c h m e n t (L /S 0 3 M ).— T h e in a u g u r a t io n c e re m o n y a n d d istrib u tio n of a w a r d s g a in e d by m e m b e r s of th is d e ta c h m e n t w a s h eld r e c e n tly a t the H a c k n e y A s s . C l u b s , M a r t e l l o - s t r e e t , H a c k n e y , E . 8. T h e r e w e r e p resen t a b o u t 160 people, in c lu d in g the . A ss. C o u n ty D irecto r, M rs. M c V ie ; the D iv . C o m m a n d a n t, M r. H . T . N a s h ; a n d the M a y o r of H a c k n e y , C o u n c illo r A. C u ll in g t o n , J. P. T h e C o u n t y D i r e c t o r a n d M a y o r in s p e c t e d t h e g u a r d of h o n o u r u n d e r the c o m m a n d of M iss S. P in n e r, a n d c o n g r a t u la te d th e m on th eir s m a r t n e s s a n d efficiency. T h e C h a ir m a n (M r. R o la n d ) open ed th e p r o c e e d in g , and sp e e c h e s fo llo w e d , d u r in g w h ic h the points m e n tio n e d w e re : S in c e t h e fo r m a tio n of th e D e t a c h m e n t in O c to b e r , 194 2, w ith a s t r e n g t h o f 1 4 officers a n d m e m b e r s , it h a s n o w i n c r e a s e d t o 30 o f f i c e r s a n d m e m b e r s a n d 2 2 p r o b a t i o n e r s . It h a s c o lle c te d o v e r ;£ 1 0 0 fo r th e P r is o n e r s o f W a r F u n d ; i t s m e m b e r s h a v e g a i n e d o v e r 100 c e r t i f i c a t e s , 6 m e d a l l i o n s a n d 2 b a r s, a n d h a v e g i v e n o v e r 3,400 h o u r s to R e d C r o s s w o rk , b esid es fu lly e q u ip p in g a F ir s t A id P o s t a t the “ E l m s ” S p o r ts g ro u n d , W a lth a m s t o w , o u t of th eir o w n funds. T h e y h a v e 6 m e m b e r s in t h e F o r c e s ; a l l m e m b e r s , w i t h t h e e x c e p t i o n o f t h e C o m m a n d a n t , a r e u n d e r 20 y e a r s o f a g e , a n d t h e y a r e t h e f i r s t m i x e d d e t a c h m e n t in E n g l a n d ,
F I R S T
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Triangular and Roller Bandaging simply explained and clearly Illustrated.
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G a s W a r fa r e , F irst A id W h a t t o D o in E m e r g e n c i e s In flu e n za , C o ld s , etc. M ea sles, M u m p s, C a ta rrh Corns and W arts P h ysica l C u ltu re T r e a t m e n t for a ll S k i n D is e a s e s
T h e P rin c ip le s of N u r s in g T h e E ye, the E a r T h e T h r o a t, the N ose T h e C h e st, the H e a r t T h e S to m a c h , the L iv e r T h e T e e th , th e M u sc les Infant W e lfa re
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The Home Guard and First Aid.
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M r. H . A d a m s C la r k e (C h ief S ta ff a nd E sta b lish m en t O fficer) h a s b een p r o m o te d b y the V e n e r a b le O r d e r of St. J o h n o f J e r u s a l e m f r o m t h e G r a d e o f S e r v i n g B r o t h e r in t h e O r d e r to t h a t of O fficer. M r . A d a m s C l a r k e is C h a i r m a n o f t h e C e n t r a l C o m m ittee of th e G . W . R . C e n tre of th e S .J .A .A . a n d C h a ir m a n of the G. W . R . D iv ision a l A m b u la n c e S ecreta ries’ Conference.
R e a d e r s w ill p e rh a p s fo r g iv e m e for w r i t i n g on a su b ject, w h i c h t h o u g h n o t s t r i c t l y c o m i n g u n d e r t h e h e a d i n g o f fi r st a id , is, a te r a ll, e sse n tial k n o w l e d g e for th e M ed ica l O rd erly. In th e e ve n t of a g e n e r a l ca ll-o ut, iso la te d a n d co u n try u n i t s m a y fin d s o m e d i f f i c u l t y i n c a t e r i n g f o r a l a r g e n u m b e r o f m e n , a n d e v e n in t o w n a r e a s , e n e m y a c t i o n m a y r e n d e r th e u s u a l s o u r c e of s u p p ly useless, a n d th e u n it c o n ce rn e d , m a y , a t le a s t t e m p o r a r ily , be fo rced to o b ta in s u p p lie s fro m a less reliab le sou rce. T h e d a n g e r s of in fection t h r o u g h pollu tio n a re m a n y , y e t t h e r e m e d i e s a r e r e a l l y s o s i m p l e if t h o r o u g h l y u n d e r sto o d , th a t th ese d a n g e r s c a n e a s ily be a v o id e d . 1 trust th e r e f o r e , t h a t fo r th o s e u n a b l e a s y e t, to o b ta in e x p e r t t u it io n o n t h e s u b je c t, a f e w g e n e r a l h in ts m a y p r o v e of in terest. N a tu r a lly , o n e ca n o n ly h o p e to to u ch the o u te r f r i n g e o f th e s u b je c t in t h e s e notes. F ir s t th en , let us lo o k a t th e v a r io u s s o u r c e s of su p p ly. T h e s e c a n b e r o u g h l y p l a c e d in t h e f o l l o w i n g o r d e r o f p u r i t y , t h o u g h n o n e c a n be c o n sid e re d e n tire ly free fr o m possible c o n t a m i n a t i o n :— ( 1 ) A r t e s i a n w e l l s ; (2) D e e p w e l l s ; (3) S p r i n g s ; (4) R a i n w a t e r ; (5) L a r g e la k e s (cen tre) ; (6) R iv e r s ( m id s t r e a m ) ; ( 7) S m a l l s t r e a m s ; ( 8 ) L a r g e l a k e s ( n e a r b a n k s ) ; ( 9) S h a l l o w w e l l s ; ( 1 0 ) R i v e r s ( n e a r b a n k s ) ; a n d ( 1 1 ) p o n d s and ca na ls. In a d d itio n , m e n tio n sh o u ld be m a d e of the w a t e r in s h e l l a n d b o m b h o l e s , w h i c h is d a n g e r o u s l y c o n ta m in a te d , a r s e n ic often b e in g p resen t. I m p u r i t i e s p r e s e n t i n w a t e r s u p p l y , a r e f o u n d e i t h e r in s u s p e n s io n (as d e c a y e d v e g e t a t io n , a n d l iv in g o r g a n i s m s s u c h a s d i s e a s e g e r m s ) o r in s o l u t i o n . T h e latter a re c o m p o sed of m in e r a l salts, su c h a s th e c a r b o n a te s a n d the su lp h a tes of calciu m and m a g n e siu m . T h e s e a re often h a r m fu l to d igestio n . T h e d e t e c tio n of p o llu tio n a n d th e p u r ific a tio n of s u p p ly , I w ill d eal w ith n e xt m on th . M ea n w h ile , the M ed ica l S e c t i o n ’ s f i r s t d u t y w o u l d b e t o p r o t e c t t h e s u p p l y , b y p o l i c i n g it , a n d t o r e n d e r it p h y s i c a l l y i m p o s s i b l e f o r t h e m e n t o g e t a t u n u sab le w ater.
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C a r d i f f a n d L l a n d a f f . — -A l a r g e n u m b e r o f r a i l w a y m e n a n d th eir fa m ilies, t o g e t h e r w ith w e ll- k n o w n lo ca l resid en ts g a th e r e d at W h itc h u r c h , C ard iff, for th e p r es en ta tion of a w a r d s g a i n e d b y m e m b e r s of th e C a r d i f f Q u e e n S tr e e t L a d ie s a nd L la n d a ff A m b u la n c e classes. M r . H . J . P e a c o c k , A s s t . S u p t . o f t h e L i n e , w h o is P r e s id e n t of th e W h itc h u r c h D iv isio n of th e S . J . A . B . , pre sid ed, a n d the a w a r d s w e r e d istrib u ted b y M r. H . H . P h illip s, D iv is io n a l T r a ff ic S u p t . for th e C a r d i f f D iv is io n . M r. B . B o a rd , D iv isio n a l A m b u la n c e S e c re ta ry , and M iss F. M oore, S e c re ta r y of th e C a rd iff L a d ie s class, w e re a ls o present. I t i s i n t e r e s t i n g t o n o t e t h a t M i s s M o o r e is t h e fir st l a d y i n t h e C a r d i f f D i v i s i o n t o q u a l i f y f o r t h e G . W . R . IS y e a r e fficien cy m ed a l.
M is s M . P . J e n k in s , c a r r i a g e cle a n e r, C a rd iff, w a s this y e a r ’s w i n n e r o f th e “ A n n B e n c e ” C h a l l e n g e C u p c o m p e t e d fo r b y m a le a n d fe m a le m e m b e r s of the C a r d if f G e n e r a l G . W . R . A m b u l a n c e cla ss. T h e C h a lle n g e Cup, to geth er w ith th e r e p lic a w h i c h s h e w ill r e ta in , w a s p r e s e n te d to M is s J e n k i n s b y D r . C l i f f o r d B e n c e , w h o is l e c t u r e r t o t h e c l a s s a n d fa th e r of th e donor.
O R S A L E . — C o r p s O f f i c e r ’ s U n i f o r m , 42 in . c h e s t , 33 in . i n s i d e l e g ; s u i t m a n 6 ft . 2 in . ; c o m p l e t e l y n e w , n e v e r w orn. A ls o M e s s J a c k e t a n d V e s t , s a m e size. B argain, 10 g u in e a s . N o coupons. B o x 2 8 3 , “ F i r s t A i d , ” 46, Cannon-street, Lo nd on , E .C .4 .
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E W D iv is io n w is h e s to p u rc h a s e St. Joh n A m b u la n c e U n i f o r m s (m a le ), m u s t b e in g o o d c o n d itio n . Par ticu lars, D iv . S u p t. F . C a rr, 14, W e m b le y A v e n u e , T h o rn to n , B radford, Y o rk sh ire.
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I R S T A I D C O M P E T I T I O N S are w on by good coach in g . A n y F ir s t A id e r (either s e x ) m a y c o a c h a n y a m b itio u s t e a m — m ale , fe m a le , o r m ix e d — to e a r ly su cce ss. C o m p etition exp erien ce not n ecessary w ith n e w G u id e ( a d a p t a b le to a n y t e x t - b o o k ) . F o r particu lars, send sta m p ed e n v e l o p e t o :— R . J e f f e r y , S, A v e n u e G a r d e n s , L o n d o n W . 3 .
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Queries and Answers to Correspondents Q u e r i e s w i l l b e d e a l t w i t h u n d e r t h e f o l l o w i n g r u l e s :— L — L e t t e r s c o n t a i n i n g Q u e r ie s m u s t b e m a r k e d on th e top le f t - h a n d c o r n e r o f t h e e n v e lo p e “ Q u e r y , ’’ a n d a d d r e s s e d to F ir s t A i d , 46, C a n n o n - s t r e e t , L o n d o n , E . C . 4 .
h e h a d l a i d d o w n In t h e w a t e r , h e s m e l t g a s a n d q u i c k l y b e g a n t o fe e l q u e e r . B e c o m in g d ro w sy, and sen sin g d a n g e r he p u lled the p lu g o u t of th e b a th w ith h is to es a n d fo r th w ith lo st c o n s c io u s n e s s . T h e la st sen ten ce su p p lies th e n a m e of th e so ld ier ( W e r n h e r K u n s t ) an d not th at of the o rig in a to r o f a n e w m e t h o d o f a r t i f i c i a l r e s p i r a t i o n ; a n d it t e l l s u s t h a t fiv e h o u r s l a t e r h e r e c o v e r e d c o n s c i o u s n e s s a n d f o u n d h i m s e l f l y i n g in t h e e m p t y b a t h . — N . C . F .
2 .— A ll Q u e r ie s m u s t b e w r it t e n o n o n e sid e o f p a p e r on ly. 3.— A ll Q u e r ie s m u s t b e a c c o m p a n ie d b y a “ Q u e r y C o u p o n ” c u t f r o m th e c u r r e n t is s u e of t h e J o u r n a l, or, in c a s e of Q u e r ie s fr o m a b r o a d , fr o m a r e c e n t issu e. 4 .— T h e T e x t b o o k to w h i c h r e fe re n c e m a y b e m a d e in this c o l u m n is t h e 3 9 t h ( 1 9 3 7 ) E d i t i o n o f t h e S . J . A . A . M a n u a l of F ir s t A id to th e In ju re d .
A s p h y x ia w ith B le e d in g . E .G . ( R u n c o r n ).— R e c e n tly at B r ig a d e P ractice there arose a d iscu ssion co n c e rn in g w h ich 1 sh ou ld a p p recia te yo u r kin d assistance. T h e q u e s t i o n a s k e d w a s w h a t w e w o u l d d o if a p a t i e n t , w h o is b l e e d i n g p rofu sely, sh o u ld b e c o m e a s p h y x ia te d from s o m e o th er cau se. I said th at I w o u ld t r e a t t h e h a e m o r r h a g e first a c c o r d i n g to th e p r in c i p le s l a i d d o w n in t h e T e x t b o o k a n d t h e n p r o c e e d t o d o artificial resp iration . I w a s told th a t th is w a s th e w r o n g p r o c e d u r e b e c a u s e , w h i l e a s p h y x i a is p r e s e n t, t h e r e w o u ld be no d a n g e r from h a e m o r r h a g e . I t h a n k y o u v ery m u c h fo r all the h elp w h ic h I h a v e re c e iv ed fro m y o u r q u ery colu m n .
A p o p le x y a n d B le e d in g P a lm . G . W . (R is c a , M o n .) .— A s a m e m b e r of a n e w ly registe red N u r s i n g D i v i s i o n o f t h e B r i g a d e I w a s i n t e r e s t e d in t h e t e a m t e s t , d e t a i l s o f w h i c h w e r e p u b l i s h e d o n p. 1 2 5 o f th e M a y issu e of F ir s t A id . I n t h e t e s t t h e p a t i e n t is sta te d to h a v e fa lle n o n to h is fa c e a s th e r e s u lt o f a n a p o p l e c t i c s t r o k e . T h e m a r k i n g s h e e t , h o w e v e r , is s i l e n t a s to w h e n p a t ie n t w a s tu r n e d o n h is b a c k — a s h e o b v i o u s l y w a s ; a n d I s h a l l b e g r a t e f u l if y o u w i l l t e l l m e w h e n this c h a n g e of p osition s h o u ld be effected. I w o n d e r if t h i s w a s d o n e i m m e d i a t e l y a f t e r a r r e s t i n g b le e d in g fro m th e p a lm of the h a n d . I t is n o t p o s s i b l e f o r m e t o k n o w w h a t w a s in t h e m i n d of the j u d g e w h o p rep ared th e test a n d to s a y w h e n he w a n te d th e p atien t tu rn e d on h is b a c k . L ik e you, how ever, I take it t h a t th e im m e d i a t e r e q u ir e m e n t s of th e test w o u l d be to co n tro l th e b le e d in g p a lm b y d ig it a l p r es su r e on the ra dial a n d u ln a r a rterie s, a n d th en , w ith a ll d u e p r e c a u tio n s a g a i n s t a g g r a v a t io n of fr a ctu re s w h ic h m ig h t b e presen t, to tu rn the p a tie n t o n his b a c k b e fo re p r o c e e d in g w it h f u r th e r tre a tm e n t. — N .C .F .
I d e a l A n tis e p tic . I t is t r u e t h a t w i t h t h e o n s e t o f a s p h y x i a , h a e m o r r h a g e d oes b e c o m e re d u ced o w i n g to the w e a k e n e d a c tio n of the h e a r t w h i c h is u n a b l e t o p u m p b l o o d t h r o u g h t h e s y s t e m . Y o u r a n sw e r, h o w ev e r, w a s not qu ite correct b ecau se y o u o u g h t n o t to d e l a y s t a r t i n g a r t i f i c i a l r e s p i r a t i o n u n t i l t h e b l e e d i n g w o u n d h a s b e e n t r e a t e d a s l a i d d o w n in t h e T e x t book. Y o u sh o u ld ra th e r t a k e p rev en tive a c tio n o n ly by p l a c i n g a t o u r n i q u e t in p o s i t i o n if s u c h s t e p is i n d i c a t e d a n d b y c o v e r in g th e w o u n d w ith a te m p o ra r y d r e s s in g so that, w h e n p a t i e n t b e g i n s t o b r e a t h e a n d b l e e d i n g is l i k e l y t o r e start, y o u c a n im m e d ia te ly tig h te n to u rn iq u et. T h is done, y o u s h o u ld a t o n c e re s o r t to a r tific ia l r e s p ira tio n , r e m e m b e r i n g t h a t th is o p e r a tio n , to b e effe c tiv e , m u s t be c o m m e n c e d a t t h e fir s t p o s s i b l e m o m e n t . T h e n w h e n b r e a t h i n g h a s b e e n r e - e s t a b l i s h e d y o u w o u l d d r e s s t h e w o u n d a s l a i d d o w n in th e T e x t b o o k . — N . C o r b e t F i.e t c h e r .
E x a m in a tio n H o w ler. M .R . (C a n n o n S t.). — In a recen t e x a m in a tio n I a s k e d a c a n d id a te w h a t h e w o u ld call a jo in t of w h ic h , a s th e re su lt of an a ccid e n t, on e or m o re b o n es h a d been d is p laced. I c o u ld not resist a sm ile w h e n he r e p lie d — “ S u c h j o i n t w o u ld be d e sic c a te d ! ” T hen, w hen I com m e n t e d — “ W h a t , d r ie d u p ? " h e r e p l i e d — “ O h n o ! I m ean d esecra ted ! ” Good!
N ext, p le a se !
!— N . C . F .
W . L . ( M a u l d e n ) . — O n p. 1 0 6 o f t h e T e x t b o o k it is s t a t e d t h a t a n tis e p tic s w h ic h do n ot stain , b u rn or irritate a n d w h i c h a r e n o t p o i s o n o u s s h o u l d b e u s e d in f i r s t a i d w o r k . C a n y o u p le a s e g i v e m e a list of a n t is e p ti c s w h ic h c o n fo r m to t h e s e r e q u ir e m e n t s ? T h e r e a r e v a rio u s p r e p a r a tio n s w h ic h c o n fo r m to th e d e f i n i t i o n o f t h e i d e a l a n t i s e p t i c g i v e n in t h e T e x t b o o k , t h o u g h it d o e s n o t n a m e a n y o n e of t h e m . T h is apparent om issio n w a s m a d e d elib erately b e c a u s e the s u rg e o n -le c tu r e r ca n e x p la in fu lly th e u se s of w h a t e v e r a n tise p tic he/she recom m ends. F o r a l i k e r e a s o n I g i v e n o lis t . I m ay, h ow e v e r , r e m i n d y o u t h a t , w h e n in 1 9 3 7 , t h e B r i g a d e w a s f a c e d - w i t h t h e s a m e d e c i s i o n , it a d o p t e d s u r g i c a l s p i r i t w h i c h c o n fo r m s to the definition of th e T e x t b o o k a n d w a s r e c o m m e n d e d by a Conference of B rig ad e S u rg e o n s .— N .C .F .
H o m o n r in F ir s t A id . J . S . ( T a v i s t o c k ) . — N o t l o n g a g o in a n e x a m i n a t i o n I a s k e d a c a n d id a t e w h a t w o u ld be his t r e a t m e n t of a p a tien t su fferin g from sh o c k a s th e re su lt of se v ere arterial b leed in g. I w a s a m u s e d w h e n h e r e p l i e d :— " I w o u ld
rem ove h im from a p o sitio n o f d a n g e r : but sin ce the w o u n d is b lee d in g freely I w o u ld ap p ly p ressu re to the artery w h ich is s u p p ly in g the w h o le n eigh b ourh ood w ith b lo o d ! " S o m e w o r k for one a rte ry 1 ! Good!
N e x t , p l e a s e ! !— N . C . F .
E s c a p e fr o m D r o w n in g .
S c h a fe r a n d N ie ls e n .
W . H . ( M id d le s b r o u g h ).— I en clo se a c u t t in g fro m a G e r m a n n e w s p a p e r a n d d ire ct y o u r atte n tio n to th e la st se n te n ce w h ic h c o m m e n c e s w ith th e w o r d s — “ W e r n h e r K u n s t . . .” I s h a l l b e g r e a t l y o b l i g e d if y o u w ill, t e l l m e w h e t h e r o r n o t h i s n a m e r e f e r s t o a n e w m e t h o d of artificial resp iration . M e a n w h ile p lea se a c c ep t m y th a n k s for y o u r a n sw e r.
M . R . ( Y o r k ). — I w is h to d r a w y o u r a tte n tio n to a n a d d itio n al m e t h o d o f a r t i f i c i a l r e s p i r a t i o n u s e d in c o n j u n c t i o n w i t h th e S c h a fe r m eth od . I a m c o n v i n c e d t h a t it c e r t a i n l y is a n i m p r o v e m e n t a n d t h a t it w i l l g r e a t l y h e l p t o r e s t o r e life. O p e r a to r N o . 1 k n e e ls at sid e of the patient, h a n d s in p o s i t i o n . O p e r a to r N o . 2 in s tru c te d b y N o . 1, k n e e ls b y h e a d o f t h e p a t i e n t ( p a t i e n t ’s . p a l m o f h a n d s d o w n w ards). O p e r a t o r N o . 2 th e n lifts p a t i e n t ’s a r m s u p w a r d s a s fa r a s p ossible. T h e n O p e ra to r N o. 1 presses
A c c o r d i n g to th e c u ttin g , a w a r - w e a r y G e r m a n so ld ier r e t u r n e d h o m e o n le a v e a n d in d u l g e d in a h o t b a th . W hen
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F I R S T d o w n a n d w h en he co m es back, O p era to r No. 2 b rin g s t h e a r m s to t h e flo or. T h e t h e o r y is t h a t th e p a tie n t b e in g lifeless c a n n o t of c o u rs e u s e th e c h e st m u scle s, but w i t h t h e a r m m o v e m e n t t h i s w o u l d s u c k a i r in t h e l u n g s w h ile d riv in g ou t th e w a t e r or oth er o b stru ctio n . T h is w a s tried o u t b y o u r d o c to r a n d w a s p roved to b e s u c c e s s ful. Y o u r c o m m e n ts w ill be a p p reciated . T h e m e t h o d d e s c r i b e d is in e f f e c t a c o m b i n a t i o n o f t h e m e th o d s of S c h a fe r a n d N ielsen . C a p t a in A l w y n B is c o e of t h e R o y a l L i f e S a v i n g S o c i e t y t e l l s m e t h a t it i s s e t o u t in d e t a i l u n d e r t h e n a m e s o f D r i n k e r a n d S h a w in a b o o k e n t i t l e d B r e a t h in g M a c h in e s a n d T h e ir U ses in T rea tm en t p u b lish ed b y th e M e d ic a l R e se a rc h C o u n cil. A s y o u s u g g e s t , t h e p a t i e n t is p l a c e d f a c e d o w n w a r d s , a n d on e o p era to r a p p lie s th e u s u a l p rone p ressu re m ethod. T h e o t h e r o p e ra to r, k n e e l i n g a t th e p a t ie n t ’s h e a d e x t e n d s a n d r a is e s th e a r m s a t t h e m o m e n t w h e n th e first o p e ra to r r e le a s e s t h e p r e s s u r e on t h e l o w e r p a r t of t h e t h o r a x . A ssist a n c e is t h u s g i v e n b o t h t o i n s p i r a t i o n a n d e x p i r a t i o n , a n d it is p o s sib le th a t th is m e th o d p r o d u c e s a s lig h t ly g r e a t e r v e n tila t io n t h a n t h a t of S c h a f e r ; b u t, D r i n k e r s t a te s , “ e x p e r ie n c e h a s n o t s h o w n th e a d v a n t a g e s to b e g r e a t e n o u g h to w a r r a n t d i s c a r d i n g all th e e d u c a t io n a l p u b lic ity w h i c h h a s been d ev e lo p e d for th e p ron e p ressu re m eth o d , a n d re - tr a in in g the l a r g e n u m b e r s o f p e r s o n s n o w s k i l l e d in i t s u s e . ” — N . C . F .
A c tio n o f C o ffe e . A . E . ( R h o n d d a ) . — P le a s e tell m e w h a t e ffe ct or a c ti o n s t r o n g b l a c k coffee h a s w h e n a d m in is te r e d to a p a tie n t w h o h a s b een b itten b y a ra b id a n im a l. A ls o p lea se a c c ep t m y t h a n k s fo r th e g r e a t h e lp w h ic h I h a v e re c e iv ed from y o u r a n s w e r s t o m y q u e r i e s in t h e p a s t . C o f f e e c o n t a i n s a n a c t i v e p r i n c i p l e w h i c h is c a l l e d c a f f e i n e a n d w’ h i c h a c t s a s a s t i m u l a n t . T h e T e x t b o o k in this i n s t a n c e ( R u l e 2, p. 1 3 4 ) s u g g e s t s a d m i n i s t r a t i o n o f c o f f e e a s a n a lt e r n a t iv e to th e u s e of b r a n d y o r w h i s k y . F u r t h e r , to g e t t h e m a x i m u m e f f e c t it t e l l s u s t o g i v e t h e c o f f e e h o t a n d a ls o b l a c k , th a t is s t r o n g . — N . C . F .
E p ile p t ic F it a n d F r a c t u r e d L e g . A . C . ( S t r e a t h a m ) . — W e s h a l l b e g l a d if y o u w i l l g i v e u s t h e b e n e fit of y o u r o p in io n a s to th e b e s t first a id t r e a t m e n t i n t h e f o l l o w i n g c i r c u m s t a n c e s :— “ A f i r s t a i d e r is a l o n e w i t h a m a n w h o f a l l s a n d fr a c tu r e s h is l e g a n d b e fo re h e h a s tim e to co n tro l the f r a c t u r e in a n y w a y t h e p a t i e n t h a s a n e p i l e p t i c f i t . ” S o m e of o u r c la ss d ec id e d to su p p o rt th e fra ctu re d l e g u n til th e co n v u ls io n s ce ased , to p rev e n t a n y a g g r a v a tion of th a t k n o w n in ju ry, a n d to r is k the c h a n c e of p a tie n t b it in g h is t o n g u e o r k n o c k i n g h is h ead . O ther m e m b e r s d ec id e d to su p p o rt th e h ead a n d p rev e n t b itin g o f t o n g u e a n d to le a v e th e fr a c tu r e u n c o n tr o lle d u n til the co n vu lsio n s ceased . M ea n w h ile our thanks. I n a n e p i l e p t i c fit t h e c o n v u l s i o n s m u s t r u n t h e i r c o u r s e . C o n s e q u e n t l y , 1 a m a f r a i d t h a t t h e r e is n o t h i n g w h i c h y o u c a n d o to p r ev e n t a g g r a v a t i o n of fr a c tu r e d le g . So m etim es, h o w e v e r , a t t h e o n s e t o f t h e fit t h e r e i s a s h o r t p e r i o d d u r i n g w h ic h all th e v o lu n t a r y m u s c le s b e c o m e tau t. If th is h a p p e n s , y o u h a v e th is b rief s p a c e of tim e d u r in g w h ic h y o u c a n t a k e w h a t p r e v e n t i v e a c t o n is p o s s i b l e . — N . C . F .
A I D t e ll m e o n w h i c h s i d e t h e r i b b o n s h o u l d b e w o r n o n H o m e G u a r d un ifo rm . T h e ty p e of u n ifo rm d oes n ot affect y o u r q u estion , b e c a u s e th e R a i l w a y rib b o n c a n n o t be w o r n o n th e left b reast. Y o u sh o u ld h o w e v e r, ob tain th e a p p ro v a l of y o u r P la to o n C o m m a n d e r befo re p la c in g the rib b o n on H o m e G u a r d u n ifo rm .— E d it o r .
T r e a tm e n t o f F r a c tu r e d R ib s . B . R . (Ip sw ic h ).-— R e c e n t l y a t a F . A . P o s t I h a d to a tt e n d a p a t i e n t f o r a s i m p l e f r a c t u r e o f t h e r i b s ( le f t s i d e ) . I let p a tie n t r e m a in se a te d , ap p lie d t w o b ro a d b a n d a g e s , l a r g e a r m s l i n g , t h e n in m y t r e a t m e n t f o r s h o c k I d id n o t k n o w w h e r e to p la c e th e h o t w a t e r bottle. S o I p l a c e d it o n t h e r i g h t ( u n i n j u r e d ) s i d e t h i n k i n g t h a t if I p l a c e d i t o n t h e i n j u r e d s i d e it m i g h t c a u s e c o n g e s t i o n ; b u t I a m s t i l l w o n d e r i n g w h i c h is correct. I s h a l l be p le a s e d to r e c e iv e y o u r r e p ly for w h ich I th a n k you. I f y o u r p a t i e n t w a s a b l e t o r e m a i n in a s e a t e d p o s i t i o n , it w o u l d s e e m ( 1 ) t h a t h e w a s n o t s u f f e r i n g s e v e r e l y f r o m s h o c k a n d (2) t h a t h is c o n d it io n d id n o t in d ic a t e t h e a p p l i c a tion of e x t e r n a l h eat. I n r e p ly to y o u r sp ecific q u e s tio n a h o t - w a te r b ottle p l a c e d o v e r f r a c t u r e d r i b s is n o t l i k e l y t o c a u s e c o n g e s t i o n a n d m i g h t a f f o r d r e l i e f t o t h e a s s o c i a t e d p a i n if t h i s s h o u l d be severe. I n t h i s c o n n e c t i o n I r e f e r y o u t o p. 4.S o f t h e T e x t b o o k w h e r e u n d e r t h e t r e a t m e n t o f s h o c k i t t e l l s y o u to a p p l y h o t w a t e r b o ttle s to th e sid e s o f th e b o d y , b e t w e e n the le g s a n d to th e fe e t.— N . C . F .
F r a c t u r e s o f P e l v is a n d F e m u r . M . S . ( C a m b r i d g e ) . — A t a r e c e n t c o m p e t i t i o n h e l d in C a m b r i d g e t h e f o l l o w i n g c a s e w a s s e t :— A m a n w a s foun d on the g r o u n d u n co n scio u s h a v in g fallen from a la d d e r w h ic h w a s n e a r b y a n d s u fferin g fr o m fr a c tu r e s of p elvis a n d fe m u r (m id d le of sh a ft) w a s treated . A ll th e c o m p e tito rs u sed a splin t for g r e a t e r s e c u rity fro m th e h ip d o w n w a r d s , b u t th e e x a m in in g o fficer ru led th at a s p lin t s h o u ld n ot b e used. W o u ld y o u k in d ly g i v e y o u r v ie w s on th is case, a s a t a recent D iv isio n a l P ractice th ere w a s con sid erab le d ifferen ce of op in ion ? W i t h t h i s c o m b i n a t i o n o f i n j u r i e s t h e f r a c t u r e d f e m u r is m o re lia b le to a g g r a v a t i o n a n d s h o u ld c o n s e q u e n t ly re c e iv e p referential tre atm e n t. In oth er w o rd s, I a g r e e w ith the m e m b e r s o f y o u r c l a s s a n d if I h a d t o d e a l w i t h t h i s c o m b i n a t i o n I w o u l d t r e a t t h e f r a c t u r e d t h i g h a s l a i d d o w n in th e T e x t b o o k a n d k n o w th a t th e fr a c tu r e d p elvis w o u ld be p rop erly co n tro lled .— N .C .F .
C o m p r e s s io n o f B r a in a n d A p o p le x y . P . M . ( C o v e n t r y ) . — P l e a s e t e l l m e w h a t is t h e e s s e n t i a l d i f f e r e n c e b e tw e e n C o m p re s sio n of b rain a n d A p o p le x y. B o t h c o n d i t i o n s r e s u l t f r o m b u r s t i n g o f a b l o o d v e s s e l in th e b r a in a n d c o n s e q u e n t rise o f p r e s s u r e w ith in th e s k u ll. B o th p ro d u ce th e sa m e s ig n s a n d sy m p to m s a n d b o th call for th e s a m e t r e a tm e n t. In C o m p ressio n , h o w e v e r, a cciden t, in A p o p le x y , d is e a s e is th e c a u s e of th e r u p tu r e d v essel. In short, doctors d ia g n o s e A p o p le x y by the sig n s a n d sym p to m s o f C o m p r e s s i o n , c o m b i n e d w i t h t h e f a c t t h a t t h e r e is n o h isto ry o r e vid e n ce of h e ad in ju rie s.— N . C . F .
H o m e G u a rd U n ifo rm . W . M . ( R u a b o n ) .— I h a v e b een a m e m b e r of the St. Joh n A m b u la n c e A ssociation (G rea t W e s te rn R a ilw a y Centre) fo r t h e p a s t t w e n t y - e i g h t y e a r s ; a n d I h o ld th e fifteen a n d tw enty-fiv e y e a r g o ld m ed als. A s a m e m b e r of the B r i g a d e I w a s su p plied w ith a rib b o n for th ese m ed a ls w h ic h sh ou ld be w o rn on the r ig h t breast. A s a first a id t r a i n e r i n t h e H o m e G u a r d I s h a l l b e o b l i g e d if y o u w i l l
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U n lik e th e o r d in a r y s o c k e tte d S p lin t, th is ty p e is r ig id ly co u p led to g e th e r and held against r e la tiv e d isp la ce m e n t b u t can be disengaged b y p u llin g a p a rt w it h su fficien t fo rce .
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N . B . — T o e n su re p e rfe c t lockin g it is im p e r a tiv e th a t th e S p lin t should be c o r r e c t ly in se rte d in th e so c k e t, i.e ., B Y M A K I N G C E R T A IN T H A T T H E IN C U R V E D ED GE O F M ETA L SO C K ET E N G A G E S W IT H T H E T R A N S V E R S E G R O O V E O F T H E S P L IN T . P r ic e : C o m p le te w it h t w o p airs o f straps - - 4/- p e r se t. ........................................... 3/- p e r se t. W it h o u t stra p s
C A S U A L T I E S
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H A M M E R , M .R .C .S .
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TO
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19 4 A
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E n te r e d a t 1 {.S ta tio n e rs H a it i
■
R E A D E R S.
E D IT O R IA L .
F U ^5 T A ID is p u b lis h e d o n th e 20t h o f e a c h A n n u a l S u b s c rip tio n is 4 S . p o s t fre e ; s in g le c o p ie s 3 d .
m o n th *
The
A n y t h in g
I t s a im a n d o b je c t b e in g th e a d v a n c e m e n t o f A m b u la n c e W o rk in a ll its b ra n c h e s , th e E d i to r in v ite s R e a d e rs to s e n d A rtic le s a n d R e p o r ts o n s u b je c ts p e rta in in g to th e M o v e m e n t a n d a lso w e lco m es s u g g e s tio n s fo r P r a c tic a l P a p e rs . A ll R e p o r ts , & c ., s h o u ld b e a d d re s s e d to th e E d i to r a t th e a d d re ss b e lo w , a n d s h o u ld re a c h h im b e fo re th e 8 t h o f e a c h m o n th , a n d m u s t b e a c c o m p a n ie d ( n o t n e c e s s a r i ly f o r p u b l i c a t i o n ) b y tb e n a m e a n d a d d re s s o f th e C o rre s p o n d e n t. S u b s c rip tio n s , A d v e rtis e m e n ts a n d o th e r b u s in e s s C o m m u n ic a tio n s c o n n e c te d w ith F I R S T A I D s h o u ld b e fo rw a rd e d to th e P u b lish e rs . D A L E , R E Y N O L D S & C o ., L t d ., 46, C a n n o n
S tre e t,
I n s t r u c to r s in F ir s t A id .
L ondon,
E .C .4 .
and
bound
to
a llo w e d
a id
to o u t r u n
p ra ctice
b litzk rie g ;
NUM BER.
no E d i t o r i a l :— ...
...
13
...
14
St. Jo h n A m b u l a n c e A s s o c ia tio n
...
...
IS
...
...
IS
B ritish R e d C ro ss S o c ie ty
...
w ill
be
v e h ic le
prog-
a m uch-
n o t in o u r
fa ith
triu m p h a n t
a n ticip a tio n
so rely
h o lo c a u s t need
end
in
th ere
to
say
m ay yet be
d iffe re n t
o f first do
not
in t h e w a y o f a n o t h e r us
sh all
deserves
of
h o stilitie s
once
m ore,
in
h a v e a re v iv a l of th e
e p ith e t
a n y th in g .
T h ey
d e c re a sin g fa cto ry
w ill
of
a
B ut
ca tego ry,
a lw a y s
in
in te n s ity ;
or
w orks
c o m p e te n t to d ea l w ith
e a rly s t a g e s ..
be
O f i n d u s t r i a l a c c i d e n t s t h e r e is
w e ll-re g u la te d are
is
not
W e
te rm in a tio n
we
th e
w h ich
sh o u ld
needed.
b e w ith
w h ich
us, a lth o u g h
every
th e
w ill
n um bers, and
th o se w h o T h e F u tu re of the St. J o h n A m b u la n c e B r ig a d e
“
have
d iscre tio n , a n d
n a tio n a l d is g r a c e .
w ith ...
W e
th at
b u t w ith
m o to r
th at
I n s t r u c t o r s in F i r s t A i d
c o llo q u ia lism )
com e ; but
in cre a se d
TH IS
fo resee
g lo o m y
is (to q u o t e
a p e rio d , h o w e v e r b rief, w h e n th e e x te n s io n
th e
T e le p h o n e — C i t y 3 7 1 0 .
OF
used lin e .”
fu tu re
lik e
n o stic a tio n
r e fe r s p e c if ic a lly to a n y t h i n g
T e le g r a p h ic A d d r e s s — ' 1 T w e n t y - f o u r , L o n d o n . ”
CO N TEN TS
PRICE THREEPENCE (4/- P h r Annum , P o s t F r e e
th ere th em
be
b u t in are
in th e
road
“ a c c id e n t s ” fa ll w it h in
and
th e
b ra n ch e s of C iv il D e fe n c e
d ec isio n
to
personnel
tra in
a a ll
in fir s t a id is
a w is e o n e , a n d w ill a t le a st e n s u r e th a t fe w v ic tim s
S .J .A .B . H ead q u a rters and D istrict R ep orts
...
IS
w a y s id e ,
a w a itin g
T h e H o m e G u ard and F irst A id
...
17
th e a rriv a l o f th e d o c to r w h o , a s so o fte n
happens,
17
a r r iv e s to o la te .
L e t t e r s to th e E d ito r
...
R a ilw a y A m b u lan ce N e w s V itam in s
...
...
R ev iew s
...
...
... ...
...
...
...
...
18 18
•••
•••
20
Q ueries a n d A n s w e r s to C o r r e s p o n d e n t s
w ill
have
be
le ft
th eir
u n atten d ed
num ber
of
E v e n th e w ise st o f d e c is io n s m u st
lim ita tio n s,
w h ich co n fro n ts
b y th e
th e
in s tru c to rs
p r o g c a m m e w h ich
h ow ever,
n a tio n to
is
22
one.
E x a m in a tio n H o w le r
...
...
...
22
o f teach ers, and
th e c o n v e r s e
B le e d in g from L u n g s
...
...
...
22
p risin g exten t.
T o
a m b itio u s T h e a b ility
T h e
m o s t eru d ite p e rso n
m ount
and
good
to a s u r
s p e a k fro m
a p la t
...
...
22
...
22
a lth o u g h
t i p s in h is s u b j e c t a n y t h i n g l i k e e x t e m p o r e d e l i v e r y
...
...
22
...
...
...
22
L a y In stru cto r C e rtificate
...
...
...
22
T r a n s p o rt of F ra c tu r e d S p in e
...
...
24
S tim u la n ts w ith Internal H aem o rrh a g e
...
24
C a lciu m C a rb id e P o is o n in g ...
...
24
th is
...
is to m o s t p e o p l e
m a y b e th e p o o re st
h o ld s
...
F r a c t u r e of P e lv is ...
...
th e
fo rm
Sch afer, S ilv ester or H o w a r d
H u m o u r in F i r s t A i d
p ro b lem su fficie n t
to im p a r t k n o w l e d g e to o t h e r s is n o t g i v e n to e v e r y ...
...
a a
sketch ed .
...
T r e a tm e n t of F ra c tu r e d F e m u r
and fin d
carry out
has been
T r e a tm e n t of C a rb o lic P o iso n in g
T r e a t m e n t of E p ile p s y
to
th e
la y m a n
a fe a rso m e e x p e rie n c e , an d m ay
be
soaked
to
h is fin g e r
o f h is k n o w le d g e m a y b e c o m e a s h e e r im p o s s ib ility . T h e
text-b o o ks
have
th e scie n ce s, a n d
th e e sse n tia l th in g stra tio n
is
a c c o m p a n ie d
proceeds.
th e ir
use
in
H ow
p ra ctica l by
a
m any,
and
lu cid it
m a jo rity of
...
...
24
c o m p e t e n t to fill s u c h
...
...
24
if m a t t e r s a r e to p r o g r e s s
as th ey
A g g r a v a t io n of F r a c tu r e d P a te lla
...
...
24
th o u san d s
w ill
e x a c tin g
in stru cto rs
but
o c u la r d e m o n co m m en tary
m ay
T h re e -m a n or T h re e -b lan k et D rill
of
th e
to a s m a ll e x t e n t in fir s t a id ;
be
as
a sk e d , are
re q u ire m e n ts, a n d , b id
fa ir to , s o m e
becom e
necessary.
F I R S T
14 T h e
h o ld in g
proof of
th e
p e rfec tio n by
poor
of
a
a b ility
m ay
;
teach
is
u n fo rtu n a te ly
o th ers, an d
h a lf its v a lu e
of
su b je c t
la n g u a g e
in c le a r a n d
no
te ch n ica l
if it is h a m p e r e d
m atter.
b u t in stru c to rs sh o u ld
to s p e a k th e ir o w n h a v e to s a y
to
lo se
d e liv e ry
not needed
ce rtifica te
O ra to rs
are
at le a st b e a b le
a n d to s a y w h a t th e y
co n n ected
form .
The Future of the St. John Ambulance Brigade. B
y
N.
CO RBET
F L E T C H E R , M .A ., S u rgeo n -in -C h ief.
M .B .,
M .R .C .S .,
R e c e n t l y s o m e o n e ra ise d a q u estio n a s to the fu tu re of the B r i g a d e a n d a s k e d w h a t in m y o p i n i o n w i l l b e i t s l i k e l y position a t th e te r m in a tio n of th e p resen t h ostilities. W h i l s t it is d i f f i c u l t t o f o r e c a s t t h e e x a c t l i n e o f d e v e l o p m en t, so m e g u id a n c e m a y b e o b tain ed b y lo o k in g b a c k w a r d s to th e W a r of 1 9 1 4 - 1 8 a n d b y c o n s id e r in g h o w fa r th e e x p e r i e n c e of t h a t t im e w ill a p p ly to th e fu tu re . D u r i n g th e la s t W a r m a n y n e w D iv is io n s c a m e into b e in g , a n d the estab lished D iv isio n s received m a n y n e w m em bers. T h e r e w a s a n a t u r a l d e s i r e t o h e l p in t h e w a r effort a n d r e c r u it s w e r e e n c o u r a g e d to t a k e u p w o r k fo r th is purpose. T h i s w a s a c o m m e n d a b le idea. A s, h o w e v e r, the m e n a n d w o m e n h ad jo in ed fo r w a r service, th e y w e r e p e r h a p s j u s t i f i e d in t h i n k i n g t h a t w i t h t h e e n d o f t h e W a r t h e i r w o r k also ended. C o n s e q u e n tly th ere w a s a c on sid erab le f a l l i n g o f f i n t h e n u m b e r o f D i v i s i o n s a n d in t h e m e m b e r s h i p of th e D iv isio n s w h ic h rem ain ed . I n d e e d , it w a s n o t u n t i l 192 2 th a t th e B r i g a d e R o ll w a s stabilised. T h i s s ta te of a f f a i r s is n o t d e s i r a b l e ; a n d it m u s t b e t h e a i m o f e a c h o n e o f u s to m a in t a in o u r s t r e n g t h , no less t h a n o u r efficien cy, a t th e en d of th is w a r . A t th e o u t b r e a k of th e p resen t h o stilities th e C h ie f C o m m issio n e r w is e ly d ec id ed th at th e p ersonn el of th e B r ig a d e s h o u ld offer th e ir serv ices, a s in d iv id u a ls , to th e lo ca l a u t h o r i ties w h o h a d b een g iv e n th e re sp o n s ib ility of o r g a n i s i n g the c a s u a l t y s e r v i c e in C i v i l D e f e n c e . T o m a n y th is se em ed a w a y of lo s in g o u r id e n tity a s a n o rg a n is a tio n ; a n d to so m e e x te n t th is w a s tru e, t h o u g h , a s th e o n u s w a s on th e local a u th o r itie s to fo r m the n e w units, th e step co u ld not be avo id ed. O u r p r o b le m , h o w e v e r , is to c o n s id e r w h a t c a n b e d o n e t o r e g a i n , w h e n f i g h t i n g e n d s t h e s t a n d i n g w h i c h w e h a d in 1 9 3 9 , a n d t h e n t o t r y t o e s t i m a t e t h e d e v e l o p m e n t ’s w h i c h m a y t a k e p lace. F ir s t a n d f o r e m o s t I w o u ld u r g e th e n e c e s s it y for m a i n tain in g h ap p y and p r o s p e r o u s D i v i s i o n s , in w h i c h t h e D iv isio n a l S u r g e o n s p la y a m ost im p o rta n t part. A good S u r g e o n w ill c o n tr ib u te m u c h t o w a r d s th e m a in t e n a n c e of a g o o d D iv is io n b y s t i m u l a t i n g th e in te re s t of m e m b e r s a n d so h e lp in g to a ttr a c t re cru its ; a n d w it h o u t a g o o d S u r g e o n no D iv is io n c a n r e a lly flourish. T h e m a jo r it y of S u r g e o n s a r e e a g e r to h e lp a n d to g i v e o f t h e i r s p e c i a l k n o w l e d g e ; b u t a t t i m e s t h e y fin d t h a t t h e y g e t little a s s is t a n c e fr o m th e L a y O ffic e r s of th e ir D iv is io n . I n s h o r t , in t o o m a n y i n s t a n c e s t h e S u r g e o n s a r e t r e a t e d a s m e r e fig u r e -h e a d s , a r e g iv e n no real in s ig h t into D iv is io n a l a ctivitie s, a n d a r e left to t h in k o u t th eir o w n m e th o d s for t r a i n i n g t h e m e m b e r s a n d t o d i s c o v e r w h a t is h a p p e n i n g in th eir u n its. I t m u s t b e r e m e m b e r e d th a t th e S u r g e o n , w h o is the t e c h n ic a l h e a d , d o e s n o t k n o w th e w o r k o f th e B r i g a d e to th e s a m e e x t e n t a s d o e s t h e S u p e r i n t e n d e n t w h o is t h e e x e c u t i v e
R I D h e a d of th e D iv isio n ; a n d th a t a D iv isio n w ill o n ly be h app y a n d pro sp ero u s w h e n th ese tw o O fficers w o r k han d -in -han d. A c a s e c a n be cited of a g e n e r a l p r a c titio n e r w h o a t th e outset of h is c a re e r w a s a s k e d to a ssist a D iv isio n . H e w a s told t h a t h e w a s f a r too b u s y a m a n to a t t e n d w e e k l y l i k e the o t h e r m e m b e r s a n d t h a t if h e c o u l d a t t e n d o n c e e a c h m o n t h h e w o u ld a fford h elp w h ic h w o u ld be g r a t e fu lly a ccep ted . T h e o u tc o m e of th is w a s th at the e n th u s ia s m of th is S u r g e o n w a s e x c ite d ; th a t for m a n y y e a r s th e S u p e r in te n d e n t a n d he u s e d t o v i e w i t h e a c h o t h e r f o r t o p p l a c e in t h e a n n u a l r e c o r d of a tt e n d a n c e s a t D iv is io n a l p r a c tic e s ; a n d t h a t th is unit b eca m e h ap p y and prosperous. M y se co n d a n d e q u a lly im p o r ta n t p oin t is th a t a ll m e m b e r s m u s t g i v e o f t h e i r b e s t in w h a t s o e v e r a m b u l a n c e d u t i e s th ey a re e n g a g e d w ith in a n d w ith o u t th eir D iv ision s. By so d o i n g th e y w ill c r e a t e a n a tm o s p h e r e fa v o u r a b le to the B r i g a d e w h i c h m a y b e s u b m e r g e d f o r a t i m e in t h e C i v i l D e f e n c e O r g a n i s a t i o n e v e n if a t t h e o u t b r e a k o f w a r in 1 9 3 9 m a n y of its u n its fo r m e d th e n u c le u s o f t h is S e r v ic e . N ever th eless, th e k n o w le d g e th at th ey a re B r ig a d e m em b e rs and a r e g i v i n g re a l h elp w ill a l w a y s be r e c o g n ise d . T h e r e h a v e c o m e t o m y n o t i c e i n s t a n c e s in w h i c h t h o s e in c h a r g e of lo c a l C i v il D e f e n c e u n its h a v e e x p r e s s e d th eir sa tisfa ctio n w ith certain in d ivid u als an d h a v e been g ra te fu l t o t h e B r i g a d e f o r t h e w o r k d o n e in m a k i n g t h e m s o e f f i c i e n t . A g a in , the o fficer-in -ch arge of a certa in B lo o d D o n o r O r g a n isa tio n told m e th a t w h e n s o m e of o u r A m b u l a n c e S iste rs a tte n d e d fo r d u ty , s h e h a d n o c a u s e to w o r r y b e c a u s e th o se m e m b e r s k n e w th eir w o r k ; a n d s h e a ls o w a s g r a t e f u l to the B r i g a d e . A g a i n in t h e v o l u n t a r y a s s i s t a n c e g i v e n t o h o s p i t a l s B r ig a d e p ersonn el freq u e n tly sta n d ou t as in d ivid u als w h o a r e h i g h l y efficien t a n d d e m o n s t r a t e th e r e s u lt s o f g o o d t r a i n i n g in t h e B r i g a d e b e f o r e t h e y t o o k u p h o s p i t a l d u t i e s . T h e effect of th e g o o d im p r e s s io n s t h u s m a d e w ill be t h a t in t h e f u t u r e a s in t h e p a s t t h e r e w i l l a l w a y s r e m a i n a h i g h r e g a r d fo r th e B r i g a d e a n d its p e rs o n n e l w h e n th e need f o r t h e i r h e l p in C i v i l D e f e n c e h a s p a s s e d . M o r e o v e r , the m e m b e r s t h e m se lv e s w ill c e a s e th eir w a r a c tiv itie s w ith the k n o w l e d g e t h a t it w a s t h e B r i g a d e w h i c h e n a b l e d t h e m to r e n d e r e ffic ien t s e r v ic e a n d t h e y w ill re ta i n a n a ffe c tio n for th e o rg a n is a tio n w h ic h w ill g o a lo n g w a y t o w a r d s c a u s in g t h e m to r e m a i n m e m b e r s o f th e B r i g a d e . W h i l s t it i s u s e f u l a t p r e s e n t t o e n r o l m e m b e r s w h o a r e k e e n t o h e l p in t h e w a r e f f o r t , it is u n d e s i r a b l e t o s e e k s u c h in d iv id u a ls b e c a u se w e k n o w th a t m a n y w ill d ese rt w h e n the w a r is en d ed . B u ild in g u p th e m e m b e rsh ip of o u r D iv isio n s s h o u ld b e d o n e w it h a n e y e to th e fu tu r e a n d its n e ed s. F u r t h e r , it is e s s e n t i a l t o t a k e s t e p s t o k e e p in t o u c h w i t h t h o s e o f o u r p r e s e n t m e m b e r s w h o a r e s e r v i n g in H . M . F o r c e s o r for o th er re a so n s a re te m p o ra r ily a w a y fro m h o m e . If t h e s e feel t h a t t h e y a r e f o r g o t t e n n o w a n d t h a t b e i n g o u t of s i g h t is b e i n g o u t o f m i n d , t h e y w i l l c o n s i d e r t h a t t h e y a r e n o t r e a l l y w a n t e d , a n d t h e y w i l l n o t r e t u r n t o t h e B r i g a d e fo r th e p e a ce-tim e w o r k w h ic h w ill s u re ly com e. N e w l y e n ro lle d m e m b e r s s h o u ld b e m a d e to r e a lis e th a t t h e B r i g a d e is p r i m a r i l y a c i v i l i a n o r g a n i s a t i o n f o r d e a l i n g w i t h c i v i l i a n e m e r g e n c i e s ; t h a t it s e r v e s i t s m o s t u s e f u l p u r p o s e in d a y s o f p e a c e ; a n d t h a t it w i l l h a v e n e e d f o r t h e i r s e r v i c e s w h e n t h e w a r is o v e r . F u r t h e r , t h e y s h o u ld b e told s o m e t h i n g a b o u t t h e w o n d e r f u l h i s t o r y o f t h e O r d e r w h i c h is t h e g o v e r n i n g b o d y a n d e s p e c i a l l y t h e w a y s in w h i c h f o r m a n y c e n t u r ie s its m e m b e r s h a v e e v e r s o u g h t to g i v e h e lp to th e s ic k a n d injured. M y t h i r d a n d f in a l p o i n t i s t h a t e v e r y t h i n g p o s s i b l e s h o u l d b e d o n e t o e n c o u r a g e o u r A m b u l a n c e a n d N u r s i n g C a d e t s on w h o m the fu tu re of the B r ig a d e d ep end s. A l t h o u g h it i s 20 y e a r s s i n c e t h e C a d e t s w e r e f i r s t a d m i t t e d t o t h e B r i g a d e , it i s o n l y in t h e l a s t t w o y e a r s t h a t a n o t e w o r t h y i n c r e a s e in th eir n u m b e rs h a s b een ob tain ed . T o -d a y , a s part of the Y o u t h M o v e m e n t , b o y s a n d g ir ls a r e b e i n g u r g e d to u n d e r t a k e so m e form of pre-service t r a i n i n g ; an d m a n y h a v e jo in ed o u r r a n k s , t h e r e b y o b t a i n i n g i n s t r u c t i o n in m a t t e r s w h i c h w i l l b e o f g r e a t a s s i s t a n c e t o t h e m t h r o u g h o u t t h e i r l iv e s ,
F u r t h e r , t h e k e e n n e s s o f o u r C a d e t s is p r o v e r b i a l ; a n d e r e th is s o m e h a v e d o n e o u t s t a n d in g w o r k . A s to th e fu t u r e I se e n o g r o u n d s fo r t h i n k i n g t h a t th e m ain s tru ctu re of the B r ig a d e w ill be a ltere d , e sp e c ia lly the p r o u d f a c t t h a t i t is a v o l u n t a r y o r g a n i s a t i o n o f w h i c h a l l it s m e m b e r s , fr o m th e C h ie f C o m m i s s i o n e r d o w n to its m o s t ju n io r C a d et, g iv e th eir services w ith o u t a n y p a y m e n t or other financial r e w a r d . T h e r e m a y b e a t e n d e n c y for th e v o lu n t a r y o r g a n i s a t i o n s i n t e r e s t e d in f i r s t a i d t o w o r k in c l o s e r c o n t a c t and e ven to m e r g e . N e v e r t h e l e s s , in p r o p o r t i o n a s o u r m e m b ers w o r k e ffic ien tly n o w a n d d o th e ir u t m o s t to u p h o ld the g o o d n a m e an d tradition s of th e B rig a d e , even so w ill the s t a n d i n g o f t h e B r i g a d e b e r a i s e d a n d i t s p o w e r in a n y s u c h m e r g in g b e increased. It h a s b e e n s a id t h a t C i v il D e f e n c e h a s c o m e to s ta y . T h i s m e a n s t h a t a ft e r t h e w a r t h e r e w ill still r e m a in s o m e k in d of o r g a n is a t io n , p o s s ib ly u n d e r th e lo c a l a u t h o r it ie s , to k e e p t h e s y s t e m in f o r c e a n d r e a d y f o r a n y n e w e m e r g e n c y . P e r s o n a l l y I d o u b t v e r y m u c h if t h i s w i l l b e o n a p a i d b a s i s ( e x c e p t p e r h a p s w i t h a f e w i n d i v i d u a l s ) ; a n d I f a n c y t h a t it w ill be e s ta b lis h e d on th e v o lu n t a r y s y s te m . In su ch post w a r o r g a n i s a t i o n t h e B r i g a d e w i l l t a k e i t s f u l l s h a r e , if o n l y w e m a i n t a i n o u r e f f i c i e n c y t o t h e fu ll a n d if w e — e a c h a n d a l l — re m ain tru e to th e g lo r io u s tra d itio n s of T h e O r d e r a n d the B rig a d e .
St. John Ambulance Association. B a l h a m . — T h e A u t u m n p r o g r a m m e o f t h i s B r a n c h is a n a tt r a c t iv e o n e a n d h a s b e en a r r a n g e d to m e e t r e q u e s ts from a ll q u a r t e r s . T h e u se of R a v e n s to n e S tre e t S ch o o l w as o b tain ed d u r in g the s u m m e r , a s a n e w m e e t in g p lace, a n d it s f a c i l i t i e s h a v e b e e n v e r y m u c h a p p r e c i a t e d . T h e r e s u l t s o f t h e f i r s t e x a m i n a t i o n s h e l d in t h e S c h o o l in J u l y , s h o w e d t h a t a l l t h e e n t r a n t s o b t a i n e d c e r t i f i c a t e s , a n d it is h o p e d t h a t t h i s i s a g o o d o m e n f o r t h e f u t u r e . T h e n e w sessio n c o m m e n c e s w ith tw o e n r o lm e n t m e e t i n g s , f r o m 7 . 3 0 p . m . t o 9 . 3 0 p . m . , o n M o n d a y , A u g u s t 3 0 th , f o r t h o s e i n t e r e s t e d in F i r s t A i d , a n d o n T h u r s d a y , S e p t e m b er 2nd, for H o m e N u r s i n g . T h e C l a s s S e c r e t a r y w i l l b e in a tt e n d a n c e on b o th e v e n i n g s to g i v e a n y in f o r m a tio n . Any l a d y o r g e n t l e m a n i n t e r e s t e d in t h e f i r s t a i d m o v e m e n t w i l l be w elcom ed .
British Red Cross Society. B r is t o l .— T h e B ristol B ra n c h of th e B ritish R e d C ro ss S o c i e t y h e ld t h e ir a n n u a l first a id c o m p e t i t i o n a t C o t h a m S e c o n d a ry S ch o o l on S a tu rd a y , J u ly 31st. O w i n g to S e r v ic e d e m a n d s th e w o m e n ’s d e t a c h m e n t s d id n o t c o m p e t e fo r the “ L a d y W i l l s ’ ” C u p , b u t s i x t e a m s w e r e e n t e r e d b y th e m e n ’s d e ta ch m e n ts to c o m p e te for th e “ S ir P e te r W i l l s ’ ” C u p . D r. L . E . C la re m o n t, A ss ista n t C o u n ty D ire c to r, w a s re sp o n s ib le for th e e fficien t o r g a n is a t io n of th e c o m p e titio n , an d D r. C. C. L a v in g to n , V ic e -P re s id e n t of th e B ristol S .J .A .A ., w a s the ju dg e. T h e w i n n i n g t e a m r e p r e s e n t i n g D e t a c h m e n t 1 1 w a s :— L e a d e r , W . G . N . W i lli a m s , C o m m a n d a n t ; N o . 1, W . E . G . P r i t c h a r d , S e c t i o n L e a d e r ; N o . 2, A . H . P r e s s , N o . 3, R . P . D y e r , N o . 4, S . G . Y o r k e , M e m b e r s .
L a d y W ills, w h ose presen ce w a s m u ch ap p recia ted by th e a s s e m b ly , m a d e o n e of h e r first p u b lic a p p e a r a n c e s a ft e r a se v er e illn ess, to p r es en t th e C u p . D r . L a v in g to n then add ressed th e co m p e tito rs a n d m a d e v a rio u s h elp fu l s u g g e s tion s for th eir fu tu r e g u id a n c e . V o t e s o f t h a n k s to L a d y W i ll s a n d D r . L a v i n g t o n received g e n e r a l a c c la m a t io n a n d c o n c lu d e d a p le a s a n t a n d in stru ctive e ve n in g .
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N o . U S ( E d g w a r e a n d M ill H il l ) D ivisio n .— M e m b ers of th is D iv is io n s e r v i n g w ith H . M . F o r c e s w ill le a rn w ith r e g r e t of th e p a s s in g su d d e n ly, on J u ly 22nd, a t R e d h ill C o u n t y H o s p i ta l, of C o rp l. E . C h i d w i c k . Co rp l. C h i d w i c k w a s a l w a y s a n u n ti r in g a n d z e a lo u s w o r k e r in h i s D i v i s i o n a n d in C i v i l D e f e n c e i n t h e c a u s e o f first a id . H i s d e a t h is a g r e a t l o s s t o t h e D i v i s i o n . T h e B r ig a d e a r r a n g e m e n ts for th e in te rm e n t w e r e a d m i r a b l y c a r r i e d o u t b y S e r g t . J. A . W e b b , t h e r e p r e s e n t a t i v e s n u m b e r in g 16, in c lu d in g L a d y D iv . S u p t. M rs. E . M c C a b e of the 101 ( E d g w a r e a n d M ill H ill) N u r s in g D iv is io n a n d P t e . H . S a r g e a n t ( b r o t h e r - i n - l a w ) of t h e 28 ( H a r r o w a n d W e a ld s to n e ) D ivisio n . F lo ra l trib u tes w e re se n t on b e h a lf of the tw o E d g w a r e D iv is io n s . T h e c a s k e t w a s b o rn e a n d g u a r d e d b y S e r g t. S. N e w , C o r p l. A l d r i d g e a n d P te . B u t l e r (of th e 1 1 Sth), w i t h P te. H S a r g e a n t ( o f t h e 2 8 t h ) , w h i l s t in t h e f i n a l s t a g e D i v . S u p t . W . H . L a n e , w h o h a d c o m m a n d e d th e p a rty, rep la ced Pte. B u tle r— a g e s tu r e m u c h a p p re c ia ted by th e relatives. T h e in term en t to o k p la ce at H e n d o n P a r k C e m e te r y on W e d n e s d a y , J u l y 28th.
N o . 150 ( B o r o u g h o f R o m f o r d ) D ivisio n . — I n ce le b r a ti o n of t h e first a n n i v e r s a r y o f t h e f o r m a t i o n of th e R o m ford C a d e t D iv is io n s , the C a d e ts a n d th e ir p a re n ts m et at D iv isio n a l H e a d q u a r t e r s on S a t u r d a y , J u ly 24th, for a B irth d ay Party. T h e re w e re present M iss P a rro tt ( L a d y D is tric t O fficer G irl C a d ets), C o u n c illo r M rs. W h ite , D iv. S u p t. D . B. H o w a r d a n d L a d y A m b . O ffic e r G . B ritto n (of the 10 8N D iv isio n ). A n a p o l o g y fo r in a b ility to a tte n d w a s r e c e iv e d fr o m D iv . S u p t . E . H o w a r d (ISO A m b u l a n c e D i v i sion ) w it h b est w is h e s for th e s u c c e s s o f th e p a rty . T h e p r o g r a m m e w a s a v e r y full one, i n c lu d in g d e m o n sta tio n s b y the C a d ets, s o n g s b y th e C a d e t C h o ir, a n d in d i v id u a l ite m s. T h e b o y s g a v e d e m o n s t r a t i o n s of first a id a n d ph y sica l tr a in in g ; th e g ir ls of b e d - m a k in g a n d ph ysica l t r a i n i n g ; a n d b o y s a n d g i r l s c o m b i n e d in t h e p r e s e n t a t i o n o f c o u n try d a n c e s — a n in te g ra l part of th eir p h y sic a l t ra in in g . T h e r e w a s a selection of H a n d w o r k by th e C a d e t s on v ie w , i n c lu d i n g a r tic le s m a d e in w o o d a n d m e ta l, w e a v i n g a n d strin g w o rk , b o o k crafts and toy m a k in g , e m b ro id e ry and a r t ; in a d d i t i o n a s m a l l c o n t r i b u t i o n f r o m t h e C a d e t A l l o t m en t. A s m a ll tab le, th e w o r k of o n e of th e b o y s, w a s g iv e n to th e S e n io r N u r s i n g D iv isio n . D u r i n g th e a ft e r n o o n a c u p — to b e k n o w n a s th e “ S y d n e y U p to n ” C u p — w a s p resen te d to e a c h of th e C a d e t D i v i s i o n s b y L . D / O M i s s P a r r o t t f o r c o m p e t i t i o n in I n d i v id u a l F ir s t A id . T h e d on or w a s L .A / O Jo yce U p to n , a fo rm er G ra n d P rio r C adet. A book, g iv e n by C o u n cillo r M rs. W h ite , w a s a lso p resen te d to the C a d e t N u r s in g D iv i s i o n in a p p r e c i a t i o n o f t h e w o r k d o n e b y t h e g i r l s in t h e lo ca l h o sp ita l. Im m e d ia te ly before th e tea in te rva l, s ix g ir ls w e re e n rolled b y L . D / O M iss P a r r o tt. T h e s e th en to o k th eir a l l o t t e d p l a c e s in t h e f o r m a t i o n o f t h e S t . J o h n C r o s s . A t th e en d of th e e v e n in g prize s w e re p res en te d to th e w in n e r s of th e c o m p e titio n s, a n d C a d e t F r a n k S m ith p re sen ted M iss P a rro tt w ith a b o u q u e t of roses on b e h a lf of the Cadets.
N o . 69 ( B o r o u g h o f L e w i s h a m ) N u r s i n g D i v is io n .— O n S a t u r d a y , J u ly 10th, a la r g e g a t h e r i n g of p eople e n jo y e d a D is p la y , D a n c e and S o cia l a t St. M a r k s C h u r c h H a ll,
F I R S T P e c k h a m , w h e r e th e n e w P e c k h a m S e c t io n h old th e ir c la s s e s e v e ry T h u r s d a y even in g. T h e officers a n d m e m b e r s of th e L e w i s h a m N u r s in g D iv is io n a n d H it h e r G r e e n S e c tio n m e m b e rs assisted th e n e w P e c k h a m S e c t i o n in p r o d u c i n g a d i s p l a y o f g e n e r a l s m a r t n e s s a n d e ffic ie n c y in first a id , e tc ., a n d to a d v e r t is e t h e S e c t i o n o f N u r s e s n o w in P e c k h a m . T h e D is p la y o p e n e d w ith a n In s p e c tio n of O fficers, m e m b e r s a n d C a d e t s ( n u m b e r i n g o v e r SO) b y t h e M a y o r a n d M a y o re ss of C a m b e r w e ll (M r. a n d M rs. E v a n -C o o k ). M i s s P e a r c e e x p l a i n e d t h a t a s t h e r e w a s n o t a D i v i s i o n in t h e B o r o u g h of C a m b e r w e ll on b e in g a s k e d to sta rt one, sh e c o m m e n c e d b y h a v i n g it a s a S e c t i o n o f L e w i s h a m , a n d f o r th e p u rp o se of h e r id e a sh e h a d g a in e d the su ppo rt of h er t w o s e n io r officers, M is s R e a d a n d M is s G u e s t . T h e tw o officers w e r e th en in tro d u c e d to th e M a y o r a n d M a y o re s s , w h o w e l c o m e d th e m to th e B o r o u g h , a n d th e M a y o r s a id h e w o u l d b e v e r y p l e a s e d t o h a v e t h e m if a D i v i s i o n w a s f o r m e d a s t h e y w o u l d b e in c h a r g e . A f t e r t h e i n s p e c t i o n , t h e d i s p l a y f o l l o w e d , a n d a v e r y fin e s h o w of effic ien c y a n d g e n e r a l s m a r t n e s s w a s d is p la y e d , all officers a n d m e m b e r s t a k i n g part. T h e M a y o r , in h is s p e e c h , s ta te d h o w th rille d h e h a d b e en a t a ll h e h a d see n , a n d th at h e w e lc o m e d th e In v a d e r s fr o m L e w i s h a m in to P e c k h a m , s in c e t h e y w e r e in v a d e r s of “ real w o r k e r s .” H e h op ed th at a D iv ision w o u ld soon be in t h e B o r o u g h if t h i s w a s a n e x a m p l e o f t h e i r “ g o o d w o r k , ” w h ic h w a s not o n ly for w a r tim e b u t for peacetim e.
N o.
EL D i s t r i c t
S ou th B u c k s .— O n S a tu r d a y , J u ly 17th , C a d e ts of the S o u th e rn a re a , B u c k s , a n d from M a r lo w , W o o b u r n G ree n a n d d istrict, w e r e in sp ected b y L a d y D u n b a r N a s m ith , D e p u t y L a d y S u p t.-in -C h ief, a cco m p a n ied by the C o u n ty C o m m is sio n er, M a jo r F . G . D a r v il- S m it h , C . B . E . T h e in sp ection w a s a r r a n g e d b y th e A sst. C o m issio n e r, M r. F . H . S c h o o lin g , a n d the p a ra d e w a s co m m a n d e d by C orps Supt. D ruce. T h e in sp ectio n to o k p la ce at th e B o y s ’ G r a m m a r Sch o o l, S lo u g h , a n d a b an d w a s p rovid ed b y th e B o y s ’ B rig a d e , S lo u g h area. E v e r y d ivision w a s represen ted a n d n early 400 C a d e t s w e r e on p a r a d e . A fte r th e in s p e c tio n th e r e w a s a d is p la y of drill, p r a c t i c a l first a id , e t c ., u n d e r t h e d ir e c t io n of C o u n t y S u r g e o n W e a v e r A d a m s , M . B . , w h o en tertain e d th e sp e cta to rs w ith a ru n n in g com m entary. T e a w a s a ft e r w a r d s p ro vid ed fo r all C a d ets .
A I D th is g o o d e x a m p l e w ill be f o llo w e d b y o th e r D iv is io n s in th e R i d i n g , ” a n d c o n g r a t u la t e d t h e H u m b e r s id e C o rp s on the p r o g r e s s m a d e , re fe rr in g fe licito u sly to the e n th u sia stic w o r k done by C o rp s S u r g e o n T h o m p s o n and C o rp s Supt. R a n k in e . T h e C o r p s , of w h i c h t h e first A m b u l a n c e D i v i s i o n w a s r e g i s tered in 1 9 4 1 , n o w c o n ta in s 3 A m b u l a n c e a n d 3 N u r s i n g D iv i s io n s , m a i n l y t h r o u g h t h e e ffo rts of t h e s e t w o officers.
N o.
V I
D istrict
H u m b e r sid e . — In con n ection w ith the a m b u la n c e a p p eal l a u n c h e d in t h i s a r e a , a G a r d e n F e t e w a s h e l d o n J u l y 1 0 t h in t h e g r o u n d s of M r . A r n o l d R e c k i t t ’s h o u s e a t B r a n t i n g h a m t h o r p e , k i n d ly offered b y h im fo r th is o c c a sisn . A large n u m b e r of peop le a tten d ed , in c lu d in g th e C o u n ty C o m m is sio n e r a n d all th e C o u n t y O fficers. C o l. W . H . C a r v e r , M .P ., a c te d a s c h a ir m a n for the fo r m a l p r o c e d u re a n d in tro d u ced L a d y W ilb e r fo r c e B ell, w h o o p en ed the F ete. In p res en tin g th e n e w b la ck and w h ite a m b u la n c e to th e H u m b e r s id e C o r p s on b e h a lf of all the s u b s c r i b e r s , - M rs . A r n o l d R e c k i t t p a i d h i g h t r i b u t e t o a l l w h o h a d w o r k e d so h a rd a n d co n trib u te d so n o b ly to m a k e the A m b u l a n c e S e r v ic e s u c h a n e s ta b lis h e d fact. D r. G eoffrey T h o m p s o n , C o rp s S u rg e o n , w h o, w ith M rs. T h o m p so n , had s a c r ific e d m u c h t im e a n d effort to th e s u c c e s s of th e a p p e a l, receiv ed th e A m b u la n c e on b e h a lf of th e C o rp s. The am bu l a n c e w a s d e d i c a t e d f o r s e r v i c e b y t h e R e v . I. W . T w e l v e trees. In p r o p o s in g a vote of t h a n k s to a ll w h o h ad a c c o m p lished so m u ch , D r. N o rm a n J e n n in g s, C o u n ty C o m m is s i o n e r , s a i d : “ Y o u a r e t h e f i r s t D i v i s i o n in t h e E a s t R i d i n g to s ta r t a n A m b u l a n c e S e r v ic e o u ts id e H u ll, a n d I h o p e th a t
(D uke
o f C o n n a u g h t ’s)
D istrict
K in g s t o n B uci C o r p s . — T h e first A n n u a l D i s p l a y b y th e S o u t h w ic k A m b u la n c e a n d N u r s in g C a d e ts D iv isio n s, K i n g s t o n B u c i C o r p s , w a s h e l d o n F r i d a y , J u l y 3 0 th , a t t h e S e n io r G irls S ch o o l. C o u n ty C a d e t O fficer P ile a n d C o u n ty C a d e t O ffice r M rs. B ro d ie c a rrie d o u t the in sp ectio n . They th e n p r e s e n te d to M r. H . E . B a r b e r a n d M rs. E S m i th e r s , t h e ir V i c e - P r e s i d e n t s w a r r a n t s to th e C a d e t s D iv is io n . C a d e t S u p t. H . G o o rd an d C a d e t O fficer H . N e w m a n w e re h an d ed th eir w a r r a n t s as O fficers of th e A m b u la n c e C a d ets . G. P a y n e w a s g iv e n his C a d e t S e r g e a n t c h e v r o n s a n d H . S tilw ell h is C a d e t C o rp o ra l ch e vro n s. N u r s in g C a d e ts w e r e th en en rolled . T h e n fo llow ed se v era l in te re stin g d isp la y s b y both g ir ls a n d boys, after w h ic h F irst A id , C h ild W e lf a r e a n d R e - e x a m in a tio n C ertifi ca te s w e re presented. C o u n t y C a d e t O fficer P ile said th at h e w o u ld lik e to see the b oys en ter for the C h ild W e lfa re , a n d stated th a t h e had v i s i t e d s e v e r a l D i v i s i o n s in S u s s e x a n d t h e w o r k h e h a d s e e n th a t n ig h t w a s s o m e of th e best. T h e even in g w as ended by a ca m p fire s in g s o n g . A lso present w e re C o rp s Su pt. W . G . Sh elton, C orps O f f i c e r J. W . G . B r o w n , D i v . S u p t . E . - W . S m i t h e r s , L a d y A m b u la n c e O fficer M iss P h illip s a n d the C o rp s C h a p la in , R ev. T arran t.
N o. N o.
V III
F o l k e s t o n e .— A n e x a m i n a t io n for L a y I n s t r u c to r s h a s b een re c e n tly held at th e R o y a l V ic t o r ia H o s p ita l, D o v e r , co n d u c te d b y D r . H in ch liff. T h e fo llo w in g m e m b e rs of the F o lk e s to n e D iv isio n w e r e s u c c e s s f u l in p a s s i n g f o r t h e L a y I n s t r u c t o r ’ s c e r t i f i ca te , a n d a r e th er efo re q u alified to g i v e le c tu re s fo r the s h o r t F ir s t A id C o u r s e in s tr u c tio n to C iv il D e f e n c e w o r k e r s , a ls o to th e g e n e r a l p u b lic , D iv is io n a l S u p t. J. H u n tle y , A m b u la n c e O fficer G . H u n tle y a n d P r iv a te R . L e p p a rd . L a d y D i v i s i o n a l S u p t . M i s s M . D a v i s is a l s o a u t h o r i s e d to g i v e s im ila r le c tu re s u n d e r th e a b o v e a r r a n g e m e n t .
IX
D istrict
P lym outh (M illb a y G . W . R . ) . — O n W ed n esd ay, Ju ly 2 1 s t , in t h e A m b u l a n c e C a d e t H e a d q u a r s e r s , N o r t h - r o a d , P lym o u th , C o u n ty C o m m issio n e r L t.-C o l. T . P. S . W a r d , C o rp s O fficers, D iv . S u p ts ., D iv . m e m b e r s a n d frien d s m et to d o h o n o u r to M r. W illia m J o h n R ic h , A m b u l a n c e O fficer, w h o w a s p la c e d on B r i g a d e R e s e r v e a t his o w n r e q u e s t a fte r 45 y e a r s of a c tiv e service. M r . R i c h e n r o l l e d in t h e B r i g a d e in F e b r u a r y , 1 8 9 8 . D u r i n g his s e r v ic e h e o b ta in e d th e S e r v ic e M e d a l a n d 5 S e r v i c e B a r s ; h e w a s a l s o a p p o i n t e d H o n o r a r y B r o t h e r in 1932. O f the G rea t W e s te rn R a ilw a y A m b u la n c e a w a rd s, M r . R i c h o b t a i n e d t h e 1 5 y r . G o l d M e d a l , 20 y r . G o l d B a r , 2 5 y r . G o l d M e d a l , 30 y r . a n d 3 5 y r . G o l d B a r s . I n t h e y e a r 1900 M r . R i c h w e n t to th e S o u t h A f r i c a n W a r a s a m e m b e r of th e P ly m o u th St. Joh n A m b u la n c e B r ig a d e U n it. T h is w a s r e c o r d e d o n a B r o n z e T a b l e t in t h e P l y m o u t h G u i l d h a l l b y th e C i v ic A u th o r itie s a t th a t tim e. C o u n ty C o m m issio n er L t.-C o l. W ard presented an E le ctric T a b le L a m p a nd a b o o k of N atio n a l S a v in g S ta m p s to M r. R ic h a n d a p u rse to M rs. R ic h . T h e C o m m issio n er p aid g r e a t trib u te to M r . R i c h ’s a c ti v it ie s a s a m e m ber, w h ic h w a s fo llo w e d b y v a r io u s s p e a k e r s . M r. R ic h su ita b ly responded.
F I R S T
N o.
X D istrict W a r e . — C o u n ty C o m m issio n e r H . L a n g l e y Jo n es in spected m e m b e rs of A m b u la n c e a n d C a d e t D iv is io n s from W a r e , H e r t f o r d , H o d d e s d o n a n d S t a n d o n a t a p a r a d e in t h e g r o u n d s of th e P rio ry , W a r e , on S a t u r d a y , J u ly 10th. T h e C o m m issio n er w a s acco m p an ied by C o u n ty S u rg e o n W . N o rm a n B o o th , C o u n ty O fficer E . K e ig h t le y a n d C o u n ty C a d e t S e c re ta r y M iss D . S p a rk e s . C o r p s O fficer T . C. F o r b e s w a s in c h a r g e o f t h e p a r a d e . A fter the in sp ection M r. L a n g le y J o n es in spected tr a n s port u n its, w h ile D r . N o r m a n B o o th , a ssiste d b y D r . G . W . S t e w a r t a n d D r . C . S t . A . V i v i a n , w a t c h e d f ir s t a i d d e m o n stration s of b a n d a g i n g a n d stre tch e r b e a rin g by th e C a d ets. M r. L a n g l e y J o n e s t h a n k e d th e officers fo r a r r a n g i n g th e p a r a d e , th e m e n fo r p a r a d i n g , a n d t h e s p e c t a t o r s for th eir su ppo rt. H e co n g ra tu late d the A m b u la n c e a n d C a d et D iv is io n s o n th e ir e n t h u s ia s m a n d efficien cy. A F e te a n d D o g S h o w w a s held on J u ly 17 th , o r g a n is e d by m em b e rs of W a r e D iv isio n and th e B ritish R e d C ro ss S o ciety, w ith a few h elp ers fr o m o th e r C iv il D e fe n c e services. T h e o p en in g ce rem o n y w a s perform ed by A n n e L a d y B ro c k e t (C o u n ty P resid en t of th e B . R . C . S . ) . S h e s p o k e o f the v aried h elp w h ic h the tw o o r g a n is a tio n s w e r e g i v i n g to th e P r is o n e r s of W a r a n d s t r e s s e d th e h e a v y a n d c o n t in u a l d r a in w h i c h is i m p o s e d u p o n t h e o r g a n i s a t i o n s ’ f i n a n c i a l r e s o u r c e s . A G u a rd of H o n o u r w a s fo rm e d b y m e m b e rs of R e d C ro ss N u rse s, St. Joh n m e m b e rs a n d c a d e ts u n d e r C o rp s O ffice r T . C. Forbes. A D a n c e w a s h e l d in t h e e v e n i n g , w h i c h a t t r a c t e d a record cro w d , a n d both F e te a n d D a n c e p ro ved a g r e a t su ccess, a n d th e C o m m it te e w e re a b le to h a n d ^ 3 4 3 to the Fund'
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S u p p l y — D etection o f P o l l u t io n .
L a s t m onth w e d ea lt w ith th e v a rio u s so u rce s of su p p ly a n d it w a s n o t e d t h a t n o n e c o u l d b e g u a r a n t e e d a g a i n s t c o n tam in ation . I t is e s s e n t i a l t h e r e f o r e , t h a t w a t e r f r o m a n e w s o u r c e s h a l l b e t e s t e d , a n d if n e c e s s a r y , p u r i f i e d , b e f o r e t h e t r o o p s a r e a l l o w e d t o u s e it . T w o m e t h o d s a r e u sed for d etection : (1 ) a s t r o n g so lu tio n of salt, fo llo w e d b y a c h e m ic a l e x a m i n a t i o n ; (2) a s o l u t i o n o f F l u o r e s c i n , w h i c h w i l l s h o w c o l o u r in w a t e r w h e n u s e d , e v e n in t h e p r o p o r t i o n o f 1 p a r t in 1 0 m i l l i o n s . N a t u r a l l y t h e l a t t e r m e t h o d is q u i c k e s t a n d m o r e c o n v e n i e n t f o r t h e m e d i c a l o r d e r l y , t h e r e f o r e it is t h e one g e n e ra lly adop ted . S u p p o s e , f o r e x a m p l e , a w e l l is t o b e u s e d b u t is f o u n d to be, o r s u s p e c t e d of b e in g , p o llu te d . A carefu l e x a m in a tion of th e s u r r o u n d in g s w o u ld be m a d e fo r th e p o s sib le so u rce of pollutio n. P e r h a p s it i s c a u s e d b y s e w a g e ; d i s c h a r g e s fr o m n e a r b y in d u s tr ia l b u ild in g s ; o r a l e a k a g e into the w ell of s u r fa c e w a t e r c o n ta m in a te d b y a n im a l e x c r e ta , d ead v e g e ta tio n , etc. A F l u o r e s c i n s o l u t i o n m a d e u p o f 1 lb. F l u o r e s c i n a n d 1 lb . c a u s t i c s o d a t o t e n g a l l o n s o f w a t e r is t h e n p o u r e d o v e r t h e s u s p e c t e d a r e a , a n d if c o l o u r b e c o m e s v i s i b l e in t h e w e l l , t h e n it p r o v e s t h a t a r e a t o b e t h e s o u r c e o f p ollu tio n. T h e f o l l o w i n g t r e a t m e n t w o u l d t h e n b e g i v e n :— F irst, a n y d eb ris lik e ly to b e the c a u s e w o u ld be r e m o v e d . N e x t, a b o u t h a lf a b arre l of lim e w o u ld be t h r o w n d o w n . T h e w e l l w o u l d t h e n b e p u m p e d o u t , a l l o w e d t o r e f il l a n d t h e lim e tre a tm e n t rep ea ted . T h i s s h o u ld be a llo w e d to sta n d 24 h o u r s , a n d t h e n t h e w e l l p u m p e d o u t u n t i l c l e a r o f l i m e . W a t e r w h i c h is r e q u i r e d in t h e q u i c k e s t p o s s i b l e t i m e m u s t b e p u r i f i e d b y m e t h o d s w h i c h a r e n o w g e n e r a l l y a d o p t e d in the A rm y. P u r i f i c a t i o n is c a r r i e d o u t in t w o p a r t s : 1 s t , c l a r i f i c a t i o n ,
17
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a n d 2nd, sterilisation . T h e f i r s t is t o d e a l w i t h s u s p e n d e d m a tte r , d e a d a n d a liv e ; a n d th e s e c o n d to d e s t r o y p a t h o g e n ic or d isease p ro d u cin g g e rm s . F i l t r a t i o n is t h e m e t h o d u s e d in t h e s e r v i c e f o r c l a r i f i c a t i o n , a n d a l l w a t e r - t a n k t r u c k s a n d w a t e r - t a n k tr a ile r s a r e fitted w it h s p e c ia l filte rs w h i c h c a r r y o u t f i l t r a t i o n a s t h e t a n k s a r e fil le d . B e s id e s th e r e g u l a t i o n filters h o w e v e r , im p r o v i s a t i o n s a r e p ossible, s u c h a s filte r in g t h r o u g h a b la n k e t. P ro b a b ly th at w o u ld be a b o u t the o n ly m e a n s a v a ila b le to th e H . G . o r d e r ly , w h o w ill no d o u b t e v o l v e s o m e m e t h o d to s u it the c a s e if 1 k n o w a n y t h i n g o f t h e m e d i c a l s e r v i c e . N e x t m o n th I w ill deal w ith sterilisation . C.
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S p r e a d b u r y (S erg t.), S ch o o l H o u se , N oel-road , W .3 .
Letters to the Editor. W e a r e in n o w a y r e s p o n s ib le fo r th e o p in io n s e x p r e s s e d , or the sta te m e n ts m a d e , b y C o rre s p o n d e n ts .— E d it o r .
