First Aid Journal 1939 by Museum of the Order of St John

FIRST AID No. 535.-VoL. XLV.

JANUARY, 1939.

NOTICE TO READERS.

OF THIS

NUMBER.

EDITORIAL : -

A. R. P. and First Aid St. 10hn Ambulance Association A Visit to 1 erusalem St. Marylebone Open First Aid Competition S.l. A. B. Headquarters and District Reports Reviews Coming Events Priory for Wales Police Ambulance News The Human Body Railway Ambulance News A.R.P. Topics Hints on Competition Work Wimbledon Ambulance Festival... Resignation of Mrs. Lancelot Dent, A. R. R. C. Our Nurses' Pages Practical Points

165 166 166 166 167 170 170 171 172 173 175 177 178 181 181 182 186

QUERIES AND ANSWERS TO CORRESPONDENTS : -

Treatment of Fractured Ankle Examination Howler Treatment of Phosphorus Poisoning ... Treatment of Burns of Eyes Treatment of \Vasp in Stomach Treatment of Fractured Knee Cap Action of Liquid Oxygen Transport Face-Downwards of Spinal Injury... Rolled Blankets in Transport Face Downwards Fracture of Neck of Femur... Transport of Complicated Fracture of Ribs Special Bandage for Fractured Knee Cap Treatment of Snake-Bite Treatment of Gassed Patient with Head Injuri~s

PI{ICE THRBBPBNCE [3/6 PER ANNUM, POST "FREE

EDITORIAL.

FIRST AID is published on the 20th of each month. The Annual SUbscription is 3S. 6d. 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 12th of each month, and must be accompanied (not necessarily jor tJu6lilation) 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., LTD., 46, CANNON STREltT, LONDON, E. C.4. Tel(graphic Address-" Twenty-jour, London." Tel,phone- City 37 IO.

CONTENTS

E,.tlrld a t ] [ Stationers' Hall

188 188 188 188 188 188 188 188 190 190 190 190 190 190

THE outcry in the general press regarding "A.R.P. muddle" AND cannot be directed against the FIRST AlDERS. first aid personnel of voluntary organisations throughout the country. A.R.P.

Since 1935, at the request of the Home Office, the St. John Ambulance Brigade, the British Red Cross Society, and the St. Andrew's Ambulance Association have been instructing their members in Anti-Gas training; and it is no exaggeration to state that these organisations have over 100,000 members fully trained in chemical warfare. Just consider for a moment how this magnificent answer to the Goverment's request has been accom plished. Many members voluntarily gave up their summer holidays to spend a fortnight at the Civilian Anti-Gas Schools (two weeks hard work) to become efficient. On their return they gave lectures to their members, trained divisional instructors, and then took up the important work of training the general public. A further request from the Home Office asked that members of the voluntary organisations be supplied as personnel at first aid posts. This mean t once more increased activity to train the general public in first aid and to enrol members in the A.R.P. Auxiliary Reserve. The duties undertaken during the September crisis clearly proved that the voluntary organisations had done their work magnificently. And since September? An even busier time has been experienced. The general public, having been aroused for action, clamoured for instruction-and then grumbled when they found they had to wait. H:ow muc:h easier it wouIe!

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have been if these same persons had come forward two, three, or even four years ago? No! There is no muddle in the A.R.P. organisations of the voluntary ambulance associations; and only praise can be extended to members for their splendid answer to their country's call.

St. John Ambulance Association COLNE.-Speaking at an .. At Home," organised by the Colne Centre, the Mayor of Colne (Councillor Arthur Burrell) said it was very pleasing to those who were behind the scenes during the recent crisis to know that the ambulanoe movement was prepared. It could be safely said that so far as A. R. P. work was concerned, they were streets ahead of any other section. On the occasion of the A. R. P. demonstration in the town, he was immensely gratified to notice the efficiency of the am bulance side of the demonstration. On behalf of the A. R. P. Committee of the Town Council, he desired to thank those who were willing and ready to be of service in time of need. Mr. W. Uttley, president of the Brierfield Centre, who o!-,ened the" At Home," said he hoped the day would never come when the movement would cease to be voluntary. Once it got into the hands of officialdom more red tape would be used than bandages. HULL.-The 8th annual open competition for the "Major Carver" Cup, organised by the Paragon (Hull) Class, was held on December 10th, when thirteen teams competed. Drs. L. F. Wilson and E. M. Dearn, of Hull, judged the team test, whilst Drs. V. P. Squire (Hull), H. Standring (Senior Asst. M. O. H., Hull), G. Clark (Hedon), A. G. Minn (Hull), and E. Simpson (Hessle) judged the individual tests. . In the team test the competitors had to deal with two patients. One was suffering from complicated fracture right ribs, liver injured, lacerated wound right forearm and shock, and the other from a Colles fracture right forearm and shock. The individual tests included an unconscious patient suffering from fractured left forearm; a patient suffering from hremorrhage left arm and dislocated elbow, iodine poisoning, and two viva voce questions. Mr. A. O. Sayner presided over the function, supported by Mr. E. H. Fowler, President; Supt. Huddlestone, Deputy Chief Constable E. R. Police; Mr. W. E. Twinham, secretary; Supt. Teasdale, Insp. Fullerton, Insp. Smith, L. N. E. R. Police, Hull, and others. The result was announced as follows :-1, Dock Engineers, Hull"L.N.E.R., 318 marks; 2, Barnborough Main Colliery, 312; 3, Grimsby Docks, L.N.E.R., 304. Individual: No.1, R. Cunningham, Pontefract; No.2, F. Green, Hull, L.N.E.R. Police; No.3, G. Bucknell, Barnborough Main; No.4, E. Green, Barnborough Main; No. S, T. Webb, Pontefract. The Lady Mayoress of Hull (Councillor Mrs. Pashby) presented the awards and appealed for more A.R.P. volunteers. Ambulance workers should disclose their qualifications when enrolling. Dr .. Standring commented on the work done, and, addressmg the competitors, said "It always astonishes me when I do a St. John Examination to find out how much you know."

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Supt. Huddlestone proposed an omnibus vote of thanks. I t was, he said, wonderful that men should give their time night after night, year after year, to learn ambulance work. The winning team also won the Hull L. N. E. R. Officers' cup competition held a few weeks before the above competition. SOUTHAMPTON.-At the annual meeting of the Southampton Centre Dr. H. C. Attwood was elected chairman in place of Mr. W. Bagshaw, J.P., who had resigned on account of ill-health. The Mayor (Councillor A. H. Powdrill) presided, and expressed the town's appreciation of the splendid work which the St. John Ambulance was doing. According to the annual report 368 candidates were successful, making a grand total for the Centre of 11,912. Meyrick A team won the "Twiss Rose" Bowl, and the Joint flagday resulted in the Centre and Corps each receiving £63 15s. 7d.

A Visit to Jerusalem. REGARDING the short article under the above heading which appeared in our December (1938) issue, we have been informed by Colonel J. T. Woolrych Perowne, V.D., T.D., the Hospitaller of the Order, that the head of the St. John Hospital is Sir John Strathearn, C.B.E., M.D., F.R.C.S. Dr. Norman Wren was Acting Warden at the time of Mr. W. H. Ball's visit. There are forty beds which are continually occupied, and the nursing staff includes tw:> English nurses. We are pleased to correct any misunderstanding which may have been caused by our previous article.

St. Marylebone Open First Aid Competition. THE schedules for this competition are now ready and can be had on application to the Hon. Secretary, Mr. W. V. M. Allen, Western District Post Office, Wimpole-street, W.1. The competition is open to teams with headquarters in the Metropolitan and City of London Police areas, and the district covered by the No.1 District of the St. John Ambulance Brigade. The Committee announce that Lord Horder, G.C.V.O., M.D. (Commander of the Order of St. John and Physician in Ordinary to His Majesty), has kindly consented to distribute the trophies and prizes at the final competition, which is to be held on Thursday, March 30th at Portman Rooms, Baker-street, London, W.1, commencing at 7.30 p.m.

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St. John Ambulance Brigade Headquarters and District Reports. Brigade Headquarters A.R.P.-On December 16th) 17th and 18th a L.A.G.C. Course was h eld at the Great Central Hotel, London, and on December 17th and 18th a Grade I course was run at the same time. Dr. W. C. Bentall (A.R.P. Staff Officer) was the chainnan, assisted by Dr. K. H. Beverley, Messrs. C. E. B,?wer, O.E.E.,. W. J. B. Trotter, W. J. Noble, E. Milburn, F: WrIgglesworth) and A. P. Bentall) Lieut.-Col. J. R. Collms, M.C., T.D., and Mrs. A. Chapman, all C.A.G.S. (.Sipecial) or First Class C.A.G.S. (endorsed). In addition Messrs. L. R. Allum and J. Wheatley were section leaders. The two courses were brought together for certain lectures but practical work was undertaken separately. The ease and smooth running of the two courses was an?ther example of the splendid 'o rganisation of the Asst. Bnga~e .Secretary, Mr. H. J. Wrigglesworth; and Asst. ComnusslOner H. C. Else paid tribute, on 'behalf of the stude~ts, for the excellent details and lecturing given by what 1S known as "The Team."

No. I (prince of Wales's) District No.

55 (SOUTHALL - NORWOOD) DIVISION. - On 23rd last the Mayor of Southall, at the annual dmner of this division hinted that a site on which new headquarters might' be erected would ~oon be available. ' This is now an accomplished fact. The Southall Council have offered a piece of land in Havelock Road and members of the Division are now workino- to raise funds for the erection 'o f new headquarters ;hich will be of great service to the movement. The Mayor, commenting on the decision of the G~ner,al Puq~oses. Committee of the Council in offering thIS land, paId tnbute to the work of the Brigade and hoped that the rpeople of Southall would now rally to the c~ll 'o f the Brigade for efficient funds in order to establIsh then:selves in a permanent building. The PreSIdent) ~r.. e. F. Collins, A.M.LE.E., is the treasurer 'o f the BU1ldmg Fund and already the sum of over £130 is in hand . Th~ Division has received notification that Col. J. J. Llev.:elhn, ~.B.E. , M.C., T.D.) M.P.) has been appointed a VIce-P'resl'dent. Novembe~

No. 114 (Lo~\IDON TRAMWAYS) DIVISION.-Some 100 members and frIends attended the annual dinner and dance on ~ecember 31st .when Div. Surgeon W. G. Wats'o n pre~I?ed, accompamed by Mrs. Watson. The SpIrIt of the festive season was fully apparent and speeches were short and to the point. ~fter the. ~~yal" t>oast Sergt. e. Chudley proposed the 114th DivisioOn and praised the Suraeon officers and men for their efficiency. b , fi Supt. G. C. D. Deadman replied and stated that in rst aId and A.R.P. all members had passed their

exam~nation. . The past year had been 'One of great work espeCIally dunng the September crisis. Members of the divisio~ .had covered 700 duties, but unfortunately the competlt1«)~ for N.C.O.'s had been postponed. He thanked hIS officers and all members for their support during the year. "Our Guests" wa~ proposed by the Chairman) who referred to the presence 'Of Mr. G. E. Craft) of FIRST AID) Corps Officer Wickens) Amb. Officer C. Mellish (Sth. Met. Gas Co.) and ex-Sergt. Mann. Amb. Officer Mellish replied and paid tribute to the work of the Division and referred to the assistance he had received from the members which was ably expressed by the words on the toast list: " Actions not words are the true criterion of friends." , ) . E~-~er~. Mann expressed his appreciation at the kmd mVItatlOn of his old comrades whilst Mr. Craft paid tribute to. t~~ voluntary work carried out not only by the. 114th. DIVISIon but also by the Brigade as a whole. FIrst AId and A.R.P. awards were then distributed by Mrs. Deadman, also competition awards as follows: " Jones" Cup, Pte. F. Brewer; runner-up Pte. L. Snell. "Dr. Watson" Shield (theory, memb~rs only), Pte. Brewer; runner-up, Pte. Embleton. A canteen of cutlery was presented to Corpl. Munday as a mark of appreciation of the work he had put in 'On the occasions of the annual dinners of the past four years. Dancing continued until 12.15 with Hon. Sergt. J. A. Preston as M.e. At midnight the New Year was welcomed in traditional style.

No. 137 (WESTMINSTER) DIVISION.-Followino- two happy evenings at the Victoria Coach Station Resta~rant this Division will hold its third dance at the sam~ Restaurant on Friday, February 20th. Tickets price 2/6, can be obtained from Amb. Offi'cer J. E. Bro~n 42 Sutton Road, N.10, or any member of the Division'. ' A course of lectures on first aid commenced on Monday, January 16th at the Victoria Coach Stati'On staff restaurant. The lecturer is Dr. F. A. Bearn and additional practical work is held on Wednesday evenin O's. Anyone wishing to attend the remaining lectures shocld apply to the Class Secretary, Mr. E. C. Pannell) 27, Landor Road, S. W.9. . On Wednesday, January 18th, a course of lectures, gIven by c.A.G.S. Instructors, on A.R.P. and First Aid for Gas Casualties, commenced at the Westminster Welfare Centre, Ebury Bridge, S.W.l. Details of the remaining lectures can be obtained from Div. Secretary R. F. Evans) 4, Manor Way, Worcester Park) Surrey. No. 51 (CROYDON AND STREATHAM) DIVISION.-At the annual inspection held last month, Asst. Commissioner Capt. A. C. White Knox paid tribute toO the magnificent turn out under Supt. D. G. Goldie. Members of the Warlingham Section and the Croydon and Streatham Cadets were also on parade, the total personnel present being 96 uniformed members) 37 cadets and 26 members

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in mufti. Forty-two members were absent through duty or other excuses. The inspecting officer referred to the enormous amount of work voluntarily carried out in connection with A.R.P. He was glad to know that, at least for the time being, members would be able to devote more time to the new textbook which was now in official use throughout the Brigade. There was also the new stretcher drill to be mastered. A course of lectures on Home Nursing (for men only) will commence at No. 3 Health Centre, 21a, Paddington Street, W.1, on Thursday, January 26th, at 7 p.m. Lecturer: Dr. M. M. Scott; fee (including manual, examination and certificate), 5/-. Full particulars can be obtained from Div. Supt. vV. V. M. Allen, 58/5 Division, S.J.A.B ., Western District Post Office, Wimpole Street, W.1.

No, II District BOURNEMOUTH.-The Bournemouth Division were successful in winning the "Mooring Aldridge" Cup competed for by divisions on the Bournemouth Corps on December 13th. The Post Office and North Bournemouth Division tied with Bournemouth B. Division f'o r second place. Div. Surgeon D. F. Morgan (Parkstone) judged the team work and Div. Surgeon Hinds-Howell (Westbourne Nursing) the individual tests. Mrs. Noble, wife of Div. Surgeon Dr. J. A. Noble (Bournemouth) presented the cup and individual prizes. BRISTOL.-On January 2nd the County of Bristol lost an esteemed officer through the death of County

Secretary Heywood Trott. Mr. Trott joined the Brigade in 1902 and five years later became transport secretary, and in 1917 became Corps Secretary. In 1925 he was promoted to Corps Officer and in 1937 was raised to the rank of County Secretary. His ~fforts :vere rewardt!d' by the Order of St. John

who admItted hIm as a Serving Brother. He was also the possessor of the Service Medal with three bars and the King George V Coronation meda1.

No. m District. NORTHAMPToN.-The annual competition for the cup presented by the late Marquis of Northampton to the Northampton Corps was held on December 10th when five teams competed. ' . The judging was carried out by Dr. H. Maguire, assIsted by Supt. H. I. Edwards and Amb. Officer J. Bu~ler, for the stretcher test; and Dr. T. M. Murphy, assIsted by Sergt. Fanner, for the individual and viva voce tests. The result was: 1st, Northampton Headquarters 222~ marks; 2nd, Northampton Borough Police No. l' 21.1~;. 3rd, Northamptonshire Constabulary Towceste; DIVISIOn, 185. The prize for the best individual work was awarded to Ser~. H. Cooley of the winning team. At . ~he same tIme the "Pim" Cup Eliminating Compe.tltlOn .f?r. the Northants Constabulary was held Kettenng DIvlslOn was placed first, followed by Tow~ cester, Northampton and Wellingborough. Cou~ty Officer W. H. Percival presided at the presentatlOn ceremony, the trophies and prizes being

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iliD distributed by the Mayoress of Northampton, Mrs. A. W. Lynne. After a few remarks by the Judges and the Chairman, the teams and friends were entertained to tea, which was arranged and served by the Nurses of the Headquarters Division under Lady Cadet Officer Miss Billinton. A large number of interested persons watched the proceedings including the Mayor of Northampton (Alderman A. W. Lynne), Lady District Supt. Mrs. H. Reeves, A.R.R.C.; Mr. and Mrs. H. Wilkinson, Lady Gorps Supt. Miss K. Bradford, A.R.R.e.; Lady Div. Supts. Miss E. Cowley and Mrs. 1. Jennings, M.B.E.; Amb. Officer F. T . Whiting and Mrs. Whiting, Mrs. Edwards and Mr. E. J. Hayw,a rd, Supts. Norris and Williams of the County Constabulary and Supt. Afford of the Northampton Borough Police. The competition arrangements were made by Corps Supt. W. E. Edwards, M.B.E., and Corps Secretary E. J. Hayward. WELLINGBOROUGH.-Four members of the Wellingborough Corps have been awarded Service Medals and bars for a total service of no less than 110 years. Gorps Sergt.-Major J. W. Francis has been granted a sixth bar to his Service Medal which represents 45 years' service. This record is one exceeded by few members in the country. Sergt. H. N. Parker, Headquarters Division, receives a third bar and Sergt. W. J. L. Gotch a first bar. Amb. Officer G. e. Powis, Headquarters Division, has been granted the Service Medal. Sergt.-Major Francis joined the Brigade in 1893 as a bugler and four years later became a member of th e team commanded by his father (the late Supt. Francis) v:rhich won the Northamptonshire Challenge Cup three tImes and the "Dewar" Shield twice (1898 and 1902). In 1898 Mr. Francis won the ICUP for the " Best all-round man" at the Brigade camp in Easton N eston Park. In 1922 he was admitted a Serving Brother of the Order. A new division of the Brigade has been formed at Perry Barr, Birmingham, Mr. Bamford, Managing Duector of the Company, takes great interest in the work and is giving every support to the division.

E~lison's Electrical ~ngineers, w~th E. E. Casson m charge.

The number of duties detailed during the past year were over 700 and cases treated over 990. The nursing section had treated 210 cases. During the September crisis the M.O.N. had asked the~ to. take charge of the most important casualty statlOn m the town. The Corps had six Grade I instr~ctn~s, 46 certificated members and 26 awaiting exammatlon. The work was really hampered, however) by lack of room where they could properly train the members and the President appealed to the Mayor to try and do something to get them new headquarters. HARWORTH .COLLI~RY CORPs.-The Corps held its 2nd anuual WhIst Dnve and Dance on Christmas Eve w~en nearly 300 players spent an enjoyable evening. Div. Supt. G. H. Burton was M.e. for the drive and Sergts. H. O. Price and J. Black officiated for the dance which carried on until midnight. Arrangements .were carried out by Corps Secretary W. G. Oldfield, assIsted by the Entertainment Committee of which Supt. Burton is chairman. SHEFFIELD CORPS.-The first annual dance of the Sheffield Corps was held last month in the Cutler's Hall. There. w.ere some 350 persons present including Asst. ComrrmsslOner H. e. Else and Mrs. Else, Mrs. Hamer Russell, Mrs. E. Boot, Corps Supt. Capt. L. T. Scott Capt..A. W. Gordon Mason (A.R.P. volunteer personnei orgamser), Corps Officers W. A. Browne, J. H. Newton and R. P. Richards. . Div. Supt. S. Gotto~ was the M.e., and he, together wlth Lady Supt. Mrs. WI?dle) made all the arrangements. . ~he proceeds were m aid of the new headquarters bUlldmg fund.

No. VI District BERWICK.-The annual inspection of the Berwick Ambulance an~ :t:'Jursing Divisions was carried out by County Commlssloner S. Emberton, accompanied by County Surgeon. W. F. J. Whitley, who examined members for theIr A.R.P. certificates. The Mayor of. B.erwick (Coun.cillor. James Macnab) tha~ed the ComrmsslOner for havmg VISIted BerwickWh.lCh Mr. Emberton had described as an outpost of the Bngade.

No. V District DERBY.-On Saturday, January 7th Supt. F. Grice on behalf ~f the members of the Derby Division, presented DlV. Surgeon G. B. Thrift with an inscribed silver coffee pot as an expression of appreciation. Dr.. T?~ift, ~ho is leaving Derby, had been Surgeon t~ the dlVIS10? smce 1935 and Supt. Grice paid tribute to ~IS wo~k dunng the past y~ars. It was, said Supt. Grice, ImpossIble to speak too hIghly of the 's terling qualities of Dr. Thrift. . D;. Thrift .expressed the hope that the happy relatJoonshws estabhshed between members of the Brigade and hImself would be maintained. DONCASTER.-The 11th annual dinner and dance of the Doncaster Corps was held on Saturday, January 7th, w~en t~e Mayor of Doncaster (Councillor E. Scargale) paId tnbute to the work of the Brigade. ~r. R. H . . Hepworth, P~eside?t of the Corps, said nothmg gave hIm greater satlsfactlOn than to know that the Co rps was growing in strength and service.

EAST. CLEVELAND.-At a social evening held recently, presentatlOns of a~ards were made by Mrs. e. Smith (Saltburn ~nd Carlm How) who presented first aid and h?m~ nursmg awards, and Mrs. Heslop (Saltburn) who dIstnbuted A.R.P. certificates. A~b. Officer J. H. Jackson introduced the chairman, CounCIllor J. Johnson, J.P., who made reference to the val~able work done by members at the lncal works dunng the past 23 years. W. Fawcett proposed an omnibus vote of Supt. th~nks whIch was seconded by Lady Amb. Officer Mrs. Kitchener. Members of the Nursing Division arranged the refreshments.

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Dragon Hotel, H;ereford. Gounty Commissioner Dr. 1. W. MacGregor preSIded, supported by County Officer G. N. Bullock, Lady County Officer Mrs. Hopton, Div. Surgeons B. G. Scholefie1d, e. W. Walker and F. O. Strange (Hereford), Langley Owen (Ross), Logan Jack (Kington) and officers from numerous divisions. Also present were the Chief Constable (Mr. Freeman Newton) and Dr. e. D. Edw~r~s (Kington). . !he Go~ffilsslOner read a letter from the Chief CommlssIOI~er. (SIr John D~ncan) in which he expressed his appreclatlOn of the stndes the Brigade had made in the County of Hereford. The ch~irman proposed "Our Guests " and referred to the appomtment of the Chief. C(:mst~ble as Secretary of the St. John Ambulance ASSOCIatIon m Herefordshire ' al~o. ~o the very great help rendered to the Kingto~ DlvlslOn by Dr. Edwards. . Dr. Edwards, replying, said the Brigade in HerefordshIre 'Y"er~ very fortunate in having such young and enthusIastlc officers at the head of affairs. Dr. MacGregor had worked wonders in the county and Dr Logan. Jack at Kington had also shown that sam~ enthUSIasm. . The" Chief Constable proposed the toast " The Bngade, and ~oped there would be close co-operation between the Bngade and the Association in the county. He would do all he could to bring this about. Dr. e. W. Walker responded. Discussions then .too.k place on the internal working of the County orgalllsatlOn and many suggestions were brought forward. The Commissioner paid tribute to the tremendous amount olf hard work put in by his County Staff and the members of the Divisions throughout the County. Mrs. Hopt.on had put t?e Nursing Divisions on a very sound footmg and kept ill close touch with them. A vote of thanks to the County Commissioner was pr~posed by Mr. B. G. Scholefield, who said that the Bngade owed a great debt of grati1ude to Dr. MacGregor for the excellent work done by him, especially during the past few weeks.