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S ir , — S p e a k i n g of t h e A . R . P . a p p o i n t m e n t s a t a r e c e n t “ C o m i n g of A g e ” D in n e r a t M irfieid , C o lo n e l G . H . L . H a m m e r t o n ( C o u n t y S u r g e o n ) s a id h e w a s n o t p r o u d of them . B e fo re the w a r th e G o v e r n m e n t a s k e d the m e m b e rs o f t h e O r d e r to a r r a n g e fo r th e t e a c h i n g o f G a s P r e c a u t i o n s to th e g e n e r a l p u b lfc , a n d t h e y a n s w e r e d th e a p p e a l . S in ce then a ll th e a p p o in tm e n ts, w ith a n ice fa t s a la r y , w e r e g iv e n to o th e r s , a n d th e m e m b e r s o f th e O r d e r o f S t. J o h n w e r e n ot co n sid ered. I d o n ’t t h in k t h a t is r i g h t a n d fa ir, a n d I t h i n k s o m e t h i n g s h o u l d b e d o n e a b o u t it , s a i d t h e s p e a k e r . T h a t is a n e x t r a c t fr o m a lo c a l p a p e r a n d m a d e m e g o fu r th e r in to th e q u es tio n . W h a t a re the facts ? In 193 5 B r i g a d e H e a d q u a r t e r s s e n t o u t in s tr u c tio n s for a ll m e m b e r s to s t u d y G a s Y V a rfa re a n d A i r R a i d P r e c a u t i o n s a n d to o b ta in a certifica te to p r o ve efficien cy, w h ic h th e m e m b e r s did w ith t h e e n t h u s i a s m w h i c h is c h a r a c t e r i s t i c o f t h e B r i g a d e . I n 1 9 3 9 w e w e r e h a n d e d o v er lo c k , s t o c k a n d b arre l to th e H o m e O ffice w ith o u t a n y g u a r a n te e (e x ce p t th a t w e w e r e g u a r a n teed t h o r o u g h ly tra in ed ), a n d fr o m th e H o m e O ffic e w e w e r e p la ce d u n d e r th e d irectio n s of M e d ic a l O fficers of H e a lt h w h o h a d , in a g r e a t n u m b e r o f c a s e s , n o t t a k e n a n y i n t e r e s t w h a t e v e r in A . R . P . , a n d i n c o n s e q u e n c e w e w e r e a g a i n h a n d e d o v e r t o t h e t e n d e r m e r c i e s of a C h i e f C l e r k w h o o n l y t o o k h is F ir s t A id C e r ti f ic a t e b e c a u s e h e w a s o r d e r e d to d o so T h e la te C h ie f C o m m is s io n e r s a y s in h is fa r e w e ll m e s s a g e t h a t h e is s o r r y w e w e r e n o t a l l o w e d t o e n r o l a s a b o d y a n d w o r k u n d e r o u r o w n officers ; th e “ little m a n ” fa ils to c o m p r e h e n d w h y it w a s p o s s i b l e t o h a n d o v e r a n a r m y o f 120,000 f u l l y t r a i n e d p e r s o n n e l w i t h o u t a n y s a f e g u a r d , a n d t h in k s th e r e w a s s o m e w e a k n e s s (a n d n o t in th e r a n k a n d fil e). N o w w e a r e b e in g h a n d e d o v e r to th e R e s c u e S e rv ic e , a n d o n c e a g a i n to t a k e o r d e r s fr o m m e n w h o h a v e no k n o w le d g e of F ir s t A id ; a n d th e “ little m a n ” is f e e l i n g v e r y so r e a b o u t th e w h o le affair. S u r e l y t h e O f f i c e r s a n d N . C . O . ’s s h o u ld be g i v e n a r a n k e q u iv a le n t to t h a t h e ld in th e B rig ad e. If th e O ffic e r s a n d N . C . O . ’s c a n r e c r u i t a n d tr a in a n a r m y o f 120,000 in p e a c e t i m e , w h e n t h e t e n d e n c y o f m o s t of th e p o p u latio n w a s for e a s e a n d e n jo y m e n t, s u r e ly th ey s h o u l d b e g i v e n s o m e c r e d i t f o r it w h e n t h e c r i s i s is u p o n u s ; b u t w e fin d t h e l o c a l a u t h o r i t i e s p u t t i n g t h e i r o w n u n tra in ed m en a n d w o m e n in to E x e c u t iv e jo b s , a n d n a t u r a lly w e fe e l a g r i e v a n c e . W e w e l c o m e t h e n e w C h i e f C o m m i s s i o n e r . H e h a s d one a g r e a t jo b , a nd w e trust he w ill s tr a ig h te n o u t a g r i e v a n c e w h i c h r u n s all t h r o u g h th e B r i g a d e h e n o w c o m m a n d s .— Y o u r s tru ly,
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M a n y a m b u l a n c e e n t h u s ia s t s in th e N o r th E a s te r n A r e a w ill be d e lig h te d to k n o w th at H is M a je s t y the K i n g h a s b e e n g r a c i o u s l y p le a s e d to s a n c tio n th e p r o m o t io n of M r. G . H . O a k e s , S h ip p in g F o r e m a n , H u ll, from S e r v in g B ro th e r to O ffic e r B ro th e r. M r . O a k e s o b t a i n e d h i s c e r t i f i c a t e in 1 9 0 1 , a n d s in c e t h a t y e a r h a s p a s s e d 35 r e - e x a m in a ti o n s . H e w a s a p p o i n t e d D i s t r i c t S e c r e t a r y a t H u l l in 1 9 2 0 a n d g r a n t e d t h e d i g n i t y o f H o n o r a r y S e r v i n g B r o t h e r in 1 9 2 3 — a s p l e n d i d r e c o r d o f d e v o t i o n t o d u t y in t h e c a u s e o f fir s t a i d . H is M a je s ty th e K i n g h a s a ls o b een g r a c io u s ly p leased to b e s to w th e d ig n ity of S e r v in g B ro th e r u p o n M r. A . E . A rm s tro n g , E n g in e E x a m in e r (D istrict S ecretary), H e a to n ; M r . W . L a w s o n , F i t t e r , H a r t l e p o o l ; M r . J. S . R i c h a r d s o n , C a r e ta k e r , S u n d e rla n d ; M r. C. W . S m ith , P ain ter, D a r l in g to n , and M r. A. L . W h ite , C h a r g e in a n P lu m b er, W e s t H a r t l e p o o l , in r e c o g n i t i o n o f t h e i r s e r v i c e s t o t h e S . J . A . A . o v e r a l o n g p erio d of ye ars. A V e l l u m V o t e of T h a n k s h a s a ls o b e en a w a r d e d to M r. S. P. T h o m p s o n , D is tric t S e c re ta r y , D a rlin g to n .
It is v e r y p l e a s i n g to n o te t h a t d e s p ite th e m a n y c a lls u p o n m e m b e r s o f t h e s t a f f w h o a r e i n t e r e s t e d in f i r s t a i d , it h a s a g a i n b e e n p o s s i b l e t o h o l d a c o m p e t i t i o n in a l l t h e s i x d istricts, n a m e ly , D a r lin g t o n , H u ll, L e e d s , M id d le s b r o u g h , N ew ca stle and Y o rk . T h e s t a g in g of th e tea m tests w a s p articu larly ou tstan d in g. W e e x te n d o u r sin ce re th a n k s to th e d o cto rs w h o g a v e th e ir v a lu a b le tim e to ju d g e th e co m p e titio n s.
D u r in g th e h a lf y e a r en ded M a r c h 31st, 1943, m em b e rs of th e N o r th E a s te r n A r e a s ta ff b e c a m e en titled to L o n g S e r v ic e G o ld A w a r d s a n d w ill he p r es en te d w ith certificates, w h ic h w ill be e x c h a n g e d for the a p p ro p ria te g o ld to k e n s as soon as c irc u m sta n c e s perm it. W e r e g r e t th a t p ressu re on sp a ce preven ts us g i v i n g a fu ll list o f t h e re cip ien ts. T h e fo llo w in g are the totals : 43 G o l d M e d a l s , 10 2 0 - y e a r B a r s , 2 2 5 - y e a r B a r s , 5 3 0 -y e a r B a rs and 2 35-year Bars.
S O U T H E R N W i m b l e d o n F i r s t A id C l a s s .— T h e p r e s e n t a tio n of a w a r d s f o r 1 9 4 2 / 3 , in c o n j u n c t i o n w i t h a S o c i a l a n d D a n c e even in g , to o k p la ce a t C o m p to n H all, Co m pton -road, W i m b l e d o n , on S a t u r d a y , J u ly 24th, b e fo re a la r g e g a t h e r i n g of m e m b e r s a n d th eir friends. It w a s g r a t i f y i n g to s e e s o m a n y p r e s e n t , b e a r i n g in m i n d t h e s t r e s s o f a b n o r m a l tim e s, w ith o fficials a n d e m p lo y e e s on w a r duties. I t w a s p r e s i d e d o v e r b y M r . A . W . O s b o r n e in t h e a b s e n c e of o th e r officials. H e w e lc o m e d M iss G rin d le y fro m the W e lfa r e D e p t., W ate rlo o , St. J o h n A m b u la n c e C e n t r e , w h o h a d k i n d l y c o m e a l o n g to p r e s e n t th e a w a r d s in p la c e o f M r. U z z e ll, w h o w a s a b s e n t o n A . R . P . d u ties. T h e c h ie f a w a r d w a s a 2 1-y e a r s G o ld M e d a l to M r. E. M itc h e ll, w h o h a d re n d ered y e e m a n se rv ic e to h is fe llo w c o m r a d e s o v e r t h a t l o n g period. A g o o d tim e w a s en joyed b y a ll p resen t.
M o r e t h a n 50 p e o p l e w i t h m i n o r i n j u r i e s r a n g i n g f r o m c u t f i n g e r s t o f a i n t i n g fi ts w e r e a t t e n d e d b y S t . J o h n A m b u la n c e m en on D u r d h a m D o w n , B ristol, on A u g u s t M o n d a y aftern oon .
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V it a m in s , of w h ich w e h a v e b e co m e in c re a s in g ly con sciou s d u r in g recen t years, a re su b sta n c e s of a c o m p le x co m p o sitio n f o u n d in v a r i o u s f o o d s t u f f s , a n d a r e e s s e n t i a l f o r t h e m a i n t e n a n c e of h e a lt h . T h e v e r y n a m e is d e r i v e d f r o m t h e w o r d v i t a l w h i c h m e a n s s o m e t h i n g n e c e s s a r y t o li f e .
K n o w le d g e of the e x isten c e of v ita m in s g r e w o u t of a n u m b e r of a tte m p ts a t v a r io u s tim e s to feed a n im a l s on n e w diets. I t w a s o b s e r v e d in t h e ’ 8 0 ’s o f l a s t c e n t u r y t h a t p u r e c a rb o h y d ra te s , p rotein s a n d fa ts w e r e n ot e n o u g h to k e e p a n im a ls h ealth y. S o m e a c c e s s o r y fo o d s u b s ta n c e s w e r e m issin g. I n E n g l a n d ( 1 9 0 6 - 1 2 ) it w a s f o u n d t h a t a s m a l l a m o u n t of m ilk a d d e d to th e diet c a u s e d a n im a ls to flo urish a n d put on w eigh t. G e r m a n y a n d A m e r i c a too, w e r e e x p e r im e n t in g a b o u t th is tim e on th e su b ject. I t w a s f o u n d in N o r w a y i n 1 9 0 7 , t h a t s c u r v y c o u l d b e i n d u c e d in g u i n e a - p i g s b y w i t h h o l d i n g g r e e n s t u f f . I n 1 9 1 5 it w a s f o u n d t h a t n o t o n e , b u t a t l e a s t t w o a c c e s s o r y s u b s ta n c e s w e r e n e c e ss a r y . T h e s e w e r e t e rm e d fatso lu b le A a n d w a te r-so lu b le B , th e latter b e in g fo u n d later to c o n sist of B , B 2 a n d C . B , and B 2 h av e so m etim es been term ed F a n d G (S h e rm an ). T h e p r o p e r t i e s o f c o d - l i v e r o i l w e r e d i s c o v e r e d in 1 9 2 1 . B y 1922, v ita m in s A to E h ad been d iscovered, th e latter a n o t h e r f a t - s o l u b l e o n e , f o u n d n e c e s s a r y f o r f e r t i l i t y in r a t exp erim en ts. ( T h e rich e st k n o w n so u rces of E a re w h e a t g e r m a n d le ttu c e leaves). T h e e vid e n ce of a n y h u m a n r e q u i r e m e n t o f v i t a m i n E is v e r y c o n f l i c t i n g . T h e n u m b e r of v ita m in s n o w k n o w n h as e xte n d ed v it a m in D to D 5 a n d v i t a m i n B to B 7 a n d r e a c h e s d o w n th e a lp h a b e t to K a n d P. C u rio u s ly e n o u g h , v itam in s a re on ly form ed b y v e g e tab les, a n im a ls h a v e to g e t th e m fro m th e food th ey eat excep t vitam in D . W i t h t h i s , in a d d i t i o n t o t h e v e g e t a b l e s o u r c e , t h e u l t r a - v i o l e t r a y s in s u n l i g h t a c t u p o n s u b s t a n c e s in t h e a n i m a l a n d h u m a n b o d y a n d p r o d u c e D in t h e t i s s u e s d irectly. A rtific ia l ir r a d ia tio n is a ls o u se d to p r o d u c e v it a m in D in food stu ffs. V i t a m i n s a r e p r e s e n t in t h e i r g r e a t e s t q u a n t i t i e s i n f r e s h foods. A l l t h e v i t a m i n s a r e p r e s e n t in f r e s h m i l k , p r o v i d e d t h a t t h e a n i m a l s u p p l y i n g t h e m i l k is g e t t i n g e n o u g h v i t a m i n s itself. T h e a b s e n c e o f a n y o n e v i t a m i n in t h e d i e t c a u s e s i t s s p e c i f i c d e f i c i e n c y d i s e a s e , a n d in t h e c a s e o f c h i l d r e n m a y lea d to irr ep a ra b le h a rm . V it a m in s A a n d D , th e a n im a l p ro d u ct v itam in s, a re n e c e s s a r y for g e n e r a l g r o w t h . A also g o v e r n s the con d ition of th e m u c o u s m e m b r a n e in its fu n c t io n o f r e s i s t i n g in fe ctio n . T h e D g r o u p , t h e f i v e f a c t o r s D , . s is n e c e s s a r y f o r b o n e fo r m a tio n a n d the h e a lth of th e blood str e a m . T h e deficien cy d is e a s e of D is w e ll k n o w n — R ic k e t s . T h e rich est k n o w n s o u r c e s o f A a r e t h e liv e r fa t s of m a n y m a m m a l s a n d fishes ( t h e r e is a h u n d r e d t i m e s a s m u c h A in h a l i b u t l i v e r a s t h e r e i s in c o d l i v e r ) a n d e g g s . V e g e ta b le s and green stuffs h ave a g o o d A content. V i t a m i n D is f o u n d i n l a r g e s t a m o u n t s i n h a l i b u t a n d c o d l i v e r o il. H a l i b u t l i v e r o il is e i g h t y t i m e s s t r o n g e r t h a n c o d l i v e r o i l in i t s D c o n t e n t , a s w a s f o u n d a t t h e c o st o f a n u m b e r of c h ild r e n ’s liv e s in C a n a d a a f e w y e a r s a g o w h e n t h e y w e r e g i v e n t h e s a m e d o s a g e o f h a lib u t oil a s t h a t p r e v io u s ly g i v e n of co d liv e r oil. C a lcificatio n of the b re ast w a s ca u se d b y the e x c ess of D 2 . V i t a m i n s B , a n d B 2 a r e f o u n d in l a r g e s t a m o u n t s i n t h e w h e a t g e r m , e g g s a n d yeast. T h e y a re n e c e ssa ry for g o o d
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The Gear illustrated (A.B.C.D.) carries tw o stretchers on one side of Ambulance, leaving oth er side clear for sitting patients. The UP AND DOW N action is quick and easy for loading o r unloading. S h o w s t h e tw o s tr e tc h e r s in p o sitio n S h o w s t h e to p s tr e tc h e r lo w e re d r e a d y fo r lo a d in g . I l l u s t r a t e s t h e s a m e G e a r w ith th e to p s tr e tc h e r f ra m e h in g e d dow n for u s e w h e n o n ly o n e s tr e tc h e r c a se is c a rr ie d . D .
S h o w s t h e s a m e p o s itio n a s in “ C ’ o n ly w ith c u s h io n s a n d b a c k r e s t fitte d fo r c o n v a le s c e n t c a s e s .
W here Ambulances are required to carry four beds two Gears are fitted, one on EITHER SIDE, and th e same advantages apply as described above. Full catalogue o f Ambulance Equipment No. 7A w ill be sent on request.
G R E A T P O R T L A N D ST., LONDON, W .1 Telegraphic Address:—
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n e rve co n d itio n a n d d ig e stio n . B t th e a n tin e u ritic v itam in , g u a r d s a g a in s t B e ri-B e ri, a d isease (w h ic h ta k e s t w o fo rm s a “ D r y ” and a “ W e t ” ; the “ D r y ” in vo lvin g le g m uscle w a s t i n g a n d p a in fu l s w e llin g s , the “ W e t ” a c c o m p a n ie d b y d r o p s y ) o c c u r r i n g in c o u n t r i e s w h e r e t h e s t a p l e i t e m o f d i e t is p o l i s h e d r i c e . B 2 is t h e P e l l a g r a p r e v e n t i n g v i t a m i n . P e l l a g r a i s a d i s e a s e o f B 2 d e f i c i e n c y o c c u r r i n g in t r o p i c a l a n d su b -tro p ical cou n tries. I t is c h a r a c t e r i s e d b y e r u p t i o n s on the s k in a c c o m p a n ie d b y d iso rd ers of th e d ig e stio n an d n ervous system . T h e v i t a m i n B g r o u p is n o w k n o w n a s t h e B c o m p l e x , ( B , t o B ). V i t a m i n C is t h e f r e s h f r u i t a n d v e g e t a b l e v i t a m i n . For m a n y y e a r s it w a s k n o w n t h a t S c u r v y ( t h e v i t a m i n C d e f i c i e n c y d ise a se ) co u ld be p r ev e n te d by fresh fruit a n d v e g e t a b le s a n d “ lim e ju ic e .” T h is “ lim e ju ic e ” (really the ju ice of the M e d i t e r r a n e a n le m o n , a t t h a t tim e ) w a s is s u e d to th e c r e w s o f E n g l i s h s a i l i n g sh ip s o n l o n g v o y a g e s to p r e v e n t s c u r v y . H e n c e the n a m e of “ L i m e y ” d erisiv ely g iv e n b y the A m e r ic a n s to th ese sh ip s a n d th eir c re w s . For years tom a toes a n d o r a n g e s w e re k n o w n a s cu ra tiv e and p rev en ta tive a g e n t s f o r S c u r v y b e f o r e t h e r e a s o n — d e f i c i e n c y in v i t a m i n C — w a s d iscovered. C o n s id e ra b le w o r k h as been d on e on v ita m in C d u r in g the past few years. It h as been fo u n d th a t in activ atio n by o x i d a t i o n o f t h e v i t a m i n C in f r u i t a n d v e g e t a b l e s is g r e a t e r in a l k a l i n e s o l u t i o n s a n d l e s s in a c i d s o l u t i o n s . ( T h e oldf a s h i o n e d p i n c h o f s o d a in t h e g r e e n s w a t e r t o “ i m p r o v e t h e c o lo u r ,” k ille d the C). T h e lo n g e r fru it a n d v e g e ta b le s a r e c o o k e d , t h e m o r e C is d e s t r o y e d . A l s o , if f r u i t a n d v e g e t a b l e s a r e b r u i s e d , e n z y m e s ( c h e m i c a l f e r m e n t s f o r m i n g in liv in g cells) set to w o r k a n d d e s tro y th e v ita m in C co n te n t ; b u t if t h e h e a t in c o o k i n g is r a i s e d t o j u s t u n d e r b o i l i n g p oint, th e e n z y m e s a r e th e m s e lv e s d es tro yed . A s e a r l y a s 1 9 1 2 it w»as d i s c o v e r e d t h a t C is a b s e n t in s e e d s b u t is p r o d u c e d b y g e r m i n a t i o n . T h e v it a m in C c o n te n t is e x p r e s s e d in t e r m s of th e a m o u n t o f a s c o r b i c a c i d p r e s e n t in m . g . p e r 100 g m . o f f r u i t or v eg eta b le . P u r e a s c o r b i c a c i d , it m a y b e m e n t i o n e d in p a s s i n g , is n o w a v a i l a b l e a n d c h e a p , a n d a p p a r e n t l y d o e s n o h a r m e v e n i f t a k e n in e x c e s s . R e c e n t w o r k h as e stab lish ed th a t of c o m m o n so u rces o f C , t h e h i g h e s t is t h a t o f h a w - b e r r i e s a n d r o s e - h i p s (50 0 m . g m . ); n e x t c o m e s t h e b l a c k - c u r r a n t (30 0) ; t h i r d l y , t h e o r a n g e a n d l e m o n (40-60) ; (a m e d i c a l j o u r n a l h a s r e c e n t l y s t a te d t h a t m a r m a l a d e r e t a i n s m o s t of its v it a m in C c o n t e n t, th e peel b e in g a v a lu a b le part). T h e C c o n te n t of o th e r fruits a n d v e g e ta b le s v arie s c o n sid erab ly. T h e ap p le com es a lo n g w a y d o w n t h e li s t , t h e b e s t , i n o r d e r o f C m e r i t a r e : B r a m l e y ’ s S e e d l i n g ( 3), B l e n h e i m O r a n g e , N e w t o n W o n d e r , t h e n t h e m u c h p r i z e d C o x ’ s O r a n g e P i p p i n r u n n i n g a b a d f o u r t h ( 1 ‘6). T h e p e a r ’s v a l u e is l o w t o o . T w o o u n ce s of p a rsle y g iv e s a n a d e q u a te v ita m in C in t a k e for a d a y . T o m a to e s retain th eir C content w h e n tinned, b u t tin n ed fruit an d v e g e ta b le s do not retain th eir C c o n t e n t i n d e f i n i t l y , a n d s h o u l d b e u s e d w i t h i n a y e a r o r so . P o t a t o e s h a v e a C v a lu e u p to 20 ju s t u n d e r th e s k in . A s u r p r is in g recen t R u s s ia n d isco v ery , con firm ed by w o r k e r s in t h i s c o u n t r y , i s t h a t t h e w a l n u t in t h e g r e e n s t a g e , w h i l e t h e s h e l l is s t i l l s o f t , h a s a c o n t e n t o f 1 , 0 8 0 . I t is b e s t u t i l i s e d b y p i c k l i n g a s it l o s e s t h i s h i g h C v a l u e a s it r i p e n s . A c o u r a g e o u s e xp erim en t w a s carried out by an A m e rica n d o c to r u p on h im se lf, w ith the a s s is ta n c e of tw o c o lle a g u e s w i t h i n t h e l a s t t h r e e y e a r s in c o n n e c t i o n w i t h v i t a m i n C . H e w e n t o n t o a d i e t d e l i b e r a t e l y , a n d c o m p l e t e l y l a c k i n g in C. I t w a s n o t u n t i l t h e fif th m o n t h t h a t h e s h o w e d s i g n s of ill-h e a lth a r i s i n g fr o m th is d eficien cy . B y th at tim e sm all e x p e r im e n t a l w o u n d s o n his b a c k fa ile d to h e a l p r o p e rly (the s c a r c o v e r i n g a m a s s o f u n o r g a n i s e d tissu e ), a n d he felt tired q u ic k ly a fte r e xercise. H e presen ted , h o w e v e r , n on e of the clin ica l s ig n s of sc u rv y . T h e ex p e rim e n ts w e re then d isco n t i n u e d a t t h e e n d o f t h e fif th m o n t h .
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V i t a m i n K is n o w g e n e r a l l y a c c e p te d a s a n anti-h aem o rrh a g ic factor. V i t a m i n P ( f o u n d in a s s o c i a t i o n w i t h C ) , m o s t d o c t o r s n o w b e l i e v e , is a f a c t o r in m a i n t a i n i n g c a p i l l a r y r e s i s t a n c e . O f c o u r s e , o n a n o r m a l h e a l t h y b a l a n c e d d i e t , t h e r e is n o n e ed to w o r r y a b o u t v ita m in s , b u t a t p r es en t, o w i n g to w a r c o n d i t i o n s , w e a r e in a p o s i t i o n s o m e w h a t a n a l a g o u s to t h a t o f t h e l i v e s t o c k o f t h e ’ 8 0 ’ s , i n s o f a r t h a t w e a r e in n e e d o f t h o s e “ a c c e s s o r y s u b s t a n c e s ” b e i n g a d d e d in m a n y c a s e s to o u r diet ; b u t w ith th e im p o r ta n t d ifferen ce th a t w e n o w p o s s e s s su ffic ie n t k n o w l e d g e to b e a b l e to r e m e d y th e d eficien cy w ith scien tific p rep a ra tio n s.
Reviews. C i v i l D e je n c e : a B a s ic T r a in in g M a n u a l.
B y L t.-C o m m ander F. A. M. Eden, R. N. London : Jordan & Sons Ltd. P r ic e 21- n e t ; by p o st 212 .
T h is book, w h ich h a s been com p iled b y a re co g n ised e x p e r t , w a s f ir s t p u b l i s h e d in S e p t e m b e r , 1 9 4 2 , a n d h a s a l r e a d y r e a c h e d its s e c o n d e d i ti o n — s u r e p r o o f o f its u s e f u l n ess an d pop ularity. T h e te x t h as b een t h o r o u g h ly revised a n d several c h a p t e r s c o m p le te ly re - w ritte n to b r i n g th e b o o k in to lin e w ith th e la tes t d e v e lo p m e n ts of C iv il D e fe n c e p ractice. C o n s e q u e n t l y , r e a d e r s o f F i r s t A i d w i l l fi n d in o n e v o l u m e in fo r m a tio n w h ic h c o v e rs th e b a s ic t r a i n i n g r e q u ir e d b y all b ra n ch e s of C ivil D e fe n ce . ■
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T h e H o m e S e rv ice A m b u la n c e C o m m itte e of the O rd er o f St. J o h n a n d B r it is h R e d C r o s s S o c ie t y c a ll a tte n tio n to the fa ct th a t a m b u la n c e s r e t u r n in g e m p ty to L o n d o n from d istricts o u tsid e th e M etro p o lita n a re a cou ld be used for the c o n v e y a n c e of p atien ts fro m th e co u n try to th e L o n d o n ho sp ita ls.
D e a t h o n S e r v i c e .— W e r e g r e t to a n n o u n c e th e d e a th , w h ile on fly i n g d uties, of P ilo t O ffic e r R . K . B e tc h le y , R . A . F . (N o . 126 B a r c la y s B a n k D iv isio n ). H e w a s s e r v i n g in C o s ta l C o m m a n d , a n d o n ly a w e e k b e fo re h is d ea th h ad a t t a c k e d a U B o a t c a u s i n g it t o c r a s h d i v e , a n d h a d s e t t h e a c c o m p a n y i n g “ f l a k ” s h i p o n fi r e. O u r sin cere s y m p a th y g o e s o u t to h is fa m ily .
A n A p p r e c ia t io n . — C a p ta in C o le, M .O ., K . O . S . B . , B y w ell, a s k s us, t h r o u g h th e m e d iu m o f th is J o u r n a l, to t h a n k J o h n Jarvis, F ir s t A id A tte n d a n t, W e s t M y la n d C o llie ry , N o rth u m b e rla n d , a n d m e m b e rs of th e S . J . A . B . on t h e p r o m p t a n d b r illia n t first a id re n d e r e d a t a r e c e n t a c c id e n t w h ic h befell s o m e of th e “ l a d s ” of tbe K . O . S . B . o n a S h o o t i n g R a n g e , w h e n t h r e e w e r e k i l l e d a n d fi v e wounded. S c u n t h o r p e ’s E m e r g e n c y F i r s t A i d H o u s e s . — S c u n t h o r p e A . R . P . a u t h o r i t i e s h a v e s p e n t £ 7 1 0 in m e d i c a l s u p p l i e s a n d e q u i p m e n t t o fit u p t h i r t y - o n e e m e r g e n c y fi r st aid points a t h o u se s sc a tte r e d o v er the to w n . T h e occu p iers h a v e a g r e e d to s to r e th e e q u i p m e n t a n d to p r o v id e a r o o m fo r th e tr e a t m e n t of c a s u a ltie s in e m e r g e n c y . T h i s is a lo c a l s c h e m e to s u p p le m e n t th e o rd in a r y C ivil D e fe n c e F ir s t A id P osts. A ld e r m a n H . V . T o m b s , the A . R . P . C o n tro ller, s ta te s th a t th e w a r d e n s h a v e co llected ;£ 8 7 0 fr o m th e p u b lic to e q u ip t h e s e p oin ts, a n d th e b a la n c e o f ; £ 1 6 0 h a d been in v e s te d fo r r e p la c e m e n ts .
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Queries and Answers to Correspondents Q u e r i e s w i l l b e d e a l t w i t h u n d e r t h e f o l l o w i n g r u l e s :— L e tte rs c o n ta in in g Q u e rie s m u s t b e m a r k e d o n th e to p l e f t - h a n d c o r n e r o f t h e e n v e l o p e “ Q u e r y , ’’ a n d a d d r e s s e d t o F i r s t A id , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 .
2. — A l l Q u e r i e s m u s t b e w r i t t e n o n o n e s i d e o f p a p e r o n l y . 3- — A l l Q u e r i e s m u s t b e a c c o m p a n i e d b y a “ Q u e r y C o u p o n ” c u t f r o m t h e c u r r e n t i s s u e of t h e J o u r n a l , o r, in c a s e of Q u e rie s fro m a b ro a d , fro m a re c e n t issu e.
4. — T h e T e x t b o o k t o w h i c h r e f e r e n c e m a y b e m a d e i n t h i s c o l u m n i s t h e 39 t h ( 1937 ) E d i t i o n o f t h e S . J . A . A . M a n u a l of F i r s t A id to t h e In ju r e d .
Treatm ent of Carbolic Poisoning. B .T .
(B irm in g h am ).— T h e recen tly by a S .R .N . P o i s o n s :—
a tta ch e d sta te m e n t w as m a d e in t h e c o u r s e o f a l e c tu r e o n
“ Y o u r S t. J o h n T e x t b o o k in s p e a k i n g of t h e t r e a t m e n t fo r C a r b o lic A cid P o is o n in g , i n s tr u c ts y o u to g iv e h a p in t of M e d ic in a l P a ra ffin , o r 1 ta b le s p o o n fu l of E p s o m o r G l a u b e r S a l t s in a t u m b l e r f u l o f m i l k o r w a t e r . I s a y — d o n ’t d o a n y s u c h t h i n g ! T h e s t o m a c h h a s a lr e a d y b e e n in ju r e d by th e c o rro s iv e a c tio n of th e acid , a n d th e r e s u l t i n g e ffe rv e s c e n c e of t h e E p s o m S a l t s w ill o n ly te n d to p e rfo r a te th e o r g a n . ” T h e r e a re p o sitiv ely no g r o u n d s for th e s ta te m e n t th a t p e rfo r a tio n of th e s to m a c h m i g h t re s u lt fro m th e a d m i n i s t r a tio n of E p s o m S a l t s in t h e c a s e of C a r b o lic A c id P o i s o n i n g ; a n d th e S .R .N . s h o u ld h a v e o b ta in e d m ed ic al ad v ice before s h e a tte m p te d to c o n tro v e rt th e T e x tb o o k .— N . C o r b et F
letcher
.
Exam ination Howler. M .R . (C a n n o n S t.).— In a recen t e x am in atio n I ask e d a c a n d id a te h o w he w o u ld pro ceed to tre a t a p a tie n t suffer in g fro m s p ra in e d a n k le. H e c o m m e n c e d h is a n s w e r :—
W ith a sp r a in e d a n k le I w o u ld f i r s t rem ove the foot I " b u t a b r u p t l y s to p p e d w ith a lo o k of s u r p r is e w h e n th o s e in h is im m e d ia te v icin ity b u r s t o u t l a u g h in g . Good!
N e x t , p l e a s e ! !— N . C . F .
Bleeding from Lungs. S .N . (N e w c a s tle ).— In a re c en t co m p etitio n , I fo u n d a m a n ly in g o n h is b a c k , c o u g h i n g a n d s p ittin g u p b r i g h t re d and f r o th y blo o d . On e n q u irin g I fo u n d th a t he w a s a T . B. s u b ject a n d also th a t he h a d a frac tu re d r ig h t patella. A c c o rd in g to th e m a r k in g s h e e t I s h o u ld h a v e a p p lie d s m e llin g sa lts to th e n o se a n d s p rin k le d th e face w ith co ld w a te r . I did n o t do eith er, m y re a so n s b e in g th a t th e s m ell in g sa lts m ig h t m a k e th e p a tie n t c o u g h m o re , a n d also th a t I w a s u n d e r th e im p ressio n th a t no d irect or in d irect stim u la tio n s h o u ld be g iv en u n til th e h a e m o rrh a g e is c o n tr o lle d . I s h o u ld be p le a se d w here, I w e n t w ro n g . Y our arg u m e n ts c o rre c t.— N .C .F .
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Treatm ent of Epilepsy. W . S . ( C o v e n t r y ) . — O n J u n e 26 t h I t o o k p a r t i n a c o m p e t i t i o n w h ic h w e w on. O n e o f t h e o r a l t e s t s w a s :— “ H o w w o u ld y o u tre a t a case of E p ilep sy ? ” A fter g iv in g
R I D tre a tm e n t rem em ber H ow stitu tio n a l
a c c o r d i n g to T e x tb o o k , th e d o c to r to ld m e to n e x t tim e to re m o v e th e cause. c a n a fir st a i d e r r e m o v e a c a u s e w h i c h is c o n ? T h a n k in g you fo r p a s t favours.
C learly you h a v e m is u n d e rsto o d th e criticism of y o u r e x a m i n e r , b e c a u s e n o d o c to r w o u ld te ll y o u , a first a id e r, to r e m o v e th e c a u s e of E p ilep sy . I s u sp e c t, th e re fo re , th a t y o u failed to s tre s s th e n e ed to p ro te c t y o u r p a tie n t b y r e m o v in g c a u s e s of in ju ry s u c h a s m ig h t re s u lt d u r in g th e co n v u lsiv e s ta g e , fro m th e p a tie n t s t r i k i n g p ieces of f u r n itu r e in h is im m e d ia te v ic in ity .— N .C .F .
Treatm ent of Fractured F e m u r. F .G . ( M itc h a m ) .— A t a r e c e n t E x e r c i s e a m e m b e r of m y s q u a d h a d to a tte n d to a p a tie n t su ffe rin g fro m fra c tu re d h e a d of th e fe m u r. H e t r e a te d a s fo r f r a c tu r e of f e m u r a n d sp lin ted a cco rd in g ly . A t th e d iscu ssio n h eld a fte rw a rd s h e w a s to ld t h a t h e s h o u ld h a v e tr e a te d th e p a tie n t a s fo r f r a c tu r e of p elv is. W e w elco m e y o u r c o m m e n ts a n d d ecisio n . M y d iff ic u lty is t o a p p r e c i a t e h o w o n e a r t h a n y o n e — be h e d o c to r o r first a id e r — c o u ld m a k e s u c h a d ia g n o s is , w h ic h in fa c t c o u ld o n ly be e s ta b lis h e d b y x - r a y e x a m in a tio n . In a c tu a l c irc u m s ta n c e s a n d esp ecially u n d e r a ir ra id c o n d itio n s , a n in ju r y in th e r e g io n of th e h ip jo in t (u n le s s th e re w a s m a r k e d s h o rte n in g of lim b ) w o u ld be m o s t s u g g e s tiv e of f r a c tu r e d pelvis a n d w o u ld rig h t ly b e tr e a te d a s s u c h . — N .C .F .
Schafer, Silvester or Howard. P . M . (B o lto n ). — In th e la s t p a r a g r a p h of th e re p ly w h ic h w a s p u b lis h e d u n d e r th e a b o v e h e a d i n g in th e J u n e is su e of F ir s t A id , th e r e w o u ld s e e m to b e a ty p o g r a p h ic a l e rro r. W h i l e t h e c o n t e x t is p e r f e c t l y c l e a r y o u a r e c r e d i t e d w i t h w ritin g — “ O f co u rse you k n o w th a t a p a tie n t w h o c a n n o t b e t u r n e d on h is back ( m y i t a l i c s ) o w i n g t o a n o p e n a b d o m in a l w o u n d . . . .” I t a k e it t h a t y o u a c t u a lly w ro te — “ o n h is fa c e .” A m I rig h t ? Y e s ; a n d y o u r l e t t e r is a p p r e c i a t e d . —
N.C.F.
Fracture of Pelvis. W . P. (B risto l).— I h a v e b een r e q u e s te d by a te a m of B. R .C .S . m e m b e r s , w h o a r e t r a i n i n g f o r a c o m p e t i t i o n , t o a s k if y o u w o u ld be g o o d e n o u g h to g iv e u s a r u l i n g o n th e f o l l o w i n g p o i n t s :— Is it c o rre c t to tie th e k n o t of th e t r i a n g u l a r b a n d a g e ( w h ic h is u s e d fo r s u p p o r t i n g a f r a c t u r e d p e lv is) in f r o n t of t h e b o d y o v e r th e m u s c u l a r w a ll of th e a b d o m e n o r o n th e sid e o v e r th e p elvic b o n e ? B o th th e S t. J o h n a n d B .R .C .S . T e x tb o o k s s e e m to s u g g e s t t h e f o r m e r b u t s o m e of o u r m e m b e r s c o n te n d t h a t th e b a n d a g e s h o u ld b e t ie d o n t h e s id e , e s p e c i a l l y w h e n t h e f r a c t u r e is k n o w n to b e o n o n e s id e only. W i t h a f r a c tu r e d pelvis th e tie d off o n t h e f r o n t a n d in th e a b d o m e n , b e c a u s e th is p o sitio n u n if o r m c o n tro l of th e f r a c tu re , w h ic h c a n o n ly b e d ia g n o s e d b y
tria n g u la r b a n d a g e m u s t be m i d d l e l i n e o f t h e p a t i e n t ’s of th e k n o t p ro v id e s a m o re th e e x a c t site a n d e x te n t of x - r a y e x a m i n a t i o n . — N .C .F .
L a y Instructor Certificate. I.V . ( C a m b r id g e ) .— F r o m a re fe re n c e in th e c o lu m n s of th e J u n e issu e of F ir st A id , I u n d e r s ta n d t h a t B r ig a d e O fficers a r e t a k i n g th e e x a m in a ti o n for th e L a y I n s t r u c to r C ertificate. A s I g a t h e r th a t th is o n ly p e rm its in s tr u c tio n fo r th e p r e lim in a r y c o u rs e s of first a id , I w o n d e r w h y O fficers w h o ta k e th e certificate w a n t to s te p d o w n . I s h o u ld h a v e th o u g h t th a t th e y s h o u ld w a n t to s te p up . W h a t is t h e o b je c t of t h is c e r tific a te ? W e are g e t t i n g v a r io u s a n s w e r s b u t n o b o d y s e e m s fu lly to u n d e r stan d . Y o u r rep ly , th e re fo re , w ill b e m u c h a p p re c ia te d .
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l t w o u l d a p p e a r t h a t y o u h a v e b e e n m i s i n f o r m e d a s to th e c h a r a c te r of th e e x a m in a tio n for L a y I n s tr u c to r C ertifi cate. I t s c h ie f o b j e c t is t o e n s u r e t h a t t h e C o u n t y C o m m is s io n e r s s h a ll h a v e re a d ily a v a ila b le a list of m e n a n d w o m e n m e m b e r s of th e B r i g a d e w h o h a v e p ro v e n b y e x a m in a tio n t h a t th e y a r e efficient a n d q u a lifie d to le c tu re o n th e S h o r t C o u r s e of t h e H o m e O ffic e a n d o n t h e P r e l i m i n a r y ( b u t n o t th e A d u lt S ta n d a r d ) C o u r s e of F i r s t A id of th e S t. J o h n A m b u la n c e A sso ciatio n . I n o t h e r w o r d s , t h e p o s s e s s io n o f t h e c e r t i f i c a t e ( w h ic h is a w a r d e d o n ly t o t h o s e w h o f a c e a n d p a s s a s t i f f e x a m i n a t i o n ) is n o t a s t e p d o w n b u t r a t h e r a s t e p u p , b e c a u s e l a y in d i v i d u a l s m u s t h a v e a v e r y c o m p le t e k n o w l e d g e o f fir s t a id if t h e y a r e to l e c t u r e in t h e s e s im p lif ie d a n d a b b r e v i a t e d c o u r s e s o f fir s t a i d . — E d i t o r .
Tra nsp o rt of Fractured Spine. J . T . ( W a r r i n g t o n ) . — I r e c e n t ly g a v e a first a id t e s t w h ic h c au s e d g r e a t c o n tro v e rs y a n d w o u ld a p p re ciate y o u r o p in io n . D ia g n o s is : H is to ry from p atie n t, c lear s y m p t o m s o f a f r a c t u r e o f s p i n e i n t h o r a c i c r e g i o n , p a t i e n t ’s p o s itio n (on b a c k ) . O n c o m p le tio n of d ia g n o s i s p a tie n t la p se s in to u n c o n sc io u sn e ss. W h ic h m e th o d of tr a n s p o r t is to b e a d o p t e d ? M y r u l i n g w a s t h a t h e s h o u ld b e r e m o v e d in s u p i n e p o sitio n. C riticism from s q u a d s w a s th a t th e p ro n e p o sitio n s h o u ld b e a d o p te d a s d ia g n o s is w a s c o m p le te b efore p a tie n t b e c a m e u n co n sc io u s. M e a n w h i l e w e t h a n k y o u in a n t i c i p a t i o n of y o u r r e m a r k s a s to a b o v e p ro b le m a n d re a so n s for su c h ad o p tio n . T h e T e x tb o o k in s tru c ts y o u to s ele c t th e s u p in e p o sitio n fo r p a tie n ts w h o , s u ffe rin g fro m s p in a l in ju ries, a r e in sen sib le. I t d o e s s o b e c a u s e in s u c h c i r c u m s t a n c e s it w o u ld n o t b e p o s sib le fo r a first a id e r to m a k e a d efin ite d ia g n o s is . W hen, h o w e v e r , t h e d i a g n o s i s h a s b e e n m a d e , a s in t h e c a s e q u o te d , t h e p o s i t i o n o f p a t i e n t d u r i n g t r a n s p o r t is q u a l i f i e d b y t h e p o sitio n of th e s p in a l in ju ry . In o th e r w o rd s, I a g re e w ith th e co n te n tio n of y o u r s q u a d s th a t su ch p a tie n t sh o u ld be r e m o v e d in p ro n e p o s itio n .— N .C .F .
Stimulants w ith Internal Haem orrhage. A .B . ( N o r w i c h ) . — A s a m e m b e r of th e B . R . C . S . I w o u ld lik e t o p a y t r i b u t e to y o u r Q u e r y C o l u m n , t h e a n s w e r s in w h ich a re m o st in te re stin g a n d e d u catio n al. Now 1 w o u l d l i k e t o p r e s e n t m y p r o b l e m a n d t o a s k if w e s h o u l d g iv e s t im u la n ts to a p a tie n t s u f fe rin g fr o m in te r n a l haem orrhage. A t a re c e n t p ra c tic e o u r in s tru c to r to ld u s th a t th e a d m i n i s t r a t i o n of s t i m u l a n t s to s u c h a p a tie n t w o u ld h e lp to c o u n te ra c t s h o c k a s p a tie n t h a d a s u b n o rm a l tem p eratu re. I d isa g re e d a n d said th a t th e a d m in is tra tio n of a s t i m u l a n t w o u ld c a u s e a n in c re a s e in th e h a e m o r r h a g e b y its a c tio n o n th e h e a r t. P l e a s e tell m e w h i c h a n s w e r is t h e r i g h t o n e . Y o u r a n s w e r w a s c o rre c t.— N .C .F .
C a lc iu m Carbide Poisoning. H.
R . (S h effield ).— I h a v e h e a r d sev e ra l s u g g e s tio n s w ith r e f e re n c e to th e t r e a t m e n t of C a l c iu m C a r b id e P o is o n in g ; a n d I s h a l l b e g r a t e f u l if y o u w i l l t e l l m e t h e c o r r e c t trea tm en t.
L i t t l e is k n o w n a b o u t t h e t r e a t m e n t o f C a l c i u m C a r b i d e P o is o n in g (w h ic h m a y p ro v e fa ta l in th r e e o r fo u r h o u rs ) ex cep t th a t tre a tm e n t m u s t be im m e d ia te a n d prev en t th e p ro d u c tio n of a cety len e g a s. T h e su b ject h a s been u n d e r d is c u s s io n in th is c o lu m n d u r i n g th e p a s t te n y e a rs. T h e n e t r e s u l t of th e s e d is c u s s io n s is t h a t g ly c e r in e ( w h ic h a b s o r b s w a t e r ) is r e g a r d e d a s t h e id e a l a n tid o te fo r u s e b y first a i d e r s w h o s h o u l d a d m i n i s t e r it fre e ly . T his
R I D d o n e th e y s h o u ld ta k e s te p s to m a k e th e p a tie n t v o m it a n d so e m p ty th e sto m a ch . If g l y c e r i n e is n o t a v a i l a b l e , t h e n m e d ic in a l p araffin m ig h t be u s e d fo r th e s a m e p u rp o se , a l t h o u g h , of c o u r s e , t h i s r e m e d y is i n s o l u b l e in w a t e r a n d a lc o h o l.— N .C .F .
H um o ur in First Aid. A . H . ( C h a r l t o n ) . — A y o u n g l a d y in m y office, a n e n t h u s i a s t i c m e m b e r of th e G ir ls ’ T r a i n i n g C o rp s, h a s re c e n tly t a k e n a c o u r s e in first a id a n d h a d h e r e x a m i n a t i o n th e o t h e r day. I w a s in te r e s te d in h e r p r o g r e s s , a n d w a s o n ly too p le a se d to h e lp h e r w ith a n y d ifficulties w h ic h s h e fo u n d a s sh e p ro g re s se d w ith th e su b ject. F in ally c a m e th e e x am in atio n . O n th e fo llo w in g m o r n i n g I a s k e d h e r s o m e of th e q u e s tio n s w h ic h s h e h a d been a sk e d a n d h o w sh e h a d a n sw e re d th em . O ne rep ly I g o t w a s " A n d o h ! I h a d 1o p a t a C a ta lin a on the h ea d f o r the p r a c tic a l test. ” Good !
N e x t, p le a s e !
1— N . C . F .
Th re e -M a n or Three-Blanket D rill. F .C . (C ro y d o n ).— C a n y ou p le a se g iv e a n y in fo rm a tio n re s p e c tin g th e T h r e e - B la n k e t M e th o d u s e d for r e s u s c ita t i o n i n c o n n e c t i o n w i t h S c h a f e r ’s m e t h o d o f a r t i f i c i a l resp iratio n ? T h i s q u e r y h a s b e e n p u t to C ivil D e fe n c e w o r k e r s re c e n tly ; b u t n o o n e s e e m s to h a v e h e a r d a b o u t it. A s t h e m e t h o d is b e i n g i n c o r p o r a t e d in a f o r t h c o m i n g t e s t , i n t e r e s t e d p e r s o n s feel h a n d i c a p p e d . So we s e e k y o u r k i n d help . A s I k n o w n o th in g a b o u t a T h re e -B la n k e t m eth o d 1 p a s s e d y o u r q u e r y to C a p t a in A l w j n B isc o e of th e R o y a l L ife S a v i n g S o c ie ty to w h o m w e a r e in d e b te d fo r th e f o llo w in g e x p l a n a t i o n :— “ W h i l s t a T h r e e - B l a n k e t m e t h o d is u n k n o w n t o m e a l s o , I t h i n k t h a t y o u r c o r r e s p o n d e n t is c o n f u s i n g t h i s w i t h o u r T h r e e - M a n D rill fo r b la n k e tin g p a tie n t. C o v erin g p a tie n t a n d so m a i n t a i n i n g t h e b o d y h e a t is a m o s t i m p o r t a n t p a r t o f S c h a f e r ’s m e t h o d o f a r t i f i c i a l r e s p i r a t i o n . A t th e o u t s e t, t h e r e f o r e , it is d e s i r a b l e t o la y t h e p a t i e n t o n a b l a n k e t p ro v id in g th a t th is do es n o t en ta il delay. T h e R .L .S .S . a d v o c a te a T h r e e - M a n D rill for p r a c tis in g th is c o v e r in g w ith b la n k ets. F o r d e t a i l s s e e p a g e s 28 a n d 56 o f t h e S o c i e t y ’s b o o k l e t A r t ific ia l R e sp ir a tio n , are you p r e p a r e d ? " - — N . C . F .
Aggravation of Fractured Patella. O.
M . ( E a s t H a m ) . — W e s h a l l b e g r a t e f u l if y o u w ill k i n d l y ex p lain h o w a fra c tu re of p atella m a y be a g g r a v a te d by m o v e m e n t of p a tie n t.
T h e s t r o n g m u s c le s o n th e a n te r io r a s p e c t of th e th i g h in th e ir lo w e r p a r t s p r e a d o u t in to a s h e a th of fib ro u s tis su e w h i c h e n c a s e s t h e p a t e l l a a n d is a t t a c h e d to t h e h e a d of t h e tib ia . W h e n t h e p a t e l l a is b r o k e n , t h i s s h e a t h w ill k e e p t h e f r a g m e n t s t o g e t h e r ; a n d t h e d a n g e r o f a g g r a v a t i o n ( t h a t is, s e p a r a t i o n of t h e f r a g m e n t s ) re s ts , n o t b n s id e - to - s id e m o v e m e n t s a s w i t h f r a c tu r e s of t h i g h a n d le g , b u t o n flex io n of th e k n e e -jo in t w h ic h th e p a tie n t m a y a tte m p t, a l t h o u g h h is l i m b is m o r e o r le s s h e lp le s s . T o g u a r d a g a i n s t th is, w e k e e p th e lo w e r lim b fu lly e x te n d e d o n a s p lin t a n d ra is e d , a n d w e e l e v a t e t h e p a t i e n t ’s h e a d a n d s h o u l d e r s . — N . C . F .
44 FIRST A I D ” QUERY and REPLIES COUPON. To be cut out and enclosed with a ll Queries. Aug., 1943.
JOHN BALE MEDICAL PUBLICATIONS MANUALS OF FIRST AID. By N. CORBET FLETCHER, M.B., B.C., M.A.(Cantab.), M.R.C.S. A ID S
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“ C o l . S i r Jam es C a n tlie con tributes a n in tro d u ctio n a n d w e en dorse n is good opinion o f th e book ." — L a n c e t ,
A ID S
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H o m e -N u r s in g S im p lifie d a n d T a b u la te d , w it h A id s t o M e m o r y .
FIR ST
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■' T h is book pivcs a c le a re r in sig h t in to th e m ethods a n d d iffic u ltie s o, em ergency tr e a tm e n t by laym en th a n th e o ffic ia l T e xtb o o k itse lf.
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INTRODUCTION TO FIRST AID
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By A. E. JOHN SO N. P O IS O N G A S.
A c o m p l e t e f o l d e r o n t h e d e t e c t i o n , e f f e c ts a n d t r e a t m e n t of g a s w ith c h a r t a n d a d v ic e o n d rill a n d p a r t i c u l a r s of d e c o n t a m in a tio n a n d c a r e of re s p ira to r. In va lu a b le ! and the m ost co m p re h e n sive lit t le fo ld e r b eing sold .
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S O N S
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FIR ST
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FIRST AID ‘SETtjc Jnitepettfoml J o u r n a l / o r tlje A m b u la n c e a u 6 p u r s i n g ^ m rt e fc s f r
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By Lt.-Com. F. A. M. E D E N , R.N. 2s„ by post 2s. 2d. Instructor, Ministry o f Home Security School, Y o rk CIVIL
DEFENCE: •
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TRAINING
E D I T I O N
MANUAL
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“ It not only brings together under one cover the information contained in five or six handbooks, but it includes also details difficult to get at present other than from a visit to a Home Security School.”— British Red Cross Society, County of London Bulletin.
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O n e o r o t h e r o r a ll o f t h e t h r e e r a c e s o f g e r m s , S t r e p t o c o c c i , S t a p h y l o c o c c i a n d B . p y o c y a n e u s a r e f o u n d in e v e r y s k i n i n f e c t i o n c o m m o n t o t h i s c o u n t r y , a n d A N T I P E O L O I N T M E N T c o n t a i n s t h e antibodies ( a n t i v i r u s ) o f t h e s e g e r m s . H e a l i n g is e x p e d i t e d b y t h e p r o v e d i n g r e d i e n t s o f t h e o i n t m e n t , a n d s e p t i c d e v e l o p m e n t is s t o p p e d o r p r e v e n t e d b y it s a n t i v i r u s s t e r i l e v a c c i n e f i l t r a t e s . A N T IP E O L O I N T M E N T is u n s u r p a s s e d f o r B U R N S a n d S C A L D S , f o r i t is m i c r o b i c i d e a n d n o n - a d h e s i v e , a n d d r e s s i n g s d o n o t r e q u i r e t o b e c h a n g e d every day. W O U N D S , B U R N S , e t c , W I L L N O T T U R N S E P T I C if tre a te d w ith A N T I P E O L O I N T M E N T .
O P H T H A L M O - A N T I P E O L is a s e m i - f l u i d o i n t m e n t , m o r e c o n v e n i e n t t h a n t h e o r d i n a r y A n t i p e o l o i n t m e n t f o r o c u l a r i n f e c t i o n s a n d l e s i o n s . E y e s a ff e c te d b y s m o k e an d d u s t are s o o th ed a lm o s t im m ed iately b y th e applicatio n o f O p h th a lm o -A n tip e o l, a n d the an tiv iru s p re v e n ts g e r m s f r o m developing.
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etc.) W rite for leaflet “ Prompt First-Aid Treatm ent o f Asphyxia and ^ other R espiratoryfailu re Em ergencies.” Sole M akers: S P A R K L E T S L T D . D ep t. 42, L O N D O N , N .10
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F IR S T J n A t p t n i c n !
A ID J o n r r a l j b r
He A m b u lance and SH ursing g e r u t o s Editor : WALTER
No.
5 9 1 .—
V o l.
is p u b lis h e d
TO on
a o th o f each m onth. 3d.
th e
The
s u g g e s t io n s fo r P r a c t i c a l P a p e r s . & c .,
s h o u ld
be
ad d ressed
to
a d d r e s s b e l o w , a n d s h o u l d r e a c h h im b e f o r e t h e a n d m u s t b e a c c o m p a n ie d (not necessarily for
th e
8th
E d ito r o f each
publication)
at
th e
“ O '1* , b y th e
n am e an d ad d ress o f th e C o rre s p o n d e n t.
SubscriDtions, A d vertisem ents and other business Com m unications connected w ith F I R S T A I D should be forw arded to the Publishers. D A LE,
R EYN O LD S
&
46, C a n n o n
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“
C o .,
L t d .,
S t r k e t , L o n d o n , E .C .4 .
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Telephone— City 3710.
C O N TEN TS
OF
TH IS
N UM BER.
25
F irst-A id In s tru c to rs R e s u s c i t a t i o n b y R o c k i n g : A d a p t a t i o n f o r F i r s t A id
26
L e tte rs to th e E d ito r
27
...
S .J.A .B . H e a d q u a rte rs a n d D is tric t R e p o rts
27
S u g a r D ia b e te s (D ia b e te s M ellitu s)
29
R .l.P .
29
R ailw ay A m b u la n c e N ew s
30
T h e H o m e G u a r d a n d F ir s t A id
30
R eview s
32
Q u e r ie s
and
A n sw ers
to
C o rresp o n d f
r s :—
S tra in s a n d R u p tu r e d M u sc le s
34
E x am in a tio n H o w ler
34
F r a c t u r e s of C l a v ic le a n d H u m e r u s
34
S ig n s a n d S y m p to m s of S h o c k
34
F ix a tio n of F r a c tu r e d P a te lla
34
A lco h o l a s D is in f e c ta n t
34
U s e s of W itc h H a z e l
EnU ndat 1 \_Stationtrs' H a l l \ r
. .
34
H u m o u r in F i r s t A id
34
S tre tc h e r D rill
36
F r a c t u r e s of P e lv is a n d F e m u r
36
T r a n s p o r t ef F r a c tu r e d
36
S p in e
PRIC E [4 /- P e r
THREEPENCE
A n n u m , P o st
F ree
EDITORIAL.
I t s a im a n d o b je c t b e in g th e a d v a n c e m e n t o f A m b u la n c e W o r k in a l l it s b r a n c h e s , t h e E d i t o r i n v i t e s R e a d e r s t o s e n d A r t i c l e s a n d R e p o r t s o n s u b j e c t s p e r t a i n in g t o t h e M o v e m e n t a n d a l s o w e l c o m e s R e p o rts,
F.R.S.A.
R EADER S.
A n n u a l S u b s c r i p t i o n is 4 s . p o s t f r e e ; s i n g l e c o p i e s
A ll
F.R.San.l.,
SE PT E M B E R , 1943.
L.
N O T IC E F IR S T AID
SCOTT,
N o se B le ed in g
36
F i r s t A id a n d D r u g s
36
I n the consideration of any matter to which importance may be attached, it is difficult, when space is limited to one column of a newspaper, fully to set out all the points involved. There exists always the danger of misunderstand ing, and this seems to be the case in connection with the editorial entitled “ Instructors in First A id,” which appeared in our August issue. In this we emphasised the need that existed for more widespread instruction in first aid, and we did go so far as to say that, in the case of industrial acci dents, there were, in every well-appointed factory or works, those who were competent to deal with them in their early stages. There could have been nothing in that to suggest that medical aid was un necessary, the use of the words “ early sta g e s” suggesting precisely the opposite. On the question of instructors, our sole point was that there were not sufficient competent persons to go round, and it was necessary that many more should be trained. As to the training of instructors that would of course be in the hands of the doctors, and in their hands alone. That such is the case is undeniable, and nothing we adduced in our statements pointed to any desire to oust the medical man. Not only must instructors be inclose touch with the doctors, but they must carry out their wishes in every way and must hand their “ patients” over to them immediately they arrive. Any instructor who neglects to do this is not only treading on danger ous ground but subverting the most elementary of the principles on which first aid is based. As to our remark that the most erudite persons are not necessarily the best of teachers, surely there is no need to labour a point which is commonly accepted in every profession, and cannot be construed into an incitement to the appointment of laymen for instructional purposes. It is one of those remarks of universal application into which those who are so minded may read anything. At the present time, there is a shortage of doctors for every class of work, and none can foresee what is going to happen if bureaucracy is to win the day, and the medical becomes a State service, under the immediate control of W hitehall. That is a matter, First-A id In stru ctors,
t
26
IXtSf
however, with which we shall be dealing later, when the actual occasion arises. We trust that we have made our position clear, and that readers will understand that we realise to the full, and have always realised, that instruction in first aid must be left entirely in the hands of the medical profession.
R e s u s c it a tio n b y R o c k i n g : A d a p t a t io n f o r F i r s t Aid.
ir ,—
n o e x p e n s e in c u rre d in c o n v e r tin g A rm y ty p e s tre tc h e r s in to ro c k in g stretch ers. W e h a v e trie d it o u t in p r a c tic e a n d w e t h i n k t h a t it w o r k s . I t m a y b e o p e n t o s o m e g r a v e c r i t i c i s m — if s o , it c a n b e e a s i l y s c r a p p e d . W e c l a i m n o p a t e n t r i g h t s , b u t , if a c c e p t a b l e , i t m i g h t p e r h a p s b e k n o w n a s t h e “ K irk c o n n e l” a d ap tatio n .
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F ig .
W e h a v e r e c e i v e d p e r m i s s i o n f r o m t h e E d i t o r o f t h e B r itis h M e d ic a l J o u r n a l t o p u b l i s h t h e f o l l o w i n g l e t t e r f r o m D r . B o w m a n E d g a r , w h ic h a p p e a re d in th e B .M .J for J u ly 24 t h , 1943 : — S
A I D
I t it s e e m s o u l y f a i r t h a t t h e m e n w h o h a v e w o r k e d fo r a f o r w a r d s te p in first a id s h o u ld b e k n o w n ; th e ir n a m e s a r e S e r g ts . A. M c A n e s p ie a n d J. T o r r a n c e , a n d C o rp l. D . H a s tin g s of th is b a tta lio n , a lo n g w ith M r. R o b e r t M c C o r m ic k , C iv il D e f e n c e F i r s t A id P o s t C o n tr o lle r , U p p e r N i t h s d a le . T h e s k e tc h of th e g a d g e t h a s b e e n m a d e b y L ie u t. G . B ro a d fo o t, K e llo h o lm . — I a m , e tc .,
-
D r . N . H o w a r d M u m m e r y ’s r o c k i n g a p p a r a t u s f o r E v e ’s m e t h o d o f r e s u s c i t a t i o n ( J u n e 19 , p . 759 ) w o u l d a p p e a r t o b e e x c e lle n t for, a s h e say s, r e s c u e s ta tio n s , a lso sh ip s, h o s p ita ls , etc. I t is, h o w e v e r , n o t p a r t i c u l a r l y s u i t a b l e a s a p o r ta b le a d j u n c t to first a id . T h e N . C . O . ’s o f t h e m e d i c a l s e c t i o n o f t h i s b a t t a l i o n , a l o n g w i t h t h e d i r e c t o r of t h e C iv il D e f e n c e f i r s t - a i d p o s t s in th e d is tric t, h a v e g iv e n s o m e tim e to th e s tu d y of th e p o s s i b ility of a p p l y i n g t h is r o c k i n g m e t h o d to first aid . They b e lie v e it to be, fr o m w h a t th e y h a v e re a d o n th e su b je c t, th e m o s t efficient m e th o d y e t k n o w n . T h e t e c h n i q u e is e a s y to lea rn . I t is m u c h le ss a r d u o u s a n d m o r e fo o lp ro o f t h a n a n y p re v io u s f o r m of artificia l re s p ir a tio n , a n d , o n c e it h a s b e e n s e t in m o tio n , it c a n b e c a r r ie d o n b y q u ite u n t r a in e d p e rso n n el. F o r th e s e r e a s o n s it w o u ld a p p e a r to b e th e m e th o d of c h o ice.
H ol e s drilled . c o u n t e r s u n k to f it I" Screw Neils
\'U
F ig .
1.
T o ta k e th e p lace of th e r a th e r c u m b e rs o m e a p p a r a tu s d e s c rib e d b y D r. H o w a r d M u m m e r y w e a r e h a v i n g a little “ g a d g e t , ” of w h i c h I e n c l o s e a s k e t c h , a t t a c h e d to all o u r s tre tc h e rs of th e A rm y ty p e — a p a ir to e a c h s tre tc h e r. I t is, in e s s e n c e , m e r e l y a g r i p to s lip o v e r a n y a v a i l a b l e pole, h a y f o r k h a n d le , fen ce, ro p e , p a lin g , e tc ., so t h a t th e r o c k i n g of th e s tr e tc h e r m a y b e c a r r ie d o n. The gadget is of t h e “ la z y -b lo c k ” p a tte r n , a n d h a s b e e n m a d e fo r m e b y M r. R o b t. C o lq u h o u n , c h ief e n g in e e r of M e s srs. B aird a n d D a l m e l l i n g t o n ’s F a u l d h e a d C o l l i e r i e s . It c o n sis ts of a b a s e p l a t e w h i c h is f i x e d t o t h e c e n t r e o f e a c h s t r e t c h e r p o l e b y fo u r s c r e w n ails. F r o m th e p late a ris e s a n a tta c h m e n t f o r f i t t i n g o v e r t h e p o l e , b a r , e t c . , o n w h i c h t h e r o c k i n g is to be d o n e . I t is e a s y to m a k e , a n d t h e r e s h o u ld b e little o r
2.
B ow m an
E dgar,
M .O ., 4th B a ttn ., D u m frie s h ire , H .G . K irk co n n el, D u m friesh ire. [S in ce p u b lic a tio n sh o w n th a t th e g a d g e t wood. T h is h a s th e m o re e asily o b ta in e d , w o o d w o r k in s t i n c t s , it
of th e a b o v e, f u r th e r e x p e r im e n t h a s c a n b e e q u a l l y w e ll m a d e o u t of h a r d a d v a n t a g e o v e r stee l of b e in g m u c h it c a n b e f a s h io n e d by a n y o n e w ith is c h e a p e r , l i g h t e r , a n d , w e b e l i e v e
w ill p ro v e e q u a lly e fficient.]
D r . B o w m a n E d g a r s e n d s u s t h e f o l l o w i n g n o t e s :— S u g g e ste d
T e c h n iq u e
fo r
F ir s t
A id
T eam s.
T h e fo llo w in g a re th e s te p s w h ic h m ig h t b e fo llo w ed b y a n y F i r s t A i d T e a m o f f o u r i n a p p l y i n g E v e ’s m e t h o d :— T h e p a t i e n t , h a v i n g b e e n r e m o v e d f r o m t h e c a u s e of t h e a s p h y x i a , S c h a f e r i s c o m m e n c e d i n s t a n t l y b y N o . 3 a n d is a p p l i e d f r o m the sid e o f t h e p a t i e n t o p p o s i t e t o t h e p r o p o s e d f u lc r u m , i.e ., th e pole, ro p e , fe n c e, e tc ., o n w h ic h th e a c t u a l r o c k i n g is t o b e p e r f o r m e d . S p a c e f o r t h e o p e n s t r e t c h e r is le ft o n t h e g r o u n d b e tw een th e c asu a lty a n d th e fu lcru m . T h e p a t i e n t ’s h e a d , t u r n e d to t h e sid e, re s ts o n t h e u p p e r of h is t w o f o r e a r m s , w h ic h a r e fo ld ed o n e o n to p of Ih e o th e r. W h i l e S c h a f e r is b e i n g c a r r ie d o n , N o s. 1 a n d 2 p r e p a re th e s tr e tc h e r w ith b la n k e ts a n d p la c e it in p o s itio n a s above. N o . 4 is, i n t h e m e a n t i m e , l o o p i n g b a n d a g e s ( r o p e s , s t r a p s , e t c .) r o u n d t h e e l b o w s a n d a n k l e s of t h e u n c o n s c i o u s m an. T h is b e in g d o n e , h e p re p a re s to g r a s p th e p a tie n t a b o v e th e k n e e s , fro m th e s a m e sid e a s N o. 3 . T h e o th e r t w o m e m b e r s o f t h e t e a m (1 a n d 2 ) , n o w a t e i t h e r s i d e o f th e h ead , g ra s p th e su p erim p o se d fo rea rm s w ith o n e h a n d a n d p l a c e t h e o t h e r u n d e r t h e i n j u r e d m a n ’s c h e s t . B o th fo re a rm s a re to b e s u p p o rte d so th a t th e y m a y n o t be d is p la c e d a n d s o a llo w t h e h e a d to fa ll f o r w a r d . W h e n a ll is r e a d y , a n d j u s t a s t h e o p e r a t o r c o m p le t e s t h e p r e s s u r e s t r o k e , t h e o r d e r to “ l i f t ” is g i v e n . The o p e r a to r s lip s h is tw o h a n d s u n d e r t h e a b d o m e n a n d pelvis, a n d , a ll li f t i n g t o g e t h e r , t h e p a t i e n t is s m a r t l y t r a n s f e r r e d to th e stretch er. N o. 3 a t o n ce b r in g s h is h a n d s b a c k to th e S c h a fe r p o sitio n a n d re s u m e s th e a rtificial re s p ira tio n . If th e m o v e m e n t h a s b e e n “ slic k ly p e r f o r m e d ,” p ra c tic a lly n o loss of r h y t h m s h o u ld o c cu r. N o s. 1 a n d 2 n o w firm ly b in d th e e lb o w s to th e s tr e tc h e r h a n d le s w h ile N o. 4 d o es th e s a m e to th e a n k le s. A s s o o n a s th e s e a r e s e c u re d , a n d a t th e e n d of th e S c h a f e r p r e s s u r e s t r o k e , t h e s t r e t c h e r is s m a r t l y lif te d o n to t h e f u l c r u m b y 1 a n d 2 a t t h e h e a d a n d 4 a t t h e feet. N o. 3 , a fte r re m o v in g h is h a n d s fro m th e p a tie n t, m a k e s s u r e t h a t t h e a d a p t a t i o n d e s c r i b e d a b o v e fits s n u g l y o v e r th e fu lcru m .
F I R S T I n c i d e n t a l l y , it m a y b e m e n t i o n e d t h a t a n u n e x p e c t e d t i m in g te s t b y a s p e c ta to r (C o lo n el, R .A . M .C . ) g a v e th e t i m e f r o m t h e d e c k t o f i r s t “ r o c k ” a s 37 s e c s . , ^ w i t h o u t a n y loss of S c h a f e r r h y th m . W ith p ra c tic e th is tim e could be c u t w i t h o u t a n y difficulty. T h e f o llo w in g f u r t h e r p r o c e d u r e is t a k e n f r o m th e e x c e l l e n t d e s c r i p t i o n o f E v e ’s M e t h o d b y S u r g . - L i e u t . G . H . G i b b e n s , R . N . V . R . ( B . M .J . , 26 / 12 / 4 2 , 751 ). H e says “ A n y a v a ila b le m a n s ta r ts to ro c k th e s tre tc h e r a t t h e r a t e o f a c y c l e e v e r y 4 o r 5 s e c s . , t h a t i s , 12 t o 15 d o u b le ro c k s p e r m in . T h e p u m p in g m o v e m e n t sh o u ld be starte d ab ru p tly , a lm o st ro u g h ly , so th a t th e a b d o m in a l c o n te n ts b e g in to m o v e e a r ly in th e s tro k e , At first t h e h a n d l e s of t h e s t r e t c h e r s h o u l d b e a l l o w e d to rest on th e d e ck a t th e en d of th e h e a d d o w n stro k e, t h e s t e e p a n g l e o f 50 d e g r e e s g i v i n g v e r y e f f i c i e n t c h e s t d ra in a g e . L a t e r , it is e a s i e r t o c h e c k t h e h a n d l e s a t a f o o t f r o m t h e d e c k , t h i s s l o p e o f 30 d e g r e e s i s e f f i c i e n t a n d is le s s w o r k f o r t h e o p e r a t o r . W h e n r o c k i n g is i n p r o g r e s s , t h e m a n ’s c l o t h e s m a y b e r e m o v e d , h e m a y be g e n tly ru b b e d d o w n , a n d effo rts m a d e to w a r m h im u p .”
Letters to the Editor. W e a re in n o w a y re sp o n sib le fo r th e o p in io n s e x p re sse d , or th e s ta t e m e n ts m a d e , b y C o rre s p o n d e n ts .— E d ito r .
H IS T O R Y
O F
T H E
O RD ER.
D e a r S ir , — I n t h e A u g u s t i s s u e o f F i r s t A i d , t h e r e is a n e x c e l l e n t article by D r. C o rb et F le tc h e r on th e F u tu r e o f th e S .J .A .B ., in w h ic h h e s a y s t h a t n e w ly e n r o l le d m e m b e r s s h o u l d b e to ld s o m e t h i n g a b o u t t h e w o n d e r f u l h i s t o r y of t h e O r d e r . I s it p o s s ib le to r e a d a b o u t t h i s w o n d e r f u l h i s t o r y ? I b e lie v e t h e r e a r e l a r g e v o l u m e s o n t h e s u b j e c t , b u t is t h e r e a n y t h i n g in a c o n c is e a n d b rie f f o r m ?— Y o u r s fa ith f u lly , D o n a ld
G.
S au n d ers.
[ O u r c o r r e s p o n d e n t w ill fin d t h e h i s to r y of t h e S . J . A . B . s e t o u t in “ T h e S t. J o h n A m b u l a n c e A s s o c ia tio n : I ts H is to r y a n d I t s P a r t in th e A m b u la n c e M o v e m e n t ” b y D r. N . C o r b e t F l e t c h e r , p r i c e 3 s. 6 d . , w h i c h i s a d v e r t i s e d i n F i r s t A id .— E d it o r .] TRA N SFERRED
TO
T H E
RESCU E
SQUADS
D e a r S ir ,— S in c e t h e t r a n s f e r o f F . A . P . m e n to t h e R e s c u e S q u a d s , th e re n a tu r a lly h a s b e e n m u c h d is c u s s io n a n d c ritic is m in c o n n ec tio n w ith th e m a tte r, b e tw e e n th e m e n c o n ce rn e d . I th e re fo re d e c id e d to w r ite to t h e officers of t h e S . J . A .B . a n d th e B .R .C .S . s ta tin g th ese g rie v a n c e s, h o p in g th a t so m e jo in t a c tio n w o u ld be ta k e n to re m e d y th e p o sitio n . H o w e v e r , I h a v e s i n c e r e c e iv e d m y A u g u s t c o p y o f F i r s t A id , a n d w a s p le a s e d t o n o t ic e t h a t o u r a t t i t u d e is n o t c o n fin e d to t h is d i s t r i c t . I a m r e fe r r in g , o f c o u r s e , to th e le t t e r s i g n e d “ 1910 . ” I n s u p p o r t of th is, I e n c lo se a co p y of th e le tte r w h ic h I h a v e s e n t to t h e lo c a l B r i g a d e o fficers, a n d w h i c h I h o p e y o u w ill p rin t, b e c a u s e , a f te r a ll, w e s h a ll, a s D r. C o r b e t F le tc h e r sa y s in h is a rtic le , b e w a n te d a f te r th e w a r. (W e a re w a n ted n o w , of c o u rs e , fo r th e w o r k s h o p , p u b lic d u tie s , s e ll in g flag s, e t c . , b u t n ot if t h e r e i s a n a i r r a i d . ) H o w , then, c an w e h o n e s t l y a p p r o a c h t h e p u b l i c f o r s u p p o r t , if t h e y d o n o t s e e u s in a c t io n a s first a i d e r s in th e s e t r y i n g d a y s ?— Y o u r s faith fu lly , S g t.
A.
L y c e tt.
C rew e. [W e re g re t th a t o w in g to p re s s u re o n sp ac e , w e c a n n o t p u b lish th e le tte r m e n tio n e d by o u r c o rre s p o n d e n t ab o v e. — E d ito r .]
R I D
S t . J o h n A m b u l a n c e B r ig a d e HEADQUARTERS AND DISTRICT REPORTS. No. I (Prince of Wales’s) District 2 5 t h ( F i n c h l e y a n d S o u t h g a t e ) C a d e t D iv is io n .— W h e n th e E a s t B a r n e t N u r s in g D iv isio n re c e n tly h e ld a m e e tin g fo r p o te n tia l c a d e ts a n d th e ir p a re n ts , e ig h te e n c a d e ts fro m th e a b o v e D iv is io n w e r e in v ite d to g iv e d e m o n stratio n s. I n tr o d u c e d b y D / O S. H . C o llin s a n d C / D / O M is s K . C le a s b y , t h e g i r l s p e r f o r m e d r e s u s c i t a t i o n d rill, tr e a t e d a first a id case, sh o w e d h o m e n u rs in g b a n d a g in g , b a th e d th e baby, tr e a t e d in f a n tile c o n v u ls io n s a n d d id s q u a d d rill. T e a a n d c a k e s w e re th e s ig n a l for a “ g e t- to g e th e r ” a n d th e F in c h le y a n d S o u th g a te cad ets, m u c h to th e ir d elig h t, w e re lite ra lly b o m b a rd e d w ith “ w h y s ” a n d “ w h e re fo re s .” D u rin g th e ev en in g , C ad e t S g t. E d n a S a y w a s p re sen te d w ith h e r G ra n d P rio r B ad g e . T h e s p o n s o r s a r e w i s h e d e v e r y s u c c e s s , a n d it is h o p e d to see a flo u r is h in g C a d e t D iv is io n in E a s t B a r n e t in th e n e a r fu tu re
County of Hampshire. I s le o f W ig h t A r e a .— T h e a n n u a l d is tr ib u tio n of a w a r d s to m e m b e rs of th e R y d e A m b u la n c e D iv isio n to o k p la c e in th e T o w n H a ll re c e n tly , a n d a ttr a c te d a g o o d a tten d an ce. T h i s w a s th e first tim e th is D iv is io n , t h e R a ilw a y m e n ’s D i v i s i o n a n d t h e C a d e t A m b u l a n c e C o r p s h a d c o m b in e d u n d e r th e n e w S u p t ., M r. A. M a y b u r y . A pre s e n ta tio n w a s m a d e to M r. G W . S lo a c o m b e , th e la te S u p t., w h o recen tly retired a fter m a n y y e a r s ’ activ e a n d e n th u sia s tic service. T h e M ay o r p resid ed a t th e d istrib u tio n , s u p p o rte d by th e M ay o ress (M rs. W ee k s) a n d o th e r n o tab le p erso n s. The M a y o r s a id it w a s v e ry p le a s in g to b e a s s o c ia t e d w ith th e th re e d iv isio n s a t t h a t jo in t m e e tin g . H e p a i d t r i b u t e to S u p t . S l o a c o m b e ’s l o n g a n d d e v o t e d s e r v i c e , a n d s a i d t h e y w e re very p leased th a t S u p t. M a y b u ry h a d u n d e r ta k e n th e w o rk , w h ic h h e h o p e d w o u ld lo n g c o n tin u e to h a v e th e s u p p o r t it m e r ite d fr o m m a n y fr ie n d s b o th in w a r a n d p e ac e . A d d re s s e s o n th e h is to r y of th e B r i g a d e b y D r. C a r p e n te r, a n d its w o r k in c o n n e c tio n w ith th e r a ilw a y s b y M r. G a r d e n e r w e r e lis te n e d to w ith g r e a t in te re s t. T h e M a y o r p re s e n te d D r. C a r p e n t e r w ith a W a r r a n t of A p p o in tm en t, a n d th ere w ere a b o u t 70 o th e r a w a rd s.
County of Lancashire. T h o r n to n C le v e le y s .— T h is D iv isio n , w h ic h h a s b e en in e x is te n c e fo r 20 y e a r s , h a s b e e n m a k i n g r a t h e r s lo w b u t sure pro gress. B e f o r e t h e w’a r a n o p t i o n o n a p l o t o f l a n d w a s s e c u re d a n d a w o o d e n h e a d q u a r te r s b u ilt. T h is served its p u r p o s e fo r a tim e , w h e n it w a s fo u n d i n a d e q u a t e fo r th e D i v i s i o n ’s r e q u i r e m e n t s , c o n s e q u e n t l y , t h e S o c i a l C o m m i t t e e , u n d e r A m b . O fficer A. H o u ld s w o r th , la s t y e a r s e t o u t to ra is e m o n e y to b u y o th e r la n d in p r e p a r a t i o n fo r b u ild in g a p e r m a n e n t a n d m o re s u ita b le h o m e fo r th e D iv isio n . L a s t y e a r £50 w a s ra ise d , a n d th is y ear, u p to A u g u s t 1s t , a f u r t h e r s u m o f £ 7 0 h a s b e e n r a i s e d . W i t h t h i s s u m a p lo t of l a n d h a s b e e n p u r c h a s e d , a n d th e c o m m itte e h a v e d e c id e d to h o ld a s e r ie s of d a n c e s a n d o th e r fo r m s of a m u s e m e n t in a f u r t h e r e n d e a v o u r to r a is e fu n d s . A m o d e rn W a ltz c o m p e titio n w a s h e ld re c e n tly in th e local P u b lic L e c tu re H a ll. F o r th is th e h all w a s p a ck e d , n o t o n ly b y local m e m b e r s b u t w ith d a n c e r s fro m a w id e a re a aro u n d . A g o o d n u m b e r of S e rv ic e m e n a t t e n d e d to s u p p o rt th e V ic e -P re s id e n t, C o u n c illo r A. J. K eisb y . M rs. M c K i n l e y , t h e S u p e r i n t e n d e n t ’s w i f e , g a v e t h e p r i z e f o r
28
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d a n c i n g a n d a ls o s p o t p rizes. T h e e v e n i n g e n d e d w ith all v o t i n g t h a t it w a s t h e b e s t d a n c e e v e r h e ld in t h e d is tr ic t.
County of Stafford. T ip to n and D is tr ic t C o r p s .— H i g h - r a n k i n g la d y officers of th e S ta f f o r d s h ir e o r g a n i s a t i o n , in c l u d i n g th e C o u n te s s of D a r t m o u t h (V ice-P resid e n t), B re n d a Lady H ic k m a n , a n d M rs. D u d s o n (L a d y S u p t.), v isited th e M .E .C . s p o rts g r o u n d , O c k e r H ill, on S a tu rd a y , A u g u s t 21 st, o n th e o c c a s io n of th e s e c o n d a n n u a l p a r a d e , in s p e c tio n a n d p r e s e n ta tio n of m e d a ls a n d tr o p h ie s in c o n n e c tio n w ith th e T ip to n a n d D is tric t C orps. M e m b e rs of th e v ario u s a m b u la n c e , n u rs in g a n d cad et d iv is io n s p a r a d e d in f r o n t of th e p a v ilio n , a n d w e re in sp ec te d b y th e C o u n ty O fficers, w h o w e re c o n d u c te d a lo n g th e r a n k s by C o rp s S u p t. E . D a k in . A n a d d r e s s of w e lc o m e w a s g iv e n b y M r. C h a s . H e a th c o c k ( P r e s i d e n t of th e C o rp s). L a d y D a rtm o u th p re sen te d th e m e d a ls a n d tro p h ies w o n in t h e v a r io u s C o r p s c o m p e titi o n , h a v i n g a s m ile , a w o r d of c o n g r a t u l a t i o n , a n d a h a n d s h a k e fo r e a c h of th e recip ien ts. S h e su b se q u e n tly a d d re sse d th e a ssem b ly , an d co n c lu d ed by s a y in g sh e w a s s u re th e y w e re very g ra te fu l fo r all t h a t h a d b e en d o n e fo r th e m b y M r. H e a t h c o c k a n d h is late b ro th er. S u b s e q u e n tl y m e m b e r s of th e C o rp s a n d th e ir fr ie n d s e n jo y e d t h e a m e n itie s of th e s p o rts g r o u n d . A w h is t d riv e w a s h e ld in t h e M .E .C . c a n t e e n , a n d a d a n c e in th e s p o rts p a v ilio n .
County of Worcester. B r ie r le y H i ll.— N o t c o n te n t w ith p e rfo rm in g th e h attric k , B rie rle y H ill D iv is io n s of th e S .J .A .B . h a v e w o n a f o u r t h c o u n t y final in W o r c e s t e r s h i r e . T h is w a s fo r th e “ C h ris to p h e r D a r b y ” S h ield , a h a n d s o m e tro p h y g iv e n by th e la te D r. D a r b y , of L y e , w h o fo r a n u m b e r of y e a r s w a s a c o u n ty s u r g e o n in th e B r ig a d e . T h e fin a l o n S a t u r d a y , A u g u s t 28th , w a s a t th e B a x t e r C hurch R o o m , B u ll R in g , K id d e rm in s te r. It w as an in d iv id u a l c o m p e titio n , a n d h a d n o t b e e n h e ld sin ce th e w ar, b u t in a c c o r d a n c e w i t h t h e d e c is io n t a k e n to r e - c o m m e n c e c o m p e t i t i o n s t h i s y e a r i t w a s d e c i d e d t o h o l d it. A la rg e c r o w d of s p e c ta to r s in c lu d e d m a n y B r i g a d e O fficers. A t th e co n clu sio n of th e c o m p e titio n , te a w a s serv ed by m e m b e r s of K id d e r m in s te r N u r s i n g D iv isio n , a n d a fte r th e in te rv a l L a d y C o u n ty O fficer D r. M rs. P o r te r a n n o u n c e d th e r e s u l t s a s f o l l o w s :— S g t . P h i l p o t t , p r a c t i c a l t e s t 78 £ m a r k s , o r a l t e s t s 77 m a r k s , t o t a l 155 £ ; S g t . N o r t h w o o d , 70 , 76 , 146 ; b o t h o f B rie rle y H ill D iv isio n ( r e p r e s e n tin g th e n o r th of th e c o u n ty ) ; L a d y A / O W i s d o n ( D r o i t w i c h ) , 54 £ , 70 , 124 J ; C p l . C r o s s ( K i d d e r m i n s t e r D i v i s i o n ) , 33 £ , 59 , 92 £ ( r e p r e s e n t i n g t h e s o u th of th e c o u n ty ). A t o t a l o f 200 m a r k s w a s o b t a i n a b l e . L a d y C o u n ty S u p t. M rs. A. H. L e c h m e r e a f t e r a few c o n g ra tu la to ry rem a rk s, p re s e n te d th e tro p h y to S e rg t. P h ilp o tt.
County of Warwick. B i r m in g h a m ( N e w S t . ) . — A p l e a s a n t e v e n i n g t o o k p l a c e a t th e W a r w ic k R o o m , Q u e e n s H o tel, on S a tu rd a y , S e p te m b e r 4th , w h e n g o l d l o n g s e r v ic e a w a r d s a n d e x a m i n a t i o n a w a r d s u 'e r e p r e s e n te d b e fo re a n a u d ie n c e of o v e r 100 m e m b e rs , th e i r w iv e s a n d frien d s. M r. T . F in c h , S ta tio n M aste r, N e w S t., p resid ed over t h e m e e t i n g , a n d C o l. S i r B e r t r a m F o r d , T . D ., D . L . , L L . D ., C o u n ty C o m m is sio n e r S .J .A .B ., B ir m in g h a m C o u n ty , w as m e t by D iv isio n al S u p t. W . H . A n d rew s. A f te r i n s p e c t i n g th e g u a r d of h o n o u r of N e w S t. L . M .S . D iv is io n , C o l. F o r d t o o k h is s e a t in t h e r o o m . A v ariety c o n c e rt th e n follo w ed .
R I D G o ld l o n g s e rv ic e a w a r d s w e r e p r e s e n te d b y C ol. S ir B e r t r a m F o r d t o W . H . R o e , 30 y e a r s ; M e s s r s . W . N . L a u g h e r , H . H a w k e r , A . L . M o r r i s , 15 y e a r s . E x a m in a t i o n a w a r d s w e r e p r e s e n t e d t o 1s t , 2 n d , a n d 3 r d y e a r s t u d e n t s , by M iss H a rris . S u b s e q u e n t y e a r a w a r d s w e re p re s e n te d by J. B. D u n k le y , P re s id e n t, N e w S t. L . M .S . D iv ., w h o r e c e i v e d t h e B r i g a d e ’s o f f i c i a l b a d g e f r o m C o l . S i r B e r t r a m Ford. T h e a r r a n g e m e n t s w e r e c a r r ie d o u t b y M r. A. L . M o rris , C lass S ecretary .
West Riding of Yorkshire. W e t h e r b y C a d e t N u r s in g D iv isio n h a s h a d a su cc e ssfu l c a re e r th is year. T w o C ad ets h a v e starte d g e n e ra l tra in in g in h o s p i t a l ; a ll C a d e t s p a s s e d t h e H o m e N u r s i n g e x a m i n a tio n . E i g h t p a s s e d t h e e x a m i n a t i o n o n t h e K n o w l e d g e of t h e H i s t o r y o f t h e O r d e r o f S t . J o h n o f J e r u s a l e m , 13 t h e C h ild W e lfa re e x a m in a tio n , a n d 3 h a v e ju st g a in e d th e A d u lt C e rtific a te in H y g ie n e . T h e D i v i s i o n w a s i n s p e c t e d o n M a y 26 t h b y C o u n t y C a d e t O fficers L a d y M o u n tg a r r e t a n d M rs. A y k ro y d a n d D is trict O fficer M rs. L o d g e . L a d y M o u n tg a r r e t s p o k e to th e C a d e ts , e n c o u r a g i n g th e m to g o o n w ith th e ir g o o d w o rk . C a d e ts h a v e t a k e n p a r t in v a rio u s p a r a d e s d u r i n g th e y ear, w h e n th e y s h o w e d in th e ir b e a r in g th e g o o d tr a in in g g iv e n th e m b y M iss W a n s b r o u g h , w h o h a d s p e n t sev e ra l n ig h ts d rillin g th e C ad ets. T h e D i v i s i o n is n o w s t a r t i n g a c t i v i t y a g a i n a f t e r t h e s u m m e r b r e a k w ith F i r s t A id le c tu r e s fo r p r o b a tio n e r s a n d H y g ie n e for C a d e ts . G i r l s b e t w e e n 11 a n d 16 m a y b e c o m e p r o b a tio n e r s , a n d a f te r g a i n i n g F i r s t A id C e rlific a te s a r e a cc e p te d a s C ad ets.
East Riding of Yorkshire. C ity o f H u ll.— D u r in g th e p a s t y e a r C a d e t D iv ision s h a v e b e e n f o r m e d t h r o u g h o u t t h e C ity of H u l l a n d o r g a n i s e d by re p re s e n ta tiv e s of t h e H u ll C o rp s w ith S u p t. B u rn le y O fficer in C h a r g e . C o m p e titio n s w e re a r r a n g e d d u r in g th e m o n th s A p ril to A u g u st. A ll C a d e t D i v i s i o n s in t h e C i t y w e r e i n c o r p o r a t e d , i n c l u d i n g th o s e a t t a c h e d to th e P o lic e C o rp s , S . J .A .B ., a n d a p o lice re p re s e n ta tiv e w a s a m e m b e r of th e C o m m itte e . F if te e n D iv is io n s c o m p e te d in th e first c o m p e titio n — a le a g u e to u r n a m e n t— th e w in n e r of e a c h sec tio n e n te rin g th e sem i-fin al. T h e sem i-fin a lists w e re B o u le v a rd B v N o rth e rn D iv isio n s a n d S u tto n v B ev e rley R d . D iv isio n s. T h e final w a s b e tw e e n B o u le v a r d B a n d S u t t o n D iv is io n s. A fte r a n in te re s tin g te a m te s t fo llo w ed b y in d iv id u a l te sts, B o u v e la r d B te a m a tta c h e d to th e P o lice C o rp s, w e re d e c la re d th e w in n ers. W e h o p e to p u b lis h th e t e a m te s t in o u r n e x t num ber. A n e lim in a tin g te s t to o k p la c e a t e a c h D iv isio n , th e w i n n e r e n t e r i n g t h e fin al. A s fa r a s p o ssib le th e C a d e t O fficers of th e tw o C o rp s w e r e in te r c h a n g e d to j u d g e th e D iv is io n a l tests. T h e a w a r d s w e r e a s f o l l o w s :— T o B o u l e v a r d B — D r . R y m e r S h ie ld a n d to e a c h m e m b e r of th e te a m a n e n g r a v e d silv er m e d a l a n d a s a v in g s c ertificate k in d ly g iv e n b y D r. R y m er. E a c h m e m b e r of th e S u tt o n D iv is io n t e a m re c eiv ed a n e n g r a v e d silv er m e d a l. T h e P rio ry C u p w a s p re s e n te d to C a d e t L a n c a s te r, B o u le v a r d B D iv is io n , fo r g a i n i n g t h e h i g h e s t n u m b e r of m a r k s in th e in d iv id u a l te s t ; a n d th e In d iv id u a l C u p to C a d e t W illis. A ll p r e s e n t w e r e p le a s e d t h a t g r e a t p r o g r e s s h a d b e e n m a d e d u r in g th e year, a n d h o p es a re e n te rta in e d for a n even b e tte r fu tu re. P u b lis h e r s Note.— W ill readers please note that all back numbers of “ First A id ” are now out of print and cannot be supplied. W ill South African and other Colonial readers please add to their remittances, “ o r English equivalent.”
F I R S T
S u g a r D ia b e te s (D ia b e te s M ellitus). B y W IL L IA M
N O RTH .
T h e f a c t t h a t t h e fir s t a i d e r m a y h e c a lle d u p o n a t s o m e t i m e to d e a l w it h a c a s e o f s u d d e n c o ll a p s e , o r e v e n c o m a , in a s u ff e r e r fr o m t h e d i s e a s e c o m m o n ly k n o w n a s s u g a r d i a b e te s , j u s t i f ie s t h e a c q u is i t io n o f a s u f f i c ie n t ly g o o d w o r k i n g k n o w l e d g e o f t h e d is e a s e . . . D i a b e t e s m e l li t u s is a m o r b id c o n d it io n in w h i c h t h e b o d y is u n a b le to m e t a b o lis e s u g a r e f f ic ie n t ly . I t is a w a s t i n g d is e a s e , w i t h t h e s y m p t o m s o f p a s s i n g l a r g e q u a n t i t ie s o f u r in e ( p o ly u r ia ) , t h i r s t a n d h u n g e r , t o g e t h e r w it h s u g a r in t h e u r in e ( g l y c o s u r i a ) . T h ro u g h o u t lite ra tu re from th e earliest tim es th e re a re re fe re n c es to a m y s te r io u s d is e a s e , w h ic h w a s a c c o m p a n ie d by th e p a s s a g e of l a r g e a m o u n ts of u r in e a n d o th e r d ia b e tic c o n d itio n s. T h e s w e e t ta s te of d ia b e tic u rin e w a s m e n t i o n e d b y t h e I n d i a n p h y s i c i a n , S u s r u t a , a b o u t A . D . 500 , a n d b y t h e P e r s i a n , A v i c e n n a , a b o u t A . D . 1000 . I n E u r o p e it a p p e a r s to h a v e b e e n first r e c o r d e d b y t h e E n g l i s h p h y s i c i a n , T h o m a s W i l l i s , i n 1679 . I t w a s a n o t h e r h u n d r e d years, h o w e v er, b efore a n o th e r E n g lis h d o cto r, D o b so n , c arried o u t e x p e r im e n ts t h a t e n a b le d h im to p ro v e th a t th e s w e e tn e ss o b se rv e d b y W illis w a s d u e to s u g a r . T h is su g ar, k n o w n a s d e x tro s e , g lu c o s e , o r g r a p e s u g a r , is o b ta in e d from th e carb o h y d ra te s (starch y m aterials), w h ich a re ta k e n a s food, b u t a c e r ta in a m o u n t is d e riv e d f r o m th e p ro te in p a r t of t h e d ie t a s w e ll. T h i s a b n o r m a l s u g a r c o n t e n t in t h e u r i n e is d u e t o t h e fa i l u r e of a s m a l l g r o u p of c ells in t h e p a n c r e a s ( t h e in s u la e e o r i s l e t s o f L a n g e r h a n s ) t o p r o d u c e a s u b s t a n c e t h a t is re sp o n sib le for th e s u g a r ta k e n in to th e b lo o d b e in g b u r n t u p in to e n e r g y a n d b e in g m a d e u s e of by th e b ody. T h i s s u g a r a c c u m u l a t e s in t h e b lo o d , a n d is e x c r e t e d b y th e u rin e. T h e first s u g g e s t i o n t h a t t h e p a n c r e a s w a s n e c e s s a r y for c o m p le te u tilis a tio n of c a r b o h y d r a te s in a n i m a l b o d ie s w a s m a d e b y B r u n n e r i n 1682 . T h e re la tio n sh ip of th e p a n c r e a s to d ia b e te s w a s first s u g g e s t e d b y a n E n g l i s h p h y s i c i a n , C o w l e y , i n 1788 . I n 1889 e x p e r i m e n t s s h o w e d t h a t c o m p le te re m o v a l of th e p a n c r e a s of a n i m a l s r e s u lte d in a c o n d itio n p ra c tic a lly id e n tic a l w ith d ia b e te s in m a n . M a n y a tte m p ts w e re s u b se q u e n tly m a d e to o b ta in th e s u b s t a n c e m a n u f a c t u r e d b y t h e i s l e t s o f L a n g e r h a n s , b u t it w a s n o t u n til u n c e a s i n g effo rts o n th e p a r t of a y o u n g C a n a d ia n d o cto r, F r e d e ric k B a n tin g , th a t th is w a s a c c o m p l i s h e d i n 1922 . T h i s d is c o v e ry w a s c a lle d in s u lin , a n d w ill r e m a in o n e of th e g r e a t e s t d isco v e ries of a ll tim e . T h e r e is a n i n t e r e s t i n g c o n n e c t i o n b e t w e e n d i a b e t e s a n d p e rn ic io u s an aem ia. T h e d is c o v e re r of th e t r e a t m e n t for th e la tte r, a y o u n g A m e r ic a n d o c to r, M in o t, w a s h i m self a s u ffe re r f r o m d ia b e te s , b u t w a s e n a b l e d b y i n s u li n to c a rry o n h is re s e a rc h w o rk a n d m a k e h is a lm o s t e q u a lly g r e a t life -sa v in g d is c o v e ry of th e t r e a t m e n t of p e rn ic io u s an aem ia, a d is e a s e w h ic h , lik e d ia b e te s , m e a n t h ith e rto a n inev itab le a n d lin g e rin g d e ath . T h e o n s e t of d i a b e t e s is g r a d u a l . I t m a y s e t in m o r e r a p id ly a f te r a s u d d e n e m o tio n , in j u r y o r s e v e re chill. The th i r s t is o fte n d istressin g , th e ap p etite m a y be e n o r m o u s , t h e t o n g u e is d r y , r e d a n d g l a z e d , a n d t h e s a l i v a is s c a n t y . T h e p a tie n t u su ally b eco m es very th in a n d w asted . M o s t s e r i o u s of t h e c o m p l i c a t i o n s o f s e v e r e d i a b e t e s is c o m a , w h i c h is c a u s e d b y p o i s o n i n g of t h e b lo o d b y a c i d o s i s b r o u g h t a b o u t t h r o u g h fa ts n o t b e i n g d e a l t w ith in th e n o r m a l m anner. A t first t h e c o n d i t i o n is o n e o f c o l l a p s e r a t h e r t h a n t r u e c o m a , a l t h o u g h l a t e r t h e p a t i e n t is c o m p l e t e l y co m a to se . T h e r e is d if f ic u lty of b r e a t h i n g , t h e p u l s e g r o w s w eak, and th e p atien t g r a d u a lly lo ses co n scio u sn ess. W ith o u t m ed ical tre a tm e n t d e a th m a y o c cu r w ith in tw e n ty -
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fo u r h o u rs. T h e c o m a m a y co m e on w ith o u t w a rn in g , or th ere m a y be h eadache, th ic k speech, a n d a s ta g g e rin g g a it, before th e c o m a c o m e s on. In o th e r cases, th ere m a y b e w e a k n e s s , g i d d in e s s , a n d liv id h a n d s a n d feet, e sp e c ia lly a f te r e x e r tio n p r e c e d i n g th e o n s e t of th e c o m a . T h e r e is a p e c u l i a r s w e e t o d o u r e m a n a t i n g f r o m t h e b r e a t h a n d th e sk in . N o a g e is e x e m p t f r o m t h e d i s e a s e , b u t i t o c c u r s m o s t l y b e t w e e n t h e a g e 50 - 60 . T w ic e as m a n y m a le s as fem ales a r e affected . T h e t r e a t m e n t of d i a b e t e s is t h e c o n t r o l o f d ie t, a n d in sev e re c ase s th e a d m in is tra tio n of in su lin . T h i s b r i n g s u s to t h e ty p e of c o m a w e a r e m o s t lik e ly to m e e t in d ia b e tic c a s e s — h y p o g ly c c e m ia , w h ic h , a s th e n a m e i n d i c a t e s , is a c o n d i t i o n in w h i c h t h e r e is a d e f ic ie n c y of s u g a r in th e blo o d . T h is co n d itio n a p p e a rs w h e n e ith e r th e p a tie n t h a s t a k e n to o l a r g e a d o s e of in s u lin (u s u a lly s e lf -a d m in is te r e d , in tw o , o r e v en th re e , d a ily d o s e s ) o r h a s fa ile d to t a k e a m e a l h a lf - a n - h o u r o r so a f te r t h e in je c tio n , o r h a s i n d u l g e d in m o r e e x e r t i o n t h a n u s u a l . T h e face u s u a lly flu sh es w ith a s w e a tin g w h ic h m a y be v ery m a r k e d ; th e p a tie n t feels g id d y , a n d h a s a d is tin c t s e n s e of p h y s ic a l c o l d n e s s a b o u t t h e l i m b s , a n d t h e r e m a y b e b l a n c h i n g of th e face. T h e r e is t h e p e c u l i a r s w e e t s m e l l in t h e b r e a t h to o . S o m e t i m e s t h e first s y m p t o m is a f e e lin g of n e r v o u s n e s s o r d is t i n c t t r e m u l o u s n e s s , s o t h a t t h e p a t i e n t fin d s it im p o s sib le to c o -o rd in a te h is m o v e m e n ts , th is b e in g o ften a c c o m p a n ie d b y d is t u r b a n c e of s i g h t , i.e., d o u b le v isio n . T h e s y m p t o m s u s u a l l y o c c u r 3— 5 h o u r s a f t e r t h e i n j e c t i o n o f in su lin . L a te r, co n fu sio n a n d d e liriu m m a y o ccu r, w ith fin al c o lla p s e a n d u n c o n s c io u s n e s s . C o n v u lsio n s a re rare. H y p o g ly c c e m ic c o m a m a y e asily b e c o n fu se d w ith d ia b e tic c o m a , b u t u s u a l l y t h e p a t i e n t , if s e e n i n t i m e , c a n h e l p w i t h th e h isto ry . T h e t r e a t m o n t o f h y p o g l y c o e m i a is t h e a d m i n i s t r a t i o n o f s u g a r b y t h e m o u t h if t h e p a t i e n t i s c o n s c i o u s . Two lu m p s sh o u ld be ta k e n as soon as th e sy m p to m s a p p e a ra n d , if n e c e s s a r y , r e p e a t e d t w e n t y m i n u t e s l a t e r if t h e s y m p t o m s still p e rs is t. If t h e p a t i e n t is s e e n b e f o r e h e h a s b e c o m e u n c o n sc io u s , h e w ill in d ic a te , v e ry o fte n , th e p o c k e t in w h ic h h e k e e p s t h e s u g a r , if h e h a s f a i l e d t o t a k e i t h i m s e l f a t t h e onset. H e m a y b e a b le to in d ic a te th e w h e re a b o u ts o f s u g a r o n h is p e r s o n , e v e n if h e is u n a b l e t o h e l p h i m s e l f t o it. (A ll d i a b e t i c s c a r r y s u g a r f o r t h i s p u r p o s e . ) If th e p a tie n t h a s re a c h e d th e c o m a to se s ta g e before b e in g s e e n b y th e first a id e r, of c o u r s e th e s p e c ia l t r e a t m e n t, o th e r th a n g e n e r a l ru le s for th e tr e a tm e n t of a n u n c o n s c i o u s p a t i e n t , is o u t s i d e h i s s c o p e . T h e a id of a d o c to r m u s t be s o u g h t im m e d ia te ly fo r th e n e c e s s a ry in t r a v e n o u s i n j e c t i o n of g l u c o s e .
R.I.P. M rs.
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T h e h i g h r e g a r d in w h ic h th e la te M rs. O liv e G . K n o t t w a s h eld w a s e v in c ed b y th e la r g e a n d re p re s e n ta tiv e a tte n d a n c e a t th e f u n e ra l, w h ic h to o k p la c e in B a r n s t a p l e re c e n tly . M rs. K n o t t w a s th e w ife of M r. F r e d G . K n o tt, of B e a r S tr e e t, D iv . S u p t. of th e B a r n s t a p l e S .J .A .B . S he w as on th e D ev o n staff as L a d y C o rp s S u p t. fo r th e N o rth D e v o n A re a , a n d s h e p la y e d a p r o m i n e n t p a r t in C ivil D e f e n c e w o r k in th e d is tric t. T h e in t e r m e n t in th e c e m e te r y w a s p re c e d e d b y a s e rv ic e i n S t . M a r y M a g d a l e n e ’s C h u r c h , w h i c h w a s c o n d u c t e d b y th e V ic ar (th e R ev. R . A. H . B ate, R .A .F .) . M e m b e r s of th e N u r s i n g D iv is io n f o r m e d a g u a r d of h o n o u r o u tsid e th e ch u rch . T h o s e p re sen t a t tb e in te rm e n t in clu d ed th e M a y o r a n d M a y o r e s s of B a r n s ta p le a n d a v e ry l a r g e n u m b e r of L a d y C o u n ty O ffic e rs a n d h i g h officials of t h e A m b u l a n c e a n d N u r s in g S erv ices. T h e flo ral tr i b u te s w e re v e ry n u m e ro u s .
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R a ilw a y A m b u la n c e N e w s . GREAT WESTERN H o n o u r s .— A s a r e s u lt of r e c o m m e n d a ti o n s m a d e b y th e C e n t r a l A m b u l a n c e C o m m i t t e e , t h e f o l l o w i n g m e m b e r s of th e s ta f f h a v e b e e n a d m i t t e d a s S e r v in g B r o th e r s of th e O r d e r of S t. J o h n of J e r u s a l e m , in r e c o g n itio n of th e e x c e p tio n a l se r v ic e s w h ic h th e y h a v e r e n d e r e d to th e m o v e m e n t o n th e G . W . R . o v e r a l o n g p e r i o d o f y e a r s :— M r. J. A. M a r t i n , C le r k , S t a f f a n d E s t a b l i s h m e n t O ffice, A ld e rm a s to n ; M r. W . H o o k in s , P a s s e n g e r G u a rd , P e n a r th T o w n ; M r. F . H a tto n , G o o d s G u a rd , S h r e w s b u ry ; M r. W . J . P r ic e , S i g n a l m a n , B a l a ; M r. A. E . W illia m s , S ta tio n M a ste r, G resford. M r. C. W . H ip k in s , A .R . P . C o n tro l, P a d d in g to n S ta tio n , h a s a lso b e e n a d m itte d to th e O r d e r a s a S e rv in g B ro th e r, o n th e r e c o m m e n d a t i o n of th e S .J .A .B . H e is D is t r i c t O fficer to th e N o. 1 L o n d o n D is tr ic t of th e B r ig a d e . A ld e rm a n D . M . C h a p m a n , of C ra d le y H e a t h , w h o retired fro m th e positio n of G .W .R . G o o d s A g e n t at N e t h e r t o n i n 1932 , h a s b e e n p r o m o t e d b y t h e O r d e r o f S t . J o h n fr o m th e G r a d e of S e r v in g B r o th e r to t h a t of O fficer ( B r o th e r ) , o n th e r e c o m m e n d a t i o n of th e S .J .A .B . A l d e r m a n C h a p m a n g a i n e d h i s fir s t a i d c e r t i f i c a t e in 1892 , a n d i s t h e h o l d e r o f t h e G . W . R . 15 - y e a r m e d a l a n d 20 y ear bar. A t t h e p r e s e n t t i m e h e h o l d s t h e p o s i t i o n of C o u n ty O fficer for N o r th W o r c e s te r s h ir e in th e S .J .A .B .
T h e L o rd M a y o r of P ly m o u th (L o rd A sto r) recen tly p re s e n te d a w a r d s to m e m b e rs of th e G .W . R . A m b u la n c e S erv ice a t P e n n y c o m e q u ic k . In th e c o u rs e of h is o p e n in g a d d r e s s , t h e L o r d M a y o r s a i d :— “ Y o u h a v e t h i s f e e l i n g t h a t it is n o t o n ly a n i m p o r t a n t w o r k in w a r tim e , b u t a w o r k y o u w ill n e e d in p e a c e tim e . T h i s w a r is b e i n g w a g e d a s m u c h in t h i s i s l a n d a s it is overseas. R e c e n tly , in a n a ir r a id in t h e S o u th - W e s t, th e in c o n v e n ie n c e a n d s u ffe rin g of m a n y p eo p le w e re m itig a te d b y th e efficient a n d r e a d y h e lp of th e a m b u l a n c e b r i g a d e . ” T h e r e w e r e n i n e a w a r d s f o r 15 y e a r s ’ e f f i c i e n t s e r v i c e , f i f t e e n f o r 20 y e a r s ’ s e r v i c e , f o u r f o r 25 y e a r s ’ s e r v i c e , f o u r f o r 30 y e a r s ’ s e r v i c e , o n e f o r 35 y e a r s ’ s e r v i c e , a n d o n e f o r 40 y e a r s ’ serv ice. T h e c h a i r m a n w a s M r. J. S. P . P e a rs o n , D iv . S u p t. of th e G .W . R .
N e w to n A b b o t.— O n F r i d a y , A u g u s t 27 t h , n in ety m e m b e r s of th e N e w t o n A b b o t G . W . R . c la ss w e re p re s e n te d w ith a w a r d s b y H . A. G . W o r t h , E s q ., D iv . S u p t., E x e te r , H e c o n g r a t u l a t e d t h e c l a s s o n t h e i r e n t h u s i a s m a n d effici en cy , h a v in g o b ta in e d 100 p e r c en t, p a ss e s for certificates, v o u c h e r s , m e d a llio n s , etc. O p p o rtu n ity w a s a lso ta k e n to s h o w a p p re c ia tio n to D r. S c r a s e , w h o t h i s y e a r c e l e b r a t e d h i s 40 y e a r s ’ a s s o c i a t i o n w ith th e class. M r. F . N o rth c o tt, C la ss S e c re ta ry , p re s e n te d D r. S c ra s e w ith a few of h is fav o u rite b o o k s a n d b o o k to k en s. D r. S c r a s e s u i t a b l y r e s p o n d e d , a s s u r i n g a l l p r e s e n t o f t h e j o y it g a v e h im in a s s i s t i n g w ith s u c h n o b le w o rk . T h e m e e tin g w a s p resid ed o v e r by T . W . H a ll, E sq ., A sst. L o co . S u p t.
LONDON & NORTH EASTERN N . E . A r e a C e n t r e . —- T h e f o l l o w i n g a r e e x t r a c t s f r o m t h e C e n t r e S e c r e t a r y ’s A n n u a l R e p o r t f o r 1942/43 :— D u r i n g t h e 1942-43 s e s s i o n a t o t a l o f 145 c l a s s e s w e r e conducted. T h e n u m b e r o f s t u d e n t s w h o w e r e s u c c e s s f u l in
R I D p a s s i n g t h e e x a m i n a t i o n d u r i n g t h e s e s s i o n w a s 2 , 345 , m a d e u p a s f o l l o w s : — C e r tif ic a te s , 228; v o u c h e r s , 243; m e d a l l i o n s , 230 ; l a b e l s , 1 , 6 4 4 ; a d e c r e a s e o f 747 o n t h e 1941/2 s e s s i o n , w h ic h w a s to be ex p ec te d h a v in g r e g a r d to th e la rg e n u m b e r of th e s ta f f w h o h a v e jo in e d th e F o r c e s . T h e resu lts a r e to b e c o n s id e re d h i g h ly s a tis f a c to r y fo r th e f o u r th y e a r of th e w a r . T h e g r a n d to ta l of a w a r d s g a in e d s in ce th e fo r m a t io n o f t h e C e n t r e i n 1895 i s n o w 76 , 095 . T h e F i r s t A i d r e t u r n s f o r t h e y e a r e n d e d J u n e 30 t h , 1943 , t o t a l 60 , 976 — m a k i n g a g r a n d t o t a l o f 2 , 235,211 c a s e s t r e a t e d s i n c e J a n u a r y , 1896 . D u r i n g t h e y e a r 43 m e d a l s , t e n 20 y e a r s ’ b a r s , t w o 25 y e a r s ’ b a r s , f i v e 30 y e a r s ’ b a r s , a n d t w o 35 y e a r s ’ b a r s h a v e been approved. — —
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T h e H o m e G u a rd a n d F ir s t Aid. W a t e r S u p p l y — S t e r il is a t io n .
F o llo w in g clarific a tio n , w h ic h w e h a v e le a r n t d e a ls w ith th e s u s p e n d e d im p u r itie s in w a te r , w e n o w c o m e to s te r ilis a tio n w h i c h is e s s e n t i a l fo r t h e d e s t r u c t i o n o f p a t h o g e n i c g e r m s . C h l o r i n e is t h e m e d i u m u s e d fo r t h i s p u r p o s e in t h e A r m y . I t c a n b e u s e d i n t h r e e f o r m s : ( 1) C h l o r i n a t i o n ; ( 2 ) S u p e r C h lo rin atio n , co m b in ed w ith d e -ch lo rin atio n ; and ( 3) C h lo ram in atio n . F o r ch lo rin atio n , b le a c h in g p o w d er, w h ic h c o n tain s 25 p e r c e n t , c h l o r i n e ( t h e b a l a n c e b e i n g l i m e ) , i s u s e d . A H o r r o c k s t e s t is c a r r i e d o u t t o fin d h o w m u c h is n e e d e d to s t e r i l i s e 100 g a l s , w a t e r . T h is test a llo w s for 1 p a rt p er m illi o n f r e e c h l o r i n e , a n d is d o n e b y m e a n s of t h e H o r r o c k s t e s t b o x , w h i c h is s u p p l i e d t o e a c h w a t e r t a n k t r u c k , a n d w h ic h s h o u l d b e in t h e h a n d s o f H o m e G u a r d b a tta l i o n s a lso . C h lo rin a tio n , h o w e v er, ta k e s s o m e tim e a s th e w a te r m u s t be left a t le a s t h a lf a n h o u r b e fo re u s e. S u p e r- c h lo r in a tio n , w h ic h g iv e s tw o p a r ts p e r m illio n free c h lo rin e , t a k e s o n ly h a lf th e tim e , b u t o w in g to th e ta s te w h i c h it g i v e s t h e w a t e r , re q u ire s d e -c h lo rin a tin g w ith so d iu m th io su lp h a te. T h i s is s u p p lie d in ta b le t fo r m , tw o t a b l e t s b e i n g r e q u i r e d p e r 100 g a l s . T h i s is t h e m e t h o d m o s t g e n e r a l l y u s e d in t h e A r m y o w in g to its q u ic k n e s s . T h e th ir d m e th o d , c h lo r a m in a tio n , is c a r r ie d o u t b y a d d i n g tw o ta b le ts of a m m o n i u m c h lo rid e , p lu s tw o s co o p s o f b l e a c h i n g p o w d e r p e r 100 g a l s , w a t e r . T h is form s c h lo r a m in e , w h ic h is v e ry effectiv e b u t t a k e s m u c h l o n g e r to act. N o H o r r o c k s te s t is n e e d e d , h o w e v e r . T h e s e th re e m e th o d s a re u s e d w h e n d e a lin g w ith la rg e q u a n titie s of w a te r, b u t fo r s m a ll q u a n titie s th e re a re o th e r a n d sim p le r m e a n s. O n e is b y i n d i v i d u a l w a t e r s t e r i l i s i n g outfits, m o stly in ta b le t fo rm , a n d c a n be u s e d by e a c h m a n fo r s te r ilis in g th e c o n te n ts of h is w a te r -b o ttle . A n o th er m e t h o d is t o c a r r y o u t t h e H o r r o c k s te s t, p u t t h e r e q u i r e d a m o u n t o f p o w d e r i n t o a w a t e r - b o t t l e a n d fill w i t h w a t e r , m a k in g a s tr o n g so lu tio n . A s c o o p of t h i s s o l u t i o n is a d d e d t o e a c h m a n ’s w a t e r - b o t t l e , a n d a f t e r h a l f - a n - h o u r , o n e s o d . th io su lp h a te ta b le t ad d ed . T h i s is su ffic ie n t to d e a l w ith 400 w a t e r - b o t t l e s . A t h i r d , c a l l e d t h e B l a c k c u p m e t h o d , c a n h a r d l y b e d e s c r i b e d h e r e , a s it is n e c e s s a r y to u n d e r s t a n d th e c o n te n ts of th e H o r r o c k s b o x . I w o u ld a d d in p a s s i n g , t h a t t h e H o r r o c k s t e s t is v e ry s im p le , full in s t r u c t i o n s a r e in c lu d e d in e v e r y b o x , a n d a l t h o u g h th e se h a v e n o t y e t b e en issu e d to th e H o m e G u a rd , I t h i n k it w o u ld fu lly r e p a y t h e M e d ic a l O r d e r l y to tr y a n d o b ta in o n e t h r o u g h h is B a tt. M e d ic a l O fficer, o r B a tt. C o m m ander. T h e y c a n b e p u r c h a s e d c o m p l e t e f o r 46 / - . I t r u s t th e s e n o te s o n w a t e r s u p p ly h a v e p ro v e d of in te re st. A s I h in te d in th e first p la c e , o n ly th e f r in g e of th e
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The COMPLAINTS OF MEN, WOMEN AND CHILDREN. Their Cause, Treatment and Cure. A f e w ot the S u b jects tre a te d : G a s W a r f a r e , F ir s t A id W h a t to D o in E m e r g e n c i e s In flu e n z a , C o ld s, etc. M ea sles, M u m p s , C a ta r r h C orns a n d W a rts P h y sical C u ltu re T r e a t m e n t fo r all S k in D is e a s e s T h e L u n g s , P leu risy H y g ie n e, A n ato m y , P h a rm a c y
T h e P r in c ip le s of N u r s i n g T h e Eye, th e E a r T h e T h ro a t, th e N ose T h e C h est, th e H e a r t T h e S to m a c h , th e L iv er T h e T e e th , th e M u scles In fa n t W elfare H o m o e p ath y , N e u ra sth en ia 375 P r e s c r i p t i o n s , e t c . , e t c .
T H E Y O U N G W IF E w i l l fi n d j u s t t h e i n f o r m a t i o n s h e r e q u i r e s . M O TH E R S w h o w is h th e ir d a u g h t e r s t o d e v e l o p n a tu ra lly w ill find exactly th e teach in g th ey need.
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s u b je c t c o u ld b e to u c h e d in m y lim ite d sp a c e . N ex t m o n th I h o p e to r e t u r n to l e g i t i m a t e first a id m a t t e r s . F in ally , I t h a n k m y m a n y c o rre s p o n d e n ts fo r th e ir v a lu a b le c o -o p e ra tio n , a n d lo o k fo r w a r d to f u r t h e r le tte rs fr o m th e m . C.
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Reviews. A id s to M e d ic in e f o r N u r s e s . L o n d o n : B ailliere,
By M a rg a re t H itch , S .R .N . T in d all & Cox. P r ic e q j- n e t ; by
p o st {/6. T h i s u s e f u l littl e b o o k , w h i c h is n o w in its s e c o n d e d itio n , is i n t e n d e d to b e a n “ a i d ” t o M e d i c a l N u r s i n g a n d n o t m e re ly a te x tb o o k . It c e r ta in ly a c c o m p lis h e s its p r i m a r y o b je c t of b e in g a g u i d e to n u r s e s in th e ir u n d e r s t a n d i n g of m e d i c a l c a s e s ; a n d b y s o d o i n g it w ill i n c r e a s e th e i n t e r e s t a n d e ffic ie n c y of n u r s e s in th is m o s t i m p o r t a n t p a r t o f th e i r w ork. O n t h e w h o l e t h e r e is little c h a n g e in t h e s u b j e c t m a t t e r b u t a g o o d d e a l h a s b e e n d o n e in t h i s e d itio n t o e l a b o r a t e a n d e lu c id a te c e r ta in se c tio n s in a w a y w h ic h w ill in c re a s e th e v a lu e of th e b o o k . I t s u s e f u l n e s s is e n h a n c e d b y a fu ll a n d co m p le te index.
A P o ck e t M e d ic a l D ic tio n a r y . B y L o i s O a k e s , S . R . N . , D . N . , a n d T h o m a s B. D av ie, M .D ., F . R .C .P . E d in b u rg h : E . & S. L i v in g s to n e . P r ic e y / - n e t ; by p o st y / y . T h i s m o s t u se fu l d ic tio n a ry , w h ic h c a n b e c a r rie d in th e p o c k e t a n d s tu d ie d a t o d d m o m e n t s , h a s r e a c h e d its s ix th e d itio n w ith in th e s p a c e of te n y e a r s, s u r e p ro o f of its u s e f u l n ess a n d p o p u larity . A s a p reface to th e d ic tio n a ry p ro p er, w h ic h c o n ta in s m o s t of th e c o m m o n te r m s a n d d efin itio n s c o n n e c t e d w i t h m e d i c i n e a n d s u r g e r y , it i n c l u d e s a n u m b e r o f h e lp fu l lists, s u c h a s a b b r e v i a t i o n of d e g r e e s , & c., a b b r e v i a t i o n of m e d i c a l t e r m s , t a b l e s of w e i g h t s a n d m e a s u r e s , & c. It c o n c lu d e s w ith elev en e q u a lly u sefu l a p p e n d ic e s , a m o n g w h ic h a re tra y s p re p a re d fo r n u r s in g te c h n iq u e s , s o m e p o iso n s a n d th e ir a n tid o te s, d ie ta ry ta b les, & c. I n s h o r t , r e a d e r s of F i r s t A id a n d e s p e c i a l l y t(io se w o r k i n g in h o s p i t a l s a n d first a i d p o s t s w ill find t h i s d i c t i o n a r y q u i t e i n d i s p e n s a b l e to t h e i r w ork.
D u r i n g t h e w e e k e n d i n g A u g u s t 28t h t h e s e r v i c e s of t h e S t . A n d r e w ’s A m b u l a n c e A s s o c i a t i o n ( G l a s g o w b r a n c h ) w a g o n s w e r e r e q u i s i t i o n e d 455 t i m e s , 281 b e i n g f o r a c c i d e n t s a n d 174 f o r c a s e s o f i l l n e s s r e q u i r i n g r e m o v a l t o h o sp ital. C o r r e c t i o n . — I n o u r A u g u s t i s s u e , p a g e 18 , w e i n a d v e r t e n t l y s t a t e d t h a t m o r e t h a n 50 p e r s o n s w i t h m i n o r in ju rie s w e r e a tte n d e d b y S t. J o h n A m b u la n c e m e n o n D u r d h a m D o w n , B risto l. T h e a m b u la n c e m en w h o dealt w ith th e s e c a s e s w e r e m e m b e r s of th e B risto l C ity a n d M a r in e A m b u la n c e C orps. T h e S t. J o h n A m b u la n c e B rig a d e C a d e ts celeb rate th e ir tw e n ty -first b irth d a y th is y ear. I n 1922 t w e l v e C a d e t A m b u l a n c e D iv is io n s (for b o y s) a n d e i g h t C a d e t N u r s i n g D iv isio n s (fo r g irls) w e re re g is te re d . T o -d a y th ere a re n e a r l y 700 o f t h e f o r m e r a n d m o r e t h a n 900 o f t h e l a t t e r i n E n g l a n d a n d N o r t h e r n I r e l a n d , w i t h a t o t a l s t r e n g t h of m o r e t h a n 32,000 b o y s a n d g i r l s . T h e re a re m a n y o th ers in W a l e s a n d o v e rs e a s .
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A d v e rtis e m e n ts .
A d v e r tis e m e n ts w ith re m itta n c e sh o u ld be s e n t t o F irst A i d , 46, C a n n o n S treet, L o n d o n , E .C 4 3d. p e r w o r d , m i n i m u m 4 s .
Q A A C o n c e r t T i c k e t s 5/ 6 . M e m o s , R u b b e r S t a m p s , R o l l Z U U T ick ets, S a m p le s — “ A ” T ic e s , 11 , O a k l a n d s G r o v e , L o n d o n , W . 12 . IR S T A ID C O M P E T IT IO N S are w on by good coach in g . A n y F ir s t A id er (eith er sex) m a y co ach a n y a m b itio u s te a m — m ale, fe m a le , o r m ix e d — to e a rly su ccess. C o m p etitio n e x p erien ce n o t n ecessary w ith n ew G u id e ( a d a p ta b le to a n y te x t-b o o k ). F o r particu lars, sen d stam p ed e n v e l o p e t o : — R . J e f i f e r y , 5 , A v e n u e G a r d e n s , L o n d o n . W .3
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S C I E N T I F I C
M A S S A G E THE
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fo r
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M en
and
W om en
SPARE T I M E O R W H O L E T IM E O C C U P A T I O N Y o u can make Massage a spare time or whole time occupation. The trained Masseur is of inestimable value to First Aid organizations, Nursing Homes, Hydros, Sports and Athletic Clubs, Physical Culturists, etc. Train with the SMAE Institute and remember you have
N O T H I N G T O LO S E as it guarantees to coach you until successful at the examination and your Diploma secured or returns your fees in full.
T H E O LD E S T T R A IN IN G C EN TR E IN G R E A T B R IT A IN The S .M .A .E . (Swedish Massage and Electrical) Institute is the oldest of its kind in Great Britain, having been established for a quarter of a century. Many of the W orld’s leading Masseurs and exponents of Manipulative Therapy have been trained by the S .M .A .E . Institute. Write without delay for FR EE Booklet No.
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‘‘ M A N I P U L A T I V E T H E R A P Y A S A P R O F E S S I O N ”
This FREE Booklet tells you how to acquire the art of scientific massage by unique method of Home Study, and how you can establish a private practice of your own.
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34
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R I D Signs and Sym ptom s of Shock.
Queries and Answers to Correspondents Q u e r i e s w i l l b e d e a l t w i t h u n d e r t h e f o l l o w i n g r u l e s :—
1- — L e t t e r s c o n t a i n i n g Q u e r i e s m u s t b e m a r k e d o n t h e t o p le ft-h an d c o rn e r of th e envelope “ Q u e ry ,” a n d ad d re sse d t o F i r s t A i d , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 .
2. — A l l Q u e r i e s m u s t b e w r i t t e n o n o n e s i d e o f p a p e r o n l y . 3. — A l l Q u e r i e s m u s t b e a c c o m p a n i e d b y a “ Q u e r y C o u p o n ”
W . K . ( N u n e a t o n ) .— I n a r e c e n t c o m p e titio n I w a s a s k e d to sta te th e s ig n s a n d s y m p to m s of sho ck . I gave as my a n s w e r t h e s i g n s a n d s y m p t o m s o n p . 44 o f t h e T e x t book. O n receiv in g m y m a r k in g sh eet I found th a t th e a n s w e r r e q u i r e d w a s t h a t g i v e n o n p . 165 f o r f a i n t i n g . W i l l y o u p l e a s e t e l l m e if m y a n s w e r w a s t h e c o r r e c t o n e o r if t h e j u d g e ( w h o w a s n o t a d o c t o r ) w a s r i g h t i n h i s m a rk in g sh ee t? O n y o u r s ta te m e n t of facts you g a v e th e rig h t a n sw e r. — N .C .F .
c u t f r o m t h e c u r r e n t i s s u e o f t h e J o u r n a l , o r , i n c a s e of Q u e rie s fro m a b ro a d , fro m a re c e n t issu e.
4. — T h e T e x t b o o k t o w h i c h r e f e r e n c e m a y b e m a d e i n t h i s c o l u m n i s t h e 39 t h ( 1937 ) E d i t i o n o f t h e S . J . A . A . M a n u a l of F i r s t A id to t h e In ju r e d .
Strains and Ruptured M uscles. N .S . ( E a s t H a m ) .— W e w e re re c e n tly d is c u s s in g th e re a so n w h y t h e T e x t b o o k in its s u g g e s t e d t r e a t m e n t of s tr a in s a n d r u p t u r e d m u s c l e s ( p . 98 ) a d v o c a t e s t h e a p p l i c a t i o n of a h o t c o m p r e s s . A s w e c o u ld no t a g re e , w e decided to a p p r o a c h y o u o n th is p o in t ; a n d w e t h a n k y o u in a n tic ip a t io n of y o u r k in d a n d h e lp fu l rep ly . W ith a s tr a in e d o r r u p tu r e d m u s c le , b lo o d collects a t th e s e a t of in ju ry a n d b y c a u s in g p re s s u re a g g r a v a t e s th e p a in a s s o c ia te d w ith th e s tr e tc h in g o r r u p t u r e of th e m u s c u l a r fibres. I n t h e s e c i r c u m s t a n c e s w e a p p l y m o is t h e a t o v e r t h e in j u r e d p a r t f o r t h e p u r p o s e o f c a u s i n g t h e s u p e r f ic ia l ( a n d , a s a n a t u r a l s e q u e n c e , t h e d e e p ) b lo o d v e s s e l s t o d i l a t e a n d s o t o d r a w b lo o d f r o m t h e s e a t o f i n j u r y w it h c o n s e q u e n t r e lie f o f p a in .— N . C o r b e t F l e t c h e r .
Exam ination How ler. M .R . (C a n n o n S t.).— In a re c en t e x a m in a tio n I a sk e d one c a n d i d a t e w h a t s h e w o u l d d o if s h e h a d t o t r e a t a p a t i e n t s tru c k by lig h tn in g . T o th is sh e g a ily re p lied — “ /
Fixation of Fractured Patella. F .A . ( T h o r n t o n H e a t h ) . — I s h o u l d b e v e r y g r a t e f u l if y o u w o u l d t e l l m e if t h e r e a r e a n y a d v a n t a g e s i n t y i n g t h e k n o t of t h e b a n d a g e , a p p l i e d t o k e e p t h e f r a g m e n t s of t h e p a te lla in a p p o s itio n , o n t h e side. I h a v e h e a r d it s a i d t h a t to tie t h e k n o t in fr o n t a s s h o w n in t h e T e x t b o o k is v e r y p a in f u l, w h e r e a s w h e n tie d o n t h e s i d e it is m u c h m o r e c o m f o r t a b l e . B y ty in g o u r k n o t b elo w th e k n e e c a p w e o b ta in a m o re c o m p le te c o n tro l of th e f r a g m e n t s of th e f r a c tu r e d p a te lla t h a n w e c a n w i t h t h e k n o t in a n y o t h e r p o s itio n . F u rth er, 1 q u e s t i o n if t h e k n o t , w h e n p r o p e r l y t i e d , d o e s i n f a c t c a u s e p ain fu l p re s s u re .— N .C .F .
Alcohol as Disinfectant. M .P . ( E a s t F i n c h le y ) .— M a n y first a id te x tb o o k s r e c o m m e n d t h e u s e of a lc o h o l in its v a r io u s f o r m s a s a d is in f e c ta n t of t h e s k in . I s h a l l b e g r a t e f u l if y o u w i l l t e l l m e h o w a l c o h o l a c t s a n d p r o d u c e s its effects. A lc o h o l is a n e x c e l l e n t s k i n a n t i s e p t i c b e c a u s e it d i s s o lv e s fats, e n te rs th e s w e a t a n d s e b a c e o u s d u c ts a n d q u ic k ly ev ap o rates. It, th e re fo re , co o ls th e sk in , w h ic h c o n se q u e n tly b e co m es pale fro m c o n tra c tio n s of th e s m a ll blo o dv essels a n d in d irec tly c a u s e s less s w e a t to b e e x c re te d . A lcohol h a s th e p o w e r o f t a k i n g u p w a t e r ; a n d it p r o d u c e s its a n t i s e p t i c a c tio n b y r e m o v in g w a t e r fro m g e r m s w h ic h a r e th u s k illed . — N .C .F .
sh o u ld firs t tu r n o ff the cu r ren t I " Good!
N ex t, p le a s e !
!— N . C . F .
Fractures of C la v ic le and Hum erus. A H . (C h a rlto n ).— A t a recen t B rig a d e P rac tic e w e w ere d e a lin g w ith in ju rie s to th e u p p e r lim b s a n d th e ir tr e a t m e n t in first a id . W e d e a lt w ith a fr a c tu re d clav icle a n d th e n w e n t o n to f r a c tu r e s of th e h u m e r u s . One m e m b e r t h e n a s k e d w h a t w o u ld b e th e c o rre c t w a y to t r e a t a c a s e in w h ic h t h e i n ju r i e s w e r e d i a g n o s e d a s b e i n g s im p le f r a c tu r e s of c la v icle a n d of u p p e r - th i r d of th e h u m e r u s o n th e s a m e sid e. A n u m b e r of d ifferen t s u g g e s tio n s c a m e fo rth . A s, h o w e v e r, w e c o u ld n o t a g r e e satisfacto rily , w o u ld y o u p le a se let u s h a v e y o u r v a lu a b le s o lu tio n of th e p r o b le m ? O b s e r v i n g t h e G e n e r a l R u l e s fo r F r a c t u r e s a n d in p a r t i c u l a r N o . 3 , T e x t b o o k — p p . 66 - 69 , I c o n s i d e r t h a t all th a t c o u ld b e d o n e w ith o u t ris k of fu r th e r in ju ry w a s to im m o b ilise th e u p p e r lim b o n th e in ju r e d sid e b y b a n d a g e s ro u n d th e lim b a n d tr u n k a b o v e a n d b elo w th e elb o w . T h e b ra c e s o n th e in ju re d sid e w o u ld , of course, b e u n f a s t e n e d if w o r n . A d e cisio n d e p e n d s o n th e d e g re e of s h o c k p re sen t. If s h o c k is n o t m a r k e d a n d p a t i e n t is a w a l k i n g c a s e , I w o u l d s u p p o rt th e lim b in a S t. J o h n s lin g a n d s te a d y th e fra c tu re d h u m e r u s w i t h a b r o a d b a n d a g e r o u n d li m b a n d b o d y (a s in ( a ) 1 , o n p . 82 o f T e x t b o o k ) . If, h o w e v e r , s h o c k is s e v e re a n d p a t i e n t is a s t r e t c h e r c a s e , t h e n I w o u ld a c t a s y o u s u g g e s t .— N .C . F,
Uses of W itch Hazel. W . N . ( R o s s e n d a l e ) . — P l e a s e t e l l u s if W i t c h a n t i s e p t i c , a n d if n o t , w h a t a r e i t s u s e s ?
H azel
is a n
W i t c h H a z e l is n o t a n a n tis e p tic . It c o n tain s tan n ic a c id w h ic h g iv e s it a s t r i g e n t a n d s ty p tic p ro p e rtie s . D ilu ted w i t h w a t e r , it m a y b e u s e d fo r b r u is e s o r s t r a i n s , fo r c a p i lla r y b le e d in g fro m s m a ll w o u n d s, or for b le e d in g from n o se or to o th s o c k e t.— N .C .F .
H u m our in First Aid. E .J . (B e c c le s ).— A m e m b e r of a N u r s i n g D iv is io n in S u ffo lk w a s seen recen tly by a sm all boy, d riv in g a n a m b u la n c e to a s e rio u s a c c id e n t w h e re a m a n w a s ly in g fa ta lly in ju re d . T h e b o y w a s h e a r d t o r e m a r k — " S e e , there
g o es one o f the tou g h la d ie s o f S t. J o h n , a n d she drove str a ig h t throu gh the crow d, a n d g o t d ow n to h elp w ith o u t t u r n in g a h a ir / ” T h e s a m e m e m b e r a n d h e r s i s t e r w e r e in a b o a t o n th e riv er, w h e n th e y s a w a c o w s w i m m i n g a fte r th e m , “ m o o i n g , ” e v id e n tly in g r e a t d is tr e s s a n d t r y i n g to a ttra c t a tten tio n . S h e w a s w a n tin g to e x p la in th a t sh e c o u l d n ’t g e t u p t h e b a n k . S o th e tw o “ re s o u rc e f u l” a n d “ sy m p ath etic ” n u rse s tu rn e d th eir b o a t ro u n d an d in v ite d th e c o w to fo llo w , w h ic h s h e g r a te f u lly d id , a n d w a s g u id e d to a m o re c o n v e n ie n t la n d in g place. A fter a p p ly in g th e u s u a l re m e d ie s fo r s h o c k , th e siste rs c o n tin u e d on th e ir w ay, th e co w a p p aren tly b e in g n o n e th e w o rs e for th e e x p erie n ce .
Good!
Next, please! !— N.C.F,
f l f e l t F O R A .R .P . and o t h e r
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36 Stretcher D rill. W .B
( B e r m o n d s e y ) — A t a H o m e G u a r d C o m p e titio n in first a id , w e h a d to lo a d a m b u l a n c e ; a n d t h e s l i n k s w e r e ju s t placed on th e stre tc h er. I d id n o t t h i n k t h a t th is w a s rig h t. In d e e d , I said th a t B e a re rs N os. 2 a n d 4 sh o u ld t u r n to t h e r i g h t , k n e e l o n left k n e e s , p a s s lo o p of g r i p p late en d over th e n e a r h a n d le , g r ip p late d o w n w a rd s, c a r r y s lin g u n d e r a n d o v e r o p p o s ite h a n d le clo se u p to c a n v a s b a c k to th e n e a r h a n d le r o u n d w h ic h tw o o r th r e e t u r n s a r e m a d e , p a s s t h e t r a n s v e r s e s t r a p r o u n d t h e p o le b e tw ee n th e ru n n e rs a n d tra v e rse a n d fa sten b u ck les o u ts id e th e s lin g b e tw e e n th e p oles. T h is done, th e B e a re rs rise to g e th e r. I w a s t o l d t h a t t h i s is n o t d o n e n o w ; a n d I a w a i t y o u r ru lin g w ith in terest. W h a t y o u w e r e t o l d i s q u i t e c o r r e c t ; a n d if y o u r e f e r t o p . 226 o f t h e T e x t b o o k y o u w i l l f i n d t h a t t h e r e is n o w n o i n stru c tio n fo r fix atio n of s lin g s .— N .C .F .
Fractures of P elvis and F e m u r. S. B. (S t. S ti t h i a n s ) . — A t a r e c e n t D iv is io n a l P r a c tic e I re a d o u t th e q u e ry w h ic h w a s p u b lish ed u n d e r th e ab o v e h e a d i n g i n t h e J u l y i s s u e of F i r s t A id , to a s q u a d a n d to ld t h e m to tr e a t th e case. C o rp o r a l H o p p e r a n d h is m e n th e n p ro c e e d e d to a p p ly t w o s p lin ts r e a c h i n g fro m th e a r m p i t s to b e y o n d t h e fe e t, o n e o n e a c h s id e of p a t i e n t . H e p o in ted o ut t h a t th e f r a c tu r e d f e m u r w a s lia b le to a g g r a v a t i o n a n d t h a t s o m e t h i n g m u s t be d o n e to c o n tro l th e f r a c tu r e d p e lv is to s a v e in ju r y to th e o r g a n s w ith in th e pelvis. A lso , h e i n s tr u c te d h is m e n , o n e to p r o te c t th e in ju r e d lo w e r lim b , o n e to p lace a b ro a d b a n d a g e r o u n d th e pelv is, a n d o n e to d r a w fo o t in to lin e w ith its fellow a n d to a p p ly f ig u r e - o f - e ig h t b a n d a g e r o u n d foot a n d a n k le . N e x t, a ll s e t to w o r k to b a n d a g e a n d s p lin t a s laid d o w n in t h e T e x t b o o k w ith th e a d d itio n a l s p lin t a l o n g u n i n j u r e d s i d e a n d u s i n g p l e n t y o f p a d d i n g t o fill u p t h e h o llo w s. W h e n th e y fin ish ed I re a d y o u r rep ly . H av in g h e a r d th is th e m e m b e r s of th e s q u a d r e a lly be lie v e t h a t fo r o n c e th e y e x c e lle d e v e n “ N . C . F . ” in r e n d e r i n g first aid . I t h o u g h t t h a t m a y b e n e x t m o n t h th e y w ill r e q u ir e t r e a t m e n t fo r s h o c k ; a n d I in v ite y o u r c o m m e n t s please. In c id e n ta lly y o u r re p lie s to o u r q u e r ie s a r e of u n to ld h elp . F r o m y o u r s t a t e m e n t of fa c ts it w o u l d s e e m t h a t C o r p o r a l H o p p e r a n d his m e rry m e n w e re g u ilty of w a s t i n g tim e w h e n th e y a p p lie d th e s p lin t o n th e u n in ju r e d sid e, a n d th e r e b y d e l a y e d t h e r e m o v a l of a s e v e r e l y s h o c k e d p a t i e n t to h o s p i t a l , u n le s s (I h e s it a te to s a y so) h e w a s a f r a id t h a t th e m e m b e r s of h is s q u a d w o u ld r o u g h h a n d le th e p a tie n t d u r in g tr e a t m e n t a n d tra n sp o rt. F u r t h e r , h is f a ith in th e b ro a d b a n d a g e r o u n d p e l v i s — “ t o s a v e i n j u r y t o t h e o r g a n s w i t h i n ” is n o t e w o rth y . A s a fa c t, th is b a n d a g e is t h e le a s t i m p o r t a n t ite m in t h e t r e a t m e n t of f r a c t u r e d p e lv is ; a n d a n y r i s k of c a u s i n g in ju ry to th e in te rn a l o r g a n s co u ld o n ly a ris e fro m m a ltr e a t m e n t d u r i n g s p l in tin g a n d b a n d a g i n g of th e fr a c tu r e d fe m u r. S o o n c e a g a i n I r e p e a t t h a t if t h e f r a c t u r e d f e m u r i s t r e a t e d p r o p e r ly a s la id d o w n in th e T e x tb o o k , n o a g g r a v a t i o n of th e f r a c tu r e d p elv is w o u ld re s u lt. P r o s i t ! !— N . C . F .
Transport of Fractured Spine. C . S . ( M i d d l e s t o w n ) . — I a m w r i t i n g re t h e q u e s t i o n o f r e m o v a l o f c a s e s of f r a c t u r e of s p i n e , a s o m e w h a t c o n t r a d i c t o r y c o n d itio n of t h i n g s h a v i n g a r is e n fr o m t h e in s tr u c tio n p o in t of v iew , m y F ir s t A id P a rtie s b e in g la rg e ly c o m p o sed of coal m in e rs. W e n o w h a v e tw o
en tirely
d ifferen t
p o licies,
A I D re g io n s h o u ld be tra n s p o rte d ly in g on th e b a c k ra th e r t h a n o n t h e fa c e, e x c e p t in c i r c u m s t a n c e s w h ic h m a k e m o v in g h im to th is p o sitio n d a n g e r o u s , in w h ic h c a s e h e w ill b e p la c e d o n t h e s t r e t c h e r in t h e p o s itio n fo u n d , in o r d e r to o b v ia te th e n e c e s sity of h a v i n g to b e n d o r s tra ig h te n o u t th e sp in e .” ( R e c o m m e n d a t i o n of t h e C. S. C o m m itte e of th e M e d ic a l R e s e a r c h C o u n cil). T h e s e in s t r u c t i o n s a r e to b e e l a b o r a t e d in t h e r e v i s i o n o f H a n d b o o k N o . 10 . 2. F ir s t A i d in C o a l M in e s . — P a g e 81 , S e c t i o n “ C a s e s of fr a c tu r e d sp in e, e x c e p t in th e c erv ic al re g io n , s h o u ld be tr a n s p o r te d in p r o n e p o s itio n .” N o w , w h a t is t h e p o o r c o a l m i n e r — C . D . F . A . P . m a n to d o ? H e w ill i m m e d i a t e l y a s k , a f t e r a le c tu re , “ W h i c h m e t h o d is t h e r i g h t o n e ? A re b o th c o rre c t ? ” A p o i n t w ' h i c h n o w a r i s e s i s :— T h e C . D . m e s h t y p e s tr e tc h e r te n d s, a f te r a little u se, to s a g c o n sid e ra b ly , d u e to s tr e tc h in g of th e w ire . I t is a d ifficult m a t t e r to a p p ly b o a r d s , e tc ., to m a k e it r i g i d a n d still b e a b le to l o a d it i n t o a n a m b u l a n c e ( u n l e s s b o a r d s a r e a p p l i e d len g th w ay s). T h is s a g g in g g iv e s s o m e m e a s u r e of h y p e r e x te n sio n w ith a p a tie n t ly in g p ro n e , th e po sitio n n o w d efin itely n e g a tiv e d in C. D e fe n ce . I s it n o t a p i t y t h a t o n e m e t h o d c a n n o t b e t a u g h t to all c lasses, so o b v ia tin g m u c h m is u n d e rs ta n d in g a m o n g s t th e m en ? Y o u r d i f f i c u l t y a r i s e s b e c a u s e F ir s t A i d in C o a l M in e s w 'a s p u b l i s h e d i n p e a c e t i m e p r i o r t o t h e p r e s e n t i n v e s t i g a t i o n by th e M ed ic a l R e s e a r c h C o u n cil. C o n s e q u e n t l y it m a y w e ll b e th a t, w h e n a n e w e d itio n of th is b o o k a p p e a r s , e x p e r t o p i n i o n w 'il l h a v e b e e n s t a b i l i s e d a n d o n e m e t h o d t a u g h t . M y p e r s o n a l o p in i o n is t h a t s u c h p a t i e n t s s h o u l d b e r e m o v e d a s f o u n d a n d t h a t i t m a t t e r s l i t t l e w’h e t h e r p a t i e n t i s o n h i s b a c k o r fa c e p r o v i d e d t h a t t h e s p i n a l c o l u m n is p r o p e r l y im m o b ilis e d . — N .C . F .
Nose Bleeding. H . H . ( O u t w o o d ) . — P l e a s e tell u s w h i c h k i n d of h a e m o r r h a g e o c c u rs w h e n a m a n , w h ile w a s h i n g h is face, s u d d e n ly sta rts b le e d in g from th e nose. W e w e re a sk e d th is q u e s t i o n r e c e n t l y a n d s a i d t h a t it is e i t h e r c a p i l l a r y o r a r t e r i a l b u t w e w e r e to ld t h a t it is u s u a l l y v e n o u s . W e t h a n k y o u fo r y o u r re p lie s to q u e rie s w h ic h a re of g r e a t h e lp in s e tt lin g d is c u s s io n s. S p o n ta n e o u s b le e d in g su c h a s y o u d esc rib e very c o m m o n ly t a k e s p la c e fro m a r u p t u r e d v a ric o se v e in in th e m u c o u s m e m b r a n e of th e s e p tu m of th e n o se. A rterial b le e d in g m a y a r is e a s th e re s u lt of a b lo w o n th e n o s e .— N .C .F .
Firs t A id and D rugs. W . N . ( R o s s e n d a l e ) . — I r e a d t o - d a y :— “ T h a t a s a r e s u l t o f A n g l o - A m e r i c a n s c ie n tific c o - o p e r a t i o n , it w a s h o p e d to o b ta in p u r e p e n ic illin — m o r e efficient lif e - sa v in g d r u g th a n even th e su lp h a g ro u p .” I w o n d e r if w e c o u l d h a v e a n a r t i c l e in F i r r t A id o n t h i s p a r t i c u l a r d r u g ? T h e a c tio n a n d a d m i n i s t r a t i o n of d r u g s a r e th e c o n c e r n of d o c to r s a n d tr a in e d n u r s e s , a n d a r e b e y o n d th e sc o p e of first a id . F o r t h i s r e a s o n y o u r r e q u e s t c a n n o t b e g r a n t e d in th is jo u r n a l w h ic h is d e v o te d to th e a d v a n c e m e n t of first a id . -— E d i t o r .
“ FIRST A I D ” QUERY and REPLIES COUPON.
as
f o l l o w s :— 1. C i v i l D e fe n c e . — T h e W e s t R i d i n g C o u n t y M . O . H . in f o r m s m e t h a t “ E v e r y c a s e of f r a c tu r e d s p in e in a n y
To be cut out and enclosed with a ll Queries.
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JOHN BALE MEDICAL PUBLICATIONS MANUALS OF FIRST AID. By N. CORBET FLETCBER, M.B., B.C., M.A.(Cantab.), M.R.C.S. AID S
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Seven th E d itio n . I s . 3 d . post 2 d . F ir s t-A id S im plified and Ta b u la te d , w ith A id s to M e m o ry . “ Col. S ir James C antlie contributes an introduction and we endorse his good opinion o f the book." — L a n c e t ,
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Prob lem s In S tu d y , T re a tm e n t and E x a m in a tio n solved l o r S en io r Stu de nt “ W ithout doubt the book w ill be or great service in the training o f those /or whom it is designed. — B r i t i s h M e d i c a l J o u r n a l .
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T h ir d E d itio n . 1 s. 3 d . p ost 2 d . E rro rs in F ir s t-A id D etailed and Explained. 41 This book gives a clearer insight into the methods a n d difficulties O) emergency treatm ent by laymen than the official Textbook itself." — L a n c e t .
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I s . 3 d . p ost 2 d . D ifficulties In S tu dy and T r e a t m e n t solved by Q ue stio n and A n s w e r. 11We commend this book to Lecturers and Students who w ill fin d it o f &reat service . " — F i r s t A i d . F ifth E d itio n .
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INTRODUCTION TO FIRST AID
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W h ig h a m , M .C ., M .S ., F .R .C .S . A n e w a n d u p to d a te m a n u a l o n th is s u b je c t b a se d o n le c tu re s g iv e n to S t. J o h n A m b u la n c e c la sses o v er a p e rio d of y ears. W ith m an y illu stratio n s. P r i c e ls . 3d. p o s t a g e 2 d .
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O n e o r o t h e r o r all o f th e th r e e races o f g e r m s , S tr e p t o c o c c i, S ta p h y lo c o c ci a n d B. p y o c y a n e u s a r e f o u n d in e v e r y s k in in fe c tio n c o m m o n t o t h i s c o u n t r y , a n d A N T I P E O L O I N T M E N T c o n t a i n s t h e antibodies ( a n t i v i r u s ) o f t h e s e g e r m s . H e a l i n g is e x p e d i t e d b y t h e p r o v e d i n g r e d i e n t s o f t h e o i n t m e n t , a n d s e p t i c d e v e l o p m e n t is s t o p p e d o r p r e v e n t e d b y its a n t i v i r u s s t e r i l e v a c c i n e f i l t r a t e s . A N T I P E O L O I N T M E N T is u n s u r p a s s e d f o r B U R N S a n d S C A L D S , f o r i t is m i c r o b i c i d e a n d n o n - a d h e s i v e , a n d d r e s s i n g s d o n o t r e q u i r e t o b e c h a n g e d every day. W O U N D S , B U R N S , e t c , W I L L N O T T U R N S E P T IC if treated w ith A N T I P E O L O I N T M E N T .
O P H T H A L M O - A N T I P E O L is a s e m i - f l u i d o i n t m e n t , m o r e c o n v e n i e n t t h a n t h e o r d i n a r y A n t i p e o l o i n t m e n t f o r o c u l a r i n f e c t i o n s a n d l e s i o n s . E y e s a ffe c te d b y s m o k e a n d d u s t are s o o th e d a lm o s t im m ed iate ly b y the a p p lic atio n o f O p h th a lm o - A n tip e o l, a n d the a n tiv iru s p r e v e n ts g e r m s f r o m dev elo p in g .
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Bandages and Bandaging. Gases U sed in W a rfa re . C o m m o n D rug s and Doses. M ethods o f G ivin g D rugs. T h e rm o m e te rs .
PRICE 3/6 Postage 3d. Tear out this advertise ment and send it with your name and address and P. O. to Sales Dept. F.A. 34.
Is le s )
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with detailed text accom panying it. 6 /-
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F IR S T
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T h e D isab le d N u rs e I m p r o v i s a t i o n in M o d e r n F i r s t A id T h e H o m e G u a r d a n d F i r s t A id S .J.A .B . H e a d q u a rte rs a n d D istric t R ep o rts P o in ts o n B o n e s for B e g i n n e r s
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38 39 39 40
L e tte rs to th e E d ito r
42
D r. R y m e r C a d e t S h ield C o m p e titio n
42 44
R eview s
44
R ailw ay
Q u e r i e s a n d A n s w e r s t o C o r r e s p o n d e n t s :— T h a n k s to th e D o c to r
44
L o a d in g A m b u lan ce
44
E x a m in a tio n H o w le r
44
A n t i s e p t i c T r e a t m e n t of W o u n d s T r e a t m e n t of S h o c k a n d F r a c t u r e s
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P o is o n in g ...
R e g i s tr a tio n of A ss o c ia tio n A w a r d s
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L a y In s tr u c to r C ertificate
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46 46 48
E x te n s io n of F r a c tu re d F e m u r ...
A ir E x c h a n g e in A rtificial R e s p ir a tio n V e ssel U s e d in B lo o d T r a n s fu s io n
46
46
F r a c t u r e s of P a te lla a n d F e m u r
F r a c tu re s of C lav icle a n d H u m e r u s
46 46 46
G a s P o iso n in g a n d B ro k en N eck T r e a t m e n t of P h o s p h o r u s
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PR1CB THREEPENCE
(4 /- P e r A n n u m , P o s t
F ree
EDITORIAL.
It s aim and object being the advancement o f A m bulance W o rk in a ll its branches, the E d ito r invites R eaders to send A rticles and Reports on subjects pertaining to the M ovem ent and also welcomes suggestions for P ractical Papers.
S o u th e rn
F.R.S.A.
O CTO BER, 1943.
L.
C O N TEN TS
F.R.San.l.,
48 48 48
F r a c t u r e of A r m a t E lb o w
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48
I m r h e r s io n in S t r o n g A cid
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the risks attendant upon
The D isa b led the profession of nursing are N urse. many and varied is a statement
of that self-evident nature which does not call for amplification, and welcome is the announcement that arrangements have been made between the Ministry of Labour and National Ser vice and the Ministry of Health under which State registered nurses who on account of disability are not fit to return to their previous nursing work, but who are suitable for employment as sister tutors, health visitors or industrial nurses, may receive training for that purpose. It is anomalous to a degree that one who has spent many years of her life, and possibly the best of those years, should find herself, through no fault of her own, on a labour market which has no place for her. Hospital authorities have now been invited by the Ministry of Health to inform nurses who are undergoing treatment about the arrangements that have been made, and any such nurse who wishes to apply will be interviewed in hospital by a representative of the Ministry of Health. A disabled nurse who is not receiving treatment in hospital and who being unfit to resume her normal occupation wishes to apply for training of this kind should write, with full particulars of her case, to the Chief Nursing Officer and Principal Matron of the Ministry of Health, Whitehall, S .W .l, who will arrange for her to be interviewed and, if she is considered suit able, to enter a course of training. Similar arrange ments for the training of disabled nurses will shortly, we are informed, be made in Scotland. Concessions have been made to meet the case of disabled nurses who are not able to take advantage of any of the courses of training for the profession referred to, and they may apply to the Ministry for training in some other occupation either under the scheme of “ Further Education and T rainin g” recently announced by the Government or under the interim scheme of training for the disabled. We understand that it is now possible in the case of disabled persons to provide a variety of courses, and arrangements will be made for nurses who may be found suitable to take courses for such occupa tions as hospital almoner, radiographer, masseuse,
F I R S T
33
and chiropodist. The cost of a training course together with maintenance allowances, will be paid by the Departments concerned. From this, and other matters in connection with the well-being of the profession, it will be recognised that good may come even out of such a vile thing as war, for it is indisputable that had things proceeded in the old jog-trot fashion, questions such as care of the dis abled, increased salaries, security of tenure, and so forth would be long ere they received consideration. There are, of course, (there always will be) many matters still calling for attention, but the past year or two has witnessed the introduction of much that has been of distinct advantage to the profession.
I m p r o v i s a t i o n in M o d e rn F i r s t Aid. M .O .,
By BOW M AN EDGAR. 4th B a ttn ., D u m fr ie s s h ire
H .G .
I n a n e a r l i e r i s s u e of F i r s t A id I g a v e a r e s u m e of t h e p o s s ib il itie s of I m p r o v i s a t i o n , a n d o ff e r e d t o s e n d p a r t i c u l a r s to th o se in te re sted . S o g r e a t w a s th e n u m b e r of such r e q u e s ts t h a t I d e c id e d to p u b lis h o u r id e a s in t h e fo r m of a sm all brochure. T h i s h a s , u n f o r tu n a te ly , p ro v e d to b e i m p o ssib le , so p e r h a p s c o r r e s p o n d e n ts w ill fo r g iv e th e d e la y in a c c e d i n g to th e ir r e q u e s ts . T h e first i n s t a l m e n t d e a ls w ith t h e u p p e r p a r t of t h e b o d y , t h e l o w e r li m b s w ill b e d e a l t w i t h n e x t m o n th . T h e w h o le t r e n d of m o d e r n first a id is t o w a r d s s im p lifi c a t i o n . r a p i d i m m o b i l i s a t i o n a n d g e n e r a l efficien cy . The d a y s of o n ly sp e c ia l ( t r i a n g u l a r o r o th e r) b a n d a g e s a n d sp e c ia lly m a d e s p lin ts a r e over. T o - d a y th e first a id e r m u s t b e a b le to t u r n to u s e a n y t h i n g w h i c h lies to h a n d . Shock, t h a t d a n g e r o u s r e s u l t of F e a r , P a i n a n d C o ld , c a n b e m u c h re d u c e d by e a rly fix atio n of fra c tu re d o r serio u sly la c e ra te d lim b s. T o th is e n d Im p ro v isa tio n p lay s a n im p o r ta n t p a rt. S o f a r a s th e A r m y a n d H o m e G u a r d a r e c o n c e rn e d , it is n o w p o s s ib le to im m o b il is e a n y f r a c tu r e , e x c e p t th e S p in e , w ith n o o t h e r e q u i p m e n t s a v e th e e v e r y d a y o u tfit of th e so ld ier. l t is i n t e r e s t i n g to c o n s id e r h o w m u c h c a n b e d o n e w ith th is a p p a re n tly m e a g r e k it. T h r e e t y p e s o f S lin g a r e a v a i l a b l e .
R I D s e c u r e ly h e l d in p o s itio n b y t h e u s e of t h e l i g h t l i n i n g o f t h e steel h e lm e t. T h e d r e s s in g , F . F . D . o r sh ell, h a v i n g b e e n a p p lie d , th e l i n i n g is a d j u s t e d so a s to p r e v e n t p r e s s u r e o n th e w o u n d , a n d th e b a n d a g e , a fte r b e in g looped ro u n d th e b a s e o f t h e l i n i n g , is t ie d b e l o w t h e c h i n . T h u s s lip p in g of t h e d r e s s i n g is p r e v e n t e d .
Fracture of Lower Jaw. 1. T h e “ b a r r e l b a n d a g e ” , m a d e w i t h a s h e l l - d r e s s i n g , s e e m s to b e th e id e a l a p p lic a tio n fo r th is ty p e of in ju ry . M o d e r n o u t l o o k o n th is f r a c t u r e (v id e “ F i r s t A id a n d t h e M e d i c a l P r a c t i t i o n e r , ” P r a c titio n er , 1943 ) i s , t h a t t i g h t b a n d a g i n g is n o t o n l y p a i n f u l b u t d i s t i n c t l y h a r m f u l . S o it fo llo w s t h a t e fficien t p a d d i n g b y t h e s h e ll - d r e s s in g , a l o n g w ith c o m fo rta b le fix atio n by th e b a n d a g e of th a t d re s s in g s h o u ld p ro v e to b e c o m f o r t in g a n d all sufficient. T h e “ b a r r e l b a n d a g e ” i s , o f c o u r s e , m a d e a s f o l l o w s :— A d ju s t th e d re s s in g c o m fo rta b le a r o u n d th e in ju re d ja w , th e b a n d a g e en d s p o in tin g u p each ch eek . A s k th e p a tie n t to h o ld th e b a n d a g e s in th is p o sitio n . T ie th e e n d s in a h a lf k n o t o n th e to p of th e h e a d . O p e n o u t th e h alf-k n o t a n d c a r r y th e fo r w a rd loop d o w n a r o u n d th e fo re h e a d , th e b a c k lo o p is s l ip p e d b e h i n d t h e o c c i p u t. N o w , h o ld in g a n end of th e b a n d a g e in e a c h h a n d , a d j u s t a n d t i g h t e n th e lo o p s above th e ears. T ie off o n to p of s k u ll w h e n c o m fo rta b le .
2. A n e x c e l le n t e m e r g e n c y s u p p o r t f o r f r a c t u r e d l o w e r ja w can be m a d e by h o ld in g tw o p u ll-th ro u g h s to g e th e r by th e ir m id p o in ts. T i e a k n o t 2-3 i n c h e s t o e a c h s i d e o f t h i s centre. T h e p o in t of th e ja w slip s in to th e lo o p th u s fo rm ed , a n d th e e n d s a re c arrie d u p, one over th e tem p les a n d t ie d o n t h e t o p of t h e s k u l l , t h e o t h e r is t ie d a t t h e o ccip u t. T h e free e n d s of th e s e tw o c o rd s a r e th e n tied to g e th e r. P a d d in g c a n b e su p p lie d b y c a m o u fla g e n et, h a n d k i e s , etc.
Fracture of Clavicle. P la c e a n a m m u n itio n p o u c h a s fa r u p in th e a x illa a s p o ssib le. L a y th e fin g e r-tip s of th e in ju r e d h a n d o n th e u n in ju re d co llar-b o n e. S lip t h e lo o p o f a rifle s l i n g o v e r t h e p o in t o f t h e e lb o w o n th e in ju r e d sid e. C a rry th e e n d s of th e slin g u p w a rd s, th e s h o rte r e n d b e h in d , th e lo n g e r in fro n t. T h e la tte r ru n s u p th e fo r e a rm a n d h a n d , th u s b in d in g th e m to th e c h est. T i e off th e e n d s of s l i n g o v e r th e b a c k of t h e u n in ju r e d sh o u ld er. U s e th e w a ist-b e lt to pu ll b a c k th e p o in t of th e e lb o w , th u s b r a c in g th e s h o u ld e r a n d fix in g a r m to c h est.
Fracture of Both Clavicles. S lip w e b -e q u ip m e n t s lin g s o v e r e a c h s h o u ld e r, tie th e m b e h in d so a s to b ra c e s h o u ld e rs b a c k . T i e lo o se e n d s to g eth er. S u p p o r t b o th a r m s in n e t s lin g .
(a ) C a n b e f o r m e d b y f a s t e n i n g t h e w r i s t b u t t o n of th e b a ttle d re ss to th e b u tto n -h o le of th e o p p o site b re a st
Fractured Clavicle and Shoulder on same side.
pocket. (b) T h e “ n a r r o w - b a n d a g e ” ty p e of s lin g , a s fo r f r a c t u r e o f s h a f t of h u m e r u s , is m a d e f r o m t h e w a i s t b e l t a s f o l l o w s :— S l i p t h e f r e e e n d o f t h e b e l t t h r o u g h th e g u a rd . P a s s t h e w r is t t h r o u g h t h s lo o p th u s form ed. T ig h te n a n d a d ju st a ro u n d w rist a s neces sary. C a r r y lo n g e n d of b e lt r o u n d n e c k a n d b u c k le a t o p p o s ite s id e of n e c k o r c h e s t, a s d e sir e d . (c ) N e t S lin g f o r i n j u r e d f o r e a r m . U s in g th e h e lm e t c a m o u fla g e n et, fa s te n th e u p p e r n e t c o rd o v e r t h e b u tto n s of th e b r e a s t p o c k e t. L a y th e in ju red a r m a c r o s s m id d le of n e t a s it lies a c r o s s th e c h est. T a k e u p lo w e r b o r d e r of n e t o v e r f o r e a r m a n d e lb o w . F a s t e n to s a m e b u tto n s . A d ju st ro u n d elb o w a n d h a n d
D o u p s h o u ld e r s a s in p re v io u s ite m . P a d w ith a m m u n itio n p o u c h b e tw e e n b ro k e n a r m a n d ch est. C over upper a r m w i t h o p e n g a i t e r a n d fix w i t h r i f l e - s l i n g a r o u n d c h e s t . W r is t s u p p o rte d in b e lt-slin g .
a s necessary. N o te .— B o th fo re a rm s c a n b e s u p p o rte d in o n e net
Head Injuries. L a c e r a te d w o u n d s o r fra c tu re d sk u ll. S u c h in ju ries m a y be p ro tected a n d
th e
d re ssin g s
Fracture of Shoulder Blade. P a d w ith n e t, h a n d k i e s , o r a n y t h i n g so ft. O pen g a ite r o v e r in ju r e d b o n e to re s tric t m o v e m e n t. F i x w ith rifleslin g . F ix a r m to c h e s t b y w a ist-b e lt ro u n d a r m a n d ch est.
Fractured Humerus. F o ld g a ite rs fo u r tim e s. O n e m a k e s in n e r a n d th e o th e r o u te r sp lin t. F ix w ith p u ll-th ro u g h , h a n d k ie s, bo o tlaces, etc. S u p p o r t w ris t in b elt slin g .
Fractured Forearm. B a y o n e t, h eld w ith b e y o n d elb o w , m a k e s a n b a rd fo rm s a n e q u ally grass, hay or an y th in g
h ilt in p a lm a n d p ro te c te d p o in t ex cellen t in n e r sp lin t. T he scab efficient o u te r s p lin t. P a d w ith soft. T ie on w ith p u ll-th ro u g h s,
h a n d k ie s, la c es, etc.
F ix to sid e in n e t-s lin g by b e lt r o u n d
a r m a n d c h est.
Fractures or Injuries of the Hand. C a n b e w e ll s u p p o r te d b y p a d d i n g w i t h a first-field d re s s in g a n d u s in g a b a y o n e t fro g a s sp lin t. S lip p in g one o r t w o "fingers t h r o u g h t h e e y e o f t h e f r o g . T i e eflf w i t h t h e b a n d a g e of th e F . F . D .
Fractu re d Ribs. A re e asily a n d c o m fo rta b ly tre a te d by o p e n g a ite rs b o u n d firm ly o n b y w e b -slin g s. T h e c o m f o r t of th e p a tie n t is t h e t e s t of t h e f i r m n e s s w i t h w h i c h t h e g a i t e r s s h o u l d b e fixed. S u p p o r t th e a r m o n th e in ju re d sid e in a n e t-s lin g . If d e s i r e d , fix a r m t o c h e s t b y w a i s t - b e l t , rif le o r w a t e r bo ttle slin g .
T h e H o m e G u a rd a n d F i r s t Aid. A n s w e r s t o Q u e r ie s .
W h i le d e a lin g w ith th e q u e stio n of w a te r su p p ly a n d p u rific a
tio n , I h a v e re c e iv e d s e v e ra l le tte rs r e q u e s ti n g a d v ic e o n s im ila r q u e s tio n s , so w ill e n d e a v o u r to a n s w e r t h e m in th e p re se n t issu e. F ir s t, th e n , t h e w e a r i n g of first a id b a d g e s . A rm y C o u n c il in s tru c tio n s d is tin c tly s ta t e t h a t h o ld e rs of S t. J o h n A m b u l a n c e o r R e d C ro s s c e rtific a te s, a r e e n title d to w e a r t h e b a d g e o n t h e l e f t s l e e v e o f t u n i c , j u s t a b o v e t h e cuflf. O ffice rs a r e n o t ju s tifie d , t h e r e f o r e , in r e f u s i n g to p e r m i t th is , a s a p p e a rs to b e th e c ase in m a n y u n its. M y o w n C .O . for i n s t a n c e , n o t o n l y e n c o u r a g e s it, b u t e v e n p a y s e x a m i n i n g fees, a s h e c o n s i d e r s , q u i t e r i g h t l y , t h a t t h e s t a n d a r d r e a c h e d b y c e r tific a te d p u p ils is a v a l u a b l e s t e p t o w a r d s effic ie n c y in th e u n it. A n u m b e r of M e d i c a l S e r g e a n t s a s k if t h e r e is a d i s tin g u is h in g b a d g e o r b ra ssa rd , w h e n th ey a re a c tin g as in stru c to rs o r B att. M ed ical O rd erlies. N o n e w h a tev e r ! I t is th e o ld g r o u s e a b o u t t h e S .B . b r a s s a r d a ll o v e r ag ain . T h e M .O . on ly , w e a r s th e G e n e v a C ro s s, all o th e r ra n k s sh o u ld w e a r th e S .B . b ra s sa rd , in c lu d in g s e rg e a n ts . M y c o r r e s p o n d e n t s c o n t e n d t h a t if t h e y h a v e r e a c h e d t h e s ta n d a r d n e c e s sa ry to ju stify th e ir a p p o in tm e n t a s lay in s tr u c to r s , t h e n it is s o m e w h a t i n s u l t i n g to b e cla ss ifie d a s stretch er b earers. I h eartily concur, b u t th e s a m e a r g u m e n t h o ld s g o o d for a n y H .G . m e d ic a l o rd e rly w h o h a s re a c h e d th e a d v a n c e d s ta n d a r d , w h e th e r N .C .O . o r n o t. T h e ir r e s p o n s i b i l i t i e s , if e v e r c a l l e d o u t , w o u l d b e t r e m e n d o u s — f a r in e x c e s s of th e o ld s tr e tc h e r b e a re rs.
P h o sp h o ru s B u r n s . — E x t e n s i v e N o r t h o v e r p r a c t i c e a l w a y s c a r r i e s t h e r i s k of p h o s p h o r u s b u r n s , a n d s o m e d if f e r e n c e of o p in io n e x ists a s to tr e a tm e n t. T h e co p p er su lp h a te m e th o d — f a v o u r e d b y t h e A m e r i c a n s , I b e l i e v e — is s till c o n s i d e r e d th e b e st in th is a re a . F o r th o se u n its w h o h a v e n ot yet b een i n s t r u c t e d i n t h i s , t h e t r e a t m e n t i s a s f o l l o w s :— ( 1) T h o r o u g h l y s w a b b u r n s w i t h a s a l i n e s o l u t i o n , m a d e b y d is s o lv in g o n e te a s p o o n fu l of s a lt in a p in t of w a te r . ( 2 ) A p p l y c o p p e r s u l p h a t e s o l u t i o n (5 p e r c e n t . ) , a n d a l l o w t o r e m a i n o n b u r n s f o r not more t h a n t w o m i n u t e s . W a s h off w ith s alt so lu tio n a g a in . ( 3) D r e s s a s o r d i n a r y b u r n .
W .
S p read b u ry
HEADQUARTERS AND DISTRICT REPORTS.
N o. I (P rin ceof W ales’s) D istrict N o . 81 ( C r o y d o n ) C a d e t N u r s i n g D i v i s i o n . — T h e f i r s t e n r o l m e n t o f N o . 81 ( C r o y d o n ) N u r s i n g C a d e t s t o o k p l a c e o n S a t u r d a y , S e p t e m b e r 25 t h , i n S . S a v i o u r ’s S c h o o l s , W e s t C roydon. O w i n g to th e in d is p o sitio n of th e L a d y A r e a C a d e t O fficer, M rs. P e te r C h e y n e y , th e c e r e m o n y w a s c o n d u c te d by L a d y D is tr ic t O fficer M iss W a t e r s . About a hundred p a re n ts, te a ch e rs a n d frien d s w e re p resen t. A d i s p l a y of b a n d a g in g , co u n try d a n c in g a n d first a id fo llo w e d th e en ro lm en t. A m o s t s p e c t a c u l a r p a g e a n t , d e p i c t i n g all a s p e c ts of th e C a d e t m o v e m e n t , w ith t h e K n i g h t s of S t. J o h n in t h e b a c k g r o u n d , b r o u g h t to a n e n d a m o s t s u c c e ss fu l a fte rn o o n . M iss W a te r s c o n g r a tu la te d th e C a d e ts o n th e ir s m a r t a p p e a r a n c e , e i g h t e e n o f t h e t w e n t y m e m b e r s b e i n g in u n ifo rm . T h is D iv isio n w a s o n ly re g is te re d in M ay .
C / N 54 a t t a c h e d t o N . 16 ( H a m p s t e a d ) N u r s i n g D i v i s i o n . — O n S e p t e m b e r 23 r d , a m o s t s u c c e s s f u l W h i s t D riv e w a s a r r a n g e d b y th e C a d e t O fficers, a n d w a s h e ld a t F i r s t A id P o s t “ F , ” B e r r i d g e H o u s e , N . W . 6 , b y k i n d p e r m is s io n of M .O .H . D r. O l d e r s h a w a n d M iss S a m u e ls ( C o m m a n d a n t P o s t “ F ” ). A p a rt fro m h elp ers fro m th e p a re n t b o d y a n d C a d e ts , th e re w e re a lso p re s e n t D is tric t O fficer M rs. R a y n e r, w h o m a d e a s h o rt a n d in te re s tin g speech, D iv . S u p t. M iss F in c h a n d o th e r B r ig a d e O fficers, a s w ell a s C a d e t S u p t. M iss B u rley . A ll a v a i l a b l e t a b l e s w e r e filled a n d t h e s u m o f 10 s . c o llected to w a r d s C a d e t fu n d s.
County of Bedford. L o n d o n R o a d ( B e d fo r d ) D iv is io n .— N e w A m b u l a n c e a n d N u rs in g C ad e ts w ere en ro lled a t th e L o n d o n R o a d (B e d fo rd ) D iv isio n of th e S .J .A .B ., in th e S ilv e r J u b ile e S c h o o l o n S e p t e m b e r 20 t h . T h e cerem ony w as opened by th e L a d y C o u n ty C a d e t O fficer J u n io r C o m m a n d e r M rs. H u g h M c C o rq u o d a le , w h o in s p e c te d th e D iv isio n . M r. W m . V e a ts , C a d e t S u p t., in a s h o r t sp e e c h , s ta t e d t h a t h e s t a r t e d t h e D i v i s i o n i n N o v e m b e r , 1942 , w i t h s e v e n m em bers. N o w , w i t h a p p r o x i m a t e l y 150 m e m b e r s , i t w a s p r o b a b l y o n e o f t h e l a r g e s t D i v is i o n s in t h e C o u n ty . H a n d ic r a f ts m a d e by th e C ad e ts a n d ju v en iles w e re on view , a n d th e s e w e r e p u t in to c o m p e titio n s l a te r o n in th e ev en in g . A fte r a d e m o n s tra tio n of ro ller b a n d a g i n g b y th e C a d e ts a n d N . C . O . ’s , P r e l i m i n a r y a n d H o m e N u r s i n g C e r t i f i c a t e s w e re p re s en te d b y M rs. M cC o rq u o d a le , w h o a fte rw a rd s a d d re sse d th e ch ild ren . S h e p raised th e ir w o rk a n d re m in d e d th e m th a t th e y b e lo n g e d to a w o n d e rfu l fello w sh ip . T h e n e w C a d e ts th e n m a r c h e d o n to th e p la tfo r m for en ro lm e n t, a n d after receiv in g th e ir e n ro lm e n t b o o k s a n d certificates fro m M rs. M c C o rq u o d a le , re p e a te d a fte r h e r th e ir C o d e of C h iv a lry . A fter th is c e re m o n y a s h o r t p ra y e r w a s sa id a n d th e s tir r i n g m a r c h “ K n i g h t s of S t. J o h n , ” w a s sung. A m o n g th o se p re sen t w e re th e M ay o r a n d M ay o ress (A id . a n d M rs . F . A. R ic k a r d ) .
County of Gloucester.
A p a il of w a t e r s h o u ld , of c o u rs e , a lw a y s b e o n th e sp o t, i n t o w h i c h t h e b u r n t p a r t s c a n b e p l u n g e d i m m e d i a t e l y , if necessary. C.
S t . J o h n A m b u l a n c e B r ig a d e
(S erg t.),
S c h o o l H o u s e , N o e l - r o a d , W . 3.
G l o u c e s t e r R o t o l D iv is io n .— T h e a n n u a l i n s p e c t i o n of th e A m b u la n c e a n d N u r s in g D iv isio n s w a s h eld on S u n d a y , O c t o b e r 3 r d , a t 11 a . m . T h e I n s p e c t i o n O ffic e r w a s C o l. S le e m a n , C .B ., C .B .E ., M .V .O . (C h ief C o m m issio n e r B rig a d e O verseas), a c c o m p a n ie d by D r. B a rre tt C ard ew ,
40
F I R S T
M .C ., F . R . S . C . E . (C o u n ty C o m m is sio n e r), M iss D . F a b e r (L a d y C o u n ty S u p t.), M r. E. O . C a m e r o n (G e n . S ecty . a n d V ic e P r e s id e n t) , M r. W ilk in s o n (S e c u rity O fficer) a n d D r. H . G . D o w le r (D iv . S u rg e o n ). A le tte r of a p o lo g y w a s re c eiv ed fro m M r. R . S ta m m e r s (G en. M a n a g e r a n d P resid en t). S u p t. D e n t c o m m a n d e d th e p a r a d e , L a d y D iv . S u p t. W a k e l a n d b e in g in c h a r g e of th e N u r s i n g D iv isio n , th e re b e i n g a l t o g e t h e r 67 m e m b e r s p r e s e n t . A f te r a n e x te n s iv e in s p e c tio n , C o l. S l e e m a n , a d d r e s s i n g th e D iv is io n s, s a id h o w p r o u d h e w a s o n th e o c c a s io n of his s e c o n d v is it t o R o t o l t o find s u c h a h i g h s t a n d a r d of w o r k a n d discip lin e, b u t a lso th e sp irit w h ic h a n im a te d th e h isto ric and an cien t O rder. A s C h ief C o m m is s io n e r, B rig a d e O v e r se a s, h e h a d tra v e lle d t h r o u g h th e D o m in io n s a n d B ritish C o m m o n w e a l t h of N a tio n s , b u t h e c o u ld ju s tifia b ly s a y th a t h e h a d n e v e r s e e n s u c h a h i g h s t a n d a r d of e ffic ie n c y . C o n t i n u i n g C o l. S l e e m a n s a i d h e w o u ld lik e to c o m m e n d t h e D i v i s i o n a l S u r g e o n , D i v . S u p t . , O f f i c e r s a n d N . C . O . ’s fo r th e v e ry h i g h s t a n d a r d of t r a i n i n g a s re fle c te d a t th e in sp ectio n . D r. B a rre tt C a rd e w also a d d re sse d th e co m p an y . M r. E . O . C a m e r o n s a id t h a t it w a s h is first a p p e a r a n c e a t a D iv is io n a l fu n c tio n , s in c e h e h a d b een h o n o u r e d a s V iceP resid en t. I t to o k h im b a c k m a n y y e a r s to h is b o y h o o d d a y s w h e n h e le a r n e d th e r u d im e n ts of first a id w ith th e B oy S c o u ts. D r. H . G . D o w le r, o n b e h a lf of th e D iv isio n , th a n k e d C o l. S l e e m a n a n d t h e O ffic e rs p r e s e n t fo r t h e h o n o u r b e s to w e d u p o n th e m by th e ir p resence.
County of Leicester. C i t y o f L e i c e s t e r . — T h e first a n n u a l in s p e c tio n of th e C ity o f L e i c e s t e r E l e c t r i c i t y D i v i s i o n of t h e S . J . A . B . w a s h e ld a t th e C en tra l G e n e ra tin g S ta tio n by C o m m issio n e r G. F. B ro w n e , a s s is te d b y C o rp s S u p t. J. J. D e x te r , a n d C o rp s S g t. M a jo r P eel. A f te r w a r d s , th e C o m m is s io n e r u n v e ile d a ro ll of h o n o u r of m e m b e r s of th e D iv isio n s e r v in g in th e F o r c e s . Com m issio n er B ro w n e c o m p lim e n te d m e m b e rs on th eir s m a r t tu rn -o u t.