No. vm (Duke of Connaught's) District GUERNSEY.-The competition for the Guernsey Brewery Co.'s Shield and Medals was won by Team B led by GorpI. H. Touzeau. County Surgeon W. B. Fox (team), Dr. 1. Fraser and Col. John P oe (individuals), and Corps Officer J. W. Dear (uniforms) were the judges. The efficiency competition for the" Colonel Randall's" Cup was won by Pte. J. H. Ingrouille, closely followed by Sergt. W. D. Holliday one mark behind. Dr. W. B. Fox judged the tests. NEW,HAvEN.-The Newhaven Ambulance and Nursing Divisions held a combined social at Headquarters on Wednesday, December 14th. Pte. L. Hodges was M.e. Numerous prizes were presented for games and dances. Refreshments were prepared and served by members of the Nursing Division.

No. IX District N o. VII District J

The annual dinner and county meeting of the Hereford County was held last month at the Green

DARTMOuTH.-On December 11th the new motor ambulance obtained by public subscription was presented by the Mayor (Mr. G. H. Marshall) to County Commissioner H. J. Vick, who received it on behalf of the Brigade. The Vicar of Dartmouth (the Rev. A. Shell)

FIRST dedicated the vehicle Ifor the use of suffering hu.m,:nity. After the dedication the County ~omm1ssLO~er thanked the public of Dartmouth for theIr generos1ty. The gift completed a c.hain of arr:bulances in South Devon linking up Totnes, Bnxham, ~a1gnton, Torquay, Newton Abbot, Teignmouth and Dawhsh. . The ambulance is a 15.9 h.p. car w1th room. fo~ two stretcher cases and will serve D artmouth and Dlstnct. PARKsToNE.-A social evening was spent by some 40 members of the Parkstone Division on Monday, January 2nd. . D During the refreshment interval D1V. Surge~n . Morgan was presented with his Grade 1 A.R.P. certIficate by Corps Supt. J. M. O'Hara. . Arrangements for the evening were made by D1V. Supt. G. Caswell, assisted by Div. Secretary A. G. Williams and Pte. R. Yeatman.

No. X District Last month the competitions for the " Cook" and (( Iveagh" Cups were held at the Lads' Club, Norwich. The results were:" Cook" Cup.-1st, Norwich Corporation Employ~es, 118 marks' 2nd Norwich City, 75; 3rd, East Harhng and Gorleston (tie), 69 ; 4th, Sheringham, 66. " Iveagh" Cup.-1st, Lads' Club, 44~ marks; 2nd, Sheringham, 438; 3rd, Yarmouth, 427. SlX teams competed. Judges were Doctors Fielding, B. J. Hancock, W. L. Burn, May Rutledge, Constance Roberts and Scott Napier. The cups were presented by County Commissioner Sir Thomas Cook, M.P., who appealed for recruits to ~he Brigade. H~ thanked .the Chl~f Constable. of NOrw1C~ (Mr. J. H. Dain) and h1S comm1ttee for placmg the L ads Club at 1:he disposal of the Brigade, the judges for their services the County Secretary (Mr. B. E. Sewell) for his hard work, and others who had assisted in the arrangements. The Chief Constable said that any service he could render was always gladly given. He supported Sir Thomas Cook's appeal for recruits.

Reviews. ANATOMICAL

ATLAS FOR NURSES AND STUDENTS. By Ian M. Burdon, M.B., F.R.C.S., and S. Macdonald, S.R.N. London: Faber and Faber Ltd. Price 5s. net. This excellent Anatomical At las has been compiled by a surgeon and a sister-tutor to provide nurses and students with a clear picture of the human body in preparation for _ their subsequent study of changes therein consequent on disease. It consists of 27 plates, many of which are coloured, illustrating the tissues, the skeleton, the muscles, the heart and circulation, the nervous system, the internal and special organs. Its val ue is further increased by 32 pages of letterpress into which a certain amount of physiology has been introduced for a better understanding of the subject. Lecturers and senior students will find the Atlas most useful and most instructive since, as far as is possible, the subject matter is set out in tabulated fashion, although, of course, in its details it goes far beyond the immediate needs of first aid and home nursing.

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Coming Events. The Editor will be pleased to receive particulars 01 forth· coming events for inclusion (free of charge) under this heading.

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Wales.

Priory for

JANUARY.

24-No. 9 District (London) "Pim" Trophy Eliminating Com petitions. 27-Central Area, No.1 District, S.J.A.B., Annual Social, Shoreditch Town Hall. 27,28 & 29-S.J.A.B. Instructor (L.A.G.C.) A.R.P. Course. Great Central Hotel, London. 28-Ipswich District, L. N. E. R., Officers' Trophy Competition. 30- IC M" Division Metropolitan Police Annual Competitions, Kennington-lane. 30-No. 74 (Fh:chley and Southgate) Nursing Division Whist Drive, Betstyle Hall, N, 11. FEBRUARY.

4-Parkeston District, L. N. E. R., Officers' Trophy Comp~tition .

4-Durham, Cleveland and Westmorland" Donald Bain" Divisional Competitions. 6-Haggerston Ambulance & Nursing Divisions, S.J .A. B., Presentation Concert. 8- Stratford District, L. N. E. R. Challenge Shield Competition. 18- Hospitallers' Club Annual Dinner, Connaught Rooms. 18- Durham, Cleveland and Westmorland "Elizabeth Bain" Divisional Competitions. 18-B. R.C.S. Blood Transfusion Service Annual Social Holborn Hall. 18-Darlington District, L.N.E.R., Competitions. 22-M.&G.N. Railway Competition, Norwich. 2S-Newcastle District, L. N. E. R. Competitions. 28, March 1 and 2-Great Eastern Section, L. N. E. R. Preliminary Competitions. MARCH.

3,4& 5- S.J.A.B. Instructor (L.A.G.C.) A.R.P. Course, Great Central Hotel, London. 4-Durham, Cleveland & Westmorland Ambulance League Competition Finals, Durham. 4-Leeds District, L. N. E. R. Competitions. 4 & 5.-S.J.A.B. All-England A. R.P. Course (Grade 1), Great Central Hotel, London. is- Hull District, L.N.E.R. Competitions. 16-Inter-Railway Police Ccmpetition, Paddington. 16-Wimbledon Ambulance Festival Competition Finals. 18-Finchley and Southgate Nursing Division, S.J.A.B., Annual Dance, Friern Barnet Church Hall. 21-Great Northern Centre, L. N. E. R., Competition Finals. 22-York District, L. N. E. R. Competitions. 24-Ungrouped Railways Inter-Railway Preliminary Competition. 25-Middlesbrough District, L. N. E. R. Competitions. 29-Great Eastern Centre, L.N.E.R. Competition Finals, Stratford. 30-St. Marylebone First Aid Open Competition Final, Portman Rooms, Baker-street, W.1.

HEADQUARTER NOTES.

The year 1939 promises to be an importa nt period within the Priory for Wales. Plans are already laid for the first All-Wales Inspection ever stag-ed by the Priory by the Lady Superintendent-in-Chief for Wales, H. R. H. the Duchess of Kent, in the grounds of Cardiff Castle on Saturday, July 1st. Her Royal Highness will be accompanied by the Sub-Prior, the Earl of Plymouth, P.C., assisted by Brigade Headquarter Staff; and from views expressed by Commissioners at a meeting of the North Wales Centre Officers at Colwyn Bay held this month, there is reason to believe that a representative parade of all Centres, Corps and Divisions will assemble on what may be regarded as an hi storic occasion . The Inspection will be preceded by a meeting of General Assembly, with Investiture, from 3 to 4.1S p. m.; and an A. R. P. Demonstration, in which participation by the Cardiff City Corporation is invited, from 5 to 5.30 p. m. It is hoped to arrange for Units forced to remain overnight from North and \Vest Wales to be accommodated in the T. A. and A. F. Hutments at Barry Island.

Remote as may appear the risk of requiring conveyance by ambulance car, the fact that an ambulance service operated by the Priory for Wales with 19 stations and 21 cars carries over 18,000 cases, an aggregate distance of 300,000 miles in a year, indicates that the contingency is one to be taken into calculation by the average citizen; and while" Safety First" may well be a New Year resolution for 1939, it will be some consolation to a harassed taxpayer to learn that in view of increasing demands by the general public the Priory announces a reduction in its charges to those outside its contributory scheme. As from January 1st, 1939, the rate will be is. instead of is. 3d. per mile for the first 100 miles, with a further reduction to 9d. per mile over 100, and a minimum charge of 7s. 6d. for a journey up to seven miles.

Ambulance workers in the mines will welcome an Agreement entered into between the Owners' and Workmen's R epresentatives on the Conciliation Board notified to the Priory by Mr. Iestyn R. Williams, Joint Secretary of the Monmouthshire and South Wales Coalowners' Association, whereby the following provisions shall be applied at all collieries concerned : 1. In order to become entitled to enjoy the provisions of this Agreement a workman shall be in possession of a certificate of efficiency a\.varded by the St. John Ambulance Association or British Red Cross Society in respect of First Aid and shall undertake to submit to an examination for the 'purpose of renewing that certificate once within a period of two years from the date the certificate was last obtain~d or renewed, provided that exemption may be granted In respect of existing ambulance men. 2. A workman who has been instructed by the Management to carry a First Aid Box and pe~forll1 First Aid Services in respect of accidents, shall be pm.d an ~mount of 8d. net per shift workeJ in respect of thiS service for a maximum of six shifts per week. 3. A workman engaged on pieceworl~ who. has been instructed by the Management to carry a FIrst Aid Box and

perform First Aid Services, and who is called upon to render first aid to an injured workman shall be paid a sum equal to that proportion of his appropriate minimum standard rate plusyercentage which the total time he is engaged on these servICes bears to the total hours of the shift. Payments made under this Clause shall be taken into account for calculations under the ~1inimum Wage Act. 4. At Collieries where payments are already made in excess of those laid down and for the services indicated in the foregoing paragraph 2, these payments shall continue in respect of the particular individual workmen who now enjoy them, providing that the payments to be made in respect of all new appointments from the date of signll1g this Agreement shall be in accordance with the provisions of this Agreement in order that in course of time there mar be uniformity throughout the Coalfield. S. Paragraph 3 is Lo apply from the date of signing this Agreement notwithstanding that other methods have hitherto been applied to reward pIeceworkers for loss of time entailed in rendering first aid services. 6. The vVorkmen's Representatives undertake to issue a strong memorandum to all workmen who now, or in the future may enjoy the provisions of this Agreement, impressing upon them the necessity to exercise every possible care to ensure that there shall be no misuse of First Aid equipment, and particularly the equipment pro\'ided in First Aid Boxes. 7. Ambulance workmen are to observe the instructions of the Management implicitly in the matter of reporting accidents and checking the contents of First Aid Boxes.

NATIONAL AMBULANCE COMPETITIONS.

Dates for the 'Welsh Brigade Final Competitions ha\'e not yet been decided, but all am bulance teams can prepare for the open competitions already arranged in connection with the two Welsh national gatherings which entrust to the Priory for \Vales each year the organisation of the ambulance contests which have become a regular feature of their proprogrammes. . . The Royal Welsh Agricultural Society hold Its annual show at Caernarvon in July; and on Friday, the 28tb, the following events will take place : 1. Silver Challenge Shield, open to teams of men in \Vales and Monmouthshire, the members of ,,,hich must hold a First Aid Certificate of a recognised Society. First prize £3 a Od. Second prize £2 0 Od. . . 2. Silver Challenge Cup, open to teams of ladles 111 \Vales and Monmoutbshire, the members of which must hold a First Aid and Home Nursing Certificate of a recognised Society. First prize £3 0 ad. Second prize £2 0 Od. 3. "Arnallt Jones" Shield, open to teams of St. John Boy Cadets in vVales and Monmouthshire, the members of which must hold a First Aid Junior Certificate of the Order of St. John. First prize £2 10 Od. Second prize £~ 1? ad. Denbigh is the 1939 "enue of the Roy~l i\atlOnal Eisteddfod of Wales during August Bank Holiday week; and entries for the four competitions detailed below must be submitted by May 1st : 1. The "Lady Lewis" Cup of. the .Priory,tor 'Wales, open to teams of five men holding First Aid Certificates of a recocrnised Society, with prizes of 1st, £10 a a d.; 2nd, £5 ad.; 3rd, £1 a Od . , and a special medal of registered design .

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2. The" Lady Bute " Cup of the Priory for Wales, oren to teams of four women holding First Aid and Home Nursmg Certificates of a recoanised Society, with prizes of 1st, £8 0 Od.; 2nd, £4 Od.; 3rd, .£1 0 Od., and a special medal of registered design. 3. The" Isca" Shield, open to teams ofJ1ve boys under 18 years of age, resident in Wales or. Monmou!hsl?ire, who must be accredited members of a JunIOr OrgamsatLOn, each in possession of a recognised First Aid Certificate, with prizes of 1st, .£3 0 Od.; 2nd, .£2 0 Od. j 3rd .£1 0 Od., and a special medal. 4. The "Gwent" Shield, open to teams of girls under 18 years of age, resident in Wales or M"onmou.thsl;ire, who must be accredited members of a Junior OrgamsatlOn, each holding a First Aid and Home Nursing Certificate of a recognised Society, with prizes of 1st, £3 0 Od.; 2nd, £2 0 Od. j 3rd, .£1 0 Od., and a special medal.

Police Ambulance News. POLICE

NATIONAL

TROPHY,

1939.

The final competition for the" Pim " trophy and prizes presented by the St. J ahn Ambulance Association will take place on Friday, February 24th. The judges will be Dr. G. D. Tullis, of Hereford (team) and Dr. A. M. Pollock, of Tunbridge Wells (individual). During January the eliminating district competitions are being held and the results of these will be given in our next issue. As is usual, owing to the great number of competing teams, the No.9 District (Metropolitan and City of London) eliminating tests were divined into two preliminary heats and held at Peel House on January 3rd and 5th. Dr. F. E. Bendix (team) and Dr. R. V. Steele adjudicated, and the following divisional teams will compete in the final eliminating contest to be held on January 24th, at the Memorial Hall, Farringdon-street, E. C.4; G, V, H, W, R, M, F, Y, T, Z, and B of the Mets and City A of the City of London. Some very interesting tests were given. On the second day the team test was that of a man who had been rescued from the river. The teams were told that severe shock and concussion was present. There was a road-house nearby where everything for treatment was available. The teams had full first aid equipment and a stretcher with them. The marks available and details were :Rapid approach to patient 1 Definite warning to lie still 1 Note possible sources of danger 1 Steady and support patient carefully from now on, avoiding any unnecessary movement 3 b patient breathing (yes) 2 3 Careful and complete examination for hcemorrhage If discovered early left leg 1 Noting bruise forehead early ... 1 Eliminate fracture signs left lower limb 2 Elevate limb and maintain 2 Is blood bright red (no) 1 Is blood dark red (yes) 1 Flowing steadily from side further from heart (yes) 2 Foreign bodies (no) ...... 1 Direct digital pressure maintained 2 For speed in arresting hcemorrhage 2 Remove constrictions from heart side of wound ... 2 2 Apply firm bandage, near wound, side away from heart Temporary dressing and bandage ... ." 2

tlltSt'

AID Note patient regaining consciousness Enquire re pain (stomach and throat) Note stains of lips... Odour of breath (iodine) Arrangements for medical aid with full details ... ... Any other pain (my leg) How do you feel (sick and faint and thirsty) Any other pain (no) Carefully place patient on his bacl, onlo a rug Head low And turned to side and maintained Loosen clothing neck, chest and waist Ensure free circulation of air ... Give starch and wa,ter freely ... Give ernetic-state dose and temperature of water Repeat every five minutes until vomiting occurs State- preserve vomited matter, etc. Give castor oil-correct dose . .. Cover well with rugs or coats. . . Raise well the lower limbs Avoid smelling salts (head injury) Speak encouragingly throughout Ensure freedom from excitement and worry Do not discuss patient's condition in his hearingTr;1nsport to roadhouse. Preparing and testing stretcher Arrange blankets ... Correct positions for loading stretcher Lifting patient Placing stretcher Lowering patient Covering patient Lifting stretcher Advancing Halting Lowering stretcher at side of bed Lifting into bed-correct method For speed in removing to shelter Remove damp clothing Wrap in blankets .. , Hot water bottles- correcpy placed (sides of abdomen, lower lim bs and feet) Ice or cold water to head continuously To relieve pain-olive or salad oil or medicinal paraffin Or demulcent drinks-barley water or gruel Give milk, raw eggs with milk or water, or cream and flour beaten up together ... Eliminate signs of injury to internal organ-air hunger, etc. Give hot strong tea or coffee with plenty sugar Apply lint soaked in equal parts spirit and water or cold compress to bruise Carefully prepare material for dressing Sterilise fingers with antiseptic (no antiseptic available) Use normal saline-correct proportions Is wound obviously dirty (no) ... Apply normal saline to wound and skin Dressing carefully applied Cover with cotton wool Bandage firmly Avoid undue stimulation Avoid exposing patient during treatment... Darken the room ... Carefully watch for improvement in patient's condition Examine and enquire re hCfmorrhage Identification and tactful message Total CITY

LONDON

SPECIAL

1 2 1 1 3 1 1 2 2 1 2 1 1 2 3 2 2 2 2 2 3 1 2 2 2 2 2 J 1 2 2 2 2 1 2 5 4 2 2

Fletcher, some ninety members gained the requisite number of marks to satisfy the examiner. This result is very gratifying to Dr. F. E. Bendix, the lecturer and to the first aid section staff. ' The annual spring course commenced on January 18th with.C~pt. A. C. White Knox, M.C., M.B., as the lecturer: and It IS heped that a further 100 passes will be obtained. Arran~ements are now being made for the annual team and individual tests; details of which will be given later,

WORCESTERSHIRE

POLICE.

The annual cup competition was held at Malvern on December 12th, the judges being Dr. G. D. Tullis, of Hereford (team), and Dr. H. Savery, of Evesham (individual). ,Mr. W. H. Grundy (Chairman, Malvern Council) preSided, supported by Capt. J. E. Lloyd-Williams (Chief Constable) and Mrs. Lloyd-Williams, Chief Supt. Davies (Deputy Chief Constable), Supt. T. W. Arey and others. Supt. Cook was responsible for the arrangements and the result was 1st. Redditch, 210 marks; 2nd, Worcester, 204; 3rd, Bromsg~o~e, 179t. Eight teams competed. Mrs. Lloyd-Williams presented the winnin a team with the" Laird" Cup and other prizes. b

NORTH

RIDING.

The annual competition for the" Lord Bolton" first aid cup, open to teams of the North Riding Constabulary was held at Northallerton Police Headquarters. ' Col. J. C. Chayton, Chief Constable, presided whilst Mrs. Chayton presented the cup. The N. R. Motor Patrol with 177t marks gained first place, followed by Whitby (170t), Lang North and Northallerton (tie, 169t). Ten teams compet~d,

2 2 3 2

The Human Body.

(Being extracts from a lecture given to members of a S.l.A. B. Division.)

By JOSEPH 2 2 2 2 1 2 1 1 1 1 2 2 2 3 3 2 1 150

CONSTABULARY.

As a result of the examinations held at Headquarters, on December 5th to 8th, and carried out by Dr. N. Corbet

J. HODGSON.

THE SKELETON. THE skeleton, or shell, upon which our bodies are built is composed of bones, some long some flat others irregular and these, we are told, numbe~ about 206. . Bone derives its rigidity to salts, mainly calClum phosphate and calcium carbonate, which make about two-thirds of it. Flexibility comes from g,elatinous matter-one third. Most bones, when Just formed, are composed mainly of cartilage. In the middle of long bones we have the marrow which is made up of blood cells and fat. All bones are living matter and so require blood to feed and nourish them and nerves to stimulate them. . This framework of the body can be divided into three main groups: the head, the trunk, and the limbs.

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17j

Bones of Head. .The skull consists of 22 bones-eight in the cranlu~ and fourteen in the face, these, with the excep~l~n of. the lower jaw, being united with fixed Jo~nts llke numerous dovetail joints. Sockets (or orbl~s) are formed conjointly by the bones of the cranlu~ and face for the eyes and nose, and the mouth lS formed between the upper jaw and the movable lower jaw. Bones of Trunk and Limbs .. If we bu~ld the body in an upright posltlOn we find that lt stands on the lower limbs; the foot-seven tarsal bones, five metatarsals and fourteen phalanges; the leg-tibia (or shin bone), and the fibula (or brooch bone); the patella (or knee cap), and the femur (or thigh bone) which is the longest bone in the body. This i5 the same in both lower limbs. It will be seen that these form two columns or upright supports. The head of the femur has a rounded portion fitted into a cup-like basin of the haunch bone. In the lowest part of the spine the sacrum and coccyx act like a wedge or keystone in the centre rof the back between the two haunch bones and form with them an arch-like basin which holds the contents of the lower abdomen. , The main support of the body, however, is the spine, or vertebral column, and this is made up of 3? small bones which are named vertebrae , and whlch, known by numbers from above downwards, are 7 cervical, 12 thoracic, 5 lumbar,S sacrum and 4 coccyx. Each vertebra consists of a body or bony mass in front, from the sides of which there are bony projections known as the transverse processes. These extend backwards and unite to form the spinal canal through which the spinal cord runs and is protected. The first vertebra is known as the atlas and is like a ring thickened at the sides and having two little hollows on its upper side. These in turn allow the two bony knobs of the occipital to fit into and so give us the nodding movement of the head. ' The second cervical vertebra, known as the axis, has a kind of peg which fits into the ring of the atlas above so that the head and the atlas work like a pivot and allow side to side movements of the head. The sacrum and coccyx are, in adults, joined together and form one bone. The chest is formed by twelve pairs of ribs and a dagger-shaped bone, known as the sternum or breast bone. The ribs are curved and all are fixed at the back to the side processes of the dorsal (or thoracic) vertebrae. The first seven pairs (true ribs) are connected directly to the sternum. The next three pairs (false ribs) are joined to the sternum by means of cartilage, whilst

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the last two pairs (floating ribs) are shorter than the others and have no attachment in front. Each upper limb is joined to the trunk by the clavicle or collar bone, which is a narrow curved bone joined at the in ner end to the top of the sternum and at the outer end to the shoulder blade (or scapula). The scapula, situate at the back of the chest, is a flat shield-like bone, and in it is a socket (or cup-like hollow) to take the head of the humerus (or arm bone). This bone extends from the shoulder to elbow where we finel the two forearm bones-the radius on the outer (or thumb) side, and the ulna on the inner (or little finger) side. At the wrlst, arranged in two pairs of four, are the carpal bones (or carpus), whilst the framework of the palm of the hand is composed of five metacarpal bones. In each finger there are three phalanges and in the th um b two. Varz"et£es of 10£nts . Wh~n two or more bones meet they form joints of va rying kinds. We have the ball and socket joints at the shoulder and the hip joint, h£nge joints at the elbow and the knee, fixed joints in the skull, and g/£d£ng joints where only movement of rotation takes place, such as in the forearm with the radius and ulna bones. In all moveable joints the ends of the bone are covered with cartilage to lessen friction and also shock in cases of a fall. The ends of the bones are enclosed in a bag of strong tissue (known as the capsule), having a lining in which is secreted synovial fluid for the lubrication of the joints. This is always present. The whole is strengthened by stronger bands of fleshy tissue or ligaments. Between the vertebrae of the spine there are pads of cartilage. The skeleton, therefore, gives shape and firmness to our body, forms the cavities to protect organs, and gives something to which to attach the muscles. THE MUSCULAR SYSTEilL

Now to cover the bones. All flesh is muscle which enables us to move and our internal organs to function. There are over five hundred muscles in the bod y and these are grouped in two main classes-the voluntary and the involuntary. The voluntary muscles, namely those under the control of the will, are in the head, neck, surface of trunk, and limbs and they give us the power of movin g these parts. They are attached to the bones by strong bands of fibrous tis~ue or tendons, striped in character, and having the power of contraction and relaxation. The involuntary muscles are unstriped and not under the control of the will. They act by day and ni.ght, even while we sleep, and they are to be found 11l the walls of the stomach, intestines, blood vessels, and all the internal organs.