A I D T h e L a d y B la n c h e C o b b o ld , C o u n ty P re s id e n t, v isited t h e g ir l s fo r te a , a n d a f t e r w a r d s w a tc h e d th e m b e in g d rilled , by a n A rm y D rill S e rg e a n t. O t h e r v isito rs w h o h e lp e d w ith in s tru c tio n a n d re c re a tio n w e re C o u n ty O fficer M iss B a ld w in , R ev . T a tte rs a ll, M iss N. M iller a n d M iss W ilb y . C o u n ty S u p t. M iss P a r k e r a n d C o u n ty C a d e t O fficer M iss B o tw o o d w e r e in c h a r g e , w h ile p o s ts of Q .M ., M . O . , e tc ., w e r e filled b y D i v i s i o n a l officers. T h e h e lp of th e school d o m e stic staff w a s m u c h ap p reciated .
West Riding of Yorkshire. A i r d a l e C o l l i e r i e s . — T h e fifth i n t e r - c o l l i e r i e s a m b u la n c e c o m p e titio n in c o n n e c tio n w ith th e A ird a le C ollieries, L td ., to o k p la c e a t th e W e lfa re H a ll, A llerto n B y w a te r, n e a r C a s t l e f o r d , o n S a t u r d a y , S e p t . 25 t h . T h e w i n n e r s w e r e : 1, A l l e r t o n B y w a t e r 136 i p o i n t s ; 2 , F r y s t o n 114 £ ; 3 , W h e l d a l e 109 L H . B a rk e r, A lle rto n B y w a te r, w o n th e in d iv id u al c o m p e t i t i o n w i t h 2 H p o i n t s o u t o f a p o s s i b l e 30 .
P o n t e f r a c t a n d D i s t r i c t C o r p s .— T h i s C o rp s r e c e n tly a r r a n g e d a f l a g d a y i n i t s a r e a a n d c o l l e c t e d ,£ 105 14 s . f o r t h e A id to R u s s i a F u n d . A T e a a n d C o n fe re n c e of O fficers, S e c re ta r ie s a n d T r e a s u r e r s o f t h e C o r p s w a s h e l d o n O c t o b e r 2n d . C orps S u p t. T . C. A m e ry p re sid ed . T h e C h a ir m a n s a id th a t a s n o in sp ec tio n s h a d b e en h eld d u r i n g th e w a r, th e a r e a s ta ff s e e m e d to b e lo s in g to u c h w ith th e C o rp s , a n d D r. B ev e rley h a d w is h e d to m e e t th e O fficers t o d i s c u s s t h e p r e s e n t a n d f u t u r e a c t i v i t i e s of t h e B r i g a d e . T h e f o llo w in g p re s e n ta tio n s w e r e m a d e — 6 b a r s to serr v i c e m e d a l s a n d 1 2 m e d a l s f o r 15 y e a r s s e r v i c e . D r. B ev e rley d r e w a tte n tio n to th e im p o r ta n c e of th e C a d e t m o v e m e n t, a n d o b s e rv e d t h a t c o u rs e s of in s tr u c tio n w e r e b e i n g h e l d fo r all C a d e t O f f i c e r s a n d t h o s e i n t e n d i n g to ta k e up th e w o rk . M an y m a tte rs w e re raised by m e m b e rs a n d d e a l t w i t h b y t h e a r e a staff.
P o in ts on B o n e s f o r B e g in n e rs .
County of Suffolk. I p s w i c h .— O n a re c e n t S u n d a y , t h e m e m b e r s of Ip s w ic h
D iv isio n m e t fo r th e a n n u a l in sp e c tio n w h ic h to o k p lace a t C h r i s t c h u r c h P a r k , w h e r e th e E a r l of C r a n b r o o k , C o m m is s io n e r fo r S u ffo lk , s u p p o r te d by th e C o u n ty O fficers to o k th e g e n e ra l sa lu te a n d in sp ected th e p arad e. A t th e clo se of th e in s p e c tio n , th e C o m m is s io n e r e x p re ss e d h is th a n k s fo r s u c h a g o o d m u s te r a n d h o p e d th a t th e C a d e ts w o u l d jo in a n a d u l t D iv is io n w h e n t h e t i m e c a m e fo r t h e m to tr a n s f e r , a n d p ro v e th e m s e lv e s w o r th y m e m b e r s of S .J .A .B . T h e t o t a l n u m b e r o n p a r a d e w a s 236 . T o clo se th e s u m m e r p r o g r a m m e of C h u r c h P a r a d e s th e in s p e c tio n w a s fo llo w e d by a D r u m h e a d S erv ice, w h ic h w a s c o n d u c t e d b y t h e R ev . H a r o l d G re e n , V ic a r of S t. N ic h o la s C hurch. T h e P a r a d e m a rc h e d b a c k to th e A m b u la n c e H e a d q u a rte rs a n d w e re d ism issed by th e C o rp s S u p e rin te n d e n t F. E. G o ddard.
O n S e p t e m b e r 18 t h , f o r t y - t h r e e N u r s i n g C a d e t s , r e p r e s e n tin g tw e lv e S u ffo lk D iv isio n s, m e t a t K e s g r a v e A re a S ch o o l, n e a r Ip sw ic h , for a tr a in in g w e e k -e n d . I t is h o p e d t h a t a s a r e s u lt t h e r e w ill b e a n in c r e a s e in th e n u m b e r s o f N . C . O . ’s . A n in te re s tin g tim e w a s sp en t a n d m a n y n e w frien d sh ip s w ere g a in e d . E m p h a s is w a s laid o n th e n e c e ssity f o r t h e S p i r i t u a l a s w e ll a s t h e p r a c t i c a l s i d e o f life b e i n g a n e s s e n t i a l p a r t o f a g o o d f o u n d a t i o n f o r life a h e a d .
T h e r e a r e a b o u t 200 b o n e s i n t h e h u m a n s k e l e t o n . B ones c o n sis t of a n i m a l a n d e a r th y m a tte r . I n c h i l d r e n ’s b o n e s a n i m a l m a t t e r p r e d o m i n a t e s , w i t h t h e r e s u l t t h a t t h e y m e r e l y c r a c k o r b e n d w h e n v i o l e n c e is a p p lied , s u c h fr a c tu re s b e in g called “ g r e e n s ti c k .” In e ld e r ly p e r s o n s t h e p r o p o r t i o n of e a r t h y m a t t e r is g r e a t e r , w h ic h c a u s e s th e m to s n a p m o re easily , b u t r e ta r d s p r o g r e s s of a c tio n . T h e s k e l e t o n is a f r a m e w o r k of b o n e s . O n it th e b o d y is b u i l t a n d c o n s i s t s o f m u s c l e s , a r t e r i e s , v e i n s , n e r v e s , e t c . , w h i l e e n c l o s i n g a ll is t h e s k i n . T h e sk e le to n d e te rm in e s th e size a n d s h a p e of th e b ody. In ta ll p e o p le th e b o n e s in th e lim b s a r e l a r g e r t h a n in t h o s e of s m a l l e r s t a t u r e . T o th e b o n e s a r e a tt a c h e d th e m u s c le s w h ic h “ p u ll ” in v a rio u s d ire c tio n s. I n w a l k i n g , f o r e x a m p l e , t h e l e g is s te p p e d fo r w a r d ch ielly by m u s c le s s tr e tc h in g fro m p e lv is to fr o n t of t h i g h , w h ile t h e k n e e is b e n t b y t h e m u s c l e s w h ic h a r e a t t a c h e d to th e b a c k of th i g h a n d e n a b le th e to e s to c le a r th e g ro u n d . T h e b o d y is r a i s e d o n t h e to e s, b e h in d , a n d c a r r ie d f o r w a r d m a in ly b y th e m u s c le s in th e calf. O f t h e e i g h t b o n e s i n t h e c r a n i u m , a n d t h e 14 b o n e s i n t h e f a c e , o n l y o n e is m o v e a b l e , n a m e l y t h e l o w e r j a w . T h is j o i n t is m a i n l y a h i n g e j o i n t , b u t a l l o w s a g o o d d e a l o f s i d e to -s id e m o v e m e n t, w i t h s o m e b a c k w a r d a n d f o r w a r d a s w ell a s its c h a r a c te ris tic u p -a n d -d o w n m o v e m e n t. T h e bones o f' t h e c r a n i u m a r e s o c lo s e ly i n t e r l o c k e d t h a t they' a r e a s o n e J bone. T h e j o i n t s a r e s a w - l i k e o r lja v e t h e a p p e a r a n c e of b e in g stitc h ed , th e ir u n io n s b e in g called “ s u tu r e s .”
F I R S T B ones a re called “ lo n g ,” “ fla t,” “ ir r e g u la r ,” a c c o rd i n g to th e ir size a n d s h a p e . L o n g b o n e s a r e lo n g n a r r o w a n d h o llo w . T hey are fo u n d in th e a r m a n d f o r e a r m a n d in th e th ig h a n d leg , a n d a s s m a l l l o n g b o n e s in t h e f in g e r s a n d to es. T h e s h o r t b o n e s a r e th o s e of th e w ris t (c a rp a l b o n e s) a n d th e a n k le (ta rs a l bones). T h e flat b o n e s a r e c la v ic le ( s h o u l d e r b la d e ) a n d th e s te r n u m (b r e a s t bone). T h e irr e g u la r bo n es a r e th e v e rte b ra e (b o n es of th e sp in e). B o n e s , l ik e o t h e r p a r t s of t h e b o d y re c e i v e n o u r i s h m e n t fro m th e b lo o d t h r o u g h th e s m a l l b lo o d v e ss e ls in th e p e rio ste u m , th is b e in g th e s h e a th w h ic h co v ers th e bone. B o n es a lso p ro v id e p ro te c tio n for im p o r ta n t o r g a n s su c h as th e b ra in , th e s p in al cord a n d th e o r g a n s w ith in c h est a n d abdom en. T h e b o n e s o f t h e s p i n e a r e 7 c e r v i c a l , 12 d o r s a l , 5 l u m b a r , w h i l e t h o s e o f t h e p e l v i s a r e 4 i n n u m b e r (2 o s s a in n o m in a ta , 1 s a c r u m , a n d 1 coccyx). T h e cerv ical (fro m cerv ix th e n e c k ) v e rte b ra e a re u p p e r m o s t ; th e d o rs a l a t th e b a c k a n d th e l u m b a r in th e lo in s ; w h ile th e o s s a i n n o m in a ta (o r h a u n c h b o n e s), th e s a c r u m (or r u m p b o n e ) a n d th e co ccy x (o r tail piece) fo rm th e b o n e y b a s i n t h r o u g h w h i c h w e i g h t is t r a n s m i t t e d to t h e l o w e r lim b s. T h e v e rte b ra e h a v e e a c h a p ro jectio n , o r “ p r o c e s s ” w h ic h s t a n d s o u t a n d w h i c h c a n e a s ily b e felt u n d e r t h e s k i n r u n n i n g d o w n th e w h o le l e n g th of th e s p in a l c o lu m n . T h e v e r te b ra e a r e piled u p o n e o n to p of th e o th e r. B e t w e e n e a c h is a p a d - l i k e p ie c e of g r i s t l e , w h i c h s e r v e s t h e p u rp o s e of a b u ffer a n d h e lp s to b r e a k th e fo rce of a b lo w s u c h a s w o u ld b e re c e iv e d a s th e r e s u lt of a fall f r o m a h e i g h t o n to t h e feet. If th e s p in e w e re a so lid b o n e th e fo rce w o u ld be c a rrie d u p to th e s k u ll w ith o u t in te rru p tio n a n d c au se fra c tu re th ere. T h r o u g h t h e v e r te b r a e , t h e r e r u n s a n o p e n i n g in w h ic h is p r o t e c t e d t h e m a r r o w o r s p i n a l c o r d . T h e first, o r u p p e r m o s t v e r t e b r a is c a l l e d t h e a t l a s . T h e h e a d r e s t s o n it a n d f o r m s a j o i n t , t h r o u g h w h i c h t h e n o d d in g m o v e m e n ts of th e h e a d t a k e s place. T h e s e c o n d v e r t e b r a is t h e a x is . T h is h a s a to o th -lik e p ro je c tio n o n its u p p e r s u r f a c e a n d a c t s a s a p iv o t b y w h ic h th e s id e - to -s id e m o v e m e n t s o f t h e h e a d a r e effected . T h e 12 p a i r s o f r i b s j o i n t h e 12 d o r s a l v e r t e b r a e b e h i n d . T h e u p p e r 7 rib s jo in in f r o n t th e s t e r n u m ( b r e a s t b o n e ) ; th e n e x t 3 in fr o n t a r e jo in e d b y c a r tila g e (g ristle ) e a c h to th e o n e a b o v e ; a n d th e r e m a i n i n g 2 of th e 12 a r e s h o r t a n d u n a tta c h e d in fro n t, for w h ic h re a s o n th e y a r e c a lle d “ free ” o r “ flo a tin g .” T h e c la v ic le (c o lla r b o n e ) jo in s th e s t e r n u m a t its in n e r e n d , a n d th e s c a p u l a ( s h o u ld e r b la d e ) a t its o u t e r .e n d . It d oes n o t fo rm a jo in t w ith th e h u m e r u s ( a r m bone). T h e s c a p u la jo in s w ith b o th clav icle a n d h u m e r u s . T h e h u m e r u s h a s , o n its u p p e r e n d , a r o u n d s m o o th h e a d w h i c h fits i n t o a c u p - l i k e h o l l o w in t h e s c a p u l a . T h is c a v i ty is s h a l l o w a n d t h e jo in t v e r y free , its s t r e n g t h b e i n g d e p e n d e n t o n t h e s t r o n g m u s c l e s w h ic h p r o te c t it a t t h e fro n t, th e b a c k a n d th e o u tsid e. W h e n t h e a r m is r a i s e d to t h e h o r i z o n t a l , t h e h u m e r u s is b r o u g h t u p t o t h e p a r t of t h e s c a p u l a p r o j e c t i n g o v e r t h e s h o u ld e r jo in t. W h e n i t i s r a i s e d s t i l l h i g h e r t h e s c a p u l a is c a r r i e d w i t h it. I n th e f o r e a r m th e r a d iu s lies o n t h e t h u m b sid e, a n d t h e u l n a lies o n t h e little f in g e r sid e . T h e r a d i u s h a s , o n its u p p e r en d , a s m o o th disc-lik e e d g e w h ic h to u c h e s a sm o o th c o n cav e su rfa c e o n th e u ln a. T h e r a d i u s a t i t s l o w e r e n d is b ro a d , a n d a lo n e fo rm s a jo in t w ith th e c a r p a l (w rist b ones). I n i t s l o w e r e n d t h e r e i s a s h a l l o w h o l l o w i n t o w h i c h fits t h e lo w er en d of th e uln a. W h e n t h e p a l m of t h e h a n d is u p w a r d s ( s u p i n a t i o n ) t h e tw o b o n e s of fo r e a rm a r e p a ra lle l. W h e n t h e h a n d is t u r n e d so t h a t t h e b a c k p a r t is u p p e r m o s t ( p r o n a t i o n ) t h e r a d i u s
4 i r o t a t e s l e n g t h w i s e , its l o w e r e n d m o v i n g a c r o s s to t h e o th e r s id e of th e lo w e r e n d of th e u ln a . In p ro n a tio n , th e u p p e r e n d of th e r a d iu s d o e s n o t m o v e its p o sitio n . I t m e re ly tu r n s o n its a x is w h ile its lo w e r e n d (a s th e b o n e ro ta te s ) tra v e ls r o u n d th e lo w e r e n d of th e u ln a , w h ic h r e m a i n s fixed a t its pivot. T h e u l n a d o e s n o t f o r m j o i n t w i t h t h e c a r p a l b o n e s ; it re s ts o n t h e r a d i u s a t its lo w e r e n d . T h e e ig h t sm all carpal (w r i s t) b o n e s , in t w o r o w s of f o u r e a c h , jo in in t h e first r o w , t h e e n d o f t h e r a d i u s , a n d i n t h e s e c o n d r o w , t h e five m e t a c a rp al (m eta, beyond) bones. M o v e m e n t a t th e w ris t ta k e s p lace b e tw e e n th e ra d iu s a n d first ro w , b e tw e e n th e tw o r o w s th e m s e lv e s , a n d b e tw e e n th e second ro w a n d m e ta c a rp a l bones, g iv in g g re a t freedom . T h e jo in t a t th e w ris t a c ts a s a d o u b le h in g e join t. T h e five m e t a c a r p a l b o n e s f o r m t h e p a l m , w h i c h of co u rse in c lu d e s th a t of th e th u m b . T h e p h a la n g e s (fin g e r b o n e s) a r e fo u r te e n in n u m b e r , th r e e to e a c h fin g e r a n d tw o to th e t h u m b ; a n d th e y s it o n e o n to p of e ac h o th e r. T h e fin g er jo in ts a re h in g e jo in ts. T h e p e lv is (p e lv is , a b a s i n ) is s h a p e d l ik e a b a s i n . I t is f o r m e d a t t h e s i d e s b y t h e t w o h a u n c h b o n e s , i n t o w h i c h is w e d g e d a t th e b a c k th e s a c ru m , lik e th e k e y sto n e of a n a rc h ; w h i l e in t h e f r o n t t h e h a u n c h b o n e s m e e t in w h a t is c a l l e d th e s y m p h y s is p u b is. T h e h a u n ch bones a rc h in g ro u n d and o u t w a r d s g iv e th e b a s in - lik e s h a p e to th e p elvic c av ity . T h e p e lv ic c a v i t y c o n t a i n s t h e b l a d d e r a n d a p o r t i o n of t h e i n t e s t i n e s ; a n d it is v e r y s t r o n g l y g u a r d e d b y t h e l a r g e b o n e s w h i c h f o r m it a n d w h i c h d i r e c t t h e w e i g h t of t h e b o d y u p o n th e lo w e r lim b s. O n t h e o u t e r s id e of e a c h h a u n c h b o n e t h e r e is a d e e p cu p -lik e so ck e t (a c e ta b u lu m , a cu p , e tc .,) w h ic h fo rm s a b a ll-a n d -s o c k e t jo in t w ith th e fe m u r (th ig h bone). The r a n g e o f m o v e m e n t is n o t s o e x t e n s i v e a s t h e s i m i l a r j o i n t a t th e s h o u ld e r ; a n d m o re o v e r th e h ip -b o n e c a n n o t m o v e a s th e scap u la can. T h e f e m u r is t h e l o n g e s t a n d s t r o n g e s t b o n e i n t h e b o d y ; a n d it r u n s fr o m h ip to k n e e - jo in t. I t s u p p e r e n d is r o u n d e d i n t o a s m o o t h b a ll l ik e h e a d w h i c h is j o i n e d t o its s h a f t b y a n a rro w p o rtio n k n o w n a s “ th e n e c k .” T h e p a t e l l a ( k n e e - p a n ) i s a s m a l l b o n e w h i c h is s o m e w h a t t r i a n g u l a r s h a p e a n d lies in fr o n t of t h e k n e e - jo in t, its b r o a d e n d b e i n g u p p e r m o s t . T h e u p p e r e d g e of th e p a t e l l a is a t t a c h e d to t h e t e n d o n w h i c h s t r a i g h t e n s t h e le g , a n d t h e l o w e r t o t h e l i g a m e n t s w h i c h b i n d it t o t h e t i b i a ( o r s h in bone). T h e i n n e r s u r f a c e o f t h e p a t e l l a is v e r y s m o o t h a n d c o v e re d by sy n o v ia l m e m b r a n e lik e t h e r e s t of th e jo in t. I n fr o n t it p la y s o n a l a r g e s u r f a c e of t h e e n d o f t h e f e m u r , w h e n th e k n e e is b e n t a n d s t r a i g h t e n e d . T h e tw o b o n e s of th e le g a r e th e tib ia in f r o n t a n d th e fib u la (fib u la , a c la s p , b u c k le o r b r o o c h ) o n th e o u t e r sid e. T h e tib i a lies v e ry n e a r t h e s u r f a c e ju s t b e lo w t h e s k i n a n d its s h a r p r i d g e c a n b e e a s ily felt r u n n i n g d o w n th e f r o n t of t h e l e g . T h e fib u la lies a little b e lo w th e k n e e a t its u p p e r e n d a n d h a s n o s h a r e in t h e f o r m a t i o n o f t h e k n e e - jo in t. Its lo w er en d h o w ev er, fo rm s o u te r a n k le. T h e ta r s a l (a n k le ) b o n e s a r e se v e n in n u m b e r , a r e s m a ll a n d irre g u la r, a n d h eld to g e th e r by lig a m e n ts . T h e la rg e st is t h e b o n e of t h e h e el. T h e m e ta ta r sa l (m eta, b ey o n d ) b o n es fo rm th e foot. B eh in d th ey jo in fo u r ta rs a l b o n es a n d first to e b o n e s . T h e p h a l a n g e s of fo o t (to e f o u r t e e n in n u m b e r a n d a r e t h e s a m e a s t h o s e in
t h e s o l e of in f r o n t th e bones) are th e h a n d .
R ed C r o s s a t H u d d e r s fie ld .— M rs. A. O x ley , 11, G r e e n w o o d S tr e e t, P r im r o s e H ill, H u d d e r s f ie ld , n o tifies u s t h a t w i t h p e r m i s s i o n , s h e is a t t e m p t i n g t o f o r m a D e t a c h m e n t of th e R ed C ro ss S o ciety a t H u d d e rsfie ld . S h e w o u ld lik e m e n w h o h o ld F i r s t A id C e r tif ic a te s , a n d in p a r t i c u l a r , m e m b e r s of th e F i r s t A id a n d R e s c u e S e rv ic e s of C iv il D efen ce, to c o m m u n ic a te w ith h e r a t th e a b o v e a d d re ss , g i v i n g p a r tic u la r s of a w a r d s held.
F I R S T
42
Letters to the Editor. W e a r e in n o w a y re s p o n sib le for th e o p in io n s e x p re ss e d , o r th e s ta t e m e n ts m a d e , b y C o rre s p o n d e n ts .— E d ito r .
S i r , — I n S e p t e m b e r i s s u e of F i r s t A id y o u w e r e n o tif ie d to p u b lish T h o rn to n -C le v ele y s A m b u la n c e D iv isio n h a d p u r c h a se d th e ir lan d . I w o u ld lik e y o u to c o n tr a d ic t th is, a n d s t a t e t h a t w h e n s a m e is b o u g h t it w ill b e a j o i n t a f f a i r of b o t h A m b u la n c e a n d N u r s in g D iv isio n s. A t p re se n t, w e d o n o t o w n b u i l d i n g la n d n o r h a v e w e a B u i l d i n g F u n d in o p e r a tio n y et. I w o u l d b e m o s t g r a t e f u l if y o u w ill i n s e r t t h i s i n y o u r n e x t is s u e .— Y o u rs truly, W.
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D e a r S ir , — I w a s g re a tly in te re s te d a n d a lso s y m p a th e tic w ith th e v ie w s of y o u r c o r r e s p o n d e n t u n d e r th e a b o v e h e a d i n g in th e A u g u s t n u m b e r o f F i r s t A id . A few fac ts s h o u ld , I th in k , b e m a d e k n o w n to th e p u b lic , of th e v a lu a b le w o r k d o n e b y m e m b e r s of th e O r d e r a t th e o u tb r e a k of w a r, w o r k t h a t n o o th e r e x is tin g o r g a n is a tio n c o u ld h a v e u n d e rta k e n . O n A u g u s t 25 t h , 1939 , a l l m e m b e r s o f a c e r t a i n S o u t h L o n d o n D iv isio n receiv ed a te le g r a m to re p o rt a t th e T o w n H a ll th a t evening. O n ly a v e ry fe w m e m b e r s w e r e a b le to a tte n d , b u t a f u r th e r m e e tin g w a s a r r a n g e d for th e fo llo w in g evening. T h i s m e e t i n g w a s w ell a tte n d e d . T h e C ouncil p u t th e ir d ifficu lty b e fo re th e s e m e m b e r s . In sh o rt, th ey h a d b e e n o rd e re d to s ta ff a n d r u n sev e n S tr e tc h e r P a r ty D e p o ts. T h e y h a d n o tr a in e d m e n of th e ir o w n a n d a p p e a le d to th e D iv isio n to h e lp th e m . A t t h a t m e e t i n g 18 m e m b e r s v o l u n te e r e d to g iv e t h e i r fu ll tim e , m a n y of th e m g i v i n g u p g o o d s itu a tio n s to d o so. T h e s e 18 m e n , w i t h t h e h e l p o f a f e w p a r t - t i m e r s , f o r m e d th e ex ecu tiv e of th e sev en d e p o ts a n d s ta rte d th e ir d u ties a t once. I n less th a n a m o n th th e y h a d o v e r a th o u s a n d m e n to su p e rv ise , tra in a n d o r g a n is e in to a serv ice w h ic h w o u ld p ro v e th e m s e lv e s of h e lp in th e e v e n t of a ir ra id s. T hese r e c r u its h a r d l y k n e w w h a t th e w o r d s “ first a i d ” m e a n t — th e re w e re tin k e rs, tailo rs a n d c a n d le stic k m a k e rs , acto rs, a rtis ts a n d all s o rts a n d c o n d itio n s of m e n . A t tim es th e p o s itio n of S u p e r i n t e n d e n t of th e s e D e p o ts s e e m e d w ell n ig h i m p o s s i b l e — t h e a g e s o f t h e 18 S . J . A . B . m e n w e r e o n a n a v e r a g e o n l y a b o u t 21 o r 22 . A ll d u e h o n o u r s h o u l d b e a c c o rd e d to th e se m e n . B u t n o w I c o m e to th e “ r a w d e a l ” p a r t of th e sto ry . I t s e e m e d t h a t a s so o n a s th e C o u n cil c o u ld g e t m e n qualified in first a id , th e S .J .A .B . m e n w e r e d is p e n s e d w ith . Of c o u rs e , s e v e ra l w e r e c a lle d to t h e S e rv ic e s b u t n o t a ll. To d a y , t h e r e i s n o t o n e o f t h e s e m e n i n t h e C o u n c i l ’s e m p l o y . S o fa r a s I k n o w , n e ith e r th e O r d e r o r th e D iv isio n h a s even b e e n t h a n k e d b y th e C o u n c il fo r r e n d e r i n g to th e m a serv ice t h a t t o o k m e n y e a r s of p r e - w a r p r a c t i c e a n d s t u d y in t h e i r o w n t i m e , t o fit t h e m f o r t h e w a r e m e r g e n c y t h a t a r o s e in A u g u s t , 1939 . H o w e v e r , le t m e r e m in d “ 1910” t h a t m e m b e r s of th e O r d e r d o n o t a s k fo r re c o g n itio n for th e ir serv ices, th e ir a im is to t r a i n t h e m s e l v e s to b e o f u s e to t h e i r f e l lo w m e n in tim e s of n e ed ; b u t I d o a g r e e t h a t a little e n c o u r a g e m e n t w o u ld b e of g r e a t v a lu e .— Y o u r s faith fu lly ,
“ Div.
H on. S ec. ”
K i l l e d o n A c t i v e S e r v i c e .— P te . H . G i b s o n , 2n d W e s t Y o r k s . R e g t ., a n d fo rm e r ly of H u n s l e t a n d H o lb e c k D iv isio n , L e e d s C o r p s , S . J . A . B . , r e p o r t e d m i s s i n g in L i b y a in J u n e , 1942 , n o w p r e s u m e d k i l l e d w h i l e s t r e t c h e r - b e a r i n g .
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D r. R y m e r C a d e t S h ie ld C o m p e tit io n . T eam T e s t — F in a l .
A s y o u a r e g o i n g to y o u r first a id c la s s , y o u fin d th is b o y ly i n g o u t s id e a c h e m i s t s s h o p ; h is left l e g a p p e a r s to b e b ro k e n , a n d h is r ig h t h a n d re sts in a pool of co rro siv e acid ( s p irits of s a lts ) w h ic h h a s r u n fr o m th e b r o k e n b o ttle n e a r h im . A ct a s y o u w ould. Y o u h a v e y o u r e q u ip m e n t w ith you. T i m e 20 m i n u t e s . Q u ic k a p p ro a c h to p a tie n t ... ... ... W a r n h i m t o lie s till ... ... ... S t a t e t h a t y o u a r e first a id e rs a n d s p e a k e n c o u r a g i n g ly N o te pool of a c id a n d d a n g e r of b r o k e n g la s s ... D e c id e to m o v e th e p a tie n t fr o m th e d a n g e r ... O b t a i n w a t e r a n d flo o d t h e h a n d i m m e d i a t e l y ( w a r m w a te r av ailab le ) ... ... ... G e n tly d r a w fo o t of in ju r e d lim b to th e o th e r a n d s e c u re to g e th e r w ith fig u re 8 b a n d a g e ro u n d a n k le s a n d feet ... ... ... ... B ro a d b a n d a g e ro u n d b o th k n e es ... ... C a r e f u l l y lift p a t i e n t f r o m d a n g e r a n d l a y o n b l a n k e t C a re b e in g ta k e n to av o id acid a n d b ro k e n g la s s ... R e m o v e p a t i e n t ’s c o a t i n c a s e t h e s l e e v e h a s s o a k e d a n y acid ... ... ... ... C o v e r p a tie n t a s m u c h a s p o ssib le ... ... B a th e h a n d w ith a lk a lin e lo tio n p re p a re d by d isso lv in g a d e s e rts p o o n fu l of b i- c a r b o n a te of s o d a o r w a s h i n g s o d a in a p in t of w a r m w a t e r ... ... C o v e r th e b a c k of h a n d w ith s tr ip s of lin t, lin e n o r gauze ... ... ... ... S o a k e d in a w a r m f r e s h s o lu tio n of b i- c a r b o n a te of s o d a C over th e d re s s in g w ith c o tto n w ool ... ... A p p ly b a n d a g e fo r th e h a n d (c o rrec tly ) ... ... P la c e a r m in a la r g e a r m s lin g ... ...
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T h i s n e w p h y s io lo g ic a l d i a g r a m is h i g h l y c o m m e n d e d to a ll le c tu r e r s a n d w ill b e m o s t u s e fu l in th e in s tr u c tio n of t h e i r c la s s e s , b e c a u s e it is life-size, is in fu ll c o lo u r , a n d a cc u ra te ly illu stra te s th e a rte rie s, v ein s and pressure p o in ts in th e ir r e la tio n to th e s k e le to n . I t is a c o m b i n a t i o n of t h e w e l l - k n o w n s e r i e s of lif e - s iz e d d i a g r a m s b y S i r J o h n C ollie, M .D . L e c t u r e r s to first a id c l a s s e s a n d C ivil D e f e n c e p e r s o n n e l a r e g r a n t e d a d i s c o u n t o n a p p l i c a t i o n to th e p u b lish ers.
le ft-h an d c o rn e r of th e env elo p e “ Q u e ry ,” a n d ad d re sse d t o F i r s t A i d , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 .
2. — A l l Q u e r i e s m u s t b e w r i t t e n o n o n e s i d e o f p a p e r o n l y . 3. — A l l Q u e r i e s m u s t b e a c c o m p a n i e d b y a “ Q u e r y C o u p o n ” c u t f r o m t h e c u r r e n t i s s u e o f t h e J o u r n a l , o r , i n c a s e of Q u e r ie s fro m a b r o a d , fr o m a re c e n t issu e.
4. — T h e T e x t b o o k t o w h i c h r e f e r e n c e m a y b e m a d e in th is c o l u m n i s t h e 39 t h ( 1937 ) E d i t i o n o f t h e S . J . A . A . M a n u a l of F i r s t A id to th e In ju r e d .
Thanks to the Doctor.
S o u t h e r n R a ilw a y . V i c t o r i a A m b u la n c e C l a s s .— A v e ry c o n g e n i a l g a t h e r i n g of m e m b e r s of t h e a b o v e c l a s s t o o k p l a c e in t h e A m b u la n c e R o o m a t V ic to ria S ta tio n re c en tly , w h e n th e a w a r d s g a in e d by th e c lass m e m b e rs d u r in g th e p re v io u s sessio n w e re p re se n te d by M r. J. B rid g e r. M r. E . U zzell, C e n t r e S e c r e ta r y a n d W e lf a r e O fficer p re s id e d , a n d s u p p o r tin g h im w e r e M r. W . W o o d , S u p t. P o lic e D e p t., V ic to ria , a n d M r. A d a m s , E n g i n e e r ’s D e p t , a n d M i s s W . G r i n d l e y , A s s i s t a n t C en tre S ecretary . T h e C h a i r m a n a n n o u n c e d th a t a s M r. B rid g e r w o u ld s h o r tly b e l e a v i n g V ic to ria , to t a k e u p d u tie s a s A s s is ta n t C e n tra l D iv isio n al S u p t. a t R ed h ill, he to o k th e e arliest o p p o r tu n i ty of c o n g r a t u l a t i n g M r. B r i d g e r a n d w is h in g h im e v e r y s u c c e s s in h is n e w s p h e r e of a ctiv itie s. T h is w as h e a r t i l y e n d o r s e d b y all p r e s e n t a n d M r. B r i d g e r re p lie d su itab ly . T o each of th e re c ip ie n ts, M r. B r id g e r a lso g a v e e n c o u r a g in g w o rd s, a n d a m o n g th e m a n y a w a rd s p resen ted w a s a G o l d M e d a l f o r p a s s i n g 21 e x a m i n a t i o n s g a i n e d b y D e te c tiv e W o o d w a r d of th e P o lice D e p a r t m e n t a t V ic to ria . M r. W o o d a d d e d w o r d s of a p p r o b a tio n o n b e h a lf of th e C h ief of P o lice.
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O n c e a g a i n , o n b e h a lf of o u r r e a d e r s a n d o u rs e lv e s , w e t e n d e r s in c e re t h a n k s to o u r H o n o r a r y M e d ic a l A d v iser, D r. N . C o rb e t F le tc h e r for h is u n b o u n d e d k in d n e s s a n d w illin g n e s s to re n d e r h e lp a n d a ss is ta n c e to re a d e rs o f F i r s t A id w h o s u b m it p ro b le m s r e la tin g to th e ir d ifficu lties o r e x p erie n ce s. W i t h th is is su e , D r. C o r b e t F le tc h e r c o m m e n c e s his t w e n t y - n i n t h y e a r of t h i s g r e a t a n d v o l u n t a r y w o r k fo r t h e c a u s e w h i c h h e h a s a t h e a r t , v iz ., r e n d e r i n g h e l p to th .ose t h a t n e e d it fo r t h e p u r p o s e o f h e l p i n g o t h e r s . A s a co m p ariso n , o u r tw o fo rm e r H o n o r a r y M ed ic a l A d v isers, D r. H e a to n H o w a r d a n d D r. F r a n k C h ris tia n e ac h c a rrie d on th is v o l u n t a r y w o r k f o r five y e a r s . In th e ir tim e , h o w e v e r, th e c o r r e s p o n d e n c e w a s i n s ig n if ic a n t in c o m p a r i s o n w i t h t h a t of D r . C o rb e t F le tc h e r , w h o in th is issu e , c r e a te s a n e w re c o rd of q u e rie s so lv ed . W e v e n tu r e to e x p re s s th e h o p e t h a t D r. C o rb e t F le tc h e r m a y liv e m a n y m o r e y e a r s to c a r r y o n th is n o b le w o r k a n d e n jo y th e b e st of h e a l th a n d h a p p in e s s . W e a r e s u r e all o u r r e a d e r s w ill jo in u s in th is .
Loading Am bulance. F H . ( P a d d i n g t o n ) .— A t a re c e n t C. D . E x e rc is e I w a s p la c ed in c h a r g e of a F i r s t A id P a r t y , a n d it w a s n e c e s s a r y fo r th e a m b u l a n c e to p u ll u p o n th e off s id e of th e r o a d fo r th e casu alties. I in s tr u c te d m y B e a r e r s to lo a d th e u p p e r b e r t h o n t h e o ff s id e o f t h e a m b u l a n c e first, w h ic h w h e n f a c i n g th e a m b u l a n c e fro m th e r e a r is t h e r i g h t sid e. T h e D istric t W a r d e n h o w e v er, c o n te n d s th a t you s h o u ld lo a d a n a m b u la n c e fro m th e sid e fu r th e s t fro m th e k e r b b e c a u s e of th e c a m b e r in th e r o a d . As th e T e x t b o o k ( p . 2 26 ) i s b r i e f o n t h i s p o i n t , I w o u l d b e v e r y p l e a s e d if y o u c a n g i v e m e f u r t h e r i n f o r m a t i o n , b u t I h a v e in m i n d t h a t t h e c a m b e r is r e v e r s e d w h e n th e a m b u l a n c e is in m o t i o n a n d is o n its p r o p e r s id e of t h e road.
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V X R S T Antiseptic Treatm ent of W ounds.
J .W . (B a rro w -in -F u rn e ss).— R e a d in g th e lectu re by S ir H e n r y L . M a r ty n in th e J u ly issu e of F i r s t A id , I b e c a m e e sp e c ia lly in te r e s te d in th e p a r a g r a p h c o n c e r n i n g th e c le a n s in g of w o u n d s, in w h ic h h e s ta te s th a t “ . . . t h e r e is n o k n o w n a n t i s e p t i c y e t i n v e n t e d , w h i c h is c a p a b le of k illin g b a c t e r ia in a w o u n d w ith o u t a t th e s a m e tim e k illin g th e tissu es th e m s e lv e s .” (1) W h e n first l e a r n i n g a b o u t a n tis e p tic s , I w a s told t h a t t h e y w e r e s u b s t a n c e s h a v i n g t h e p o w e r t o restrain t h e d e v e l o p m e n t of g e r m s . T h i s b e i n g s o , is it c o r r e c t t h a t fo r first a id p u r p o s e s th e a p p lic a tio n of a m ild , n o n i r r i t a t i n g a n t i s e p t i c is b e n e f ic ia l, b e c a u s e it s l o w s u p t h e d e v elo p m en t of g e rm s , a n d th u s g iv es th e tissu es a c h a n c e to b rin g u p re-in fo rcem en ts ? I p re s u m e th a t ev en a m ild a n tis e p tic dev italizes th e s u r r o u n d in g tissu es s o m e w h a t, b u t I also p re s u m e th a t th e y h a v e a c h a n c e of q u ic k e r r e c o v e r y a s th e y a r e c o n s ta n tly b e in g su p p lied by th e b lo o d stre a m ? (2) I s h o u ld lik e to a d d t h a t I m o s t f r e q u e n tly u s e a crifla v in e , s o m e tim e s a s a s o lu tio n , a n d s o m e tim e s as m a d e u p b y c h e m i s t s w i t h a c r e a m o r je lly b a s is , a n d it s e e m s b o t h s o o t h i n g a n d e ffectiv e. (3) C o n c e r n i n g s a l i n e s o lu ti o n , d o e s n o t t h e c o n tin u e d u s e of th is c a u s e th e e d g e s o f th e w o u n d to b eco m e sore a n d irrita ted ? I have h eard nurses say t h a t t h e y h a v e h a d t o a p p l y v a s e l i n e r o u n d t h e e d g e s of th e w o u n d w h e n a p p ly in g salin e d re ssin g s. I th a n k you fo r th e g r e a t h elp w h ic h I h a v e received fro m y o u r q u e ry c o lu m n . ( 1) T h e l e c t u r e r p u t s i n t o a f e w w o r d s t h e w h o l e difficu lty c o n c e r n i n g th e a n tis e p tic t r e a t m e n t of w o u n d s . F o r th is r e a s o n th e T e x t b o o k r e c o m m e n d s t h e u s e of m ild a n tis e p tic s , c h o ic e of w h ic h it le a v e s to th e le c tu r e r s a n d w h ic h fo r first a id p u r p o s e s a r e p r e v e n tiv e r a t h e r t h a n p o w e r ful a n d a c tiv e . I n o t h e r w o r d s it s e e k s to a v o id f u r th e r in fe c tio n p e n d in g m e d ic a l a s s is ta n c e ; a n d e x p e rie n c e s h o w s t h a t t h e s e c a u s e l ittl e , if a n y , i n j u r y t o t h e w o u n d a n d s u r r o u n d in g sk in . ( 2 ) A c r i f l a v i n e s o l u t i o n ( 1 - 1 , 000 ) i s a m i l d a n d u s e f u l a n t i s e p t i c b u t a s y o u k n o w , th is is u s e d u n d e r in s t r u c t i o n s of d o c t o r o r t r a i n e d n u r s e a n d is n o t p a r t o f t h e n o r m a l e q u i p m e n t c a r r ie d b y a first a id e r. ( 3) A n y w e t d r e s s i n g c o n t i n u o u s l y r e - a p p l i e d w i l l t e n d t o i r r i t a t e t h e e d g e s of a w o u n d b u t t h i s c o m p l i c a t i o n w ill n o t a r i s e a f t e r t h e a p p l i c a t i o n o f a s i n g l e d r e s s i n g a s is r e c o m m e n d e d in th e T e x t b o o k .— N .C . F .
Treatm ent of Shock and Fractures. W . R . ( B a r n s l e y ) . — T h e fo ll o w i n g p r o b le m is c a u s i n g m u c h c o n tr o v e r s y in o u r F i r s t A id R o o m a n d y o u r r u l i n g o n t h i s p r o b l e m w o u l d b e g r e a t l y a p p r e c i a t e d :— “ A m a n h a s b een b u rie d d u r in g a n a ir raid a n d w h e n h e w a s e x tric a te d h e w a s fo u n d to be su ffe rin g fro m s im p le fra c tu re s of b o th fe m u rs a n d sim p le fra c tu re s of fifth a n d s i x t h r ib s o n b o t h s id e s . H e is u n c o n s c i o u s a n d su fferin g fro m s h o c k .” T h e T e x tb o o k say s th a t w h e n y o u h a v e im m o b ilised th e f r a c tu r e s y o u m u s t a p p ly c o ld to th e affected p a rt. A lso it s a y s t h a t w h e n t r e a t i n g s h o c k y o u m u s t a p p ly h o t w a te r b o ttle s b e tw e e n th e le g s a n d d o w n b o th sid es of th e body. W h ic h of th e se tre a tm e n ts w o u ld you a p p ly in a c a s e lik e th is ? N o w h e r e d o e s t h e T e x t b o o k te ll y o u to a p p ly c o ld to s im p le f r a c tu re s of t h i g h b o n e s o r rib s. I t a k e it, th e re fo re , t h a t you w e re th in k in g a b o u t th e tr e a tm e n t of co m p lic ated f r a c tu r e s of ribs. W ith s im p le fra c tu re s of th ig h b o n e s a n d c o m p licated f r a c t u r e s of r ib s o n b o th sid e s , s h o c k w ill b e p r o f o u n d a n d w ill call fo r p re fe re n tia l tr e a tm e n t. T h e c o ld c o m p re s s for th e r ib s w ill h a v e little effect in th e s e c ir c u m s ta n c e s ; a n d , a s a first a id e r, I w o u ld o m it it a n d c o n c e n tr a te o n t r e a t m e n t of s h o c k , p l a c i n g h o t w a t e r b o ttle s b e tw e e n le g s, to sid es of b o d y a n d t o f e e t ( T e x t b o o k , R u l e 1 , p . 45 ).
A I D S u c h a c t i o n is c o m p a t i b l e w i t h t h e g e n e r a l s c h e m e o f th e T e x t b o o k w h ic h tells u s to m o d ify th e g e n e r a l r u le s in a c c o r d a n c e w ith t h e p rin c ip le s of first a id b y t h e e x e r c is e of o u r q u a l if ic a tio n s a s first a i d e r s . — N . C . F .
Gas Poisoning and Broken Neck. H . B . ( B a r n a r d C a s tle ) .— P l e a s e c o u ld y o u tell m e h o w to tre a t a p erso n a sp h y x ia te d by coal g a s a n d su fferin g from a f r a c tu r e of c erv ic a l r e g io n of s p in a l c o lu m n (b r o k e n n e c k ) c a u s e d by s tr ik in g th e b e d rail w h ile e n d e a v o u rin g to t u r n off g a s ? F o r r e s c u i n g p e o p le f r o m c o a l g a s it is c u s t o m a r y t o - d a y to u s e t h e re m o te b r e a t h i n g a p p a r a t u s ; a n d in th e c i r c u m stan c e s n a m e d , th e re scu e r sh o u ld w e a r a m a s k a n d ta k e in to th e g a s - la d e n r o o m a s e c o n d m a s k fo r th e v ictim . B o th re s c u e r a n d p a tie n t w o u ld th e n be b re a th in g p u re a ir w h e re b y t i m e is a l l o w e d f o r r e m o v a l o f p a t i e n t . T h i s c o u ld b e effected by w o rk in g a b la n k e t u n d e r th e p a tie n t a n d so d r a g g in g h im in to p u re a ir .— N .C .F .
Treatm ent of Phosphorus Poisoning. W .L . ( N e a t h ) .— R e c e n tly a t B r i g a d e P r a c tic e w e failed to a g re e a s to th e c o rre c t tr e a tm e n t of P h o s p h o ru s P o is o n i n g ( T e x t b o o k p . 174 ) e s p e c i a l l y w i t h r e f e r e n c e t o R u l e 1 — “ A d o p t g e n e r a l ru les w h ic h a p p ly .” S o in o r d e r to s a tis f y e v e r y o n e , w ill y o u b e s o k i n d a s to d e ta il t h e g e n e r a l r u le s w h ic h w o u ld a p p ly w ith such a case ? T h e T e x t b o o k ( p . 174 ) t e l l s y o u t o t r e a t a s f o r i r r i t a n t p o is o n in g ; a n d th e re fo re th e g e n e r a l ru le s w h ic h a p p ly a re t o s e n d f o r d o c t o r , t o g i v e e m e t i c if p a t i e n t i s c o n s c i o u s , t o a d m in is te r E p s o m o r G la u b e r sa lts a fte r e m e tic a c ts, to sav e v o m it a n d to tre a t sh o ck . T h e r e is f u r t h e r a s p e c ific w a r n i n g to w i t h h o l d o ils w h ic h m i g h t d is s o lv e t h e p h o s p h o r u s a n d s o f a c ilita te its a b s o r p t i o n . — N . C . F .
Registration of Association Aw ards. H . P . ( B o d m in ) .— I to o k m y first a id w ith th e G . W . R a i lw a y C en tre. T h e n I jo in ed th e B rig a d e w ith w h ic h I o b ta in e d m y v o u c h er a n d m ed allio n . A fte rw a rd s I realised th a t I w a s lo s in g facilities b y n o t t a k i n g m y e x a m in a tio n s w ith th e G .W . R . C e n tre ; a n d so I h a v e sin ce o b ta in e d lab els w ith th e la tte r. P l e a s e tell m e h o w I s t a n d fo r m y B r ig a d e serv ice c h ev ro n . If y o u t a k e a n e x a m in a ti o n u n d e r a R a i lw a y C e n t r e y o u sh o u ld a r r a n g e for th e s u rg e o n -e x a m in e r to be s u p p lie d w ith th e a p p ro p ria te B rig a d e F o r m s w h ic h h e s ig n s in trip licate. T h i s w ill e n s u r e y o u r s u c c e s s in t h e a n n u a l r e - e x a m in a tio n s b e in g reco rd ed b o th by th e R a ilw a y C en tre a n d by th e B r ig a d e .— E d ito r .
L a y Instructor Certificate. M .D . (C h e ste r) a n d o th e rs .— C o u ld y o u k in d ly a d v ise m e w h e re to m a k e th e n e c e s sa ry a p p lic a tio n to q u a lify a s a L a y I n s t r u c t o r in first a i d ? A c tu a lly I a m a m e m b e r of th e B .R .C .S . C a n y o u a l s o p l e a s e tell m e t h e p r o c e d u r e fo r t a k in g th e q u a lify in g e x a m in a tio n fo r th e c ertificate ? T h e L a y I n s t r u c t o r C e r t i f i c a t e is a n a w a r d w h i c h is re s e rv e d fo r (a n d c a n o n ly b e o b ta in e d by ) m e m b e rs of th e B r i g a d e a f te r p a s s i n g a stiff e x a m in a ti o n . A r r a n g e m e n ts for th e e x a m in a ti o n a r e m a d e b y th e C o u n ty C o m m is s io n e r to w h o m ap p licatio n s h o u ld be m a d e th r o u g h th e C o rp s or D iv is io n a l S u p e r in t e n d e n t.— E d ito r .
Fractures of Patella and F e m u r. L .A .
(B elfast). — R e c e n tly a t B r ig a d e P rac tic e discu ssio n a ro se a b o u t th e c o rrect tre a tm e n t of fra c tu re d p a te lla w h ic h w a s a s s o c ia te d w ith a s im p le f r a c tu r e of f e m u r of t h e o th e r lim b . O n e t e a m p u t u p b o th f r a c tu r e s a s laid d o w n in th e T e x tb o o k , r a is in g th e lim b w ith th e fra c tu re d p a te lla. O u r te a m p u t u p th e fra c tu re d p a te lla, ap p lied e x te n sio n to fo o t of lim b w ith f r a c tu r e d f e m u r a n d tie d b o th feet to g e th e r. T h is done, o u r te a m ap p lied th e lo n g sp lin t for fr a c tu re d f e m u r b u t d id n o t p u t th e b a n d a g e ro u n d
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F I R B T
b o th k n e e s b e ca u se of th e fra c tu re d p atella. W i l l y o u p l e a s e t e l l u s if w e s h o u l d h a v e a p p l i e d t w o s p lin ts to th e fra c tu re d fe m u r sin ce w e could n o t u se th e o t h e r l i m b if w e r a i s e d i t ? W i t h t h i s c o m b i n a t i o n o f i n j u r i e s t h e f r a c t u r e d f e m u r is th e m o r e lia b le to a g g r a v a t i o n a n d c o n s e q u e n tly d e m a n d s preferen tial tre a tm e n t. In th e se c irc u m s ta n c e s I w o u ld c o n tro l th e fra c tu re d p ate lla w ith a fig u re-o f-eig h t b a n d a g e a n d t h e n p ro c e e d to t r e a t th e f r a c tu r e d f e m u r a s la id d o w n in th e T e x tb o o k . B y so d o in g I sh o u ld k n o w th a t th e frac tu re d p atella w a s p ro tected from a g g ra v a tio n . In c id e n ta lly th e b a n d a g e ro u n d b o th k n e e s w o u ld n o t a d v e rse ly affect th e b ro k e n p a te lla.— N .C .F .
Extension of Fractn re d Fe m u r. S. R . (L e e d s ). — R e c e n tly w e h a d a d is c u s s io n o n th e tr e a t m e n t of a s im p le f r a c tu r e of f e m u r a t o u r F i r s t A id P o st. O n e of o u r le a d e r s s a id t h a t th e a p p lic a tio n of e x te n s io n w a s e a s ie r s a id th a n d o n e a s th e p a in suffered by p a tie n t w o u ld b e so in te n s e e v e n w ith all c a r e a n d g e n tle n e s s . H a v i n g a p p lie d e x te n s io n in a n a c t u a l c ase , th e p a tie n t b e in g a d m itte d ly very d r u n k , I a r g u e d th a t I a g r e e d th a t t h e p a i n w o u l d b e i n t e n s e b u t t h a t N a t u r e h a d a w a y of re n d e rin g th e p a tie n t u n co n scio u s. Y o u r le a d er w a s q u ite rig h t w h e n h e said th a t ex te n sio n of a f r a c tu r e d f e m u r m a y b e e a s ie r s a id t h a n d o n e . H e for g o t, h o w e v er, th a t th e T e x tb o o k in stru c tio n s a re th a t e x te n s i o n is t o b e a p p l i e d (1) w i t h g r e a t c a r e , (2) w i t h o u t u s i n g fo rce in o r d e r t h a t th e lim b m a y b e b r o u g h t in to a s n a t u r a l a p o s it io n a s p o s s ib le , a n d ( 3) w i t h o u t l e t t i n g g o fo o t u n ti l lim b h a s b e en sp lin ted . I f t h e s e t h r e e c o n d i t i o n s a r e o b e y e d , t h e n t h e p a i n is n o t lik e ly t o b e i n c r e a s e d ; a n d f u r t h e r it d o e s n o t fo llo w t h a t th e r e w o u ld b e a n y d e g r e e of in s e n s ib ility a s th e r e s u lt of th e actio n t a k e n — N .C .F .
Fractures of C la v ic le and H um erus. H . S . ( K i n g ’s L y n n ) a n d S . D . ( B i r m i n g h a m ) . — R e c e n t l y a t B r ig a d e P r a c tic e 1 to ld th e m e m b e r s of a s q u a d of o u r D i v is i o n to t r e a t a p a t i e n t f o r s im p le f r a c t u r e s o f left c la v ic le a n d o f left h u m e r u s ( m i d d l e of s h a f t) . T h e y p l a c e d t h e p a t i e n t ’s a r m a t r i g h t a n g l e s a c r o s s th e b o d y a n d fa s te n e d a b a n d a g e ro u n d elb o w a n d body to k e e p t h e f r a c tu r e d clav icle a t re st. N e x t th e y ap p lied a n o th e r b ro ad b an d ag e round lim b (above b ro k en h u m e r u s ) a n d b o d y t o fix t h e f r a c t u r e . I to ld th e m t h a t t h e y s h o u l d h a v e first p la c e d t h e li m b in a s m a l l a r m s l i n g a n d t h e n a g o o d p a d in t h e a x illa ; a n d t h a t a f te r a p p ly in g th e th re e sp lin ts to th e fra c tu re d h u m e r u s th e y s h o u l d h a v e fixed l im b to t r u n k w i t h b r o a d b a n d a g e ro u n d elb o w a n d tru n k . Y o u r k i n d r u l i n g w ill be a p p re ciate d . T u t ! T u t ! ! W h at next ? 1 d o n o t lik e y o u r s m a ll a r m s lin g w h ich w o u ld p ress on th e b ro k e n c o llarb o n e or v o u r “ g o o d p a d ” in a x i l l a w h i c h m i g h t a d v e r s e l y a ffe c t t h e i r a c t u r e d h u m e r u s , b e t h e f r a c t u r e in m i d d l e of s h a f t o r in u p p e r th ird . W i t h th is c o m b in a tio n of in ju r ie s th e f r a c tu r e d h u m e r u s is t h e m o r e l i a b l e to a g g r a v a t i o n a n d c o n s e q u e n t l y d e m a n d s p re feren tial tre a tm e n t. In th e se c irc u m s ta n c e s I s h o u ld tre a t th e f r a c tu r e d h u m e r u s a s la id d o w n in th e T e x t b o o k e x c e p t t h a t I w o u l d n o t s u p p o r t t h e l i m b i n a n a r m s l i n g b u t f le x fo re a rm a t r ig h t a n g le s to a r m a n d a p p ly a b ro a d b a n d a g e r o u n d lim b a n d b o d y to im m o b il is e th e f r a c tu r e d lim b . In s o d o i n g , I s h o u l d k n o w t h a t s o l o n g a s d u e c a r e is e x e r c i s e d d u r i n g t r a n s p o r t n o a g g r a v a t i o n of e ith e r f r a c tu r e w o u ld
R I D Vessel Used in Blood Transfusion. C . P . ( B a t h ) . — P l e a s e tell m e w h y t h e v e in is u s e d fo r b lo o d tran sfu sio n . T h e v e i n is u s e d b e c a u s e i t is e a s i l y l o c a t e d a n d q u i c k l y h e a l s .— N .C . F.
Fracture of A rm at Elbow. E .A . ( B i r m i n g h a m ) a n d S . G . ( W i l l e s d e n ) . — P l e a s e tell m e h o w t h e f ig u r e - o f - e i g h t b a n d a g e is a p p li e d to t h e h a n d a n d w r is t in c a s e of f r a c tu r e of a r m in v o lv in g e lb o w jo in t. I n o u r D i v i s i o n it is t h e p r a c t i c e t o a p p l y c e n t r e of b a n d a g e to h a n d first, to c r o s s o v e r a n d to tie o ff o n t h e w ris t. Is th is c o rre c t? A lso s h o u ld t h e t h u m b b e e n c lo s e d a s in t r e a t m e n t o f c r u s h e d h a n d ? Y o u r u l i n g w ill be ap p reciated . W ith fr a c tu re a t elb o w , th e fig u re-o f-e ig h t b a n d a g e s h o u ld b e a p p lie d to h a n d a n d w r is t a s is la id d o w n fo r f r a c t u r e of f o r e a r m ; a n d t h e t h u m b s h o u l d n o t b e e n c l o s e d b y th e b a n d ag e . W i t h a c r u s h e d h a n d t h e t h u m b is e m b r a c e d b y t h e b a n d a g e b e c a u s e it h a s to b e k e p t in c lo s e a p p o s i t i o n w ith th e fin g ers. Y o u r D iv is io n a l m e th o d of s t a r t i n g th e fig u re -o f-e ig h t b a n d a g e i s n o t c o r r e c t ; a n d F i g . 45 o f t h e T e x t b o o k c a n o n l y b e r e p r o d u c e d if t h e b a n d a g e i s a p p l i e d a s f o l l o w s :— T h e p a t i e n t ’s u p p e r l i m b b e i n g f l e x e d a t t h e e l b o w a n d th e p a lm of th e h a n d b e in g tu rn e d to w a rd s h is b o d y , a n a r r o w b a n d a g e is p l a c e d b e t w e e n l o w e r e n d of t h e f o r e a r m a n d th e b o d y w ith a s h o r t e n d w h ic h ju s t co v ers th e sp lin t. T h e l o n g e n d is t h e n b r o u g h t f r o m w i t h o u t in ( a n d o v e r t h e sp lin t), w r a p p e d firm ly tw ic e ro u n d th e lo w e r e n d of th e fo re a r m im m e d ia te ly a b o v e th e w rist, p a sse d a s a fig u re-o f-e ig h t ro u n d th e h a n d , a n d th e n b ro u g h t b a c k w ith a slo p in g tu rn to t h e lo w e r e n d of t h e f o r e a r m w h e r e th e tw o e n d s a r e tied off o n th e e x te rn a l sp lin t. I t is n o t e w o r t h y t h a t t h o u g h in th is in s t a n c e t h e t r i a n g u l a r is u s e d a s a r o l l e r b a n d a g e , t h e g o l d e n r u l e of a l w a y s b a n d a g i n g f r o m w i t h i n o u t is b r o k e n . — N . C . F .
Im m e rs io n in Strong Acid. H .L . ( L e i c e s te r ) .— W o u ld y o u be k in d e n o u g h to o u tlin e briefly t h e first a id t r e a t m e n t w h ic h y o u c o n s id e r b e s t for a p a t i e n t w h o h a s fa lle n i n t o a l a r g e v a t of s t r o n g s u lp h u ric o r n itric acid ? It w o u ld a p p e a r t h a t th e g e n e r a l fe e lin g of th o s e c o n c e r n e d is t h a t t h e w a t e r h o s e p ip e s h o u l d fir st b e u s e d fre e ly o r e v e n i m m e r s io n in a l a r g e co ld w a t e r v a t, i g n o r i n g th e p o ssib ility of a g g r a v a t i n g s h o c k . A n o th er s u g g e s t i o n t h a t s e e m e d w o r t h y of c o n s i d e r a t i o n is t h a t t h e p a t i e n t w h e n s tr ip p e d , s h o u l d b e w r a p p e d in b l a n k e t s , first b e i n g s o a k e d in a w a r m s o l u t io n o f s o d i u m b i c a r b o n a t e a n d p ro te c te d by d r e s s in g s , & c. W e sh all b e g r a te f u l for y o u r h e lp fu l c o m m e n ts . T h e c o n d itio n of s u c h p a tie n t w o u ld b e e x tr e m e ly s e rio u s u n l e s s i m m e d i a t e a c t i o n is t a k e n . T h e i m p o r t a n t p o i n t s , in m y o p in i o n , w o u l d b e (1) t o r e m o v e a ll c l o t h i n g w i t h o u t o n e s e c o n d ’s d e l a y , i n t h e h o p e t h a t p a r t s o f t h e s k i n w o u l d n o t b e a f f e c t e d , ( 2 ) t o w r a p p a t i e n t i n b l a n k e t s , a n d ( 3) t o a r r a n g e for h is im m e d ia te a n d sp e e d y tra n s fe r to h o sp ital. I a m a fra id t h a t y o u r s u g g e s t i o n s w o u ld in v o lv e c o n s id e ra b le d e la y in s u c h r e m o v a l a n d t h a t t h is m i g h t m a k e all th e d if f e r e n c e b e t w e e n life a n d d e a t h fo r t h e p a t i e n t . — N . C . F .
resu lt. — N .C .F .
A ir Exchange in Artificial Respiration. C .P .
( B a t h ) . — P l e a s e tell m e w h i c h m e th o d of artificial r e s p i r a t i o n — S c h a f e r o r E v e — g i v e s t h e g r e a t e r r a t e of a ir e x c h a n g e fo r e ac h resp iratio n .
I d o n o t k n o w t n e e x a c t f i g u r e s b u t I t a k e i t t h a t , if th ey a re p ro p erly carried o u t, b o th m e t h o d s w ill g iv e a p p ro x im a te ly th e s a m e ra te of e x c h a n g e .— N .C .F .
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“ PORTLAND AMBULANCE GEAR The Gear illustrated (A.B.C.D.) carries two stretchers on one side of Ambulance, leaving other side clear for sitting patients. UP A N D D O W N action is quick easy for loading or unloading. A.
S h o w s th e tw o stretch ers in p osition '
B.
S h ow s th e to p stretch er lo w ered re a d y for lo ad in g.
C.
Illu stra tes th e sam e G e a r w ith the top stretch er fram e hinged down for use w hen o n ly one stretch er case is carried.
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Where Ambulances are required to carry four beds two G e a rs are fitted , one on EITHER SIDE, and the same advantages apply as described above. f u l l c a t a lo g u e o f A m b u la n c e E q u ip m e n t
N o. 7A w
i l l b e s e n t o n re q u e s t
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FIRST AID ^ l ) e ^ r u ie p e n ik n f J o u r n a l f o r tlje A m b u l a n c e
N o .
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R e a d y 18th N o v . T H E
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T R A I N I N G F IR S T
Q U E S T IO N S A N S W E R E D By R. D. W o r m a l d , M.A., L.A.R.P., and J. M. Y o u n g , M.A., L.A.R.P. This new book by the Authors of “ 250 A.R.P. Questions Answered” covers the following subjects:— Blitz First Aid ; Light Rescue; Fire Prevention in Business Premises; Decontamination; Incident Control. There are numerous line drawings. 2s . 6 d . ; b y
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O n e o f o t h e r o r a ll o f t h e t h r e e r a c e s o f g e r m s . S t r e p t o c o c c i , S t a p h y l o c o c c i a n d B . p y o c y a n e u s a r e f o u n d i n e v e r y s k i n i n f e c t i o n c o m m o n t o t h i s c o u n t r y , a n d A N T I P E O L O I N T M E N T c o n t a i n s t h e antibodies ( a n t i v i r u s ) o f t h e s e g e r m s . H e a l i n g is e x p e d i t e d b y t h e p r o v e d S f -t h e o i n t m c n t > a n d s t P ti c d e v e l o p m e n t is s t o p p e d o r p r e v e n t e d b y i ts a n t i v i r u s s t e r i l e v a c c i n e f i l t r a t e s . A N T I P E O L O I N T M E N T is u n s u r p a s s e d f o r B U R N S a n d S C A L D S , f o r it is m i c r o b i c i d e a n d n o n - a d h e s i v e , a n d d r e s s i n g s d o n o t r e q u i r e t o b e c h a n g e d e v e r y d a y . W O U N D S , B U R N S , e t c , W I L L N O T T U R N S E P T I C if tre a te d w ith A N T I P E O L O I N T M E N T .
O P H T H A L M O - A N T I P E O L is a s e m i - f l u i d o i n t m e n t , m o r e c o n v e n i e n t t h a n t h e o r d i n a r y A n t i p e o l o i n t m e n t f o r o c u l a r i n f e c t i o n s a n d l e s i o n s . E y e s a ff e c te d b y s m o k e a n d d u s t are s o o th e d a lm o s t im m ed iately by th e a p p licatio n o f O p h th a lm o -A n tip e o l,' a n d the a n tiv iru s p r e v e n ts g e r m s f r o m dev elo p in g .
R H I N O -A N T I P E O L affords ra p id relief o f C O M M O N C O L D S , I N F L U E N Z A , A N D C A T A R R H . C o n ta in in g th e a n tib o d ie s o f th e g e r m s c o m m o n to ? T>r1(\crS ? DL*nOSi p h a iy n x (Staphlylococci, Strep to co c c i, B . p y o c y an e u s, p n e u m o c o c c i, p n e u m o b a c illi, e n te ro c o c c i, M . c atarrh a lis, B. P f e i f f e r ) , R h i n o - A n t i p e o l is n o t j u s t a p a l l i a t i v e , b u t is a r e m o v e r o f t h e cause o f t h e i n f e c t i o n . D u r i n g e p i d e m i c s i t is t h e id e a l p rev en tiv e o f m ic ro b e developm ent.
Cl i n i ca l S a m p le s o n r e q u e s t fr o m M E D IC O -B IO L O G IC A L L A B O R A T O R IE S L T D ., C a r g r e e n R o a d
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A u x ilia ry B rig a d e S erv ice P e rfo ra ted G a stric U lc er L o a d in g S tre tc h e r... B u rs t V a ric o se V ein T h o m a s S p lin t P o in ts on B ones T r e a t m e n t of F r a c t u r e s F r a c t u r e s of F e m u r a n d P e lv is R a i s in g of F r a c t u r e d L e g . T h e F u t u r e of th e B r ig a d e . C o lo u r of B lo o d S u rg e o n s a n d th e B rig a d e . N a m e s of B ones ... E s c a p e of B lo o d E ffe cts of F r a c t u r e d T h i g h . E v e ’s R o c k i n g M e t h o d F r a c t u r e s of A r m a n d S h o u ld e r - B l a d e
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The
A l l R e p o r t s , & c ., s h o u l d b e a d d r e s s e d to t h e E d i t o r a t th e a d d re s s b e lo w , a n d s h o u l d r e a c h h i m b e f o r e t h e 8th o f e a c h m o n t h , a n d m u s t b e a c c o m p a n i e d ( not necessarily for publication J b y th e nam e a n d address of th e C orresp o n d en t.
OF
r E n te re d a t 1 LStationers' H a l l \
EDITORIAL.
Its aim a n d object being th e ad v an c e m e n t of A m b u la n c e W o rk in all it s b r a n c h e s , t h e E d i t o r i n v ite s R e a d e r s to s e n d A rtic le s a n d R e p o r t s o n s u b j e c t s p e r t a i n i n g to t h e M o v e m e n t a n d a ls o w e lc o m e s s u g g e s tio n s for P r a c t i c a l P a p e r s .
C O N TEN TS
F.R.San.l.,
I t would be invidious to single P o lice First-A id out any special body of men for “ F in a ls.” mention in connection with first aid, and we have no intention of doing so ; but it must be agreed that the police forces of the country perform much good work in this direction, owing partly, of course, to their having opportunities which do not offer themselves to the ordinary civilian. Their aid is requisitioned in every manner of case, from the pedestrian who, having indulged too unwisely, may have received injury while in a helpless condition, to those un fortunates who may have found themselves in a blazing building and suffered more or less severe injury, to say nothing, in these latter cases, of the actual rescue work performed prior to the administration of first aid. Too, in these days, injuries from traffic occur by the thousand every year, the victims relying for aid on the members of the force in the great majority of instances. To quote from the speech of Mr. Herbert Morrison, Home Secretary and Minister of Home Security, speaking in London at the finals of the Metropolitan Police First Aid Competition, “ ‘ First Aid ’ might almost be made the slogan of the British police man. He is ready to give his aid in any emergency, and there is nobody who is more often first on the scene when distress occurs. He is there to help the old lady across the busy street, to stop the run away horse, to deal with the air raid victim, at the scene of a road accident or a crime, or to help the bewildered American soldier or country cousin up from the provinces to find his way through the maze of London’s streets.” Nothing is more sur prising than the keenness and enthusiasm which are displayed by the men of the police force in all parts of the country, and it is even related (Mr. Morrison referred to it) that on one occasion, when the men of Scotland Yard had the choice between giving up their first aid classes and losing their dinner hour, they plumped for the latter. Whether it is a fact or not, it makes a very pretty little picture and has truth for its foundation. In referring to “ the fine demonstration of first aid work afforded by the ‘ finals,’ ” Mr. Morrison dwelt (somewhat unnecessarily, maybe) upon the
F I R S T
importance of first aid in time of war when there is danger to life and limb at every turn, and when the arm-chair critic may at any moment be dis persed in space. The war has certainly been of the greatest assistance in stimulating the move ment, and we can hope that the restoration of peace will not be the precursor of a falling off. In Mr. Morrison’s words, “ whatever may happen, the police, we may be sure, will always be up to the scratch in this as in other respects.”
I m p r o v i s a t i o n in M o d e rn F i r s t Aid. M .O .,
By BOW M AN EDGAR. 4t h B a t t n . , D u m f r i e s s h i r e
H .G .
R I D S e c o n d ly , w e w o u ld n o t c a r e to t r u s t th e c o n tro l of a f r a c tu r e d f e m u r to th e flim sy b a n d a g e of a F irst-fie ld d r e s s i n g o r e v e n to t h a t of a S h e ll- d r e s s in g . S o m eth in g m uch m o r e s t a b l e is r e q u i r e d t o o v e r c o m e t h e p u l l of t h e l a r g e m u s c le s of th e th ig h . In p lace of th e R .A .M .C . m e th o d w e w o u ld s u g g e s t th e f o l l o w i n g :—
1. B y c a r e f u l e x t e n s i o n b r i n g t h e f e e t a s n e a r l y i n t o a p o s itio n a s p o ssib le, a n d k e e p th e m th e re b y ty in g th e b o o tlaces to g e th e r. 2 . R e m o v e t h e s l i n g a n d b e l t f r o m p a t i e n t ’s r i f l e ( s to rin g th e la tte r in h is b re a s t- p o c k e t fo r safety ), a n d a p p l y t h e rifle, t r i g g e r u p p e r m o s t , a l o n g t h e l e n g t h o f t h e in ju re d lim b . 3. T h e g a s - c a p e th ig h s a n d leg s.
com fy. In c a s e of f r a c tu r e of b o n e , c o m f o r t c a n o n ly b e o b ta in e d in t h r e e w a y s . c o n tro l 2. on th e 3. to g iv e
su itab le
sp lin tin g
or
o th er
of th e bone. A m p le p a d d in g to p re v e n t a n y p ossible p re s su re in ju red bone. S u ffic ie n tly firm a p p lic a tio n of th e p a d d e d s p lin ts p re s e n t c o m fo rt w ith o u t la te r p ain .
T h e c h ief m i s t a k e s
m ad e by a m a te u r
first a id e r s a re ,
I t h i n k :— (a) U n n e c e s s a r y h a n d l i n g a n d m o v in g of th e lim b . (b) In s u ffic ie n t s p lin t p a d d in g . •(c) S l a c k f i x a t i o n o f s p l i n t s . (d) F a i l u r e to c o n s u lt p a tie n t a s to h is c o m fo rt. A n d n o w to c o n tin u e w ith Im p ro v isa tio n .
Fractured Pelvis. T h is fra c tu re c a n be ex cellen tly co n tro lled a n d s u p p o rte d b y th e u s e of tw o g a i te r s a t th e s id e s o r o v e r th e site of f r a c tu r e . T h e g a i t e r s a r e a p p lie d u p a n d d o w n in th e a x is of th e b o d y . T h e y a re fa s te n e d a b o v e by th e w a istb e lt, a n d b e lo w b y a w e b - s l i n g a r o u n d t h e p elv is. T h e g a s - c a p e , fo ld ed in to a l o n g p a d , m a y b e p la c ed b e tw e e n th e th ig h s a n d le g s as p a d d in g . A n o t h e r w e b - s l i n g fixes t h e t h i g h s a b o v e t h e k n e e s , a n d t h e a n k l e s a n d f e e t c a n b e f a s t e n e d t o g e t h e r b y a rifleslin g o r p u llth ro u g h .
Fracture of Femur. F o r a t le a st tw o re a s o n s w e d o n o t a g r e e w ith th e m e t h o d of d e a l i n g w i t h a b r o k e n t h i g h - b o n e a s l a i d d o w n in t h e “ R . A . M . C . T r a i n i n g P a m p h l e t N o . 1. ” I n th e first p la c e th e rifle is s u e d to t h e H . G . d o e s n o t le n d itse lf to c o n tr o l b y t h e m u z z le b e i n g fixed in t h e g a i t e r a s d e s c r ib e d o n p a g e IS .
as a
pad
b e tw ee n
th e
w aist-b elt
now
fu rth er
fix es
th e
b u tt
to
th e
6. T w o w e b - s l i n g s f o r t h e “ f r a c t u r e - b a n d a g e s , ” o n e a b o v e a n d o n e b elo w th e b re a k . T h is w o u ld a p p e a r to be m o re re lia b le for th is d u ty th a n F. F .D . b a n d a g e s .
I t is, of c o u r s e , t o b e u n d e r s t o o d t h a t , w h i l e I m p r o v i s a t i o n s s a v e tim e a n d tr o u b l e in lo o k in g fo r s p lin ts , e tc ., th e y d o n o t d o a w a y w ith t h e n e e d fo r effic ie n c y a n d c o m m o n s e n s e . I t i s n o u s e d o i n g a b r i l l i a n t I m p r o v i s a t i n n if t h e r e s u l t is n o t c o m fo rtin g to th e p atie n t. T h e c o m f o r t of th e p a tie n t, f r o m t h e p la c e of a c c i d e n t to h i s b e d in h o s p ita l , is t h e te s t of o u r s u c c e s s a s first a id e r s . W e sh o u ld a s k th e in ju red m a n , a t e a c h s t a g e of d o in g h im u p — “ I s t h a t c o m f y ? ” A n d w e m u s t e n s u r e t h a t t h e fin a l r e s u l t is, a n d w ill r e m a i n ,
1. B y s u f f i c i e n t a n d
be used
4. L o o s e n t w o o r t h r e e o f t h e t u n i c b u t t o n s to a l l o w of t h e r i f l e b u t t b e i n g a p p r o x i m a t e d tq. t h e p a t i e n t ’s s i d e . The t u n i c b e lt is n o w f a s t e n e d o v e r t h e b u t t t h u s h o l d i n g it in p o sitio n . T h e b u tto n s a re th e n refasten ed . 5. T h e p elvis.
Pelvis and Lower Limb.
m ay
7. T h e g a i t e r s h o l d t h e l e g s t o g e t h e r b e l o w t h e k n e e s . 8. F i n a l l y , t h e f e e t a n d a n k l e s a r e t i e d t o g e t h e r b y a fig u re -o f-e ig h t c a r rie d o u t b y th e rifle-slin g . O r a p u llt h r o u g h m a y b e fix ed to t h e m u z z l e of t h e rifle b y a h a l f k n o t a n d u se d to fa s te n th e feet to g e th e r.
9. I n t h e c r o w n o f t h e s te e l h e l m e t w ill b e f o u n d a r u b b e r p ad , w h ich m ig h t m a k e a u seful p a d b e tw ee n th e m alleo li.
Fractured Patella. T h e l i m b is r a i s e d a fo o t o r s o f r o m t h e g r o u n d t o f a c ili t a t e a p p r o x i m a t i o n of t h e f r a g m e n t s . T h e rifle is l a id w i t h t h e b u t t e n d u n d e r t h e t h i g h a n d t h e m u z z l e u n d e r t h e feet. I t is t h e n f a s te n e d to t h e l e g b y t w o w e b - s l in g s , o n e a t t h e t h i g h , t h e o t h e r a t t h e foot. T h e f r a g m e n t s of th e p a te lla a r e d r a w n t o g e t h e r b y a fig u re-o f-e ig h t, m a d e by th e w a ist-b e lt p a s s in g belo w a n d ab o v e th e k n eecap . C o rrect p re ssu re sh o u ld be m ade b e f o r e t h e b u c k l e is f a s t e n e d . T h e f o o t i s h e l d o n t h e m u z z l e a s f o l l o w s :— A w e b s l i n g is p la c e d w i t h its m id d l e u n d e r t h e rifle m u z z le , o n w h ic h re s ts th e heel. T h e e n d s of th is slin g a re c a rrie d u p w a rd s to cro ss o v er on th e fro n t of th e a n k le , a n d a r e t h e n c a r r i e d d o w n w a r d s to t h e s o le o f t h e foot. T h e y a g a i n c ro s s h e r e a n d a r e tied off o v e r t h e m u z z le. If t e m p o r a r y e l e v a t i o n of t h e f o o t is d e s i r e d , a b a y o n e t m a y b e s t u c k p o in t d o w n in t h e g r o u n d w ith th e h ilt s t a n d in g p e rp e n d ic u la rly e r e c t— th e fo o t o n th e rifle-sp lin t c a n n o w be tie d to th e b a y o n e t by a p u ll- th r o u g h .
Fracture of Both Bones of the Leg. C a n b e c o n t r o l l e d in t h e s a m e m a n n e r a s f o r t h e F e m u r (see above). O r th e b ay o n et m a y be d ra w n fa r e n o u g h from th e s c a b b a r d to a llo w of a p u ll- to r o u g h b e in g p a s s e d t h r o u g h th e ho le in t h e b a y o n et cross-piece a n d fa sten e d to t h e b e lt- s lin g of th e tr o u s e r o n t h a t sid e. T he ex te n d e d b a y o n e t-in -sc ab b a rd splin t, w h ich s h o u ld re a ch from t h e sole-- t o m i d w a y u p t h e t h i g h , s h o u l d n o w b e e n c lo s e d in t h e l e n g t h w i s e fo ld e d g a i t e r s t o p r e v e n t i n j u r y to th e leg . T h e w h o le m a y n o w b e fixed to t h e le g b y t h e rifle -slin g ab o v e th e k n ee, tw o w eb -slin g s a s frac tu re b a n d a g e s ab o v e a n d b elo w th e site of fra c tu re , a n d th e w a ist-b e lt c a n fa s te n feet a n d a n k le s to g e th e r b y a fig u re-o f-e ig h t.
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Fracture or Wounds of the Foot. W e v e n tu re to s u g g e s t th a t th e b est sp lin t fo r s u p p o rt of a n i n j u r e d f o o t is t o b e o b t a i n e d b y u s i n g t h e s o l e o f h i s boot for th a t p u rp o se, c u ttin g a w a y th e p a rts of th e up p er w h ic h a re n o t re q u ired . If th e b o o t-s o le is n o t o b ta in a b le, th e n a fo ld ed A m m o -p o u c h w o u ld m a k e q u ite a n efficient s p lin t. F ix in p o s itio n b y w e b -s lin g s , p u llt h r o u g h , etc. T h u s w e find th a t , w ith a little i m a g i n a t i o n , i n g e n u i t y a n d c o m m o n s e n s e , it is p o s s ib le to “ do-up, ” very e fficien tly , a n y ty p e of f r a c t u r e , e x c e p t i n g t h e S p in e , w ith no o th e r e q u ip m e n t sa v e th a t w h ic h a so ld ie r c a rrie s w ith him . I t is t o b e n o t e d t h a t n o m e n t i o n h a s b e e n m a d e of p a d d in g in th e d e s c rip tio n of th e a b o v e m e th o d s . It is' of c o u r s e , u n d e r s t o o d t h a t s u f fic ie n t p a d d i n g , t o r e n d e r th e s p l i n t i n g t h o r o u g h l y c o m f o r t a b l e , m u s t b e i n s e r t e d in every case. If s u c h s im p le m e t h o d s a r e a b le to f a c ilita te g o o d e m e r g e n c y F i r s t A id in t im e of w a r , it s h o u ld n o t be b ey o n d th e p o w e rs of e n th u s i a s ts to th in k o u t s im ila r easy a n d useful Im p ro v isa tio n s to d e al w ith fra c tu re s a n d o t h e r e m e r g e n c i e s w h i c h o c c u r a l l t o o f r e q u e n t l y i n c i v i l lif e .
T h e H o m e G u a rd an d F i r s t Aid. T h is m o n t h I s h o u l d l ik e to r e p o r t o n t h e a n n u a l c u p c o m p e t i t i o n f o r M e d i c a l S e c t i o n s a t t a c h e d t o t h e 10 t h M i d d l e s e x H . G . T h i s c u p is p r e s e n t e d b y t h e B a t t a l i o n C o m m a n d e r , L i e u t.- C o lo n e l M o s s , w h o h a s a l w a y s t a k e n a liv ely in te r e s t in t h e i r w o r k . T h e c o m p e titio n is r u n o n p r o g r e s s i v e lin e s, e a c h y e a r th e te st b e in g m o r e a d v a n c e d t h a n th e p re v io u s o n e . T h is p re v e n ts t h e s e c tio n s f r o m j u s t s t a n d i n g still w h e n a c e r ta in s t a n d a r d is r e a c h e d , a s is o fte n t h e c a s e w i t h first a id o rg a n isatio n s. N a t u r a l l y , t h e i n c r e a s i n g d e g r e e o f e fficien cy th u s o b ta in e d , te n d s to g iv e s a tisfa c tio n a n d in c re a se d c o n fidence to t h e officers a n d m e n a lik e , of t h e u n its fo r w h ic h they a re re sp o n sib le . A s I h a v e so o fte n sa id , H .G . m e d ic a l sec tio n s c a n n o t afford to b e j u s t satisfied w ith m a s t e r i n g th e te x tb o o k . W h i l e t h i s is e s s e n t i a l a t t h e o u t s e t , F i e l d t r a i n i n g , c a l l i n g for m o r e in itia tiv e , k n o w s n o e n d . B u t I d ig re s s ! T h e ab o v e test th is y e a r co n sisted of f o u r p a r t s : ( 1) O r a l ; ( 2 ) P r a c t i c a l , c o v e r i n g a l l t y p e s o f i n j u r y ; ( 3) S p e c i a l s p l i n t i n g , i n c l u d i n g t h e T h o m a s a n d rifle s p l i n t s ; a n d ( 4) R e s c u e a n d D r i l l . In som e cases no re g u la r e q u ip m e n t w a s p e rm issib le — th is to te st im p ro v isa tio n . T e n te a m s to o k p a rt a n d co m p etitio n w a s e x trem ely keen. “ D ” C o m p a n y (m y o w n un it) w h o h a d w o n th e c u p for tw o y e a r s in s u c c e s s io n , w a s n a r r o w ly b e a t e n in to s e c o n d p lace by “ E ” C o m p a n y . T h i s w a s d u e to th e in c re a se d in tere st a n d e n th u s ia s m o n th e p a rt of th e o th e r u n its, w h ic h w a s all to th e g o o d , a n d th e 1 0 th c a n n o w b e s u r e of re a lly effic ie n t s e r v i c e s h o u l d it e v e r b e n e c e s s a r y . T he squads w ere s m a r t a t d rill, a n d th e ir v a r io u s m e th o d s of re s c u e in te re s tin g , r a n g i n g a s th e y d id fro m th e u s e of th e F ir e m a n ’s L i f t , t o c r a w l i n g t o c o v e r w i t h t h e “ w o u n d e d ” o n their b a c k s . S e v e r a l o f f i c e r s w i t n e s s e d t h e t e s t s , i n c l u d i n g t h e B a t t;. C o m m a n d e r , a l s o t h e S e c t o r M . O . a n d C o m p a n y M . O . ’s w ere p re sen t. F in ally , th e S ecto r C o m m a n d e r, w h o p re sen te d th e c u p , vo iced h is a p p re c ia tio n a n d p le a s u re a t th e h ig h d e g r e e ot efficiency s h o w n b y all c o n te s ta n ts , a n d esp ecially a t th e p r o g r e s s m a d e d u r i n g th e p a s t y ear. C.
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(S e rg t.),
S c h o o l H o u s e , N o e l - r o a d , W . 3,
S t . J o h n A m b u l a n c e B r ig a d e HEADQUARTERS AND DISTRICT REPORTS.
N o. I (P rin ceof W ales’s) D istrict N o . 91 N ( P a l m e r s G r e e n ) . — T h e c h o i c e o f A l d e r m a n V . J . W e s t l a k e a s M a y o r o f S o u t h g a t e f o r 1943-44 w i l l b e a p o p u la r o n e w ith m e m b e r s of th is D iv isio n a s it b r i n g s w ith it a n h o n o u r t o t h e i r o w n D r . L . W e s t l a k e , w h o is h e l d in g r e a t e s te e m a n d affectio n b y all m e m b e rs , b o th n u r s i n g a n d a m b u lan ce. D r . W e s t l a k e ’s a s s o c i a t i o n w i t h t h e B r i g a d e d a t e s b a c k to t h e la s t w a r w h e n s h e w o r k e d v e ry h a r d a s first a id lectu rer. H e r m e m b e r s h i p in t h e B r i g a d e c o m m e n c e d in 1933 w h e n s h e b e c a m e D i v i s i o n a l S u r g e o n t o t h e 91 s t N u r s i n g D iv isio n . A l d e r m a n a n d D r . W e s t l a k e c a m e t o S o u t h g a t e i n 1913 fro m T a u n t o n a n d h a v e s p e n t th e w h o le of th e i r m a r r i e d life t h e r e . T h e D o c t o r ’s w o r k a s l e c t u r e r d u r i n g t h e p r e s e n t w a r h a s b een very c o n sid e ra b le a n d m a n y c a n d id a te s a re g ra te fu l to h e r fo r th e ir s u c c e ss in g a i n i n g first a id a w a r d s a s th e resu lt of h e r ex cellen t te a c h in g .
N o . 175 ( T e d d i n g t o n ) . — A d i s p l a y o f f i r s t a i d w a s g i v e n by th is D iv isio n a t th e B a p tist H a ll, C h u rc h R o a d , T e d d in g to n , o n O c to b e r 4th , to m a r k th e ir p r o m o tio n to D iv is io n a l statu s. A m o n g o th e r very m u c h a p p re c ia te d item s th e re w a s a d is p la y of b lin d fo ld b a n d a g j n g , a n d w h ils t a t e a m of m e m b e r s w e re o u ts id e th e h all, th e a u d ie n c e w e re a s k e d to c h o o se th e ir in ju r ie s fo r th e te a m to d e a l w ith o n c o m p e titio n lin es. A t th e c o n c lu sio n , M r. S y d n e y J . W a r r e n , A s s is ta n t C o m m is s io n e r , w h o h a d p re v io u s ly in s p e c te d th e m e m b e r s of th e D iv isio n , c o n g ra tu la te d th e m o n th e ir s m a r tn e s s a n d p raised th e h ig h s ta n d a rd of th e ir w o rk . H e also p resen ted th e m w ith a S t. J o h n A m b u l a n c e F l a g o n b e h a lf of M rs. B o w d e n , w ife of M r. C. G . B o w d e n th e A m b u la n c e O fficer in C h a r g e . T h e a u d i e n c e c o n s i s t e d o f r e p r e s e n t a t i v e s o f t h e 84 t h ( T w i c k e n h a m ) D i v i s i o n , 151 s t ( M o i e s e y ) D i v i s i o n , t h e T e d d i n g t o n S e c t i o n o f t h e 63rd ( T w i c k e n h a m ) N u r s i n g D iv is io n , 142 n d ( W h i t t o n ) N u r s i n g D i v i s i o n , t h e T w i c k e n h a m , T e d d in g to n a n d H a m p to n s D iv isio n , B .R .C .S ., th e A m e ric a n M e d ic a l C o rp s, th e T e d d i n g t o n S e c tio n M e tr o p o lita n P o lice, C iv il D e f e n c e S e r v ic e s , W o m e n s ’ V o l u n t a r y S e r v ic e s , 3rd M id d le se x B a t ta li o n H o m e G u a r d , a n d first a id w o r k e r s fr o m lo c a l b u s in e s s firm s.
County of Cambridge. Pye. — In creased m e m b e rsh ip a n d c o n tin u ed useful ser vice, a s w e ll a s c o m p e t i t i o n s u c c e s s e s , w e r e r e p o r t e d a t t h e g e n e r a l m e e t i n g of th e P y e A m b u la n c e D iv isio n . The P r e s id e n t (M r. C. O . S ta n le y ) w a s in th e c h a ir. D iv . S u p t. A n d e r s o n s ta t e d in h is r e p o r t t h a t t h e r e h a d b e e n five p r o m o t i o n s d u r i n g t h e y e a r . A c e r ta in a m o u n t of c o m p e titio n e x p e rie n c e h a d b e e n g a in e d , a s in th e C o rp s c o m p e t i t i o n ; t h e D i v i s i o n t o o k 1s t , 2 n d , 3 r d , a n d 4 t h p l a c e s , th e w in n in g te a m b e in g le a d by C o rp o ra l S c a rle tt. A c o n sid e ra b le n u m b e r of p u b lic d u tie s h a d b een p e r fo rm e d a t s p o rts m e e tin g s , e tc ., a n d all m e m b e r s w e re in th e A R .P ., eith e r B o ro u g h o r F a c to ry . D u r i n g t h e y e a r , 22 m e m b e r s o f t h e D i v i s i o n g a i n e d H o m e N u r s i n g C e r t i f i c a t e s a n d 32 w e r e s u c c e s s f u l a t t h e a n n u a l first a id r e - e x a m i n a t i o n . C o rp o ral W ilso n h a d been su c c e ss fu l in g a i n i n g th e a w a r d , l e c tu r e r A . R . P . T h e C h a irm a n e x p re sse d p le a su re a t th e satisfacto ry m a n n e r in w h ic h th e D iv is io n w a s b e i n g r u n , s t a t i n g t h a t
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th is w a s d u e in th e first p la c e to th e s p le n d id le a d e r s h ip g iv e n b y D iv. S u p t. A n d e r s o n . H e w a s p le a se d to see th a t th e D iv i s i o n m a n a g e d t h e i r o w n a f f a ir s s o w ell.
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o f C o rn w a ll.
R e d r u t h . — T h e p io n e e r D iv is io n in th e W e s t of E n g l a n d
— R ed ru th A m b u la n c e D iv isio n , c e le b ra te d th e ir g o ld e n ju b ile e t o w a r d s th e e n d of la s t m o n th . T h e D i v i s i o n w a s f o r m e d o n O c t o b e r 18 t h , 1893 , a t a m e e t i n g c a lle d a t th e s u g g e s t i o n of th e la te D r. C. R . L a u rie . T h e o n l y s u r v i v i n g f o u n d e r m e m b e r is M r . J. F . R a s h l e i g h of W e s t E n d , R e d r u th . F o r ty - o n e m e m b e r s of th e D iv is io n a r e s e r v in g w ith th e F o r c e s , a n d t w o , A. B . A. H o d g e , R . N . , a n d S i g m n . D . S ib t h o r p e . R o y a l C o r p s of S i g n a l l e r s , h a v e lo s t t h e i r lives. S i n c e 1937 t h e D i v i s i o n h a s b e e n i n t h e c h a r g e o f S u p t . C . C . P e l l o w e , w h o h a s b e e n a m e m b e r f o r m o r e t h a n 20 years.
C o u n ty
o f H e rtfo rd .
L e t c h w o r t h . — T h e L e tc h w o r th D iv isio n of th e S .J .A .B .
h a s b e e n h o n o u r e d b y h a v i n g f o u r of its m e m b e r s s u c c e s s fu lly p a s s th e e x a m i n a t i o n fo r th e L a y I n s t r u c t o r s C e rtific a te . T h e e x a m in a tio n w h ich w a s c o n d u cted by D r. C ra g g s, a s s is te d by D r. K e r r of K n e b w o r th , c o n s is te d of p ra c tic a l, o ral, w ritte n , p r e p a r in g a n d g iv in g a le c tu re tte . T h e resu lts w e re p a s s e d o n to S t. J o h n A m b u la n c e H e a d q u a r t e r s for fin a l e x a m i n a t i o n . T h e s u c c e ss fu l c a n d id a te s w e re A m b u la n c e O fficer K . C. W a r n e r a n d S e rg e a n ts R. W . B arn es, W . S a v a g e , J. S eato n . R e f re s h m e n ts w e re su p p lie d d u r in g th e c o u rse b y M rs. C raggs. T h e in a u g u r a l m e e tin g of th e S .J .A .B . C a d e t D iv isio n w a s h eld recen tly a t th e R ep o rt C en tre, L e tc h w o rth . T here w a s a g o o d a tte n d a n c e , a n d th e s p e a k e rs in c lu d e d M iss S p a r k s , C o u n t y C a d e t S e c r e t a r y ; L a d y S u p t . M rs . D a m e s of th e H a r lo w D iv isio n ; M r. W . E . D o u g la s , C o u n ty C o rp s O fficer, a n d o th e rs . T h e m e e tin g w a s very successful a n d t h e C a d e ts s h o u ld flo u rish u n d e r th e v e ry a b le g u i d a n c e of S e rg e a n t J im m y S eato n . T h e D iv is io n w a s r e p r e s e n te d b y s o m e of its m e m b e r s a t th e s p e c ia l s e r v ic e fo r t h e B r itis h R e d C r o s s a n d S t. J o h n A m b u l a n c e , w h ic h w a s h e ld in t h e C a t h e d r a l , S t. A lb a n s , o n S u n d a y , O c to b er
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16 t h .
o f N o rfo lk .
19 t h , M r . H . A . M i t c h e l l ( c h a i r m a n of C r o m e r U . D . C . ) p re s e n te d lo n g s erv ice a w a r d s to m e m b e r s of th e C r o m e r D iv isio n of th e S .J A B. Am ong th e m w e re th re e b a rs for th re e m e m b e rs of th e R a n d a ll f a m i l y , w h o s e t o t a l s e r v i c e i s 95 y e a r s , a n d i n c l u d e s 40 y e a r s ’ serv ice fro m th e fo rm e r s u p e r in te n d e n t a n d p re s e n t s e c re ta ry , M r. R . L. R a n d a ll. H is tw o so n s, A m b u la n c e O fficer T . L . R a n d a ll a n d C p l . R . E . R . R a n d a l l , h a v e 35 a n d 20 y e a r s ’ s e r v i c e resp ectiv ely . E a c h receiv ed a b a r to a lo n g serv ice m e d a l, a s d i d S u p t . F . R . C a r t e r (35 y e a r s ) , a n d A m b u l a n c e O f f i c e r F . H . P e a r c e (20 y e a r s ) . S g r . J. H . T a r l i n g a n d P te . G. B o l d e r o r e c e i v e d a m e d a l f o r 15 y e a r s ’ s e r v i c e . C ro m e r. — O n O cto b er
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o f S urrey.
G u i l d f o r d . — A t t h e i n v i t a t i o n o f t h e o f f ic e r s , p a r e n t s of t h e G u ild f o r d S .J . A. C a d e ts a t t e n d e d a m e e t i n g a t th e A m b u la n c e H a ll, L e a s R o a d , recently. In a n in tro d u c to ry sp eech C a d e t S u p t. F . B o lto n stressed th e im p o rta n c e of p a re n ta l c o -o p eratio n a n d th e e n c o u r a g e m e n t o f t h e i r s o n s in lo y a lty t o t h e o r g a n i s a t i o n to w h i c h th e y b e lo n g e d a n d its c u r r i c u l u m . T h e re w a s also a ta lk by C a d e t O fficer T . H ir s t, in w h ic h h e o u tlin e d t h e a c tiv itie s
R I D u n d e r t a k e n sin ce th e fo r m a tio n of th e D iv isio n a s w ell a s th e w in ter p ro g ra m m e . T h e p a re n ts to o k a d v a n t a g e of th e o p p o rtu n ity to d iscu ss w ith th e officers th e ir v ie w s o n p o in ts of m u t u a l in te re s t. I n t h e N e w Y e a r a c o u r s e of in s tr u c tio n w ill be s t a r t e d f o r b o y s b e t w e e n 14 a n d 16 w h o a r e d e s i r o u s o f j o i n i n g t h e D iv isio n .
County of Stafford. T a m w o r t h .— T h e a n n u a l in s p e c tio n of th e a b o v e A m b u la n c e a n d N u r s in g D iv is io n s w a s h e ld re c e n tly in th e g r o u n d s of T h e L o d g e , A s h l e y R o a d , b y p e r m i s s i o n o f t h e A s s i s t a n t C o m m is s io n e r (D r. D . M cC o ll) a n d M rs. M cC o ll. The i n s p e c t i n g officer w a s D r. R ic h a r d , C o u n ty S u r g e o n . M any h i g h o fficers w e r e p r e s e n t. D r . R i c h a r d in h is a d d r e s s , r e m a r k e d t h a t h e w a s satisfied a lik e w ith th e t u r n o u t in g e n e r a l a n d th e w o r k p e r form ed. I t h a d b e e n a p le a s u re to h im to c o n d u c t th e in sp ec tio n . H e t h e n p r e s e n t e d 5 l o n g s e r v i c e r i b b o n s f o r 15 y e a r s ’ serv ice, a n d 2 L a y I n s tr u c to r s ’ C ertificates. M rs. E . V. de H a m e l, donor, p resen ted tw o su rg ical h a v e r s a c k s to th e N u r s i n g D iv isio n . T h e f o l l o w i n g p r e s e n t a t i o n s w e i e t h e n m a d e : 13 F . A . C ertificates, 5 P r e lim in a r y C ertific a te s, 3 V o u c h e rs, 4 M e d a l lio n s, a n d 6 L a b e ls . I t w a s a n n o u n c e d t h a t i n t h e N u r s i n g S e c t i o n , 21 can d id ates passed th eir ex am in atio n .
County of Worcester. D u d le y a n d D i s t r i c t . — T h e la st S .J.A .B . co m p etitio n fo r th e C o u n ty of W o r c e s te r fo r th e p r e s e n t s e a s o n w a s h e ld in t h e C o u n t y H i g h S c h o o l, S to u r b r i d g e . T h e tro p h y at sta k e , a very h a n d s o m e o n e w a s th e “ C a p ta in a n d M rs. L echm ere ” Cup. T h e re w e re fo u r c o m p e tin g te a m s, tw o fr o m t h e S o u th a n d tw o f r o m th e N o r th of th e c o u n ty . T h e r e w a s a v e ry l a r g e a t t e n d a n c e of s p e c ta to rs . C o u n ty C o m m issio n e r D r. F. L. N e w to n w a s th e ju d g e fo r th e te a m te st a n d C o u n ty O fficer D r . M rs. P o r te r th e in d iv id u al test ju d g e . A fte r tea, w h ic h w a s s e rv e d b y th e m e m b e rs of th e S t o u r b r i d g e N u r s i n g D iv is io n a t th e c o n c lu sio n of th e c o m p etitio n , D r. N e w to n said th a t h e w a s v ery p le a se d th a t th e C o u n te ss B e a u c h a m p th e ir P resid e n t w a s w ith th e m . He a ls o t h a n k e d a ll t h e o fficials w h o h a d h e lp e d to m a k e t h e co m p etitio n su ch a success. M iss M . H . W a lto n (C o u n ty S e c re ta ry ) th e n a n n o u n c e d t h e r e s u l t a s f o l l o w s : T . W . L e n c h ’s A m b u l a n c e D i v i s i o n , a t o t a l o f 166 m a r k s ; B r i e r l e y H i l l N u r s i n g D i v i s i o n , a t o t a l o f 130 m a r k s . T h e C o u n te ss B e a u c h a m p p re s e n te d th e c u p to th e w in n i n g te a m , a n d in a g r a c e f u l s p e e c h , t h a n k e d all fo r g iv in g h e r s u c h a w o n d e rfu l w e lco m e. S h e w a s v e r y i n t e r e s t e d in th e ir w o rk a n d a n y th in g s h e c o u ld d o to h e lp th e m s h e w o u ld g la d ly do. S h e c o n g ra tu la te d th e co m p etito rs on t h e ir h i g h d e g r e e of skill.
East Riding of Yorkshire. H u m b e r s id e . — T h e a m b u l a n c e se rv ic e of th e a b o v e C o rp s is n o w a w e ll- e s t a b lis h e d f e a t u r e , a n d t h e p ro o f of its n e c e ssity , in a n a r e a s u c h a s it c o v ers, lies in th e fa c t t h a t d u r i n g t h e t w o m o n t h s it h a s b e e n in o p e r a t i o n it h a s r u n a lm o s t 2 ,0 0 0 m ile s c o n v e y in g civ ilian sic k a n d ro a d c a s u a ltie s to h o sp ita l. T h a t it is a p p r e c i a t e d is s h o w n b y t h e a m a z i n g fin an cial re s p o n se th e re h a s b e e n fo r its p ro v isio n . T h e r e h a s b e en a n e q u a lly g r a tif y in g re s p o n se to a n a p p e a l fo r d riv e rs a n d a tte n d a n ts , a n d th e a m b u la n c e m a in t a i n s a 24 h o u r a d a y s e r v i c e w i t h v o l u n t a r y h e l p e r s f r o m t h e six D iv is io n s c o m p r is in g t h e C o rp s , a n d fr o m C o rp s O fficers.
F I R S T
D e r m a t o l o g y an d t h e P u b lic H e a lth . [F ro m a L e c tu re d eliv ered by R o b e r t K la b e r, M .D ., F . R . C . P . , D . P . H . , a t th e R o y a l I n s titu te of P u b lic H e a lth a n d H y g ie n e, on W e d n e sd ay , N o v e m b er 3 r d , 1943 , w i t h M a j o r - G e n e r a l R . J . B l a c k h a m , C .B ., C .M .G ., C . l . E . , D .S .O ., in th e C h a ir. |
T h e im p o r ta n c e o f th e s tu d y o f d is e a s e s o f th e s k in , e s p e c ia lly in r e la t i o n t o t h e p u b lic h e a lt h , h a s n o t y e t r e c e iv e d t h e r e c o g n it i o n it d e s e r v e s . T h e r e a r e m o r e t h a n 400 d i f f e r e n t d i s e a s e s o f t h e s k i n . F o r tu n a t e ly o n ly a s m a ll n u m b e r of th e s e a r e of s e rio u s im p o r t to th e p u b lic h e a lth . T h e v a s t m a jo rity of s k in d is e a s e s a r e n o t a s s o c ia te d w ith a n y th in g m a n ife stly “ w ro n g w ith th e b lo o d .” They do n o t re s u lt d ire c tly fro m c o n ta c t w ith d irt. M ost are n e ith e r c o n ta g io u s n o r in fectio u s. I s tre ss th e se deeplyro o te d e r r o n e o u s id e a s to e m p h a s is e th e w id e s p r e a d i g n o r a n c e still p r e v a l e n t in m a n y q u a r t e r s . T h e c o n f u s e d a c c e p ta n c e of th e s e illu s io n s is in p a r t r e s p o n s i b l e f o r s e v e r a l u n s a t i s f a c t o r y f e a t u r e s in d e r m a t o l o g y . I t h a s re s u lte d in th e s u b je c t b e i n g “ n o t q u ite n ic e ” for d isc u ssio n in p u b lic o r s o m e tim e s , o n e fe a rs, in W h ite h a ll. C o n c e n tr a tio n of t h o u g h t o n th e d ie t, th e d irt, a n d th e su p p o se d ly d is o rd e re d b lo o d to o o fte n m e a n s im p r o p e r or u n satisfacto ry tre a tm e n t. W h e n d i s c u s s i n g t h e s o c ia l o r d o m e s t i c c a u s e s of d erm a titis, D r. K la b e r said : “ T h e n th e re a re w h a t m a y be d e sc rib e d a s th e so cia l o r d o m e s tic c a u s e s of d e rm a titis . T h e n u m e ro u s a n d h ig h ly a lk a lin e a n d m u c h -ad v ertised p rep a ra tio n s w h ic h m a k e d o m e stic w a s h in g so m u c h e asier ; c ertain d a n g e r o u s h a ir dyes to w h ich s o m e p erso n s a re a c u te ly sen sitiv e ; th e m o d e rn a n d a llu rin g lip stic k s ; so m e dyed fu r s ; a n d so fo rth . “ T h e h a z a r d s a s s o c ia te d w ith th e u s e of s o m e of th e se p r e p a r a tio n s a r e w ell k n o w n . B u t n ew p ro d u c ts a re co n s ta n tly b e in g offered to th e p u b lic, s o m e tim e s w ith o u t th e ir k n o w le d g e of th e n o v e lty o r th e h a z a r d in v o lv ed . T h u s , in A m e ric a q u ite re c e n tly m a n y c a s e s of d e rm a titis fo llo w ed th e use of a n e w sy n th etic ‘ fin ish ’ fo r u n d e rc lo th e s a n d sto ck in g s.” S c a b ie s h a s b e e n r e c e n t ly m u c h in t h e p u b lic e y e a s w ell a s in its s k in . W e h a v e h a d a S c a b ie s O r d e r , s c a b ie s c linics, a n d a sca b ie s s k in . S c a b ie s h a s b e en m a d e n o tifiab le by s o m e lo c a l a u th o r itie s w h o h a v e p ro v id e d a d e q u a t e facilities for tr e a tm e n t. I t is s t i l l t o o e a r l y t o e s t i m a t e t h e r e s u l t s of these m e a su re s. In d e e d , in th e a b s e n c e of g e n e r a l n o tifica tio n t h e r e is a s y e t n o re lia b le y a r d s tic k . P e d ic u lo s is w a s d e s c rib e d b y S h ip le y a s o n e of th e m in o r h o rr o rs of w a r . U n t i l t h e e v a c u a t i o n o f c h i l d r e n i n 1939 it w a s n o t r e c o g n is e d , e x c e p t b y th e m e d ic a l se rv ic e (school), h o w g r e a t a p a r t h a d b e e n p la y e d b y s ch o o l n u r s e s in m a i n ta in in g a lo w in c id e n ce of th is co n d itio n . T h e new p a ra siticid e s m a y m a k e tr e a tm e n t e asier, b u t u n til th e g e n e r a l s t a n d a r d s of h y g ie n e a n d e d u c a tio n h a v e b e e n f u r th e r r a is e d , in t o w n a n d c o u n tr y , w e s h a ll still be d e p e n d e n t o n th e v ig ila n c e of s ch o o l n u r s e s a n d te a c h e rs . In th e p a s t th e b a rb e rs ’ sh o p s h a v e b een freq u en tly b la m e d , n o t w ith o u t re a so n , fo r c o n v e y in g th is a s w ell a s o th e r in fe c tio n s. T h e re has, how ever, been a s trik in g a n d s p o n ta n e o u s a d v a n c e in th e s ta n d a r d s of sa lo o n h y g ie n e , a n d in fe c tio n s fro m th is s o u rc e h a p p ily s e e m m u c h less c o m m o n th a n h ith erto . C a ttle r in g w o r m in m a n a rise s la rg e ly fro m n o n c h a la n c e o n t h e p a r t of t h e s m a l l f a r m e r , w h o is l ittl e c o n c e r n e d b y t h e o c c u r r e n c e of th is d is e a s e in h is h e rd . I t te n d s to clear u p s p o n t a n e o u s l y w h e n t h e b e a s t s a r e t u r n e d o u t to g r a s s in th e sp rin g . T h e re f o r e h e fails to c a r ry o u t t r e a tm e n t w h ic h is b o t h s i m p l e a n d e ffectiv e. W h e n th e h u m a n sk in becom es i n f e c te d , h o w e v e r , t h e r e a c t i o n is m o r e v i o l e n t a n d p r o l o n g e d .
M o s t of th e o th e r a n i m a l r i n g w o r m s a r e d e riv e d fro m cats a n d dogs. T h e P e rs ia n k itte n s e e m s to b e p a rtic u la r ly dangerous. T h e s e c a t a n d d o g r i n g w o r m s m a y affect a n y p a r t of th e b o d y . T h e y can rarely be d istin g u ish ed from th o s e of h u m a n o r ig i n w ith o u t s p e c ia lis e d c u ltu r e m e d ia a n d exp erien ce. T h e resp o n sib le c a t or d o g m a y s o m e tim e s s h o w n o o b v io u s s ig n s of in fe c tio n , a n d e v e n th e v e te r in a r y s u r g e o n ’s o p i n i o n m a y b e u n c e r t a i n . T h e in c id e n c e of s c a lp r i n g w o r m , lik e t h a t of p e d ic u lo sis, h a s b een very g re a tly re d u c ed by th e w o rk of th e school n u r s in g serv ice. R i n g w o r m of th e g r o in s s e ld o m affects g ir l s o r w o m e n . S o m e o n e o n c e s a i d t h a t i t w a s e n d e m i c a t a l l t h e b e s t b o y ’s sch o o ls. I t is n o t i m p o s s i b l e t o c o n t r a c t t h i s f o r m o f r i n g w o rm fro m la v a to ry seats. I t is, h o w e v e r , m u c h m o r e lik e ly to b e tr a n s m i t t e d fro m th e free in t e r c h a n g e of s p o r ts s h o rts a n d flan n els. T h i s y o u th f u l h a b it c a n n o t b e to o stro n g ly d isco u rag ed . R i n g w o r m of th e to e s a n d feet h a s in c re a s e d in in c id e n c e in t h i s c o u n t r y s in c e t h e l a s t G r e a t W a r . In th e U n ite d S t a t e s of A m e r ic a its in c id e n c e h a s b e e n v a r io u s ly e s t i m a t e d a t 65 p e r c e n t , t o 90 p e r c e n t , o f t h e w h o l e p o p u l a t i o n . In t h e U n i t e d S t a t e s it h a s b e c o m e f a m i l i a r t o e v e r y l a y m a n a n d a d v e r t i s e m e n t m a n a g e r u n d e r t h e n a m e o f “ a t h l e t e ’s f o o t . ” T h e r e is littl e d o u b t it is m o s t e a s i l y a n d o f te n c o n t r a c t e d in s w i m m i n g b a th s a n d g y m n a s i u m s . T h e u s e of r u b b e r sh o es, b y p r e v e n tin g th e e v a p o r a tio n of s w e a t, u n d o u b te d ly m a k e s th e s k in m o re a ttra c tiv e to th is fu n g u s . Its sp read s e e m s a t p r e s e n t to b e o n e of th e p e n a ltie s in v o lv e d in c o n v e rtin g a C. 3 in to a n A .l p o p u la tio n . T h e m o re w id e s p re a d p ro v isio n of s w i m m i n g p o o ls a n d g y m n a s i u m s m a y b e e x p e c te d to s p r e a d t h e in fe c tio n still f u r t h e r u n til its in c id e n c e a p p r o a c h e s t h a t in A m e r ic a . W h ile th e r e a r e a v a rie ty of effective t r e a t m e n t s , th e p r e v e n t i o n of t h e s p r e a d of t h i s c o n d i t i o n is e x c e e d i n g l y d ifficu lt. T h u s , th e p ro v isio n of a n tis e p tic p a d d lin g p o o ls th r o u g h w h ic h b a th e rs m u s t p a ss before e n te rin g th e s w im m i n g b a t h is n o t l i k e ly to p r o v e h e l p f u l u n l e s s t h e f e e t a r e im m e r s e d th e r e fo r a t le a s t 10-20 m in u te s .
St. J o h n A m b u la n c e A s s o c ia tio n . P e t e r b o r o u g h .— D r. W . M a rsh a ll p resid ed a t th e a n n u a l m e e t i n g of th e P e t e r b o r o u g h C e n tr e of th e S .J .A .A . w h ic h w a s h eld a t th e C o w g a te R o o m s on S u n d a y , O c to b er 31 s t . H e w a s s u p p o r t e d b y a l l t h e o f f i c e r s , w h o w e r e r e
e lected . M r. F o w le r, th e H o n . S e c re ta ry , in tr o d u c in g h is a n n u a l r e p o rt, s a id : “ I n th is tim e of w a r th e title of th e O r d e r of S t. J o h n s e e m s to fall in to th e b a c k g r o u n d a n d to b e s u p p l a n t e d b y its p a r t n e r in t h i s g r e a t w o r k , t h e R e d C ro s s . T h e title of th e W a r O r g a n is a tio n of th e R e d C ro ss a n d O r d e r of S t. J o h n is r a t h e r lo n g a n d u n w ie ld y a n d e v e r y o n e , in c lu d i n g th e m e m b e r s of S t. J o h n , d e s c r ib e s t h e w o r k a s ‘ R e d C r o s s . ’ T h e P e t e r b o r o u g h C e n t r e o f S t. J o h n is s till r u n n i n g i n d o u b l e h a r n e s s , a n d h a s c a r r i e d its fu ll s h a r e of th e h e a v y b u rd e n s b r o u g h t a b o u t by w a r c o n d itio n s, e sp ecially th e e x tra d u tie s placed u p o n th e m e d ic a l pro fessio n , n u rs in g staffs a n d o th e rs . W e a r e still u n a b le to u s e t h e H e a d q u a rte rs w h ich w e p u rc h a se d fo u r y e ars a g o , b u t th e y a re b e in g u s e d b y th e C o u n ty C o m m itte e to c a r r y o n a n o t h e r p a r t of t h e w o r k of t h e W a r O r g a n i s a t i o n . ” T h e re h a d b een tw e n ty -e ig h t co u rses of le c tu re s a n d e i g h t y - n i n e e x a m i n a t i o n s , a n d a m o n g t h e 766 f i r s t a i d a w a r d s w e r e 252 f i r s t a i d c e r t i f i c a t e s . T h e a w a r d s for th e w a r p e r i o d t o t a l l e d 3,470 t o d a t e . T h e r e w e r e 453 a w a r d s f o r H o m e N u r s i n g a n d t h e R a i l w a y s h a d a d d e d a n o t h e r 119 . M r. F o w le r g a v e in te re s tin g fig u res of m e m b e rs h ip a n d v a rio u s a m o u n ts co llected o n fla g d a y s a n d a t fo u r g a r d e n fetes. H e s a id t h a t in th e N u r s i n g C o r p s a ll officers a n d m e m b e r s w e r e w o r k i n g w ith k e e n n e s s a n d effic ie n c y ; h a r d l y
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a m e m b e r in th e C o r p s w a s n o t d o in g e ith e r fu ll-tim e o r p a rt-tim e d u ty a t eith e r F .A .P ., h o sp ital or conv alescen t hom es.
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D o u g l a s B r i t t e n o f 29 , R o c k R o a d , M i d s o m e r N o r to n , h a s b e e n a w a r d e d a p a r c h m e n t v o te of t h a n k s b y t h e c o m m i t t e e of t h e S .J . A A. fo r “ v a lu a b le a n d g r a t u i t o u s serv ices.” H e h a s o r g a n i s e d m a n y first a id c la s s e s s in c e t h e w a r i n t h e N o r t o n - R a d s t o c k d i s t r i c t , a n d g i v e n o v e r 200 e v e n in g s to tr a in in g stu d e n ts. A w a r d e d t h e B r itis h R e d C r o s s C e r tif ic a te a t t h e a g e of 12 y e a r s , h e h a s b e e n a m e m b e r o f t h e S . J . A . A . f o r 25 y e a r s , g a i n i n g h i s c e r t i f i c a t e i n 1920 , a n d t h e v o u c h e r , m e d a l l i o n a n d la b e ls a t p e rio d ic a l e x a m i n a t i o n s sin ce.
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L O N D O N , M ID L A N D & S C O T T ISH I t i s w i t h r e g r e t t h a t M r . M i l b u r n ’s r e s i g n a t i o n a s H o n o r a r y S e c r e ta r y of th e N o. 1 ( L o n d o n ) L .M .S . A m b u la n ce D istric t h a s been accep ted c o n se q u e n t u p o n his r e tir e m e n t fro m th e R a ilw a y S erv ice. M r. T . E. M ilb u rn h a s b een a sso c ia te d w ith th e R a ilw a y A m b u la n c e M o v em en t, fo rm erly on th e L. & N .W . R a i lw a y a n d la tte rly w ith th e L M .S . O r g a n is a ti o n , fo r p r a c t i c a l l y 40 y e a r s , a n d f o r o v e r 30 y e a r s h e h a s a c t e d i n th e h o n o ra ry c ap a c ity as D istric t A m b u la n c e S ecretary . D u r i n g th is lo n g p erio d , M r. M ilb u rn h a s g iv e n of h is b e s t in t h e f u r t h e r a n c e of t h e w o r k o f t h e a m b u l a n c e m o v e m e n t a m o n g s t th e r a ilw a y staff, w h ils t in a d d itio n h e h a s b e e n v e ry clo se ly a s s o c ia te d fo r m a n y y e a rs w ith th e a c tiv itie s of th e S t. J o h n A m b u la n c e B r ig a d e . F o r these s e r v ic e s h e r e c e iv e d w ell d e s e r v e d r e c o g n itio n by a d m is s io n a s a m e m b e r o f t h e O r d e r in t h e g r a d e of S e r v i n g B r o t h e r in 1917 a n d f u r t h e r p r o m o t i o n t o O f f i c e r B r o t h e r i n 1940 . M r. C. H o p k in s , a m e m b e r of th e s ta f f of t h e L a b o u r a n d E sta b lish m e n t D e p artm e n t a t W atfo rd H ead q u arters, h a s b e e n a p p o i n t e d t o s u c c e e d M r . M i l b u r n a s f r o m t h e 1s t O cto b er. M r . H o p k i n s is a S e r v i n g B r o t h e r o f t h e O r d e r of S t J o h n , th is r e c o g n itio n h a v in g b e en c o n fe rre d u p o n h im fo r serv ice s re n d e re d to th e m o v e m e n t in p a s t y e ars.
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M a n y of o u r r e a d e r s w ill h a v e h e a r d w ith r e g r e t of th e la m e n t e d d e a t h of M rs. R eg in ald M cK en n a, A ssista n t L a d y S u p e r in t e n d e n t- in - C h i e f of th e S t. J o h n A m b u la n c e B r i g a d e , w h o l o s t h e r life b y f a l l i n g f r o m a n e l e c t r i c t r a i n o n N o v e m b e r 1s t . M rs. M c K e n n a w a s a p p o in te d to h e r h ig h r a n k a b o u t tw e lv e m o n th s a g o ; befo re th a t s h e w a s fo r s o m e y e a rs S ta ff O fficer o n th e L a d y S u p e rin te n d e n t-in C h i e f ’s s t a f f .
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I w o n d e r h o w m a n y s u r g e o n s l e c t u r i n g in F i r s t A id to C ivil D e fe n ce P e rso n n e l, m o n th a fte r m o n th , for fo u r lo n g y e ars of w a r h a v e , so fa r, fo u n d th e m s e lv e s a s e rio u s c a s u a lty a t t h e te n d e r m e rc ie s of th e ir d iscip les. It h a s p ro b ab ly h a p p e n e d o ften e n o u g h , fo r th e n a m e s of d o c to rs a r e n o t lai k i n g fr o m th e R o ll of H o n o u r of civ ilia n d e a d a n d in ju r e d ' It c an seld o m , h o w ev er, h a v e o ccu rred u n d e r c irc u m s ta n c e s w h ic h a llo w e d of s u c h c o ld ly c ritic a l o b s e r v a tio n b o th of th e s y m p to m s a n d s e n s a tio n s of th e v ic tim a n d of th e w o r k of p a r t tim e F i r s t A id P o in t p e rs o n n e l, a s in th e fo llo w in g in cid en t. 1 h a d re tire d a fte r tw e n ty -fiv e y e a rs of C o n s u ltin g S u r g e r y in th e y e a r b e fo re th e w a r a n d m a d e m y h o m e in a c h a r m i n g w e s t c o u n ty v illa g e a s d e e p in th e h e a r t of th e c o u n t r y a s it s e e m e d p o s s ib le to g e t . T h e v illag e w a s seven m ile s fro m th e n e a re s t to w n , ra ilw a y o r d o c to r, b o a ste d th re e t i n y s h o p s , a p o s t office a n d s o m e t h r e e h u n d r e d i n h a b i t a n t s . I h a d l o n g felt t h a t w a r w a s i m m i n e n t a n d h a d b e e n a m o n g th e e a r lie s t of th o s e w h o s e voices w e r e ra is e d in th e w i l d e r n e s s in a n e ffo rt t o s t i m u l a t e a l e t h a r g i c p u b lic to in te r e s t in its o w n d e fe n c e . A s a c o n se q u e n c e I very soon f o u n d m y self a t w o r k in m y n e w h o m e d e te r m in e d to c re a te , a t a n y ra te , in m y o w n v illa g e , a F i r s t A id P o in t w ith su fficien t tr a in e d p e r s o n n e l to d e a l efficiently w ith c a s u a ltie s u n til su c h tim e a s h e lp co u ld re a c h th e m . F r o m th e first a fa ir n u m b e r of th e i n h a b ita n ts b e c a m e i n t e r e s t e d in th e w o r k a n d e v e n in t h e fa c e o f m ild lo c a l rid icu le c o n tin u e d to p ra c tic e a n d a tte n d r e g u la r w e e k ly lectu res. A s th e first th r e e w e a r y y e a r s of w a r d r a g g e d s lo w ly p a s t, th e p a rty w e n t t h r o u g h m a n y v icisitu d es. P eo p le m o v e d f r o m t h e d i s t r i c t , s o m e w e r e c a l l e d u p , a f e w fell b y th e w ay sid e co n v in ced th a t th e y w o u ld n ev er be n eed ed b u t a lw a y s a fa ith fu l n u c le u s c a rrie d on a n d n o w a n d a g a i n a n e w face a p p e a re d a m o n g th e m . B y th is t i m e all h a d q u a lifie d b o th in first a id a n d in h o m e n u rs in g , se v e ra l e v en h e ld P ro ficien cy C ertific a te s a n d th e y w e r e w illin g e n o u g h to fo r m a D e t a c h m e n t of th e B ritis h R e d C ro ss w h e n th e o p p o rtu n ity w a s offered to th e m . T h e n c a m e t h e d a y s o f t h e tip a n d r u n r a id , w h e n o u t of c lear sk ies a n d w ith no w a rn in g w h a tev e r, c a m e th e ro a r of lo w fly in g p la n e s , th e r a ttle of m a c h in e g u n s a n d th e c r a s h of t h e b o m b s . V illag e a fte r v illag e w a s sh o t u p o r b o m b ed , a n d a lth o u g h w e o u rse lv es suffered n o th in g w o rs e th a n c a n n o n fire, m i n o r c a s u a l t i e s f r o m n e i g h b o u r i n g h a m l e t s so o n b e g a n to b e b r o u g h t to th e P o in t. I t w a s th e n , I th in k , fo r th e first tim e t h a t th e v illa g e a s a w h o le really a p p re c ia te d th a t th e re w a s a w a r on, a n d th a t a l l i d e a s o f “ U s ’ll n i v e r b e b o m b e d ’e r e ” f i n a l l y d i s a p p e a r e d fro m th e m in d s of e v en th e m o s t o p tim istic. T h e re c am e a d a y w h e n th e n e arest m a rk e t to w n w as h e a v ily a t t a c k e d , a n d th e p e rs o n n e l, c alled in to re in fo r c e th e s ta f f of th e lo cal h o s p ita l, s a w , fo r th e first tim e , th e re a litie s of to ta l w a r. T h e y b e h a v e d m a g n ific e n tly , flin ch ed fro m n o t a s k h o w e v e r h o rrib le, a n d e m e rg e d a t th e e n d of a g ru e llin g fo u rte e n h o u rs w ith a n e w fo u n d co n fid en ce a n d th e re a lis a tio n th a t n e a rly fo u r y e ars of m o n o to n o u s tr a in in g h a d been m o re th a n re p a id . I h a d lo n g w o n d e re d w h a t th e re a c tio n of th e se p eo p le w o u ld b e w h e n faced w ith th e re a l th in g . I k n e w w ell e n o u g h th a t n o n e of th e m h a d p ro b a b ly ev er seen a n y th in g w o rse th a n a c u t fin g er a n d th a t no o p p o rtu n ity w o u ld o c cu r to g iv e th e m even th e p re lim in a ry b lo o d in g of th e p ro b a tio n e r n u r s e in t h e m i n o r c a s u a lty w o r k of a h o s p ita l o u t p a tie n t de p artm en t. I k n e w th a t w h e n th e y d id g o in to a c tio n th e y w o u ld d o so to face h o rr o r s a t w h ic h e v e n th e m o s t h a r d e n e d s u rg e o n m ig h t re a so n a b ly react.
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T h e ra id ta u g h t m e all th a t I w a n te d to k n o w , a n d fro m t h a t d a y I h a d n o f e a rs a s to th e i r a b ility to c o p e w ith a n y t h i n g t h a t I m i g h t d e m a n d of th e m . T h e la st a n d h a rd e st te st o n ly r e m a in e d — h o w th e y w o u ld d e al w ith s e rio u s c a s u a l tie s in t h e field its e lf, w h e n n o t a c t i n g d i r e c t l y u n d e r m y o w n co n tro l. I w as soon to learn ! R a ts , w e a r e to ld b y a b en ificien t G o v e rn m e n t, a re a N a t i o n a l M e n a c e in c a p i t a l l e t t e r s , a n d t h o s e of u s w h o live in th e c o u n tr y a r e left in little d o u b t u p o n th e m a t t e r w h e n w e d isco v er th a t o u r s c a n ty a n d v ery p recio u s p o u ltry ra tio n s a re b e g in n in g u n a c c o u n ta b ly to d is a p p e a r. Q u ie t o b s e rv a tio n o n e e v e n in g s h o w e d a really m a g n ifi c e n t fello w e m e r g i n g fro m a d itc h b o r d e r in g m y c h ic k e n ru n w ith d e s i g n s u p o n th e r e m a i n s of food in th e tr o u g h s . S ince th e d is a p p e a r a n c e of L iv e rp o o l V ir u s fr o m th e m a r k e t I h a v e a lw a y s b e e n tim id of th e u s e of o th e r p o is o n s h o w e v e r safe t h e y m a y b e s a i d t o b e if c o n s u m e d a c c i d e n t a l l y b y o t h e r d o m estic a n im a ls. In a v illag e s w a r m in g w ith d o g s a n d c ats th e y a r e n o t p o p u lar. 1 d e te r m in e d , th e r e f o r e , to la y fo r th is f a t h e r of all th e ra ts fro m th e s h e lt e r of a n e a r b y s h e d w ith a rev o lv er, a w e a p o n to w h ic h I w a s w e ll a c c u s to m e d a n d w ith w h ic h I k n e w m y s e lf to b e a fa irly a c c u r a t e sh o t. O n e c h a m b e r o nly w a s lo a d e d a n d th a t, fo r s a fety s a k e , la y fo r th e tim e b e in g w ith a n e m p ty c h a m b e r b e tw e e n it a n d th e firin g p o sitio n . I s to o d silen tly w a itin g a n d w a tc h in g fo r th e ex p ec te d e m e r g e n c e of m y fr ie n d fro m h is h o le s o m e six y a r d s a w a y on m y rig h t. A n d th e n th e u n e x p e c te d b e g a n to h a p p e n . A soft b u t u n m is ta k e a b le s q u e a k c a m e from th e d itch b e h in d m e a n d a b o u t th r e e y a r d s o n m y left a n d I t u r n e d to see a g re y nose e m e rg in g . A s I d id s o m y left l e g w e n t b a c k b u t, u n fo r tu n a te ly fo r m e, p la n te d itself u p o n a n a l m o s t p erfectly ro u n d s to n e a n d m y a n k le g a v e w a y a t o n ce w ith a n a g o n i s i n g s t a b of p a in . T h i n g s b e g a n to h a p p e n e v e n m o r e q u ic k ly . T h e s u d d e n p a in e v id e n tly c a u s e d m y fin g e r to c o n tr a c t u p o n th e tr i g g e r a n d so th ro w th e c a r trid g e in to th e firin g p o sitio n. T h r o w n o ff m y b a l a n c e I fell f o r w a r d s o n t o m y left k n e e a n d h e a r d th e c r a s h of th e s h o t b e n e a th m e a s m y h a n d s in v o lu n ta rily w e n t fo rw a rd s, a n d , a second later I fo u n d m y s e lf o n t h e g r o u n d w ith m y left l e g fu lly flex ed b e n e a t h m e a n d t h e s m o k i n g r e v o l v e r still in m y h a n d .
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Queries and Answers to Correspondents Q u e r i e s w i l l b e d e a l t w i t h u n d e r t h e f o l l o w i n g r u l e s :— 1.— L e t t e r s c o n t a i n i n g Q u e r i e s m u s t b e m a r k e d o n t h e to p left-h an d c o rn e r of th e envelope “ Q u e ry ,” a n d ad d re sse d t o F i r s t A i d , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 .
2. — A l l Q u e r i e s m u s t b e w r i t t e n o n o n e s i d e o f p a p e r o n l y . 3. — A l l Q u e r i e s m u s t b e a c c o m p a n i e d b y a “ Q u e r y C o u p o n ” c u t f r o m t h e c u r r e n t i s s u e of t h e J o u r n a l , o r, in c a s e of Q u e r ie s fr o m a b r o a d , fr o m a r e c e n t issu e.
4. — T h e T e x t b o o k t o w h i c h r e f e r e n c e m a y b e m a d e i n t h i s c o l u m n i s t h e 39 t h ( 1937 ) E d i t i o n o f t h e S . J . A . A . M a n u a l of F i r s t A id to t h e I n ju r e d .
Perform ance of Schafer’s Method. F W . ( B i r m i n g h a m ) . — 1 h a v e b e e n t a k i n g a c l a s s of W a r d e n s i n S c h a f e r ’s M e t h o d o f A r t i f i c i a l R e s p i r a t i o n a c c o r d i n g to t h e T e x tb o o k , w h ic h tells u s to p la c e t h e h e a d to o n e sid e. I w a s a s k e d if t h e r e w a s a n y p a r t i c u l a r s i d e i n w h ic h to p la c e th e h e a d , to w h ic h I rep lied “ N o .” W h e n th e m e n w e n t fo r th e ir e x a m in a ti o n s , th e C hief W a r d e n t o l d t h e m t h a t t h e y m u s t a l w a y s p u t t h e p a t i e n t ’s h e a d o n t h e l e f t s i d e b e c a u s e if i t w a s p l a c e d o n t h e r i g h t s i d e t h e y w e r e a p t t o b r e a k t h e p a t i e n t ’s n e c k . W o u ld yo u k in d ly g iv e m e y o u r v e rd ict on th is p o in t ? T h e r e a r e n o g r o u n d s fo r t h e s u g g e s t i o n t h a t in th e p e r f o r m a n c e o f S c h a f e r t u r n i n g t h e p a t i e n t ’s h e a d t o t h e r ig h t m ig h t b r e a k h is n e c k .— N . C o r b e t F le t c h e r .
Exam ination How ler. M .R . (C a n n o n S t.).— In a re c en t e x a m in a tio n 1 a sk e d a c a n d id a te h o w h e w o u ld tre a t a p a tie n t su fferin g from shock. H e r e p l i e d “ K e e p p a tie n t w a rm . ” W hen, h o w e v e r, I p re s s e d h im to tell m e h o w h e w o u ld d o th is , h e e l e c t r i f i e d m e b y s a y i n g — “ I w o u ld f i l l the hath w ith b o ilin g w a ter a n d p la c e the p a t ie n t th erein / / ” Good!
N e x t , p l e a s e ! !— N . C . F .
A u x ilia ry Brigade Service. D .O . (W e llin g b o ro u g h ).— I h a v e been a n a u x ilia ry m e m b e r of th e B r ig a d e fo r th r e e y e a r s a n d h a v e n o w jo in e d th e N u r s in g D iv isio n . C a n y o u p l e a s e te ll m e if a l l t h e d u ties w h ich I h av e p erfo rm ed d u rin g th ese th re e years w ill c o u n t to m y c r e d it ? A s t h e d u t i e s w e r e n o t p e r f o r m e d u n d e r i n s t r u c t i o n of B r i g a d e O fficials th e y c a n n o t b e p la c e d to y o u r c r e d it.— E d ito r .
B r ig a d e R o m a n c e . to C a d e t O fficer J o a n R o y s to n a n d P te . F r e d . M a r s to n , b o th of th e H u d d e r s f ie ld C o rp s, S .J .A .B ., o n th e ir m a r r i a g e a t S t. B a r n a b a s C h u rc h , C ro s s la n d -M o o r, C o n g r a tu la tio n s
o n N o v e m b e r 6 th . A v e r y l a r g e c o m p a n y of m e m b e r s of t h e C o r p s a t t e n d e d . T h e b r i d e s m a i d s w e r e C a d e t O f f i c e r S . B e r r y a n d t h e b r i d e ’s siste r, M iss M . R o y sto n . T h e b r i d e g r o o m is s e r v i n g in t h e R .A . M . C . , a n d it w a s v e ry fittin g th a t h is b e st m a n s h o u ld b e c o m r a d e P te. R . T . K im p to n , R .A .M .C . T he groom s m e n w e r e P t e s . H . E v a n s , R . A . M C . , a n d J . JolifFe, S . J . A . B . B o t h t h e b r i d e a n d b r i d e g r o o m h a v e b e e n m e m b e r s of t h e H u d d e r s f i e l d C o r p s f o r 10 y e a r s . E v id en c e of th e esteem in w h ic h th e y a r e h e ld w a s p ro v id e d by th e fa c t t h a t a m o n g s t th e m a n y g u e s ts w e re L a d y D is tric t C a d e t O fficer M rs. C u m m i n g - B e l l a n d L a d y D iv . S u p t. M iss D . C h e e th a m . A m o n g s t th e m a n y p re se n ts w e re a S a la d B ow l from th e N u r s in g C a d e ts a n d a C ase of C u tle ry fro m th e C en tral D iv isio n .
Perforated Gastric Ulcer. F .S . ( W a lla s e y ) .— A t a r e c e n t c o m p e titio n a frie n d of m in e also a B rig a d e m e m b e r, co rrectly d ia g n o se d a p erfo rated g a s tr ic u lcer. I n t h e t r e a t m e n t a s p e r T e x t b o o k , “ if t h e s e a t o f t h e h a e m o r r h a g e is k n o w n a p p l y a c o ld c o m p r e s s , ” t h e D o c t o r w o u l d n o t h a v e it, a s h e m a i n t a i n e d t h a t a c o ld c o m p re s s o n th e s to m a c h w o u ld in c re a s e s h o c k e sp ecially b e in g so n e a r th e s o la r p lex u s. Y o u r r e m a r k s o n th is p o in t
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Loading Stretcher. W .F . (T o rq u a y ).— A t a B rig a d e m e e tin g recen tly a d isc u s s io n a r o s e w ith r e g a r d to th e T e x t b o o k in s tr u c tio n s for “ L oad S tretch e r.” B y th e in stru ctio n B ea re r N o, 4
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p a s s e s h i s l e f t h a n d a c r o s s t h e p a t i e n t ’s c h e s t a n d g r a s p s h is r ig h t sh o u ld e r. H e b rin g s h is r ig h t a rm b e n e a th t h e left s h o u ld e r th u s s u p p o r t i n g th e h e a d . T h o s e p r e s e n t w e r e u n a n i m o u s in e x p r e s s in g th e o p in io n t h a t th e p a s s i n g of th e left h a n d a c r o s s th e p a t i e n t ’s c h e s t a n d g r a s p i n g t h e r i g h t s h o u l d e r p u t a n u n d u e a n d u n n e c e s s a r y s t r a i n u p o n N o . 4. A ll a g r e e d t h a t t h e p a t i e n t c o u ld b e lifted m o r e e x p e d itio u s ly a n d w i t h f a r l e s s s t r a i n o n N o . 4 , if t h e l e f t h a n d w e r e p a s s e d u n d e r t h e u p p e r p a r t of th e t r u n k . L iftin g w ith th e p a l m of t h e h a n d u p w a r d s is a m o r e n a t u r a l m e t h o d t h a n re a c h in g o v er a n d c lu tc h in g th e o th e r sh o u ld er. C a n y o u e x p la in , p lease, th e re a s o n fo r th e in s tru c t io n b e i n g s o f r a m e d a n d h o w it is a n i m p r o v e m e n t on th e easier a n d m o re n a tu ra l m eth o d ? T h e T e x tb o o k in stru c tio n s a re b a se d on m a n y years e x p e r ie n c e in t h e u s e of t h e s tr e tc h e r ; a n d th e g e n e r a l c o n s e n s u s o f o p i n i o n is t h a t t h e s e in v o lv e le ss s t r a i n o n B e a r e r N o . 4. — N . C . F .
Burst Varicose Vein. F .C . (M e lto n ).— A t a re c e n t c la ss, th e fo llo w in g q u e stio n s w e r e a s k e d :— (11 I s i t p o s s i b l e f o r a v a r i c o s e v e i n t o b u r s t w i t h o u t b r e a k in g th e sk in , a n d w h a t w o u ld be th e s ig n s a n d sy m p to m s ? (2 ) W o u l d t h e p a t i e n t , a f t e r a w h i l e , s h o w t h e s i g n s o f i n t e r n a l b l e e d i n g if i t w a s n o t c o n t r o l l e d ? Y o u r r e m a r k s w ill b e n o te d w i t h in te re s t. ( 1) I t i s p o s s i b l e f o r a v a r i c o s e v e i n t o b u r s t a n d t o c a u s e h a e m o r r h a g e b e n e a th th e u n b ro k e n sk in . T h e re su lt w o u ld b e a b ru ise, th e a r e a of w h ich w o u ld v a ry w ith th e a m o u n t of b lo o d w h ic h h a d e s c a p e d fro m t h e v essels. (2) T h e r e w o u l d n o t b e m a r k e d s i g n s of i n t e r n a l b l e e d i n g b e c a u s e th e e s c a p e of b lo o d w o u ld b e a rre s te d b y th e re su ltin g p re ssu re — N .C .F .
Th om a s Splint. G .V . ( W a tf o r d ) .— W ill y o u p le a se g iv e y o u r ad v ic e o n th e fo llo w in g p o in ts w h ic h h a v e a ris e n a t th e C .D . A m b u lance D e p o t to w h ic h T h o m a s S p lin ts h a v e been s u p p l i e d :— ( 1) A t w h a t s t a g e d u r i n g th e ap p lic atio n of a T h o m a s S p l i n t is t h e p a t i e n t p la c e d o n t h e s t r e t c h e r ? T h e T e x t b o o k is n o t c le a r . (2) H o w c a n th e fo o t b e m a d e r ig id ? The Hom e O f f i c e h a s s u p p l i e d s p l i n t a n d e x t e n s i o n b a r b u t no
s tirr u p . ( 1) W h i l e I a g r e e t h a t t h e i n s t r u c t i o n s i n A p p e n d i x I I I o f t h e T e x t b o o k a r e n o t q u i t e c l e a r o n t h i s p o i n t , i t is o b v i o u s th a t th e p a tie n t m u s t n o t be lo a d e d o n th e s tre tc h e r u n til th e f r a c tu re h a s b e e n c o n tro lle d by th e T h o m a s S p lin t. T h i s is c l e a r if y o u r e m e m b e r t h a t t h e T h o m a s S p l i n t i s a s u b s t i t u t e f o r t h e s p l i n t s r e f e r r e d t o o n p . 89 o f t h e T e x t b o o k a n d t h a t th e lim b m u s t be re n d e re d a s im m o b ile a s p ra c tic a b le before t h e p a t i e n t is m o v e d , a s p e r i n s t r u c t i o n s o n p. 66. ( 2) T h e s t i r r u p is p a r t o f t h e e q u i p m e n t a n d s h o u l d h a v e b een su p p lied . I n its a b s e n c e it w ill b e fo u n d t h a t t h e s lin g m e n t i o n e d i n C l a u s e 5 ( d ) o n p . 253 o f t h e T e x t b o o k a n d t h e f ig u r e - o f - e ig h t b a n d a g e n a m e d in C la u s e 8 w ill s e rv e to c o n tro l th e fo o t.— N .C .F .
Points on Bones. G .A . ( O v e r s e a l ) . — I n t h e a r t i c l e w h i c h in t h e O c t o b e r is s u e o f F i r s t A i d i s p u b l i s h e d u n d e r t h e t i t l e P o in ts on B o n e s fo r B e g in n e r s , I n o t e a n e r r o r . O f c o u r s e , th e flat b o n e s a re th e s te r n u m a n d th e sc a p u la a n d n o t a s stated . W e th a n k y o u for y o u r le tte r a n d fo r c o rre c tin g a n error. — E
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A I D I d o n o t k n o w a n y i n s t r u c t i o n s w h i c h tell y o u to p la c e b a n d a g e s d ire c tly o v er fra c tu re s ; a n d I c a n o n ly s u g g e s t th a t y o u fo llo w th e in s tr u c tio n s of th e T e x t b o o k .— N .C .F .
Fractures of F e m u r and Pelvis. F . B. ( B l a c k b u r n ) . — A t a r e c e n t E x e r c is e a t o u r F i r s t A id D e p o t w e h a d to tr e a t a p a tie n t s u ffe rin g fro m sim p le f r a c tu r e s of r i g h t f e m u r (th r e e in c h e s a b o v e k n e e jo in t) a n d of le ft p elv is. O u r i n s t r u c t o r s d iffe re d in t h e i r t r e a t m e n t . One a d v is e d t r e a t i n g th e p elv is first a n d th e n s p lin tin g th e frac tu re d fem u r. T h e o th e r ad v ised tw o lo n g sp lin ts o n e to c o n tr o l th e f e m u r a n d th e o t h e r t h e p elv is. P lease t e l l u s w h a t y o u r t r e a t m e n t w o u l d b e , a n d if w i t h t h e p e lv is s p lin te d t h e r e is r i s k of p r e s s i n g t h e p elv ic f r a g m e n ts in to th e b la d d e r. W i t h th is c o m b i n a t i o n o f i n j u r ie s ( a s I w r o t e in t h e J u l y i s s u e o f F ir s t A id ) t h e f r a c t u r e d f e m u r is m o r e l i a b l e to a g g ra v a tio n a n d co n seq u en tly d e m a n d s p referen tial tre a t m e n t. I s h o u l d t r e a t t h e f r a c t u r e d f e m u r a s la id d o w n in t h e T e x t b o o k a n d k n o w t h a t t h e f r a c t u r e d p e lv is is p r o p e rly c on tro lled . Y o u w ill n o te t h a t b o th in ju r ie s r e q u ir e a b a n d a g e r o u n d t h e p e l v i s w h i c h , if p r o p e r l y a p p l i e d , w o u l d n o t p r e s s t h e p elv ic f r a g m e n t s in to th e b l a d d e r ; a n d a lso t h a t th e e x a c t site of f r a c tu r e of p e lv is c a n o n ly b e d i a g n o s e d b y x - r a y ex am in atio n . T o m e t h e l o n g s p l i n t a l o n g t h e o t h e r s i d e of b o d y is a s h e e r w a s t e of t i m e . — N .C . F .
Raising of Fractured Leg. A. W . ( C h a t h a m ) . — P l e a s e tell m e w h y t h e T e x t b o o k te lls u s n o t to ra ise a fra c tu re d lo w e r lim b d u r in g o u r tr e a tm e n t a n d tr a n s p o r t, e sp e c ia lly in v ie w of th e fa c t t h a t th e foot o f t h e p a t i e n t ’s b e d i s r a i s e d w h e n h e i s a d m i t t e d t o h o sp ital. R a i s i n g of th e lo w e r lim b s c a u s e s m o v e m e n t in th e jo in ts a b o v e t h e f r a c t u r e a n d th e r e f o r e is c o n t r a r y to t h e i n s t r u c t i o n s i n R u l e 5 a o n p . 67 o f t h e T e x t b o o k . O n th e o th er h a n d r a i s i n g a b ed o n b lo c k s d o e s n o t h a v e th is effect.— N .C . F .
Th e Future of the Brigade. D . S . ( B i r m i n g h a m ) . — W i t h r e f e r e n c e t o D r . C o r b e t F l e t c h e r ’s m o s t i n t e r e s t i n g a r t i c l e o n T h e F u t u r e o f the S t. J o h n A m b u la n c e B r ig a d e , w h i c h w a s p u b l i s h e d i n A u g u s t is s u e of F ir s t A i d , I s u g g e s t t h a t a v e rv u se fu l m e m b e r s h i p a f t e r t h e w a r f r o m C ivil D e f e n c e U n i t s is lik e ly to b e l o s t f o r t h e f o l l o w i n g r e a s o n :— M a n y o f u s in C . D . F i r s t A id P a r t i e s h a v e a s o u r c o lle a g u e s m e n a n d w o m e n w h o w e a r th e S t. J o h n B a d g e o n t h e i r u n i f o r m s , 75 p e r c e n t , o f t h e s e p e o p l e a r e i n e fficie n t in first a id a n d p a r t i c u l a r l y in c a r r y i n g a n d lo a d in g . T h e o t h e r 25 p e r c e n t , a r e m a g n i f i c e n t a n d a c t a s in stru c to rs. I w o u ld s u g g e s t t h a t b e c a u s e th e se p eo p le w e a r th e S t. J o h n B a d g e ( w h a t q u a lific a tio n th is im p lie s, 1 d o n o t k n o w ) w e e x p ec t th e m to h a v e a g o o d a v e r a g e p ra c tic al k n o w l e d g e o f f i r s t a id ., a n d if t h e y a r e n o t e f f i c i e n t t h i s b a d g e sh o u ld b e d e n ie d th e m . T h o s e of u s w h o w o u ld join th e B r i g a d e a f t e r th e w a r a r e n o t to o i m p r e s s e d w i t h t h i s v i e w o f it, a n d c o n s id e r t h a t in th e in te r e s ts of th e B r i g a d e th e b a d g e po sitio n sh o u ld b e e x p la in e d . In c o n clu sio n I w o u ld a d d th a t th is m a in ly a p p lie s to th e d ire c te d m e m b e r s s e n t to u s d u r i n g th e la s t tw e lv e m o n th s. T h e S t. J o h n b a d g e w o r n o n C . D . u n i f o r m is a b a d g e of m e m b e r s h i p of t h e B r i g a d e a n d n o t of t h e effic ie n c y of its w e a r e r to r e n d e r first a i d . — E d it o r .
Treatm ent of Fractures.
C olonr of Blood.
A .G . ( W a r e ) . — P l e a s e te ll u s if i n t h e t r e a t m e n t o f f r a c t u r e s it is n o w c o r r e c t to a p p ly b r o a d b a n d a g e s d ir e c tly o v e r th e fra c tu re s in s te a d of ab o v e a n d b elo w as w e h a v e a lw ay s b een ta u g h t.
J . W . ( I l k e s t o n ) . — P l e a s e te ll m e w h a t is t h e c o lo u r of t h e b lo o d w h ile it is c i r c u l a t i n g in t h e b o d y a n d b e f o r e it c o m e s in to c o n ta c t w ith th e a ir. S o m e s a y t h a t it is. g re e n , o r a n g e a n d v a rio u s o th e r c o lo u rs,
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A s t h e T e x t b o o k t e lls y o u , t h e b l o o d w h e n c i r c u l a t i n g in t h e v e s s e l s v a r i e s f r o m b r i g h t t o d a r k r e d ; a n d i t s c o l o u r is d e p e n d e n t o n t h e o x y g e n ( w h i c h m a k e s i t b r i g h t r e d ) o r of i m p u r i t i e s ( w h i c h m a k e s it d a r k r e d ) p r e s e n t a t a n y g i v e n p o in t. I s u sp e c t th a t y o u a re th in k in g a b o u t th e v a rie d co lo u rs a s s o c ia te d w ith a b r u is e w h ic h r e s u lt f r o m c h a n g e s in th e re d b lo o d c o rp u s c le s a fte r th e ir e s c a p e fro m th e b lo o d v e ss e ls.— N .C .F .
Suxgeons and the Brigade. A .E . ( B a r k i n g ) . — T h a n k y o u fo r y o u r a rtic le in A u g u s t issu e o f F i r s t A i d e n t i t l e d T h e F u tu r e o f the S t. J o h n A m b u la n ce B r ig a d e . O n e .s t a t e m e n t w a s of p a r t i c u l a r in te re s t to m e , v i z : “ T h e m a jo r ity of S u r g e o n s a r e e a g e r to h e lp a n d to g iv e of th e ir s p e c ia l k n o w l e d g e . ” T h e D iv is io n to w h ic h I b e lo n g e d h a d th r e e d ifferen t S u r g e o n s d u r in g th e se v e n te e n y e a rs I h a d th e priv ileg e of b e i n g in it ; a n d I c a n o n ly r e c o lle c t t h e m g i v i n g t h r e e lectu res d u r in g th a t p erio d — th e y w e re very g o o d . W e, t h e N . C . O . ’s , a s k e d f o r m o r e ; b u t t h e D o c t o r s w e r e a lw a y s to o b u sy . I d o w a n t to s tre s s th e p o in t th a t, h o w e v e r g o o d th e S u p e r i n t e n d e n t i s , i t i s t h e S u r g e o n ’s i n t e r e s t a n d p r a c tic a l h e lp t h a t c a n m a k e a t h o r o u g h l y g o o d a n d efficient — a n d t h a t m e a n s a h a p p y — D iv isio n . In y o u r la st p a r a g r a p h y o u s ta te a fact to w h ic h I h a v e d ra w n a tte n tio n tim e a n d tim e a g a in , n am e ly , th a t u n less th e S u r g e o n ( w h o is t h e te c h n ic a l h e a d ) a n d th e S u p e r i n t e n d e n t ( w h o is t h e e x e c u t i v e h e a d ) r e a lly c o - o p e r a te , n o D iv is io n can be tru ly “ h a p p y a n d p ro sp e ro u s.” F u r t h e r , i t i s m y e x p e r i e n c e t h a t if t h e S u r g e o n i s p r o p e r l y t r e a t e d a n d m a d e t o feel t h a t h e / s h e is a n a c t i v e m e m b e r of th e D iv isio n a n d a n e s s e n tia l p a r t of th e o r g a n is a tio n , h e /s h e w ill g iv e a d e q u a t e a s s is ta n c e a s in th e c a s e w h ic h I q u o te d in m y a rtic le . — N .C . F .
Nam es of Bones. J . W . ( I l k e s t o n ) . — ( 1) P l e a s e t e l l m e w h o g a v e t h e n a m e s t o th e b o n e s a n d w h e re d id th e y o rig in a te . W a s it fro m th e L a t i n t o n g u e o r w e re th e n a m e s ju s t c h o s e n to su it th e d o cto rs ? A l s o ( 2 ), p l e a s e t e l l m e w h a t a r e t h e t w o h o l e s i n b o tto m c o r n e r s of th e p e lv is— ? o b t u r a t o r fo r a m e n . D o e s a n y t h i n g p a s s t h r o u g h t h e s e h o l e s o r a r e t h e y filled u p w ith m u scles ? I a w a i t w ith in te re s t y o u r k in d rep lies w h ic h w ill b e m u c h a p p re c ia te d . ( 1) T h e t e r m s u s e d i n t h e d e s c r i p t i o n o f b o n e s o r i g i n a t e d fr o m th e L a t i n t o n g u e w h ic h in th o s e f a r off d a y s w a s th e l a n g u a g e of s c ie n c e . (2) E a c h of t h e l a r g e o p e n i n g s in l o w e r p a r t of r i g h t a n d left ilia c b o n e is c a lle d t h e o b t u r a t o r (o r th y r o id ) f o r a m e n . It re p re se n ts a n in te rv a l b e tw ee n th e p u b is a n d isch iu m a n d th o u g h m o s tly clo sed b y th e o b tu r a to r m e m b ra n e , tra n s m its th e o b tu r a to r v essels a n d n erv e. In cid en tally , th e te rm o b t u r a t o r m e a n s “ s to p p e d u p ” a n d th y ro id “ in f o r m of a sh ield .”— N .C .F .
Escape of Blood. L .A . ( B a t h ) . — P le a s e tell m e w h e r e th e b lo o d g o e s w h e n a n a r t e r y of th e a r m is t o r n a n d th e r e is n o e x t e r n a l w o u n d . I n th e c irc u m s ta n c e s n a m e d , b lo o d w o u ld e sc a p e a m o n g t h e t i s s u e s of t h e p a r t a n d r a i s e a t e n s e s w e l l i n g w h i c h is c a lle d a “ b l o o d - t u m o u r ” a n d w h ic h w ill v a r y in size w ith th e vessel in v o lv ed . F u rth e r, th e sw ellin g m a y b ecom e l o c a l i s e d o r if e x t e n s i v e m a y o b s t r u c t t h e m a i n a r t e r i a l s u p p l y of th e lim b a n d c au se g a n g re n e . I n e ith e r c as e e arly su rg ic al i n t e r f e r e n c e is i n d i c a t e d . — N . C . F .
Effects of Fractured T h ig h . D . T . ( B i r m i n g h a m ) . — A t a r e c e n t p r a c t i c e t h e q u e s t i o n of tr e a tm e n t of sim p le fra c tu re of th ig h (a c co m p an ie d b \ 2* i n c h e s o f s h o r t e n i n g ) c a m e u n d e r d i s c u s s i o n . I t w a s c o n te n d e d t h a t th e fig u re -o f-e ig h t b a n d a g e ro u n d feet a n d a n k le s w o u ld n o t b e su fficien t to h o ld th e e x te n sio n
A I D a n d so p e r m it th e r e m o v a l of p a tie n t o n a c c o u n t of th e s tr o n g th ig h m u s c le s fle x in g th e u n in ju r e d lim b a t th e knee. Y o u r r u l i n g w ill b e a p p re c ia te d . I t is n e w s to m e t h a t a f r a c tu r e of o n e t h i g h w ill c a u s e th e m u s c le s of th e o th e r a n d u n in ju r e d t h i g h to c o n t r a c t .— N .C .F .
E v e ’s H ocking Method. H .D . (C o lc h e ste r).— W o u ld y o u k in d ly p a ss y o u r o p in io n on D r . E v e ’s r o c k i n g m e t h o d o f a r t i f i c i a l r e s p i r a t i o n , a s it is b e i n g d e m o n s t r a t e d b y t h e A . R . P . C a s u a l t y S e r v i c e in a n d a ro u n d th is d istrict. M y p e r s o n a l o p i n i o n i s t h a t t h e E v e ’s r o c k i n g m e t h o d falls w ith in th e s a m e c a te g o r y a s th e T h o m a s S p lin t ; a n d t h a t b o th m e th o d s of t r e a t m e n t s h o u ld b e re s e r v e d for s p e c ia lly t r a in e d s q u a d s of first a id e r s . T h e c o n clu sio n s of P ro fesso r H . C o rd ier, M .D . , p u b l i s h e d i n t h e S e p t e m b e r 25 t h i s s u e o f t h e B r it is h M e d ic a l J o u r n a l a r e a s f o l l o w s :— ‘ ‘ E v e ’s r o c k i n g m e t h o d c e r t a i n l y h a s g r e a t p r a c t i c a l a d v a n t a g e s b u t th e e x p e r im e n ta l c r ite r ia so f a r e m p lo y e d to s t u d y its p h y s io lo g ic a l e ffic ie n c y s e e m to m e in s u ffic ie n t to p ro v e its s u p e r io r ity to o t h e r m e th o d s of a rtificia l re s p ir a tio n . A m o r e c o m p l e t e e x p e r i m e n t a l s t u d y is n e c e s s a r y b e f o r e its efficiency c a n b e d e t e r m i n e d . ” — N . C . F .
Fractures of A r m and Shoulder-Blade. W .K . (E a s tle ig h ).— In a re c en t co m p etitio n , a m a n w a s fo u n d ly in g o n th e g r o u n d (u n c o n s c io u s ), h a v i n g fallen from a la d d e r on w h ic h h e w a s w o rk in g . H e re c e iv e d a c o m p o u n d f r a c tu r e of th e left a r m ( u p p e r t h i r d ) w i t h a r t e r i a l b l e e d i n g , a l s o a f r a c t u r e of t h e left s h o u ld e r b la d e . ( 1) W h i c h w o u l d b e c o r r e c t , d i g i t a l p r e s s u r e o n t h e s u b c la v ia n a rte r y , in re la y s, in p r e fe re n c e to p a d a n d b a n d a g e to a x illa r y a r te r y , a s o w i n g to c o m p o u n d fr a c t u r e of a r m ( u p p e r t h i r d ) it w o u ld b e u n w i s e to a p p ly th e o th e r b a n d a g e over th e elb o w w ith fo rea rm (acro ss th e bo d y ) a n d d r a w i n g th e a r m in t i g h t to th e b o d y ? ( 2) F r a c t u r e d l e f t s h o u l d e r b l a d e w o u l d r e q u i r e b r o a d b a n d a g e o v e r f r a c tu r e , a n d a r m s u p p o r t in a S t. J o h n s lin g , w h e r e a s f r a c t u r e of left a r m ( u p p e r th ir d ) w o u l d r e q u i r e b r o a d b a n d a g e o v e r f r a c t u r e , lev el w ith to p of s h o u ld e r a n d s e c u re a r m to body, a n d s u p p o rt a r m in s m a ll slin g . W h ic h s lin g w o u ld b e c o rre c t to u se ? A s th is co n te st s e e m e d to ra is e th e se q u e rie s a n d leav e th e m o pen for d isc u ssio n . I s h a ll b e v e ry g l a d of y o u r o p in io n . (1) I a g r e e ; a n d I c o n s i d e r t h a t y o u r s u g g e s t i o n of co m p re ssio n of th e su b cla v ia n a rte ry by relay s of a ss is ta n ts is c o r r e c t . ( 2) W i t h t h i s c o m b i n a t i o n o f i n j u r i e s , t h e f r a c t u r e d a r m is t h e m o r e l i a b l e t o a g g r a v a t i o n d u r i n g t r e a t m e n t a n d tra n s p o rt a n d c o n se q u e n tly d e m a n d s p referen tial tre a tm e n t. A s a first a id e r, th e re fo re , I w o u ld u s e th e s m a ll a r m s lin g . — N .C .F .
N o t e . — O w i n g to th e la r g e n u m b e r of q u e rie s re c eiv ed , a n d o u r lim ite d s p a c e , a n u m b e r h a v e u n a v o id a b ly b e e n h eld over.
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GERMOLENE
Be Prepared^ instantly For protects against germ in Emergencies' fection, prevents blood and Keep a 1 poisoning, and promotes T in Always rapid healing I Germolene at Hand causes the broken tissues to unite, grows new skin A / W W W V ^ / V and heals over the broken place cleanly. It soothes at a touch, ends pain and brings ease. A t the present time, N O home should be without a tin o f the w o r ld ’s quickest healingointment. G et yours to-day ! IS W O N D E R F U L FO R S U C H S K IN T R O U B L E S A S : E C Z E M A , S K IN R A S H , IM P E T IG O , LEG T R O U B L E S , C U TS, P I M P L E S , SORE FEET HEALING A dhesive Plaster GERM OLENE
[F o r F i r s t - A i d in E m e r g e n c y use
S o l d
G e rm o n ia s t
FlRSTAIDlDRESSINGS
E veryw h ere
1/4 & 3/3 per tin In clu d in g Purchase T a x )
E lastic, They
Heal
with
A d h esiv e,
A n tisep tic
w hile they Soothe and Protecti because th ey are
IM P R E G N A T E D Medication.
GERM OLENE
Fro m a ll C he m ists.
6d. & I/- per tin of assorted dressings
A IR
R A ID
F IR S T
A ID
A Series of 15 Charts c o v e r i n g a ll t h e d u t i e s o f a F i r s t A i d W o r k e r , g i v i n g f u l l i n s t r u c t i o n s a s t o A i r R a i d e ff ects a n d p r e c a u tio n s, re c o g n itio n a n d tre a tm e n t o f injuries. Th e Ideal W a ll Chart. S i z e 22 £ i n . x 14 ^ i n . , h a s b e e n p r e p a r e d fo r u s e in A ir R a i d S h e lte r s , R e d C r o s s a n d S t. J o h n ’s A m b u l a n c e S t a t i o n s a n d C l a s s e s , a n d a l l p l a c e s w h e r e F i r s t A i d a n d N u r s i n g a r e r e q u i r e d . P r i c e 2s. 6d. P o s t a g e 6 d . Th e H om e Chart. S i z e 13 i n . x 7\ i n . , h a s b e e n s p e c i a l l y p r e p a r e d f o r u s e i n t h e H o m e o r s m a l l g r o u p s , p r i c e Is . 6d. p o s t 3d . A lso in B o o k le t F o r m . P r i c e 9d . ; p o s t I d . P r in t e d o n s t r o n g p a p e r a n d m o u n t e d o n r o l l e r f o r h a n g i n g . Second Im pression.
By A. E. JOHN SO N. P O IS O N G A S .
A c o m p l e t e f o l d e r o n t h e d e t e c t i o n , e f f e c t s a n d t r e a t m e n t of g a s w ith c h a r t a n d a d v ic e o n d rill a n d p a r t i c u l a r s of d e c o n ta m in a tio n a n d c are of re sp ira to r. In va lu a b le ! and th e m o s t co m p r e h e n s iv e lit t le fo ld e r b e in g so ld .
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HOBSONS
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G a u n t H o u s e , 28 O r c h a r d S t r e e t , B r i s t o l I
“ S A N O I D ” INTERLOCKING EXTENSION
SPLINTS
(Patent Number 53165 o f 28/7/39.) INCURVED EDGE OF SOCKET
TRANSVERSE G R OO V E OF .S P L IN T
IN C U R V E D E D G E O F SOCKET
S .1343 “ S A N O ID ” INTERLOCKING EXTENSION SPLINTS W ith Metal sock ets for jointing. 2 pieces 2 5/8ths. in. x 3/16ths. In. x 15 in. 2 pieces : 2 5/8ths. in. x 3 /l6 th s . in. x I3J in. I p iece : 2 5/8 th s. i n x 3 /l 6 th s. In. x
in.
I piece : 2 5/8chs. in. x 3 /l6 th s. in. x 6 in. 2 W ebbing Straps w ith m etal buckles : 18 in. x I in. 2 W ebbing Straps w ith m etal buckles : 27 in. x l£ in. 3 sockets. A By this Invention Splints made in any con ven ient lengths make f \ rigid connections by means of incurved op posite edges of th e m etal sock ets or sleeves firmly engaging w ith transverse grooves in the surfaces of the Splints w hen pressed hom e into th e socket. U nlike the ordinary sock etted Splint, this type is rigidly coupled togeth er and held against relative displacem ent but can be disengaged by pulling apart w ith sufficient force. N .B .—To ensure perfect locking it is im perative that the Splint should be correctly inserted in the sock et. I.e., BY MAKING CERTAIN THAT THE INCURVED EDGE OF METAL SOCKET ENGAGES WITH THE TRANSVERSE GROOVE OF THE SPLINT. Price : C om plete w ith tw o pairs of straps • - 4 / - per set. W ith o u t straps - - - - * - - - 3 / - per set.
★ ★
f o r
M inor
u ries
“ Elastoplast ” wound dress ings stay in place, are quickly applied and stretch with the movement of the skin.
r.
Remove protective muslin.
2. Place antiseptic
Pad on wound. 3. Press down
clastic adhesive.
S o le M a n u f a c t u r e r s :
CUXSON,
GERRARD & CO. LTD.
First Aid Specialists Printed and rnbllsheo
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N o .
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L .]
a tib J f r u r s i t t g p e r u k e s
D E C E M B E R ,
Ju st
1943.
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Q U E S T IO N S A N S W E R E D By R. D. W o r m a l d , M.A., L.A.R.P., and J. M. Y o u n g , M.A., L.A.R.P. This new book by the Authors of “ 250 A.R.P. Questions Answered” covers the following subjects: — Blitz First Aid ; Light Rescue; Fire Prevention in Business Premises ; Decontamination; Incident Control. There are numerous line drawings.
O F
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T E A M S
By
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Id lte d b y N O R M A N H A M M E R . M .R .C .S ., M a jo r, late R .A .M .C ..T .A . IR S T
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No. 594.— V
o l.
WALTER
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CO N TEN TS
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TH IS
NUM BER.
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A m p lif ic a tio n of t h e “ N u r s e s ’ C h a r t e r ”
61 62
E x p e re n tia D ocet ...
...
...
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63
T h e H o m e G u a r d a n d F i r s t A id
63 65
S .J.A .B . H e a d q u a r te r s a n d D istric t R ep o rts
L e tte rs to th e E d i to r
65
T h e C o tto n W o o l S a n d w ic h
66
F.A . P u z z le C o rn e r
68
Q u e r ie s
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R ev iew 's
F.R.S.A.
D E C E M B E R , 1943.
L.
N O T IC E
E d it o r ia l —
F.R .Sin.l.,
C o r r e s p o n d e n t s :—
R esu scitatio n E x a m in a tio n H o w le r F r a c tu r e d L e g a n d T o r n V a ric o se V ein H y p n o t i c P o i s o n s ... A R e a d e r ’s D i l e m n a C o m p r e s s io n of T e m p o r a l A rte ry T r e a tm e n t of B ru ises P a ra ly s is of L im b s in A p o plex y H u m o u r in F i r s t A id C a p a c ity of L u n g s ... A m o u n t of B lo o d in B o d y ... C arb o n M o n o x id e P o iso n in g F r a c tu re d F e m u r a n d S p ra in e d A n k le F r a c t u r e o f B o t h C l a v i c l e s ... M e th o d of C h a n g in g O p e ra to rs G a s P o iso n in g a n d B ro k en N eck L a y I n s t r u c t o r C e r t i f i c a t e s ... E lectric S h o c k a n d A sphyxia S y n co p e, S h o c k a n d C o llap se T ria n g u lar B andage
68 68 68 68
70 70 70 70 70 70 70 70 70 72 72 72 72 72 72 72
to the profession was
A m plification the announcement that (to quote of the “ N u r se s’ the heading of the many comC harter.” mentatory and commendatory
articles upon it which appeared in the press) “ 17,000 nurses were to share ,£500,000 pay increase.” It does look, at long last, that the profession is to come into its own, and that the Government is at last seriously con cerning itself with salaries, conditions of service, uniforms, hours of work, night duty, holiday pay and sick pay— to mention the more important matters having immediate effect upon the members of theprofession. The new national scales to which we refer are recommended by Lord Rushcliffe’s Committee in a report published as a White Paper and accepted by the Government. Mr. W illink, Minister of Health, is asking all employ ing authorities to adopt the scales with retrospective effect to April 1 this year, and has agreed to meet half the extra cost, which is estimated at £500,000 a year. Among those who are affected by the new scale, the following may be cited: Nurses employed in the public health services, including health visitors, superintendents of infant welfare, regis tered nurses in dental work, school nurses and nurses in V.D. clinics ; district nurses and district nurse midwives ; State-registered nurses in day and residential nurseries, and male nurses in hospitals and public assistance institutions. Hospital nurses generally and midwives have already been put on national scales, and the new report completes what has been called the “ nurses’ charter.” The total cost of all the increases is about £',750,000 a year, and the new scales will apply in England and Wales generally with extra allowances in some cases in the London area. In most instances they will mean undoubtedly substantial increases. There will of course be a certain amount of disappoint ment, together with something in the way of heart burning and bickering at the amount and allotment of the scales, but we do consider that on the whole, and on a dispassionate and non-partisan view of the matter, the Government are to be congratulated upon their decisions. Of course, in times like the present, a few millions more or less are of small
62
F I R S T
moment, for there are appalling calls upon the country’s finances. W e are confident that the members of the profession will, as a body, accept the increased salaries and emoluments and the general bettering of conditions in the right spirit. W e had almost said “ gratefully ” ; but that is not the word to use when nothing above one’s dues is accorded.
E x p e r e n t ia D o ce t. Bv
T H E
V IC T IM .
( Continued, from p a g e 5 b . )
T h e first t h i n g t h a t I re a lis e d w a s th a t, a p a r t fro m th e a n k le , 1 h a d n o p a in w h a te v e r in sp ite of th e fa c t th a t a g la n c e a t m y left k n e e s h o w e d tw o n e a t h o le s w h e r e th e '45 c a l i b r e b u l l e t h a d d r i l l e d i t c l e a n l y f r o m s i d e t o s i d e . I f e l t r a t h e r g l a d a b o u t t h a t a n d f o r a m o m e n t s u r v e y e d it w ith c o m p lete d e ta c h m e n t. I h a d a lw a y s , in le c tu r in g to F i r s t A id P e rs o n n e l, im p r e s s e d u p o n th e m t h a t local p a in , e x c e p t in c e r ta in r a r e in s ta n c e s , w a s u n u s u a l in w o u n d s fro m b u llets or b o m b fra g m e n ts . I k n e w fro m tw e n ty -fiv e y e a rs e x p e r ie n c e of s u r g e r y in p e a c e a n d w a r t h a t it w a s tr u e , b u t a lw a y s a t t h e b a c k of m y m in d I w o n d e r e d h o w t r u e it w o u ld b e “ W h e n it h a p p e n e d to o n e s e lf . ” N ow I knew , and w as d u ly in te r e s te d in t h e b e a u tif u l e x a m p le of lo cal s h o c k . B y th is tim e I w a s b e g in n in g to re alise o n e o r tw o o th e r th in g s. F i r s t l y , t h a t if I d i d n o t g e t h e l p , a n d t h a t q u i c k l y , th e re w a s g o in g to be tro u b le. A h e a v y c a lib re rev o lv er b u l l e t t h r o u g h a k n e e j o i n t , e s p e c ia lly in a d i r t y c h i c k e n y a r d , m i g h t e a s i l y c o s t t h e l i m b a n d e v e n life. P ain w as i n e v i ta b ly g o i n g to b e s e v e r e a s s o o n a s t h e p h a s e of lo c a l s h o c k p a ss e d , a n d a lr e a d y s y m p to m s of g e n e r a l s h o c k w e re b e c o m in g o n ly to o o b v io u s. M e m b e r s of m y F i r s t A id P a r t y w e r e a m o n g m y close n e ig h b o u rs a n d h elp w a s soon a t h a n d . M y first r e q u e s t w a s fo r m o rp h ia , a n d h a lf a g r a in so o n re d u c e d m e to th a t c o n d i t i o n in w h i c h it is p o s s i b l e f o r t h e i n j u r e d m a n t o b e in c o m p le te c o m f o r t a n d y e t o b s e r v e d is p a s s io n a te ly all th a t g o e s on a ro u n d h im . B y t h a t t i m e a ll t h e c la s s ic a l s y m p t o m s of s h o c k w e r e ap p aren t. I felt a s t h o u g h it w e r e a n A rc tic w i n t e r in s te a d of a h o t s u m m e r e v e n in g , w a v e s of g id d in e s s a n d n a u s e a s w e p t o v e r m e a n d I w o n d e re d h o w m a n y of th e p a r ty w o u ld r e m e m b e r m y oft r e ite r a te d o r d e r s t h a t w h e n first h a n d l i n g a s h o c k e d c a s u a lty th e y w e r e to t h i n k o n ly of th e fo u r g r e a t c a u s e s of s h o c k — H a e m o r r h a g e , P a in , C o ld a n d F e a r. H o w o fte n h a d I s e e n in e x e r c ise s a n d p ra c tic e s , p eo p le w h o b la n d ly left th e ir m o c k c a s u a ltie s e x p o s e d to all th e w in d s of H e a v e n w h ile th e y e n e rg e tic a lly sp lin te d s o m e im a g in e d fractu re. I t h o u g h t ev e n of th e u n fo rg iv e a b le sin w h ic h I h a v e see n c o m m itte d by so m a n y — th a t of carefu lly b la n k e tt i n g a s tr e tc h e r w h ile th e c a s u a lty r e c e iv in g first a id lay exposed. T h e p a rty h o w e v e r w e re r u n n in g tr u e to form . T h e i r le a d e r w a s a lre a d y b y m y sid e s littin g u p th e tro u s e r le g a n d su rv e y in g w ith a p rofessional eye tw o n eat h o l e s f r o m w h i c h , I feel s u r e to h e r d i s a p p o i n t m e n t , n o t o n e s p o t of b lo o d e m e rg e d . H o w o fte n h a d 1 told th e m , I a lw a y s felt s u r e to t h e i r c o m p le te d isb elief, t h a t s e v e re h a e m o r r h a g e a t le a s t w a s u n u s u a l in w a r w o u n d s u n le s s a l a r g e vessel w as dam aged. M ea n w h ile , b la n k e ts h a d been sw a th e d a ro u n d m e le a v in g o n ly 'th e le g exp o sed , w h ile h o t b o ttles w h ic h m u st h a v e b o iled by m a g ic , w e re tu c k e d b esid e m e. I l a y in c o m p a r a t i v e c o m f o r t w a t c h i n g a s f r o m a n o t h e r
A I D w o rld th e p a rty w o rk in g u p o n m y leg. I c o u ld a l m o s t feel th e th o u g h ts c h a s in g o n e a n o th e r th r o u g h th e m in d of th e leader. W h a t h a v e I b e e n to ld to d o w ith a n y w o u n d ? C o v e r it a t o n c e w i t h a s t e r i l e d r e s s i n g . R ig h t. T w o shell d re s s in g s p u t on w ith o u t to u c h in g th e sterile s u rfa c e s a n d m a d e fa st w ith a t r i a n g u l a r b a n d a g e so lv ed t h a t p ro b le m a t once. T h e n e x t q u e stio n w a s not n e arly so easy a n d I s y m p a t h i s e d m e n t a l l y w i t h h e r d if f ic u ltie s , a l t h o u g h I w a s in n o c o n d itio n to so lv e h e r p ro b le m s . She k n ew th a t she had to m o v e m e s o m e tw e n ty m ile s by a m b u la n c e to th e n e a re s t la r g e h o s p ita l a n d t h a t e fficient s p lin tin g w a s e ss e n tia l. She k n e w to o t h a t th e flex ed k n e e s h o u ld b e s t r a i g h t e n e d a n d th a t th e d o in g so w o u ld be no fu n a n d g a m e s. S h o u ld it be a T h o m a s o r a c o m fo rta b ly p a d d e d b a c k sp lin t w ith a footp iece a n d sid e sp lin ts ? T e c h n i c a l l y t h e a n s w e r d e p e n d e d u p o n t h e d e g r e e of d a m a g e to th e jo in t. U n d o u b t e d l y , if t h e b o n e s h a d b e e n s h a t t e r e d , a T h o m a s w a s t h e r i g h t a n s w e r , b u t t h e l o o k of t h e j o i n t d i d n o t s u g g e s t it. T h e e x it w o u n d w a s n o la rg e r t h a n th e e n tr a n c e a n d o b v io u sly n o m a s s of s h a tt e r e d b o n e f r a g m e n ts h a d d riv e n o u tw a r d s w ith th e e m e r g in g p ro jectile. A c t u a l l y the' s t e e l c o a t e d b u l l e t h a d d r i l l e d i t s w a y n e a t l y t h r o u g h o n e c o n d y le of t h e f e m u r a n d , t h e jo in t b e in g fully flexed, h a d e m e r g e d t h r o u g h t h e l i g a m e n t u m p a te lla e w i t h o u t to u c h i n g th e tib ia. W h e th e r o r n o t th e ir k n o w le d g e allo w e d of a n a c c u ra te d ecisio n , I d o u b t, b u t w h a t I d id a d m ir e w a s th e fa c t th a t th ey m a d e th e ir decisio n w ith o u t h o ld in g a m o th e rs ’ m e e tin g a b o u t it. H o w o fte n d o es o n e see th e b a d ly tra in e d p a rty a r g u i n g v o lu b ly a s to w h e t h e r a c e r ta in t h i n g s h o u ld o r sh o u ld n o t be done, a n d I h a v e a lw ay s m a in ta in e d th a t I w o u ld r a t h e r a le a d e r c a p a b le of m a k i n g a d ecisio n a n d c a r r y i n g it o u t p r o m p t l y , e v e n if it b e w r o n g , r a t h e r t h a n o n e w h o w o u ld h e s ita te a n d sp lit h a ir s u p o n u n im p o r ta n t te c h n ica lities. A t a n y r a te in m y c a s e th e r e w a s n o a r g u m e n t a n d a b a c k s p lin t a p p e a re d w ith sid e p ieces, fro m th e h a n d s of a p a n tin g m essenger. N o w t h e w o u l d - b e f ir s t a i d e r is c a r e f u l l y i n s t r u c t e d b y h is p a sto rs a n d m a ste rs, th a t before s p lin tin g a fra c tu re — or e q u a lly a n in ju r e d jo in t— it m u s t b e s t r a i g h t e n e d b y firm a n d s te a d y tra c tio n , a n d 1 h a d o ften w o n d e re d h o w h e w o u ld fa c e u p to it in a c tu a lity . D e lib e ra te ly to c a u s e a c o n scio u s p a tie n t p a in calls fo r v ery c o n sid e ra b le n e rv e h o w e v e r c o m fo rtab le th e su b se q u e n t re su lt m a y be. T h e a m a te u r alm o st i n v a r i a b l y t e n d s t o d o o n e o f t w o t h i n g s , e i t h e r , f e a r f u l of c a u s i n g p a in , h is effo rts a t e x te n s io n a r e t r e m b l i n g a n d in effective, o r d e t e r m i n e d to b e d e c isiv e , h e b e c o m e s r o u g h . M y p a rty w ere m a k in g no m ista k es, h ow ever, a n d I n o tic e d w ith c o n s id e ra b le joy th e w a y in w h ic h th e ir le a d e r h a d by n o w p u lled h e r p a rty to g e th e r a n d w a s u tilis in g e ac h o n e to th e b e st a d v a n ta g e . L e a d e rs h ip h a d a lw a y s s e e m e d to m e to be th e m o st difficult t h i n g in th e w o rld to te a c h . S o m a n y people in te r p re t it to m e a n w h a t in fa c t is t h e la s t t h i n g t h a t it d o e s m e a n — n a m e ly a fu ssy s u p e r v is io n of th e u n i m p o r t a n t d e ta ils of o th e r p e o p le s w o r k . T h e y a p p e a r to b e to ta lly u n a b le to see th e w o o d fo r th e tre e s a n d c a n s e ld o m b e m a d e to a p p r e c i a te t h a t it is n o t t h e w o r k of t h e in d iv id u a l t h a t m a t t e r s b u t t h a t of th e u n ified w h o le. S p lin ts, p a d s a n d b a n d a g e s lay n e a tly b e sid e m e , th e s t r e t c h e r , b l a n k e t t e d a n d w i t h h o t w a t e r b o t t l e s u p o n it, la y r e a d y a t m y fe e t, a n d I c o u ld a l m o s t s w e a r to t h e g l e a m of d e t e r m i n a t i o n i n t h e l e a d e r ’s e y e s . S h e d id it, to o , m a g n i f i c en tly . W ith h e r sec o n d in c o m m a n d s te a d y in g th e foot a n d h o ld in g it firm a t th e a n k le , h e r o w n s t r o n g h a n d s slid u n d e r t h i g h a n d l e g a n d I felt t h e m h e ld in a g r i p w h i c h a t o n c e g a v e m e co n fid e n t k n o w le d g e th a t I n e ed fe a r n e ith e r te m e rity o r ro u g h n e ss. W ith o n e s tea d y m o v e m e n t th e lim b w a s s tra ig h t, w ith littl e m o r e t h a n a s i n g l e s t a b of p a i n , a n d I fe lt it l o w e r e d w ith o u t a ja r on to th e sp lin t, re a d y p a d d e d , w h ic h w a s
F I R S T slip p e d b e n e a t h it. E v e n th e p ad b eh in d th e k n e e a n d th a t b e n e a th th e T e n d o A chillis, k e e p i n g th e p o in t of t h e h eel ra is e d c le a r of th e sp lin t, n e e d e d o n ly fr a c tio n a l a d j u s t m e n t , a n d in le ss t h a n a m i n u t e s id e s p lin ts a n d p a d s w e r e in p o sitio n a n d t h e w h o le m a d e fa s t w ith b a n d a g e s . W i t h th e le g s e c u re ly c o n tro lle d fr o m w ell u p th e th i g h to t h e fo o t, n o t h i n g w a s to b e g a i n e d b y t y i n g t h e l e g s t o g e t h e r a n d a l m o s t b e f o r e I r e a lis e d it I f o u n d m y s e l f lifted s m o o t h l y o n to t h e k n e e s o f t h r e e of t h e w o m e n a n d t h e n c e to th e s tre tc h e r. H o w I m e n ta lly c o n g r a t u l a t e d m y s e lf u p o n t h e p o lic y w h ic h 1 h a d a lw a y s in siste d u p o n in t r a i n i n g th e p e rso n n e l of F ir s t A id P o in ts o v e r a v e ry w id e a re a .