.AID

FIRST

Muscles are live cells and obtain their nourishment and power from the oxygen and food brought by the blood and are controlled by the two systems of nerves-the cerebra-spinal, and the sympathetic.

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Railway Ambulance News.

CONTENTS OF THE BODY. ,,/

Commencing with the cavity formed by the bones of cranium we have the brain-seat of intelligence, will and sensation. This can be called the "Control Tower." It records or gets its sensations from the five senses, viz., the eyes for sight, the ears for sou nd, the nose for odours, the mouth for taste, and the touch for sensation. Motor nerves are the means whereby the brain's commands are carried into effect. Next we divide the trunk into two main compartments- the upper, which is the chest (or thorax), and the lower, which is the abdomen. These are divided by the diaphragm, a large movable arched-shaped muscular wall or partition. In the thorax, which is bounded by the breastbone in front, by the spine behind and by the diaphragm below, we have our main organs of circulation-the heart, the lungs (or" Purification Plant "), the air tube or trachea, the greater part of the oesophagus (gullet or food-tube) and the main part of the thoracic duct, blood vessels and nerves. The abdomen, the lower compartment which is bounded by the diaphragm above, by the lumbar vertebrae at the back and by the pelvic bones below, houses the stomach which is situated just below the diaphragm towards the left side, the Ii ver (or" Cleansing Station ") on the upper right side, the spleen (on the upper left side), the pancreas, behind the stomach, large and ' small intestines, the kidneys, right and left ureters in region of the loin, the bladder, rectum, large blood vessels, lower part of thoracic duct and part of the sympathetic nervous system. The whole of the body is covered with skin consisting. of an outer and hard layer (the cutide or epidermis) and an inner layer (true skin or dermis). In the latter there are numerous glands which excrete water and impurities of the blood. This is known as sweat which on passing through the pores of the skin evaporates, cools, and thus helps to regulate the temperature of the body. Between the skin and the underlying flesh we have both yellow elastic and white tissue, known as connective tissue which binds these parts of the body together. (To be concluded.) We are prepared to supply Ambulance Secretaries and others with specimen COpies of this Journal for distribution among their members. Apply to the Publishers, FIRST AID, 46 Cannon St .. London E.C.

I nter- Railway Police Competition. As Railway Police are not eligible to enter for the National Police First Aid Competition the Chi efs of Rai lway Police have subscribed together and presented a ch allenge cup fo r annual competition open to members of their r espective fo rces. This competition will be run on similar lin es as the Inter -Rai lway Competition but IS confin ed to th e five fo llowing Rai lw ay Police Forces;Great Western, L on don Midland and Scottish, London and North Eastern, Southern) and the London Passenger Transport Board. One team from each force will compete in the final a nd eliminating tests will be held (if necessary) by the Railway Companies concerned. All members of the teams must be holders of the St . J ohn or St. Andrew's Ambulance Association certificate and tests will be based on the latest editions of the official textbooks of those associa1i on s. Captain W. Good ley, O.B .E., M.C, is tl~e. actil:g Competition Secretary, and the first final compeb~lOn wdl take place at Padding-ton on Mar~h 16th. Captam A. C White Knox, M.C, 11. B., 01. B., IS to be th e Judge. It is hoped that the presentation o~ this cnp w!l1 do much ,to stimulate the interest of first aId among RaIlway Police Forces and encourage a greater number of members to become ce r tificated first aiders .

Great Western. LANDoRE.-The Mond Building was the scene of the annua: concert and pr esentation of a wards organised by the L andore Central ambulance class; no fewer than 77 members received their examination awards; in addition ten efficiency medals and bars were distributed. .1\1r. D. Edwards, Station Master, presided oyer the functIOn, and among those present were the M~yor. and lV1ayoress of Swansea, Councillor and Mrs. DaVid Rlch-ards, Alderm~n 'W. K. Owen) ex-Mayo r of Neath, Mr. G. Matthews, Dn·. Supt., Mr. A. L an e, Asst. Chief of Po lice, G.W.R., Mr. W. Davi es District Goods Manager, and 11r. F. J. l\Iay, Chief Con~table of Swansea. The r ecipients of awards included an 80-year-old vete r an, M r. W. Thomas .. A pleasing feature in the proceedings was the presentatIOn of crifots on behalf of class members to Dr. S. Gordon, l ect~r e r, Mr. E. D. Abraham, instructor, and 1\1r. J. Comley, se creta ry. TRoWBRIDcF..-Mcm bers of the Trowbridge olass met on D ecember 1st to receive exam in aL ion awa rd s, the Q·atherino· taking the form of a concert. 11r. A. C Dr ew, Station 11aster, who presid ed, was supported by 1\1r. R. G. Pole, Di \T. Supt., and 1\1rs. P ole, 1\1r. R. G. B.al:e.foot, District Goods Manager, Mr. W. F. \Vtll s, DIVIsIOnal Ambul ance Secreta ry, and class officials. ~he presentations which included a number of gold effiCIency medals, were'made by Mrs. PoIc, who received a bouquet at the hands of' Miss Richman. No fewer than seven membe rs of th e class arc hold ers of the IS-year medal) while four

h ald the 20-year bar and 1h ree the Quarter Century medal. CAERPIIILLY.-The ann ual dinner and presentation of awards to members of the Caerphilly class took place on December 2nd, under the presidency of Mr. A. \V. H olling-dale, Divisional Engineer. Among those present were Mr. C T. H. Riches) Diy. L oco. Supt., Corps Supt. R. J. Carter, Dr. E. Savage, and Mr. P. Coleman, Chief of the Fire Brigade. 1\1r. M. G. R. Smith, Asst. Diy. Engineer, distributed examination awards, and gold medals for 15 and 25 years' first aid effici ency were presented by Mr. Riches. SWANSE,\.-l\Ir. VV. Davis, District Goods l\1anager, presided over the annual dinner jointly organised by the S,vansea Central, RiYerside, and Ladies' Ambulance Classes. He congratulated the Swansea ambulance division on having- gained 890 examination su~c~s,ses last session, the highest number of any G.\V.R. DIVISIOn, and hoped they would be the first to reach the 1,000 mark. H e particularly complimented the ladies' class on th~ir successful session. Examination awards were then dIStributed by ~Irs. Davis, 1\1r. ·V. R. Illingworth and Mr. J. A. Reynolds. A number of gold efficiency medals and bars were presented by 1\1r. '\V. P. Morgan. On behalf of the class members presentations were made to Dr. W. L. Hefferman and Dr. J. Shibko and to l\1essrs. C H. Bevan and B. Cos1cU, Instructors, and Mr. H. A. EYans, secretary. WESToN-suPER-MARE.-The Mayor of \V estol1-superMare, Alderman H. Butt, attended the annual c?ncert of the G."W.R. class when Mr. W. N. Pellow, Dnr. Loco. Supt., presided over a large and enthusiasti.c g.athering. Examination awards and gold medals were dIstrIbuted by Mr. H. A. Alexander, Diy. Engineer. Mr. A. C Kapper, class secretary, presented his annual report, and was made th e rct:ipient of a gift from the class members.. The Mayor, ,,,,ho has already made many generous gIfts to the Great Western Railway ambulance eentr~, pr~sented a further silve r cup for competition. Expressl~g hIS keen interest in the moYement, Alderman Butt sal~ that the progress of the town was largely linked up WIth that of the railway. LI SKEARD.-The re was a unique presentation at the S tag H otel, Liskeard, on December ?th, when the Mayor of Liskeard, Alderman J. Pitts, rec~nled the G.Vv.R. golcl m edal for 15 years ambulance effiCiency at the hand~ of Mr. E. L ake, D iv. Engineer. The 1\1ay~r, who 1S a G.'W.R. signalman and a met~1~er of the Llskea.rd cla:s, referred to the thriving condItIOn of the first aId mo\ ement both in the town and station. Among those present were Dr. J. G. l\lorgan, Aldemlan E. Spl~r\\'ay. peputy 1\fayor, Mr. F. Temple Roberts, president. of the L1skeard S.J.A.B., and M r. F. H. Wherly, staotton _ master, . the btter having qualified for the 20-year gold bar . ExamInation awards were also presented hy :Hr. Lake,

FIRST PORT TALBOT DocKs.-The annual dinner of the Port Talbot Docks class took place at the Walnut Tree Hotel on December 10th, when Mr. J. T. Edmunds, Dock Manager, presided, supported by local officers of the Company. Presentations were made of examination awards, gold efficiency bars and medals and the Local Officers' Challenge Cup, won by Messrs. R. Turner and R. Davies. READING.-The annual presentation of awards Lo members of ,t he G.W.R. Division of the S.J,A.B. and class took place at the Lower Ship Hotel. Mr. H. M. Young, Asst. Signal Engineer, presided, and Mr. C. T. Cox, Div. Supt., made the presentations. Among those present were Mr. V. O. Fenner, Station Master, Mr. Powney, District Inspector, and Mr. O. J. Cripps, Class Secretary and Brigade Superintendent, who referred to the fact that lOO per cent. of the members had passed successfully.

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Dr. G. P. Williams associated himself with Mr. Shaw's remarks and said that they had worked together with the greatest unanimity. Mr. J. Fred Roberts, the new Secretary, spoke of his years of apprenticeship with 11r. Griffith and urged the staff to give him the same support. WOLVERTON.-Mr. J. Purves presided over the anllual dinner which was attended for the first time by a number of ladies. Mr. A. Felts proposed the health O'f the President and referred to his great help. The toast of "The L.M.S. Ambulance Movement" was submitted by Dr. Bull and in reply Mr. Ibell thanked the doctor for his assistance in the past. The heal th () ( .. The Medical Profession" was proposed by Mr. S. A. Walker (Captain) and in responding Dr. Fildes said he was indebted to Messrs. Webber, Nichols and Barby. Mr. S. W. Andrews and his committee were responsible for the arrangements. " Invicta" A. R . P. Trailer Ambulance.

london, Mid land and Scottish. COMPETITIONS.-It is worthy of record that L.lVI.S. teams during 1938 gained first position in each InterRailway Ambulance Competition in England, Wales, and Scotland. In addition, premier honours in the St. John Ambulance Brigade-the "Dewar" Shield; and in the St. Andrew's Ambulance Association~the " President's" Cup-were also gained by members of the L.M.S. Staff. ApPLEBY.-Enthusiasm for their work was the keynote of the combined gathering of the Appleby Detachment of the V.A.D. and the Railway Ambulance workers. Dr. Fo.wlie presented 5 certificates) 1 voucher, 22 labels to the ratlwaymen. Mr. W. H. Benson presided and was supported by Messrs. Dent, E. H. Garner Major Ingham and Dr. Sime. ' . ~r. Garner presented a set of glass dishes to Mr. R. Wllkmson (Secretary), to whom best wishes were expressed for a long and happy married life. The presentation was followed by a whist drive the prizes for which were distributed by Mrs. D ent. ' . SWANsEA.-On December 11th members of the St. John Ambulance Class presented Dr. VV. H. Thomas, Class Lecturer for the past eiO'ht years with a clock in recognition of his work. They ~lso pres~nted Mr. H. C. L. Havard, ex-Class Secretary, with a barometer. Mr. ~avard has resigned his position owing to recent promotton as Corps Secretary for the Swansea Centre of the St. John Ambulance Brigade. Mr. H. Owen made t~e presentation) and was supported by Mr. Spear, ChaIrman, Mr. R. A. Hutchinson Class Secretary, and Mr. A. H. Havard, Class Instructor: HOLYHEAD.-The distribution of awards was made recently by Cap~. H. W. Smith, who in his opening remarks gave a short hlstory of the Order from the time of the Crusades. The awards were as follows : Gold Medal,' L. H. Ingram; 35 years' Gold Bar, ]. F. Jones; 30 years Gold Bar, Arthur Shaw; 25 years' Gold BaTS! Frank Bell, J, Fred Roberts; Meda.llions, Griff. Wlll~ams, H. ]. Davies, E. J. Brown; 26 Labels and 16 Certtficates. The Chairman, Mr. ~rthur Shaw, referred to the late Secretary, Mr. Rober:t Gnffith, who for 34 years had held o~ce, and Capt. Smlth was called upon to present him WIth i1, wa 1let and notes.

STAFFORD.-The annual presentation of awards was presided over by Mr. W. H. Phillips, who referred to the absence, through a cycling accident, of Mr. H. Taylor, winner of the "Thomas Howard" silver cup. Mr. F. Egerton distributed the following :-22 labels, gold bar (20 years), G. Griffiths; gold bar (25 years) M. V. Lockley. Thanks were voiced by Mr. G. Pye to Mrs. Howarcl, Mr. Egerton and to members of the police for their support.

London and North Eastern. Awards gained by members of the Hull Docks Engineers' Class were presented at a concert and dance held last month. Mr. W. Garden (Works Supt.) presided and congratulated the No.2 Team 011 winning the L.N.E.R. District Shield, Officers' Cup, "Major Carver" Cup during the year, and the class for winning the" Mrs. Harper" 1irophy. Mrs. W. Garden presented the awards. Mr. H. Hudson presented the" Mrs. Hudson" silver cup for individual competition to Mr. J. Scott, and also presented the dlass doctor, Dr. A. M. Boyne, with an electric torch, and the instructor, Mr. W. H. Lambert, with a gent's companion. Mr. C. H. Nicholson moved thanks to the chairman Mrs. Garden and Mr. Hudson. '

Southern. All members of the ,Southern Railway Ambulance Centre are asked to wear the button-hole badge which is presented to them when awarded their first year's certific.ate. These badges, which signify the wearer's qualificatwns to render first aid, furnish means of easy recognition of qualified men in the event 'Of an emergency. The Chatham Southern Railway No. 1 Team were successful in gaining the Chatham and District Shield at the annual competitions held last month. Rochester Division were second and gained the "Gower" Cup. The Mayor of Rochester (Councillor C. Sherwin K!lig~t) presented the trophies and congrat111ated the WlTInJng team.

A.R.P. Topics. TRAILER AMBULANCE.

I t is a defin ite fact that there is a shortage of vehicles which, in time of need, could be used or converted into suitable conveyances for the removal of stretcher cases. Further, the Dormant Contracts entered with owners of such vehicles do not guarantee that the vehicles in question would not be disposed of during the I i quiet" season; also the majority are too high to be suitable for easy loading. The serious difficulties from the decontamination standpoint must also be considered. VI e were therefore very interested in a new trailer ambulance which we inspected a few weeks ago. It has been designed by the Invicta Motor Engineering Works Ltd., of Canterbury, and is known as the" Invicta" A.R.P. Trailer Ambulance. On first sight the possibilities of the trailer were apparent, and on closer inspection our first impressions were confirmed. The construction is of iron and steel, mounted on Ford Motor wheels and springs, thus making sure that all parts of the chassis can be easily and quickly replaced if needed. The trailer can be attached to the bumpers of any size of car, thumb screws being fitted for this purpose. Actually, the model we saw was attached to an 8 h. p. car and had travelled at various speeds with ease and smooth running. The accompanying photographs show clearly the construction and appearance of the trailer. It has tubular supports, all interchangeable, which are covered with a canopy of oil dressed material which is kept in position along each side by a tubular edge. This covering can be detached in a few seconds for decontamination. The outer side supports are kept in position by a tubular stay from a central support, and can be lowered when loading operations are in progress.

The trailer can accommodate two stretcher cases and an attendant who sits on a seat in a central gangway. The stretchers, all steel, sit in a cup-like holder. . T~e advantages of this trailer are:: easy and Immediate attachment to any vehicle; low loading, which is a very important feature when we consider that the bearers may be over military age; always available in case of emergency and for use in training volunteers; easily stored as all parts are detachable; easily decontaminated should liquid gas be used; and reasonably cheap to purchase. Although primarily designed for A. R. P. work we venture to suggest that a slightly more elaborate model would be found of great use in first aid roadside duties. 6

ANSWERS TO QUERIES.

This month we are giving a few answers to A.R.P. queries asked by readers and some submitted to, and answered by, Dr. W. C. Bentall at the S.J.A.B. Courses. Q. Would" No.1 Eye Drops," as used in Factory First Aid Regulations be suitable for use in treatment of mustard gas in the eye? A. No. The eye drops contain castor oil, bichloride and cocaine and would set up a more irritant effect. Castor oil, if fresh, could be used but it is better to use a solution of normal saline or soda bicarbonate (10 grains to the pint). \Vhy is it necessary to have the water actually Q. boiling before putting in clothes for decontamination? A. It prevents shrinkage. Q. What is the technique for getting rid of blister gas swallowed in the saliva? A. Produce vomiting (first aid rules) and give a solution of bicarbonate of soda to drink.

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Q. What is the distinction between insidiousness and delayed action? A. The medical definition of the word insidious is "a disease existing without marked symptoms, etc." Therefore the action of mustard is insidious because the action is delayed. Q. If an area contaminated by blister gas is sealed would it eventually have to be unsealed to be properly decontaminated? Yes. Sealing would not destroy the gas and A. is only a temporary measure. Q. Should gloves be worn when washing infected clothing? A. Yes, like some ladies do for washing up. The operator must be fully protected against the vapour which may be present. Q. How CCln one tell the difference between a splash of tear gas or a splash of mustard gas in the eye? A. (1) Mustard liquid makes a small local red area. Tear gas makes a widespread redness. (2) Mustard liquid is intensely agonising. Tear gas much less so. Q. Does the waterglass used for sealing need heating, and how big an area would a gallon cover? A. Waterglass when used for gas infected floors is mixed with a little cold water to the consistency of a thin paste and brushed over the area to be covered. This should be made up a little at time. A gallon would cover an area of about 70 to 80 feet according to the consistency of the material.

Murton Colliery won the Sunderland Area preliminary round of the Durham Bronze Shield competition, which is open to St. John tea ms in Durham. 3'

At the annual dinner of the Thetford Division, S.]. A. B., the May~r (Mr. G. E. Lambert) said that the town was proud of such a splendid body of men. Pte. H. Grantham won the" Mayor's" Cup annual competition of the Nuneaton Division, S.J.A. B., and Ambulance Sister A. Ivins the" rvIayoress's" Cup. :3

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Dunston, last year's winner, again won the" George Jackson" Memorial Ambulance Trophy competition, held on December 17th, at Sunderland; East Baldon A team was second. 3

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The preliminary round for the" Palmer" Trophy was held last month when Hetton-Ie-Hole were declared the winning team. The competition is open to teams in Northumberland l Durham and the North and East Riding.

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Hints on Competition Work. By DR. A. T. LAKIN.

THE competition season now being with us we have pleasure in repri nting this article by such an eminent judge from the L.M.S. Magazz'1,ze. The figures given refer to pages in the St. John Textbook.

Competitive First Aid. The judge can only award marks for what you tell him or what you actually do, so speak distinctly and towards the judge (do not mumble). State reasons for y.our actions whenever possible. The conditions of the competition usually state that the captain only should ask questions and speak to the judge-the others should speak to the captain. All team tests can be divided into three stages: (a) The approach; (b) Diagnosis and treatmen t ; (c) Transport. The stages will overlap in the test, but keep them separate during the earl y practices. (A) THE ApPROACH INCLUDES 1. Understanding the card and / or the conditions of the test. Conditions governing the competition also. 2. Getting the team to the scene of the accident. 3. Getting the ambulance material. Improvising. 4. Noting the prOVISIOn for second aid. Doctor, hospital, ambulance. 5. Making provision for warmth, etc. 6. Taking precautions re traffic, crowds, etc. 7. Noting additional heIr, bystanders, messengers, etc. M/187, 1, 2,3,4,5,6. Suggestion :-No. 2 takes special notice of surroundings, weather, traffic, etc., and acts; No. 4 takes special notice of ambulance material, second aid, etc., and acts; No.3 notes everything connected with the patient; No.1 keeps a general oversight over everything. Important.-Make the patient safe at once. 1. Visible hcemorrhage. If found treat at once. 2. Breathing. If ceased, artificial respiration at once. 3. Deformity or unnatural position of the limbs. Steady and support as found always. 4. Make the surroundings safe. Patient may

have to be moved at once from danger. Practice moving him before treatment-in or under motors, drains, electrical contact, etc. If he has to be moved, move him well away and place him on a rug or stretcher. Surroundings suggest: T07:V7Z, St1/eet, House-traffic; police to help; crowd to control; telephones; materials; improvIsing; shops; doctor; ambulance; helpersalways sure of medical aid at hospital. Discrimination needed. Country-difficulties; little or no help; nearest house for drinks, blankets, etc.; use of improvised material, etc. Use resource. Factory-first aid box or room; dirt; grease; moving machinery; gas; electricity; plenty of hel p, etc. Be explicit. 1I1£lles, Sewe1/s, Tunnels -difficulties; darkness, cramped space; poisonous gas or fumes. ExplosIve Surroundings, Petrol Fumes (always in motor accidents), Escape of Gas -no smoking for 50 yards around (get a helper to see to this). Electr£cal Accidents-switch off current or short-circuit; protect live wires; insulate; dry materials; no metals; remember possibility of burns. 7 -ime of Year: W£nter-cold; dark; keep patient warm and dry; care if snow about, shelter. Summe1/-sun or heat stroke-shelter or shade. (B) DIAGNOSIS AND TREATMENT. Remember that artificial respiration and the arrest of severe hcemorrhage are, if necessary, to be done immediately. No waiting. No hesitation. (It may be only a question of minutes before death occurs.) Encouraging \vords to the patient, etc. M/ 187,4. No reponse - patient unconscious. (Ask judge.) .\II / 188. Response-patient conscious. M/ 190 b. Breathing. Rate, character. ;\1 / 188, 3. Pulse. Presence, rate, character. M/ 188, 4. Colour of face. Pulse and colour of face must be watched, since they are the indications as to the progress and condition of the patient.

(a) If the PaNent z's UnconsC'':ous. Examine head. All over scalp, ears, nose. M/ 89,6. Protect any injury found. M/24,7. Examine mouth. Burns suggest corrosive poison. Doctor at once. Scald of throat always present and must be treated. M/ 156. False teeth may be a cause of asphyxia. M/ 189, 7. Examine eyes. Both eyes must be examined at the same time and in the same light, so do not try it if the patient is face down or the head is turned to one side. (But do not forget to do it later.)

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Examine ribs, abdomen, groins, back (include buttocks). M/189, 8. Dampness between thighs may mean urine passed. Examine upper limbs (include clavicle and scapula) for fractures, wounds and hcemorrhage. Eliminate fractures before testing joints for movements (dislocation). Examine lower limbs. (Notes as for upper limbs.) Examine body for limpness. Note the temperature of ~he body. State suspected injuries. "Sufficient diag. " nos 1::;' •M/ 18 , a. Send for doctor or ambulance.