{To be continued.)
Reviews. A d v a n c e d A . J?. P . Q u estio n s A n s w e r e d . B y R . D . W o r m a l d , M .A ., L .A .R .P ., a n d J. M . Y o u n g M .A ., L . A .R . P . L o n d o n : Jo rd a n & S o n s L td. P r ic e 2/6 ; by p o s t 2IS. E a r l y in th is w a r th e s e a u t h o r s c o m p ile d a b o o k le t w h i c h t h e y c a l l e d 250 A . R . P . Q u estio n s A n s w e r e d . They h a v e n o w p r o d u c e d a m o r e a d v a n c e d s e t w h i c h c o n t a i n s 400 q u estio n s a n d a n sw e rs . T h e s e d e a l w ith F i r s t A id in A ir R aid s ; L ig h t R es c u e W o r k ; th e use of ropes, k n o ts, la s h in g s a n d o th e r e q u ip m e n t of th e H e a v y R e s c u e S e rv ic e s ; F ire S erv ices ; D e c o n ta m in a tio n a n d In c id e n t C o n tro l. T h e boo k p ro v id es a re a d y m e a n s of te s tin g th e k n o w le d g e g a i n e d a t le c tu re s , a n d w ill a ls o e n s u r e a c o n v e n ie n t b a s is for r e v is io n c la s s e s .
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T h e a u t h o r , w h o is F i r s t A id a n d A . R . P . O ffice r, L o n d o n A m b u la n c e S erv ice, s e ts o u t in a c le a r a n d c o n cise w ay th e tra in in g of co m p e titio n te a m s. H e d e a ls w ith h is su b jec t in th re e m a in p a rts. I n th e first h e re fe rs to th e ru les a n d r e g u la tio n s , th e te sts (te a m a n d in d iv id u a l, a n d t r a n s p o r t ; in th e s e c o n d h e d e sc rib e s th e n e c e s s a r y q u a lifi c atio n s of th e m e m b e rs of th e te a m ; a n d in th e th ird h e e la b o r a te s o n p o in ts in f o r m in g a d ia g n o s i s a n d in e x a m i n a tion ro u tin e , H e rig h tfu lly cla im s th a t h a rd w o rk a n d c a re fully p l a n n e d t r a i n i n g p r o v i d e t h e k e y n o t e o f s u c c e s s ; a n d h e r e c o r d s h is be lie f t h a t c o m p e titio n t r a i n i n g is b y f a r t h e m o s t e ffectiv e m e a n s of i m p r o v i n g th e th e o r e tic a l a n d p r a c tical a b ility of t h e first a id e r.
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by p o st 1 /-. T h i s b o o k h a s b e e n c o m p i l e d b y t h e a u t h o r , w h o is C a s u a lty S e rv ic e s S ta f f O fficer a n d F i r s t A id I n s t r u c t o r fo r th e B o ro u g h of W a n d s w o rth . It h a s been w ritte n w ith th e o b ject of h e lp in g th e in d iv id u a l m e m b e r s of a c o m p e titio n team , a n d p a rtic u la rly th e lead er ; a n d th e in fo rm a tio n a n d a d v i c e w h i c h it c o n t a i n s is b a s e d o n p r a c t i c a l e x p e r i e n c e . C o n s e q u e n t l y , t h e s e n o t e s w ill p r o v e o f r e a l v a l u e to first a id e rs w h o a r e a n x io u s to d e v e lo p th e i r k n o w l e d g e a n d ex p erien ce. R en e w a l
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S t . J o h n A m b u l a n c e B r ig a d e H EA D Q U A R TER S AN DD ISTR ICT R E PO R TS. No. I (Prince of Wales’s) District 58/5 ( W e s t e r n P o s t a l a n d S t . M a r y l e b o n e ) . — O n W e d n e s d a y a f t e r n o o n , N o v e m b e r 17 t h , 44 m e m b e r s o f H . M . F o rc e s d re s se d in “ H o s p ita l B lu e ” w e re su cc e ssfu lly e n te r t a i n e d b y t h e S t . M a r y l e b o n e D i v i s i o n s , S . J . A . B . , a t 30 , G lo u c e s te r P lace, W . l . T h e b o ro u g h w a s re p resen ted by H is W o r s h ip th e M a y o r a n d L a d y M a y o r e s s M rs. S tiles-A llen , th e B ritish R e d C ross by L a d y S u ird a le a n d M rs. F e w ster, w h ile W . L . D a v ie s E s q ., P o s tm a s te r , a n d W . F . G a b b ita s a t t e n d e d o n b e h a lf of th e W e s t e r n D i s t r i c t P o s t O ffice. • T h a n k s to th e e n e r g ie s of D iv is io n a l S u p t. W . V . M. A llen , s p le n d id a r r a n g e m e n t s w e r e m a d e to g iv e th e s e b o y s a n d g irls a real b re a k fro m h o sp ita l ro u tin e. A su m p tio u s te a w a s p ro v id ed by S g t. J. C. M a y e rs w h o se h a r d w o rk w a s re w a rd e d by th e h a p p y faces p e rfo rm in g co n tin u e d ja w exercise. L ig h t e n te rta in m e n t w a s p ro v id ed by F r e d C la rk a n d h is P o s ta l C o n c e rt P a r t y w h o k e p t th e g u e s ts in h ig h s p irits, e sp e c ia lly so w h e n B illy W illia m s g o t o v e r w ith “ O n th e ro a d to M a n d a la y .” A t 4 .3 0 p . m . E . N . S . A . t o o k o v e r b e i n g r e p r e s e n t e d b y : A lfred G r a n t , c o m p e r e , s i n g e r a n d s to ry te lle r, M iss S te lla S w a in e , pian ist, a n d G ip sy L illian , acco rd io n ist. T h i s trio w a s e x c e lle n t f a r e a n d th e i r h a r d w o r k is w o r t h y of s p e c ia l m en tio n . T h e in e v ita b le e n d c a m e a ll to s o o n , w ith S u p t. A llen e x p la in in g th a t h o sp ita l ru les fo rb ad e th e c o n tin u a n c e of th e p a r t y b e y o n d 5.30 p . m . . T h e rep ly c a m e fro m a p a tie n t, w h o in w e ll-c h o s e n w o rd s , t h a n k e d all re s p o n s ib le fo r a g r a n d aftern o o n . T o t h e s t r a i n o f “ F o r h e ’s a j o l l y g o o d f e l l o w , ” fo llo w ed b y “ T h e K i n g , ” th e c u rta in w a s r u n g d o w n o n a very p le a sa n t g a th e rin g . T h i s o p p o r t u n i t y is t a k e n t o e x p r e s s t h a n k s to t h e m a n y frien d s w h o s e n t g ifts of c a k e , ta rts , ja m , te a , s u g a r a n d c i g a r e t t e s , e t c ., a fine g e s t u r e to a w o r t h y c a u s e .
C ou n tyof N orth ,E ast an dM id-D evon . A t th e a n n u a l m e e tin g of th e S id m o u th A m b u la n c e D iv i sio n , o v e r w h i c h M r. B e r n a r d H e a p e p re s id e d , t h e a c c o u n t s w e re p r e s e n te d b y M r. J. E. M u m m e r y , th e t r a n s p o r t a c c o u n t s h o w i n g a b a l a n c e o f £ 3 0 9s . 6 d . , a n d t h e g e n e r a l f u n d a c r e d i t o f ; £ 458, t h i s l a t t e r b e i n g h e l d i n r e s e r v e t o w a r d s t h e p u r c h a s e of a n e w a m b u la n c e . M r. A. H . B ailey , p r e s e n ti n g th e s e c re ta ria l a c c o u n t, s t a t e d t h a t t h e y e a r ’s w o r k h a d b e e n s a t i s f a c t o r y . The s t a n d a r d of e fficiency h a d b e e n w e ll m a i n t a i n e d , t h a n k s to th e tim e a n d h a rd w o rk p u t in b y S u p t. A. W . Iiis h . S ix n e w m e m b e rs h a d b een e n ro lled , all of w h o m h a d p a sse d th e ir first e x a m in a ti o n . T h e n u m b e r of m e m b e rs n o w serv i n g w i t h t h e F o r c e s w a s 17 . I t h a d j u s t b e e n le a r n t o n e of th e m , M r. R id o u t, h a d d ie d in a c tio n . O n b e h a lf of th e O r d e r h e e x te n d e d to t h e re la tiv e s t h e i r s in c e re s y m p a t h y . A n o u ts ta n d in g e v en t w a s th e p re s e n ta tio n of L o n g S erv ice M e d a l s f o r 15 y e a r s ’ s e r v i c e t o S u p t . A . W . I r i s h , A m b u la n c e O fficer W . T u r n e r , S e rg t. P arso n s,* S e rg t. H a r t a n d C p l. O ld re y . T h e a m b u l a n c e h a d t r a v e l l e d 1,743 m i l e s , c a r r y i n g 141 p a t i e n t s . S u p t. Irish said th e w o rk of th e B rig a d e , u n d erstaffed a s it w a s , h a d b e e n v e r y h e a v y . T h a n k s t o t h e e f f o r t s of M iss P a g e , th e B rig a d e w a s a t p re s e n t b e tte r h o u s e d th a n e v er before. In c o n clu sio n , h e sp o k e of th e g o o d w o rk d o n e by th e A m b u lan ce S a v in g s G ro u p .
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w e r e e n r o l l e d o n S a t u r d a y , N o v . 27 t h , a t t h e H o l y T r i n i t y H all. C o u n ty C a d e t O fficer M iss M a c k e n z ie , w h o p re s e n te d th e c e rtific a te s of m e m b e r s h ip , c o m p lim e n te d th e C a d e ts a n d th e O fficer (M rs. B ish o p ) o n th e v e ry s m a r t p a r a d e , a n d s a i d :— “ I w a n t y o u to t h i n k w h a t m e m b e r s h i p of th e S t. J o h n m eans. I t m e a n s , a m o n g s t o t h e r t h i n g s , m e m b e r s h i p of o n e of t h e g r e a t e s t s o c i e t i e s of c h i v a l r y a n d h u m a n i t y e v e r c re a te d by m a n a n d in sp ire d by th e C h ris tia n Id eal. I t is a s o c ie ty c r e a t e d b y t h e id e a ls of a f e w m e n n e a r l y 1 ,0 0 0 y e a r s a g o in P a le s tin e to h e lp th e ir le ss f o r tu n a t e fello w m e n a n d w om en. F r o m th is g r e w th e g r e a t a n d p o w e rfu l I n te r n a tio n a l B ro th e rh o o d k n o w n th ro u g h o u t th e w o rld as th e O r d e r of th e H o s p i ta l of S t. J o h n ot J e r u s a l e m , c h a m p i o n s of t h e C h r i s t i a n c iv ilis a tio n , a n d in p r e s e n t t i m e s t h e St. S t. J o h n A m b u la n c e A s s o c ia tio n a n d S t. J o h n A m b u la n c e B rig a d e w h ich h av e s p r u n g fro m th e O rd e r. Y ou have b e e n p r iv i le g e d to b e c o m e a m e m b e r o f a w o r l d - w i d e b r o t h e r h o o d , p l e d g e d t o t h e s e r v i c e t o m a n k i n d a n d t o t h e G l o r y of th e F a ith .” A t t h e c o n c l u s i o n o f M i s s M a c k e n z i e ’s s p e e c h , t h e C a d e t s f o r m e d a S t. J o h n C ro s s w ith ro lle r b a n d a g e s . T h e C ad ets w h o p assed th e e n tra n c e e x a m in a tio n s w ere Jo ce lv n K ay P u g h , A n n M a c k a y , V alerie L ay, T h e lm a G o r d o n , P h y llis C ritta ll, V a le r ie V V arne, S te lla G re e n , G w y n e t h B all, S h irle y L a y , S te lla M a c k e n z ie a n d D o re e n F le n d ic a tt.
County of Lancashire. A t h e r t o n ' . — A s m a l l s t a i n e d g l a s s w i n d o w in t h e p o r c h of H o w e b r id g e C h u rc h w a s u n v eiled a n d d ed icated on S u n d a y a f t e r n o o n , N o v e m b e r 28 t h , t o t h e m e m o r y o f M a r y A n n e P a s q u ill, L a d y S u p t. of th e A th e r to n S t. J o h n A m b u la n c e N u r s i n g D i v i s i o n i r o m 1929 t o 1943 , a n d C h r i s t o p h e r R o b i n s o n , S u p t . o f t h e A t h e r t o n D i v i s i o n f r o m 1920 t o 1930 . T h e w in d o w w a s d e d ic a te d d u r i n g a sp ec ia l serv ice w h i c h w a s h e ld in H o w e b r i d g e C h u r c h a n d w h i c h w a s a t t e n d e d by m e m b e r s of th e A th e r to n S .J .A .B . a n d N u r s i n g D iv isio n . B efo re th e se rv ic e a p a r a d e of th e D iv isio n w a s h e ld a t “ T h e H in d le s ,” a n d w a s in sp e c te d by C o m m is sio n e r W . G . S m i t h , O B. E . T h e w in d o w b e a r s th e fa m ila r e ig h t p o in te d silv er c ro ss of t h e S . J . A . B . w i t h t h e L a tin m o tto “ Pro U tilita te H o m i n u m ” ( F o r th e serv ice of m a n k in d ) . U n d e r n e a t h is th e in s c r ip tio n : T h i s w in d o w w a s g iv e n b y th e m e m b e r s of th e A th e rto n A m b u la n c e a n d N u r s in g A sso c ia tio n D iv isio n s a n d o t h e r f r ie n d s in g r a t e f u l m e m o r y of M a r y A n n e P a s q u ill, L a d y S u p e r i n t e n d e n t , 1929 - 1943 , a n d C h r i s t o p h e r R o b i n s o n , S . B . , S u p e r i n t e n d e n t , 1920 - 1930 . ” T h e c h u rc h serv ice w a s c o n d u c te d by th e R e v . C. K . K. P r o s s e r , V ic a r of H o w e b r id g e , a n d M r. C le m e n t F le tc h e r read th e lessons. D u r i n g th e s i n g i n g of a h y m n th e V ic a r a n d r e p r e s e n ta tiv e s of th e D iv isio n p ro c e e d e d to th e c h u r c h p o rc h , w h e re th e w in d o w w a s u n v e ile d a n d d e d ic ate d . A n a d d re ss w as a fte rw a rd s g iv e n by C o m m issio n er S m ith , w h o also p aid trib u te to th e tw o la te m e m b e rs .
County of Northampton. R o t h w e l l . — A m o s t i m p o r t a n t d a y in th e a n n a l s of th e B r i g a d e in N o r t h a m p t o n s h i r e o c c u r r e d o n S u n d a y , O c t o b e r 17 t h , w h e n G r a n d P r i o r C a d e t B a d g e s — t h e f i r s t e v e r t o h a v e b e e n w o n in t h e c o u n t y — w e r e p r e s e n t e d to c a d e t s of th e R o th w e ll A m b u la n c e a n d N u r s in g C a d e t D iv isio n s, b y th e L o r d L i e u t e n a n t of th e c o u n ty , T h e M o s t H o n . T h e M a r q u e s s of E x e te r , K .G ., C .M .G ., K .S t .J ., w h o w a s a c c o m p a n ie d by th e M a r c h io n e s s of E x e te r, O .S t .J ., C o u n t}' P r e s id e n t. T h e c erem o n y w as w itn essed by re p re sen ta tiv e cad ets f r o m a ll C o r p s of t h e c o u n ty , a n d all D iv is io n s of th e K e tte r in g C orps. P r e v io u s to t h e p r e s e n ta tio n L o r d E x e te r in s p e c te d th e c a d e ts , a n d a n u m b e r of th e m g a v e a n e x c e lle n t d e m o n s t r a t i o n of fire f i g h t i n g , r e s c u e , f ir s t a i d a n d h o m e
n u rsin g .
R I D T h e L o r d L ie u te n a n t w a s w e lc o m e d to R o th w e ll by C a d e t O fficer J. C. L . A u stin , w h o re fe rre d to th e g r e a t h o n o u r a n d c o m p lim e n t h is L o r d s h ip h a d p a id to th e C a d e t D iv is io n s of th e B r ig a d e , in a t t e n d i n g to p r e s e n t th e B a d g e s . A v o te of t h a n k s to L o r d E x e t e r w a s p ro p o s e d by C o u n ty C o m m issio n e r D r. E. H . S h a w , J .P ., a n d seconded by L a d y C o u n t y S u p t . M r s . 1. J e n n i n g s , M . B . E . I n a d d itio n to th o s e m e n tio n e d a n u m b e r of o th e r d is tin g u is h e d v isito rs w e re p re sen t. T h e a r r a n g e m e n ts fo r th e w e e k e n d w e re in th e h a n d s of C a d e t O fficer J . C. L . A u s tin a n d L a d y C a d e t S u p t. M rs. E.
A u stin .
County of Sussex. T h e i m p o r t a n c e of t h e c o n t i n u e d e ffic ie n c y o f t h e St. J o h n A m b u la n c e B r i g a d e in S u s s e x w a s a p p a r e n t a t th e O f f i c e r s ’ T r a i n i n g C o u r s e h e l d o n N o v . 2 7 t h a n d 28 t h a t t h e P e lh a m S tre e t C o u n ty S chool, B rig h to n . A b o u t 100 o f f i c e r s a t t e n d e d , a n d s o m e o f t h e t o p i c s d i s c u s s e d w e r e P r o v is io n of A m b u la n c e S e rv ic e s, g e n e r a l D iv i s io n a l ro u tin e , sp ecial tra in in g s u b je c ts to be p a ss e d o n a t o n c e , a n d m a t t e r s to b e p r e p a r e d fo r i n t r o d u c t i o n i m m e d i a te ly th e w a r is e n d e d . T h e S .J .A .B . in S u s s e x h a s a n e x c e lle n t re c o rd . D ur i n g 1942 , i t s a m b u l a n c e s e r v i c e c o n v e y e d 7,055 p a t i e n t s a d i s t a n c e c o v e r i n g 114,131 m i l e s . P ractically every m e m b e r is to - d a y r e n d e r i n g s e r v ic e e i t h e r w i t h H . M . F o r c e s o r o n e of th e o th e r W a r S erv ices. M e m b e r s h a v e u n d e r t a k e n C iv il D e fe n c e d u tie s in e v ery d istric t. S u c h a r e c o r d is a s o u r c e o f g r a t i f i c a t i o n t o a l l m e m b e r s of t h e B r i g a d e in S u s s e x , w h e r e m e m b e r s c e r t a in ly m a i n t a i n th e m o tto of its O r d e r , “ F o r th e F a i t h a n d fo r th e S e rv ic e of M a n k i n d . ”
West Riding of Yorkshire. H u d d e r s fie ld C a d e t s .— T w en ty -fo u r can d id ates passed t h e i r f ir e - f i g h t i n g t e s t in t h e e x a m i n a t i o n fo r S t. J o h n A m b u la n c e B r ig a d e C a d e ts h eld re c en tly . T h e e x am in atio n w as u n d e r th e d ire c tio n of th e D iv is io n a l O fficer, H u d d e r s f ie ld D D iv isio n , N .F . S . , w h o r e p o r te d t h a t th e c a d e ts w e r e w ell ab o v e th e a v erag e , a n d w e re k een a n d in tellig en t. In th e e x a m i n a t i o n a l l t h e c a d e t s o b t a i n e d 75 o r m o r e m a r k s . T h e f o l l o w i n g w e r e s u c c e s s f u l :—
A m b u la n c e C a d e ts .— S erg ts. J. W h ite ly a n d P. L a v e n d e r , C p l. K . H a r r i s o n , C a d e t s B . H a r r i s o n , D . H a i g h , B. B eev ers, D . R o b e rts, D . H a rr is o n , S. W h ite ly , P. W a d e , L. C l a r k , P . B r o o k , R . W i l l i a m s , P . W a r d . J . N orclifife, C. C ap p ell, A. G u m b y a n d W . M c D e rm o tt. N u rs in g C a d e ts.— S erg ts. M. G reen a n d S. C o w h am , C p ls. M . L a y c o c k a n d M . D a y , L /C p l. D . W a l k e r a n d C a d e t N. Sykes.
P it s m o o r .— C o u n ty C a d e t O fficer W . B a n h a m o fficiated a t th e first r e - e x a m in a tio n of th e P it s m o o r A m b u la n c e C a d e t D iv isio n h e ld re c en tly , w h e n h e in s p e c te d th e D iv isio n , w h o p a ra d ed 68 m em b ers. T h o s e p r e s e n t in c lu d e d D iv . S u r g e o n P. N . G rin li n g a n d D iv . S u p t. G . B u x to n . C a d e t S u p t. R . W a i n w r i g h t a n d A c tin g C a d e t O fficer W . R i g b y w a s in c h a r g e of th e p a r a d e . *
A C o u r s e of L e c t u r e s f o r O ff i c e r s of N u r s i n g U n i t s of th e W e s t R i d in g of Y o r k s h ir e w a s h e ld a t th e H o te l M e tro p o l e , L e e d s , d u r i n g t h e w e e k - e n d D e c e m b e r 4 - 5 t h , 1943 . O v e r 150 O f f i c e r s f r o m a l l p a r t s o f t h e W e s t R i d i n g o f Y o r k s h ire a tte n d e d a n d w e re w e lc o m e d by a m e s s a g e fro m th e L a d y L o u is M o u n tb atten . T h e C h air w as ta k e n
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F I R S T C o m m is sio n e r M r. H . L . T h o r n to n , a n d on th e S u n d a y by th e L a d y D is tric t S u p t. M rs. B irk b e c k . M a n y in te r e s tin g le c tu re s w e re d e liv e re d b y s p e c ia lis ts in th e i r o w n s u b je c ts , a n d i n c l u d e d t h e f o l l o w i n g : H o w to te a c h first a id a n d h o m e n u r s i n g ; B lo o d t r a n s f u s io n ; O r g a n isatio n of N u r s i n g D iv is io n s ; I m p o r ta n c e of t h e C a d e t M o v e m e n t ; P r a c tic a l in s tr u c t i o n in D iv is io n a l d rill ; L e a d e r s h i p ; T r e a t m e n t of w a r w o u n d s ; V e n e r e a l d is e a s e ; H is to r y of th e O r d e r ; T r e a t m e n t of b u r n s ; O v e r s e a s c iv ilia n relief w o r k ; C h ild w e lfare. L a d y C o u n tv O fficer M iss A sh b e rr y p ro p o se d , a n d L a d y C o u n ty O fficer M iss U n t h a n k s e c o n d e d , a v e ry w a r m v o te of t h a n k s to L a d y D is tric t S u p t. M rs. B ir k b e c k fo r th e e x c e lle n t o rg a n is a tio n of su ch a n in stru c tiv e c o u rse a n d fo r h e r e n e r g e t i c a n d i n s p i r i n g w o r k in t h e W e s t R i d i n g a t all tim es.
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“ H o m e G u a r d e r ” s h o u l d r e m e m b e r t h a t , o w i n g to th e ir sp ec ia l c h a ra c te ris tic s, w a r w o u n d s o ften r e q u ire m u c h d ifferen t t r e a t m e n t to t h a t g iv e n in s tr e e t a c c id e n ts . The d a n g e r f r o m s e p s i s i s m u c h g r e a t e r , e s p e c i a l l y if f i g h t i n g is t a k i n g p la c e in o p e n , c u ltiv a te d c o u n try . T h e p rev alen ce of d u n g , e tc ., fo r i n s t a n c e , l e a d i n g t o g a s g a n g r e n e ; t h e d a n g e r of t e t a n u s a n d o th e r d is e a s e s u s u a ll y a ss o c ia te d w ith th e s e c o n d itio n s m a k e it e ss e n tia l t h a t n o t o n lv m u s t th e first a i d e r w o r k s k ilfu lly a n d q u ic k ly , b u t th e p a tie n t m u s t b e in th e h a n d s of th e s u r g e o n a s s o o n a s p o ssib le. N o a t t e m p t s h o u ld b e m a d e to c le a n s e th e w o u n d by w a s h i n g it. C l o t t i n g s h o u ld b e e n c o u r a g e d a n d fu ll u s e m a d e of t h e o f f i c i a l f i e l d d r e s s i n g s . T h e d o c t o r m a y fin d it n e c e s s a r y to p e r f o r m e x c is io n , w h e n h e w ill r e m o v e t h e c lo t a n d all d e a d t i s s u e s , o n w h i c h th e g e r m s feed, a n d ty i n g off a n y d a m a g e d v essels. T h is s h o w s h o w e s s e n t i a l i t i s t o s t a t e o n t h e p a t i e n t ’s l a b e l t h e d ate a n d tim e h e w a s w o u n d e d , as th e d o c to r c a n th e n ju d g e th e e x te n t of e x cisio n , a n d w h e t h e r th e w o u n d s h o u ld b e a llo w e d to d r a in , a s is n e c e s s a r y in p a r t i c u l a r fo r o ld e r w ounds. I n s t r e e t a n d t o w n f i g h t i n g t h e r e is, p e r h a p s , le ss d a n g e r fro m sep sis, b u t o w i n g to th e w e a p o n s u sed , lik e g r e n a d e s a n d lig h t a u to m a tic s , m u ltip le in ju rie s a re to be re c k o n e d w ith , a n d th o u g h e a c h in d iv id u a l w o u n d m a y n o t a p p e a r serio u s, to g e th e r th e y m a y be d a n g e ro u s . G r e a t c a r e in h a n d l i n g is e s s e n tia l, a n d s h o c k t r e a t m e n t m u s t b e g iv e n im m e d ia te ly , fo r w ith th e lo ss of b lo o d a n d a c c o m p a n y i n g p a in t h is w ill i n v a r ia b ly b e s e v e re . The p r o m p t a c t i o n o f s t o p p i n g o r r e d u c i n g t h e b l e e d i u g 'w il l h e l p t h i s , a n d if m o r p h i a c a n b e a d m i n i s t e r e d , i t w i l l d e a d e n t h e p ain a n d g iv e fu r th e r a ssista n c e . T hen, as reg ard s ban d ag in g . It sh o u ld be re m e m b e re d t h a t w h e n t h e b o d y is w o u n d e d a n d b l o o d e s c a p e s , t h e l a t t e r te n d s to clo t a n d p lu g th e w o u n d . T h e b lo o d vessels s u r ro u n d in g , th e n d ila te a n d b r in g a n in c re a se d s u p p lv o f w h ite b lo o d cells, w h i c h d e s t r o y g e r m s a n d f o r m a s o r t of b a r r i c a d e b e tw ee n th e so u n d a n d d ead tissu es. T h e s ig n s of th is process a re th e sw e llin g , re d n e ss a n d in c re a se d h e a t ro u n d th e w o u n d . O n n o a c c o u n t m u s t first a id in te r f e r e w ith th is, th e r e f o r e w a t c h t h e b a n d a g i n g clo sely . A bandage a p p lie d firm ly in t h e first p la c e m a y b e u n c o m f o r t a b ly a n d d a n g e r o u s ly tig h t in h a lf a n h o u r.
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Letters to the Editor. W e a r e in n o w a y re s p o n s ib le fo r th e o p in io n s e x p re s s e d , o r th e sta te m e n ts m ad e, b y C o rre sp o n d en ts.— E d ito r .
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D e a r S ir , — In y o u r O c to b er issu e a c o rre sp o n d e n t ask s, “ w h i c h m e t h o d o f a r t i f i c i a l r e s p i r a t i o n — S c h a f e r ’s o r E v e ’s — g iv e s th e g r e a t e r r a te of a ir e x c h a n g e fo r e a c h r e s p i r a tio n ?” I n h is rep ly , y o u r H o n . M e d ic a l A d v ise r s ta te s , “ 1 t a k e it t h a t b o th m e th o d s g iv e a p p r o x i m a t e l y th e s a m e r a te of e x c h a n g e . ” I n t h e B . M . J . o f O c t o b e r 16 t h , 1943 , P r o f . M c I n t o s h , o f O x fo rd , r e p o r ts re s u lts of e x p e r im e n ts o n th is p o in t. He says, “ E v e ’s r o c k i n g s t r e t c h e r m e t h o d , w i t h t h e p a t i e n t p r o n e , r o c k e d t h r o u g h 90 d e g s . , g a v e a n e x c h a n g e o f 580 c . c . , S i l v e s t e r ’s m e t h o d , 400 c . c . , a n d S c h a f e r ’s , 340 c . c . ” T h e s e re s u lts m a y b e of in te re s t to y o u r q u e stio n e r. Y o u r s faith fu lly , B o w m a n E d g a r , M .B ., C h .B .
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S c h o o l H o u s e , N o e l - r o a d , W . 3. P u b lis h e rs N o t e .— W ill readers please note that all back numbers of “ First Aid ” are now out of print and cannot be supplied. W ill South African and other Colonial readers please add to their remittances, “ or English equivalent.”
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A s o n e o f t h o s e w h o h a v e b e e n t e a c h i n g E v e ’s m e t h o d o f re s u s c ita tio n in th e C o lc h e s te r d is tr ic t fo r o v e r tw o y e a r s, m a y I b e p e r m i t t e d t o r e p l y t o H . D . ( C o l c h e s t e r ’s ) q u e r y i n y o u r i s s u e o f N o v e m b e r , a n d t o a d d t o D r . C o r b e t F l e t c h e r ’s rep ly . S in c e P r o f e s s o r C o r d i e r p u b lis h e d h is a r t ic le in t h e B r itis h M e d ic a l J o u r n a l , P r o f e s s o r M a c k i n t o s h o f O x f o r d h a s c a r r ie d o u t f u r t h e r e x p e r i m e n t s r e p o r t e d in t h e s a m e j o u r n a l o n O c t o b e r 16 t h , i n w h i c h h e s h o w e d t h a t t h e v e n t i l a t i o n b y E v e ’s m e t h o d w a s o v e r a p i n t , b u t t h a t S c h a f e r ’s m e t h o d o n ly p r o d u c e d a little o v e r h a lf a p in t of a ir e n try . I n a d d i tio n to th is , m a y I a d d t h a t in a h a lf d e a d b o d \ t h e s tiffn e s s o f t h e d y i n g m u s c l e s , e s p e c i a l l y w h e n c o ld a s in d r o w n in g , te n d s to p r e v e n t c h e s t e x p a n s io n w h e n th e p r e s s u r e i n S c h a f e r ’s m e t h o d i s r e l e a s e d , b u t t h a t t h i s d o e s n o t i n t e r fere in th e s a m e w a y in ro c k in g . M oreover, D r. E v e cla im s t h a t r o c k i n g h e lp s th e b lo o d to c irc u la te in t h e b o d y o w i n g to t h e n o n - r e tu r n a c tio n of th e v a lv e s in t h e v e in s, w h ic h a llo w t h e b lo o d to flow d o w n to t h e h e a r t f r o m t h e le g s w h e n t h e h e a d i s d o w n , s o t h a t t h e r e is a m e a s u r e o f a r t i f i c i a l circu latio n . A g r e a t a d v a n t a g e o f r o c k i n g is t h a t it c a n s o q u i c k l y b e ta u g h t to a n in ex p erien ced b y stan d e r. T h e m o s t serio u s d is a d v a n t a g e is t h a t s o m e f o r m o f a p p a r a t u s is r e q u i r e d o n w h ic h to ro c k th e s tre tc h e r, a n d s o m e fittin g to h o ld th e m to g e th e r. M a n y v ery in g e n io u s g a d g e t s h a v e b e e n dev ised , s u c h a s t h a t d e s c r ib e d in th e O c t o b e r is su e , b u t th e y all h a v e th e s a m e fa u lt, t h a t t h e y a r e n e v e r fo u n d fitted to t h e s t r e t c h e r w h i c h is b r o u g h t a l o n g in t h e h u r r y of t h e e m e r g e n c y . I t is b e tte r in m y m in d fo r t h e first a i d e r to m a k e u s e of h is t r a i n i n g in i m p r o v is a t io n , a n d r i g u p , s a y , a h a n d c a r t o r a h u r d l e o n a w a ll, t h a n to te ly o n sp e c ia l a p p a r a t u s , w h ic h w ill b e fo u n d m o s t u s e f u l, k e p t fo r e x a m p l e , b y t h e d o c k s i d e in h a rb o u r areas. W ith r e g a r d to th e d rill r e c o m m e n d e d b y D r. B o w m a n E d g a r , I t h i n k t h i s is of g r e a t i m p o r t a n c e . C orporal M ayes of th e W iv e n h o e D iv isio n k i n d ly w o r k e d o u t fo r m e a n o t h e r m e th o d , w h ic h I s h o u ld lik e to s u b m it a s a n a lte rn a tiv e . W h i l e S c h a f e r ’s m e t h o d i s b e i n g c a r r i e d o n , a n d w h a t e v e r a p p a r a t u s is a v a i l a b l e f o r r o c k i n g is b e i n g p r e p a r e d , r o ll t h e p a t i e n t o n to a h a lf ro lle d u p b l a n k e t , t a k i n g a d v a n t a g e of th e in sp ira tio n p a u s e in th is w a y : A s th e o p e ra to r s w in g s b a c k , lift u p t h e o p p o s ite s id e of t h e p a t i e n t to t h a t o n w h ic h t h e o p e r a t o r is k n e e l i n g a n d p u s h u n d e r t h e r o l l e d b l a n k e t ; n o w c h a n g e o p e r a to r s a n d a t a c o n v e n i e n t m o m e n t lift u p th e o th e r sid e a n d pull th e b l a n k e t r i g h t th r o u g h . T o lift t h e p a t i e n t o n t h e b l a n k e t o n to t h e s t r e t c h e r , p la c e t h e s tr e tc h e r a t t h e h e a d of th e p a tie n t in lin e w ith h im
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a s fo r lo a d in g . S t i l l k e e p i n g u p S c h a f e r ’s m e t h o d , t h r e e h e l p e r s lift t h e p a t i e n t a b o u t a f o o t o f f t h e g r o u n d w h i l e a f o u r th slid es th e s tr e tc h e r b e n e a th , th e o p e r a to r m e a n w h ile k n e e lin g on o n e k n e e so th a t h e c a n g iv e o n e e x p ira tio n w h ile t h e p a t i e n t is s u p p o r t e d o n t h e b l a n k e t o ff t h e g r o u n d . To d o t h i s it is n e c e s s a r y t o k e e p t h e b l a n k e t q u i t e t a u t u n d e r th e abd o m en . T o lift t h e s t r e t c h e r w i t h t h e p a t i e n t o n to t h e tr e s tle , th r e e s te p s a r e t a k e n in t im e w ith re s p ir a tio n . T h e first o n e lif ts u p d i e s t r e t c h e r o n l y a b o u t n i n e i n c h e s , a n d it is h e ld th e re w h ile th e o p e ra to r, k n e e lin g o n o n e k n e e g iv e s o n e e x p ira to ry stro k e . T h e s e c o n d s t e p t a k e s t h e s t r e t c h e r to w a is t h e ig h t, th e o p e ra to r ris in g to h is feet a n d th e n g iv in g th e n e x t e x p ira to ry stro k e . T h e t h i r d s t e p is a s id e s t e p o v e r th e tre s tle p la c e d b e fo re h a n d clo se to th e m id d le of th e stretch er. It w ill b e fo u n d , by th e w a y , t h a t th e b e st p o sitio n fo r t h e t r e s t l e is n o t t h e e x a c t m i d d l e , b u t a l ittl e n e a r e r t h e h e a d e n d — o n th e steel A .R .P . s tr e tc h e r a b o u t th e th ird f a s t e n i n g of t h e w ire m e s h to th e s id e tu b e . I n t h i s d r il l t h e r e is n o n e e d to lo s e e v e n o n e b r e a t h t h o u g h of c o u rs e th e a m o u n t of p re s s u re p o ssib le o n a b l a n k e t in m i d - a i r is le s s t h a n it is o n h a r d g r o u n d . By b e i n g t h e p a t i e n t I h a v e s a t i s f i e d m y s e l f t h a t S c h a f e r ’s m e t h o d o n a s u s p e n d e d b l a n k e t is effective. Y o u r s faith fu lly , W a lte r
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A I D A n y m a l e p e r s o n o f 18 y e a r s o r o v e r ( s u b j e c t t o c e r t a i n c o n d i t i o n s n o t a p p e r t a i n i n g t o t h e w a i t e r ’s l e t t e r ) m a y b e c o m e a m e m b e r of a n A m b u la n c e D iv isio n of th e S t. J o h n A m b u l a n c e B r i g a d e if h e h a s o b t a i n e d t h e n e c e s s a r y F i r s t A i d C e rtific a te is s u e d b y th e S t. J o h n A m b u l a n c e A s s o c ia tio n o r B ritis h R e d C ro s s S ociety. A s th is c e rtific a te m a y be o b ta in e d a fte r a t t e n d i n g six D o c t o r ’s l e c t u r e s , a n d a l s o a m i n i m u m o f s i x h o u r s p r a c t i c a l i n s t r u c t i o n , a n d t h e n p a s s i n g t h e n e c e s s a r y e x a m i n a t i o n , it m u s t b e e x p e c te d t h a t th e p e r s o n is n o t a fu lly q u a lifie d “ a m b u l a n c e m a n ” in all its b ra n c h e s . T h e S t. J o h n A m b u l a n c e B r i g a d e is a n o r g a n i s a t i o n w h e r e t h e e n l i s t m e n t o f m e m b e r s is p u r e l y v o l u n t a r y , a n d it m u s t b e a s s u m e d , th e re fo re , t h a t a n y p e rs o n w h o a p p lie s for m e m b e rs h ip h a s a d e sire to s tu d y th e su b je c t fu r th e r a fte r h a v i n g re c e iv e d h is first c ertific a te . O n th is a c c o u n t, I w o u ld s u g g e s t to D . S. th a t h e sh o u ld p a s s o n to th e s e a p p a r e n t l y raw ' first a id e r s t h e b e n e fit of h is m o r e e x te n s iv e k n o w le d g e , w h ic h I a m s u r e w ill b e t h a n k fu lly re c e iv e d a n d d ig e s t e d b y th e s e d ire c te d m e m b e r s of h is F i r s t A id P o s t . — Y o u r s faith fu lly , D iv is io n a l
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I w 'a s v e r y i n t e r e s t e d t o r e a d t h e l e t t e r p u b l i s h e d in y o u r S e p te m b e r issu e from D r. B o w m a n E d g a r d e a lin g w ith a n i m p r o v i s e d m e t h o d o f p e r f o r m i n g E v e ’s R o c k i n g M e t h o d of R e s u s c i t a t i o n , a n d feel t h a t s o m e o f y o u r r e a d e r s m a y a lso b e in te re s te d in a n o th e r im p ro v isa tio n w h ich th e S h a r s t o n ( M e n ’s ) D e t a c h m e n t ( B . R . C . S . ) d e v i s e d l a s t M a y a n d p e r f o r m e d a s a n e x h ib itio n a t a lo cal S h o w in A u g u s t. T h e p a t i e n t is la id fa c e d o w n w a r d o n a n im p r o v is e d s tre tc h e r m a d e by tu r n i n g tw o tu n ic s (o r ja c k e ts) in sid e o u t a n d f a s te n e d t o g e th e r c o lla r to c o llar, artificial re s p ira tio n i s c o m m e n c e d i m m e d i a t e l y b y S c h a f e r ’s m e t h o d . M ean w h ile tw o b ro o m s tic k s o r s im ila r s to u t p o les a r e p a sse d t h r o u g h t h e s le e v e s o f t h e c o a t s a n d t h e p a t i e n t s e c u r e d to th is s tre tc h e r b y t r i a n g u la r b a n d a g e s , tw o c ro s s in g th e s h o u ld e rs fa sten e d to th e e n d s a n d m id d les of th e stick s, o ne a cro ss th e b u tto c k s also s e c u rin g th e a rm s a n d one a cro ss th e an k le s. W h e n th ese b a n d a g e s a re secu red , one o p e r a to r s t a n d s a t e a c h s id e of th e p a tie n t, g r a s p s th e b r o o m s ti c k w ith o n e h a n d a t th e m id d le o r p o in t of b a la n c e a n d o n t h e w ' o r d o f t h e o p e r a t o r p e r f o r m i n g S c h a f e r ’s m e t h o d , on th e p re ssu re “ o f f ” m o v e m e n t (in sp ira tio n ) th e o th er t w o r a is e t h e p a t i e n t f r o m t h e floor h e a d first a n d c o m m e n c e t h e r o c k i n g m e th o d in th e s a m e r h y t h m , th e th ir d o p e r a to r s ta n d s b y to ta k e o v e r fro m o n e o r th e o th e r a s re q u ire d . W i t h p ra c tic e , th e tim e ta k e n to im p ro v is e th e s tre tc h e r a n d secu re th e p a tie n t can be red u c ed to th re e m in u tes, an d t h e a i r e x c h a n g e is v e r y e ffe c tiv e . T h e b i g a d v a n t a g e o f t h i s m e t h o d i s , w e fe®l, i t s e a s y i m p r o v i s a t i o n , a n d t h e r e is n o n e c e s s i t y t o c a r r y a n y a p p a r a t u s f o r its p e r f o r m a n c e . W e l a r g e l y o w e t h i s m e t h o d t o o n e of o u r m e m b e r s , P te . B u c k le y , w h o , w h e n w e w e r e first e x p e r i m e n t i n g , s u g g e s t e d t h e u s e of t h e “ S c o u t ” s tre tc h e r . Y o u rs faith fu lly , W . A . W r ig h t s o n , C o m m an d an t. N o rth e n d e n , M an c h e ste r. T H E
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B R IG A D E .
S ir ,— T h e r e m a r k s of D .S . ( B i r m i n g h a m ) call for a rep ly , a n d I h o p e t h a t th e fo llo w in g in fo r m a tio n w ill e n lig h te n h im so m e w h a t.
A f e w y e a r s a g o a t O ly m p ia , d u r i n g o n e of th e fr e q u e n t e x h ib itio n s of th e p r e - w a r p e rio d , a m e m b e r of S t. J o h n w a s faced w ith a n u n u s u a l e m e rg e n c y . A ch ild , w h o h a d ju s t s w a llo w e d a n open safety-pin, w a s b r o u g h t in to th e a m b u la n c e ro o m b y its m o th e r. H e ro se to th e o cca sio n w ith v ery c o m m e n d a b le re so u rc e , a n d g a v e th e ch ild c o tto n w ool a n d b re a d to eat, w a s h e d d o w n w ith w a te r. T h e pin w a s s u b s e q u e n t l y s a f e ly r e c o v e r e d , e m b e d d e d in a m a s s of c o tto n w ool. I n A p ril th is y e a r th e w rite r c a m e a c ro ss in te re s tin g c o n f ir m a tio n of th e efficacy of th is t r e a t m e n t . A d o c to r, in a l e t t e r t o t h e B r it is h M e d ic a l J o u r n a l ( M a r c h 20 / 4 3 ), d e s c r i b e d a c a s e t h a t o c c u r r e d i n 1936 i n v o l v i n g a s o m e w h a t s im ila r p ro b le m — th e s w a llo w in g of p in s. In h is o p e n in g p a r a g r a p h , h e s a y s — “ T h e s w a llo w in g of s h a r p - p o in te d fo re ig n b o d ie s p re s e n ts a p ro b le m to th e p ra c titio n e r, o ften a t a m o m e n t ’s n o t i c e , a n d p r o v i d e s a s o u r c e o f a n x i e t y t o h im , h is p a tie n ts, a n d th e ir relativ es. I h a v e recen tly been s tr u c k by th e fact th a t so few d o c to rs re a lise th e v a lu e of th e co tto n w ool s a n d w ic h . T h e fo llo w in g c ase ex em p lifies th e v a lu e of s u c h .” T h e d o c to r th e n g o e s o n to d e s c rib e a c a se tr e a te d a t th e W h i te h a v e n a n d W e s t C u m b e r l a n d H o s p i ta l in S e p t e m b e r , 1936 . A d re s sm a k e r w as ra d io g ra p h e d th ere because sh e h a d sw allo w ed “ a p in .” T h e film d e m o n s t r a t e d t h e p r e s e n c e o f 23 p i n s a t a l l a n g l e s w i t h i n t h e g a s t r o - i n t e s t i n a l tra c t. T h e S ister ra d io g ra p h e r p ro m p tly g a v e th e p a tie n t a series of s m a ll c o tto n w ool s a n d w ic h e s, h a v in g im p r e g n a te d t h e t e a s e d - o u t c o t t o n w o o l w i t h b a r i u m s u l p h a t e i n o r d e r , if po ssib le, to fo llo w th e p r o g r e s s of th e p in s. T h e p r o g r e s s of th e p in s w a s e asily c h e c k e d e a c h d a y b y ra d io lo g ic a l m e a n s, th a n k s to th e b a riu m . G ro u p s of p in s w e re e v a c u a te d in tu rn a t d a ily in terv als, w r a p p e d in c o tto n w ool. I n th r e e d a y s all h a d b e e n e v a c u a te d , “ w ith o u t a n y p a in o r o n e d ro p of blood b e in g s h e d .” A m o n th a fte r th e lette r m e n tio n e d above, th e sa m e jo u rn a l p u b lish ed a n o th e r lette r on th e su b ject, th is tim e fro m a lad y v e terin ary su rg e o n . S h e s ta te d th a t a m o d ifica tio n of th is m e th o d h a s b e e n in u s e in th e v e te r in a r y p ro fe s s io n fo r s o m e tim e. D o g s a n d cats, s h e said, o fte n s w a llo w p in s a n d n eedles, U s u a lly th e se a r e fo u n d w ith th e p o in ts
F I R S T
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embedded in the walls of the mouth or pharynx, but some times they reach the stomach. In these cases the animals are given twenty to thirty small pellets of tightly rolled cotton wool, lubricated with lard or vaseline, followed in about an hour by a dose of liquid paraffin. The pins and needles are delivered in due course, neatly wrapped up in the centre of a roll of cotton wool. “ This treatment has saved many patients from the surgeon’s knife,” the veterinary surgeon concludes. The foregoing establishes that the ambulance man’s treatment was sound, but would have been improved from the point of view of palatability if the cotton wool had been teased out between thin bread and butter. Even so, it was a jolly good show ; let us hope that we fellow first-aiders will be able to demonstrate equal presence of mind and resource if faced with other first aid problems of a like urgency.
F .A .
P u zzle
C o rn e r.
W e have received the following from Inspector W. H. White, X. Div. M.S.C., prepared for one of his Revision Classes as a change from the usual routine Question and Answer :— 1 . Try cold first ........ 2 . Figure of eight for .... and double it fo r....... 3 . Pad sizes : four by two by two ......
4. 5.
6. 7. 8. 9. 10 . 11 . 12 . 13 . 14. 15 . 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35.
billiard ball ...... tennis ball small or large is needed for ..... ring pad for ...... The first is sleep, the others are ...... He throws his arms about ....... He burns like the desert ........ This is always present ......... This is sometimes absent ... do not despair do _ You note this first in every case .... Stop it ..... A large towel will do .... Refuse these for ...... This should be covered quickly _ No leg pull for ...... Don’t fish for .... With all the help available ... Up into the air ...... Heat has done this but apply hot flannels _ You must try to prevent this .... Raise or lower ... a matter of colour .... Onlyr two of you yet you supply a four ...... Let him sleep ... but keep this one awake .... It is marked by extreme thirst .... Give fluids freely' for .... It must have length, width & firmness, how much.... This is the only time when you hit your patient .... To give or not to give _ how do you know .. ? This is not your job, don’t do it .... Think of the “ Derby” _ He carried the world, it carries _ If it does not sxxxx, bxxx, or ixxxxxxx it is perfect. These are frowned upon ............ Don’t try to take his place he knows more than you ... Use this one, he knows less than you .... Four under, two over ...
R I D
Queries and Answers to Correspondents Q u e r i e s w i l l b e d e a lt w i t h u n d e r t h e f o l l o w i n g r u le s :— 1 . — L e t t e r s c o n t a i n i n g Q u e r i e s m u s t b e m a r k e d o n t h e to p le f t - h a n d c o r n e r o f t h e e n v e lo p e “ Q u e r y , ” a n d a d d r e s s e d to F i r s t A i d , 4 6 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 . 2 .— A l l Q u e r i e s m u s t b e w r i t t e n o n o n e s id e o f p a p e r o n ly . 3 .— A ll Q u e r ie s m u s t be a c c o m p a n ie d b y a “ Q u e r y C o u p o n ’ c u t f r o m t h e c u r r e n t is s u e o f t h e J o u r n a l, o r , in c a s e o f Q u e r i e s fr o m a b r o a d , fr o m a r e c e n t is s u e .
4 . — T h e T e x t b o o k to w h ic h r e f e r e n c e m a y b e m a d e in this c o lu m n is t h e 3 9 th ( 1 9 3 7 ) E d it io n M a n u a l o f F i r s t A i d t o t h e I n ju r e d .
of
th e
.S .J .A .A
Resuscitation. H.M. (Tipton). — With reference to the article which was published in the September issue of F i r s t A i d under the title “ Resuscitation,” I shall esteem it a favour if you would report upon the advisability of using this method of artificial respiration on (1) very young children, (2) aged people and (3 ) casualties with severe head injuries or severed arteries. The methods of Schafer and Eve are similar in that both rely on pressure of the abdominal organs upon the diaphragm; and the modifications necessitated by the conditions named by y’ou apply to each. Tbe time however, is not ripe for the expression of a definite opinion, as Eve’s method is not yet universaly accepted and his apparatus is not always avail able.— N . C o r b e t F l e t c h e r . Examination Howler. L.R. (Charlton Park).— In a recent examination I asked a candidate how he would compress the carotid artery and was vastlyamused when he replied :— “ A p p ly tourn iquet ro u n d neck a n d tighten it fo r tw enty m i n u t e s ” Good! Next, please! !— N.C.F. Fractured Leg and Torn Varicose Vein. C.T. (Ulster).— I am in a house alone with an elderly lady who trips over an object, falling and breaking her leg, and at the same time sustaining a lacerated wound involving a varicose vein near the fracture. How should I proceed before leaving the patient to telephone for the doctor? Should I elevate the limb? Meanwhile please accept my thanks. Proceed as is laid down in the General Rules for Treat ment of Fractures on pp. 66 and 67 of the Textbook. In other words, place patient on back (head to side) control the bleeding (without raising the limb), tie both limbs together, wrap patient warmly and then telephone for doctor.— N.C.F. Hypnotic Poisons. A.B. (Bedford).— (1 ) Will you please clarify the wording of the last paragraph on page 169 of the Textbook, and tell me if the signs mentioned belong to Irritants and Hypnotics, or to the two groups of the latter— Opium preparations and tablets, etc., for relief of pain ? Also (2 ) may I ask why it is that in this instance, stertorous breathing goes with a weak and slow pulse and a livid face, instead of the usual flushed face and full pulse ? Please accept my thanks in anticipation of your kind replies to both queries. (1 ) The signs and symptoms under “ Hypnotics” refer to the two groups of Hypnotics— the Opium group and the sleep inducing group— and not to the Hypnotic and Irritant Poisons. (2 ) On this point I think that the description is not strictly correct and that when in such a case the face is livid
F I R S T
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HOUSEHOLD PHYSICIAN D e s c rib e s in s im p le lan g u ag e w ith helpful c o lo u r e d p la te s an d d ia g ra m s
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and the breathing stertorous, the pulse will be slow and full. At any rate I have never seen the combination of stertorous breathing and weak pulse ! !— N.C.F. A Reader’s Dilemna. H.P. (Cockfield).— 1 am a young boy just over sixteen years of age and am greatly interested in first aid and home nursing. I have attended lectures on both subjects for three years, and I am quite sure that I could pass any examination for boys of my age. But you see, I live in a little village where there is no S.J.A.B. or S.J.A.A. examiner. As I am very keen to gain my certificates I will be glad if you could en lighten me on this point. You do not say who has given the lectures which you have attended. If these have been given by a doctor he could notify the Chief Secretary of the Association who would arrange an examination by another doctor nearby. So far as the home nursing certificate is concerned you can be examined in this subject by the District Nurse.— N.C.F. Compression of Temporal Artery. E.J. (Staines).— Having learned much from your answers to correspondents, I ask you please to answer this query :— The Textbook tells us to put pad and bandage on temporal artery as most suitable. Do you consider that the bandage should go straight round the head and be tied off on pad or that with centre of bandage on pad the ends should be taken to the other side and twisted. Then one end being passed over the head the other under the chin and finally tied off on the pad. I know that both methods seem sound but would the first method be as satisfactory as the second method, which seems to have more control of the pad ? Your kind reply will be much appreciated. Experience proves the first method (by which the band age is carried straight round the head and tied off on the pad) is quite satisfactory, and that if this is applied properly, the pad will not slip.— N.C.F. Treatment of Braises. R.E. (Aberavon).— With reference to treatment of bruises, for which equal parts of water and methylated spirits are advocated in the Black Book, or ice or cold com presses, the reason for this being that they all cause constriction of vessel wall. The addition of methylated spirits to the water, according to your W h y a n d W h ere fore in F i r s t A id , increases this action through evapora tion. Could you tell me please in what way, or why does the addition of spirits to water increase the above action of constriction ; what action has the spirits on the water to bring about this effect on a bloodvessel ? 1 know from experience that if spirits of above type are added to water in equal quantities it causes or creates terrific heat which threatens to crack any glass vessel. I should have thought that surgical spirits used by itself would be sufficiently cold enough to cause any con striction through evaporation, as it seems very much colder than water when applied “ neat ” on the skin. When you refer to the generation of heat, you are prob ably thinking of spirits of salts which is a corrosive and will have this effect if mixed with water. When methylated spirit is added to water no heat is evolved. The effects of methy lated or surgical (which contains 95 per cent, methylated) spirit are that heat is absorbed from, the tissues and brings about the evaporation of the liquid.— N.C.F. Paxalysis of Limbs in Apoplexy. A.E. (Rhondda).— Among the signs and symptoms of Apoplexy the Textbook (p. 1 6 6 ) tells us that one side of the body is more limp than the other. Will you please tell me how a first aider can diagnose this condition if the patient is unconscious ? If the patient is unconscious, it would, in my opinion, be
R I B
extremely difficult for a first aider to detect the difference in limpness between the two sides of the body. Indeed, recogni tion of this sign can only be learned by long experience ; and doctors, when making this test, raise the limb three or four inches and then let it fall on the bed or couch, watching closely to see how it falls.— N.C.F. Humour in First Aid. J.C. (Bishopsgate).— In a recent Police examination a mem ber was asked to state the difference between stupor and coma. He replied— “ T h e difference between day-duty a n d n ig h t-d u ty ! ” Good !
Next, please 1 !— N.C.F. Capacity of Lungs. R. E. (Aberystwyth).— Please tell me what is the capacity of one lung in residual, tidal and complementary air. As the tidal lung capacity is— residual air, 1 0 0 cubic inches ; tidal air, 30 cubic inches; and complementary air, 100 cubic inches— the capacity for one lung would be approximately one-half.— N.C.F. Amount of Blood in Body. W.W. (Kettering).— At a recent Divisional Practice one member asked (1) what is the total amount of blood in the body of an average adult, while another asked (2) how much blood the left ventricle empties into the,aorta at each contraction. As no one could supply the correct answers, we submit the questions to you and thank you in advance. 1 also do not know the answers, but 1 have submitted your queries to an expert, whose replies are as follows — “ (1 ) The amount of blood in the body of an average adult is 6 litres (approximately 10 pints). (2 ) The amount of blood pumped by the heart is from 4 to 6 litres per minute at rest. Under conditions of active exercise this amount is greatly increased. From this it follows that, at rest, the amount of blood pumped into the aorta would be half the total amount, and at each contraction would be 80 to 100 cc per minute (approximately 3 ounces).”— N.C.F. Carbon Monoxide Poisoning. T.A. (Southgate).— Please would you tell me if it is advisable to use carbon monoxide (in conjunction with artificial respiration) to resuscitate a patient asphyxiated by carbon monoxide ? At present I am of opinion that it is definitely not, although I would use oxygen if it was readily available. Meanwhile may I thank you for the help I have received from the Query column in the past ? Experience teaches us that it is good treatment to ad minister oxygen with 5 per cent, carbon dioxide in combintion with artificial respiration in cases of carbon monoxide poisoning.— N.C. F. Fractured Femur and Sprained Ankle. B. B. (Bath).— In a recent examination I had for my practical test a fracture of the femur with a sprained ankle on the opposite foot. I treated the fractured femur firs t accord ing to the Textbook, and finally applied a cold compress to sprain. As there were already two bandages round the ankles tied off as a figure-of-eight and a pad be tween, I didjnot think it necessary to apply a third band age. Our little section have had many discussions on this point, and we cannot agree on the treatment, some saying the sprained ankle should have been treated first with a tight bandage and cold compress, even i f the s p ra in w as on the sam e fo o t as the fra c tu re d fe m u r.. Also would it be possible to draw the fodt in line with its fellow, as stated in the Textbook, if there was ' a sprain on one foot or the other ? We should be very grateful if you will tell us the correct treatment. With this combination of injuries I should act as you
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EMERGENCY TREATMENT OF SKIN INJURIES Be prepared for an em ergency and keep C u ticu ra Brand O in t m ent in you r First A id K it. It brings instant soothin g relief to cuts, burns, skin lacerations— prevents spread of infection, quickly heals. O btain able at all C hem ists and S tores.
F I R S T
did, because the fractured femur is more liable to aggrava tion and calls for preferential treatment. Traction on the foot, whether sprained or not, is still necessary ; but with the former you would modify your method of holding the foot and do your utmost to avoid un necessary pain.— N.C.F. Fracture of Both Clavicles. E. B. (Glazebrook).— The Textbook gives the treatment for a fracture of the collar-bone, but does not say how a patient suffering from a fracture of both collar-bones should be treated. 1 should be obliged if you will tell me which is the most efficient way of controlling these fractures. This combination of injuries occurs so rarely that refer ence to it has wisely been omitted from the Textbook. If, however, you should have to treat the combination, you can follow the instructions which used to figure in the Text book, and which reads as follows :— “ When both collar-bones are broken, keep the shoulders back by narrow bandages tied round each arm (close to the shoulder), passed across the back, over the opposite arm and tied together in front. The forearm should be raised and supported by the bandages.”— N.C.F. Method of Changing Operators. G.A. (Overseal).— The Textbook does not state any method by which the operators can most efficiently be changed during performance of Schafer’s artificial respiration. I shall, therefore, welcome your suggestions. Mean while I thank you for your help in the last 28 years and I hope that I shall continue to learn much from your instructions in the Query Column for another 28 years ! You will find the best description of the way to change operators on p. 53 of the A . R . P . B ooklet which is published by the Royal Life Saving Society and which tells you every t h in g about Schafer’s artificial respiration. This reads as follows :— “ While working, instruct one or more of your helpers to watch your actions very carefully while you explain the general idea underlying them. When at lasl you tire, ask him to kneel down on the opposite side of the patient and (during the relaxed or ‘ off’ position) to place his hands accurately over yours. Work thus together for a few cycles to establish the sense of your rhythm in his muscular move ments ; and at a later ‘ off’ position withdraw your hands leaving his to slip down into their place. Then take your well earned rest, while still supervising your assistant and preparing to take over again.” On your last point you are hopeful for both of us !— N.C.F. Gas Poisoning and Broken Neck. C.M. (Sheffield).— I am a member of the B.R.C.S. ; and I write to ask about the treatment of the case with which you dealt in your reply published under the above head ing in the October issue of F i r s t A i d . T o me it would seem that your previous correspondent wanted to know which method of artificial respiration should be applied. As my previous correspondent has not written again, I take it that I gave the answer which he desired. You, how ever, would seem to have misread his query which sought to ascertain how a patient with a broken neck should be removed from a gas-laden atmosphere. In reply to your query, any first aider should know how to treat asphyxia when patient has been removed to fresh air and has to be kept on his back. You will find the necessary instructions in this connection on pp. 2 3 2 and 233 of the B.R.C.S. Textbook and if you want further details you can look up p. 149 of the St. John Textbook.— N.C.F. Lay Instructor Certificate. C.M. (Sheffield).— In the query, which was published under the above heading in the October issue of F i r s t A i d , a member of the B.R.C.S. asked if (and how) he could qualify for the Lay Instructor Certificate which, from the
R I D
Editor’s reply, I gather is strictly reserved for members of the Brigade. He may, however, be interested to know that three years ago the B.R.C.S. introduced for its members an Instructor’s Examination in First Aid. We thank you for your letter and for the syllabus of examination which you enclosed. From the latter it seems that the B.R.C.S. examination consists in the main of a lec ture, whereas for the Lay Instructor Certificate a candidate must obtain 75 per cent, of marks in practical and oral tests (Part I), in a lecture test (Part II) and also in a written paper test (Part III). Finally, while the B.R.C.S. Instructor may give half the six lectures for the Adult Course, the St. John Lay Instructor is not so allowed, all six lectures being given by a medical practitioner.— Editor. Electric Shock and Asphyxia. A.E. (Rhondda).— Please tell me what is the cause of asphyxia in the case of electric shock. Electricity passing through the body has the effect of stopping the action of the nerve centres which are situated in the brain and which preside over the circulation and breath ing.— N.C. F. Syncope, Shock and Collapse. A.E. (Rhondda).— Lastly please tell me how Syncope, Shock and Collapse differ from each other. (1 ) Syncope is a temporary (may be fatal) depression of the Brain Centres, associated with disturbance of the heart’s action and sudden interference with the circulation in the brain. (2 ) Shock is a profound (may be momentary) depression of the Brain Centres which disturbs the action of the heart ; usually gradual in onset and associated with marked fall in body temperature ; may precede and terminate in Collapse ; very liable to relapse ; insensibility not a marked or constant feature. (3 ) Collapse is an extreme (may be rapidly fatal) depres sion of the Brain Centres and of the Heart ; usually gradual in onset ; often secondary to Shock but different in that in sensibility and muscular relaxation are more marked and more constantly present ; most liable to sudden relapse.— N.C.F. Triangular Bandage. P.M. (Caistor).— I read recently in a contemporary journal that the triangular bandage was invented by (and named after) a Dr. Esmarch, Professor of Surgery in the Uni versity of Kiel. I shall be grateful if you will tell me if this statement is correct. The triangular bandage was invented in 1831 by a Dr. Mayor, of Lausanne, Switzerland, who gave it the name “ handkerchief bandage.” Under this title it was popular ised by Dr. Esmarch, of Kiel, who in or about 1875 taught its usefulness to the German Army, and so describes it in his “ F i r s t A i d to the I n j u r e d '' which was translated from the German by H.R.H. Princess Christian and published in London in 1 8 8 2 . Consequently, the bandage was for many years unfairly called “ Esmarch Bandage,” this being its name in the original issue of the Textbook (1 8 7 8 ), through which the St. John Ambulance Association introduced the bandage into this country. As the result of protests, which I made in this column, the name “ Esmarch” was afterwards deleted from the Textbook, the 3 6 th Edition (1 9 1 9 ) being the first edition in my possession in which it was called “ the triangular bandage. ”— N.C. F.
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One or other or all of the thtee races of germs, Streptococci, Staphylococci and B. pyocyaneus are found in every skin infection common to this country, and ANTIPEOL OINTMENT contains the antibodies (antivirus) of these germs. Healing is expedited by the proved ingredients of the ointment, and septic development is stopped or prevented by its antivirus sterile vaccine filtrates. ANTIPEOL OINTMENT is unsurpassed for BURNS and SCALDS, for it is microbicide and non-adhesive, and dressings do not require to be changed every day. WOUNDS, BURNS, etc., WILL NOT TURN SEPTIC if treated with ANTIPEOL OINTMENT.
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CONTENTS : THE TEAM Som e Prelim inary A dvice ; THE COM PETITION RO O M Points to W atch ; D O C T O R A N D A M B U L A N C E H ow to A ct ; THE C O N S C IO U S PATIENT H ow to Handle. T reatm ent for Shock ; U N C O N S C IO U S PATIENT Examination and T reatm en t ; G EN ERAL PO IN TS ; STRETCHER W O R K .
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OF
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E d it o r ia l —
Youth Organisations Experentia Docet St. John Ambulance Association S.J.A.B. Headquarters and District Reports Letters to the Editor ... Osteoarthritis... Waltham Holy Cross Civil Defence Service London and North Eastern Railway Steel, Peech and Tozer First Aid Services Reviews The Home Guard and First Aid
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73 74 74 75 76 76 77 78 78 78 80
Q u e r i e s a n d A n s w e r s t o C o r r e s p o n d e n t s :—
Treatment of Fractures Examination Howler Stretcher Bearers and Fire Guard Treatment of Fractured Patella Status of Ambulance Attendant Fractured Clavicles and Crushed Hand Asphyxia and Crushed Ribs Causation of Collapse Effects of Sodium ... Successful Artificial Respiration Compound Fracture of Skull .j. The Future of the Brigade ... Multiple Injuries and Transport Performance of Schafer’s Method Complicated Fracture of Clavicle Pain in Insensibility Effects of Cyanide of Potassium Temperature of Blood
1944
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EDITORIAL.
FIRST AID is published on the aoth of each month. The Annual Subscription is 4 s. post free ;single copies 3 d . Its aim and object being the advancement of Ambulance Work in all its branches, the Editor invites Readers to send Articles and Reports on subjects pertaining to the Movement and also welcomes suggestions for Practical Papers. All Reports, &c., should be addressed to the Editor at the address below, and should reach him before the 8th of each month, and must be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with FIRST AID should be forwarded to the Publishers. DALE, REYNOLDS & Co., L t d . ,
CONTENTS
F.R.San.l.,
JA N U A R Y
Vm T V O L . L,.
NOTICE
W ALTER
80 80 80 82 82 82 82 82 82 82
. ...
84 84 84 84 84 84 84 84
T h e war has brough t about a Y o u th definite ch an g e in the relations O r g a n i s a t io n s , between this country and the U n ited States of A m erica. T h ere has alw ays existed that bond which obtains between people of the sam e ancestry sp e a k in g the sam e la n gu a ge, but the bond has been considerably strengthened, and we now have a continuous flow of com m unication between the two countries. O n ly a w eek or two a g o a woman architect left these shores to study A m erican m ethods, and now we have the visit of another, M iss L ou ise M orley, of the U . S . A . Office of W a r Inform ation, whose mission is to investigate the w o rk in g of our Y o u th O rgan isatio n s w hich, it is scarcely necessary to say, have as their basis an intense hatred of a n y th in g ap pro xim atin g to H itlerism and the vaporous out pourings w hich have em anated from his subservient henchm an, M ussolini. O n e of her first visits was to the L iverp o ol headquarters of the S t. John A m b u lance B rigade, where representatives from the G irl Cadet D iv isio n s of the L iverpo ol N u rsin g Corps g a v e dem onstrations. O u r purpose in reporting her activities is to stress the im portance of visits such as hers, in cem en tin g the bond w hich already unites the two nations. W e are not, of course, so prolific in organisations as our Am erican cousins. O ur traditions are of much lo n ger gro w th , but in A m erica every bo y and girl belo n gs to some association or another, and they g iv e practical effect to their m em bership, w hile, in this country, this is o n ly too often regrettably half-hearted. One A m erican organisation deserves a word of special m ention. It is known as the “ F o u r H ’s C lu b ,” the aitches representing head, hands, heart and health, translatable into “ C lear H ead, Clean H an ds, W a rm H eart, S tu rd y H e a lt h ” — som ew hat childish in its conception perhaps to our notions, but none the less a vigoro us and em in en tly practical body w hich is perform ing m uch of a useful nature. It need scarcely be said that in these m ultifarious organisations, first aid form s a prom inent feature. T o sum up, the im portance of such co-operation between the two countries cannot be overestim ated. Personal contact is not an ea sy m atter now, but with the resum ption of norm ality difficulty w ill have
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vanish ed, and we m ay look forward with assurance to a period of useful intercom m unication. Solid arity in the Y o u th M ovem ent is o n ly one of the m any w a y s in which the relation between the two countries can be im proved ; indeed it is o n ly upon that and an alo go u s m ovem ents that future peace can be assured in this harassed and perplexed world. T h e y are a strik in g contrast to the m ethods of the pro fessional politicians.
E x p e re n tia B y
D ocet.
TH E VICTIM.
( Concluded, from page 63. J There is still maintained by the powers that be, the policy that members of First Aid Points are not expected to leave their Points and deal with wounded in the Field. I have seen this policy gravely set out in official memoranda which stated dogmatically that wounded would be brought to the Points by members of the Rescue Services. Did they really imagine that the trained personnel of a Point in some village or small market town would be content to wait quietly in their Points while the wounded lay in the ruins waiting for the arrival of a First Aid Party, the nearest of which was often as much as ten miles away ? The personnel of these parties are largely part time and even to mobilise them for tip and run raids in the day time, from fields and shops, takes a considerable time, quite apart from the journey from base to incident ! In the face of official disapproval, therefore, I had trained the personnel of every Point over a very wide area that they were to be pre pared to look after themselves entirely for the first vital hour after a tip and run raid. This meant that they must know (1 ) how to lift a patient on to a stretcher ; (2) how either to carry it themselves or instruct the “ intelligent bystander” to carry it ; (3 ) how to lift a patient from stretcher to bed ; (4 ) how to load an ambulance. It was not easy at first. The Victorian impression that for a woman to lift might entail life long damage, took a lot of eradicating but they soon began to appreciate that once they had learned the secret of how to do it, no more effort was entailed than in lifting wash tub or coal scuttle. They very soon, too, began to realise that if carrying a heavy man on a stretcher was too much for four women, it became childs play with two additional bearers on either side. Demonstrations by a party of four women who had worked through very heavy attacks upon a large city and none of whom were of exceptional physique, were of immense value. To see them lift a heavy man on to a stretcher, lift the stretcher and run it with one smooth movement into the top runners of an ambulance, the whole in such a way that a glass of water balanced upon the patient would have remained unspilled, was a lesson in attainable perfection. It is a matter upon which even good First Aid Parties have often had far too little training. Trigg Lifts have improved matters but even so the tendency remains to con sider the lifting and smooth transport of the patient of infinitely less importance than first aid. In actuality it is always of equal importance, and in certain cases, such as chests, of infinitely greater. There is a not unreasonable tendency to imagine that the poor broken body of the air raid casualty protected from immediate obvious pain by either local shock or morphia can be handled in any way, provided no additional pain is apparently caused.
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No greater fallacy exists and it must always be remembered that the shock from which a patient is suffering, even if apparently protected from pain by complete uncon sciousness, will be enormously increased by the slightest rough handling or jolting. I was to have a clear demonstration of the truth of my own theories. By this time, installed upon the firm comfort of an A. R. P. stretcher, I had been carried smoothly to my house and lay warm and comfortable, absorbing cups of sweet tea, the while one of the first aid party swiftly turned back the dressing and dusted both wounds freely with powdered sulphonamide. From now on I knew that I must pass from the hands of my Civil Defence Personnel and rely for trans port upon local sources, by no possible means could I claim to be an air raid casualty. The civil ambulance arrived and the first snag was apparent at once, the runners had not been adjusted to take an A. R. P. stretcher and 1 had to be transferred to a St. John’s. Nothing so modern as a Sorbo rubber mattress had reached these depths of the country and no arrangements of blanketting or boarding were going to result in the happy mean between a sagging and a hard base. There is no question whatever, but that the modern A.R.P. stretcher is out and away the most comfortable and efficient ever produced. By the time I had been carried a hundred yards to the nearest point to which the ambulance could be brought and loaded aboard, I was very conscious of my leg, and before ten miles had been covered 1 was once more in a condition of severe shock. The unfortunate attendant did his utmost, but water and sal volatile are poor things at best and a surgeon is a difficult person to overrule. Realising the approach of the ambulance to a village pub, I demanded a halt and sent for the stiffest double— or quadruple whisky which could be produced. I can imagine the horror of my well trained readers ! It arrived however, was duly absorbed, and I passed once more into blissful tolerance of pot holed roads, rousing only at my destination. I have always felt considerable doubt as to whether hot sweet tea was really the best treatment for shock ! !
S t . J o h n A m b u l a n c e A s s o c ia t io n . B a r n s t a p l e . — Tributes to the efficiency of the adminis tration and to the public-spirited zeal of the uniformed voluntary ambulance personnel were paid at the annual meet ing of the Barnstaple S.J.A.A., held in the Commercial-road Headquarters of the movement. The Mayor of Barnstaple (Alderman C. F. Dart, J.P.,' C.C.), who, as President, took the chair during the opening part of the meeting, voiced the feelings of the Borough Coun cil and the burgesses, and reiterated the view he expressed a year ago that the Council would, in their re-planning scheme to be put into effect after the war, incorporate provision fora new Health Centre housing such services as the St. John Ambulance Association and Brigade, the Red Cross and V.A.D., in addition to the official health and sanitary departments. He advised the Association and the Brigade to seek con tact with the Red Cross organisations, and with them, to give the Council a lead by indicating their accommodational needs and plans for future activities in the service of the public. Sundry excellent reports were given. The Motor Amb. Com. reported a journey mileage of 9 , 7 0 7 . A total of 478 patients (61 P.A.C. cases, 11 Service, 152 Hospital Aid Society, and 254 private) had been carried. Officers and committees were then elected. At the outset of the meeting those present stood in silence in memory of members of the Association who had passed away during the year.
F I R S T
S t.
J o h n A m b u la n c e
h ead q u ar ter s
a n d
B rig a d e
d is t r ic t
r epo r ts
.
No. I (Prince o f Wales’s) District No. 1 4 8 N ( T e d d i n g t o n ) D i v i s i o n . — Teddington now has its own S.J.A.B. Nursing Division. It was inaugu rated at the British Legion headquarters in High-street on Thursday, December 9 th, with a visit from Lady District Officer Miss West. There is also to be a separate Tedding ton Cadet Division, but the enrolment of the cadets has had to be deferred until the new year. Ambulance Officer C. G. Bowden, in charge of the men’s division was in the chair. Addressing the cadets, Lady District Officer Miss West told them that when they were enrolled they would be members of the oldest charitable organisation there was. She wanted them to make the Teddington Division one of which they could be proud. After presenting certificates to cadets, Miss West made a presentation to Lady Ambulance Officer Mrs. Dorothy A. Jackson, who is in charge of the new division, as a token of appreciation of the work she has done for the members. She has just completed IS years with the Brigade, and is thereby entitled to the long service ribbon. This is the third Divi sion she has had charge of. The gift took the form of a fountain pen. In making the presentation. Miss West mentioned that she herself had been 30 years in the Brigade. Mrs. Jackson, in reply, said she had enjoyed every one of her IS years in the service, first as an ambulance sister, then as an officer. She was sure the new division would be a great success. County o f Berkshire. Mrs. Porter, M.B.E., who has been Acting Lady County Supt., has now gone on to the Brigade Reserve after 32 years continuous service, and her place has been taken by the Hon. Mrs. Leslie Gamage. R e a d i n g . — In the two months from October to Decem ber, 1 9 4 3 , £ 5 0 0 was collected by members of the Corps for the St. John and Red Cross Prisoners of War Next-of-Kin Parcels Scheme. W i n d s o r . — A competition was held on November 2 8 th, between St. John Divisions and Detachments of the British Red Cross Society. The competition was won by members of the Windsor Nursing Division, S.J.A.B.
County o f Lancashire. L i v e r p o o l . — Miss Louise Morley, of the U.S.A. Office of War Information, who is in this country to investigate the working of our Youth Organisations, paid a two days’ visit to Liverpool on December 2 0 th and 2 1 st. One of her first visits was to the S.J.A.B. Headquarters, where representatives from each of the Girl Cadet Divisions of Liverpool Nursing Corps demonstrated the various aspects of Cadet Training. Triangular and roller bandaging, splinting, artificial respiration, first aid in a street accident, preparation of a fracture bed and reception of the patient, and washing a baby and preparing its feed were included. Six Boy Cadets were present and demonstrated handseats and the blanketing of a stretcher. Miss Morley inspected a display of handwork and cookery by the girls. The handwork included knitting, embroidery, new and made-over garments and toys.
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After visiting the First Aid Station at the Headquarters, staffed by the Nursing Corps, Miss Morley addressed the Cadets, telling them something of the Youth Movements in America and of the life of the ordinary American boy and g ’rl-
Commissioner W. G. Smith, Asst. Commissioner Col. Simpson, County Surgeon Dr. Murray Cairns, the Corps President, Helena, Countess of Sefton, and Col. MacPhail (Chairman of the Association) were present to meet Miss Morley. County of Leicester. The young Leicester ambulance and nursing cadets derived as much pleasure in preparing and producing enter tainments and providing good fare as the 3 0 0 old age pensioners who were their guests at two large Christmas parties. Two hundred pensioners in the Belgrave area turned up at Belgrave W. M.C., where, following a tea provided by club and Brigade members, they were entertained by the Kerry troop of dancers, and Miss Violet Lorcen, vocalist. The Rev. D. E. K. Llewelyn was a visitor during the afternoon, as were the Supts. of the Ambulance and Nursing Divisions. At West Humberstone Adult School, the Arthur Faire nnrsing cadets and the Moat-road and G. F. Bourne boy cadets entertained 100 pensioners with song, music and nativity play. A group of juniors presented “ The Mad Hatter’s Tea Party,” which was greatly enjoyed by the old folk. The boys, under Supt. Heighton, gave a bandaging display. Similar parties have been arranged for the Aylestone, St. Leonard’s and Braunstone areas. County o f Sussex. B r i g h t o n . — For the first time in the history of the St. John Ambulance Brigade or British Red Cross Society cadet divisions in Sussex, representatives of both organisations met in a first aid competition at the Royal Pavilion recently. A team of S.J.A B. girl cadets beat the opposing ream of girls from the B.R.C.S. by obtaining 146 £ points to 103 £, while the St. John boys’ cadet team also emerged victorious over their Red Cross opponents, scoring 155 i marks against 1 3 0 . The competition consisted of an individual test and a realistically staged team test, in which the “ casually” had supposedly been injured while riding a cycle. Each team went confidently about the work of caring for the “ patient”, and in only one case did he “ die” ! Dr. J. Thwaites, who, with Mr. N. McLean, judged the competition, announced that the standard attained was ex tremely high. The tests were arranged as an experiment by Miss D. Gore-Browne, R.R.C. (deputy president), Dr. F. H. Stutta ford (corps surgeon and superintendent), and a small com mittee, and proved a great success. A cup was presented to each winning team by Miss Gore-Browne, the donor.
County of Worcester. Miss E. Ollis, Div. Supt. (now on Reserve) of the Dudley Nursing Division of the S.J.A.B. has been notified by the Secretary General of the Venerable Order of St. John of Jerusalem, that H.M. The King has sanctioned her promo tion in the Order from Serving Sister to Officer (Sister) for services rendered in the cause of humanity. Miss Ollis was one of the members who joined the Dudley Nursing Division when formed in 1 9 1 5 , thereby being a member for 28 years. After holding several offices Miss Ollis became Div. Supt. in 1 9 2 0 . She holds the Service Medal and 2 Stars, and was awarded the Silver Jubilee Medal in 1 935 . Miss Ollis went on Reserve in March, 1 9 4 3 . She is still greatly interested in the work.
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L e tte rs
to
th e
E d it o r .
We are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r . TR EA TM EN T FOR PHOSPHORUS BURNS. D e ar S ir,—
It has been pointed out to me, that in the October issue of F i r s t A i d , when describing the CuSO., treatment for Phosphorus burns, I omitted the word “ sterile ” from the 1 st part of treatment (Saline solution). This was, of course, an error, and should read : “ 1 teaspoonful of salt in a pint of s te rile water.” I would point out however, that bearing in mind the far greater danger of infection likely from war wounds, Home Guard medical units are trained from the start, to use sterile water for a ll medical purposes, whenever practicable, and few but the untrained, would have omitted to use it. However, as it is the latter we are trying to help, I apologise for the omission, and thank the Brigade Officer who pointed out the error. Incidentally, it is interesting to note that my small contributions are read and criticised by others besides the Home Guard.— Yours faithfully, C . W. S p r e a d b u r y . E V E ’S ROCKING METHOD. D e a r S ir ,—
Following your publication of the “ Kirkconnel ” sug gested technique for Eve’s method of Artificial Resuscitation for teams of four, may I add the following rider ? Once bearers have accustomed themselves to working in teams and have grasped the general technique, it can be pointed out that, in an emergency, two bearers should have a patient “ rocking” as, if not more, quickly than four bearers. This may be achieved by making use of the stretcher straps with which to bind the one arm and leg on the same side to the stretcher. Immediately this is accomplished, rocking should begin. Thus there need be no waiting or searching for bandages, etc., with which to prevent slipping. Rocking having been started, the spare bearer should slip bandages, ropes, etc., over the free arms and tie them to the stretcher handles— as opportun ity arises. The patient is q u ite safe though only fastened by one arm and leg. Any reasonably efficient pair of bearers should have no difficulty— working smoothly and not injuring the patient — in having him rocking in 2 0 to 25 seconds. This is equal to 4 to 5 breaths, which should satisfy the most impatient bystander who, himself doing nothing, calls loudly for “ someone to do something.” Yours faithfully, B o w m a n E d g a r , M.B., Ch.B. TH E
FU TU RE
OF
TH E
BRIGADE.
D ear S ir,—
I have read with keen interest D .S.’s (Birmingham) comments on the above subject in the November issue, also the previous article by our most worthy Dr. Corbet Fletcher. Whilst I agree that recruitment could be made from the C.D. First Aid Parties which are now merged with the Rescue Service, a large number of these members have been brought in under the compulsory enrolment scheme. Several others holding the St. John Ambulance First Aid Certificate, in some cases as many as 14 years have elapsed since it was first obtained, yet the Association has issued its badge to those members to wear on the C.D. uniform. No annual re-examination has been taken, and they are not much better than pew entries ipto the service,
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D.S. has probably had the above type as colleagues in his unit, since he states that 75 per cent, are inefficient. The Brigade Badge is quite distinct from the Association Badge. The former requires the standard of efficiency to be maintained as a member by passing the annual re-examina tion, and in that case could only qualify for the Cloth Badge for the C. D. uniform ; whereas the Association Badge can be obtained by anyone possessing the First Aid Certificate, however long the period since the last exam, was taken. The last clause stating that the “ St. John Badge worn on C.D. uniform is a badge of membership of the Brigade and not of the efficiency of its wearer to render first aid ” is to me incorrect. There are two distinct badges, as previ ously stated, and the one who wears the St. Jahn Ambulance Brigade Badge is, by virtue of its issue to him, accredited as an efficient member by hfs annual re-examination. The Association Badge does not necessarily infer that the holder is efficient in first aid. Trusting this information may help to clear the air. Yours faithfully, Wigan. W m . P a r k i n s o n , Corps Sec.
O s te o a rth ritis . [From a Lecture delivered by Matthew B. Ray, D.S.O., M.D., M.R.C.P., in the Lecture Hall of the Royal Institute of Public Health and Hygiene, 2 8 , Portland Place, W .l, on Wednesday, November 1 0 th, 1 9 4 3 , with the Rt. Hon. Lord Horder, G.C.V.O., M.D., F.R.C.P., in the Chair.] H e r e d i t y seems to play a part in the causation of osteo arthritis, but there are no controlled statistics available. In my personal experience patients very frequently state that a similar form of arthritis runs in their family. With regard to age incidence, osteoarthritis is essentially a disease of late middle life when early degenerative changes first make their appearance. Traumata are important causative factors. Under this term are included not only bruises and injuries to joints, but also any long continued stress or strain. Certain occupa tions are very apt to bring about the condition in individuals who by reason of their work are liable to joint strains. It has been said that every trade has its own particular form of arthritis. While changes suggestive of a toxic or infective element may be superimposed, there seems to be no evidence at all to suggest that focal sepsis plays any causative role in osteo arthritis. The subjects of osteoarthritis are usually well-nourished, robust individuals of a somewhat plethoric type. The onset of the condition is, as a rule, slow, progressive, and insidious. Constitutional symptoms are almost entirely lacking in osteo arthritis ; and, to state the matter shortly, it is almost entirely a disease of joints. The locol treatment ot the osteoarthritic hand should be directed to the avoidance of stiffness so far as is possible. Paraffin wax melted and applied in successive coats to the hands has proved very effective in relieving muscular spasm and rendering the fingers more supple. Much the same effect can be obtained by immersing the hands, enclosed in rubber gloves, in hot w'ater for about 20 minutes every day. After the hands have been removed from the water and the gloves taken off they can be well massaged with wintergreen oil. Osteoarthritis of the elbow joint is usually an occupa tional affection, in that it is associated with long continued strains at work. Blacksmiths who are constantly wielding heavy hammers seem specially prone to it, As the condition
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is largely occupational, every endeavour should be made in the early stages to relieve the strain on the joint by periods of rest or even change of work, if possible. Active move ments in hot water are also very helpful, and if these can be carried out in a pool bath with the under-water douche so much the better. Osteoarthritis of the shoulder joint is in most instances probably occupational, as it has been repeatedly seen in plasterers and painters who have to work with their arms above their heads for long periods. Treatment is the same as for the arthritic elbow joint. As some degree of osteoarthritis of the spine is so com mon in the later decades of life one might almost say that with advancing years some amount of change is physiologic rather than pathologic. Arthritis of the hip-joint is much commoner in men than in women. It is essentially a disease of middle life or old age. As regards treatment, the two chief indications are the relief of pain and the avoidance of fixation in a bad position. Since the foot and ankle are more exposed to stress and strain than any other part of the body it necessarily follows that osteoarthritic changes are extremely common. Treat ment should aim at keeping up the mobility of the foot as long as possible. G eneral T reatment.
Physiotherapy includes all methods based on the utilisa tion of (i) the energy of heat, as in the use of hot air, vapour, or hot water, locally or generally applied ; (ii) the energy of movement, as in manipulations and exercises, frictions, per cussion by douches, and the action of whirling water ; (iii) radiation, employed as heat, light, and invisible rays from arc, mercury vapour, or other lamps ; and (iv) electricity applied to resolve exudations and promote nutrition, to cause movement in muscle fibres, or to raise the temperature of deep-seated parts. The value of the pool bath has already been men tioned, and it is only necessary to refer to it again to urge the provision of such baths in all centres of popula tion. A hot or warm pool bath should find a place in every public bathing establishment. For some un explained reason the therapeutic pool which has been described has never caught on in this country. Only a few institutions have installed them. So far as is known there is only one in London. This form of treatment is extensively used in the United States as clearly shown by the reply to a questionnaire addressed to 100 prominent institutions which indicated that two-thirds had had therapeutic pools for on an average five years. Weight reduction, where possible, is usually highly beneficial as it obviously relieves the strain on the joints of the lower extremity. Rest without weight-bearing is more often required than complete rest from all kinds of movement. If rest is unduly prolonged without at the same time keeping up the tone of the muscles which control the joint, infinite harm may be done. Counter-irritation is an old and well-tried treatment for the relief of pain. As no known drug has any influence on the inter-articu lar changes in osteoarthritis, it necessarily follows that their employment must be limited to the treatment of any general symptoms that may arise.
F o u n d . — Bronze Medallion, B.R.C.S. Blood Transfu sion Service, engraved Awarded to W. S. J. Webber for 10 Transfusions. Owner can have same on applying to Supt., No. 2 Depot, Leyton C.D., Hainault Road, E .ll,
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W a l t h a m H o l y C r o s s C iv il S e rvice . T he W a l th am
M ethod of P lacin g U nder a C a su a lt y .
D efen ce
a
B lanket
object attained by the Waltham method of placing a blanket under a casualty lying on the ground is the provision of immediate anti-shock treatment with the absolute mini mum of movement of the casualty (it being unnecessary to raise any part of a casualty’s body more than one inch from the ground), It also provides for a blanket lift in serious cases without aggravating injuries. The casualty can be wrapped in a blanket in 15 seconds. Procedure :—
The
W h e n C a s u a l t y is o n
B ack.
1 . A blanket is laid flat on the ground lengthwise
beside the casualty, i.e., the blanket hems at the head and feet. 2 . Two attendants, one on each side of the blanket and facing the same hem, take hold of the blanket with both hands at point 18 in. from the hem, their outer hands taking the edge of the blanket and their inner hands some 12 in. in from the edge, both pairs of hands making a fold across the width of the blanket by lifting it slightly from the ground. The blanket is then rolled towards the hem, both attendants retreating towards the middle of the blanket, until only 2 in. of the hem end of the blanket remains outside the roll. This procedure should be repeated at the other end of the blanket. 3 . The first attendant then brings the rolled blanket towards the casualty so that the lines of the rolls is at right angles to the body, with one roll towards the natural hollow in the small of the back, and the other roll towards the natural hollow under the buttocks and remains kneeling at the casualty’s side, facing the hips, holding one roll of the blanket in each hand. The second attendant then straddles the casualty, facing the casualty’s head so that his one foot is close to the thigh, jut below the hip, and the other close to the casualty’s body a little higher than the waist. He then places his hands well under the casualty, his left hand next his left foot and his right hand next right foot. In lifting the casualty he must apply a straight lift, raising the casualty’s buttocks not more than 1 in. from the ground. The first attendant then pushes the rolls of the blanket halfway under the casualty and, going round the casualty’s feet to the other side, again taking hold of the rolls of the blanket, draws it through so that the middle of the blanket is under the casualty. The second attendant then gently lowers the casualty on to the blanket. 4 . Both attendants then position themselves at the level of the casualty’s head, facing the casualty’s feet, kneeling on their inside knees with their inside hands steadying the casualty’s shoulders and, with their outside hands, take hold of the hem protruding from the rolled blanket as close as possible to the body. Both attendants then pull the hem towards themselves, the blanket unrolling as they do so, until it is quite flat under the casualty’s back and puckered under the neck. 5 . The first attendant then lifts and supports the casualty’s head with both hands about 1 in. from the ground, whilst the second attendant draws the blanket under the head and out until taut. 6. This procedure is repeated with the lower roll, puck ering the blanket under the hollow of the ankles, steadying the feet and drawing the blanket taut. W h e n C a s u a l t y is o n S id e .
1.
The blanket is laid flat on the ground lengthwise beside the casualty, at his back. Each attendant takes hold
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of a hem IS in. from one edge, and they make one length wise roll in the same way as for the breadthwise roll. 2 . They then place the roll of the blanket as close as possible to the back of the body and very gently roll the casualty on to his back. This will expose the protruding edge of the rolled blanket, which should be gently drawn out until taut. The casualty is then lying face-upwards on the middle of the blanket. 3 . In the case of a smashed jaw, or other injuries which prevent the casualty being placed on his back, the lengthwise roll of the blanket should be placed close to the front of his body, and he should then be gently rolled face-downwards, when a comfortable blanket lift will be possible.
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S t e e l,
Peech & T o z e r S e r v ic e s .
F irs t
A id
We have received the following from Mr. Gyril T. Gregory of Rotherham, First Aid Organiser, Steel, Peech & Tozer :— “ I am enclosing details of two of our training schemes which we have used very successfully at Steel, Peech & Tozer, The Ickles, Sheffield, for our works first aid services. “ No. 1 consists of a question to which the answer is yes or no, and 5 seconds are allowed to answer. “ No. 2 . On occasions the class is thrown open to any member who cares to act as instructor or lecturer for the hour ; all agree to obey his instructions for 45 minutes, this W h e n C a s u a l t y is F a c e -d o w n w a r d s . includes myself, then for the remaining 15 minutes the class 1. If the injuries allow, turn the casualty on to his side is allowed to criticise or praise his methods, with myself act ing as chairman. In this way a potential No. 1 may be and proceed accordingly. discovered, while it gives confidence to the others. If the injuries will not permit of the casualty being turned, the Waltham method cannot be used, and the “ Several more have been used with success and I hope casualty will therefore be immediately lifted on to a these two will serve some useful purpose for the benefit of blanketed stretcher by some other approved method. others. Publicity ought to be given to more schemes how ever small, because some first aider, somewhere, will find it (The above method of blanketing has been devised by new and interesting.” the Officers and personnel of the Waltham Cross Civil Defence Service.) T r a i n i n g S c h e m e No. 1 .— Yes or No (5 seconds allowed). Page. 15
London
and N o rth R a il w a y .
Ea ste rn .
The continued keen interest shown by L.N.E.R. Scottish employees in the first-aid movement under the auspices of the St. Andrew’s Ambulance Association is indicated by the number of awards made in 1 9 4 3 . The results achieved are regarded as most encouraging, since all the training under taken is voluntarily carried out by the staff in their leisure time, which in these days, is considerably curtailed by additional working hours and time given up to other services in the war effort. The number of the various awards made were as follows : Bar to L.N.E.R. Long Service Gold Medal (35 years) 2 , (30 years) 4 , (25 years) 1 , (20 years) 12 ; L.N.E.R. Long Service Gold Medal, 15 ; S. A. A. A. re-examination voucher or section efficiency test qualification (3 years and over), 858 ; S. A. A. A. Medallion (2 years), 45 ; S. A. A. A. Certificate (1 year), 6 1 . In addition, a large number of proficiency awards were gained by non-railway employees, to whom the railway com pany were able to extend facilities for attending the classes.
23 25 29 31 31 33 -34 34 36 43 44 45 47 214 15 191 165 124
I p s w i c h . — Awards won by Ipswich members of the L.N.E.R. Ambulance Division were presented at the County Hotel, Ipswich, by Dr. H. McEwan. Mr. Maude, Goods Agent, presided, supported by Mr. Coops, First Officer, and Messrs. F. Spalding and W. H. Brown, joint secretaries. Several members of the East Suffolk Police last season attended lectures and practises. The awards were :— Nine First Aid Certificates, 5 Vouchers, 22 Labels. Special awards for 35 years’ service, 11 . During the evening a programme was presented by the Celebrities’ Concert Party.’
Publishers Note.—Will readers please note that all back numbers of “ First Aid ” are now out of print and cannot be supplied. Will South African and other Colonial readers please add to their remittances, “ or English equivalent."
161
Question. Does the redressing of wounds come under the head ing of first aid ? Should severe bleeding receive the first attention in all cases ? Is ammonia a stimulant ? Are there 32 bones in the spine ? Are the floating ribs attached to anything ? Has a person 14 true ribs ? Has a normal person 52 phalanges ? Is the pelvis composed of 11 bones? Does the femur compose two different kinds of joints ? Is the fibula part of the knee joint ? Is shock always present after an accident ? Is a red face a sign of shock ? Is the treatment of shock different for a woman ? Would you cover a cold compress with cotton wool and bandage ? With a loaded stretcher, is the correct order “ March ” ? When a first aider has handed over to a doctor should he go away ? Should you use a feather bed in case of nursing accidents at home ? Is this correct ? (Fainting is a sudden depression of the nervous system). When applying pressure on femoral artery, do you press on to the femur ? Is it advisable to leave an hysterical girl alone ?
R e v ie w s . T reatm en t a n d R e m e d ie s Jo r P o iso n in g . By A. E. Hawkins. London : The Fountain Press. P r ic e gd. This is a useful chart which has been compiled by a Divi sional Supt. of the St. John Ambulance Brigade, and which shows at a glance the signs and symptoms and the treatment of 30 different poisons, all arranged in alpha betical sequence. It is well prepared and printed ; and it can be pinned to the wall for handy and quick reference. The one mistake which we have noted is the statement that in cases of prussic acid poisoning artificial respiration must be carried out at the rate of 20 movements to the minute.
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R I D
Queries and Answers to Correspondents Queries will be dealt with under the following rules :— 1 .— Letters containing Queries must be marked on the top
has been proved in the Regular Army that a very high percentage of casualties are caused by individual careless ness, especially habit forming tendencies, which are quite easily observed by the enemy. Cigarette smoke pall over latrines, for instance, can be easily spotted. Failure to move around with minimum exposure also accounts for man}' casualties. The Home Guard, with less training, despite their relatively high efficiency, might easily fail victims to such circumstances, and it is even more essential for the medical service to use meticulous care. Remember, you are not a large or easily replaced unit, and the lives of your comrades may easily depend on your initial treatment. Hence, battlecraft should be an essential part of your training. Those of you who have trained for the proficiency badge will easily understand its value. And what of the wounded man ? He also has his duty, if conscious, both to himself and to his unit. He should know how to apply his field dressing properly and stop bleeding as much as pos sible, if this is practicable. If he cannot walk, he should try and attract attention without being conspicuous to the enemy. For this reason, and also because he must guard against loss of blood and shock, he must make no un necessary movement. All ranks of the H.G. should have elementary first aid training, and senior N.C.O.’s of the Medical Section, where an M.O. is not available, should try and arrange with the C. O. for this to be given. The system of treatment and evacuation of casualties in most areas for the H.G. is as follows :— When a man is wounded he should receive first aid treatment from himself or his comrades if the unit stretcher bearers are not immediately available. These will take over, give any further skilled treatment where necessary, and transport him back to the C.C.P., where the M.O. will probably take control. The casualty will then be removed as soon as possible to hospital by the Civil Defence or by other local arrangements. As obviously circumstances may delay this evacuation, the medical unit should make abso lutely sure that their C.C .P.’s are suitable for harbouring the wounded for some considerable time, if necessary— means of keeping the patient warm ; hot water available ; good shelter ; cleanliness, etc. It
C. W. Spreadbury (Sergt.), School House, Noel-road, W . 3 . Every week more than Z/1 ,0 0 0 is collected in Liverpool for the Red Cross Penny-a-Week Fund, the money being contributed by industrial workers and householders.
Classified A dvertisem ents. Advertisements with remittance should be sent to First Aid, 46, Cannon Street, London, E.C 4. 3d. per word, minimum 4s. Q A A Concert Tickets 5 /6 . Memos, Rubber Stamps, Roll ZUU Tickets, Samples— “ A ” T i c e s , 11 , Oaklands Grove, London, W. 1 2 .
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IR ST AID COM PETITIONS are won by good coach ing. Any First Aider (either sex) may coach any ambitious team— male, female, or mixed— to early success. Competition experience not necessary with new Guide (adaptable to any text-book). For particulars, send stamped envelope to:— R. Jeffery, 5 , Avenue Gardens, London. W .3
left-hand corner of the envelope “ Query,’’ and addressed to F i r s t A i d , 4 6 , Cannon-street, London, E.C. 4 . 2 .— All Queries must be written on one side of paper only. 3 .— All Queries must be accompanied by a “ Query Coupon ”
cut from the current issue of the Journal, or, in case of Queries from abroad, from a recent issue. 4 .— The Textbook to which reference may be made in this column is the 3 9 th (1 9 3 7 ) Edition of the S.J.A.A. Manual of First Aid to the Injured.
Treatment of Fractures. T. H. (Darlington).— In your reply to the query which was published in the November issue of F i r s t A i d , you stated that you did not know any instructions which tell us to place bandages directly over fractures. May I, there fore, remind you of the article which appeared in the June 1941 issue of F i r s t A i d and which was written by Dr. D. S. Todd-White. In it he suggests that with a fractured femur a broad bandage may be placed round both thighs. Will you please give a ruling on this point as I have been interested in the Query Columns for many years ? There is a difference between instructions and sugges tions. Of course, it is known and understandable that under air-raid conditions splints may not be available in all cases and that some modification of the instructions of the Text book have to be made, as in the instance which you quote. In ordinary first aid work, however, your actions must be governed by the Textbook.— N. C o r b e t F l e t c h e r . Examination Howler. H.H. (West Riding).— The amusing howler which you related in the December issue of F i r s t A i d reminds me of one which was perpetrated at a recent examination and also concerned the carotid artery. In this instance the examiner asked a candidate what he would do if he could not control bleeding from the carotid artery by digital pressure. The latter promptly replied to the amusement of all within hearing — “ I w o u ld at once com press the su b cla v ia n a ite ry ! ” Good !
Next, please ! !— N.C.F.
Stretcher Bearers and Fire Guard. J.M. (Keighley).— I wonder if you could answer this question for me on behalf of members of our Division of S.J.A.B. A number of us are registered as voluntary stretcher bearers at the local hospitals and have a rota of duty for emergency at the hospital. We go on duty one night from 9 p.m. until 6 .3 0 a.m. the following morning, every fourteen days. This arrangement has stood from August 1940 until to-day. Now the local Fire Guard Officer says that we must undertake fire guard duties. We are on call for sirens or emergency convoy work any day or night. Brigade Regulations exempt us from Home Guard and Civil Defence duties if we are registered Stretcher Bearers.. So are we exempt from fire guard duties ? We want to help the hospital all we can, but if we have to be fire guards every day, will we be able to serve two masters ? I wonder if you could oblige us with an answer. I am a regular reader of F i r s t A i d and realize that this is not a first aid but a Brigade question. By law, voluntary work must amount to 48 hours each month, and it would appear from your letter that you are
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only doing 19 hours. If, however, the hospital authorities see fit to give you a note certifying that, apart from the time spent in the hospital on rota, you are also available for emergency duty, this may alter the position of affairs. Further, the Minister of Home Security has recently decreed that volunteers should not be asked to remain at their posts provided that they are within easy call should the need arise. — E d ito r.
Treatment of Fractured Patella. D.H. (Southbourne).-— In the treatment of a fractured patella I shall be obliged if you will tell me (1) what height the foot should be from the ground and (2) what amount of padding should be placed between the heel and the splint. (1 ) The reason for the elevation of the foot from the ground is to relax the muscles on the front of the thigh and so to prevent traction on the upper fragment of the fractured patella. Consequently the exact number of inches does not matter, though the Textbook suggests “ pillow, roll of clothing, &c.,” which amounts in practice to 10 or 12 inches. (2 ) The padding should be just sufficient to raise the heel off the splint and will vary with the development of the patient. Incidentally I have never yet seen this done in examinations for Association awards, the heel being invariably left in contact with the splint !— N.C.F. Status of Ambulance Attendant. H.H. (Wallington).— I will be much obliged if you can give a definite ruling on the following queries :— (1 ) Who takes, and is responsible, for the casualty sheet in the case of a Civil Defence Ambulance ? (2 ) Under what authority should the driver enter the details and take charge of the sheet ? (3 ) What is the priority status re attendant and driver of a Civil Defence Ambulance ? It is not possible to give definite rulings on your three points as circumstances vary in different areas. The questions refer to matters which fall within the jurisdiction of (and will be determined by) the Station Ambulance Officer. Further, there is no official priority status for either driver or attendant. — E d ito r.
Fractured Clavicles and Crushed Hand. E.A. (Bath).— In a recent examination I had to put up fractures of both clavicles and a crushed hand. I attended to the clavicles first, while the patient was made to support the crushed hand. I passed a narrow fold bandage beneath the armpits, round each shoulder, without pads under the arms, tying ends off across the back, with a pad beneath knots. Next, I treated the crushed hand as stated in Textbook. Then I tied the arms round the trunk with 3 . broad fold bandages. We have discussed this at our practice classes and would be very glad if you would tell us the correct treat ment. Some say that a sling should have been used, with both hands placed in it and the knot tied at the back of the neck. Also should the crushed hand have been treated first? Thank you for the great help we have received from your query column. With this combination of injuries the fractured clavicles are the more serious injuries and demand preferential treat ment. So you were quite right in leaving the crushed hand until the clavicles had been controlled. Incidentally, those who suggested the use of a sling were guilty of meddlesome first aid, since they forgot that the sling would press on the broken clavicles. Your suggested treatment would probably have resulted in the prevention of aggravation of the injuries, but I think that it was rather cumbersome and I do not like the knot being tied “ across the back.” Indeed, I consider that better results would have been obtained if you had adopted the
A I D
treatment which used to figure in the Textbook and which I have several times in the last year or two described in this column, the last being in the December issue of F i r s t A i d . In short, you should keep both shoulders back by narrow bandages tied round each arm (close to the shoulder), passed across the back, over the opposite arm and tied together in front. This done you should treat the crushed hand as laid down in Textbook, and then you should undo the knot which you have just tied, raise the forearms, support them by the two bandages and finally retie the knot. Thereby, I think that you would complete a neat and efficient piece of first aid. — N.C.F. Asphyxia and Crushed Ribs. C . S . (Bromley).— After a recent A.R.P. Exercise a con troversy arose as to the correct method of artificial respiration which should be used on a patient with crushed ribs. I would very much appreciate your advice on this subject. With this combination, Schafer is the correct method of artificial respiration because pressure is exerted on the Joins and involves no risk of further aggravation of the injured ribs.— N.C.F. Causation of Collapse. J.L. (Cymmer).— We have often been informed by our Lecturer that “ Collapse is caused by the dehydration of the body, or, in other words, by the loss of the body’s fluids.” In the official Textbook we find collapse referred to in different ways on pp. 4 2 , 1 5 2 , 1 6 8 , 170 and 174 . In the handbook Com m on E r r o r s in F i r s t A id , it is stated on page 45 that “ Collapse is one of the ? degrees of depression of the nervous system which accompany injury and disease.” All this leaves us rather mystified as to the real nature of collapse, for assuming that our Lecturer’s definition is correct we would like to know how collapse can occur without any apparent loss of the body’s fluids. We await your answer with interest. Dehydration does not necessarily mean a loss of fluid from the body although it can occur in consequence of pro fuse perspiration or excessive diarrhoea. What often happens in Collapse is that the blood stagnates within the body and is not circulating through the body. To me, therefore, de hydration is rather a symptom than the cause of Collapse. In these circumstances it may occur as the result of severe haemorrhage, grave physical injuries or an upset of brain or nervous system, e.g., effects of poison.— N.C.F. Effects of Sodium. R.M. (Cambridge).— Here is a first aid problem which I hope you will be able to solve for a friend of mine who works in a chemical works— the problem of burns with sodium. It is a metal that burns to make caustic soda ; if water is put on the burn it fizzes and makes caustic even fiercer. This is very dangerous if allowed to get in contact with the eyes. I would be very much obliged if you could give me some information on this subject. You do not say on what point you want information. It is quite correct that sodium has a burning effect on the skin consequent on its caustic properties. Should this occur then the immediate treatment is the application of a dilute acid solution, e.g., vinegar and water.— N . C . F . Successful Artificial Respiration. A. B. (Bedford).— I shall be grateful if you will please answer the following two queries which 1 was asked at a class and which I could not answer :— (1 ) What is the longest known period of time artificial respiration has been performed to end in success? (2 ) How long can the human body be left under water to stand any chance of recovery by means of artificial respiration ?
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While I also cannot answer your queries authoritatively, 1 know (1) that in treatment of cases of asphyxia due to electric shock the rescuers are advised to persevere with artificial respiration for the minimum period of four hours ; and (2) that victims have been restored to life after sub mersion for ten and even fifteen minutes.— N.C.F. Compound Fracture of Skull. F.H. (Dorking).— At a recent Practice the question arose as to whether a dressing should be applied first to a wound of fractured skull before adding a ring pad, or some lint and cotton wool be placed inside the ring pad, after putting this into position. Your kindly advice will be very much appreciated. All wounds must, as you know, be protected against in fection at the earliest opportunity. When treating a com pound fracture of skull, therefore, I would paint wound with antiseptic, apply clean dry dressing and then fix the ring pad in position.— N.C.F. The Future of the Brigade. P.M. (Harrogate). — With reference to the query answered under the above heading in the November issue of F i r s t A i d , 1 would like to point out that the St. John badge worn on C . D. uniform is usually an Association and not a Brigade badge. Further, while I agree that there are good and bad in every organisation, I would also point out that Brigade members must retain a high standard of efficiency by passing an annual re-examination. On the other hand, many Association members are content with one certificate which lasts for all time. We thank you for your letter and for pointing out that (as we are well aware) the Brigade does make every effort to maintain the knowledge and efficiency of its members.— E d ito r .
Multiple^Injuries and Transport. W.W. (Darlington).— At a recent competition the patient was supposed to be suffering from fracture of cervical vertebrae, fracture of pelvis with injury to bladder and also from concussion which quickly changed to com pression of the brain. The judge, a layman, gave marks for raising the head of the stretcher while being marched a distance of twenty yards to the ambulance. Please tell me if this would aggravate the fractures or not. The raising of head of stretcher in this instance would not have any harmful effect on the fractures ; and your query is a repetition in another form of the problem with which I dealt in the November issue of F i r s t A i d under the heading R a is in g o f F ra c tu re d L eg . Further, if, as I suspect, the judge was seeking to treat the compression of brain, very little benefit would result by raising the head of the stretcher for such a short distance. It would, however, be grossly unfair to criticise on this score the decision of the judge.— N.C.F. Performance of Schafer’s Method. B.C. (Marlborough).— With reference to the query which you answered under the above heading in the November issue of F i r s t A i d the Royal Life Saving Society in its Artificial Respiration Drill, instructs its members to place the patient’s head on the left cheek. This is done for uniformity of class work so that, when turning the patient into the supine position for promotion of circula tion, the head would be in the most suitable position. You will, 1 know, agree that if the patient s head is facing towards the operator when he turns the patient, there may be danger of injury to the patient’s neck. While I agree that, if patient is to be turned on to his back from the left side, the placing of his head upon his left cheek will facilitate the movement, I must emphatically dis
A l t )
agree that, when the right cheek is on the ground, any serious damage would result to the patient’s neck ! Certainly the most careless operator would not succeed in breaking the patient’s neck as was said to have been stated in the previous query. To me the instruction to protect patient’s head and face during the turning on to his back really means that, unless this is done, the patient may sustain wounds of scajp or face, and further, that his nose and mouth may come in contact with the ground which might aggravate matters in the presence of sand or mud.— N.C.F. Complicated Fracture of Clavicle. H.W. (Bulwell).— In the case of a complicated fracture of clavicle piercing the subclavian artery and causing arterial haemorrhage beneath the skin, would the result ing escape of blood gain entrance to the chest cavity ? If so please tell me what would be the result and the possible first aid treatment. Complicated fracture of clavicle involving the subclavian artery is a very rare accident. Should it occur, a small quantity of blood might find its way into the chest cavity but none into the lung tissues. Since the inner end of the broken clavicle is drawn upwards by the neck muscles, pressing the torn artery on to the first rib can still be maintained, and the pressure must be maintained until patient has been removed to hospital.— N.C.F. Pain in Insensibility. H.W. (Bulwell).— Can an unconscious person feel pain? Also would pain cause an unconscious person to return to consciousness ? Your kind replies to my two queries will be much appreciated. Insensibility indicates a condition in which the functions of the brain are in abeyance. It follows, therefore, that an unconscious person cannot feel pain and that he would not be restored to consciousness by the pain.— N.C.F. Effects of Cyanide of Potassium. F.G. (Ossett).— At a recent Divisional Practice we had an interesting discussion on poisoning by Cyanide of Potassium. Some members said that the poison killed the white cells of the blood first but others said that the red cells were killed first. As a regular reader of F i r s t A i d I await your ruling on this point. Cyanide of Potassium has an immediate effect on the brain centres especially those which control the circulatory and respiratory systems, the result being that with fatal doses the victim will die forthwith. Consequently the suggestions made in your letter are not correct.— N.C.F. Temperature of Blood. F.G. (Ossett).— Please tell me which registers the higher temperature, the blood in the arteries or that in the veins. As far as 4 know, the temperature is the same.— N.C.F.
N o t e . — Owing to the large number of queries received, and our limited space, a number have unavoidably been held over. These will be published in due course.— E d i t o r .
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E
■THE Male Atlas is th e com plem ent o f th e Female Atlas. It is com p lete itself, but only deals w ith th e male body. T h ere are 8 plates, 89 illustrations, and 876 distin ct parts show n in this A tlas. It is e x tre m e ly accurate, and th e c o lo u r plates are excep tion ally clear.
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One or other or all of the three races of germs, Streptococci, Staphylococci and B. pyocyaneus are found in every skin infection common to this country, and ANTIPEOL OINTMENT contains the antibodies (antivirus) of these germs. Healing is expedited by the proved ingredients of the ointment, and septic development is stopped or prevented by its antivirus sterile vaccine filtrates. ANTIPEOL OINTMENT is unsurpassed for BURNS and SCALDS, for it is microbicide and non-adhesive, and dressings do not require to be changed every day. WOUNDS, BURNS, etc., WILL NOT TURN SEPTIC if treated with ANTIPEOL OINTMENT.
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CONTENTS d it o r ia l
OF
THIS
NUMBER.
—
First Aid in Extremis
85
86
Load Stretcher by Two Bearers ... Nigeria’s Gift to Red Cross and St. John...
86
S.J.A.B. Headquarters and District Reports
87
Police Ambulance News
89
Great Western Railway
89
The Home Guard and First Aid The Mauve Indelible Copying Pencil
90
Q u e r ie s
and
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C o rre sp o n d e n ts
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TH REEPENCE
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Its aim and ob ject b ein g the advan cem en t o f A m b ulan ce W ork in a ll its branches, the E d ito r in vites R eaders to send A rticle s and Reports on subjects pertaining to the M ovem en t and also w elcom es suggestions for Practical Papers.
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E
F.R.San.L,
90 :—
92
Boracic Lint Examination Howler Treatment of Fractures
92
Cigar Ash in Beer...
94
Compound Fracture of Ribs
94
Stertorous Breathing Simple Fractures of Both Legs Shock from Abdominal Injury
94
92
94 94
Air Exchange in Artificial Respiration
94
Treatment of Crush Injuries
94
Mystery of Lay Instructor Certificate
94
Effects of Drowning Definition of “ F it”
96
B.R.C.S. Certificate
96
Control of Carotid Artery
96
96
Lay Instructor
96
Treatment of Fractured Leg
96
N o t h in g has more astonished the male portion of the population than the w ay in w hich the women have adapted them selves to war needs and conditions. A s has been said, we are all engineers now, and the tim e when the women regarded their husbands as individuals especially hefty and pow erful— b ein g convinced on their arrivin g home that they had at least assem bled a couple of steam rollers and a locom otive durin g the d a y — has lo n g since passed, never to return. W o r k of every kind, in factory and w orkshop, is bein g undertaken b y the wom en, w ho have in num berless cases proved the absolute eq u ality of the sexes." B u t there is more than that. In tim es of stress and d an ger— when the stoutest heart m ay becom e appalled— the women have com e to the scratch in a m anner which calls for universal adm iration, and we feel that a special tribute must be paid to the nurse w ho went, in the dead of a dark nigh t, to the rescue of the crew of an A m erican bom ber w hich crashed over a v illa g e in the H om e Counties. S h e is, we are informed, a M rs. D a ly , a 2 4 -years old secretary w hose husband is se rvin g in the arm y overseas. S h e joined the R ed Cross in 1 9 3 9 . A t the sound o f the crash she grabbed her first-aid kit and scram bled in the dark throu gh woods and tan gled undergrow th to the plane. T h e re she worked for two hours before the doctor and am bulances arrived. S h e found the airmen ly in g near their plane, w hich was turned on its side and blazin g. O ne of them had a com pound frac ture of the leg, and was in great a g o n y . S k ilfu lly Mrs. D a ly applied a tourniquet and splints. T h en she w as ordered to m ove aw ay as am m unition in the plane was expected to explode. W ith the help of soldiers she transferred the men to an im provised stretcher and continued her first aid, in the course of w hich she applied a splin t to a broken arm and dressed a w ounded shoulder, broken ribs and a badly cut face. A t the conclusion of this m agn i ficent w ork the am bulance arrived and the men were removed to hospital where, we note with satisfaction, all are m ak in g good progress. H ow differently matters w ould have turned out had it not been for her prom pt action, and for the train F i r s t A i d in E x tr e m is .
86
Fjl R S T
in g she had received in first aid. T h is is, of course, o n ly one instance of the work w hich women are perform ing in all parts of the country, and we cite it as a strik in g exam ple of coolness in the face of danger, of skill, and of entire disregard of self in the performance of an act w hich has well been defined as one of extrem e ga llan try. Mrs. D a ly w ill possibly receive some decoration for w hat she did on that dark w inter’s n igh t, but her best reward will be in the know ledge of the lives she saved and the noble manner in w hich she placed the calls of h um anity before every other consideration. H ero ism is certain ly not the attribute of one sex only.
Load
S t r e t c h e r by T w o
B ea re rs.
W e have received permission from the Editor of the B r it is h M e d ic a l J o u r n a l to publish the following letter from Dr. Bowman Edgar, which appeared in the B . M . J . for Decem ber 2 5 th, 1 9 4 3 . S ir,—
The following method of loading stretcher when only two bearers are available is suggested as an improvement on the present, generally accepted, R.A.M.C. mode of pro cedure. The modern trend of first aid is towards simplicity, ease of performance, and economy in personnel—-i.e., two bearers per stretcher. The method described renders the task of loading a heavy patient quite an easy matter for two light bearers. B la n kets : Prepare stretcher with two blankets in the usual manner. Blanket No. 1 lies across the stretcher ; No. 2 , folded in three, lies downwards from shoulders to feet. The lower ends of No. 2 are opened out to provide
folded over on itself till its edge lies over the left pole. Arrange the right side of the blanket in similar fashion (Fig. 2 ). The free edge, which protrudes from the middle of these folds, are the “ trigger edges,” for on these being pulled, the whole blanket flattens out. T o Load. 1 . Carefully turn patient on to his side and raise arms above shoulders. Place prepared stretcher along side patient’s back. 2 . Raise stretcher to the perpendicular against his back. (Pressure between pressure and back keeps the lower blanket folds in position.) 3 . Bearers stand behind stretcher, holding upper blanket folds against pole with outer hand to keep them in place (i.e., No. 1 bearer, at foot, uses his left hand ; No. 2 , at head, uses his right). 4 . Reaching downwards over the stretcher No. 1 grasps with his right hand the folds of the injured man’s trousers immediately above the gaiters. In similar manner No. 2 grasps the waist-belt with his left hand (Fig. 3 ). 5 . Then, h old in g the p a tie n t a g a in st the stretcher (no lifting is required), the bearers allow the latter to resume its normal position on the ground. 6. The casualty is now on the stretcher and can easily be assisted to assume his most comfortable position on the middle of No. 2 blanket. 7 . The “ trigger edges ” on each side are now pulled out, thus freeing the blanket, which can be tucked round the patient as desired. The advantages of this method of loading would appear to be :— (a ) It is extremely easy to carry out and imposes the minimum of effort on the bearers ; two light bearers can deal with a heavy man. (b) Harmful movement or disturbance of the casualty is practically n i l ; therefore there is no increase of shock. (c) As there is no carrying of the patient by bearers, the margin of safety for him is much increased.— I am, etc., B owman
E d g a r , M .B .
M.O., 4 th Battalion Dumfriesshire H.G. Kirkconnel. P. S.— Since writing the above I have tested the sug gested “ load” in the following manner:— Two recruits who had joined only a fortnight before with no knowledge of stretcher work, one weighing 9 st. 2 lb. and the other 9 st. 3 lb., were asked to load a sergeant who weighs 16 st. 7 lb. Using the above method no difficulty at all was experienced. An attempt to load by the R.A.M.C. method was distinctly a failure.
N i g e r i a ’ s G i f t t o R e d C r o s s & S t. J o h n Chief Commissioner, Southern Provinces, Nigeria (retired), formally presented to Major-General Sir John Kennedy at the Red Cross and St. John Headquarters an ambulance subscribed for by the people of Warri and Burutu. When the war is over the ambulance will be returned to Warri and Burutu for the benefit of patients there. Major-General Sir John Kennedy expressed the thanks of Red Cross and St. John to the donors, saying that the gift came at a most opportune time, when they were forming a pool of ambulances for the benefit of sick and wounded which the coming great conflict was bound to produce. S ir W illia m H u n t,
No. 2 BEARER
No.l&EAftl
later cover for the latter. Now carry the left free end of No. 1 across the stretcher and back again till it lies over, and an inch beyond, the left pole (Fig. 1 ). The folded edge, which now lies approximately over the centre of the stretcher, is
C o r r e c t i o n . — In our last issue, under Liverpool, in Headquarters and District Reports, Col. MacPhail is spoken of as Chairman of the Association in Liverpool. This should have been “ Chairman of the Trustees.” County Surgeon W. Murray Cairns is Chairman of the Association.
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S t.
Jo h n
A m b u la n c e
H EADQU ARTERS
AND
B rig a d e
D IS T R IC T
REPORTS.
N o. I (Prince o f W ales’s) District No. 163 (Wanstead and Woodford).— At the presenta tion of first aid certificates to cadets of the above Division, on Friday evening, January 2 1 st, at South Woodford Senior School, a deal of interest was given to the proceedings by the presence of a nephew of the late Nurse Cavell ; the nephew, a member of the Metropolitan Police Force, is a Serving Brother of the Order of St. John. The presentation was made by Chief Inspector Farthing of the Metropolitan Police, also a Serving Brother, who before presenting the awards, gave a very homely talk to the cadets on the usefulness of first aid and his general experiences in this direction as a Police Officer. Councillor Galbraith in thanking the Chief Inspector for his presence, wished him every success in his forthcoming work with A. M .G.O.T., and laid stress on the link between the cadet movement and the general work of the Youth Committee. No. 11 (Borough o f Wembley).— A social and dance was held at Terry’s Restaurant, Sudbury, on the occasion of the annual presentation of awards for efficiency, on January 22nd. After several musical items had been perfectly rendered, Div. Supt. W. Thompson opened the proceedings with a message of regret from Assistant Commissioner S. J. Warren that he was unable to be present. After touching on the activities of the Division during the past year, Supt. Thomp son said the Wembley Division was keeping its head well above water despite the fact that fifty members were now serving in H.M. Forces. Awards for efficiency were presented to members by Mrs. R. Tudor Edwards. The high spot of the evening was reached when Supt. Thompson remarked how pleased he was to announce that their Divisional Surgeon— Doctor R. Tudor Edwards— had been awarded the honour of Serving Brother of the Order, and this certificate of appointment was duly presented to the Doctor by Lady Supt. Miss M. E. Duligall. Supt. Thomp son then said that in the absence of Assistant Commissioner Warren, he also had the honour of asking the Doctor to accept the long service certificate, awarded for fifteen years service as Divisional Surgeon. Doctor Tudor Edwards in a well chosen speech said how pleased he was to give his service to No. 11 , despite the claims of doctors in war time. Dancing and social good fellowship took up the re mainder of a thoroughly enjoyable evening. No. 175 (Teddington).— The first annual general meet ing of this Division, which was attended by the Assistant Commissioner, Mr. Sydney J. Warren, was held on Monday, January 2 4 th, at their Headquarters, the British Legion, Teddington. The Secretary’s Report revealed that although 4 members were on active service, and the majority of the remainder were on part-time civil defence work, they had performed 542 public duties, and had a total of 450 drill attendances to their credit. The Treasurer stated that although the year had not been a full one (the Division was not inaugurated until June 2 4 th, 1 9 4 3 ), it had been financially successful. The Ambulance Officer-in-Charge, Mr. C. G. Bowden, welcomed the visitors, especially Mr. Warren who had twice within the past six months inade the long tedious journey in the black-out to be with the Division. He thanked all those
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who had helped the Division, and offered the congratulations and best wishes of the members to the newly-formed 148 (Teddington) Nursing Division, many of ■whom were present, and spoke of the cordial relations existing between these two Divisions. Mr. Warren said he was delighted to be present at the first annual general meeting. As a new Division, he thought it right to remember their previous experience as a Section of the 84 (Twickenham) Division, and he wished to thank the Acting Supt. of that Division, Mr. G. Ewer, for the way he helped in putting the new Division on its feet. He was delighted to hear that the two Divisions had settled the question of their boundaries and other problems amicably. Mr. Ewer said he welcomed the opportunity of giving his public blessing to the new Division. Mrs. D. A. Jackson, Lady Ambulance Officer-in-Charge of the Teddington Nursing Division, thanked Mr. Bowden for the kindly reference to her Division and spoke of her confidence that the two Divisions would work well together. Mr. Warren presented service chevrons to Privates Bartholemew, Gibbs, Slack and Spalding ; re-examination awards to members of the Division, and preliminary first aid certificates to a number of cadets.
C/N 54 a t t a c h e d t o N. 16 ( H a m p s t e a d ) N u r s i n g — On January 2 9 th the Hon. Mrs. Copland-Griffiths (Lady Supt.-in-Chief, Overseas) gave a stimulating address on Brigade work Overseas, to Officers, Ambulance and Nursing Cadets of Northern area, who were invited by the Officers and Cadets of the above Division. They were informed that membership Overseas was 7 5 ,0 0 0 , and that Cadet Divisions were first started in India in 1925 which included every race, colour and creed, dealing chiefly with casualties caused through riots, floods, bites from crocodiles, dogs and snakes. In Burma 2 Divisions are flourishing and when Japan attacked the Burmese, the Rangoon members attempted to cross the mountains into India, and by helping other refugees kept up the Brigade traditions of service and courage ; un fortunately they have not been heard of since. In sparsely populated Australia the first Grand Prior Badge was awarded in 1 9 3 3 . The chief duties of Australian members include fighting forest fires, treating shark bites, controlling and policing life-saving squads, and helping the flying doctors and nurses who tend the sick in remote places which may be as far away as 6 0 0 miles from the nearest hospital. In New Zealand the proportion of the Brigade is 6 to the thousand, as against 4 over here. This small Colony is very Brigade minded, and has won 350 Grand Prior Badges. Adult Divisions have been formed in all universities, and Cadets in schools. Transvaal has the largest membership, and 11 Military hospitals staffed and financed by the Brigade. When war was declared the Brigade in South Africa was taken over by the Government. Great skill in first aid is needed to deal with people badly mauled by lions, tigers, or trampled on by elephants. One hour after Pearl Harbour was attacked, Canadian Brigade members attended to survivors from shipwrecks, and worked in shifts of 24 hours ; they also manned the Atlantic and Pacific Coasts, A.R.P. and First Aid Services. Ski-ing accidents in Quebec and Montreal are also treated by Brigade members. In Bermuda, Cyprus and Ceylon, Brigade members are also rendering efficient service. Cadets were asked to correspond with members Over seas. At the close of the address, prayers were offered for the 4 ,5 0 0 members of the S.J.A.B. thought to be in Japanese hands D iv is io n .
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A War Service Badge (fourth for the Division) was pre sented to Nursing Cadet Anna Wisla, of Hampstead. On the platform were Miss Walker L. D. Supt. No. 1 Dist. (Retired), Mr. Collins, D.O., Miss Cleasby, L. D.O. i/c Cadets N. Area, Miss Finch, L. Supt. Hampstead N. 1 6 , Miss Burley, Supt. i/c C/N 5 4 , Miss Housden, L.A.O. N. 1 6 , and Mrs. Milburn, L. Supt. Highgate. No. 84 ( T w i c k e n h a m ) . — The annual general meeting of this Division was held at York House on January 3 1 st, with President Councillor C. VV7. Beckett in the chair. The membership is now 8 2 , 41 of whom are in H.M. Forces ; 1 ,4 0 6 public duties were covered during the year, and 739 casualties attended to. Five public classes had been conducted at which 114 candidates were successful in obtain ing certificates. Ambulance Officer Mr. Chandler (Whitton Section) had conducted three resuscitation classes, and eight members had obtained badges. The Treasurer reported a balance at Dec. 3 1 st, of ^ /9 8 13 s. Id. plus £ 5 5 s. 9 d. money in hand. Mr. S. J. Warren congratulated the Division on their hard work, and the formation of the Teddington Division, making special mention of the efforts of Divisional Supt. G. Ewer, complimenting him on his promotion. A / O Mr. Chandler gave a favourable report on the Whitton Section, as did Cadet Officer A. F. Cook of the Cadet Section. After presentation of annual awards by Mr. Warren, a successful meeting closed with refreshments. County o f Berkshire. The Hon. Mrs. Leslie Gamage was appointed Lady County Supt. in August, 1 9 4 3 . This was not made clear in our notice which appeared in the issue of January, 1 9 4 4 . R e a d i n g . — The Nursing and Ambulance Cadets of the Reading Corps were given a party on December 2 7 th, through the kindness ot Mr. and Mrs. Prew and the Com mittee of the Greyfriars Fire Guards. A very enjoyable afternoon was spent, with games and competitions arranged by the Officers. The County Com missioner, Mr. C. A. Poole, M.A., and Lady County Cadet Officer Mrs. Poole, paid a short visit during the afternoon, and thanked Mr. and Mrs. Prew and Committee for all they had done to make the party such a success. The afternoon ended with all sitting down to tea.
O b i t u a r y . — We regret to announce the death of Amb. Officer Francis H. Webb of the Great Western Division, Reading Corps. He took his first aid certificate in April, 1 9 2 0 , and joined the Brigade on June 3 0 th of the same year. He was promoted to Corporal in 1927 ; Sergeant in 1 9 3 3 . He was awarded his long service medal in 1 936 , and owing to his great love of and interest in cadets, he was appointed Cadet Supt. in 1 9 3 9 . He was also further promoted to Ambulance Officer in 1 9 4 3 . The funeral took place on Thursday, January' 13 th, at the Henley' Road Crematorium, Caversham, Reading. County Officer F. A. C. Jarvis represented the County Com missioner who was unable to attend, and a Guard of Honour was formed by Officers and members of the Reading Corps and Cadets.
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Dr. John Williams the Corps Surgeon-Supt. set the test and the adjudicator was Dr. L. A. Gillet. One of the Moreton teams was successful with 164 points out of a possible 2 0 0 , a Wallasey team being next with 144 . The winning team distinguished itself by completing the test in 8 minutes, the time allowed being 20 minutes. Supt. W. E. Lewis of Moreton Ambulance Division had promised that if a Moreton team should win, he would buy each boy a medal, and both medals and trophy were presented on Tuesday evening, January 2 5 th, at Moreton Divisional Headquarters, by Dr. John Williams. Tne function was well attended, among those present being County Officer R. E. Anthony, Dr. Gillet, Corps Officers Gorst and Carr. Unfortunately Supt. W. E. Lewis was unable to attend owing to illness, and his place was taken by A/O E. Rowlands who acted as host. The cadets who were responsible for placing the first name-plate on the trophy are as follows : Cpl. T. Mercer (leader), Cpl. R. Heslin, and cadets G. Harding and L. Cooke. County o f Hampshire. B a s i n g s t o k e . — The annual general meeting was held on January 4 th, with Div. Supt. S. Wilde in the chair, assisted by County Officer N. R. Turnbull. Also present were Rev. B. S. Lombard, Vice President, and Amb. Officer L. P. Botting, Div. Secretary', and 45 members of the Division. During 1943 the Division’s Ambulance covered a record distance of 1 3 ,0 5 5 miles in transporting over 400 patients. Thanks were due to the Venture Bus Co. for the free use of a garage. The strength of the Division is now 82 of whom 27 are serving in the Forces ; 47 members passed their annual re-examination and 3 members passed the examina tion for Lay Lecturers. Ambulance Officer L. P. Botting was created a Serving Brother of the Order, and Div. Supt. S. Wilde awarded a Certificate of Honour. County Officer N. R. Turnbull said the Division was well on its way to the endowment of a second bed in the Malta Hospital.
H o u n d a n d N e t l e y . — Thursday, January 13 th, marked a happy occasion in the history of this Division, when twentyone Home Nursing Certificates were awarded to members of a newly-formed Nursing Division. Mrs. Clayre was pro posed President, with Mrs. Gosling as Div. Supt., Mrs. Wheeler, Secretary, and Mrs. Sanger, Treasurer, also Sister I. Ware, Vice-President. Mr. Stephen Clarke, Vice-President of the Ambulance Division, opened the meeting which was held in the Jubilee Hall, introducing Mrs. Clayre who presented the certificates and one pendant. Mr. A. Bright, Div. Supt., in his report on the y’ear’s work, said that it had been a most successful year, both for attendance and interest, the average attendance being 26 meetings per year and Divisional Exaininations passed with credit ; 105 cases had been efficiently dealt with by the Divi sion and four public duties performed. The Div. Supt. ended his report by expressing the great hopes that were placed in the young people in continuing the building up of the Division. Mrs. Gosling proposed a vote of thanks to Mrs. Clayre, which was unanimously supported.
County o f Hertford. County o f Cheshire. — The Wallasey Corps Competition for Ambulance Cadets was held recently'. Three teams from W a ll a s e y and two from Moreton Division were the con testants for the trophy which was given by Mr. Laurie of Wallasey. W
a lla s e y .
W a r e . — Lady Corps Officer Miss D. Sparkes invited t h e Ambulance Cadet Officers of the county to a meeting to form a County Ambulance Cadet Council. After unanimous agree ment, the following Officers were elected : C/Supt. T. Peitingell as President, Amb. Officer Cull, Vice-President, C/Supt. G. Henderson Smith, Secretary, C/Supt. H. Beaumont-
F I R S T
Smith, Publicity Officer, and Lady Corps Officer Miss D. Sparkes agreed to act as adviser to the Council. The main objects of this Council are to promote friendly inter divisional competition, combined county camp holidays, and the exchange of ideas and experiences for the mutual benefit of all Cadet Officers and Cadets. The Council gratefully accepted from the President the gift of a silver challenge cup for cadet competitions. The Council meetings have been well attended and quite success ful. It is believed that this Council is the first of its kind in the country. County o f Warwick. C o v e n t r y ( C e n t r a l ) . — An enjoyable time was spent b y all on the occasion of the dinner and dance held at the Masonic Hall on January 1 1 th, to present the awards to the winners of the “ Quiz” competitions which have been held weekly throughout the last eight months. The trophy, which was won by the Morris Engines Division team, was presented by the County Commissioner, Major E. S. Phillips, D.S.O., who congratulated the winners on their excellent work and efficiency. Corps Supt. L. T. March, in proposing the toast to the “ Quiz ” teams, spoke of the keenness and enthusiasm shown throughout the competition. He particularly mentioned the Rover team. The Central Corps now has over 6 0 0 members. The ambulances have moved over 1 2 ,0 0 0 patients during 1943 — 4 ,0 0 0 more than in the previous year. Great credit is reflected on the permanent and voluntary staff. Any transferred workers who are members of the Brigade, will be always made welcome if they care to contact Supt. Taylor, Ambulance Station, Swanswell Terrace, Coventry.
East R idin g o f Yorkshire. H u m b e r s id e .— A social evening arranged by the Humberside Corps S.J.A.B., was held in the Memorial Hall, Brantingham, on Saturday, January 2 9 ih, at which a large gathering of S.J.A.B. members in the Corps, and friends attended. The first step towards the extension of St. John activities in the district was made in January, 1 941 , when 7 enthusiasts signed the register, and extension has been so rapid that now there are 4 Nursing and 3 Ambulance Divisions, about 175 personnel, active and trained in the area constituting the Humberside Corps. Its activities have been many. A medical comforts depot has been established. An ambulance service for civilian sick and casualties has been opened which is proving an immense boon to the district. In the six months, during which this has been in operation, 120 cases have been transported in comfort and safety ; the work being done completely voluntarily by Divisional members and friends at any hour of the day or night. Various duties are performed regularly at Hospitals and Clinics by members. And a pro posal is on foot now for the acquisition of a house locally in Brough area as a Corps Headquarters and sick bay where minor sickness can be nursed. During Saturday evening when a whist drive, games, dancing and refreshments provided attractions for all, 7 warrants of appointment were presented also 1 fireguard instructor’s certificate, special grade. Among those who spent a most enjoyable evening were Assistant County Commissioner G. Edwards, Lady County Supt. Mrs. Edwards, and members of the County Staff.
County Officer F. R. Stent, officer in charge of the Bath City Division of the S J.A. B., has been promoted from the rank of Serving Brother to that of Officer in the Venerable Order of St. John of Jerusalem in the British Realm.
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A m b u la n c e
N e w s .
M ETROPOLITAN SPECIAL CONSTABULARY. Nine teams entered theX Division First Aid Inter-Station Competition for the cup presented by Commandant E. B. Brown, B.E.M., L D.S., R.C.S., Director of Ambulanceand A. R P. The competition which had not been held since 1 9 3 9 , was held on Sundav, January 2 3 rd, at Wealdstone, and was set and judged by Commandant Brown. Eight teams took the floor, the winners being Harlesden (Captain S. C. A. Hine) ; runners un, Harrow, followed by Pinner, Uxbridge, Greenford and Harrow Rd. who tied for fifth place, Wealdstone, Wembley. The card said “ You four are called to the assistance of a workman who has fallen through the skylight into the room below, in an empty house. Your Station is 100 yards away ; 12 minutes.” The scene showed a patient huddled on the floor in slippers, severe bleeding, wristband round left wrist. Broken glass all round ; one bystander with broom.
G re a t W e s to rn R a ilw a y . Ambulance work has continued to be steadily maintained throughout the system during the past year, and in spite of difficulties entailed by war conditions, it is encouraging to note that some Divisions show an actual increase in exam ination results over the 1941-2 figures. It is appreciated that the results in general have only been achieved by the untiring efforts and high purpose of all concerned in the welfare of the first aid movement. The number of successful candidates was 6 ,0 9 6 , a decrease of 447 on the previous year. Of these students, 381 were recruits to the movement. The Athlone Bowl, awarded to the Division gaining the highest percentage of new members in proportion to the total number of adult staff employed, has this year been won by the South Wales Docks Division with a percentage of ’9 9 . This Division was previously successful in winning the Bowl in the years 1940 and 1 9 4 1 . The runners-up (for the second year in succession) are the Plymouth Division with a per centage of "8 7 . The practical value of the first aid movement continues to be manifested in the fine work of trained men and women members of the staff who serve in connection with A. R. P. posts, casualty clearing stations and first aid posts, and assist in the instruction of classes. For exceptionally efficient first aid rendered during the year 1 9 4 2 , the following awards have been granted :— 1 Gold Medal ; 1 Silver Medal ; 1 Bronze Medal ; 11 Certificates. No fewer than 568 gold efficiency awards or certificates in lieu thereof were granted during the year, made up as under :— 15 year gold medals, 2 4 0 ; 20 year gold bars, 203 ; 25 year gold medals, 72 ; 30 year gold bars, 39 ; 35 year gold bars, 10 ; 4 0 year gold bars, 4 . In appreciation of valuable services rendered to the G.W.R. Ambulance Centre over a long period of years, the following members of the staff have received recognition from the Order of St. John of Jerusalem :— O fficer f B ro t h e r). Mr. G. H. lies, Chief Clerk, Docks Manager’s Office, Cardiff. (Divisional Secretary, South Wales Docks Division).
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S e rv in g B rothers. Mr. E. H. Lewis, Brake Examiner, Chief Mechanical Engineer’s Dept., Swindon. Mr. W. F. Burdett, Signalman, Traffic Dept., Saltney. Mr. J. Green, Oil Gas Maker, Chief Mechanical Engineer’s Dept., Exeter. Mr. F. Hatton, Goods Guard, Traffic Dept., Shrewsbury. Mr. W. J. Price, Signalman, Traffic Dept., Bala. Mr. A. E. Williams, Station Master, Traffic Dept., Gresford. Mr. W. Hookins, Passenger Guard, Traffic Dept., Penarth Town. Mr. J. A. Martin, Assistant Centre Secretary, Staff and Establishment Office, Aldermaston. V e llu m Vote of T h a n ks. Mr. F. E. Saunders, Acting Dock Foreman, Docks Dept., Swansea.
T h e H o m e G u a r d a n d F i r s t A id . D R ILL
REVISIONS.
T h is m o n t h I w a n t to d e a l w it h th e r e v is e d d rill for th e c o l l e c t i o n o f w o u n d e d , a s a d v i s e d f o r t h e s e r v i c e s in t h e fie ld .
It is realised that the original drill, as per textbooks, is not practicable under war conditions, as Medical Orderlies may have to work while exposed to fire, and must therefore take whatever cover is possible, and also get their patients under cover before attempting any but essential treatment. If, in practice, stretcher squads are taught this from the start, it will come natural should they experience the real thing. First of all, unless ordered otherwise by a superior officer, the senior N.C.O. or senior private, as the case may be, should assume the duties of No. 1 at the stretcher and should fully realise his responsibility, as the lives of his squad and his patient may depend on his initiative and efficiency. All the squad, however, should be trained to act as No. 1 . When practising collection of wounded by a squad of four (casualties having been placed), procedure is as follows :— The instructor will order “ For carriage, prepare stretcher,” which is passed on by No. 1 . This order will be followed by “ At the double, carry on 1 ” No. 1 will then order “ Follow me,” and the squad will double out and Ja il fia t just short of casualty. No. 1 will crawl forward and find out if casualty is still alive. If this is so, he will order “ No. 3 help me,” and together they will make complete ex amination of patient. At this stage, however, wounds are not dressed (unless there is dangerous bleeding). No. 1 will give order to Nos. 2 and 4 , “ Open and blanket stretcher,” which they should do while keeping as low as possible. All bearers should then take usual positions and lift patient on to stretcher. He should be transported to cover as quickly as possible and necessary wounds dressed. If any distance is to be covered, bearers should adopt the shoulder carriage. For two bearers only the procedure is similar, except that No. 1 , after ascertaining the condition of patient, will assist No. 2 to blanket stretcher. They will then lift patient on to stretcher, as illustrated on page 221 St. John’s Hand book, and No. 1 will order “ Hand carriage, lift,” followed by “ Adjust slings.” To slip the sling loops over handles, the bearers should learn to balance the stretcher handles on alternate knees. C. W.
(Sergt.), School House, Noel-road, W . 3 .
S p read b u ry
T h e M a u v e In d e l i b l e C o p y i n g By WILLIAM
P e n c il.
NORTH.
Two facts noted recently by the present writer led to a train of thought responsible for this article. The first was the case of a colleague in possession of an old-style mauve indelible copying pencil ; the second, another colleague who ran the point of a black copying pencil into the fleshy base of his thumb, the point breaking off, embedded therein. It may be mentioned that the latter case cleared up without untoward develoyments after the point had been removed ; the graphite preparation used in this type appears harmless. But if it had been the possessor of the first mentioned pencil who had embedded his pencil point in his hand, a serious injury may have resulted. Fortunately, there does not seem to be any of the old type mauve “ copying ” pencils on sale now ; their issue by Government departments was stopped some years ago, but there must be quite a number of this type of pencil in use in the country. In fact, an article appeared in the “ British Medical Journal” hardly more than two years ago dealing with this very problem, and the author appeared to regard the danger as still being sufficiently existent to describe its peculiar perils and special treatment. There is always the possibility that the first aider may come across a case of indelible copying pencil injury involving the mauve kind. The mauve indelible copying pencil “ lead” is com posed of a mixture of graphite and an aniline dye, produc ing the characteristic colour. Unfortunately, this dye, unlike so many aniline dye products used in modern medical practice, is most injurious to human tissue. If the broken off point of such a pencil were left in the wound, necro sis of all tissue in contact with it would ensue, including even bone. Attempts to remove the piece of point with splinter forceps would lead to a worsening of the injury, as the fragments of this type would shatter into tiny pieces, spreading the area affected, and accelerating the rate of tissue destruction. The only permissible first aid in this case is to prevent meddling with the foreign body and to get the patient to proceed to hospital for the only treatment that is efficacious — complete excision of the affected part. Interest attaches to the mauve aniline inasmuch as it was the first aniline dye to be discovered. W. H. Perkin, in 1 8 5 6 , attempted to prepare quinine from aniline. He failed in his original object, but he did produce Perkin’s mauve, and thus was born the vast aniline products industry of the present day.
TH E S T . JOH N A M B U L A N C E A S S O C IA T IO N I ts
H is to r y
and
I ts
A m b u la n c e
P art
in
th e
M ovem ent By
N. CORBET FLETCHER, M.A., M.B., M.R.C.S. “ A s a w o r k of re fe re n c e , t h e b o o k w ill b e e x tr e m e ly useful an d sh o u ld b e In th e lib ra ry o f all a m b u la n c e w o r k e r s . ” — First Aid. Price 3s. 6d ., by post 4s.
THE ST. JOHN AMBULANCE ASSOCIATION Willey Park, Broseley, Shropshire.
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C O . ,
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it cart be stated that this will not apply to peacetime measures. It is unlikely that any of these modified methods would aggravate the injury or increase the pain. There is, how ever, a slightly increased risk of aggravation during trans port as the fracture is not completely immobilised as would be the case where splints were used. Further, the modified method has not been: adopted as a general practice by the medical services with the Forces. In effect then, this means that whilst engaged on civil defence work, emergency civil defence measures should be adopted ; and for all other purposes splinting and bandaging should be carried out as laid down jn the Textbook.— N.C.F. Cigar Ash in Beer. R.R. (Sheringham).— As a member of the Brigade I should be glad to know if there is any foundation in fact of the belief that cigar , ash dropped into a person’s beer will cause him to become doped after drinking it. Thank ypu very much. Personally I do not believe that cigar ash could have the effect suggested when mixed with beer ; and I am not dis posed to try the effect of the mixture which would probably upset my stomach and make me vomit.— N.C.F. Compound Fracture of Ribs. H.W. (New Barnet).— Will you please comment on the treat ment of a case of compound fracture of ribs accompanied by severe haemorrhage ? In the body there are no pressure points to control the bleeding as there are in the limbs ; and direct pres sure is taboo because of the risk of causing injury to internal organs. This being so, would the application of a cold compress on the open wound be permissible and may we ignore the possibility of causing further shock ? The application of cold water dressings to an open wound is contrary to the principles of first aid. There is, therefore, no justification for the use of a cold compress in treatment of compound fracture of ribs. After all, the application of a cold compress is a minor detail in the treat ment of concealed (or internal) haemorrhage.— N.C.F. Stertorous Breathing. W.R, (Exhall).— It seems to me that stertorous breathing is only produced when the higher brain centres are in abeyance. If that is so, what produces that character of breathing ? Thank you for all past answers which are always helpful and make one keen in the work of helping suffering humanity. Breathing ceases when the higher brain centres, especially those controlling circulation and respiration, are in abeyance. It becomes stertorous only when a rise of pressure takes place within the brain and exerts its effects on these centres. — N.C.F. Simple Fractuxes of Both Legs. A.N. (Hull).— At a recent Divisional Practice we were told to treat a man for supposed simple fractures in the middle of the shaft of each leg. We could not agree as to whether four splints or only two outer splints should be used ; and so we submit the problem for your kind ruling. Were I in your place I should treat each fractured leg separately and then bind limb to limb. By so doing I should facilitate my task as a first aider and also that of the doctor who subsequently took charge of the patient.— N.C.F. Shock from Abdominal Injury. P.M. (Cardiff). — Please tell me what is the precise cause of shock in the case of a man who is winded and also injured in the lower abdomen which combination is often seen on the football field. You refer to two common causes of shock due to abdominal injury :— In the first as the sequel to a sharp and sudden blow on the abdominal wall (especially that part often called “ pit of
T
A I D
stomach ” ) shock results from irritation of the sympathetic nervous system and particularly the important portion of it which is known as “ the solar plexus.” As part of the shock there is a reflex stoppage of breathing which, as the most marked symptom, gives its name— “ winding ”— to the con dition. The effects vary from transient incapacity to fatal syncope ; and this often without any apparent lesion, i Iff . the second, these organs of the lower abdomen are really internal organs which in process of development pass outside the body and as such receive their nerve supply from the sympathetic .nervous system. Ip these circumstances you can now appreciate why, with thlsicorrtbination of injuries there is often present a grave degree of shock.— N.C.F. Air Exchange in Artificial Respiration. M.E. (Manchester).-n-In a query which was published in the October issue of F i r s t A i d , mention is made of Eve’s ' method of artificial respiration.' My colleagues and I know the Schafer method, but have never heard of the Eve method. Could you please enlighten us about it ? Eve’s method was described in the September issue of F i r s t A i d in an article which was headed— “ Resuscitation by Rocking.”— N.C.F. Treatment of Crnsh Injuries. C.G. (Ventnor).— The local rescue party has been instructed to place a tourniquet on a limb which has been badly crushed for any considerable length of time, before re leasing the limb from the pressure. The object of this is to prevent toxins developing in the crushed muscle from being absorbed into the circulation. Should the tourniquet be adjusted so firmly as to completely stop arterial circulation or only more loosely so as to prevent considerable outflow of venous blood and lymph from the damaged area? Also, should the tourniquet be released at 15 -minute intervals or not re leased until the patient arrives at the hospital ? If it is released there will be some inflow of toxins into the blood. If not, the limb will undergo gangrene. Is this method preferable to the other method which has been suggested, viz., to enclose the damaged limb in a very firmly compressing bandage from the toes, or fingers, to above the area of crush ? The treatment to which you refer is being taught throughout the Regional C.D. Schools and is based on experience gained during the heavy air raids when deaths occurred in hospitals in cases of crush injuries. The instruction affects cases in which a heavy weight has been pressing on a limb for some time pending the release of the victim. It does not refer to light pressure or to heavy pressure for a brief period. When heavy pressure has been prolonged, amputation is almost always indicated. When the tight ligature has been applied, it should not be released until arrival at hospital ; and this is not likely to aggravate the condition, because the circulation in the limb has already been cut off by the pressure.— N.C.F. Mystery of Lay Instructor Certificate. H.B. (Sheffield).— Can you please explain the mystery of the Lay Instructor Certificate ? I cannot find anyone who has a clear idea as to the motive behind it, though I have heard several conjectures, of which here are three : (A) That as Brigade members are having to pass on their knowledge in connection with Civil Defence work, some safeguard is necessary. (B) That owing to the shortage of medical men able to take on Brigade work, laymen will be able to fill the gap. (C) That it is to put Brigade members on an equal footing with members of the B.R.C.S. which has Lay Instructors. Your reply to C. M. (Sheffield) in the December issue of F i r s t A i d seems to support (C)and definitely “ washes
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out ” (B). So in that case it seems that the examination is a waste of time for both examiners and examinees. If a Lay Instructor is not an Instructor, what is he ? Under the Air Raid Precautions Act, firms are required to have a number of their employes trained in first aid. This requirement can be met by training them in the Short Course of Instruction, which can be given by lay personnel and for which no certificate of proficiency after examination is issued. It was, therefore, decided by the Chief Commissioner that steps should be taken to ensure that County Commis sioners should have immediately available lists of Brigade lay personnel who had proven by examination their ability to supply the necessary instruction. Further, these lists pro vide lay lecturers for the Preliminary Course of Instruction, which can be given by lay personnel but for which, to obtain a certificate, the candidate must have been examined and passed by a doctor. Even so your mystery is solved.— E d i t o r . Effects of Drowning. K.A. (Treorchy, Glam.).— Recently I was asked an unusual question which was to state how I should know the sex of a body which I saw floating in a lake some distance from the shore. I replied that a drowned woman floated on her stomach and a drowned man on his back. This was agreed by all present but I could not accept the suggested explanation that the prostate gland was responsible for this difference in the effects of drown ing on the two sexes because I do not think that a women possesses this gland. So I submit the point for your kind explanation. Tut ! T u t ! 1 Your answer was correct only on one point, namely that a woman does not possess a prostate gland. You will, therefore, be interested in the reply which 1 gave under the above heading in the May 1943 issue of F i r s t A i d and which reads as follows :— “ In a fatal case of drowning the body is submerged until the gases of putrefaction accumulate in sufficient quantities to make the specific gravity of the body less than that of the water in which it lies. This usually occurs within one week after which period the body rises to the surface. “ The bodies of men (unless there is an excess of abdominal fat) usually float in the prone position, with head and limbs below the level of the water— that is, face down wards. The bodies of women, however, on account of the fatty tissue in breasts and abdomen, usually float in the re cumbent position— that is, face upwards.”— N.C.F. Definition of “ Fit.” N.O. (Carlisle).— Recently at Divisional Practice, discussion arose as to the real meaning of the term “ fit.” As we could not agree we decided to seek your kind help. The root meaning of the term is “ a sudden attack of anything, such as laughter.” Applied to first aid, it is taken to signify “ a sudden seizure in which there is partial or com plete loss of consciousness, with or without convulsions.” The term is unscientific and is usually used by people who cannot discriminate between its various causes ; and it should not be used without a qualifying adjective— e.g., hysterical fit, apoplectic fit, epileptic fit and so on.— N.C.F. B.R.C.S. Certificate. D.D. (Clacton-on-Sea).— Please tell me if the procedure was correct with reference to a recent St. John examination held for members of a Mobile First Aid Post. Half of us hold the St. John certificate while the other half have taken the B.R.C.S. first certificate. All passed ; but now the Red Cross certificate holders are told that they will only get the St. John certificate, whereas the St. John certificate holders are to receive the voucher. If there has been a mistake please let us know how it can be rectified ; and meanwhile accept our thanks.
A I D
On your statement of facts there was a mistake, because your class secretary clearly did not know either that half of your members had already taken the B.R.C.S. first certificate or alternately that this is recognised by the St. John Ambu lance Association. It follows that all who passed qualified for the voucher which is the award for the second St. John examination. In these circumstances your class secretary should report the circumstances to the Chief Secretary of the Association, who, we expect, will be happy to rectify the mistake.— E d ito r .
Control of Carotid Artery. G.G. (Beith, N.B.).— An argument arose at our First Aid Post concerning the Examination Howler which was published in the Query Column of the January issue of F i r s t A id . We could not agree as to what a first aider could do if he failed to control bleeding from the carotid artery. Obviously the first aider in this report failed to controt the bleeding because he was not compressing Pressure Poini No. 1 . Once this was found, digital pressure would at once stop the bleeding. Hence the “ howler ” ! !— N.C.F. Lay Instructor. M.S. (Wigan).— Please tell us if an individual, not a member of the Brigade, can offer his services as a lay instructor of first aid supposing that he only possesses the St. John first certificate (1 9 4 1 ), and voucher (1 9 4 2 ). Is such individual qualified to instruct classes in first aid ? While I know no reason why a voucher-holder should not offer his services as lay instructor, I should not advise him to do so. The medallion of the Association was originally (1 8 7 9 ) introduced as the mark of the efficient first aider, it being ruled by the Executive Committee that " n o in d iv id u a l is deem ed p ro p e rly q u a lifie d to re n d e r f ir s t a id beyond a y e a r from the date o f h is certifica te." Further, in my youth I was taught that one must learn (and forget) a subject three times before one really knows anything about it ! Later (19051 the Association followed the example of the Brigade (which in 1889 first insisted on the annual re-examination of its mem bers) and introduced the label as the award for each examina tion passed annually by medallion holders.— N.C.F. Treatment of Fractured Leg. G.A. (Overseal).— When we have to treat a fractured leg other than single-handed, should the bandages be tied as they are put under the limb or should all bandages be first placed in position and then tied in the same order as they were passed under, as is the method in the treat ment for a fractured thigh. We await your reply and accept it as final. Also we thank you for the great help which you give in the Query Column. To me this is a minor detail ; and if the treatment is carefully carried out, one method is as good as the other.— N.C.F.
N o t e . — Owing to the large number of queries received, and our limited space, a number have unavoidably been held over. These will be published in due course.— E d i t o r .
“ FIR ST A ID ” QUERY and REPLIES COUPON. 7 o b e c u t o u t a n d e n c lo s e d w it h a l l Q u e r ie s .
Feb., 1944.
JOHN BALE MEDICAL PUBLICATIONS M
( jm
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m
A ID 8
ASEPTIC O IN TM E N T
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IS*
d.
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A ID S
TO
H O M E -N U R S IN G . ..
.,
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E F F IC IE N C Y
IN
F IR S T-A ID . ..
d.
Third E dition. Post frfee, 1 3 P r o b l .m a In S t u d y , T r u t m a n t a n d E x a m in a t io n s o lv e d l o t S e n io r S t u d e n t “ I V it h o u t d o u b t th e book w i l l be o r g r e a t se rvice in th e t r a i n i n g o f those f o r w h o m i t is d e sign ed . — British Medical Journal.
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WHY
AND
W HEREFORE
IN
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Fifth E dition. 3 post 2 D i f f i c u lt ie s In S t u d y e n d T r e a t m e n t s o lv e d b y Q u e s t io n e n d A n s w e r . “ W e c o m m e n d th is book to L e c t u r e r s a n d S tu d e n ts w h o w i l l f i n d i t o f & re a t s e r v i c e — First Aid.
H IN T8
T H E
M M /V W IM
For Wounds, Cuts, Burns, Skin Irritation
A I D vV w vaaaaaa
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Be Prepared^ GERM O LENE instantly For protects against germ in Emergencies* fection, prevents blood and Keep a< poisoning, and promotes Tin Always , rapid healing ! G erm o len e at Hand causes the broken tissues W VW M AAi to unite, grows new skin A/WW\A^/WW and heals over the broken place cleanly. It soothes at a touch, ends pain and brings ease. A t the present time, N O home should be without a tin of the world’s quickest healing ointment. Get yours to-day !
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I N T R O D U C T I O N T O F I R S T R I D by John R. M. Whigham, M.C., M.S., F.R.C.S. A new and up to date manual on this subject based on lectures given to St. John Ambulance classes over a period of years. With many illustrations. Price 1b. 3d. postage 2 d. By Col. R. J. BLACKHAM, CH., C.M.G., C.I.E., D.S.O., M.D. A IR R A ID F IR S T A ID A Series of 15 Charts covering all the dudes of a Pint Aid Worker, giving full instructions as to Air Raid effects and precau tions, recognition and treatment of injuries. The Ideal Wall Chart. Size 22 £ in. x 14 £ in., has been prepared for use in Air Raid Shelters, Red Cross and St. John’s Ambulance Stations and Classes, and all places where First Aid and Nursing are required. Price 7 s. 6d. Postage 6d. Tho Home Chart. Size 13 in. x 1 \ in., has been specially prepared for use in the Home pr small groups, price ls. 6d. post 3 d. Also in Booklet Form;. Price 9 d. ; post Id.
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Price 2 <L ; postage Id. F
I R
E
(Companion to POISON GAS folder) by same author. Complete lolder giving all the essential points on how to tackle the latest incendiary bombs, which every Fire Fighter should know. Price
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J O H N B A L E M E D IC A L . P U B L I C A T I O N S L T D . 1 4 , G r e a t S m ith S tr e e t, W e s tm in s te r , S .W . 1 .
a r e
T O V
A L L
< V V <Jv
O
e s s e n
T W
t i a l
D IV IS IO N S
O F
T H E
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St. John Ambulance Brigade and
can
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L T D .
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OF THE
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HUM AN
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ATLAS CVERY FIRST AIDER and Student N urse should possess this Atlas. The plates are beautifully coloured and v e ry clear w ith lift-up parts show ing th e internal anatom y of the abdom en and chest. T he te x t gives a clear and accurate account o f th e anatom y and physiology of th e fem ale body.
“ SANOID” RESPIRATOR FRAME N o. 8 0 6 8 3 8
S I
T I
The MALE ATLAS
HOBSONS FOR SMARTER UNIFORMS.
R e g is t e r e d D e s ig n
E
ATLASES
fro m
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O
"THE Male Atlas is the com plem ent o f th e Female A tlas. It is com plete itself, but only deals w ith th e male body. T h ere are 8 plates, 89 illustrations, and 876 distinct parts show n in this Atlas. It is extre m e ly accurate, and th e colo u r plates are exception ally clear.
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CUXSON, CERRARD & CO. LTD. F ir s I
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S p e c ia lists
or
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PAGES of essential information. H u n d re d s o f illu s tr a tio n s . Words defined, explained and pronounced • Invaluable to the first aider and Student Nurse. Includes Special Illustrated Sec tions on-:— .
First A id Treatm ent. Antiseptics and Disinfectants. Blood Transfusion. PoisoningAverage W eights and Heights.
PR IC E
3 /6
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FIRST AID ^tje Jtttaperutenf Journal for fl)o Ambulance attb p u rsin g Bernices? N o . 5 9 7 , V o l.
Second
L .]
M ARCH,
1944.
In c lu d in g
E d it io n
[s, . S r . ‘ S.,,]
N o te s
on
th e
F ir e
G u ard
P la n
THE FIRE GUARD’S POCKET CHART S lb. Explosive Incendiary.
First Aid.
Phosphorus,
Duties.
Oil
and
Organization.
Trailer Pumps. Pump
Multiple Effect Bombs.
Stirrup
Team
Methods
in
R escue.
Action.
of
Escape. C a r e of
Stirrup Pump, etc.
4 d. p e r c o p y (b y post S d . ) ; 1 0 0 c o p i e s 3 0 s. (b y post 3 0 s. I d . ) S p e c ia l Q u o t a t io n s fo r L a r g e Q u a n t it ie s
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BIOLOGICAL M B I 3 PREPARATIONS A
N
T I P
E O
CUTAN EOU S VACCI NE
L
O
I N
T M
E
N
T
One or other or all of the three races of germs, Streptococci, Staphylococci and B. pyocyaneus are found in every skin infection common to this country, and ANTIPEOL OINTMENT contains the antibodies (antivirus) of these germs. Healing is expedited by the proved ingredients of the ointment, and septic development is stopped or prevented by its antivirus sterile vaccine filtrates. ANTIPEOL OINTMENT is unsurpassed for BURNS and SCALDS, for it is microbicide and non-adhesive, and dressings do not require to be changed every day. WOUNDS, BURNS, etc, WILL NOT TURN SEPTIC if treated with ANTIPEOL OINTMENT.
O
P
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T H
A
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O
- A
N
T I P
E
O
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is a semi-fluid ointment, more convenient than the ordinary Antipeol ointment for ocular infections and lesions. Eyes affected by smoke and dust are soothed almost immediately by the application of Ophthalmo-Antipeol, and the antivirus prevents germs from developing.
R
H
I N
O
- A
N
T I P
E O
L
affords rapid relief of COMMON COLDS, INFLUENZA, AND CATARRH. Containing the antibodies of the germs common to infections of the nose and pharynx (Staphlylococci, Streptococci, B. pyocyaneus, pneumococci, pneumobacilli, enterococci, M. catarrhalis, B. Pfeiffer), Rhino-Antipeol is not just a palliative, but is a remover of the couse of the infection. During epidemics it is the ideal preventive of microbe development. Clinical Sample, on request from M E D IC O -B IO L O G IC A L L A B O R A TO R IE S L T D ., Cargreen Road South N orw ood, London,
S.E.25
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The First A id man’ s skill Is unavailing If the victim ’ s respiration Is allowed to fall — prom pt action w ith the Sparklets Resuscitator Is vital to successful recovery.
C o a t, New Style. To measure from 7 8 / -
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Human Osteology, Anatomy, Etc., 18, F IT ZR O Y STREET, F IT ZR O Y SQ U A R E, L O N D O N , W .l T e le p h o n e : MUSEUM 2703.
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Editedby N O R M A N H A M M E R , M .R .C.S., M a Jo r,la te R .A .M .C .,T.A . FIRST AID JOURNAL.— " O ne o f the most concise works on the subject p u b lish e d at a p o p u la r p r i c e ."
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FIRST A ID dje Ambulance aitf 3 Hursing ^ e rtrk w Editor I
to t V /-.T N o . 5 9 7 . --- V O L .
W A LTER
T L ,.
S C O TT,
M A R C H
iV lrt.K .L .n ,
NOTICE
TO
READERS.
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CONTENTS
d it o r ia l
OF
THIS
NUMBER.
—
The Prevention Factor
...
...
...
97
Recent Advances in First Aid Work in War
...
98
First Aid ... ... ... ... S.J.A.B. Headquarters and District Reports
••• ...
99
The Home Guard and First Aid
...
...
101
■ ■ ■
■ ■ ■
101
Priory for Wales
...
...
Reviews ... Haemorrhage ...
... ...
...
Q
u e r ie s
a n d
A
n sw e r s
to
99
101
C
102
o r r e spo n d e n ts
:—
Blood in Arteries and Veins
...
...
104
Examination Howler ... Treatment of Abdominal Wounds
... ...
... ...
104 104
Injured Femoral and Fractured Femur
...
104
Effects of Sodium ...
...
...
Effects of Liquid Bromine ...
...
...
106
Treatment of Wounds ... The Textbook and the Journal
... ...
...
106
Loading Stretcher
...
Artificial Respiration
...
...
Action of Cocoa
...
•••
...
Action of Saccharin
...
Amputation of Foot Effects of Electrocution
... ..
106 106 106 106
•• •••
■ ■ ■ ...
1944
ly '+ ^ t.
F.R.S.A.
f
F.^t,r,dai 1 HaU\
IS Ia iio m r s
p ric e th re e p e n c e [4/- Per Annum, Post Frhe
EDITORIAL.
FIRST AID is published on the aoth of each month. The Annual Subscription is 4s. post free ; single copies 3d. Its aim and object being the advancement of Ambulance Work in all its branches, the Editor invites Readers to send Articles and Reports on subjects pertaining to the Movement and also welcomes suggestions for Practical Papers. All Reports, &c., should be addressed to the Editor at the address below, and should reach him before the 8th of each month, and must be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with FIRST AID should be forwarded to the Publishers. DALE, REYNOLDS & C o ., L t d . , 46, C a n n o n S t r e e t , L o n d o n , E.C.4. Telegraphic Address— ” Twenty-four, London."
E
F.R.Sin.l.,
106 108 108
...
108
Priority in Despatch ... Treatment of Fractured Clavicle
...
...
108
Compound Fracture of Leg
...
...
108
108
T h a t prevention is better than T h e P r e v e n t i o n cure — better even than the F a c to r . prom ptest rendering of first aid — is a fact that adm its of no d is pute, and it is surprising, when one considers the introduction of safety appliances, the increased education of the workers, and the fatherly control exercised by the G overnm ent, that there is such an abnorm ally h ig h rate of casualties in industry. In one period of tw elve m onths the accident figure had risen to over 3 0 0 , 0 0 0 , which, if viewed o n ly from the hum anitarian standpoint, reveals a very terrible state of thin gs. In these tim es, unfortunately, hum anitarianism has but sm all appeal and a thousand or so, more or less, are of sm all concern. It is the loss of productive cap acity that counts, and it is surprisin g, se ein g w hat a loss there is in -w ages when that abnormal figure is taken into con sideration, that the workers do not interest them selves more in the matter. First aid has made great strides a m o n g them in recent years, but how m uch better it w ould be if the necessity of the rendering of this was notew orthy by its infrequency. A t a recent conference held under the auspices of the Nuffield O rgan isatio n , S ir M iles T h o m a s, the chairm an, pointed out that the m ost valuable con stituent of our industrial system was the w orker— m ale or fem ale, and it w as first ch arge on factory m anagem ent to sustain and protect them , to pro mote their w e ll-b ein g and to keep them safe. O n ly a safe factory could be an efficient factory. S lip shod surroundings from w hich d an ger hazards have not been ruthlessly removed lead to slipshod q u ality of output, and that is a condition that cannot for one m om ent be tolerated when q u ality of perform ance m ay mean life or death to the men in the firing line, no less than to the w orker on the factory floor. In v isu a lisin g how accidents m ay be reduced in the future, S ir W ilfred G arrett, H .M . Inspector of Factories, said it required train in g and experi ence to know where accidents happen, but the problem could be reduced alm ost to an exact science. Factories of sufficient size should establish S a fe ty Com m ittees, w ith trained accident officers, e n ab lin g closer statistical exam inations to be pro duced. T o us, there seem s no reason w h y in every
98
F I R S T
factory and w orks where m achinery is installed there should not be formed a com m ittee of the workers (both male and female) to review the whole m ethod of w o rkin g and especially the sufficiency and condition of the safety appliances, with power to com pel the workers to make use of them to the fullest extent. Chem ical hazards must not be over looked. T h e y are both numerous and com plex, and vary with the introduction of new production m ethods. S lo w or delayed action leads to contem pt of danger, and a workm an is m uch more likely to protect him self again st a substance which he knows w ill produce an unpleasant effect sharply than a g a in st a m etallic poison, the effect of w hich is cum ulative and slow in appearin g. T h e m ajority of accidents arise doubtless from n eglect of pre caution and carelessness, but the workm an is not iri the position alw ays to protect him self, and the d u ty devolves upon the m anagem ent to exercise every precaution possible to decrease the figures of the casu alty roll.
R ecent
A dvan ces in
in
F ir s t
A id
W ork
W ar.
By SIR H EN RY L. MARTYN, K.C.V.O., F.R.C.S. (Casualty Staff Officer, G Area, Devon C.C.) A STUDY of your query columns and of the carefully con sidered replies to the questions of correspondents by N.C.F., demonstrates an increasing interest in first aid personnel in the use of abbreviated methods in Civil Defence work as contrasted with the formal and more laborious technique of the St. John’s Textbook. This increasing interest has been largely actuated by the instruction originating, as the result ot experience in the handling of casualties under actual blitz conditions, from the various regional schools, and there is no question but that far greater attention should be given to them than they are at present receiving. As N C. F. points out in your February issue, under the heading of ” Lay Instructor,” the medallion of the Associa tion was originally introduced as the mark of an efficient first aider, it being ruled by the Executive Committee that “ no individual be deemed properly qualified to render first aid beyond a year from the date of his certificate.” Although the annual re-examination often proves im possible during wartime, revision courses in first aid are constantly necessary. Unfortunately, only too often these are based upon a weary reiteration of the St John’s Text book, which, although undoubtedly the best book of basic instruction for elementary candidates desiring to acquire a knowledge of first aid in civil life, is in urgent need of revision if it is to be regarded as a textbook for first aid under war conditions. Let us consider for a moment in what way the differ ence in the conditions of peace and war impose changes both in training and technique. The basic training of bt. John’s is largely, indeed almost entirely, concerned with the injuries incidental to civil life, in which probably the greatest forces imagined are those of a railway smash or a machine accident, forces not com parable for a moment with those of high explosive. The
A I D
circumstances under which the injury is received, generally speaking, are considered to be totally different from those of war, and the picture in the student’s mind is almost always based upon that of a single casualty in pacific sur roundings into which extraneous factors do not obtrude : moreover, the most careful limitation is placed— quite rightly — upon the responsibilities which he may assume, and it is impressed upon him that under no circumstances may he take upon himself those of a doctor. It this be the only training which the first aider re ceives to fit him for casualty work under blitz conditions, it is not surprising that he finds himself lost and be wildered when first he is called upon to deal with casualties in action. What vast variations must perforce be introduced by the factors of daikness, constant bombing, the threat of fire and falling buildings, and the number of cases with which he is called upon to deal in the shortest possible time. Be yond all this he must be prepared to make decisions and assume responsibilities infinitely greater than those formerly permitted to him, trusting in the certain knowledge that, provided that he does his best, no criticism will ever be justified. Apart from these differences between civil and war in juries, it is seldom appreciated how vastly progress in medi cal and surgical knowledge is imposing its own changes upon the technique of first aid. The treatment of war wounds has been completely revolutionised, many of the elaborate methods of splinting fractures in the field have been proved to be an unneces sary waste of vital time, and the handling of trapped casualties has been entirely changed by reason of research work only available within the last twelve months. Even so simple a matter as the blanketing of a stretcher has undergone modification to meet the requirements of blitz technique, and the eternal question of the best treatment of burns remains an ever present argument. Reviewing the whole position, therefore, it must be apparent to all that the training of first aid personnel, if they are to become proficient under war conditions, must be conducted upon totally different lines to those formerly adopted during peace. The first essential must always remain, namely, the basic training upon the lines of the St. John’s Textbook enabling the candidate to obtain an elementary certificate. Without such training the student will never gain either a knowledge of the essential groundwoik or the confidence which the possession of a certificate gives him. From this point, however, things are less easy. Either the student in the stress of war remains content with his certificate or, if he is keen, is only too often subjected to repeated courses of lectures, still based upon the bt. John’s Textbook, by virtue of which he duly acquires bigger and better certificates while completely unaware that the sub ject matter which he now knows word for word has in manv cases for years been completely out of date. While it is essential to insiil into the student during the elementary stages of his training the simplest possible principles of treatment expressed in the most dogmatic way, it must be kept ever before his mind that advances in knowledge and in the methods of application of that know ledge are constantly taking place, and that even the basic principles of his training are not necessarily inviolable. Thus when a first aider, rigidly trained in the exact technique of the textbooks, is suddenly told that it does not matter in the slightest degree whether, when treating a fractured leg, the bandages be tied as they are put under the limb or whether all the bandages should be first passed and then tied, or indeed in some cases whether a splint as such need be used at all, he is apt to be bewildered unless he has learned to distinguish the essential from the nonessential under war conditions. Once the stage of preliminary training is over the
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method of teaching hy dogmatic statements and memorised lists of what to do and what not to do should be abandoned. The student in revision courses should be taken far more fully into the reasons why certain things are done or not done. If his intelligent interest can be aroused by such teaching he is likely to become infinitely more efficient and will the more willingly absorb and adopt constantly changing methods and advances in treatment rather than adhering to the rigid rule-of-thumb methods of his element ary tiaining. What an amazing romance of scientic achievement lies behind our present treatment of war wounds in the field. The instructions given in the textbooks as to the cleansing, bathing with antiseptics, etc., of the civil wounds are now applicable only to the most insignificant clean cuts and scratches of war. You are taught now that all that is necessary for the wounds of high explosive is the application of a dressing kept as sterile as possible in order to prevent further contamination. Even the necessity for extreme sterility is not unduly stressed, and the student is apt to be amazed when he is quite frankly told that if it is a question of controlling haemorrhage and saving life he may even compress a bleeding artery by pressure with his own fingers in the wound itself, even though his hand cannot by any possible chance be considered surgically clean. What is the justification for this extraordinary change in treatment, and why are antiseptics no longer relied upon ? During the first part of the last war we were accus tomed to follow the old routine. Wounds were cleaned by antiseptics under an anaesthetic, and during the progress of healing constant dressings and the use of varying antiseptics were continued. These methods proved quite ineffective, wounds took many months to heal, and deaths from blood poisoning were frequent. Towards the end of the war other methods were beginning to appear. Many small wounds were being cut out complete, and the resulting wound either sutured or allowed to heal cleanly from the bottom. The results showed promise, but it was not until the time of the Spanish war that the full value became apparent. During the siege of Barcelona a Spanish surgeon called Truetta did an immense amount of work in the Central Hospital. Not only did he operate upon a great number of cases, but he found time to keep careful records of his cases and subsequently to do considerable research work. ( T o b e c o n t in u e d . )
F i r s t A id . W e have received the following verses from Mr. S. Dodd of Wolverhampton :—
First, Aid. Bestir yourselves to tend and bind The maimed and broken on the way of life, Then, if you will, you of enlightened mind Ask why so much of pain and woe is rife. First, Aid, so runs the word of ancient lore, When Good Samaritan by wayside found One who had come by ill, Neighbour ! restore, Then work to make life’s highway safe and sound. First, Aid, to this the Order of St. John, Is pledged, nor dare it’s members turn aside From urgent human ill, Whilst yet there’s one Depending on their skill. For none must be denied. First, Aid, the Spirit of the Lcrd shall rest On all who spend their lives to help and heal. All human worth is measured by this test, For Christ himself, It was God’s sign and seal.