(b) Ij the Patz'enf z's Conscious and able to gzve Relz'able Information. Approach and make the patient safe, as before. Enquire as to pain. If present, examine and treat. Enquire as to dampness (bleeding). If present, examine and treat. Ask the patient to move his limbs (separately). If he can move them without pain or difficulty it eliminates fractures, dislocations, wounds, sprains, strains. (Exception: Fracture of the pelvis). If he cannot, then examine. Rest of the examination as unconscious, where necessary. State suspected injuries. Send for doctor or ambulance. Do not forget to treat shock. As the injuries are found or diagnosed, nla?'k them in some way, covering with a cold compress or an improvised dressing is sound. \i\1hen the examination is completed, make a spectal examz'nat£011- of the £njzw£es and treat them. M;105-135, M/66-93 are very important. Treatment of the unconscious state must be started early and must be continuous. Frequent examination of the pulse and colour of face as a guide to the condition and progress. Breathing in asphyxia treatment. Severe hcemorrhage, asphyxia, severe shock need early medical aid. There is no option in cases of poisoning-send at once as soon as diagnosed. The name of the poison is not as i m portan t as the fact that the mouth and lips are burned or not. Carry out the treatment without waiting. Tlte nature oj tile case must be staled wizen send-£ng for tIle doctor (1\1 / 26, 13), so that it is wrong to send for him before making a sufficient diagnosis. It is "wise to adopt a definite plan for the examination and make it as exact and mechanical as possible. Try this plan: Draw imao-inary lines through the shoulders and hips of thebpatient and allot the different areas

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to members of the team: No.4, head and neck; No.3, trunk and upper limbs; No.2, lower limbs. The examination will then proceed: Nos. 4 and 1 will examine the head, face and neck; No. 4 will do the actual examining j whilst No. 1 directs and asks the question. (No.3 is standing by; No. 2 steadying and supporting the lower limbs as found.) If an injury is found, No.4 will cover it and prepare for treatment j no injury found, then insensibility may have to be treated and a close watch must be kept on pulse, breathing and colour of face. No.3 can cover patient warmly. Nos . .3 and 1 will now examine shoulders, upper limbs, trunk (back and front), etc. j No.1 directing and examining one side and asking the questions; No.3 conforming to his movements on the other side j No.3 will mark any injury and prepare for treatment. No.1 will examine the lower limbs j No.2 to tie the ankles and feet together, mark any injury and prepare for treatment. The first examination should be completed in three or four minutes; No.1 looks at the coverings of the injuries and can give his sufficient diagnosis and outline the plan of treatment to the team (but distinctly so that the ju<ilge hears it), and full treatment can commence. Always ask questzons when actually feeling j01' the -inJury or looking at the part. State clearly any act1,on taken. 1 he treatment oj the inJury most dangerous to ltfe is the duty oj No. 1 and the man whose area it is. Shock must always be treated. Undue exposure of the injury or body must be avoided. Those who are not busy with the actual treatment must be busy helping the others (do not hang about doing nothing- " busy bees" is the ide~l). Messages j hot water bottles j keeping patlent covered and warm; keeping materials handy, neat and clean; preparing dressings, bandages and splints (be ready to hand them just before they are wanted). Do not crowd round the patient. The advantages of this plan are that, with care, nothing is overlooked, every man has his own definite duties to do and can be practised in th~m and it is the team that is doing the work. Alm a~ a general knowledge of the whole job and a speCIal knowledge of the work in their own area. Every mem ber of the team should act as the patient occasionally, they will know and do their own job better afterwards. (C) TRANSPORT AND AFTER-CARE. (1) Blanketing the stretcher. (2) Stretcher and/or hand-seat drill. (3) Loading an ambulance wagon.

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(4) Accompanying the patient to shelter.

(5) Care of the patient during transport. (6) Report (diagnosis and treatment).

Wimbledon Ambulance Festival. Be

exph'C£t. (7) Arrangements for after-care at home.

(8) Arrangements for after-care at shelter. (9) After-care of materials, patient's clothing, things borrowed, etc. (10) Clearing up; replacement of materials used or arranging for their replacement. The team test is not finished when the patient is loaded on the stretcher. Stretcher drill is not a display of military smartness; it is to get the patient to hospital as comfortably, safely and speedily as possible. Loading . the stretcher is usually badly done. Study Figs. 94, 95, 96, 97, 98 in the Manual. Be careful in using improvised stretchers made with ropes or bandages; they are very uncomfortable and cannot be carried more than a few yards at a time. No.1 should always accompany the patient in the ambulance and take first aid material with him. Special care in cases of severe bleeding, shock, collapse, failure of breathing. Do not dawdle about waiting for the time limit j get the patient treated and away. If there is any time left, fill in the time by doing 9 and 10 properly. Do not forget to restore traffic conditions and get the main lines cleared as soon as possible. Do not overlook the rules for the carriage of stretchers. M/224. More marks are lost in proportion in Approach and Transport than in Diagnosis and Treatment. Marks earned in Approach and Transport may make the difference between winning and losing. By doing all the work themselves and not trusting the others to do their work correctly and well, captains throwaway a large proportion of the marks that are lost in a team test. Team work is essential. Twice within a fortnight Driver G. Bull and Sgt.-Major J. Miller drove the Kettering ambulance containing a patient to London, and on each occasion the doctor accompanying the case had to carry out a blood transfusion during the journey. 3"

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The Mayor of Coventry (Alderman S. Stringer) speaking at the annual dinner of the Central Division commented on the fact that the work of the St. John Ambulance Brigade was taken for granted, forgetting that the work was done voluntarily. The Griff Colliery Division, S.J.A. B., held its annual dinner on Saturday, December 17th, Mr. F. Povey Harper (President) presided. It was announced that ex-Supt. Ashley Randle had been made an honorary vice-president of the Division.

THE final competitions of the above will be held on March 16th, and a prospectus, giving full particulars of the various events, can be had from Mr. L. H. Ennis, hon. secretary, 16, ErnIe-road, Vvimbledon, London, S. W.20. Entries close on February 13th, so teams interested should make early application. Events include men and women team and individual tests, whilst a new competition this year is for novices-i.e., men and women who have not held a first aid certificate prior to January 1st, 1936, and who have attended classes in the Borough of Wimbledon and/or the Urban District of Merton and Morden. Competitors will receive copies of the appropriate marking sh€ets showing the marks gained. Events for juniors are also included. As in previous years, preliminary tests will be held in the evenings during the weeks immediately preceding the final. There is no restriction as to entries, except in the novice class, and teams from any part of the country are eligible to compete.

Resignation of Mrs. Lancelot Dent, A.R.R.C. IT is officially announced by Colonel J. L. Sleeman, Chief Commissioner St. John Ambulance Brigade Overseas, that Mrs. Lancelot Dent, A. R.R.C., D.St.J., has resigned her appointment as Lady Superintendent-in-Chief of the Nursing Divisions of the Brigade Overseas, a position she occupied for seventeen years. Since February, 1921, when Mrs. Lancelot Dent was first appointed, the personnel of the Brigade Overseas has been greatly increased and this increase has meant additional work which Mrs. Dent carried out in a most understandable manner. Official visits were made to South Africa, Canada, Southern Rhodesia and certain of the West Indies, whilst India and Ceylon were both visited on two occasions. Such visits proved of the greatest value and the contacts made on those occasions ~ were continued when members from Overseas visited England. The Chief Commissioner has expressed his regret that her services with Overseas members has ended but he is confident that Mrs. Lancelot Dent, as a member of the Order, will continue to take an interest in the work of the Brigade Overseas. No appointment of a successor has yet been made.

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INVALUABLE TO FI~ST =AIDE~S In spite of its name" The Family Physician " is a book which will be found invaluable by all connected with First Aid or Ambulance work. The Editor, Douglas Hay Scott, M.B., Ch.B. , is a lecturer in First-Aid, Hygiene, Home Nursin g, Anatomy and advanced Physiology at Morley College, Lo .1don, and First-Aid Commandant , Surrey Cadet Brigade. Formerly he was County Director, British Red Cross Society, City of Dundee, and Lecturer and Examiner in First Aid and Home Nursing, St. Andrews Ambulance Association. He has taken great care in compilin g this work and has been assisted by othe r wellknown medical men to ensure that the information given is absolutely authoritative.

SOME

OF THE

SUBJECTS.

First Aid-Home Nursing-H ygiene- Dru gs -The Giving of Medicines- Electricity a nd Medicine-Anatomy and Physiology-Physical Culture --General Diseases-Infectious Diseases-Diseases of the Heart, Blood, Digestive System, Urinary System, Respiratory System, E ye and Ear, Skin , Nervous System, Ductless Glands-Vitamin-Deficiency Diseases - Diseases due to Impaired Metabolism-Diseases of the Bone- Diseases of the Joints, etc., etc.

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The section on First Aid con stitutes a complete manual of "First Aid " work. The chapters on " Fractures," "Dislocations and Sprains, " and " Bandaging and Slings, " have been writte n by one of the foremost medical authorities on the subject, and are profusely illustrated with X-Ray and other photographs and diagrams .

A. R. P. Included in the First-Aid Section is a chapter on Air Raid Precautions. This contains all the latest information on protecting the home and family from air attack. It tells how to administer First-Aid, and describes all types of weapon likely to be used in hostile born bardment.

SEND FOR PARTICULARS. To The Caxton Publishing Co. Ltd., 46iCIun House, Surrey Street, London, W.C.2 Please send me, free of charge, full pa rticulars of " The Family Physician." Name ... ... . .. .. .. ....... ... .... ···· ·· ···· ··· ···· ······ .... ....... . .... ..... . Send this form in unsealed envelope (t d. stamp) or a postcard . Address .. .. .. . ....... .. .... ... ......... ... ... ... ................ .... ....... .

U.6 ... ..... ....... .. ...... ............ ·· ·········· ···· ....................... .

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Is your First Aid Antiseptic 100 Safe?

"FIRST AID WALL DIAGRAMS II

Our Nurses' Pages. 3

COMPILED

•

AMBULANCE SISTER.

(Size 2 ft. 2 ins. by 3 ft. 4 ins.) Complete Set of 19 sheets on tough cartridge paper. with Roller, 42/- net. Post 9d. ; or mounted on Linen, 70/- net. Post 1/-. Adopted by the War Office, the Admiralty and the British Red Cross Society,etc.

Special Set of 6 Sheets for the use of

No.1 DISTRICT, S.l.A.B. No. 73 (SHOREDITCH) N URSIl\G Dn'IsloN.-On December 22nd, after the Divisional drill, Ambulance Sister D. M Rood asked th(:. Lady Div. Supt. Miss Cotton to accept a handsome oak striking- clock from the members on her resignation from the Division, as a mark of their esteem and aiTection. In thanking them for their beautiful and useful gift, Miss Cotton ex pressed her regret at having to sever her connection with the Division, and wished them all every bappiness and success in their Brigade work. No. 74 (FINCHLEY AND SOUTIIGATE) NURSING DIVISION. Since its formation in 1932 members of this Division have undertaken 2,300 public duties, either locally or when called upon by District Headquarters, and 2,632 cases of first aid have been attended. The me:mbers have also made 1,800 attendances at various hospitals.

Recruits are always welcome for both Divisions, and classes in first aid and home nursing are held from time to time. Anyone interested should write to Lady Div. Supt. M iss Daniel, 34, Holly Park-road, N .11. No. 2 DISTRICT, S.].A. B. MILTON NURSING DrvlsIoN.-Officers and members held their annual dinner at the Savoy Cafe, on Tuesday, December 6th. Lady Div. Supt. Miss Olding received Nursing Officer Sister P. Nottingham, and later presented her with a box of chocolates. Mrs. L. N ellthorp presented the" Nellthorp " Cup to Miss E. Dykes, who had one it for the second year in succession, together with a replica given by Miss Olding. Miss P. Calder, the runner-up, received a silver serviette ring, the gift of Mrs. Nellthorp. A travelling clock was also presented to Miss Dykes as a mark of esteem from the members of the Division, on her departure for Leatherhead.

Some Important Factors to bear in mind

LECTURERS & A. R. P. CLASSES comprising Anatomy, Physiology, Haemorrhage, Dislocations and Fractures. Mounted on linen with roller, 21 ,6 net; postage 6d. BRIT. MED . JOUR.-"Wil/ be found most useful. The diagrams are clear and good, and the subjects have been selected with judgment. May be confidently recommended." I 6th Edition. I 87th Thous. Fully revised and enlarged . With 31 I illustrations Some coloured.

WARWICK

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328 pages.

"FI RST AI D" 2/6

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Stiff Boards. net. Postage 3d.

An Advanced Ambulance Handbook.

E,dited by F. C. NICHOLS, M.C., M.B., Ch.B., late Capt. R.A.M.C.(T.) The chief feature of this edition is the much fuller account given of G3S Poisoning in Warfare. FIRST AID JOUR.-" One of the most concise works on the subject published at a popular price."

JOHN

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ST. MARYLEBONE OPEN FIRST AID COMPETITION. The Second Annual Competition will be held at The Portman Rooms, Baker Street, W.1, on THURSDAY, MARCH 30th, 1939.

Open to All Teams of Men in the City of London, Metropolitan Pol ice and No. 1 District S.d.A.B. Areas.

Entries Close on March 1st, 1939. TROPHIES TO BE COMPETED FOR: Photograph by] [R. VV. Crane, N.J J. Finchley and Southgate Nursing Division, No.1 District S.].A.B. The first A. R. P. course of training was given to the Division in 1932, and since that date members have been kept efficient in the su bject, and have assisted the local councils in training A. R. P. volunteers. The Division was successful in 1936 and again in 1938 in winning the" Brooks' " Efficiency Cup and by so doing la~t year helped to win the Rideout Cup for Northern Area, beIng the Area to gain the greatest number of trophies in district competitions during the year. .. ~o. C. N. 2S (Finchley and Southgate) Nursing Cadet DIVISIOn WaS formed and is already making rapid strides.

Bouquets of flowers were handed to the Lady Div. Supt., Lady Ambulance Officer Mrs. Clark, and l\1r~. Nellthorp. COSHAM NURSING DlvrsION. - A variety concert was given by Miss] oan Stoneham's juveniles at Rathgar Han, on December 14th, in ai-d of the funds of the Cosh am Nursing Division. A programme was presented by babies of three to five years and older . children. Solo and concerted numbers, comedy, character, national tap and operatic

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CHAMPIONSHIP AWARD "STILES ALLEN" CHALLENGE TROPHY. (Presented by Alderman R. Stiles Allen, D.L ., J .P.) RUNNERS UP AWARD "SELFRIDGE "~CHALLENGE SHIELD. (Presented by Selfridge & Co. Ltd., London.) BEST TEAM LEADER "FIRST AID" CHALLENGE CUP. (Presented by the Publishers of "FIRST AID" Journal.)

Entry Forms and Full Particulars from

Mr. W. V. M. ALLEN, Honorary Secretary, Western District Post Office, W.1.

The new S.J.A.A. Text book stresses that SAFETY is an all-important factor in the Antiseptic chosen for First Aid work. That is just why T.C.P. has been so promptly adopted as the standard Antiseptic by hund reds of First Aid organisations throughout the country. Not only does T.C.P. completely conform to the Text book recommendations-that the Antiseptic used should be non-poisonous, non-burning and non-irritant. It also possesses "plus" properties, which make it 100 per cent. safe for every first aid requirement. First, T.C.P. is so perfectly harmless and beneficial that it can actually be given internally, as well as used on sensitive tissues and membranes, and even in the eyes. Thz's intenzal use is particularly valuable z'n prophylactic measures dU1'z'ng Cold and 'Flu epidemics. Secondly, the exceptional pain-relieving and soothing properties of T.C.P. make it ideal for use in severe burning, injury or shock , where many antiseptics cause additional shock and pain. Thirdly, T.C. P. is such a powerful germicide and so penetrating that it completely prevents risk of sepsis. Finally, T.C.P., unlike antiseptics with a spirit content, is non-z'njlammable (see diagram below). The advantage of this is obviolls, where first aid dressings may be exposed to risk from flame, lighted cigarettes, etc. Test the safety and healing properties of T.c. p. for yourself. If you are a qualified First Aid Worker, send your name, address and qualifications to British Alkaloids Ltd., Dashwood House, London, E.c.2, aski~g for a trial bottIe of T.C.P. and the T.C.P. First Aid Manual (both free).

MAKE THIS SIMPLE TEST! Are you sure that the antiseptic you are at present using is noninflammable? If not, pour a little into a saucer, and apply a lighted match. I f it catches fire, it is not 100 per cent. safe. T.c.P, is absolutely noninflammable, and safe under all conditions.

FIRST

AID

dances were interspersed with songs, monologues and accordion solos. During the interval, Div. Surgeon Dr. Cope thanked Mrs. and Miss Stoneham for their kindness in arranging the concert, also the performers and all who had helped to make the evening a success. The vote of thanks was seconded by Lady Div. Supt. Mrs. Baxter.

office. That was because they took over a duty to help and to make others happy. The ambulance worker took on a similar work, to help others, and in so doing also found happiness. In reply, the Mayor said that rather tban accord a vote of thanks to him, it was his duty to thank the volunteers for the service they had rendered.

No. 3 (WESTERN) DISTRICT, S.J. A. B. BIRMINGHAM NURSING CORPs.-Colonel Sir Bertram Ford, County Commissioner, who was accompanied by Lady Ford, carried out an inspection of the Nursing Corps on December 9th, at the Headquarters, Birmingham. Lady Corps Supt. Mrs. O . Lee was in command of the parade of some 240 officers and members. After the inspection Sir Bertram presented 60 A. R. r. certificates of all grades, and congratulated all on their smart appearance and efficiency. He spoke of the splendid service the Brigade was rendering to the community by its voluntary work. In the previous fortnight the ambulance service in Birmingham had carried more than 1,000 patients, and the St. John nurses had contributed greatly to the smooth working of the service by their devotion and enthusiasm.

No. 6 DISTRICT, S.] . A. B. BIRKENHEAD NURSING DIVIsION.-On Tuesday evening, Decem ber 13th, the com petition for the "E. Betterley" Home Nursing Cup was held at Divisional Headquarters. The judge was Lady Div. Supt. Mrs. E. Sutton, of the Wallasey Nursing Division, and the winner was Miss Rotherwell, the runner-up being Miss Kenny. On the same evening a presentation was made by the members of the Birkenhead Nursing Division to Lady Ambulance Officer Miss D. G. Price, the Div. Secretary, as a memento of the receipt of the Service Medal for fifteen years' efficient service in the Brigade. The thanks of all the members were accorded her for her long service in the Division. The gift took the form of a fountain pen.

No. 5 DISTRI CT, S. ].A.B. HUDDERSFIELD WOMEN A.R. P. VOLUNTEERS. - On Wednesday, December 21st, the Mayor (Ald. F. Lawton) presented first aid certificates to 87 H uddersfield women A. R. P. volunteers. They were members of the first class in first aid to be conducted by the Huddersfield S.J.A.B. who were assisting the Corporation Air Raid Precautions Committee. Ninety-four candidates sat for the examination, and only seven failed. The ceremony, which took place in the Mayor'S Reception Room at the Town Hall, was presided over by Cr. D. J. Cartwright. Chairman of the A. R. P. Committee. The Mayoress and Dr. Gibson, Medical Officer of Health, were also present. The Chairman said that he regarded none of the notable events which had taken place in that room as being more important than that ceremony. It gave him the opportunity once again of congratulating the Brigade on its excellent work. If every section of the community were to take up A. R. P. work with the same enthusiasm as the Brigade, there need be no fears for the future. A. R. P. was a humanitarian, Christian work, and he could think of nothing finer than the course which these volunteers had taken. He spoke also of the good relations which existed between the Brigade and the Medical Officer's Department, and especially thanked Lady Div. Supt. Mrs. Tinker, who had been demonstrator to the class. After presenting the certificates, the Mayor said that if everyone would realise his or her duty as these volunteers had done, A. R. P. schemes could be carried through efficiently. He urged the volunteers to continue their studies so that they would be ready for any emergency. They had a glorious opportunity of serving their fellow men and women. The percentage of successes in the examination was excellent. Assistant Commissioner H. L. Thornton proposed a vote of thanks to the Mayor and Mayoress for their kindness in attending. He suggested to the volunteers that they might now take the home nursing courses. They could kebp up their first aid practise in the Brigade or its auxiliary service. District Officer H. Harrison, in seconding the motion of thanks to the Mayor and Mayoress, said the retiring Mayors always said that they had had a happy year of

No. 7 DISTRICT, S.). A. B. BRIGADE WORI" IN SHROPSHIRE. - Recently Lady County Supt. Miss Corser reviewed the work of the Shropshire Nursing Divisions in the local press, calling attention to the untiring voluntary services rendered by the officers and members, and appealing to all who liked to help the sick and suffering to join the St. John Ambulance Brigade. Although each candidate for membership had to hold first aid and home nursing certificates awarded by the S.J.A.A. or B.R.C.S., anyone of the age of 18 and upwards could join as a probationer, and even wear the Brigade uniform without badges, until she had passed t.he two examinations. In Shropshire there are seven Nursing Divisions and more are in process of formation. There are two in Shrewsbury and one each in Ironbridge, Madeley, Oswestry, Market Drayton and Burford. Besides this, Shrewsbury, Ironbridge and Madeley have raised Cadet Divisions of girls from 11 to 17, who are attached to the adult Divisions. Many of the Nursing Divisions are V.A.D.'s, in fact the 1st Shrewsbury Nursing Division was the earliest group of women to become a Detachment under the War Office scheme of 1910. They organised and staffed the St. John Auxiliary Military Hospital of 50 beds, in Shrewsbury, from 1914 to 1919. War nursing was also carried out by all the other St. John detachments in the county. Much interest in the work of the Nursing Divisions was taken by Lady Forester, County Officer for Shropshire, who is the elder daughter of the Lady Supt.-in-Chief. Members of Nursing Divisions are always at the service of the pu bIic wherever large or small functions are held throughout the county and elsewhere. Members also work in the hospitals when required, and recently the Shrewsbury Division gave their services to the Eye and Ear Hospital when the staff were away ill. They received an excellent r(port from the Matron. Excellent work is also being done by the Oswestry and the BurforJ Divisions at their local hospitals. In A. R. P. work many members have joined up with the local authorities for staffing first-aid posts. During the recent" Black-out" in the Shrewsbury area all were at work in these posts, dealing with" casualties." The St. John V.A.D.s are, of course, ear-marked for military nursing in

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186

FIRST

time of war, but are available for A. R. P. service until they are called up. Several of the officers are trained specially as instructors in A.R.P., and hold C.A.G.S. and L.A.G.S. certi fica tes. Work in the Brigade is useful and absorbing, and there is the added joy of working for the community. It is done without any advertisement or "flag waving," quite voluntarily, and for the joy of serving. The motto of the Brigade expresses exactly what the great movement is : Pro CtiIi/ate Homt'mtlll.

CHESIIIRE BRANCH, B.R.C.S. Eleven teams from the women's detachments of the Cheshire Branch took part in the annual competition for the "Stamford" Casket and County Controller Cup, held at the Crosfield Centenary Institute, Warrington. Birkenhead had been in the finals four times, and on this occasion won the Casket, No. 40 Birkenhead Division securing the prizE', with No. 2-t Chester Division runners-up, and No. 29 WalJasey Division third. The" Stamford" ChalJenge Casket WqS presented at the conclusion by Lady Stamford, President of ~~e Cheshire County Section. Two Birkenhead mem bers also tie": 'vith another member from a different branch for the highest points for the individual cup.

CHIPPENII .lM AND DULLINGIIAM DIVISIONS, B. R. C. S. There was a large attendance at the half-yearly meeting of Red Cross representatives held on Monday, December 12th, at Chippenham Park (by kind permission of l\1rs. Gerard Thorp, Vice-President of the Chippenham and Dullingham Divisions). The Hon. Secretary reported that all the villages in the Divisions had organised flag days since May, and £49 13 6d had been collected. As early as July, first aid courses had been held at Fordham, Chippenham and Chevelt:y. Examinations were held at the first two, 17 and 11 candidates passing the tests, respectively. During the crisis, supplies of dressings were obtained ready for despatch to the villages. The demand for classes after the crisis resulted in courses being held in Soham, Stetchworth, Dullingham, and Islebam. A nursing course for Fordham, Chippenham and Kennett had just been completed, and others were contemplated for Soham, Isleham and Stetch worth. A well-attended first aid course was in progress at Burwell. The peace programme had gone on steadily in the Divisions, and in the home massage and orthopced ic services. Some 300 people had been trained in A. R. P. It was hoped that when the County Council was satisfied that the A. R. P. first aid personnel was adequate, grants would be forthcoming and further training could be carried out. Thanks were due to Drs. McFeeters, Ennion, Hazell and Brookman who had taken lectures and examinations. Mrs. Tharp reported on enrolments, and said she had got in touch with the County Medical Officer to ascertain how Red Cross work for A. R. P. was to be co-ordinated with other A. R. P. services.

It was agreed that each local representative should get in touch with the chief air raid warden and select a suitable person to be responsible for the post or point in the village.

Does your colleague read FIRST AID, if not, send us his address and we will post him a copy.

AID

FIRST

Practical Points. The Editor invites Notes on actual Cases-with special reference to good and bad points in Treatment-for inclusion in this Column.

ELECTROCUTED IN SHOP. Recently a man, aged 21, was electrocuted in a curious manner in Romford. vVbile at work in the cutting-up shop of a wholesale butcher's establishment he was hanging up a steel yard when a metal hook came into contact with some electric light wiring. He received a fatal shock and died within a few minutes in spite of all eJTorts to revi\'e him.M. P. (Romford).

AID

AMBULANCE ESSENTIALS ...

SAVED BY FALL FROM LADDER. Just before Xmas a man, aged 41, escaped 1I1Jury in a truly remarkable manner. Standing on a ladder, he was fixing an electric sign over a shop in this town when he touched a live wire and found it impossible to let go . R ealising his danger, he threw himself back\,,'ards and so broke the electrical Circuit. He fell to the pa\'ement and was afterwards found to be suffering only from shock and brLlising. His thumb and index finger however were burned.-R.H. (Leigh).

OVERCOl\JE BY SLEE P. Appearances are often deceptive. A few weeks ago some motorists tra\'elling between \\' indsor and Maidenhead late at night, came across the body of a man lying at the side of the road. As there were no signs of life, they stopped; and, finding that the man was completely unconscious, they telephoned the police who called an am bulance from Maidenhead three miles away. Without delay the man was quickly conveyed to hospital where the doctors found that the patient was neither sick nor injured and that he was merely overcome by sleep.-B. W. (Maidenhead).

-------.--.-----The V.A.D . London / 150 won the Hampstead InterDetachment competition, London / 130 were second. Tests included first aid, nursery and also uniforms. 3

•

The first meeting of the Gosport A. R. P. Auxiliary Reserve (men) was held on December Hth, at the S.J.A.B. Headquarters. Corps Supt. O. Francis presided, and Mr. P. Greenwood was appointed to take charge of the organisation and arrangements . Practices will take place every Wednesday evening. Lt.-Col. G. Maskie, County Controller, B.R.C.S., presented awards to members of Worcester V.A. D., 1 and 3, and referred to the efficiency of the members. He congratulated the respective commandants, Mr. W. P. Woodward and Mr. G. L. Pitt, on the valuable assistance given to him at the time of the crisis.

SOCIAL EVENTS.- The attention of the general public to your needs can be attractively arranged by purchasing copies of the Poster advertised in this Journal for your Dances and other activities. Samples will be sent on request.

auxhall ambulances, incorporating independent front wheel suspension, rear shock absorbers adjustable from the driving seat, synchromesh gears and smooth transmission, are built on the luxurious Vauxhall limousine chassis and have every essential dictated by modern operating cond itions. Equally outstanding in their class are the famous Bedfords, bUilt on the Bedford ambulance chassis with soft progreSSive springing, hydraulic shock absorbers and low-pressure tyres. Both engines have dual thermostatic control to ensure an immediate warm-up in the coldest weather, and long life.

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BEDFORD Ambulances There is a wide range of Bedford Vans and Lorries (from 5/6 cwt. to 3 ton capacity) Ambulances, Fire Engines, Tenders, Refuse Wagons, Tippers, Gulley Emptiers and other special municipal models. Full details from Vauxhall Motors Ltd., Luton, or any Bedford dealer.

At £478 the Bedford de luxe ambulance provides accommodation for one 'recumbent and five or six sitting patient~, or for two ~~ cumbent cases. Other Bedford ambulances are avaJiable from £3 .

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188

Queries and Ansvvers to Correspondents. Queries will be dealt with under the foIIowing rules : 1.-Letters containing Queries must be marked on the top ldt-hand corner of the envelope" Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C. 4. 2.-AII 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. 3.-The Textbook to which reference may be made in this column is the 39th (1937) Edition ot the S.j.A.A. Manual of First Aid to the Injured. TREATMENT OF FRACTURED ANKLE. 1. R. (Petts Wood). -Please be good enough to tell me what is the correct treatment for a Fractured Ankle for which no specific instructions are laid down in the Black Book. I ask this query because I saw this problem set in a recent medallion re-examination. The term "Fractured Ankle" is usually applied to fractures of the lower ends of the tibia and/ or fibula at the ankle joint. Consequently the treatment should be as laid down in the Textbook for Fractured Leg.-N. CORBET FLETCHER. EXAMINATION HOWLER. D.S. (East London). - During a recent examination I asked a candidate to tell me what are" Signs." I was profoundly amused when she replied, in all sincerity:-

" Names on the fronts of shops / " Good!

Next, please! !-N.C.F.

TREATMENT OF PHOSPHORUS POISONING. J. L. (Brighton).-In the treatment of Phosphorus Poisoning the Textbook (p. 174) tells us that oil or fat in any form must not be given. In these circumstances should milk and cream be avoided even when mixed with strong tea, or would the quantity of fat in the milk be too small to matter? We thank you in anticipation of your kind ruling. Undiluted milk by reason of its fat content might act as a sol vent and facilitate the absorption of the phosphorus, and should not be administered to a patient suffering from Phosphorus Poisoning. A small quantity added to strong tea, however, would have little or no effect. Nevertheless, it is wise for first aiders to abide by the instructions of the Textbook to avoid oil or fat in any jorm.-N.C.F. TREATMENT OF BURNS OF EYES. ]. F. (Brighton).-Please tell me why cold water is recommended in such cases of injury to the eye as burns by corrosive acid and corrosive alkali? In the latter case we are even advised to "wash freely with cold water" if vinegar is not readily available. Surely lukewarm water would be better both to avoid shock to the t~ssues of the eye (especially in cold weather) and to dtssolve the baking soda in the case of burn by corrosive acid.

AID Cold water is advised because, by absorption of heat, it will relieve the severe congestion which accompanies burns of the eyes resulting from corrosive acids and alkalies. Indeed, a doctor-friend, with whom I discussed your query, told me that, when several years ago his eyes were acutely inflamed, he had insisted on cold lotions being used because these eased the pain much more efrectively than tepid lotions. In like fashion an pye-specialist spoke favourably of the instructions in the Textbook.-N. C. F.

TREATMENT OF WASP IN STOMACH. T.E. (Wirral).-In a recent first aid examination I was told that wasps-dead or alive-sting and was then asked what I would do for a boy who accidentally swallowed a wasp while drinking a glass of lemonade. Remembering that dead wasps only sting when crushed, I replied that I would give an ounce of salts mixed with sal volatile or brandy and follow this up five minutes afterwards with plenty ot hot drinks such as tea or water to help the action of the salts. Please tell me if I was correct in my answer. Personally I would do nothing except advise the boy to keep quiet for several hours. I would certainly not stimulate the action of his bowels by administering salts and hot drinks.-N.C.F. TREATMENT OF FRACTURED KNEE CAP. ]. W. (BulwelI).-In its instructions with reference to the treatment of a Fractured Knee Cap the Textbook in Rule 2 on p. 90 says, "The splint must be well padded under the natural hollow of the leg so as to raise the heel from the splint." Our team captain insists upon the heel being raised from the splint with the padding, but our instructor thinks that the padding should come under the heel so that the foot rests upon it. To try and settle this question I have had the bandage and padding put on in both ways and find that, when the foot is raised from the splint as the Textbook says, Bandage C. gradually pulls the heel down until it touches the splint thus causing a little extension by pulling upon the foot. We would be very much obliged if you will give us your ruling upon this point. The first suggestion is correct; and I suspect that your personal experience was the result of too small a pad being placed under your heel. As the Textbook states, the splint must be well padded to raise the heel from the splint.-N.C.F.

ACTION OF LIQUID OXYGEN. F.A. (Kentish Town). - When liquid oxygen comes into contact with the skin, it causes a blister similar to a burn with no signs of frost bite. This condition is caused by the intense cold of the liquid (about -300°). Please state if treatment should be as for a burn or as for frost bite. With frost bite the blood vessels of the extremities are constricted, whereas with liquid oxygen applied to the skin the condition is one of local injury. Consequently you should treat on the lines laid down in the Textbook for a burn.-N.C.F. TRANSPORT FACE-DOWNWARDS OF SPINAL INJURY. W. W. (Brynmawr}.-We have difficulty when placing our patient face-downwards for transport when suffering from spinal injury. We find that he usually lands on

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FIRST the edge of the stretcher instead of the middle of the canvas. Of course his position can be easily adjusted by using the under blankets. Your kind assistance will be appreciated .. This method of transport was demonstrated to the Surgeons at their recent Week-End Conference b~ Dr. A. C. White Knox who urged that members of the Bngade should take every opportunity of accustoming themselves to a completely new routine and added the following useful hints ; -

(1) Do not turn the patient too far over on to his face. (2) Push the lower pole of the stretcher close up to the patient. (3) Hold the pole in this position with the foot and lean the stretcher well over the patient. (4) Do not load patient on stretcher too slowly.N.C.F.

AID

FIRST

that there is no danger of aggravating the fracture during loading and transport especially if the stretcher is properly prepared as laid down on p. 208 of the Textbook. Consequently, no special instructions are either indicated or given for transport of such cases. -N. C. F.

SPECIAL BANDAGE FOR FRACTURED KNEE CAP.

W.D. (Blyth Bridge).-Will you kindly tell me if the double figure-of-eight bandage round splint, ankle, foot and splint, after crossing in front of the instep, is crossed again underneath the foot before it is passed under the splint? I have been applying the bandage without crossing it on the sole of the boot. Yes-otherwise the curious term "double figure-ofeight" would not be justified.-N .C. F.

TREATMENT OF SNAKE-BITE. ROLLED BLANKETS IN TRANSPORT FACE-DoWNWARDS.

T.A. (Southlands).-As the surgeon-lecturer of a railway ambulance class I would like to ask if the placing of the patient on rolled blankets on the stretcher will not in your opinion, increase the curvature of the spine which to me seems to be the reverse of stabilising the spine. Of course, you are right; but that is the very purpose of the new method of treatment, viz.-to cause hyperextension (and stabilisation in that position) of the spine. Indeed, Fig. 39 shows very clearly that without the rolled blankets there would be no hyper-extension of the spine.N.C.F.

W. D. (Blyth-Bridge).-In the instructions with reference to the treatment of Snake-Bite, the Textbook makes no mention about applying a dressing after washing the wound. Please tell me if it is best to leave the wound uncovered or if you would advise the application of a dry dressing. Principle No.7 on p. 24 of the Textbook requires that wounds should be covered with a clean dressing and the note on p. 47 at the end of the description of dressings requires that the dressing should be covered with cotton wool and kept in place by a bandage.-N.C.F.

FRACTURE OF NECK OF FEMUR.

A.H. (Great Yarmouth).- We have often discussed the treatment of Fractured Femur at its neck and cannot agree as to what should be done. If the fracture is at the neck then the Bandages E and F in Fig. 48 of the Textbook would both be below the fracture. Further, a bandage round the head of the femur would cover Bandage C. We thank you for past help and look forward to your kind help in the future. From a doctor's point of view Bandages E and Fare unnecessary; but as a first aider you must not undertake the duties and responsibilities of a doctor. Consequently, since you cannot determine the exact position of the fracture, you should carry out the treatment as laid down in the Textbook (p. p. 89 and 90), particularly as a departure from these instructions would lose you marks in examination and competition. Further, had the Textbook intended you to modify your treatment on the lines laid down for Fracture of Humerus close to shoulder (p. 82), it would have given special instructions.-N. C. F.

You should at once turn off the gas and throw open wide the door and window. This done, you should determine whether or no breathing has ceased. If your patient is not breathing and the room is filled with gas you should (in accordance with Principle No.4 on p. 23 of the Textbook) drag him out of the room into the passage where you should without further delay commence artificial respiration. Breathing being present or re-established, you should proceed to treat the" serious head injuries. "-N. C. F.

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QUESTIONS AND ANSWERS, etc., IN FIRST AID.

H.C. (Sutton Coldfield).-I shall be pleased if you will kindly advise me how I should treat a patient who was found with his head in a gas oven and also suffering from serious head injuries. I am a beginner and am now attending my first course of lectures in first aid.

FIRST AID FOR FOOTBALLERS and other ATHLETES. A.H. (Chesterfield).-We have discussed the possibility of a special way in which to load on to a stretcher a patient suffering from Complicated Fracture of Ribs. We think that, as the patient should be inclined towards the injured side and lifted in that position, there is danger of forcing the fractured ribs further into the lung. As we cannot find any special instructions on this point in the 38th or 39th Edition of the Textbook, we would much like to have your opinion.

For rapid clearing up of Eczema. any nurses have been astounded at the rapidity with which Sphagnol Ointment clears even the most persistent eczematous condition. The reason is not far to se~k. Sphagnol contains co?ce?trated distill.at~s of peat whIch soothe and allay the irntatIOn. These dIstIllates are strongly antiseptic-although gentle in action-and they penetrate to the root of the trouble, healing and helping the growth of

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FEBRUARY, 1939.

No. 536.-VOL. XLV . NOTI CE

READERS.

FIRST AID is published on the 2 0th of each month. The Annual Subscription is 3S. 6d. post free; ~ingle copies 3d. Its aim and object being the advancement of Ambulance Work in all its branches, the Editor invites Readers to send Articles and Re ports 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 12th of each month, and must be accompanied (not necessarily jor fJublication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communic'l.tions connected with FIRST AID should be forwarded to the Publishers. DALE, REYNOLDS & Co., LTD., 46, CANNON STREET, LONDON, E.C+

CONTENTS

members oj the medi· cal pro, and essionhospital and to nurses otlicials who enclose t h t i r projessional ca,ds.

THIS

NUMBER.

EDITORIAL ; -

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National Service The Human Body Fifth International Congress for Life-Saving and First Aid to the Injured S.] .A. B. Headquarters and District Reports The Hospitallers' Club ... Priory for Wales St. Marylebone Open First Aid Competition Coming Events Railway Ambulance News Police Ambulance News S.]. A. B. Overseas Our Nurses' Pages A.R.P. Topics

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193 194196 197 201 202 203 203 204 206 208 210 214

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Fractures of Spine and Patella Examination Howler Wound of Abdominal Wall and Fractured Leg Treatment of Heatstroke or Sunstroke Acute Alcoholism and Fracture of Ribs Plaints of a Competitor Humour in First Aid Fractured Thigh in Prone Patient Treatment of Dog Bite Head to Side with Fractured Base Insensibility During TreatmenL for Fractured Spine

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216 216 216 216 216 216 218 218 218 218 21 R

WITH the publication of the Handbook on National Service, SERVICE. first aid organisations, the St. John Ambulance Brigade, the British Red Cross Society and the St. Andrew's Am bulance Association, have received thousands of applications for enrolment. I n fact so many applications have been made that it has been found necessary in some cases to place on one side the ordinary duties of Headquarter staffs. Whilst we do appreciate this enthusiasm to take up first aid, it is well to realise exactly what this enrolment work entails. The receipt of an application at, say, St. John's Gate, one of the addresses given in the National Handbook, a card has to be sent to the applicant informing him or her of the nearest local division, and the address of the officer-in-charge. This means extra work, extra postages, extra printing bills; but no extra staff is provided by the Government to assist in carrying out this essential service. The usual staff at Brigade Headquarters battle manfully against the inward flow of applicants. On the other side of the picture is the distribution of certificates to successful examination students. After the September crisis new classes were arranged everywhere, and applications to attend were tremendous. And the result? That during the last three months of 1938 the St. John Ambulance Association alone issued 45,000 certificates-a greater number than is usually issued during an ordinary year! Only complete and exact organisation could carry out such an enormous increase, and credit is due to those in charge and to the staffs under their jurisdiction. This new drive for first aiders will mean an even greater increase in activities, but we have no fear that class secretaries will let down their organisations. The first aid family is a happy one, and co-operation is a n ess~nti~l feature of it. NATIONAL

FIRST

194

The Human Body. By JOSEPH

J. HODGSON.

(Being extracts from a lecture gi\'en to members

of a S.].A. B. Division.) (Concluded from page IN.) FUNCTIONS OF THE BODY.

To maintain life the body requires fuel and material to build and keep in good repair all cells of the body. To do the carrying backwards and forwards to all parts of the body we have the circulation of the blood. The building up and renewing of tissues and energy in the form of heat and power is produced by chemical action, known as metabolism. Fuel and new material are obtained from the food we eat. This is taken and made capable of assimilation by the digestive system, whilst heat is obtained by the oxygen from the air in the respirative system. Waste matter is removed by the excretory organs, the skin, the lungs, the kidneys and the bowels. In food which we eat we must have proteins -that is meat, white of egg, lentils, peas and cheese. These foods give us nitrogen, carbon, hydrogen and oxygen, build up the body and make good the waste tissue. Creams, butter, fat (meat and oils) give us carbon, hydrogen and oxygen, and produce the body heat and a certain amount of power. Then we have carbohydrates which produce heat and power and are contained in starch, sugar and vegetables. Salts, which build up and support the skeleton, and produce the digestive juice.;;, are obtained from lime, soda, calcium, iron, potassium and phosperous. Vitamins, which are chemical substances present in all natural foodstuffs, are most essential because their absence will cause certain diseases and in childhood imperfect growth. Water, an essential constituent of the body, is necessary for the chemical action which takes place in all organs of the body. It serves for solution and conveyance of food to the various parts of the body and also for the excretion of waste. RESPIRATORY SYSTEM.

Oxygen is obtained from the air by the respiratory system which is composed of the nose, throat, the wind pipe (trachea), the air tubes (bronchi) and the air cells of the lungs. Pure air is a mixture of gases-one fifth oxygen, four fifths nitrogen, and under one pel cent. carbon dioxide [he main use of the nitrogen is to dilute the oxygen. The air is conveyed

FIRST

AID by the nostrils, or by the mouth, to the back of the throat, through the larynx (or voice box) which is guarded by a flap called the epiglottis. This flap prevents solids and fluids entering the larynx. The air then passes into the trachea which divides into the left and right bronchi, the latter in turn being sub-divided into the air (or bronchial) tubes and end in the air cells (or alveoli) of the lungs. The process of breathing has three movements -inspiration (breathing in), a pause, and expiration (breathing out). In the first movement the ribs are raised, the diaphragm flattens out, and the lungs become filled with air. Then there is a slight pause which is followed by the expiration movement. The ribs are lowered, the diaphragm becomes arched and the air is thus expelled from the lungs. These movements take place from 15 to 18 times per minute. CIRCULATORY SYSTEM.

The body now has both fuel and material. These are passed (or carried) to the tissues and cells all over the body by the blood which also removes waste products and surplus heat. Blood is composed of a fluid called plasma and cells known as red or white corpuscles. The plasma takes water to the tissues, collects waste and assists the blood to clot. Red corpuscles take oxygen from the lungs to all parts of the body and collect carbon dioxide from the tissues. The work of the white corpuscles is to fight disease and to destroy impurities in the blood. The organs concerned with the circulation of the blood are the heart, the arteries, the capillaries, and the veins. The heart, which we may call the "power station" of the body, is a hollow muscular pearshaped organ and about the size of a person's clenched fist. It is divided into four compartments with a partition between the right and left sides and valves between the upper and lower compartments. The upper compartments are called auricles and the lower ventricles. The heart lies obliquely, apex downwards, behind the breast bone between the lungs, a quarter of its bulk to the right and three-quarters to the left side. Its beat can be felt just below and on the inner side of the left nipple. In adults the heart contracts on an average of 72 times per minute. Arteries have elastic tissues in their walls giving them power to dilate and contract. This dilatation and contraction propels the blood along its course and is known as the pulse which can be felt in any superficial artery. Capillaries are thin walled vessels all over the body connecting arteries with the veins. The latter have valves at frequent intervals to prevent the backward flow of the blood. Arteries carry blood from the heart and veins take the blood to the heart.

The circulation of the blood is divided into two parts-the general (or systematic) and the pulmonary (or lung). I n the systematic system blood leaves the left auricle, passing a valve (which ' opens downwards only) into the left ventricle. The latter contracts forcing the blood into the main artery (the aorta) which first ascends to the upper part of the chest where it forms an arch. Before it descends, branches (arteries) are given off from this arch to supply the head and the upper limbs. First there are the carotid arteries, one on either side of the windpipe. If necessary, the flow of blood can be stopped by compressing with the thumb the artery backwards against the transverse process of the cervical vertebrae of the spine at a point level with "' Adam's Apple." Care should be taken not to press on the windpipe or on both carotid arteries lest unconsciousness b~ caused. The carotids divide into the internal (which ascends direct to the cranium to supply the brain) and the external carotids. The external carotid arteries give off four branches (1) the lingual artery which supplies the tongue; (2) the facial which supplies the face and and can be com pressed two fingers breadth from the angle of the jaw; (3) the temporal, which supplies the front and sides of the- head and can be compressed in front of the opening of the ear, and (4) the occipital. The last named supplies blood to the back of the head and can be compressed four fingers breadth behind the ear. Leaving the aorta are also the arteries of the upper limbs. The subclavian runs over the first rib, under the collar bone to the arm pit where it becomes the axillary artery, which can be compressed by something small, hard and round such as a billiards ball. It now continues down the upper limb as the brachial under the inner side of the biceps muscle, passing forward until it reaches the middle of the front of the elbow. The brachial may be compressed against the arm bone in the middle of its shaft roughly in line with the coat seam. At the elbow the artery divides into two, the radial on the thumb side and the ulna on the little finger side of the upper lim b. These can be felt and stopped by pressure about one inch above the wrist and half an inch from the inner and outer sides of the forearm. The arteries now combine to form the palmar arches in the palm of the hand and Give off branches which pass along either side of each finger and thumb right down to the tips of each digit. Going back to the aortic arch we follow the descending aorta which gives off branches all along its course to feed the internal organs. It divides into the two iliac arteries which pass, one either side, to the centre of the fold of the groin

.AID

1q5

where it becomes the femoral, the main arterial trunk of the lower limb. Its course now runs in a straight line from the middle of the groin to a point on the inner side of the knee, where it is known as the popliteal (or ham) artery. Digital pressure on the femoral artery can only be applied at the middle of the groin; though a tourniquet (the pad being the size of a tennis ball) may be applied on the line of the artery as high up as possible. Passi ng behind the knee joint the popl iteal divides into the anterior (front) and posterior (back) tibial arteries. The anterior passes down between the leg bones to the middle of the front of the ankle. Here it continues as the dorsal artery, dips down to the sole of the foot between the first and second metatarsal bones. There it joins with the posterior tioial artery to form what is known as the pl3.nter arch from which branches travel along the sides of the phalanges to the tips of each toe. The posterior tibial artery passes down the back of the leg to the inner side of the ankle and then into the sole of the foot and divides into the plantar arteries. The foregoing gives the course of the main arteries. Blood in such is pure being !::right red in colour: and if an artery is cut near the ski n, it spurts out in jets corresponding with the pulsations of the heart. These arteries divide and subdivide until they become minute capillaries which have thin walls. Through these walls the inter-change of gases and fluids take place. The blood gives off oxygen and nourishment to the tissues and organs of the body, and collects from them carbonic aCid gas and waste matters. These changes cause the body to lose its bright red colour and it becomes dark red or impure blood. The capillaries now unite to become veins which become longer and larger until two large veins are formed-the superior vena cava by the veins from the upper part of the body, and the inferior vena cava by the veins from the lower part. Both enter the right auricle of the heart and thus complete the systematic circulation. The blood is now impure and passes for purification from the right auricle through a valve into the right ventricie which, on contraction, sends the blood into the pulmonary artery and its right and left branches, the only arteries which carry impure blood. These enter the lungs divide and subdivide into capillaries which come into contact with the air cells where the blood gi ves off carbonic acid ga~, water, and other impurities in exchange for oxygen and so become pure again. The capillaries re-unite to form the four pulmonary veins, the only veins which carry pure blood. These, two left and two right, carry the blood to the left

riRsr AID

19 6

ventricle of the heart, and so the circulation IS completed. THE NERVOUS SYSTEM.