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REPORTS.
N o . I (Prince o f W ales’s) District 1 2 0 r n ( B e x l e y ) . — On February 9 t h the above Division held its 12th annual general meeting under the chairmanship of Supt. F. G. Ellis. The Treasurer (Amb. Officer A. E. Aylott) reported that the balance sheet for the year showed exceptionally good progress. The Secretary (Sergt. E. A. Wheble) reported that there had been a net increase of 5 in the Division’s membership for the year, the roll now standing at 1 3 6 , and of these 74 mem bers were serving in H.M. Forces, an increase of 11 during the year, whilst 11 were full-time and 21 part-time A. R. P. workers, and 57 members were now in Brigade uniform ; 1 ,0 6 2 cases had been dealt with during the year, and the record number of 1,761 duties had been attended. Cadet Supt. E. Goodall (3 0 th Cadet Division) reported that there was a cadet membership of 4 0 with an average attendance of 2 8 . During the year the cadets had gained 114 certificates, 12 proficiency badges and Private J. Lloyd had gained the Grand Prior’s Badge. The Chairman of the Social Committee (Sergt. T. B. Paine) reported that during the 8 months of the year in which the Committee had been active, 6 whist drives had been held and one social evening. The Chairman, Supt. Ellis, congratulated the Division on its excellent reports and thanked the Committees for the work they had done, also Cadet Supt. Goodall and Cadet Officer Gravett for the great work they were doing among the boys who were well-trained and well-behaved and were a great credit to the Division.
O r p i n g t o n (100 /2 ).— Some idea of the splendid work this Division is maintaining was given at the annual meeting held at the British Restaurant, Orpington, on Saturday, February 2 6 ih. In his report the secretary, Mr. A. J. Uphill, commented on the record work of the ambulance drivers, who conveyed 5 00 patients and attended 91 accidents. The mileage was 10 ,54 7 .
The strength of the Division remained the same as last year with 82 members. Thirty-five members passed the annual re-examination. Cpl. Bilby passed the London A.R.P. examination and 14 N.C.O.’s and men passed the Royal Life Saving Society’s Respiration Service examination. Mr. G Eastlake Davis, in presenting the awards, said he was surprised at the wide scope of the Division. He expressed appreciation on behalf of the Council. The awards were : Royal Life Saving Society’s Respira tion Service Certificates, 11 ; Vouchers, 2 ; Medallions, 3 ; Labels, 3 1 . County o f Berkshire. During the week beginning January 3 0 th, 1 9 4 4 , the sum of ^ 1 .9 3 2 was collected at the local cinemas by members of the S.J A. B. and B.R.C.S. for the Red Cross and St. John Prisoners of War Fund. R e a d in g N u r s in g D i v i s i o n . — It has been necessary to split this Division owing to its large size and increasing num bers. Two new Divisions have now been formed, namely, the Reading South Nursing Division and the Reading West Nursing Division.
R eading T own “ B ” A mbulance D ivision .— T he Chief
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Commissioner has approved the appointment of the Deputy Mayor, Mr. W. Mcllroy, as President of this Division. Members of the Division who recently took a course in Home Nursing under Divisional Surgeon C. A. Boucher, all passed for their certificates. W in d s o r N u r s in g D i v i s i o n . — A successful dance was given by the St. John’s Social Club at the White Hart Hotel on January 2 8 th. Over 300 people were present and Mr. Stovell w'as M.C. The Mayoress gave away the prizes won in various competitions.
County of Bristol. F i s h p o n d s . — A new feature in the above Division is the individual cup competition to he held annually, the first of which has just taken place, and proved most interesting and stimulating to the younger members of the Division. It was with that idea in view that Corps Officer Jefferies presented to the Division a cup which was proudly called the “ Jefferies Cup” and was keenly contested. J. Moss, a younger member of the Division, succeeded in winning it. Supt. W. Hobbs, B. E. M., of Butlers Division was the adjudicator, and he spoke highly of the efficiency of the competitors. A book on the “ History of the Order ” was also pre sented to the winner by Corps Officer Jefferies, and it is difficult to express in words the Division’s gratitude for the great work and service that this Officer has given to the Fish ponds Division in particular, and to No. 2 Corps as a whole. The “ Jefferies Cup” will alw'ays be a reminder of his loyalty and service, and a background for the efficiency and extension of good first aid.
County of Cheshire. P o r t S u n l i g h t . — A general meeting of the Port Sun light Corps took place on Friday, January 11 th, in the Hulme Hall, Port Sunlight. Corps Supt. H. O. Rothery presided. County Officer Anthony presented warrants of appoint ment and seavice aw'ards. He congratulated the recipients, especially Supt. Dodd w’ho had completed 25 years service in the Brigade. The Secretary (Corps Officer E. H. Alderson) then read his report, and stated that the Corps now comprised seven Ambulance Divisions, three Nursing Divisions, three Cadet Ambulance and two Cadet Nursing Divisions. At Decem ber 31 st, 1 9 4 3 , the membership numbered 312 officers and other ranks and 151 cadets. Of the seniors 74 are in the Forces, and 175 are serving in the Civil Defence Services. The Cadet Divisions of the Corps are going from strength to strength and were prominent in several parades including the Rally of the Central Wirral Youth Organisations which took place on the Port Sunlight Recreation Ground on June 2 6 th last year on the occasion of the visit of the First Lord of the Admiralty (The Rt. Hon. A. V. Alexander). The meeting was follow’ed by an excellent concert which was given under the direction of Mr. J. Reason of Port Sun light and which was attended by the President of the Corps (Rt. Hon. The Viscount Leverhulme) and Lady Leverhulme.
County o f Hertford. W a r e . — A well attended annual general meeting of the Ware Division was held in the Priory on February 8th, Dr. W. G. Stewart, M.B.E., Divisional Surgeon, presiding. In his report, Supt. T. H. Burgess stated that the Division now had 46 members, of whom 15 are serving in the Forces. Every available man is serving in the Civil Defence services. The motor ambulance travelled 9,0 3 5 miles last year conveying 455 patients, including 41 accident cases,
Cadet Supt. H. Beaumont-Smith reported on the progress during the year of the newly formed Cadet Division which now has nearly 40 members. The cadets receive training in first aid, home nursing and many other subjects in which they can gain badges for proficiency. All the boys have shown a tremendous keenness and several have gained pro ficiency in more than one subject. The Ware Cadet Division was the first Ambulance Division in the county to have one of its members awarded two Proficiency Badges for passing in 8 subjects. During the evening the chairman presented first aid certificates including 5 vouchers, 1 medallion and 16 labels. Pte. S. E. Clark has gained the Brigade’s Long Service Medal for 15 years efficiency, but as he is now serving in the Forces the presentation had to be postponed. County of Lancashire. L i v e r p o o l . — The Liverpool Corps was inspected by Lady Louis Mountbatten, C.B.E., Lady-Supt.-in-Chief, on Satur day afternoon, February 2 6 th. The inspection was held in the big shed at No. 2 , South Canada Dock. Lady Louis Mountbatten was accompanied by Colonel, The Earl of Sefton and Lady Seftor., the Lady Mayoress of Liverpool and other distinguished persons. Visiting Divisions were present from Southport, Water loo, Warrington, St. Helens, Huyton, Prescot, and Widnes. The whole Parade was under the command of Corps Supt. W. E. Searl, Senior Corps Supt. of the Liverpool Brigade. The total number on Parade was approximately 2,000. Lady Louis Mountbatten made a wonderful tour of in spection, missing no detail and chatting in a charming man ner to officers and members of all ranks as she passed along. On completion of the march past which was led by the Nursing Corps, Lady Louis Mountbatten made a short, friendly, speech. She and her party were then entertained to tea at the Mersey Docks and Harbour Board Dockside Canteen. The musical arrangements for the inspection were successfully carried out by the Band of the A. T. & E. Com pany, and the Bugle Bands of the Cadet Units. Lady Louis Mountbatten greatly endeared herself to all members, and they look forward to her next visit to them.
County of Surrey. A d d i s c o m b e . — There was a large attendance of members at the annual general meeting of the above Division at the Addiscombe Methodist Hall, when District Officer E. J. Prew was in the chair. It was reported that during the past year 2 ,2 3 0 cases of first aid were treated by members, not including air-raid casualties, and of these 320 were removed to hospital, despite considerable depletion of personnel due to the demands of the National Services. The 21 years’ service of Nursing Sister G. Prew had brought recognition in the form of a gold service medal awarded by the Southern Railway Centre of the Association. She had treated 216 cases during the year. District Officer E. J. Prew, on behalf of the Trustees, reported that the Addiscombe Motor Ambulance Service, which had suffered a severe loss in the death of Mr. Lovell W. Vicars, S.B.St.J., had transported 1 ,0 3 6 patients over a total of 1 0 ,7 9 5 miles during 1 9 4 3 . The chairman paid tribute to the officers, N.C.O.’s and men of the Division, and felt confident that with the con tinuance of the voluntary and enthusiastic help of members, the Addiscombe Division would go on to even greater heights in its aim to alleviate suffering. County of Warwick. C o v e n try
( C e n tr a l) .
— At a recent meeting, Corps Supt
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L. T. March paid tribute to the wonderful work being done by the Hospital Saturday Fund Nursing Division on trans port work. Mr. March said that there were about 30 nurses of the Division that formed mainly the night rota at the ambulance station, and most of them are at work all day, and gave up their evenings to stay at the station all night, a fact that is regarded with high appreciation, and in conjunc tion with drivers and attendants they have turned out no fewer than 2 ,0 0 6 times mainly during the night. The ambu lance fleet have transported a total of 12,341 cases during 1 9 4 3 , an average of 34 cases per day, and travelled no less than 9 8 ,6 7 6 miles, and in view of the fact that there is such a small skeleton staff left, more than 50 per cent, of this work was carried out by the voluntary personnel of the Brigade. The Coventry Central Corps is certainly doing a grand job, and the citizens should feel proud in the knowledge that these efficient and well trained men and nurses are always at hand for any emergency.
The “ F ig u r e o f E ig h t C a r r y ” for two bearers is more useful over a distance than ordinary hand carriage. To do this, join two stretcher slings or three belts (bearer’s and patient’s) together to form one big loop. This is crossed at centre to form a figure of eight. This cross is so placed, that one of the patient’s legs passes through each loop so formed. The bearers then place their ends of these loops over their outer shoulders and raise patient, who will be in a sitting position, leaving the outer hands of bearers free. In closing, let me remind instructors that when orderlies have mastered the various lifts and carries, they should be exercised with respirators in the “ Gas ” position. C. W.
T h e H o m e G u a r d a n d F i r s t A id . FU R TH ER
LIFTS AND CARRIAGE METHODS.
S i n c e writing last month’s article, I have studied and tested the method of loading stretcher when only two bearers are available, as suggested by Dr. Bowman Edgar in the issue for February. This is a decided improvement, and I have not the slightest hesitation in recommending it. My own unit has now adopted it, and it becomes an automatic amendment to my own article on the collection of wounded by two bearers. The old method was always decidedly awkward and difficult to the novice.
The “ B a ck L i f t " is very useful for a patient with, say, a wounded leg, if you are working alone, and provided he is conscious. First, help patient to stand on good leg. Then taking up position back to back and getting patient to stretch his arms sideways, bend down, and placing your hands under his arms, grip the upper arms near the shoulders. Bearer then bends forwards, pulling patient on to his back, and straightens his legs. He can be carried some distance in this manner. If the patient is unconscious or there are other injuries, some help is necessary for helping with the lift. The “ N e ck D r a g " is used for pulling a patient for a short distance to cover, from an exposed position, when un conscious. Turn patient on to his back, tie his wrists firmly with his hands clasped, kneel astride his body, pull his arms over your head, taking his weight low down on your neck Then crawl away on hands and knees, dragging patient with you.
S p read b u ry
(Sergt.),
School House, Noel-road, W . 3 .
P r i o r y f o r W a le s .
East R idin g o f Yorkshire. N o r th F e r r i b y . — The annual meeting of the North Ferriby and District Nursing Division was held recently at Mrs. Farrell’s, The Red House, attended by a large propor tion of members. Among interested visitors were Lady Atkinson, Lady County President ; H. Rankine, Humber side Corps ; and Miss E. G. Moore, Lady Corps Officer. Mrs. Jarman, Lady Divisional Supt., presided and pre sented the report of the year’s activities. This showed a total of 3 , 2 1 5 | hours duty performed by members in hospital wards, on ambulance, public and other duties. In support were A/O Mrs. Storey, Hon. Secretary, and A/O Mrs. Farrell, Hon. Treasurer, who each submitted illuminating statements as to the healthy state of the Division. Lady Atkinson congratulated the Division on its achieve ments and record, expressing her whole-hearted interest in the work Brigade members are doing.
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— The annual meeting of this Division was held on January 3 0 th. The chair was occupied by the Vice President, Mr. Josiah Jenkins who was also supported by Divisional Supt. T. G. Bartlett, Ambulance Officer James L. Lewis, Sergeants Allan Harries and E. C. Thomas, and Corps Officer M. G. Thomas, M.E. The treasurer’s report was given by the auditors, who revealed that the Division still maintained a sound financial position. The Secretary then proceeded to give a brief review of the year’s working. Four new senior members and 2 new nurses were trained and qualified ; 24 senior members qualified at the annual re-exam., 19 senior members qualified in A.R.P. Gases examination, 16 senior members qualified in first aid in coal mines, 10 nurses qualified in both home nursing and first aid, 8 male junior cadets qualified in pre liminary first aid. A Nursing Cadet Division was established and 10 qualified in preliminary home nursing and first aid. During the course of the year, Mr. R. D. Morris, M.E., F.G.S., accepted the office as Hon. President and the Rev. John Jenkins accepted the position of Hon. Member. Mr. M. G. Thomas, M .E., was promoted to the rank of Corps Officer. Competition successes for the year were as follows :— Seniors, 1 st prize at Ystradgynlais Open Competition, 1 st prize at Briton Ferry Open Competition. A Divisional team representing Seven Sisters Colliery won the Evans and Bevan Cup for Inter Colliery Competitions. Nurses, 1 st prize at Seven Sisters, 2 nd prize at Neath. Male Cadets, 1 st prize at Seven Sisters. The only set back the Division has to record is the death on active service of one of its most popular members in the person of Corporal John Williams. The meeting ended with the Chairman complimenting the Division on a very successful year. O n llw v n
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R e v ie w s . The F i r e G u a rd ’s Pocket C h a rt. By T. M. Ross. Jordan & Sons Ltd. P r ic e <j.d. ; by post yd .
London :
In this most practical chart (the previous issue of which was so widely welcomed by Fire Guards all over the country) information essential to Fire Guards is presented by means of pictures, diagrams and tables in a manner which will facilitate their training and make revision easy. It is thoroughly up to date.
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H a e m o rrh a ge . To the keen and enthusiastic first aider there are few more interesting- or absorbing studies than the subject of hasmorrhage, its various kinds and different methods of treatment. Most readers are conversant with the peculiar character istics of each variety. It is not proposed therefore, in this article, to enter into any detailed description of arterial, venous or capillary bleeding, but rather to endeavour to impress on readers the absolute necessity for maintaining their efficiency in this very important subject. A well-known authority on ambulance work says :— “ One of the chief obstacles to usefulness of volunteers in first aid is the natural dread of blood. The sight of an injured artery spurting with blood, is a sight enough to appal the stoutest heart and unnerve the steadiest hand. Many a one who would face without flinching, a case of fracture, or is coolness itself when dealing with a severe fit, quails at the sight of a gushing wound and turns away with blanched lips from a patient streaming with blood.” Many can doubtless recall their first course of lectures. The class as a whole went bravely through the ordeal of the descriptive account of the skeleton, etc., but. when at the second lecture the doctor commenced to describe the circula tion of the blood, one or more of the students were soon visibly affected and found it necessary to quit the lecture room. This dread of blood, is however, to a great extent a wise provision of Nature, as the sight of blood at once arouses u« to a sense of danger, and prompts us speedily to adopt efficient treatment, with a view to minimising its effects. That is the effect that the sight of blood would have upon the resourceful and skilled first aider. Should, however, this dread of blood be allowed to gain too pronounced an influence over us it will eventually result in less nerve power. This mav render the first aider so acutely nervous, that the assistance given may be made not onlv non-effective, but, in the case of some injuries, it may possibly increase the gravity of the danger. Continued practice, however, and a strong determination to overcome this failing, will, in time, enable these faint-hearted ones to acquire the habit of keeping a cool head and steady hands, when they find themselves confronted with the sight of blood. It is a somewhat common idea with many people that a case of bleeding left unattended must necessarily be fatal. This, however, is-not always so. In the case of an injury to one of the largest blood vessels, such as the femoral or carotid arteries, there is little doubt that if skilled assistance were not properly administered, the patient would undoubtedly bleed to death. Nevertheless with some cases, in which arteries are severed. Nature has the knack of assisting itself without artificial aid ; and this she often does in the interests of those, who, in their hour of need, are deprived of human assistance. It is our duty, therefore, to study Nature’s methods, to assist her operations, to remove obstacles from her path, and to regard her, as we should, as a skilled and sagacious colleague. If we do these things, we shall, in our subsequent treatment, interfere as little as possible with her handiwork, especially when our action bears the impress of efficiency. Now, what are the usual means whereby Nature usually brings about the spontaneous arrest of haemorrhage ? They are three in number and may briefly be described as follows : 1 . By the contraction of the cut ends of the wounded vessels. 2 . By the coagulation of the blood at the mouth of the injured vessels, the clotted blood thus forming a plug and thereby sealing up the vessel. 3 . By the tendency of the patient to faint. This necessarily has the effect of slowing the heart’s a tion, thereby retarding the flow of blood and thus favour
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ing coagulation. In a case of this kind, therefore, it will at once be seen that the act of fainting is really beneficial. It follows, therefore, that the common practice on the part of ignorant, or untrained persons, to attempt to revive the patient by the administration of stimulants and by other means is entirely wrong and may have a tendency to start afresh the bleeding, thereby frustrating the well-intentioned efforts which Nature had made to effect it’s control. Now how are we to aid Nature’s methods ? Briefly put they are as follows :— 1 . Position. 2 . Pressure. 3 . Free circulation towards heart. 4 . The application of cold. With all these, most readers are well acquainted, and therefore it is not proposed to enter into lengthy explanations but to draw attention to one or two points which should be impressed upon your memories. 1. P o sitio n .— Never lose sight of this most necessary precaution. The raising of an injured limb (remember that blood finds it harder to flow upwards and that its progress is therefore materially retarded) ; and the placing of the patient in the best and most appropriate position, be this sitting, supine or semi-recumbent. In nose bleeding it is a common mistake to allow the patient to lean over a basin or the like in case some house hold or personal clothing be spoiled. See that the patient is placed on a chair with head back and arms above or resting on the head. At the same time, of course, applying cold compresses to the bridge of the nose and to the nape of the neck. 2. P re ssu re .— This may be of two kinds (a) direct by pad and bandage, digital, etc., or (b) indirect, i.e., digital or tourniquet on pressure point. Should the wound contain some foreign body or be too large for direct pressure, then we must resort to the indirect method. When applying a tourniquet make sure that the pad is on the right spot before tightening, and only exert enough pressure to stop the bleeding. So many are of the opinion that it is necessary to apply a tourniquet as tight as is possible, instead of only as tightly as to stop haemorrhage. j . F re e C irc u la tio n .— Always remember to loosen all re stricting articles of clothing— collars, belts, suspenders, tight socks, etc., with a view to securing free circulation towards the heart. 4. C o ld A p p lic a tio n .— The application of cold (water, ice, compresses) to a site assists in closing the ends of the minute capillaries which have been broken. A typical case is that of a “ black eye ” (bruising) where the blood vessels under the skin have been broken and the blood, although not escaping through the skin, is nevertheless escaping from the blood vessels. In internal haemorrhage an ice or cold water compress over the seat of injury is of the greatest assistance in stopping the escaping blood. OAA
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Queries and Answers to Correspondents
A ID
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Blood in Arteries and Veins. N.O. (Harrow).— The blood in the arteries is bright red. A friend says that bright red blood is sometimes found in the veins. As I cannot accept this, I write to ask for your kind ruling. The name “ artery ” is given to those blood vessels which carry blood from the heart, while the name “ vein ” is allotted to those which carry blood to the heart. Consequently we find venous blood in the pulmonary artery which carries im pure blood to the lungs for purification ; and we find arterial blood in the pulmonary veins which return the purified blood from the lungs to the heart. In all the other arteries the blood is always bright red (or arterial) and in all the other veins it is always dark red (or venous).— N. C o r b e t F l e t c h e r . Examination Howler. M.R. (Cannon St.).— The amusing howler, which was pub lished in the December 1943 issue of F i r s t A i d and which told how a first aider proposed to control the carotid artery by means of a tourniquet round the un fortunate patient’s neck, reminds me of a similar mistake. Some years ago I was examining a class and asked a candidate how he would treat a patient suffering from bleeding from the tongue. I was much amused when he replied “ I w o u ld p la ce a to u rn iq uet ro u n d the tongue a n d heep it q u ie t ! ’’ Good!
Next, please ! !— N.C.F. Treatment of Abdominal Wounds. N.T. (Cardiff).— Please tell us why salt solution is suggested in the Textbook (p. 131 ) as the correct treatment of wounds of the abdominal wall accompanied by protrusion of the bowel. Thus far nobody has given me a satisfy ing answer ; and so I venture once again to ask your kind help. The salt solution, as suggested in the Textbook, is of the same consistency as the fluids of the body tissues. Con sequently it acts beneficially in that, when applied to wounds of the abdominal wall accompanied by protrusion of the bowel, it prevents extraction of salt from the tissues of the bowel.— N.C. F. Injured Femoral and Fractured Femur. G.E. (Northwich).— I will be glad if you will give me the correct treatment for a wound of the femoral artery accompanied by fractures of femur and of pelvis. The patient also needs a blood transfusion, immediately after having been treated and made ready for hospital. I am a H.G. instructor with 15 years unbroken ser vice in S.J.A.B. ; and I was asked the above question by my superior officer. I said that I would arrest bleeding first and splint the femur. He replied, however, that our Medical Officer does not accept this treatment and that the splint should not be used owing to transfusion having to take place.
F I R S T
A I D
105
W hat do yo u k n o w about I O D I N E Y
OU are already familiar with the use of tincture of iodine as a wound
dressing. Do you know some of the other
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F I R S T
Your query relates to a military rather than to a civilian problem in first aid. Further it is not clear from your letter what facilities exist in the circumstances named for giving a transfusion. If this is to be done in hospital, then the limb must certainly be controlled by a splint on the spot to prevent aggravation during treatment and transport. Should, how ever, a Mobile Transfusion Unit be available, it is still necessary, in my opinion, to splint the fracture pending the arrival of the Unit. This done, the bandages could then be loosened under the watchful care of the Medical Officer should he decide that transfusion is indicated without further delay.— N.C.F. Effects of Sodium. R. B. (Scunthorpe). — I read with interest your reply to the query which was published in the January issue of F i r s t A i d ; and, in order t o g o deeper into the matter, I wonder if I may be permitted to pass these comments :— The burning caused by solid sodium is due, in the main part, to oxygen atoms in the human tissues. If a dilute acid solution is applied before the remaining sodium is removed from the skin, I venture to suggest that an aggravation of the injury' will result from the chemical reaction of the sodium and the watery solution, which produces intense heat in such a confined area. Therefore, I suggest that the correct treatment would be first to remove the remaining solid particles in the quickest way possible (by the use of forceps, or by flooding with a stream of water) and then to apply the dilute acid solution to neutralise any caustic soda which may have been formed. I should like to add that no aggravation of the injury will result from flooding the area with water, as the sodium will be washed away before any heat reaction can assume sufficient propor tions to be harmful to the patient. It will then, of course, be necessary to treat the patient for the resultant burns. Many thanks for your letter which has been read with interest and agreement. The treatment given in my previous reply was for the burns and pre-supposed that any solid par ticles of sodium on the skin had already been removed.— N.C.F. Effects of Liquid Bromine. R . B . (Scunthorpe) — I wonder if you will be kind enough to give me guidance in a matter which I have failed to find official treatment, either in first aid books or medical works. During my work as an analytical chemist I have had to treat patients for burns caused by liquid bromine. I might add that a very severe burn quickly ensues from this liquid. I have always treated such injuries with sodium bicarbonate solution ; but I am not satisfied that this is the best treatment. One of our senior chemists assures me that a paste of quick lime is the correct treat ment. Will you give me your views on the subject please ? (N o te .— A. paste of quick lime will not burn the skin as the heat evolved in adding quick lime to water has subsided before the paste is applied.) The application of liquid bromine to the skin will pro duce an injury which, although analogous to a burn, is rather in the nature of a sore. There is no evidence that quick lime, even if available, would be particularly effective ; and I think that, for first aid purposes, it is wiser to stick to the bi carbonate of soda which is known to he soothing.— N.C.F. Treatment of Wounds. R. H. (Morley).— Would you please explain the two following paragraphs which are included on p 107 of the Text book, under the section— “ Objects of Treatment of Wounds ” ? In paragraph (b) we read the words “ by the addi tion of an antiseptic ” and in paragraph (d) we note the words “ or ointment.” I want to know how an anti
I I D
septic or an antiseptic ointment will introduce germs into the body ; and I await your kind reply with interest. You have misread paragraph (b) which does not say that an antiseptic may introduce germs. What it does say is that washing a wound with ordinary water may introduce germs and that this may be prevented by boiling the water or by adding an antiseptic to it. Next, as to paragraph (d) the Textbook does not refer to “ antiseptic ointment ” but only to “ ointment.” It is well known that any greasy surface such as results from the application of ointment may form a base in which germs may rapidly multiply. Hence the warning not to apply oint ment to any wound.— N.C.F. The Textbook and the Journal. A.T. (Birmingham).— The questions and answers given in F i r s t A i d have the St. John Textbook as their basis of information. In giving the details for the treatment of wounds, on pages 106 -7 , we are definitely instructed not to apply sticking plaster or ointment— a teaching which you have often substantiated in the query column. Is it not rather inconsistent for you to be confirming the Textbook rulings, whilst other pages of the magazine contain advertisements urging the first aider to use various preparations ? We fear that your suggestion of inconsistency is not understood. Since it was first published in July, 1 8 8 5 , F i r s t A i d , acting down the years on the advice of its Hon. Medical Correspondents (Drs. Heaton Howard, Frank Christian and Corbet Fletcher) has consistently regarded the St. JohnTextbook as the best and most useful guide to the art and practice of first aid.— E d i t o r . Loading Stretcher. G.A. (Overseal).— At one of our class meetings after a lengthy discussion we concluded with a difference of opinion on the following point :— What should be the position of a Bearer’s right knee in relation to his elbow— inside or outside— when lifting a patient on to a stretcher ? Personally, I think that outside the elbow is better, because it is more com fortable for the Bearer who can get lower down to his patient. Fig. 94 on p. 209 of the Textbook shows the Bearers with their elbows outside their right knees ; and experience has proved that this is an effective and comfortable position. It is, however, possible that you find it more comfortable to have your elbow inside the right knee. If this is so, I see no objection to your variation of the official method.— N.C.F. Artificial Respiration. W. P. (Bristol).— Having received assistance from yon on several occasions in connection with difficult questions on first aid, I would be grateful if you would once more come to my help on the following point :— In the pressure movement of Schafer’s method, is the diaphragm forced up to the arched position or is the diaphragm forced higher thus forcing out more air ? It is, of course, understood that under normal conditions a forced expiration can get rid of an extra 1 ,5 0 0 c.c. of air, leaving only 1,000 c.c. of residual air which cannot be expelled. The diaphragm is always arched but this arching is flattened during inspiration. In Schafer’s method the arch is forced higher into the chest cavity than is usual thus expelling air ; and it is the return of the arch to its normal position which results in inspiration.— N.C.F. Action of Cocoa. G.A. (Leeds).— Please tell me why cocoa is never included in the list of stimulants together with tea, coffee and meat extracts. Cocoa is a food and so cannot be regarded as a stimulant. — N.C.F.
F I R S T
TRAINING IN HYGIENE THE ROAD TO PROMOTION
107
A I D
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EMERGENCY TREATMENT O F S K IN IN JU R IE S Be prepared for an em ergency and keep C u ticu ra Brand O in t m ent in you r First Aid Kit. It brings instant soothin g relief to cuts, burns, skin lacerations— p reven ts spread of infection, quickly heals. O btain able at all Chem ists and S tores.
(U tic u r a O
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F I R S T
Action of Saccharin. G.A. (Leeds).— Please tell me if saccharin has any value as a stimulant and also if it has any effect on diabetes. Saccharin is a chemical substance which, bulk for bulk, has a sweetening power from 300 to 500 times that of cane sugar. It is prepared from toluene, hasmo stimulant or food properties, and is used as a sweetening substitute for sugar, particularly in diabetic cases.— N.C.F. Amputation of Foot. R.L. (Londonderry).— A controversy has arisen in our Post as to the proper procedure to be adopted by a First Aid Party Leader in the following circumstances :— The F.A. P. and N.F.S., operating in a fiercely burning building, have removed and attended to all casualties. The F.A.P. are leaving when the roof crashes ; and one of the Party is trapped by a 3 -ton girder falling across his foot on a cement floor. All efforts to release him are without result and telephonic communications are disrupted. So a messenger has been despatched to the nearest Report Centre. Other girders may crash at any moment ; and the Fire Service Chief pronounces the building dangerous. If anything is to be done it must be done at once, and by those on the spot. What, in your opinion, should be the decision of the F.A.P. Leader ? One line of action suggested is that the limb should be amputated, using a knife or any suitable instrument available. This naturally brought forth many pro and contra arguments. So we decided to enlist your help, as we have here a great respect for your guidance to those who, like ourselves, are eager to be prepared for anything our duties as first aiders may present or demand. Your query suggests that in the circumstances named, a decision means the choice between the life or death of the victim. In point of fact, this is not true because, if a layman should attempt amputation of a limb or part of a limb, par ticularly with inadequate equipment, the patient though rescued momentarily, would die subsequently from haemorrhage, increased shock or sepsis. Further, as this was a major incident, I want to know why a doctor was not sent by the Report Centre when the First Aid Party was despatched.— N.C. F. Effects of Electrocution. F.J. (Barnet).— Recently I was giving instruction on electro cution and the resultant asphyxiation. A member of my class asked me if it was correct that in some cases a patient, having recovered from asphyxia, was placed in a rubber suit in hospital for 4 8 hours, as he had heard that it was so. Is it possible for a charge to be transmitted to the metal parts of the bed thereby involving any person approaching ? Personally I do not think this is so, the patient not being now in contact with electricity. Or is it just a “ bright lad ” of the class indulging in a little leg pulling ? Being unable to give a satisfactory answer I told him I would endeavour to find the reason. Thank you for your invaluable help in the past. You are correct in your opinion. The small amount of static electricity which remains in the body after partial electrocution is not sufficient to cause harm to others. In these circumstances the suggestion that such patients are placed in a rubber suit on admission to hospital seems to me to be somewhat facetious.— N.C.F. Priority in Despatch. T.B. (Barnard Castle).— I would like the favour of your valued judgment on the following : A team of four is called to attend at an upset motor wagon, casualties as follows :— No. 1 . Driver, pain at right lower ribs ; signs and
A I D
-
symptoms of internal haemorrhage ; semi-conscious. No. 2 . Fractured femur ; shock ; conscious. No. 3 ; Vertical wound in abdomen; no protrusion; unconscious. No. 4 . Right hand severed at wrist ; faint ; conscious. After four minutes a van arrives, cannot take two stretchers, but might take stretcher and one patient on floor of van. No signs of ambulance or other vehicle. What should be the order of treatment and despatch ? Hospital is five minutes journey. Please accept our thanks in anticipation of your kind ruling.
As it is possible for the first aiders in attendance to give some assistance to the second and third casualties pending the quick return of the van, I would select the first casualty as the stretcher and the fourth as the sitting case. Of course, the second and third casualties would have to be removed in the recumbent position.— N.C.F. Treatment of Fractured Clavicle. A.B. (Rotherham).— In a recent competition which was judged by a first aider, we had to treat a patient suffer ing from apoplexy and fractures of left femur and of right clavicle. The accident occurred in the open and there was no shelter available. 1n the circumstances we did not remove the patient’s coat in our treatment of the broken clavicle because of the risk of lowering the body temperature which might adversely affect the most serious condition, viz apoplexy. Afterwards we were amazed to hear the judge say in his comments that we had lost four marks for not removing the coat. On the facts stated I approve your action, and as a first aider I would not have removed the coat because this would take time and would delay the patients removal to hospital. — N.C.F. Compound Fracture of Leg. E.L. (Kingsbury)’— In a practice test the patient had a com pound fracture of leg with bone protruding. The injury was treated by straightening the limb, and then apply ing splints and bandages according to the instructions on pp. 91 and 92 of Textbook. Commenting on the test I said that I believe all judges would accept that method, but that I thought a better method is as follows :— Gently bend to straighten the limb if it eases the pain ; but stop before the bone re-enters the wound. Maintain support and prevent movement while the sound limb is brought into line with it ; bandage limbs above and below fracture, ankles, knees and thighs ; apply splint from armpit to below feet and secure by bandages round chest, ankles and feet, and pelvis ; turn patient on his back ; and support limbs with pillow. (Reference to dressing wound and padding is omitted to save space). Opinions are divided and I was asked if my method would be approved by a competent authority. To this I could not reply ; and so I would be pleased if you would kindly express your views upon it. To me there is little, if any, difference in the two methods described in your letter. Further, it would seem that the word “ straighten” has been confused with the word “ extend.” In no case should the protruding end of the fractured bone be drawn into the wound but usually it is possible to place the injured limb in line with its fellow with out exerting any extension.— N.C.F.
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For Wounds, Cuts, Burns, Skin Irritation
GERM O LENE Instantly Bo Prepared^ For protects against germ in Emergencies* fection, prevents blood and Keep a< poisoning, and promotes Tin Always rapid healing ! G erm o len e at Hand causes the broken tissues vam m m aa) to unite, grows new skin AA /W W V V W and heals over the broken place cleanly. It soothes at a touch, ends pain and brings ease. A t the present time, N O home should be without a tin of the world s quickest healing ointment. Get yours to-day !
IS WONDERFUL FOR SUCH SKIN TROUBLES AS: ECZEMA, SKIN RASH, IMPETIGO, LEG TROUBLES, CUTS, PI MPLES, SORE FEET H E A L I N G A d h e s iv e P la s t e r GERMOLENE
[F o r F ir s t - A id in E m e r g e n c y use
Sold
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fientunflagt FIR S T A ID
O R D E R LIE S .
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D R ES S IN G S
Elastic, Adhesive, Antiseptic They H e a / while th ey Soothe and Pro tect because they are
IMPREGNATED with GERMOLENE Medication. From all Chemists. 6d .& I/-p er tin o f assorted dressings
w n i w w w w w w w v w n w *'
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. c o n ta in s m u c h u s e f u l in f o r m a t i o n . " —
Prbscriber.
I N T R O D U C T I O N T O F I R S T A I D by John R. M. Whigham, M.C., M.S., F.R.C.S. A new and up to date manual on this subject based on lectures given to St. John Ambulance classes over a period of years. With many illustrations. Price ls. 3 d. postage 2 d. By Col. R. J. BLACKHAM, C.B., C.M.G., C.I.E., D.S.O., M.D. A IR R A ID F IR S T A ID A Series of 15 Charts c o v e r in g a ll the d u tie s o f a F ir s t A id W o r k e r , g iv in g f u ll in stru ctio n s as t o A i r R a id effects an d p r e c a u tio n s, r e c o g n itio n and tre atm e n t o f in ju rie s.
The Ideal Wall Chart. Size 2 2 \ in. x 14 £ in., has been prepared for use in Air Raid Shelters, Red Cross and St. John’s Ambulance Stations and Classes, and all places where First Aid and Nursing are required. Price 7 s. 6d. Postage 6d. The Home Chart. Size 13 in. x 1 \ in., has been specially prepared for use in the Home or small groups, price ls. 6d. post 3 d.
Printed on strong paper and mounted on roller for hanging. Second
Impression.
By A . E. JO H N S O N . P O IS O N G A S .
A complete folder on the detection, effects and treatment of gas with chart and advice on drill and particulars of decontamination and care of respirator. Invaluable
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F I R
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(Companion to POISON GAS folder) by same author. Complete tolder giving all the essential points on how to tackle the latest incendiary bombs, which every Fire Fighter should know. Price 3 d . postage I d . J O H N B A L E M E D IC A L . P U B L I C A T I O N S L T D . 1 4 , G r e a t S m ith S tr e e t, W e s tm in s te r , S .W . 1.
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“ This is u ndoubtedly one ’o f the finest books on the subject th >t has been produced w ell and thoro u ghly tau ght, and from tl Is t e x t b o o k
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Pp 514
U nlike the ordinary so cketted Splint, this typ e is rigidly coupled togeth er and held against relative displacem ent but can be disengaged by pulling apart w ith sufficient force.
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A N .B .— To ensure perfect locking it is im perative th at the Splint A C should be correctly inserted in the socket, I.e., BY M A K IN G C E R T A IN T H A T TH E IN C U R V E D ED GE O F METAL S O C K E T E N G A G E S W IT H TH E T R A N SV ER SE G R O O V E O F THE SPLINT.
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A ll the information Is up-
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★
Price : C o m p lete w ith tw o pairs o f straps - - 4 / - per set. W ith o u t straps ...................................... 3 / - per set.
. . . The first
aider will find th a t he is not only Instructed, he is
a Bv this Invention'Splints made in any convenient lengths make rigid connections by means of incurvedopposite edges of the metal sockets or sleeves firmly engaging with transverse grooves in the surfaces of the Splints when pressed home into th« socket.
A id
re a d y at
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FIRST AID Ifye |n6cpcn6citt Journal /or ftje Ambulance anb Jftursmcj perukes; N o . 5 9 8 , V o l.
L .]
A P R IL ,
1944.
ADVANCED A.R.P. QUESTIONS ANSWERED
TH E
T R A IN IN G F IR S T
A ID
C O M P E T IT IO N
By R. D. W o r m a ld , M .A., L.A.R.P., and J. M. Y o u n g , M .A ., L.A.R.P. This new book by the Authors o f “ 250 A.R.P. Questions Answered” covers the following subjects:—
OF
TEAM S
By
R. B O Y C E -M E A R S
Blitz First A i d ; Light Rescue; Fire Prevention in Business Premises; Decontamination; Incident Control. There are numerous line drawings.
F ir s t A i d a n d A . R . P , Officer
2s. 6 d . ; b y p o s t 2 s. 8d.
I s . ; b y p o s t l s . 2d.
Lon d on A m b n la n ce S erv ice
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BIOLOGICAL M B L PREPARATIONS A
N
T I P
E O
L
S C T I
O
I N
T M
E
N
T
One or other or all of the three races of germs, Streptococci, Staphylococci and B. pyocyaneus are found in every skin infection common to this country, and ANTIPEOL OINTMENT contains the antibodies (antivirus) of these germs. Healing is expedited by the proved ingredients of the ointment, and septic development is stopped or prevented by its antivirus sterile vaccine filtrates. A N T I P E O L OINTMENT is unsurpassed for BURNS and SCALDS, for it is microbicide and non-adhesive, and dressings do not require to be changed every day. WOUNDS, BURNS, etc., WILL NOT TURN SEPTIC if treated with ANTIPEOL OINTMENT.
O
P
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A
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O
- A
N
T I P
E
O
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is a semi-fluid ointment, more convenient than the ordinary Antipeol ointment for ocular infections and lesions. Eyes affected by smoke and dust are soothed almost immediately by the application of Ophthalmo-Antipeol, and the antivirus prevents germs from developing.
R
H
I N
O
- A
N
T I P
E O
L
affords rapid relief of COMMON COLDS, INFLUENZA, AND CATARRH. Containing the antibodies of the germs common to infections of the nose and pharynx (Staphlylococci, Streptococci, B. pyocyaneus, pneumococci, pneumobacilli, enterococci, M . catarrhalis, B. Pfeiffer), Rhino-Antipeol is not just a palliative, but is a remover of the cause of the infection. During epidemics it is the ideal preventive of microbe development. Clinical Sample* on request from M E D IC O -B IO L O G IC A L L A B O R A TO R IE S L T D ., Cargreen Road South Norw ood, London, S.E.2S
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R e g u la tlo n
The First Aid man*s skill Is unavailing If the victim's respiration Is allowed to fall — prompt action with the Sparklets Resuscitator Is vital to successful recovery.
C o a t, New Style. To measure from 7 8 / -
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Write for leaflet **Prompt First-Aid Treatment of Asphyxia and other Respiratory'Failure Emergencies." Sole Makers: S P A R K L E T S L T D Dept. 42, L O N D O N , N .I8
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I$ th E d itio n . F u lly Revised. 232nd Thousand. 313 Illus. Some coloured.
W A R W IC K
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A
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A n A d v a n c e Am bu lance H a n d b o o k . E d ite d fry N O R M A N H A M M E R , M .R .C.S., M ajor, lata R. A . M .C ..T.A .
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Special Set of 6 Sheets for the use of L E C T U R E R S & A . R. P. C LASSES comprising Anatomy, Physiology. Haemorrhage, Disloca tions snd Fractures. Mounted on linen with roller 27/6 net; postage 7d.
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FIRST A ID JrofepenAen! ^onntdf^fbr tije Ambulance nab p u r s in g Editor 1
CQQ INO. o y o .
W ALTER
V(1 r T VOL. L .
SCOTT,
A P R II 1 9 4 4 IX I1^, 19 T t.
TO
READERS.
CONTENTS
OF
THIS NUMBER.
—
A National Ambulance Service ... Recent Advances in First Aid Work in War
... ...
110
Police Ambulance News ... ... S.J.A.B. Headquarters and District Reports
... ...
Ill Ill
Railway Ambulance News
109
...
...
...
113
Letters to the Editor ... ... St. John Ambulance Association...
... ...
... ...
113 113
Allergic Diseases ... ... ... 8 Qualifications for the First Aider in Verse
... ...
114
The Home Guard and First Aid
...
116
••
f 16
Reviews Q
u e r ie s
... a n d
A
n sw er s
... •••
to
C
■ ■ ■
o r r e spo n d e n ts
113
:—
Burns of Face and Compression
...
...
118
Examination Howler
...
...
...
118
Lay Instructor
...
...
...
118
Blitz First Aid ... ... Treatment of Black Eye ... Treatment of Dislocated Hip
••• ... ...
••• ... ...
118
Humour in A.R.P. ... Examination of Fractured Pelvis
••• ...
... ...
118 120
Treatment of Scorched Lungs
...
118 118
....
...
120
Colour of Face in Asphyxia... ... Performance of Artificial Respiration
... ...
120
Eversion of Eyelids Temperature of Body Burns Due to Electricity
... ... ...
... ... ...
120
•••
...
120
Lay Instructor
...
... ... ...
f( S t a Et inot ne re er ds ' at 1 (4/. Phr PRICB THREEPENCE H a ll\ Annom, Post Frbb
EDITORIAL.
FIRST AID is published on the aoth of each month. Tbe Annual Subscription is 4S. post free ; single copies 3d. Its aim and object being the advancement of Ambulance Work in all its branches, the Editor invites Readers to send Articles and Reports on subjects pertaining to the Movement and also welcomes suggestions for Practical Papers. All Reports, &c., should be addressed to the Editor at the address below, and should reach him before the 8th of each month, and must be accompanied (not necessarily fo r publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with FIRST AID should be forwarded to the Publishers. DALE, REYNOLDS & Co., L td., 46, C a n n o n S t r e e t , L o n d o n , E.C.4. Telegraphic Address—“ Twenty-four, London." Telephone— City 3710.
d it o r ia l
F.R .S.A .
t \ r
NOTICE
E
F.R.San.l.,
120 120 120
T o o m uch stress cannot be laid upon the im portance of an am bulance service in d ays such as those the country is now p a ssin g throu gh . T h e road slau gh ter alone is sufficient to prove its absolute necessity, not o n ly in the bu sy streets of the towns but in th e m ost remote parts of the country, in the most sequestered lanes— everyw here indeed, where motor traffic finds its w a y . It is an indisputable fact that am bulances have not follow ed the pro gress w hich has marked advance in other veh icles. A s a correspondent points out, it m ust be re membered that the vehicles supplied for am bulance purposes in som e of the country districts were old cars, converted w ith a structure to carry stretchers. T h e s e vehicles are now five or more years older than when supplied. Furtherm ore, a certain am ount of the n o n -startin g trouble is due to the unsuitable places in w hich the veh icles are housed, and alth o u gh repeated application has been m ade to the authorities for im provem ents, little or noth in g has been done. W e have all of us seen antiquated vehicles of this kind and they certainly serve to inspire the reverse of enthusiasm in those who are w hole-heartedly e n g a g e d in first-aid work. T h e re was a time, some h alf-a-century or so a g o , when the fire brigade of rural and sm all urban districts were subjected to the m ost un grateful treatm ent. T h e fact that they were m aintained by volu n tary labour with voluntary funds was over looked and they were subjected to universal con tem pt and ridicule, not o n ly in the variety halls but in the press. T h e men were zealous in the performance of their duties and formed a bo d y (un fortunately, not united) of the utm ost usefulness. T h e y were, how ever, the butt of jo k es on their alleged inefficiency, the fact b e in g en tirely over looked that efficiency was possible o n ly w ith proper and sufficient equipm ent. It was realised on the outbreak of war, when everyone w as, so to speak, in the front line that such a state of th in g s could not be permitted to exist, that the fire-figh tin g services could not cope w ith the various troubles that m igh t arise (and did arise) an yw here at an y tim e. T h e result was that the N . F . S . was started A N a tio n a l A m b u la n c e S e r v ic e .
F I R S T
and is now in a very efficient state, due not o n ly to the new personnel infused into its ranks but to the lavish o utlay that has been expended on equipm ent. T h e re is not the least reason w h y the am bulance service, if it were placed on a national basis, should not becom e eq u ally efficient, with the most modern appliances in place of its far too great a quantity of old, tim e-worn vehicles and other equipm ent. T h e re would be no trouble about its personnel— the su p p ly of that is a foregone conclusion. W ith a N ation al Fire S ervice, a N ational F irst-A id S ervice and a N ational A m b u la n ce Service, the nation would stand prepared for every eventuality both in war and peace.
R ecent
A dvan ces in
in
F ir s t
A id
W ork
W ar.
By SIR H EN R Y L. MARTYN, K.C.V.O., F.&.C.S. (Casualty Staff Officer, G Area, Devon C.C.) ( C o n tin u e d from page 9 9 . ) The summation of his discoveries and that of others was that wounds due to high explosive must be regarded as in an entirely different category to those of civil life. Because of the tremendous force concentrated by the pro jectile in the small area of the wound the tissues, often for a depth of more than half an inch immediately sur rounding the wound, were killed, and into this mass of dead skin and muscle were ground enormous numbers of bacteria carried in from skin and clothing. No antiseptics applied to such a wound were capable of penetrating the dead tissues and destroying, or even limiting the growth, of the bacteria. For a certain period of about six to eight hours these invading bacteria tended to remain inactive and confined to the dead tissues in immediate relationship to the wounds, but after that time had elapsed they commenced both to increase rapidly in numbers and to spread into the surround ing and otherwise undamaged tissues of the body. Almost simultaneously with this advance in knowledge came the discovery of the large group of drugs, of which M and B is most familiar to the lay mind. These are not antiseptics in the accepted sense of the term, but they are nevertheless capable both when applied locally or taken by the mouth of preventing the spread and growth of bacteria. What vast changes these discoveries produced in the treatment of every sort of war wound. It became apparent at once that if a wound could be excised complete with all the dead tissues and the contained bacteria within 6 to 8 hours, the wound so created sprinkled with one of the newly discovered drugs, and the limb sub sequently completely immobilised in a plaster of Paris casing the ideal of the surgeon would result— a wound practically clear of infection, one that would heal cleanly with the minimum necessity for dressing in the shortest possible time and, above all, one that would occasion little chance of dangerous blood poisoning. The treatment has revolutionised our hospitals called upon to deal with air raid casualties. Seldom now do we see those ghastly suppurating wounds dragging their slow course to eventual healing over weeks and months, the
A I D
patient’s life a burden with constant painful dressings. Not only is the mortality of wounds vastly decreased, but the time of recovery shortened and the eventual result infin itely better. Now let us consider to what extent these things depend upon the work of the casualty services in the field. The main thing is that the casualty should be operated upon within the time limit of 6 to 8 hours from the receipt of his injury, during which the bacteria ground into his wound remain quiescent. No patient can be operated upon while still in a state of severe shock, and valuable hours may have to be devoted to resuscitation before any treatment of his wound can be undertaken, It is therefore clear that two things become of even greater importance than ever be fore—the limitation of shock and the speed with which the patient can be got into hospital. It is largely from this point of view that the modern abbreviated methods of first aid treatment in the field become of such great importance. Careful discrimination must ob viously be used in determining which cases warrant the employment of speedy methods, and in which shock would be dangerously increased by anything less than the most careful and full treatment in the field. I shall have more to say upon this point later on, but one example is now sufficient. In your February issue a correspondent raises the ques tion as to the wisdom of applying a broad bandage over the site of a fracture. The answer is given that such treatment — employed perhaps in bandaging an upper arm fracture to the side without using splints— would not be likely either to aggravate the injury or increase the pain. That being so, the method has great advantages over the formal splint ing since the time necessary to complete it is obviously very much less than that required by other methods. It is not only the point of view of conserving equipment that enters into the question but the still more important conservation of time. In short— the sooner a patient can be got on to the operating table and the less his shock when he reaches hospital, the greater will be his chance not only of life but of rapid recovery. Any methods therefore which can eliminate the laborious and unnecessary, with due regard to shock, should be brought into use on every possible occasion. Without entering into a detailed description of the numerous abbreviated methods of handling fractures taught in the Regional Schools, it may be profitable to review them generally. Any method advocated must conform as nearly as possible to the two primary requirements for the treatment of any fracture, namely, that the fracture itself and the joints above and below it must be immobilised, and that the risk of aggravation of the injury during transport must be reduced as far as possible. The elementary training of first aiders is largely influenced by the idea that these results can only be obtained by the use of rigid splints either real or improvised. Careful consideration however will show that this view may in many selected cases be changed without unduly risking an increase in shock.For instance in the case of compound fractures of the upper limb, unless accompanied by severe haemorrhage, the shock element is not likely to be predominant as it is invari ably in the case of fractures of the thigh, pelvis, or spine. As a general rule therefore, it may safely be assumed that abbreviated methods such as bandaging an upper arm fracture to the body with a broad bandage while the wrist is supported in a narrow arm sling, and the similar bandaging of a fractured forearm supported in a broad arm sling to the front of the body will be both harmless and speedy. On the other hand anything save the most careful splint ing of any fracture involving the femur before tbe case is moved from the site of injury is likely so to increase the shock that abbreviated methods will defeat their own ends.
F I R S T
This does not imply that improvised splints should not be employed rather than waiting for formal equipment, or that shortened methods such as the utilisation of broad band ages rather than several narrow ones, are not equally effec tive. The main point to be insisted upon is that speed plus the avoidance of shock is the essential factor, and that the exact and meticulous observation of routine is of very secondary importance. With regard to compound fractures of the leg involving both hones below the knee, I am strongly in favour of one of the abbreviated methods now advocated in preference to formal splinting in all cases. Not only is it quicker but it is definitely more effective in its control of the type of injury most commonly found. When a bomb fragment does hit a leg below the knee, the smash is generally very complete indeed, and the first aider is apt to find himself faced with a wound involving a considerable part of the limb, bones extensively fragmented, and in fact, very little left to which a splint can be securely fastened to give adequate support even if the sound leg be also included. The difficulty can be overcome very effectively by utilisa tion of the following method. Start by dressing the wound, straightening the smashed limb, placing it beside the sound leg and fastening the feet together. Now take a blanket and fold it to a width corresponding to the distance between the centre of the thigh and below the foot of the injured patient. Slip the folded blanket carefully beneath the legs leaving an equal length of blanket on each side. Roll the free ends of blanket inwards as tightly as possible until the rolls are closely against the sides of the legs. Complete by bandages passed beneath the blanket above and below the injury and above the knees tying very firmly over one of the rolls. The injured limb now lies in a gutter of blanket which supports it behind and between two tight rolls of blanket on either side providing the lateral support. ( T o b e c o n t in u e d .)
P o lic e A m b u l a n c e
News.
E le v e n teams competed in the V Division annual first aid competition, held at Barnes, on Tuesday, March 2 8 th, at Barnes District Garage. The team test took place on a small stage, depicting a room scene, complete with hearth and fire, and the “ patient”, who had fallen from a chair while hanging a picture, on the floor. The judge was Capt. T. R. H. Wrangham, County Surgeon, Western Area, S.J.A.B. Whilst this test was in progress, waiting candidates were competing in pairs in another part of the premises, where two casualties were provided. The judge for these events was Assistant Commissioner S. J. Warren, S.J.A.B. Out of a possible total of 340 for the double event the winners were Barnes A team with 295 ; second came the Putney team with a score of 2 8 0 . Other teams scored as follows : D. T. 5 team, 2 6 2 £ ; East Molesey, 262 ; Richmond S.C., 250 ; Richmond Police team, 2 4 8 ; Malden, 247 ; Wimbledon, 2 4 4 ; BarnesAux., 231 ; Malden S.C., 223 ; Molesey S.C., 1 6 9 . Supt. R. Donaldson, V Division Metropolitan Police, thanked Station Sergt. Rabson and his assistants for the excellent staging, the judges and the patients. In particular he welcomed Civil Defence members from Richmond, and commented upon their keenness and co-operation with the police in this most important field of work. Presenting the cup, medallions, and prizes, Chief Con stable Bennett said to-day, more than ever before, each citizen required practical experience of first aid.
111
A I D
S t.
Jo h n
A m b u la n c e
H EADQUARTERS
AND
B rig a d e
D IS T R IC T
REPORTS.
County o f Berkshire. There are thirteen Ambulance Divisions and seventeen Nursing Divisions in the county including Reading Corps which has five Ambulance and seven Nursing Divisions. The total number of members in the county including ambulance and nursing cadets is 1 , 529 . On March 1 Sth, eighty officers and members from Nursing Divisions in the county paid a visit to the West minster Hospital, London. Through the kindness of the House Governor and Secretary, Mr. Power, and the members of the nursing staff, they were personally shown round many of the most interesting departments of the hospital. R e a d i n g C o r p s . — 114 ambulance and nursing members are serving in H.M. Forces ; 106 on full-time and 367 on part-time war service. On March 1 8 th, at the Ambulance Hall, Chatham Street, a lecture on anaesthesia was given to members of the Corps by Dr. Ronald Jarman, one of the leading anaesthetists in London. He took as his main subject the anaesthetics which are administered by intravenous injection. He described the newest drug which is being used with such success on people seriously injured in air raids, as well as at the battle fronts. The County Commissioner, Mr. C. A. Poole, introduced the speaker.
R e a d in g T o w n “ B”.— Hon. Sergt. Walker, Treasurer of this Division, has resigned owing to pressure of work and ill health. Private Eric Coak has been appointed to take his place.
T h e a le N u r s in g D i v i s i o n . — A competition was held on March 1 1 th, when a shield was presented to the winning team by the County Commissioner, Mr. C. A. Poole. The shield was given by the President of the Division, Sir Felix Pole. Three teams entered the competition, and the captain of the winning team was Sergeant Glazier.
County o f Lancashire. B l a c k b u r n . — The first general meeting of the Black burn Aircraft Nursing Division, was held on March 15 th at one of the Company’s factories. Among those attending was Lady County Supt. Mrs. Edwards. Reports presented by Lady Divisional Supt. Mrs. Peace, Secretary Miss Collier and Treasurer Mrs. Hornby revealed a strikingly healthy new Division with a live membership of 29 and one probationer. Formed in July, 1 9 4 3 , with 19 members, the Division, already fully uniformed, is in addi tion to working a 55 hour week with domestic responsibilities too, doing regular weekend duties at the Works First Aid Post, Hull Royal Infirmary in the casualty and blood trans fusion wards, and at the Welfare Sick Bay, and helping as drivers or attendants for the ambulance services run by County Headquarters and by the Humberside Corps. The Division has had 100 per cent, pass in all examina tions and is at present taking a Gas Course for the St. John Ambulance Brigade A.R.P. Certificate. The financial position of the Division shows a balance in the bank of over ^jl00— a very fine achievement which reflects equally on the enthusiasm of the Treasurer and the co-operation of all members.
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F I R S T
Votes of thanks to all visitors by Ambulance Officer Mrs. Longley closed an exhilarating general meeting. County of Oxford. W i t n e y . — On March 2 9 th the above Division held its 15 th annual meeting under the chairmanship of the Divisional
Surgeon Dr. Dagleish, supported by E. A. Huddleston, Esq., Vice-President, and the Divisional Supt., J. C. Chesterman. The Secretary reported that the strength of the Division was 38 (and 17 boy cadets) ; 15 members were serving in H.M. Forces, 2 were prisoners of war, the remainder were engaged in A.R.P. work and work of national importance. Cadet Supt. S. Collis reported that the 17 cadets had an average attendance of 1 6 . During the year they had gained the Preliminery Nursing Badge. The Treasurer reported a very satisfactory balance sheet. The Div. Supt. in his report stated that he felt very proud owing to this being an important year in the work of the Division, because it meant that a number of the rank and file would qualify for the coveted distinction of the Long Service Medal. He thanked all ranks for their loyalty and devotion to him and to their Divisional duties, and for the good comradeship which existed between all ranks. They had done excellent work during the 15 years the Division had been in existence, and although they had treated a very large number of cases, never once had he ever heard any complaint, which spoke volumes for their treatment, and he thanked them all very much. During the evening the Certificates and Nursing Badges were presented to the cadets, all of whom were successful. County o f Surrey. G u i l d f o r d . — Corps Supt. Julius D. Rutter of the above Corps notifies us that he has received interesting news from one of his members serving overseas, who writes to say that he has been awarded the Military Medal for his first aid work at Mt. Cammino in Italy. The member’s name is Guardsman F. Smith of No. 2 Coy., 6 Battn., Grenadier Guards, C.M.F. An extract from the letter reads :— “ You will be interested to hear that I have been awarded the M.M. for my first aid work on Mt. Cammino. As I owe my first aid training to St. John’s, I feel that Mr. Cheshire, Mr. Norton and yourself, also the rest of the members have done much to earn me this award, for which I gratefully thank you.”
County o f W arwick. C o v e n t r y . — At the very kind invitation of the Hospital Saturday Fund Committee, members of the Coventry (Central) Corps, who do transport duty at the ambulance station, attended a dinner given by the Committee at the Masonic Hall on the evening of March 1 4 th. Mr. Beesley the Chairman of the Committee, speaking after dinner, said how proud he and his Committee were of the wonderful work performed by the voluntary helpers both men and nurses in giving up so much time after working hours and he thanked personally, several to whom awards were made. Afterwards, Corps Supt. March in giving figures stated that many of the men and nurses had done over 3 ,0 0 0 hours duty during 1 9 4 3 , and had assisted in moving over 2 ,0 0 0 patients. County Transport Officer J. H. Harris also paid tribute as did County Officer Fowler. The evening ended with dancing and another very successful event concluded.
On Sunday, March 2 6 th, the Corps held a Church Parade to the Central Hall, in conjunction with other organisations, for tbe Red Cross and St. John Prisoners of War Fund.
A I D
Over 6 0 0 officers, men and nurses, also cadets were present on parade. Corps Supt. L. T. March was in charge of the men and cadets and Corps Supt. Mrs. Weston in charge of the nurses. Thanks are due to all concerned in giving up their leisure, and on such a beautiful day, to make the parade such a remarkable success, and Corps Supt. March would like to record his most grateful thanks to all for turning up in such good numbers. West R id in g o f Yorkshire. R ipon.— T he annual general meeting of this Division was held at Headquarters. Among those present were Div. Surgeon A. Carnegie Brown, Supt. W. Booth, Mr. J. T. Hirst (Hon. Treasurer), and A. Orton (Hon. Secretary). The Div. Surgeon and Supt. Booth thanked all the members and the ladies for their co-operation and the way in which they had carried out their duties during the past year. Supt. Booth also reported that another class of cadets had just finished their training and were due for examination. The Hon. Treasurer said that the year had been a record one both in work and finance. A total of ^ 6 5 0 was now in vested in Defence Bonds and the credit balance at the bank stood at £ i 9 6 . He reminded the meeting that after the war when conditions permitted, a large amount of this money would have to be used to purchase new equipment. The Hon. Secretary reported that the past year had been a record one, 371 patients had been carried a distance of 8 ,2 0 9 miles, and 30 road accidents covering a mileage of 534 were attended. The present strength of the Division was now 2 6 , of whom 12 were in the services and 7 in the A.R.P. The cadets had been very useful again, doing telephone duties and acting as attendants. Mr. Hirst reported that he had purchased some blankets through Headquarters, and was now awaiting word from them regarding the purchase of pillow slips and bandages. Northern Ireland (Ulster) District. At the annual meeting of the St. John Ambulance Brigade, held in Belfast on March 2 5 th, Mr. W. M. Brennen, F.R.C.S., Acting Commissioner, presided in the absence on active service of Lieut.-Col. Ian Fraser, O.B.E., D.S.O., F.R.C.S., Commissioner. Presenting the annual report, Mr. Brennen^ expressed pleasure at the number of divisions now operating, 121 in comparison with 108 in 1 942 . Unfortunately there was a slight fall in the number of personnel. The need for more members and the means by which new members could be interested, were discussed. The financial report, presented by Mr. A. W. Mann, M.P.S.I., Assistant Commissioner and Hon. Treasurer, was satisfactory, although the grant of ^J350 from the Ulster Joint Committee had been withdrawn. Reports also presented were Mrs. G. N. Wallace on the Nursing Division ; Mrs. Lockhart for the Girl Cadets ; and Mr. W. Wilton for the Boy Cadets. Mr. and Mrs. Mann were presented with a silver salver. Mr. Brennen congratulated them on their recent marriage, and wished them every happiness.
Colonel C. J. Trim ble. On the 1 6 th of last month, Col. Charles Joseph Trimble, C.B., C.M.G., L.R.C.P., attained the age of 88 years. On behalf of all ranks we extend hearty congratulations to the Colonel, who is still on the active list as Inspecting Officer for Lancashire. All wish him continued health and service He is known as the Grand Old Man of the Brigade.
F I R S T
Railway Ambulance News.
A I D
L e tte rs
to
th e
E d ito r .
W e are in no w a y respon sible for the opinions exp ressed, or the statem en ts m ade, b y C o rresp o n d en ts.— E d i t o r .
L .N .E .R . W a v e r l e y . — In the an n u al com petition of the W a v e rle y Statio n A m b u la n ce Section , five team s w ere exam in ed by D r. P. H . S co tt, M .B ., C h .B ., in oral, p ra ctical, and tra n s port w o rk . T h e w in n in g team w as A n d rew M orrison (cap tain), M iss C . Seath , M iss J. D ick , and M rs. J. W a tt. M rs. C r a ig , w ife of the statio n m aster of W a v e rle y Statio n , pre sented the cup to the successfu l team . M r. G . M. Johnston, D ist. S u p t., L .N .E . R . , E d in b u rg h , exp ressed gratifica tio n a t the am o u n t of w o rk accom plished b y the first aid students, and recalled som e in stan ces of h o w life had been saved by prom pt action by ra ilw a y servan ts. H e m entioned th at a ca m p a ig n w a s b e in g in itiated by the r a ilw a y com p an y to stim u late the in terest of the staff, w hen it w as hoped the n um ber of students w ou ld be in creased.
M ETHOD D ear
OF
L O A D IN G
W IT H
TW O
BEARERS.
S ir ,—
O u r H o m e G u a rd stretch er bearers h a ve been p ra ctisin g D r. B o w m an E d g a r ’s m ethod of lo a d in g w ith tw o bearers, p ublished in F i r s t A i d for F eb ru a ry . P riva te K in s le y Sm ith s u g g e s te d th at the p atie n t’s belt be put round his chest for the lift, a s the lift from the w aist g a v e the p atient a go o d deal of distress. W e tried both m ethods on several m en and a ll com p lain ed of a “ ru sh of blood to the head ” w h en w a ist lifted and no d istress w hen the belt w a s round the chest. A t P riva te K in s le y S m ith ’s request I am s e n d in g you this s u g g e s tio n to m a k e a n y use of th a t you th in k fit. Y o u r s faith fu lly ,
W h en ra ilw a y w o rk e rs com peted a t C a m b rid g e on S a tu rd a y , A p ril 1st, in the a n n u a l com petition for the alnbulance shield, M arch Statio n not only carried o ff the honours, but, w ith their o th er team , w ere a lso the runners-up. F iv e team s from th e L .N .E .R . (G re a t E a stern Section) C en tre of the S .J .A .A . com peted, in the H o u g h to n H a ll, before a la r g e audien ce, in the event for the C a m b rid g e D istrict O fficers’ A m b u la n ce Shield. T h e M arch “ B ” team , g a in in g 165 points in the team test and 100 points in th e individual test, w ere w ell a cclaim ed w in n ers over th e M arch “ A ” team , w h o scored a total of 201 points. T h ird cam e C a m b rid g e “ A , ” fourth C a m b rid g e “ B ” (a team of three lad ies un der a m ale captain), and fifth K in g ’s L yn n . F o r the team test the p atient w a s a p ain ter w ho had suffered a fall. A ll his in ju ries w ere in dicated, and the tim e allo w ed w a s 18 m inutes. T h e ju d g e s w ere C a p ta in W . G o od ley, M .C ., and Mr. W . W a lsb y . W h en p resen tin g the shield, M r. J. P. A lix, ch airm an (district go o d s and p a ssen g e r m a n a ger) said it w a s the s ix teenth occasion on w h ich th e com petition h ad been held. H e co n g ra tu la te d the w in n ers and all the finalists, and w en t on to em ph asise the im p ortan ce in a m b u la n ce w o rk of b e in g ab le to a ct alon e and im provise. C a p ta in G o od ley sp ok e of the h ig h stan d ard sh o w n by the finalists.
GREAT
W ESTERN
A t a recent D iv isio n a l A m b u la n ce S ecretaries’ Conference, M r. H . A d am s C la rk e , the C h airm an , th a n k ed M r. J. L o n g , w h o la st yea r resign ed from the position of D iv. A m b. S e cre ta ry to the S w a n se a D ivisio n , fo r his w o rk d u rin g his ten ure o f office. M r. G . S. H o d d er, B risto l, supported by M r. W . J. W a ite, W o rcester, paid tribute to M r. L o n g ’s ser vice to the m o vem en t and a sk ed him to accep t, on b eh alf of th e D iv isio n a l A m b u la n ce S ecretaries, a D u n h ill pipe and lig h te r, w ith their best w ishes. M r. L o n g had a very lo n g and a ctiv e a m b u la n ce career, h a v in g passed his first a m b u la n ce exa m in atio n a t H ereford in 1 8 9 7 . H e form ed a class a t N eath in 1910 and for several y ea rs acted a s secreta ry to classes a t N eath , an d a lso rep re sented the L ocom o tive D ep artm en t on the S w a n s e a D ivisio n a l A m b u la n ce C om m ittee from 1913 until his app oin tm en t as D iv isio n a l S e cre tary in 1 9 3 6 . M r. L o n g holds the G .W .R . 15, 2 0 , 2 5 , 30 and 35 y e a r g o ld efficiency a w a rd s, and w as adm itted to the O rd er of St. John of Jerusalem in th e G rad e of S e rv in g B ro th e r in 1 9 2 4 . H e h a s g iv e n his services to the R ed C ro ss and St. John Joint C om m ittee and A .R .P . o rg a n isation s d u rin g the G re at W a r and the present w ar.
C.
L a m b to n
(M rs.
P.
L am b ton ).
C o m m a n d an t S X / 106, B .R .C .S . R otherfield, T u n b rid g e W e lls.
St. John Ambulance Association, W i s b e c h . — F o r the a n n u a l com petition for m em bers of the W isb e ch C entre, held on W ed n esd a y, M arch 2 2 nd, a ra th e r u n u su a l test w as set. A lth o u g h this test w as not so sp e cta cu la r a s those of p revious y ears, the problem w a s e x tre m e ly p ra ctical. T h e scen e w as set on the m ain n orth-south road, a b o u t tw o m iles from th e to w n ; the o n ly a v a ila b le equ ipm en t w a s th at of the St. John A m b u la n ce m an w ho, in ru n n in g from his house to h elp a w o b b lin g cy clist, slipped on a piece of o ra n g e peel and becam e a n o th er co m p licatio n for the F .A . p arty ! T h e in ju ries w ith w h ich the team s had to cope w ere not exten sive, the cy clist w a s su fferin g from cerebral haem orrhage, w h ile th e S t. Joh n A m b u la n ce m an had a sim p le fra ctu re of the kn ee-cap. E a ch team w as allo w ed 15 m in utes. D r. H . L . G room w a s the ju d g e , an d in his re m a rk s at the close of th e con test, told the co m p etito rs h o w m ost of them had “ com e u n s t u c k ” on th eir m ethod of e x a m in in g the u n con sciou s patient, and h o w o n ly one team h ad realised th at the cy clist w a s a cerebral haem orrh age ca se an d not m erely a “ d r u n k .” T h e doctor also criticised th e team s for fa ilin g to m a k e th e best use of the con sciou s p atien t w h o se h ouse and b ro th er w ere clo se by, and w h o could h a v e told them all th ey w an ted to kn o w . T h e la d ies’ team w h ich w on the R o th sch ild C u p w a s a W isb e ch N u rs in g D iv isio n team w h ich w a s a w a rd e d 80 m a rk s out of a possible 100. T h e G orefield team w h ich w on the E lg o o d C u p w as a w a rd e d 73 m ark s.
B i r m i n g h a m . — T h e a n n u a l report of th e B irm in g h a m C o u n ty C en tre of the S t. John A m b u la n ce A sso cia tio n records th a t 316 classes w ere held d u r in g the y e a r— a n in cre ase in a ll a ctiv ities over the p revious y ea r. T h e re w a s evid en ce of the con tin ued d em an d for in stru ctio n in the vario u s bran ches of first aid. T h e in crease in cla sses for boys and g ir ls w as due to the drive fo r cad ets in th e S t. John A m b u la n ce B rig a d e . T h e C o m m ittee feels “ th a t the B irm in g h a m C o u n ty C en tre is fu lfillin g its fu n ction s and p u llin g its w e ig h t in the g e n e ra l w a r effort, and thus h e lp in g to w a rd s th a t com p lete victo ry w h ich a ll a rd en tly d e sire ,”
ii4
F I R S T
Allergic Diseases. By
G eorge
W .
B ray,
M .B ., C h .B ., M .R .C .P .
(F ro m a lectu re delivered a t the R o y a l In stitu te of P u b lic H e a lth and H y g ie n e , P o rtla n d P la ce , L on d o n , W . l , on W e d n esd a y, F e b ru a ry 2 3 rd, 1 9 4 4 .)
term “ a l l e r g i c ” is app lied to a g ro u p of diseases ch a ra cterised by h yp ersen sitiven ess on the part of the sufferer to m a n y u su a lly h a rm less a rticles encoun tered in his diet or environm en t, and in cludes such a p p a ren tly diverse conditions a s a sth m a , h a y-fever, vaso m o tor rh in itis, eczem a, u rticaria, an d m ig ra in e . T h e ten den cy to develop a lle rg ic diseases runs p redom i n a te ly in som e fam ilies, w h o com p rise from 2 to 10 p ercen t, of the p opu lation of som e countries. In the m a jo rity of cases, and esp ecially those in w h ich an h e re d ita ry ten den cy cann ot be determ in ed, a definite h isto ry of som e severe illness sh o rtly before the onset of the a lle r g ic condition can be obtained. T h e com m on est sen sitisation is to som e a rticle of diet or to en viron m en t ; and the ca u sativ e su b stan ces m a y be divided for con ven ien ce into five g ro u p s :— (i) T h o s e a b sorbed by In h a latio n , such as a n im a l h airs, feathers, dusts, pollen s, m oulds and fu n g i ; (ii) those absorbed on in gestio n , such a s foods and d r u g s ; (iii) those absorbed from in jec tion, e .g ., sera, d ru g s , bites and stin g s ; (iv) those absorbed from in fection , v iz., b a cteria and w orm s ; and (v) those absorbed th ro u g h co n tact, such a s from fabrics, and chem i cal and p h ysical a g en ts. In certain less sen sitive in d ivid u a ls the g e n era l tendency is for th e body to o vercom e the ten den cy to rea ct by produc in g sufficien t ad ren alin e. If, d u rin g such tim e a s the bo d y ’s re sista n ce or a d ren alin e p ro d u cin g ca p a city is lo w ered, as o ccu rs d u rin g illn esses, m en tal o r nervous upsets, or endocrine disorders, or sta tes of fa tig u e , the a lle rg ic re actio n ensues. T re a tm e n t of the a cu te a tt a c k .— A ll a lle rg ic conditions respond to the a d m in istra tio n , of ad ren a lin e, if properly g iv en . M ost a lle r g ic con dition s are asso cia ted w ith a hypog ly c a e m ia , and repeated ad ren a lin e in jectio n s deplete the liv e r’s su p p ly of g ly c o g e n , so one to tw o tablespoon fu ls of g lu c o se tw o or th ree tim es a day help to lessen a n y ten dency to la ssitu d e and w ea k n ess. T re a tm e n t to prevent re cu rre n ces.— T h e first essen tial is to determ in e the sp ecific se n sitiz in g su b stan ces. O n ce th e ca u se h a s been d eterm in ed, treatm en t con sists in (i) d e a lin g w ith th e specific se n sitiz in g su b stan ces, and (ii) a v o id in g or re m o v in g co n trib u to ry factors. A ctiv e rem o val of the sp ecific sen sitizin g substan ces m a y be acco m p lish ed in the ca se of foods or d ru g s by their com p lete a vo id a n ce ; in the ca se of in h ala n t su b stan ces by the rem o val of pets and the su b stitu tio n of ru b b er for bed d in g , and g a rm e n ts of w ool, silk , cotton or flax in terch an ged a c co rd in g to the fin d in gs. A ctiv e rem o val of pollens or d u sts m a y be acco m p lish ed b y th e use of alle rg en -fre e ch a m b ers or m ech an ical filters. In d u st sen sitiv ity e lectrical va cu u m cle a n in g of th e hom e is ad visa b le, and the p rovid in g of a m in im um of a rticles of fu rn itu re in th e room , an a b sen ce of d u st-h o ld in g le d g e s, and a sm ooth un carpeted floor. O rris-ro o t free co sm etics can be obtain ed. P a ssiv e re m o va l m a y be a cco m p lish ed frequen tly by a d m ittin g the sufferer to a co n valescen t hom e or clin ic or b y a c h a n g e of altitu d e or clim a te som e of the w ell-k n o w n sp as or b y a sea v o y a g e . U n fo rtu n a te ly sym ptom s g e n e ra lly re cu r on the p atie n t’s return to his previous diet or en viro n m ent, u n less he h a s been a ctiv e ly treated a t the sam e tim e. T h e m a jo rity of a lle rg ic p atien ts sh o w a hyp ochlorh yd ria, so som e d ig e s tiv e h y d ro ch lo ric a cid before each m eal is The
R I D in dicated. M ost a lle rg ic con dition s are a sso cia ted w ith low ered m etabolism , so sm all doses of thyroid are frequen tly beneficial. S ep tic foci should be d ealt w ith on g e n e ra l p rin ciples. P ro lo n g ed fears and em otion s m a y p recip itate a lle rg ic responses by u s in g up a n y a v a ila b le a d ren alin e, so su ch facto rs need special atten tion . A g r e a t d ecrease in th e in ciden ce of a lle rg ic diseases w ou ld occur if m em bers of a lle rg ic fam ilies did not m arry. A s such a s u g g e s tio n is im p racticab le, g r e a te r efforts should be m ade to prevent sym pto m s d evelop in g in the children of such m a rria g es by p ro tectin g them from the com m enest causes. D u rin g p re g n a n cy and la cta tio n the m other should ta k e a w ell-b a lan ced and varied diet, a v o id in g a n y cra v in g for sp ecial foods and satu ra tio n w ith the variou s e g g -m ilk cocoa-cereal-cotton seed d rin k s on the m a rk et com m on ly recom m ended at this period. A fter birth the in fan t should only h ave m attresses, p illo w s, and eid erd o w n s w ith nona lle rg ic fillin g s ; rab b it w ool clothes and g lo v e s should be a voided, and h a ir a n im a ls and d u sty toys avoided. D u rin g the in fectious fevers of childh ood, the sam e p recau tio n s abou t b ed d in g should be observed ; and d u rin g g a s tr o in testin al upset a sufficien cy of g a s tr ic ju ice s sh ould be assu red and la r g e qu an tities of a n y food should g iv e p lace to as w ide an asso rtm en t as possible. W h en the tim e com es for ch o o sin g a career, fa rm in g and w o r k in g in d usty factories and w ith certain ch em icals, in w h ich a sso ciatio n w ith potent a lle rg en s is lik e ly to occur, should be avoided.
8 Qualifications for the First Aider in Verse. (1 )
O B S E R V A N T you should a lw a y s be, T o ta k e in a ll around you see, A lert, and q u ick you w ill detect W h a t’s w ro n g , and so yo u r facts collect.
(2)
B e T A C T F U L th at you m a y secu re T h e p atien t’s tru st, and to ensure A full acco u n t of a ll th a t’s done— T h e history, sym p to m s, d o n ’t m iss one.
(3 )
R E S O U R C E F U L , too, th a t yo u m a y use W h a t is to han d, you can n o t choose. S p lin ts, b a n d a g e s, a re n ’t on the spot, So im provise, use w h at y o u ’ve go t.
(4 ) D E X T E R I T Y w ill sh o w yo u r skill In k e e p in g p atient very still, E lim in a tin g needless pain, T h u s help to g e t him w ell a g a in . (5)
E X P L I C I T th at in struction s clear B e m ade to helpers s ta n d in g near, T o patient, too, th a t each m a y lend A ssistan ce a s you him attend.
(6)
D I S C R I M I N A T I O N w ill m a k e plain W h a t first to treat, so y o u ’d refrain F rom g iv in g aid to cases s lig h t T ill serious ones w ere m ade a lrig h t.
(7 )
Be P E R S E V E R I N G if not soon H e w a k en s up from o u t his sw oon . P ersisten cy oft w in s the day, So ca rry on, ’tw ill you rep ay.
(8)
S Y M P A T H Y the p atient needs. K in d ly w ord s a s w ell a s deeds. M a k e him feel h e ’s in g o o d care, H e lp him thus his pain to bear.
F I R S T
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HOUSEHOLD PHYSICIAN Describes In simple language with helpful coloured plates and diagrams
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The C O M P LA IN TS OF M EN, W O M EN A N D CH ILD R EN .
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Their Cause, Treatment and Cure.
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A jew ot the Subjects treated: G as W a rfa re , F irst A id W h a t to D o in E m e rg e n cies In fluenza, C olds, etc. M easles, M um ps, C a tarrh C orns and W a rts P h y sica l C u ltu re T re a tm e n t for all S k in D ise ase s T h e L u n g s , P le u risy H y g ie n e, A n atom y, P h arm a cy
T h e P rin cip le s of N u rsin g T h e E y e, the E a r T h e T h r o a t, the N ose T h e C h est, the H e a rt T h e S to m a ch , the L iv e r T h e T e e th , the M uscles In fan t W e lfa re H o m o ep a th y , N e u ra sth en ia 375 P rescrip tio n s, e tc ., etc.
THE YO U N G W IFE w ill find just the information she requires. MOTHERS who wish their daughters to develop naturally will find exactly the teaching they need.
W O M EN OVER 40 w ill fin d th eir d ifficu ltie s re g a rd in g h ealth fr a n k ly d iscu ssed .
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T h e S .M .A .E . (S w ed ish M a ss a g e and E lectrical) In stitu te is the old est of its kin d in G re a t B rita in , h a v in g been e stab lish ed for a qu arter of a cen tu ry. M a n y of the W o r ld ’s le a d in g M asseurs and exp o n en ts of M a n ip u la tiv e T h e ra p y h ave been trained by the S .M .A .E . In stitu te. W rite w ith o u t d elay for free-B o o k let "M A N IPU LA T IV E T H E R A PY AS A PROFESSION” This FREE Booklet tells you how to acquire the art of scientific massage by unique method of Home Study, and how you can establish a private practice of your own.
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The Home Guard and First Aid. W h y is it th a t, even in th e field of F irst A id, w h ich su rely sh ould m ove fo rw a rd w ith e ve ry step m ade b y m odern m ed ical scien ce, so m a n y of us a re in clined to be “ dieh ard s ” ? I w a s so m ew h a t a m azed a t the reason s g iv e n for criticism of th e revised stretch er drill as outlined by m e in the F e b ru a ry issu e. B u t first, in self-defen ce, let m e m a k e one or tw o th in g s clear. T h e revised d rill, as quoted, is from th e official b o o k let issued for th e R .A .M .C ., and is n ow p art of their drill tra in in g , and is not m erely m y ow n idea, a s som e of m y critics seem to th in k . If this w ere so, I w ou ld h ave put it fo rw ard a s a su g g e s tio n , not in the p ositive m a n n er in w h ich it app eared. A lso , m y sm a ll con tribu tio n is intended p rim a rily for the H o m e G u a rd m edical u n its, w h o n ece ssa rily m u st tra in a lo n g R .A .M .C . lines. F ield procedure an d treatm en t of w ou n d s received in b attle m u st v a ry co n sid era b ly from th at u s u a lly adopted for civil a ccid en ts. B u t n ow for the reaso n s of criticism !
(1) “ It ig n o re s the fa ct th a t th ere m ust be g e n era l u n ifo rm ity of p ro cedure th ro u g h o u t both the civ il and m ilita ry s e r v ic e s .” W h y ? C o lla b o ra tio n , y e s — but su rely not u n iform ity of p ro ced u re ? T h e d rill w a s p rin cip a lly con cerned w ith the collection of w ou n ded, w h ich w ou ld be carried out by th e m ilita ry u n its. T h e civil service s w ou ld n o rm a lly ta k e o ver ca s u a ltie s from co lle ctin g posts ajter the w ou n ded had been b ro u g h t in and g iv e n , a t least, in itial treatm en t. And co n sid er th e effect, in these d a y s, of a squad m a k in g th eir app ro a ch to a ca s u a lty in the m a n n er a s ou tlin ed in the g e n e ra l tex tb o o k s. I am a fraid the re su lt w ou ld often be m ore fa ta l fo r rescu ers than for p atien t. M ed ical personnel, lik e the fig h tin g u n its, m u st ta k e a d v a n ta g e of a ll possible co ve r— h en ce the reason for fa llin g flat an d w o r k in g as m u ch a s possible in the prone position . T h e ch a n g e in p ro ced u re fo r N o. 1 is obvious. H e h a s to a scerta in first if the c a su a lty is alive before p ro ce ed in g farth er. S u rely the in feren ce is clear. A g a in , h o w can th ere be g e n e ra l u n iform ity betw een th e services w h en th eir very equ ipm en t is so m uch at va ria n ce. T o m ention one th in g o n ly : A ca su a lty h a s to be tra n sferred from the stre tch er service to the C .D . stretch er before he can be rem oved by a m b u lan ce, sim p ly becau se th e C . D . a m b u la n ce h a s not been adap ted to ta k e the form er. A t lea st th is ap p lies in m ost areas. R e su lt : fu rth er d e lay and fu rth er discom fort for the patient. (2 ) “ It in troduces u n n ece ssa ry ch a n g e s in w ords of co m m an d , long established (the ita lics are m ine), and adds to re d u n d a n cy .” W h y th is g r e a t re lu cta n ce to b re a k a w a y from oldestablish ed ru les and w ord s of com m and ? T h e services a re in tro d u cin g new d rills, n ew co m m an d s and n ew m ethods of a tta c k and defence a lm o st every d ay. A nd w e should be in a sore p lig h t if they d id n ’t. W e first-aid ers h a ve ju s t g o t to m ove fo rw ard w ith them . I s tro n g ly ad vise m y critic to stu d y th e a rticle in the M arch issu e by S ir H e n ry L . M artyn , K . C .V . O . , F . R . C . S . , w h o is him self a C a s u a lty S ta ff O fficer in th e C iv il D efen ce. H e p la in ly illu stra te s the need for p ro g re ss in first a id procedure, and I a g r e e w hen he says th a t, a lth o u g h the St. John T e x tb o o k is th e b est b o o k for b a sic, e le m e n ta ry in stru ctio n fo r first aid in civ il life, it is in u r g e n t need of revision u n der w a r conditions. H o w ev er, desp ite the fo re g o in g re m a rk s, let m e say th a t I w elco m e such criticism s. O n ly by p o o lin g o ur ideas and op in ion s can w e re a lly sep a ra te the w h e a t from the c h a ff and decide w h ere im p rovem en t ends and red u n d an cy b e g in s. C. W . S p r e a d b u r y (S e rg t.), Sch oo l H o u se, N oel-road, W . 3.
R e v ie w s .
Bandaging Made Easy. B y M . F a b e r & F ab er. Price 2/6.
R . H o s k in g .
L on d o n :
T h is u sefu l little bo o k , w h ich is n ow in its sixth edition, h a s been revised and b ro u g h t up-to-date. It deals w ith the a p p licatio n of th e roller, tria n g u la r and sp ecial b a n d a g e s ; and the in stru ctio n s are set out sim p ly, yet co m p rehensively, so th a t it ju stifies its title, It w ill app eal a lik e to the student, to the nurse, and to the first aider.
Handbook of First Aid and Bandaging.
B y A . D . B elilios, M .B ., D . K . M u lvan y, M .B ., F .R .C . S ., and K . F . A rm stro n g , S .R .N . L on don : B a illiere, T in d a ll & C o x .
Price 4I6 postjree. T h is e xcellen t SOO-paged b o o k w as prepared to provide a com plete tra in i