The nervous system consists of two sectionsthe cerebra-spinal, which is under the control of the will, and the sympathetic, which is not under the control of the will. In the cerebra-spinal we have the brain, the spinal cord and their nerves. The brain-our main Control Box-is a large organ, situate in the cranium and is made up of a mass of nerve fibres and nerve cells, which weighs, in an adult, about three pounds. The chief parts are ; (1) The cerebrum, or main part of the brain, which is the seat of sensation, intelligence and will. It receives sensations fram our five s~nses -sight, hearing, smell, taste and touch, relayed by nerves. These in the cerebra-spinal system are pearly white cords made up of two kinds-sensory fibres, which convey the sensations to, and motor fibres, which convey commands fram the brain. (2) The cerebellum, or small brain, which ensures co-ordination of movement and maintains balance in the body. (3) The pons, or bridge, which are broad bands of fibre connecting these parts together. (4) The medulla oblongata, or pith, which is like a bulb, about an inch in length and through which pass all the nerves from the brain downwards in the spinal canal as the spinal cord. The spinal cord is really a continuation of the brain and is com posed of nerve tissue. I t extends to the second lumbar vertebra and sends out nerve branches along its course to every part of the body. The sympathetic system works day and night and even whilst we sleep. It controls the action of the organs of the body, the blood vessels and the involuntary muscles. It contains two chains of nervous tissue or ganglia, one on each side of the front of the vertebral column, passing along its length as far as the second lum bar vertebra. The main part of this network of nervous tissue is known as the solar plexus and is to be found in the upper part of the abdomen behind the stomach. THE DIGESTIVE SYSTEM.

In order that we may benefit by the food taken, it has to be digested, absorbed and assimilated. The digestive tract is known as the alimentary canal. The digestive organs are the mouth, the teeth, the salivary glands, the pharynx, the resophagus or gullet, the stomach, the liver, the pancreas, the small intestines, the large intestines, the rectum and its orifice known as the anus. Food entering the mouth is masticated by the

teeth and intimately mixed with saliva, which secreted by glands in our necks converts starch into sugar. It then passes thraugh the pharynx and gullet into the stomach where proteins are converted into peptLlnes by the gastric juices. The food is now more or less fluid and a great deal is absorbed by capillaries of the blood in this organ. The food which does not become absorbed passes as chyme into the small intestine where it meets bile from the liver and pancreatic juice from the pancreas. The latter contains ferment of which one converts starches into sugar, thus com~ pleting what was left by the mouth, another supplements the action of the gastric juice by peptonising that which has not been absorbed by the stomach, and a third, in conjunction with bile, acts on fats making them capable of absorbtion. As food passes along the small intestines it is gradually absorbed by the capillaries and walls of the intestines, some parts going to the liver for further treatment whilst other parts enter the thoracic duct, a large channel which empties itself into the large vein at the base of the neck and so to the right side of the neck. From the small intestines that which has not been absorbed passes into the large intestines, and these carry off indigestible and accidently undigested food through the orifice of the bowls. Water and nitrogenous waste are secreted from the blood by the kidneys and passed into the bladder.

Fifth International Congress for life-Saving and First Aid to the Injured. THE above Congress will be held in Zurich and St. Moritz, Switzerland, from] uly 23rd to 28th, 1939. Mr. Philipp Etter, Federal Councillor, has consented to be the patron ot the Congress, whilst Professor Dr. med. Heinrich Zangger, Head of the Institute of Forensic Medicine, Zurich University, will be Honorary President. The Secretary-General is Dr. D. C. J. Mijnlieff, of Holland. It is five years since the last International Congress was held, at Copenhagen, and since that time science and technique have progressed in all fields of first aid and life-saving, and the questions for this year's event are divided into eight sections and include rescue work and first aid in catastrophic events and international traffic, first aid to the injured in general, organisation of first aid, rescue work and first aid, also history and idea of life-saving and first aid to the injured. Those wishing to give papers must give notice by March 1st, and full particulars of the various sections can be obtained from the Secretary, Schmelybergstrasse 4, Zurich Switzerland.

FlRS1'

St. John Ambulance Brigade Headquarters and District Reports. Brigade Headquarters A.R.P.- On ] anuary 27th to 29th the third L.A.G.C. Course was held in London with Dr. W. e. Bentall as Chairman of Instructors, and on ] anuary 28th and 29th the monthly Grade 1. course was held concurrently. SIr john Duncan, Chief Commissioner, at the opening of the Grade I course introduced Mr. Eady, Deputy Under-Secretary for State, A.R.P. Department, who m a few well chosen words, paid tribute to the work of the Brigade-a very essentIal movement in A.R.P. first aid post scheme. lie was sure that the Brigade would undertake this new branch of their work WIth the same hIgh pnnciples and the same high standard as give~ to other spheres of their activity. The lecturers and instructors at the course were Messrs. W. J. B. Trotter, W. ]. Noble, F. Wrigglesworth, E. MIlburn, C. E. Bower, L. R. Allum, Lieut.-Lo!. J. R. Collms, Mrs. A. Chapman, Messrs. ]. Wheatley and M. A. P. Bentall. Headquarter's staff were responsible for the excellent arrangements and the whole week-end went with a swing. ' " . . On Saturday evening a speCIal A.R.P. FIlm exhIbItion was gIVen by Mr. L. K Allum, who .is A.R.P.O. for Esher, and the films proved 'o f great mterest to those takmg the course. At the close of the course Lieut.-Col. Gore proposed a vote of thanks to Dr. Bentall and his fellow lecturers and paid tnbute to the H.Q. staff for the public spirit they had dIsplayed in arranging such week-end courses. T hese sentiments were echoed wholeheartedly by all present.

members of the various divisions and the interchange of views assist in the smooth running of the organisatIon. Asst. Commissioner Capt. H. A. Fenton was supported by his Area Staff, District Officer T . McBride, Lady District Officer ,Miss Masson, Corps Supt. A. E. Vvells (A.R.P,), whilst the guests included Lady District Supt. Miss Walker) District Staff Officers N. Burton, G. C. Green and W. A. Roust, District Officer Standing ford, Lady District Officers Robinia, Viscountess Mountgarret and. Mrs. Morrish, together with ... many other distinguished persons. As is usual a splendid short concert followed the supper interval. The artIstes were Miss ] ean Harley, Miss Emelie Benfield, George Barker, Harry May, Mountford Scott Alexander Henderson and George Web ber, the latter having arranged the programme. items given were excellent in quality and varied in nature and greatly added to the evening's enjoyment. Capt. Fenton expressed thanks to the artistes for t~eir splendid entertainment, and for then voluntary serVIces. This was unanimously supported by all present. District Officer McBride was responsible for the organisation of the function which was a great success; and all too soon the clock struck twelve. Supt. Woodgate eN o. 108 Division) was an . effi.cient M.e.

No. I (Prince of Wales·s) District

NORWOOD AND CRYSTAL PALACE Drv rSION.-SUPt. ]. S. Harber presided at the Annual Dinner held last month, supported by Mrs. Harber, -{\sst. Commissioner Capt. A C. White Knox and Mrs. WhIte Knox. Amb. Officer Gladden proposed the health of the Chairman and his lady; whilst Sergt. Hibbms proposed ., Our Guests." Capt. White Knox, in response, .referred to the revision of Area boundaries which were bel11g done in accordance with the Police Divisions. AR.P. arrangements and the desire for closer co-operatlOn between Police and the Brigade made th~ alterat~?n desir~b~e., " Mrs. G. Collins, in propo~I11~, the 2,3rd Dlv;,slOn! referred to the " Thin Black Ll11e, as agal11st the Thl11 Red Line" of the British Army. The work m.embers 0,£ the Brigade did was magnificent,. more e~peClal}y as It was entirely voluntary and carned out m theIr spare time. Supt. Harber) in reply, said tha~ some years ag? seven members of the division at that tIme stood outSIde the fire station on the Crystal Palace Parade. They had no hope-should they continue or should ~hey throw. up the sponge? Instead they threw up a C0111 and as It came down "heads" they carried on, ~nd the result was the wonderful gathering- of tha~ evenl11g.. " Following dinner, danClng was cont111ued un~ll mIdnight, Corp!. Clark ~fficiating as M.e. Pte. C0111115 was responsible for the dl11ner arrangements.

CENTRAL AREA.-Friday, January 27th was the date of the Annual Area Social and once again a bright and cheerful evening was spent by some 350 members and friends. These socials do much to bring together officers and

WESTERN POSTAL AND ST. MARYLEBO~E 1?r:v~sION. Accordino- to the annual report of thIS dIVISIon on Decembe; 31st last the personnel was 131 all ranks, an increase of 46 over 1937.

Unfortunately, owing to the tremendous amount of work fallmg on Brigade Headquarters in c?nnection w~th the NatIOnal Service Scheme, we are adVIsed by Major P. G. Oarvd-~ll1ith, C.B.E., Brigade St!cretary, that all week-end courses (L.A.G.e. and Grade I) arranged to. be held in London have been suspended untIl further notlce. We cannot let this opportunity pass without paying tribute to the enormous amount of extra work which has been carried out by normal Brigade Headquarters in consequence of A.R.P. training. Since 1935 week-end courses ha ve been held almost every month, excluding summer months and we on behalf of the many students who attended sl;ch cours~s, extend to Major Darvil-Smith and Mr. H.]. Wrigglesworth. (Asst. Se~retary) our best thanks for all the assistance gIven. TheIr work has been strenuous and arduous, but they have undertaken it in a true St. John spirit.

FIRST Cases treated numbered 1434, and of these 18 were removed to hospital or home. Nearly 700.duties we.re carried out. Four courses of lecturcs were gIven by DIV. Surgeon 1\'1. M. Scott, Dr. Chavasse and Dr. Pl:att. Subsequent examinations resulte? in good .enrolments mto the division. The V.A.D. sectlOn held Its second War Office and County Controller's Inspection on October 13th. The inspecting officers were Lieut. -Col. F. R. B.. Skrimshire, R.A.M.C. and Major J. H. Banks, who praIsed the members on their efficiency and appearance. The inception and formation of Cadet Division on July 20th, with Dr. C. Porter, M.O.H. for the Borough of St. Marylebone, as Div. Surgeon. Dr. R. C. Grave, LL.D., Town Clerk of the St. Marylebone Borough Council, was appointed a Vicepresident of the Division. Four members, Corps Officer P. J. M'o rris, Sergt. T. E. Clark, Ptes. H. Thornborrovv and W. C. H. Bruton were awarded the Service Medal. Div. Surgeon Scott presented a trophy for individual competition. This was judged by Div. Surgeon F. A. Beam, assisted by Corps Officer P. J. Morris, and the winner was Pte. W. H. Richard. In A.R.P. this division has been very active. Nine complete courses were held which resulted in 580 receiving instruction. The Division is, indeed, fortunate in having 3 C.A.G.S. (Special), 5 c.A.G.S. (Class 1), 5 S.J.A.B. (Grade I and 4 Grade II instructors), and we doubt whether any other Division can boast of such splendid array of talent. Amb. Officer R. R. Dare in conclusion of his report ' with thanks for assistance received from many quarters and we congratulate Supt. W. V. M. Allen on the splendid record ·of service which his members have given. The annual dinner of the No. 93 (Fine-hley) Division will be held on March 14th at the King Edward Hall, Finchley.

No IT District SOUTH BUCKS CORPs.-A big increase in the number of cases handled and the mileage travelled by ambulances is reported for 1938. Patients carried numbered 2,020, some 500 more than in 1937, and the mileage being 27,049, an increase of 8,000. Experiences of the year clearly indicate the need for another ambulance of which four are already in use. WITNEY.-The 10th annual meeting of the Witney Division was held on January 19th, with Div. Surgeon P. J. Purcell presiding. Supt. J. C. Chesterman reported an ardous but a very successful year. During the 10 years the division had been in existence 1,584 patients had been treated and 47 road accidents attended. Public duties total 1,332. Twelve members hold A.R.P. certificates and 3 Grade I Instructors' certificates. The Superintendent stated that he began his first aid career thirty-six years ago and urged up~n all present, from the youngest cadet to the oldest Bngade member, to stick to their work and the division and they would receive, as he had received compensations in the thanks and gratitude from those t~ whom assi.stance has been rendered. Supt. Chesterman, who mentIoned the newly formed Cadet Division and wished them and their officers every success, was thanked for the work done ·on behalf of the division. The Div. Secretary reported 47 extra duties carried out, 223 sick and injured attended during the year,

AID including 8 road accidents. They had attended 141 public duties. Cadet Supt. S. Collis reported personnel of 24 all ranks . . A satisfactory financial statement was presented by Div. Treasurer W. J. Rowe. The " Chesterman" attendance cup was won by Pte. R. Pratley, whilst Cadets R. Woodcock and C. Ivings also received prizes for perfect attendanccs. Certificates of appointment as Cadet Supt. and Cadet Officer were presented to S. Collis and A. E. Hickman, respectively. It is hoped that the strcngth of the Division, now 30 ranks, will be increased as a result of a recent examination.

FIRST by some 70 members and friends. Amb. Officer G. e. Powis was the M.e. Supt. Parker thanked those who had arranged the evening. Amb. Officer Powis (Chairman of the Social Committee) expressed thanks to those who had contributed gifts to the enjoyment of the evening. The division formed by employees of Messrs. George Elli.son, Ltd., of Perry Barr, Birmingham, has, as its member in charge, Mr. e. E. Casson. Mr. H. Bamford, Works Manager (not Managing Director as previously stated), is giving every encouragement to the movement.

No. IV District No. III District. BRIERLEY HILL.-Mr. E. E . Marsh (President) presided at the aru1Ual dinner of the Brierley Hill, ac'c ompanied by Mrs. Marsh. County Surgeon Campbell, responding to the toast of the "St. John Ambulance Bri'g ade," urged the local COlmcil to recognise the good work of the Brigade by seeing that the division were housed in a place which is suitable and of the standard deserved. The numbers were increasing and they urgently required a suitable room for the work. Mr. T. Williams proposed the toast of the Division. Without the help of the Brigade he could not ,see A.R.P. constitution being satisfactory and effi.cient; and the public generally did not realise the great sacrifices which were necessary for the work to be carried on. Div. Supt. J. H. Watkins gave a brief resume of the year's activities. Col. Thomas and Major Webb had been appointed Vice-Presidents and Dr. Appleton Div. Surgeon. The division was now at its strongest: 50 men and 40 cadets. Over 5,000 hours of public duty had been put in; 110 serious cases) 30 of which were conveyed to hospital, received attention. Pte. K. Billingham had won the " Campbell" Cup. Replying to the toast of " The Visit·o rs," Col. Denham said that the Brigade was playing a noble part (in A.R.P.) and he appealed to others to do the same. Numerous awards were distributed by Dr. Campbell, Mr. J. Solari, and County Officer P. H. Schofield, whilst a grandmother clock was presented to Supt. J. H. Watkins by the President on behalf 'Of the members.

WELLINGBOROUGH.-Further increases in the number of patients carried and miles covered is c·o ntained in the annual report 'Of the Wellingborough Corps. Patients transported numbered 432, against 426, and the mileage 7,031 was 146 miles more than in 1937. Of the cases 347 were medical) 33 road accidents and 52 were accidents at work or at home. In addition to ordinary transport various sports meetings and other functions were attended at which 82 persons received attenti'On. The Brigade's resuscitation apparatus had been put to good use and proved the means of preventing further serious casualties, especially in one case of gas poisoning. Members of the Wellingborough Headquarters Division held their annual social recently. Div. Supt. J. S. Parker pr~sided, accompanied by Mrs. Parker, and supported by DIV. Surgeon A. e. R. Walton and Mrs. Walton, County Officer F. Holgate Smith, M.B.E., and Mrs. Holgate Smith. A 'Varied programme of entertainments was enj oyed

LIVERPOOL.-The annual general meeting of the Liverpool Inval id Transport Di vision was held on January 17th, when Mr. Evan T. Edwards was presented with his warrant of appointment and badge of office as President of the Division.

AID Waterfoot Ambulance and Nursing Division and presented numerous awards. A President's Badge was handed to the Deputy-Mayor AI~ern:an Miss C. Whitehead, J.P., c.c., and Dr, Clegg paId trIbute to the work she had done for the ambulance movement. Handing to Mrs. E. Crabtree, J.P., of Waterfoot a Vice-President's Badge the Asst. Commissioner thanked her for her kindness in helping the nursing division. Both ladies acknowledged the investiture and thanked the members of the Division for the honour bestowed on them. They both had the greatest admiration for the work carried out voluntarily by the St. John Ambulance Brigade. After presenting A.R.P. certificates, including a Grade I Instructors' to Nursing Officer S. Moorhouse, and first aid and home nursing awards Dr. Clegg referred to the early days of the Association and its work to-day. Lady Supt. Mrs. Eatswood proposed a vote of thanks to Dr. Clegg, whom they were always pleased to see becaus~ they knew what an interest he had in the Brigade for whIch he had worked so long. Supt. Taylor associated Dr. McKinney, who had presided, in seconding the thanks.

Annual Dinner of the No. 114 (London Tramways) Division.

Corps Officer T. W. James, Mr. Dickerson (Group Secretary) and Div. Surgeon Major W. H. Broad were among those present. Corpl. J. Crosby (secretary) report on public duties. Supt. J. Anthony gave in detail the work of the Invalid Transport during 1938. The ambulance travelled 1,000 miles, whilst the motor van (in commission for six months only) covered 567 miles. The whole of the driving and the maintenance of the vehicles is done voluntarily by members of the Transport Division and reflects great credit on them. Unfortunately difficulty has been experienced in obtaining voluntary driven: during the day a,nd therefore a number of calls hac! to be reluctantly turned down. Members ·o f the division have received full instruction ill A,.R.P. by Amb. Officer J. J. Brown (Liverpool Gas Co. Division) and most of them hold certificates-two holding Grade II instructors' certificates. Supt. J. Anthony is a C.A.G.S. first class. RAWTENSTALL.-Asst. Commissioner Dr. R. Clegg recently attended a function of the Rawtenstall and

No. V District BOURNE.-The seventh annual dinner of the Bourne Division was held 'On January 1st, and presided over by the Rt. Hon. the Earl of Ancaster. The company included Asst. Commissioner Capt. G. B. Armstrong, VicePresident Mr. C. C. Macleod, Div. Surgeon J. A. Galletl)" Div. Supt. E. W. Judge, Dr. Donnan, Div. Offi~er Enderley (Boston), and members of the Local. AuthOrIty. The president expresse.d wa~m appr.ecl~tlOn of the services rendered by the BrIgade 111 the ~ls~nct, an~ as a first aider of former years) referred to hIS 111terest 111 the work. Others present also spoke of the valued services rendered by the Division. The Earl of Ancaster presented the following cups to the successful competitors: "Senior" Cup, Pte. C. G. Barr; "Junior" Cup, D. Barsby; "Progress" Cup, J. Coppin; "Efficiency)J Cup, .Corpl. H. Darnes. A most enjoyable even1l1g was concluded by singing "Auld Lang Syne." HOPE VALLEY DrvISION.-This division has suffered

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a o-reat loss by the death of its Superintendent, Mr. G. W. C~x, who passed away on January. 27th. He had b~e~ ill for nine months, but his interest 111 ambulance actIvIties was keen to the end. His ambulance work commenced on the L.~1.s. and in 1930 started the Hope Valley Division. The interment took place on January 31st, members of the division acting as bearers. The coffin, covered with St. John Colours and surmountecl with his cap and belt, was conveyed to Hope Church 011 the Division's wheeleel ambulance. In addition to divisional members, Asst. Commissioner H. C. Chambers and Supt. A. Wilson (SidesweU) were present to pay their last respect. Among the many floral tributes was one from the Division in the form of the eight-pointed Cross of St. John.

No. VIII (Duke of Connaught's) District GUILDFoRD.-The annual meeting of the Guildford Corps was held on January 17th, when the Mayor (AIel. R. H. Tribe) presided, supported by Mrs. F. H. Coo~, Corps Surgeon H. Bell, District Officers C. E. Chaphn and B. W. Wells, Dr. F. A. Belam (M.O .H.), Wing Commander T. N. Fletcher (A.R.P.O.) and others. Corps Supt. ]. D. Rutter stated that the total personnel was 134 and quite a number of men had enlisted in the M.H. Reserve. The Corps had 21 members holding the much prized Service Medal. It was satisfactory to know that more nurses hac! been recruited, but he still hoped for a 100 per cent. addition. Cadet Supt. Miss Elmes and Cadet Officer Miss Reeves, deserved hearty congratulations upon the excellent manner in which they had continued to conduct the cadet division. Several members had been transferred to the adult section. COI-PS Treasurer A C. Stoughton referred to the financial statement of the Corps. Extension scheme to headquarters had entailed a heavy expenditure, and he was anxious that night quarters for men who had volunteered to sleep at headquarters for night calls should be provided. This accommodation should be the best they could provide and thus bring relief to Corps Officer A. Norton and Supt. G. E. Cheshire, two offi'cers who for a long time had carried the brunt of night calls. Corps Supt. Rutter enumerated some of the public duties undertaken and also mentioned the increased call on the invalid transport service. They had added another ambulance, making four cars in service and one trailer. Mention was also made of the medical comforts' depot, the roadside first aid cabinets and the sales depot. The Corps has 325 A.R.P. reservists, and close contact had been maintained with the local authorities on A.R.P. matters. The ambulances had removed 2,174 cases as aO'ainst 1,990 last year; 546 public duties were attend'ed, anbd 644 cases treated. The ambulance travelled oyer 21,000 miles. Corps Surgeon Heward Be1l congratulated the members on their efficiency in the medical aspect of their work. The Mayor in a short speech said that 0.£ a1l the social ~ervices in th~ Borough, the great voluntary work the Bngade was domg stood pre-eminent.

BRIGIIToN.-The Brighton Town Division helel its annnal meeting last month. Asst. Supt. C. L. Hughes presiding. The personnel had grown and was now larger than

ever before. Cases treated were roughly 300, and public duties had been carried ont. The Chairman expressed thanks to the President, M1'. A. S. Nicholls, Alderman and Mrs. Huggett, Mr. and Mrs. Howick, the Brighton Rotary Cluh, Corpl. G. Lenty anel his Appeals Committee for the splenoicl assistance.

N.o IX District NEWTON ABBOT.-Ambulance men in DeVOll heard with regret of the death, while returning home by train on \tVedneselay, February 1st, of iltIajor Edgar William Greenslade, who was a Serving Brother of the Order of St. John and Corps Supt. of Newton Abbot Corp,s. l\Iajor Greenslade, who was 74 years of age, was a natiYe of Dartford, Kent. He was assistant teacher at Wolborough School, Newton Abbot, from 1886 to 1930. He secured his First Aid certificate in 1901 and medallion in 1904. He joined the Brigade in January, 1903, and was awarded his Service Medal in 1922, during which year he was appointed Corps Officer and Secretary. He was promoted to the rank of Corps Supt. in January, 1938. He was also one of the Trustees of the Newton Abbot Ambulance Hall. Apart from his St. John activities, before the war he was keenly interested il1 the old yolunteer movement and held non-commissioned rank. He served in the Rifle Brigacle during the Great War in India, attaining the rank of Major. The funeral took place on Monday, February 6th, Rev. H. R. Cooke, Vicar of Kingsteignton, officiating. The coffin was covered with a Union Jack, surmounted by l\Iajor Greenslade's cap, medals and bell. Members of the Newton Abbot Corps) Ambulance Officers W. Laskey, B. Mallet and \tV. Underhill, Cadet Officer Fone, Staff Sergt. G. Carnell and Sec. Sergt. E. Kerley, acting as bearers. The Brig-ade was represented by County Commissioner H. J. Vick, Asst. County Commissioner G. \tV. Hingston, County Surgeon F. Morton Palmer, Mr. H. G. Michelmore, President of the Newton Abbot S.].A.A., and officers and men representing the Newton, Totnes, Torquay, Dawlish, Chuclleigh, Christow, Teignmouth and Ashburton. In addition there was a ver'y large attendance representative of Freemasons, Police and other organisations.

PAlGNToN.-When the first distribution of AR.P. certificates to?k place at Paignton on Thursday, February 2nd, the Chaln1lall of Paignton Urban District Council, Mr. G. 'vV. H. Spanton, J.P., c.c., showered high praise on the work which the Brigade had been doin o' in connection with Casualty Services. l\Ir. and Mrs. SlJanton handed the certificates, which included civilian first aid awards and the A.R.P. badges, to the successful candidates t~ the nu.ml~er of over 160: On the platform were County CommISSIOner H. J. Vlck, Asst. County Commissioner G. 'vV. Hingston, Lady County Officer Miss Whitehead, officers and surgeons of the Paignton Divisions and representatives of Paignton and District Hospital. M1'. Spanton (who is Chairman of the Area Con1mittee) mentioned that the Torbay area, coniprising the three towns of Torquay, Paignton and Brixbam, was a separate area and had its own arrangements for A.R.P. Excellent prog ress had been made. and the re had been a mag'nificent response from the public. Splendid work had been. done by Air J3,aid Wardens, Auxiliary Fire and oth er senTlces. Regard111,g- the Casualty Services, he said he could not too hig'hly praise the volunteers who were taking pains to undergo their train in g, and without the

aid of the St. John Ambulance Brigade no preparation or progress would have been possible. COl.1l1ty Commissioner H. J. Vick ,stated that the Brigade in Paignton. started training in 1936, but lectures for the general pubhc had only been commenced in 1938. Examinations after these public lectures had resulted 1n ce rtificates being obtained by 61 women and 16 men. The Paignton Divisions had a number 'o f instructors and 38 men held both AR.P. and First Aid certificates while the Nursing Division had Home Nursing certificat~s also. It had been conside.red n.ecessary to form a St. John An~b ul ance A.R.P. First AId reserve to replace personnel wl11ch .ml~ht be drafted elsewhere in an emergency. .DlvlslOnal S.urgeon G. E. Sawdon explained the detaIls of the Palgnton Casualty Services of which he i in charge, and gene r al arrangements were outlined by the Torbay Area A.R.P. organiser, Mr. G. H. Marshall.

No. X District BECCLES.-A supper parly was held last month when Supt. W. C. Watts, in response to the toast of the "Becc1es Division,)) referred to the progress of the division. Only four men remained of those who formed the division thirteen years ago, and only one original member of the nursing division. From the time the division had started up to the present time, they had been able to report progress eacb year, and to-day they were the strongest they had ever been. Dr. H. Wood-Hill (Deputy Mayor and also Div. Surgeon), said much was due to Supt. Watts, who bad two very able and loyal lieutenants in Div. Secretary C. Bennett and Transport Officer R. Elliott. He also paid tribute to Lady Supt. Miss Tedder and Lady Amb. Officer Miss D. Hamley. They were particularly fortunate in having Mr. C. L. Hamley as President. Lady Supt. :;\1iss Tedder thanked Dr. Wood-Hill for his ~ords of encouragement. She expressed gratitude to MISS Hamley and Mrs. Bennett for their loyal cooperation. M1'. Hamley, in reply to the toast of "The President," ably proposed by Mr. G. E . Brown, expressed his pride at being President.

Y ARMOUTI-I.-At the annual dinner of the Yarmouth Ambulance and Nursing Divisions a plea for increased membershiD was made. Div. Surgeon J, Russell presided, supported by Div. Surgeon D. Wainwrio'ht (Nursing Division), 1\lr. B. VV. Smith, Mr. B. V. Smith, l\lr. and Mrs. Oglesby, l\lr. W. J. Vl estmoreland and others.

Corps Supt. T. C. Amery (Pontefract) speaking at the ann ual meeting of the South Kirkby Division, S.J. A. B., said" First aid is more important than any other bran ch of A. R. P. work, because lives are of more value than property."

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The fourth birthday pa rty of the Greenford and N orlholl Division was held on January 28 1 h, when 120 members and frie nds attended. A varied programme of singing, games and dancing was enjoyed. Amb. Offi ce r Vaughan organised the function .

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Club. 01\' Friday, January 20th, l\lr. J. Standing-ford presided at the annual general meeting. Two new members were admitted Messrs. F. H. Hurford and C. Shaw, and it was unanimously decided to elect 1\1r. S. B. Piers, an old and esteemed member of the Club who now resided in the country, an hon. member of the Club. Mr. A. E. Wells present€'d the Secretary's report. The year had been happy and successful in spite of the black outlook. Under the presidency of Mr. Standingford the Club had made progress. The membership of the Club was 111, the Club having lost through death Capt. Butcher, past-president. 1\1r. Wells paid tribute to the work carried out by 1\1r. Stallard as treasurer and organiser of social functions; and extended thanks to 1\lr. H. Langley Jones for the use of his offices for Committee meetings; and to the Committee and mem bers for their su pport. Owing to other activities 1\1r. \.Vells stated that he relu ctantly and regretfully tendered his resignation as secretary after sev€'n years of happy work. 1\1r. F. E. Stallard presented the financial report which was follo\ved by a discussion. The auditors paid tr ibute to the way in which the books were kept. Mr. Herbert proposed a vote of thanks to the mem bers of the Committee for th<)ir work and the interest taken in the Club's interest. I\h. Standing-ford expressed thanks to 1\1r. \.\'ells and lr. Stallard for their support, and the Committee for their sympathy and help during his term of office. As the retiring president he had the pleasure and privilege to nominate his successor-l\lr. G. C. Green. This proposal was carried unanimously and 1\1r. Standingford invested 1\1r. Green with his badge of office and congratulated him on his election. Mr. Green said he felt a very proud man and he would do his best to keep up the high standard of the Club. Other positions were filled as follows :-

Vice-President-1\1r. J. Kemp. Treasurer-Mr. F. E. Stallard, for the 17th year. Secretary-:.'Ilr. A. E. Turtle of 13, Mayfield-road, N.8. Committee-Messrs. \\'a]sby, LangleyJones and Hodges Auditors-Messrs. Appleton and Dines. A special vote of thanks was extended to l\1 r. \\Tells. He had '\.yorked tremendously hard and the Club \.\'as greatly indebted to him for all the work he had done. The roll caIl was carried out and the President read the Hospitallers' Remem brance at 8.15. Particulars of forthcoming ene'nts \-\'ere gi\'en and members urged to support the meetings and social events. Lt.-Col. F. Higginson will give a talk on the \\Tar Graves Commission at the l\larch meeting. We are prepared to supply Ambulance Secretaries and others with specimen copIes of this Journal for distribution among their

members.

Apply to the

Publishers. FIRST AID, 46 Cannon 5t., London E..C.

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Priory for Wales. HEADQUARTER NOTES.

The number of First Aid and Home Nursing Examinations held under the Priory throughout the Principality during 1938 reached the record total of 1,027. !he large increase is consequent largely upon the prom1l1enc~ of First Aid in A.R.P. work; and one of the most frUltful issues in connection with Air Raid Precautions is the wider dissemination of first aid knowledge, which has not to be assimilated to put to practical account only in time of war) like other branches of A.R.P. training, but has a yalue little less pronounced in peace time. While for AR.P. purposes selected laymen can be employed by the Medical Officer of Health to give a modified course, to be known as the "Short Course in Elementary First Aid," instituted by the Lord Privy Seal for a certain proportion of A.R.P. volunteers requiring some instruction though not a full first aid course, St. John Ambulance Association rules have not been relaxed to the point of recognising" lay" instructors as competent to give the prescribed course qualifying students to sit an examination for the recognised awards. The services of members of the medical profession remain therefore indispensable; and the extent to which doctors are giving their services gratuitously as lecturers is not always appreciated. One token of recognition of such assistance which Honorary Lecturers are pleased to accept is the certificate of Honorary Life Membership; and at the last meeting of the Ambulance Committee the following were elected to the Roll :-Dr. R. D. Thomas (Commissioner for Montgomeryshire), Dr. E. P. Coyne (Corps Surgeon, Neath Corps), Dr. Tom Davies (Div. Surgeon, Aberdulais), Dr. John H. Howell (Diy. Surgeon, Pontyberem), Dr. N. K. T. Jordan (Div. Surgeon, Brecon Division), Dr. J. A Thompson (Div. Surgeon, Maesmarchog), Dr. V. T. P. Webster (former Surgeon, Cefn Coed), Dr. S. G. Budd (Newcastle Emlyn) and Dr. J. A Rees (Aberystwyth). It would be interesting to trace the number of families in which occupancy of Brigade rank has become a family tradition. There have been a number of recent instances in Wales of sons and daughters of Brigade ~urgeons accepting office as Divisional Surgeon, for 1l1stance Dr. Audrey Turner, daughter of Capt. S. B. Turner, M.R.C.S., L.R.c.P. (Priory Headquarter A.R.P. Staff Officer) is Surgeon to the Bargoed Nursing Division, while the daughter of Dr. Edgar Llewellyn (Commissioner for Cardiff), Dr. Mary M. Llewellyn, who has just obtained her Diploma in Public Health, is Surgeon to the Penarth Nursing Division. Particularly worthy of note is the appointment of Dr. Gwyn Rocyn Jones, son of the Surgeon-in-Chief for Wales, who has held office as Divisional Surgeon for the past twelve months, as Assistant Commissioner for the Gwent County Area of Monmonthshire. The following summary of the cases carried and mileage travelled in the Priory ambulance durinO" the ye.ar 1938 shows an increase of 520 cases and 10,754 mIles on the figures for the previous twelve months the Service having been increased by one Station op'ened at Clydach in August, 1938. Since the establishment of

the Service in 1918 the Priory has dealt \;v ith 140,783 removals, involving a total mileage of 2,275,929. Station. Cases. Mileage. Aberdare 1,486 11,605 Ammanford (accident) 267 7.077 Ammanford 1,647 25,071 Bryn 571 10,556 Cardiff 2,562 28,382 Clydach 2,278 (from Aug-ust 22nd) 156 20,526 951 Coeddy 9,04R 412 Cross keys 23,441 1,089 Cwmllynfell 19,451 732 Cymmer 9,502 677 Gowerton 24,987 1,656 Gwuan-Cae-Gurwen 14,880 735 Ken6g Hill 7,935 425 Llan bradach 5,061 753 Llanelly 18,074 689 Pen coed 17,053 1,007 Pon tard ulais 9,-295 479 Pontypridd 21,467 986 Trimsaran 27,305 1,481 Tumble Totals

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312,994

NATIONAL SERVICE SClIE1IIE.

A great opportunity is afforded by the National Service recruitment to enrol members both in the Brigade and its AR.P. Auxiliary Reserve. Applications for Enrolment on Form E.D.60 are reaching Priory House almost daily; and no time is being lost in putting applicants in touch with the nearest Unit of the Brigade. As the procedure to be follovled is not generally known, it may be helpful to quote the following Special Brigade Order issued by the Chief Commissioner:"Applications from persons who apply to join the Brigade on National Service Form E.D.60 should be treated in the same manner as before the form was issued, but those not in possession of the qualifying certificates should be informed that there is a small charge for the initial course of training. Pending qualification, non-certificated applicants may be enrolled at once as probationers. They should also be informed that if they desire to volunteer for the A.R.P. First Aid Service, the initial course of training can be obtained free by applying to the Borough A.R.P. Authority; and after they have obtained the qualifying certificate they can join the Brigade. To obtain .a free qualifying certificate in this manner might lead to delay. " As it is the instruction of the Ministry of Labour that Section 11 of Form E.D.60 should be filled in before enrolment in the A.R.P. Service, the forms of any new persons joining the Brigade as well as those of existing members, who wish to enrol ill the A.R.P. Service, shou ld be sent by the Divisional Superintendent to the local AR.P. Authority, who will get Section 11 of Forms E.D.60 filled in by the local representative of the Ministry of Labour and will then include them in his roll of AR.P. volunteers for first aid service. "The Ministry of Labour has instructed that all

volunteers for service for Air Raid Precautions must complete National Service Form E.D.60, excepting in the case of those without occupation, or in private domestic service, and that Section 11 of the form must be completed by the Ministry of Labour through the Ministry's local Officers before a volunteer can be accepted. "The procedure therefore is as follows:" (a) For enrolment in the Brigade the Brigade Regulations remain entirely unaffected. " (b) Existing members and new members volunteering for the AR.P. Casualty Service will obtain and complete Form E.D.60, and hand it to the Officer-inCharge of the Division in which they are enrolled. " (c) The Officer-in-Charge of the Division will forward National Service Form E.D.60 to the local A.R.P. Officer, whose responsibility it will be to get Section 11 completed by the Ministry of Labour. " (d) The local A.R.P. Officer should advise the Brigade Officer the names of those whom the Ministry have allowed to be accepted for enrolment. For such information, the Brigade Officer will compile his list of A.R.P. First Aid Service volunteers." A separate circular is being issued regarding enrolment of existing and new members into the Royal Naval AuxlTiary Sick Berth Reserve, the Military Hospitals Reserve and Voluntary Aid Detachments; and it should be pointed out that young men liable for military service are '\Tell advised to join the M.H.R. which assures to them a definite branch of military service in time of war.

St. Marylebone Open First Aid Com petition. ENTRIES for this competition are arriving very well but those teams who have not yet sent in their entry forms should do so at once as the closing date is March 1st. The preliminary competitions will be held on Thursday, March 9th, and teams will be advised in due course as to time and place. The Committee has pleasure in announcing that the following have consented to become patrons of the competition: Lady Hartley, Sir Hugh Turnbull (Commissioner, City of London Police), Sir John Duncan (Chief Commissioner, S.J. A. B.), Dr. N. Corbet Fletcher (Surgeon.in-Chief, S.J.A. B.), Capt. W. Goodley (Commissioner No.1 District, S.J.A. B), Sir Harry Bashford (Chief Medical Officer, Post Office), Mr. G. L. Darbyshire (Chief Officer for Labour and Establishment, L. M. S. Rail way), and Mr. W. E. C. Lazenby (Asst. Chief Officer for Labour and Establishment, L.M.S. Railway). The final competition to be held on March 30th, at Portman Rooms, Baker-street, W.1, will be judg-ed by Capt. F. C. Bendix, M. R.C S .. L. R.C. P. (team). and CRpt. A. C. Wh ite Knox, M.e., M.B., Ch.B. (individual). Team captains are reminded that this year there is a challeng-e cup for the best tt am leader and points gRined in t1leir individual test, tog-ether with special ., Leader's Marks" in the team test, will decide the home of this trophy. A further trophy hRs been presented by the Town Clerk of the St. Vlarylebone Borough. The Committee has decided to award this trophy to the team gaining- the highest number of marks in the individual section of the final.

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Coming Events. The Editor will be pleased to receive particulars or forth. coming events for inclusion (free of charge) under this heading.

FEBRUARY. 22-M.&G.N. Rail.way Competition, Norwich. 25-Newcastle District, L. N. E. R. Competitions. 28, March 1 and 2-Great Eastern Section, L. N. E. R. PrelimilJary Competitions. MARCH. 4-Durham, Cleveland & "Vestmorland Ambulance League Competition Finals, Durham. 4-Leeds District, L. N. E. R. Competitions. 10-No. 83 (Hig-hg-ate and Crouch End) and No. 109 (Hornsey British Legion) Divisions, S.J.A. B., Dance, Homsey Town Hall. 10-Hospitallers' Club Meeting, B:mnington Hotel, London. 14- Finchley Division, S.].A B., Annual Dinner, King Edward Hall, Finchley. lS-Hull District, L. N. E. R. Competitions. 16-Wimbledon Ambulance Festival Competition Finals. 16-No. 46 (Ilford) Division, S.J.A.B., St. Patrick's Eve Dance, llford Palais de Dance. 18-" Stanley Shield," B. R.C.S., Wom,en's First Eliminating Round. 18-Finchley and Southgate Nursing Division, S.J.A.B., Annual Dance, Friern Barnet Church Hall. 21-Great Northern Centre, L. N.E. R., Competition Finals. 25-" Stanley Shield," B. R.C.S., Men's Eliminating Round. 25-Hag-g-erston Division, S.] ,A. B., Jubilee Dance, Shoreditch Town Hall. 22-York District, L. N. E. R. Competitions. 24-Ungrouped Railways Inter-Railway Preliminary Competition. 25-Middlesbrough District, L. N. E. R. Competitions. 29-Great Eastern Centre, L. N. E. R. Competition Finals, Stratford. 30-St. Marylebone First Aid Open Competition Final, Portman Rooms, Baker-street, "V.i. APRIL. 1-" Stanley Shield," B.R.C.S., ''''omen's Second Eliminating Round.

Members of the CrclVdon and StreRtham Division, S.J.A.B., went on duty 5,000 times during 1938 and treated more than 1,800 casualties. About 400 officers and other ranks of the St. John Ambulance Corps and Divisions of the six collieries in the Doncaster Al1lal~amated Collieries (Ltd.) group, attended the first annual dinner, held at Doncaster on Saturday, January 21st. Assistant Commissioner H. C. Else mentioued that the six units were to be joined and known as the D.A e. AmbulRnce Corps ar.d 1 hRt the District OfTicer would be Mr. J. Le Brun (Bullcroft and Brodsworth Collieries).

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Railway Ambulance News. I ntel~- Rai Iway Pol ice Com pet ition. The final competition, as annoL1llced in our January issue, will not novv take place. 0\~l11g to unfor~seel: circumstances it was not found possIble for. certal11 01 the Railway Companies to hold ~he1r p'relllUlnary competitions and therefore, for the time bel11g at least, the competition will be in abeyance.

Great Western. CO.:lIPETITIO;\S.-The annual senes of ambulance cumpetitiolls is being held throughout the Great 'Western Railway system during the month of February, t~e. e.ntry heino' 283 teams from the seyentcen ambulance dl\'lS10ns. Of these 120 are in Class 1 (Advanced) and 163 in Class 2 (Beginners) . The semi-final eliminating contests have heen fixed for l\Iarch 14th, 17th, 21st and 2-hh, and will he held at Bristol, Ne\;yport, Birmingham a119 P~ddington. The adjudicators in the semi-final contests w111 be Dr. S. l\IcCormac, of Newport and Dr. 'vV. ]. Crawfor.d, of Southall, for the team and individual tests respect1vely.

HONouRs.-Follo\\,ing a recommendation made by the Great Western Railway Central Ambulance Committee, 1\1r. J. E. Jones, Clerk, Goods Department, Birkenheacl, has been elected a Serving Brother O'f the Order of St. John of Jerusalem in consideration ·of services to the movement over a long period of years, as secretary and instructor of the Birkenhead class.

Tmmu.-The annual smok111g concert o£ the Tondu class 'was held at the Star Hotel, Aberkenfig, under thE' presidency of 1\lr. Thomas D. Eyans. ,"."ho presented (1 large number of class awards and gold efficiency medals. The 30 year efficiency bar was presented to Mr. A. S. Pile, the first memher of the class to achiew this distinc tion, by l\Ir. Vi. Homeyard.

PLYMOUTll.-l\l1'. E. Lake, Divisional Eug'ineer, who rresided over the annual gathering of the. Plymouth classes at the Abbey Hall on January 21st, sald tl~at ~he vea l' 1938 had broken all records for exam111atlO11 ~ ucc esses for the Division No few'er than 126 men had qualified for awards in the Plymouth class, and the number in the Division was 525. During the year Mr. J. H. Tippett, their Divisional Secre~ary, and Mr. A. T. Andrews had been admitted as Serv111g Brothers of the Order of St. John. Thirty-two members of the class were attached to the Millbay D ivision of the St. John Ambulance Brigade. Awards gai n ed by m embe rs were presented by Mrs. Lake.

BYNE.\.-The annual gathering of the Bynea class took place at the Uwynhendy Church Hall on. January 25th, when Mr. T. Price, station master, pres1de?, ~nd local artistes ente r tained the company. Examl11abon awards and efficiency medals were distributed by the Assistant Divisional Enginee r, Mr. H . V. Illingworth.

G .'vV.R. POLICE CO'lIIPETITION.-A competition for ambulance teams of Great Western Railway Police was held at Bristol on February 9th) five teams ente rin g, from London, Swansea, Cardiff, No r thern Division and West of England respectively. Dr. A. P. Gorham, of \Vestbury-on-Trym, adjudicated and the arranl=?ements were in the capable hands of l\Iessrs. \V. F. vVdls and G. S. Hodder. The team test, w hi ch was suitably staged, r epresented an accident consequent on a road obstruction being unguarded by lamps, inj uries being. sustained by a lad cyclist. The results were 1 st, Card1ff, 220 marks; 2nd, orthern, 203; 3rd, West of Eng'land, 183. Mr. S. Smith, who represented the Chief of Police, expressed his appreciation of the arrangements, and complimenleri the te::lms nn their excellfnt ·s tandard of work.

TOTNEs.-~le111bers of the Totnes and district G .VI/.R. class met at the station on January 4th for thcir annual presentation of awards) when ~Ir. J. F. Anstey, Assistant Traffic lIanag-er, was in the chair, and gave some interesting information as to the progress of the movement throughout the system. He congratulated th e class secretary and others concerned on thc excellent results achieved by the class. The awards were distributed hy Alderman R. Drennan, who in complimenting members on their efficiency, said that first aid was onc of the most useful services to the community.

SHREWSBuRY.-Ambulance workers m the Chester D1vision met for their annual dinner at Shrewsbury on F'ebr uary 1st under the presidency of Mr. A. V. R. Brown, Div. Supt., who was supported by local officers of the Company and by Drs. A. W. H. H o ughton and A. C. Williams, of Shrewsbury. M1'. F. R. Poller. Superintendent of the Line. had travelled from Padding-ton to make the presentations, which in clud ed awards gained in examination by various classes in the Divi s ion and a large numbe r of gold efficiency medals and bars. He fJaicl special tribute to the excellen t se rvices of Mr. J. A. Mart.in, Divisional Secretary and h is class secretaries and in st ructors. Ref er ence was made to the admission to the Order 0 F St. J oh 11 in the grade 0 r Se rvin g Brother 0 r t h ree prominent workers ill the Division.

PADDI?{GTOX.-At a friendly little gathering in the Paddington Goods Offices on January 5th, Dr. C. H. Pen-am, lectmer to the first aid class, was p res ented by Mr. C. F. Gaynor, sccretary, with a fountain pen as a !oke't1 of rtpprecirttioll of his services.

LLr\j\,'1)AFF.-The ann u al presentation at Lland a ff 011 Febru a r y 5th was fo llow-cd by a class practice) at which Mr. H. H. Phillips, Assist.ant Divisiona l Superintendent, w h o presented the awa rds, and Mr. J. E. Al exander, took pint. The tlw;;I rcls inc1ncled gold effki en cy awards.

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London, Mid land and Scottish.

london an d !\ol'l th Easter'n.

The Southern Area Cup Competition of the No. 1 Ambulance District was h eld at Euston on January 14th. The judges were Dr. Leslie Thomas (team) and Dr. A. Burns (individual). Mr. C, Hopkins was the Competit ion Secretary and h e was assisted by Mr. W. J. Edgson and Mr. Lawrence. Some good work was witnessed by an inter ested aud ience and at the presentation ceremony Mr. Edgson anno unced the result as follows: 1, St. Albans A, 208; 2, Broad Street A, 207; 3, Watford B, 205. Seven teams competed. Dr. Thomas said that the standa rd was good, whilst Dr. Burns) w h o had to leave before the presentation, left a message that competitors should read the card well before answering the question set. The Cup was presented to the winning team by M1'. G. E. Craft of First Aid) who congratulated the members on their enthusiasm and expressed the hope th at a team from the No . 1 District wou ld bring the Inter-Railway Shield back to London. Thanks were extended to the patients and stewards for their assistance.

The annual competition for the Norwich D:strict Officers' Shield was held on January 21st, the judges being Captain W. Goodley, O.B.E., M.C., Commissioner No. 1 District, S.J.A.B . (team) and District Officer C. J. Fitch (individual). The result ,vas : 1st, K orwich, 300 marks; 2nd, Lowestoft, 264; 3rd, Yarmouth, 249. Thetford, Attleborough and B r andon also competed . The members of the No rwich team were 1\1essrs. H. G. Linder (captain), P. Middleton) C. Farrant and C. Etheridge. The winning team, in addition to holding the Shield, were presented with a set of stainless steel carvers, the presentations being made by :\1rs. Bender. 111'. E. F. Greenfield (District Supt.) presided, supported hy Mr. H. R. Statham (District Goods and Passenger Manager) and Mrs. Statham; Mr. O. F. S. Bender (District Engineer) and Mrs. Bender; Mr. H. G. Fish (District Loco' Supt.); Mr. Ainger (Station Master, Norwich Thorpe) and Mr. R. D. Brown (Competition Secretary) . 11r. Greenfield welcomed the opportunity of expressing the appreciation of the District Officers, of the work clone by first aiders and of the continued support given to the competition, particularly ha ,-ing regard to the difficulties experienced in teams getting together for practices. \Vith the unsettled state of the world, first aid loomed largely in the life of eyeryboc1y. The teams were composed of olclcr members of the moYement, and it would be a source of satisfaction if young members eligible to compete, came fonnrd. Replying to the ,'ote of thanks to the judges, proposed by the captain of the winning team, Capt. Goodley said that if at some future time we are unfortunate enough to be brought into warfare, we must remember that the front line will not be in France or Belgium, but our o\\'n doorsteps . The thing we must prepare for most was high explosive, and we can best prepare for this by acquiring a knowledge of first aiel. It should be everybody's business to obtain a first aid certificate, which is also of great value in time of peace. A vote of thanks to the patients, stewards. and all \\'ho had assisted in the success of the competition, also to ~Ir. Bayfield, Secretary of the Railwaymen's Social and Athletic Club for the use of the hall concluded the proceedings.

BOLToN.- There was a close finish to the No. 18 District Competition (Division 1) held at Bolton on February 3rd. Bolton Loco, 256 marks, gained first ,place, followed by Heaton Park, vvho scored a similar number of marks. Bolton, however, gained more marks in the individual section and thus were placed first. Mr. W. Hepworth (District Engineer, Blackburn) presided, and prizes were distributed hy Mrs. Walstenrraft.

FORRES.- At the annual meeting the following appointments were made: Commandant, Mr. John Cowie; Asst. Commandant and Secretary, Mr. D. King; Asst. Commandant, 1\11'. B. J. Young; Sergeant, 1\1r. G. R. Singer; 1st Corp!', 1\11'. James Henderson; 2nd Corpl., 1\Ir. A. G. Williamson; Committee, Messrs. VI/m. 'vValker, Vlm. 1\Iackenzie and J. Paterson. Following a series of lectures by Dr. Bruce, about forty members of Fones Station first aid class present.ed themselves for examination. They were examined by Dr. D . R. Macdonald, Nairn, while the members of Forres L.M.S. Railway Ambulance Brigade were examined by Dr. Bethune, Forres. On the call of Mr. Richardson votes of thanks were accorded to the examiners. 1\1r. J. Locke. Secretary of Inverness District Amhulance Council, addressed the members.

GLOUCESTER.-On January 20th a successful smoking conce-rt was h eld , an attendance of 100 being recorded. Mr. A. E. Walker (president) occupied the chair and was accompanied by Messrs. A. _So Cook, H. J. King and others. Mr. Cook presented awards to 47 successful candidates and Mr. L esli e Boyce, M.P., distributed the following: long service awards :-Medal. P. M. Critchley; 25 years e:~ ld bars, A. E. .Tames, W. Mason and A. E. G r een. Mr. H . T. Shewell presented a g lass cabinet to :\lI r. A. J. Allison (Secretary) as a token of the memhers' apprC'ciation,

The 8th annual competition for the Stratford District Amhulance Challeng-e Shield ,vas held on 'vVednesday, February 8~h, \"hen twelye teams entered. The judg'es were Captain \ V. Goodlev, O.B E., 1\1.C (team) and District Officer T. E. \ Valsby (individual). The tests fully tested the knowledge of the competitors but, on the whole, the work was well done. Bishopsgate carried off all the honours, tl:e first three places being filled bv teams from that strttlOn. The result was: 1st. BishoPsf!ate "A ." 303 marks; 2nd, Bishopsgate "C," 299: 3rd, Bishopsf!ate "B." 291. Other teams were Printing- vVorks " A." "B " rtnc1 "C"; Truck Sheet Factory, Gidea Park; Sig-nal ancl Telegraph, Ley ton ; BishoPsQ'ate Police: Vvay and Works, Stratford; \.\fo·odford and Str~tford \ .\forks. The Shield ;:lnd prizes were present-ed by Mrs. F. \V. Carr. wife of Mechanical Ene'ineer, Stratford. There was a represf'ntative gathc r in(')' of of/irers pr esent inrJuding l\Tc>ssrs. S. L. Ba;stf'r. A. Chilve r s. F. S. Chilvers, H. C. L. Edwards, B. P. Fletcher, J. H. Glen-

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uinning, J. 1. Hill, T. O. Mein, L. P. Parker, G. J. Pearce, B. M. Sprouts, D. J. Thornton and F . C. Wilso~. Votes of thanks were extended to the Judges, stewards and patients. . .. Miss H. White carried out the dutIes of competltlOn secretary.

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So uthern. MERITORIOUS FIRST AID. - Amongst the cases reported at the last meet~ng. of th~ Cent~e Committee, it was agreed that Mcntonous FIrst AId certlficates should be awarded to the four members of the class at Basingstoke, namely, Repairer G. E. Cowdrey, Po:ter R. E. Harris, Boilersmith's Asst. H. Parker, and ~epalfer J. Clarke, whose first aid services were conspICuously rendered early in the morning of September 29th last, when Ganger Simmons was knocked down by an engine and sustained extensive injuries, his right leg and left arm being torn off, and his left foot crushed. T~e co~ sequences of inadequate emergency treatment 10 thIs case would have been almost immediately disastrous, and it is gratifying to know that trained men were available. BASINGSTOKE.-At Basingstoke recently the Town Hall was packed to capacity on the occasion of the Smoking Concert arranged conjointly by the Basingstoke Ambulance Class and Athletic Club. An excellent musical programme was thoroughly enjoyed. Mr. W. H. Hayne (Station Master) presided and was supported by the Mayor and Mayoress (Councillor and Mrs. W. G. Dear), Mr. and Mrs. E. A. Richards, Mr. J. E. Sharpe, Mr. H. 1. Bond, Mr. E. S. Moore, Mr. H. E. Kemp, Dr. and Mrs. H. R. Potter and others. The Mayor presented the Ambulance class awards and in so doing expressed his pleasure, adding that he felt he was one of the Company. Amongst the recipients of awards were a number of local Policemen who take a refresher course every few years. . Mr. G. E. Cowdrey, the Class Secretary, received his SlIver Medal (14 years) and a further presentation was made to him in recognition of the excellent work he had ~one f?r !he class during the past ten years. Mr. Francis, 10 ~estlfymg to Mr. Cowdrey's abilities, stated the prospenty of the class depended upon their Secretary. He then called upon Mr. Richards to make the presentation. Mr. Richards eulogised the good work done by Mr. Cowdrey, and then handed him a barometer suitably inscribed. Mr. F. A. Trott expressed thanks to Mr. W. H. Hayne for presiding, which was accorded with much enthusiasm.

Mr. J. G. Taylor, mana~er of the Houg-hton Main Colliery, speaking at the annual dinner of the Wombwell Divisioll, S .}. A. B., said that in a mine an ambu lance worker might be regarded as ranking second in importance to the manager.

The Post Office and North End Division of the Bournemouth Corps held their tenth annual suppe r and social recently. Div. Supt. Biles stated that 1,205 public duties had been attended and 170 cases treated. Dr. Witham pres~nted trophies anct awards,

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Police Ambulance News. NATIONAL

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COMPETITION.

During- January eliminating tests were held in nine districts; the winners to compete in ~he final for the "Pim" trophy and olher prizes to be held on February 24Lh, at the Central Hall, \Vestminster, London. Some surprise rE'suhs were to be found, among- them being the holders (Brighton Police) being narrowly beaten by Kent County Constabulary, and also there are some previous holders missing. Liverpool, owing to A. R. P. work, were unable to enter. The District competitions resulted as follows : No. 1 DJSTRrcT.-Preston Borou~h with 248 points gained first place a,-d were awarded the "Molley" cup. Manchester City "B' were second, seven points behind, and became the holders of the" ]\lajor Cran "shield. The Right Worshipful the Mayor of Preston (Alderman W. E. Morris, ]. P . ) presented the trophies. Chief Constable E. E. Holmes (Blackpool) was the com petition secretary. No. 2 DtSTRlcT.-Held at York, on January 24th. Chief Const~ bit! Harry H. Hl:'rman, O. B. E., competition secretary. Durham County with 305t points gained first place, followed by Scarborough, 267~; East Riding-, 25 7l Ten teams competed, the judges being Dr. W . Anderson and W. J. G. Modlin. No.3 DISTRlcT.-Yorks West Riding- "C" will represent this District, having gained first place at the competition held at Doncaster, on January 26th. The judg-es were Dr. J. J. Huey, of l\lexborough, and Dr. J. K. A. Beverley, of Worsborough Dale, whilst Chief Constable J. Clayton, of Doncaster, was the competition secretary. The question given to teams in this District was : -

(a) \,-Vhat are causes of unconsciousness? Aroplexy 1 Epilepsy 1 Concussion 1 Compression 1 Opium and other poisons 1 Drunkenness... 1 Sunstroke 1 Starvation 1 Syncope-shock t Collapse t Faint 1 Any cause of asphyxia ... 1 Diseases 1 (b) What may be learned from an examination of the pupils? Degree of unconsciousness 2 Compression or apoplexy 2 Opium poison 2 Deliriant narcotic poison 2 20 No.4 DrsTRlcT.-Fourteen teams competed on January 19th before Dr. F. H. Edwards, of Shrewsbury, and Dr. D. W. A. Bull, of Stony Stratford. Chief Constable Jas. N. Campbell (Dudley) was the competition secretary, and the result was a win for the Birmingham No. 1 team (263) followed by Coventry (244) and Wolverhampton (238). No.1 had tlte following individual test ; Card.-This man has fa llen heavily on his back from the top of a truck laden with hay. He is conscious. Examine him and repo rt your diagnosis. Time allowed, 6 minutes. Warn him to lie still Has he pain in his back (yes) .. ,

FIR S T Anywht're else (bac.k of head) ... Examination of head for wounds (nil) " fractures (nil) " " " " bruises (yes, back of head) Examination of face (pale) Examination of pulse (rapid) ... Examination of upper limbs (normal) ... Examination of back (pain in lower dorsal region) Examination of abdomen (no sensation) Exam ination of lower limbs : Can he move them (no) Has he sensation in them (no)... Right lower limb : Femur, patella, tibia alld fibula, foot (normal) Left lower limb :Femur, patella, tibia and fibula, foot (normal) .. . Diai-{nosis (1) FracLured spine in lower dorsal region.. . (2) Bruise at back of head ... ...

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Except in inlernal injury ... Avoid alcohol... '" ... (3) Examine for and treat all injuries, avoiding unnecessary handling in regions of injuries

30 . . No.7 DlS:fRIcT.- Three teams competed in this elimmatm g competition held at Exeter on January 23rd. Plym outh City Police were successful, followed by Dorset County and Exeter City.

No.8 DIsTRlcT.-Held at Barry, Breconshirt! Police with gained first place and the "Devereux" challenge cup. Glamorgan No.1 and No.2 were second and third respectively. S!r Willi.am Jenkins, M. P., J. P., (Chairman, Glamorgan Standing JOint Committee), presented the trophy. Chief Cons~able Joseph J ones (Glamor~an) presided over the functIOn.

246i points of 4

3 1

30 No.5 DISTRlcT.-Great Yarmouth will again represent this district. At the competition held on January 31st, at Norwich, Lt.-Col. M. MacEwan, D.F.C., T.O., M.B., gave a very interesting and also a very appropriate team test. It concerned a man who had been injured in a house in a flooded area. The patient was found lying in two inches of water and teams were informed that the water was risin g one inch every five minutes. On examination the patient was found to have a compound fracture of the right tibia and fibula with arterial hremorrhage. After ten "m inutes the teams were inform(~d that •• There is a strong smell of gas present. " Chief Constable B. W. Smith (Great Yarmouth) was the competition secretary. No.6 DrsTRlcT.-To Kent County Constabulary goes the honour of putting out the ,. Pim" trophy hold ers, Brighton Borou~'h Police. This tbey did on January 26th, when eleven teams presented themselves at Brighton bdore Dr. R. B. Duncan (team) and Dr. R. V. Steel (individual). West Sussex, who represented this district for many years, being third. Chief Constable Alfred S. Beesley, of Folkestone, was the competition secretary. The question given to No.5-to be answered in four minutes-was : Card.-Wbat are the objects of the treatment of shock? Give also details of treatment. Objects. (1) To promote warmth of the body (2) To e ncourage a better circulation (3) To keep patient's mind and body at rest Treatment. (a) Immediate 1 (1) Arrest severe h remo rrhage if present. .. 3 (2) Lay patient on his back on a rug 1 Steady and support injured part 2 Place head low and turned to one side 1 (3) Loosen clothing about neck, chest and waist 1 ~4) Prevent ag-gravation of any injuries by temporary measures 2 (5) Cover well with rugs or coats 1 (6) Raise well lower limbs 1 (7) Smelling salts to nose except in head injury 2 (8) Encouraging- words 1 (9) Ensure freedom from excitement and worry 1 (10) Do not discuss patient's condition 1 (11) Remove patient to shelter 2 (b) On arrival at shelter (1) Wrap in blankets, apply hot water bottles to sides of body, between legs and to feet 2 (2) If able to swallow, hot strong lea or coffee with . ugar

No.9 DISTRICT. -As announced last month two prelimininary eliminating co ntests were held and the twelve leadin g teams, six in each heat, contested the final eliminating-, held on January 24th, the City of London being the hosts. T~e judges were Dr. M. M. Scott (team) and Capt. A. C. White Kn.ox, l\1. C: .. M. B. (individual) and, as may be ex~ected, some lOtere~l.tng tests were set. Chief Inspector Fnth was the competition secretary and Inspector Mumford (City) acted on his behalf when absent. For the second time since the inauguration of the " Pim" trophy this District will be presented by a City Police team, as City" A " team gained first place and the "Sir Hugh Turnbull" cup. "V" and "G" Divisions (Mets.) were second and third respectively. l\Jr George Abbiss (Asst. Commissioner, Met.) presented the trophy and wished the team success in the final. He hoped the" Pim " trophy would find a home in London. Sir Hugh Turnbull (Commissioner, City Police) presided, and those present included Sir Percival Wilkinson (Secretary-General of the Order of St. John), Mr. D. G. Monteith (Competition Secretary, S.J.A.A.), Capt. W. Goodley (Commissioner, S.J.A. 8.), Dr. Gibson (City Police), Dr. Isaac Jones (Chief Physician, Mets.) and many senior officers to the Di visions competing. The teams, therefore, to fight out tbe final will be Preston Boroug-h, Durham COUllty, Yorks \Nest Ridin g" C," Birmingham No.1, Great Yarmouth, Kent County, Plymouth City Police, Breconshire and City of London. The judges in the final will be Dr. G. D. Tullis, of Hereford, and Dr. A. :\1. Pollock, of Tunbridge Wells.

METROPOLITAN. The annual competition for the" Dalton-l\latthew " cup, open to teams in " l\1 " Division, was held on January 30th, when seven teams competed. The judges were Capt. A. C. vVhite Knox, l\1.C., M. B. (team). and Mr. G. E. Craft, of F1RST AID (individual) ; the compel ition secretary heing Sergt. Berry. Very interestin~ tests were given. In the team test competitors had to treat a man who had been stabbed in the armpit and also received a fractured leg. The arterial hremorrhage gave trouble to some and much time was wasted on this condition. The individual tests included a dislocated arm \",ith burns on leg and burst varicose vein with simple fracture of fib 'Jla. Supt. Brig-gs presided at the function and welcomed Chief Constahle Dalton, M. B. E., and Commar,dant Matthews (donors of the cup), Deruty Asst. Commissioner Archer, O.B.E., Chief Constable Sprulls, M.8.E., Chi~f

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208

Inspector Frith, D eputy Commandant-in-Chief Mr. Ritchie, Dr. M. M. Scott and others; A team from every station had entered and also one from the Special C..mstabulary. Supt. Big~s extended tha~~s to the judges, patients and stewards and thanked the vIsitors for their su pport. Capt. White Knox con~ratulated all team leaders, who were as good as any he had yet judged in the Nat.io.nal Competition. He emphasised the importance of not glvmg to bystanders a serious part of the test, such as pressure on the subclavian artery. Mr. Craft also congratulated the competitors. He stressed the point that in dual practical tests both competi~ors must work together and not just one with the other lookmg on. The result was 1, Kennington-road, not; 2, Deptford, 210 ; 3, Specials, 204t. . COI~mandant Matthews presented the trophy and paId tribute to the fact that Supt. Briggs had allowed one of his National team members to train the Specials. He thanked Mr. Ritchie for his presence which gave great encouragemt:nt to his men who had done well. Mr. Dalton congratulated Mr. Brig~s on the entry of seven teams. He referred to 6rst aid parties under A. R. P. and the importance of all police officers to be efficient in first aid. Mr. Ritchie also spoke.

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FIRST

S.J.A. B. Overseas. SOUTH

NORWOOD AND ST. PETERS DIVISION.-SUPt. Moores, presiding' at the annual gent::ral meeting and reviewing the year's work, expressed his appreciation and congratulated officers, N. C. O. 's, men and cadets on the efficient man'1er in which they carried out their work. He was extremely pleased at the financial position; the buildin!{ fund was steadily increasing, but he appeal<!d to members to augment same with a view to building a first aid station. l<.eference was made to the efficient manner in which the treasurer, Amb. Officer S. C. Nation, kept his books. The personnel was now 43 uniformed members and 12 uniformed cadets. Supt. Moores asked all members to use their influence to increase the numbers. Presentations were made to each of the caretakers at Norwood and St. Peters and Supt. Moores, in asking each to accept a shaving set, expressed the members' appreciation and thanks for their co-operation. .supt. Moores also extended thanks and appreciation to members of the Ladies' Committee and to the Norwood and St. Peters Councils for their great assistance. WESTERN

CITY

OF BIRMINGHAM SPECIAL CONSTABULARY.

Five teams competed for the" Proctor" Challenge Cup, which was won by "A" Division with 169t points. "B" Division (165k) and "0" Division (154) were second and third respectively. The cup and medal3 were presented to the winning team, and medals to the runners-up, by the Lord Mayor, Alderman J. Crump, at the Special Constabulary Conversazoine held in the Town Hall on Friday, January 6th. On Sunday, January 15th, after the "B" Division drill parade, the Chief Constable, Mr. C. C. H. Moriarty, presented the Divisional Ambulance Challenge Cup and prizes to the successful competitors: S. L. "B" 70 A. \\T. Moppett, 6rst prize and replica of cup; S. L. "B" 43 C. H. Gray, second prize; S.c. "B" 156 R. A. Shaw, third prize. A special prize for the best performance of members who had never won a prize in a competition was presented to S.C. T. VV. Sweetzer. A gift was also made to the patient, S. L. "B" 227 J. W. Taylor. The Chief Constable congratulated the prize-winners and spoke of the efficiency of "B" Division in first aid and A. R . P. He also congnl.tu\ated the division on having- the very valuahle services of Sub-Commander H. Bannister and Section Leader E . G. Marsh as instructors. Commander S. C. Taunton, M B. E., thanked Mr. Moriarty for presenting the prizes, and said it gave great encouragement to the Division to have his attendance at such functions . The fifth annual meeting of the Kidderminster Division, S.lA. B., was held last month. The number of cases treated was 157. ;I

•

AUSTRALIA.

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BIG BELL DIVISION. - In our November, 1938, issue we referred to the trials which members of Brigade Overseas are sometimes faced. This has caused Supt. E. J. Ryan to write giving particulars of his Division. The Big Bell Division, typical of many divisions in Western Australia, is situated some 500 miles from Brigade Headquarters, consequently too far for the Commissioner to travel to inspect. The nearest doctor is at Cue, 20 miles away. The Division is naturally regarded as a necessity to the lifeofthecommunity and the calls made on the Division's services are many. One such instance happened recently. A man employed at the Big Bell Mines fell into a shute 50 feet deep and became practically buried in the ore ""aiting to be let down the ore pass. Only one arm and the bloodstained face of the man was visible and for over three hours the first aid squad and miners laboured to release the mar. but without avail. Finally he was sa\'ed by being precipitated down the ore pass with tons of stone and dirt. Willing hands cau~ht the patient as he hurtled downwards and on being conveyed to the service post received attention from St. John members. After which he was rushed to hospital. The Murchl'son Times reporting the event stated: "The valiant efforts of Supt. E. J. Ryan and the members of the Brigade who joined in the work of rescue, and the unremitting labours of the men on shift at the time, are regarc.led as examples of heroism by mine officials and others. " Supt. Ryan who was at one time a member of the B.A.T. and Kirkdale Cadet Division, No. 4 L'lIlcashire District, S.lA. B . , and later a member of the 27th West Lancs Detachment, B. R.C.S., would like to hear from members of the Brigade At-Home. His address is Ambulance Department, Big Bell Mines, Ltd., Big Bell, Western Australia, and any letters would be appreciated not only by Mr. Ryan but also by the members of his Division.

The Earl of Dudley presided at the annual meeting of the Birmingham County Centre of the St. John Ambulance Association. During last year 119 classes were held and 2,851 stLldents sLlccessful,

AID

The annual competition for the" Burton" Shield of the Wolverhampton and District Corps was held on January 29th when Wolverhampton Division gained first place followed by Thompson Bros., Bilston and Wednesfield .

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FIRST

2 ro

Our Nurses' Pages. :g

COMPILED

It is announced that Her Majesty the Queen, Commandant-in-Chief of the Nursing- Corps and Nursing Divisions of the St. John Ambulance Brigade, has graciously sent a donation to the funds of the Nursing Divisions. No.1 DISTRICT, S.lA.B. EASTERN AREA. -A course of instruction for women on First Aid to the Injured has been arranged by No. 27 (West Ham) Nursing- Division, to be held at Whitehall-place School (ground floor), Infants' Dept., Forest Gate, E. 7, on Tuesdays from February 21st, 7 tv 9.30 p. m. There will be about six lectures by Dr. F. M. Hogg. Fee for the course, including the examination for the S.J.A.A. certificate, 3/6d. Application for enrolment should be made to Lady Div. Supt. MISS Strathern, 10, Claremontroad, E.7. No.2 DISTRICT, S.J.A.B. Mrs . E. L. Battye, of Salisbury, formerly Lady Div. Superintendent of Salisbury Nursing Division, has been appointed Lady County Officer for Wiltshire. Mrs. Battye was instrumental in forming the Salisbury Nursing Division, and was its first Superintendent. Previously she had served as a staff officer in Northern India. Among her many dutif's she will make connections with the existing- Nursing Divisions in the County, and assist in the formation of new ones. Mrs. Battye is succeeded as Superintendf'nt of the Salisbury Nursin~ Division by Mrs. E. G. Audla>1d, who has, in turn, been succeeded as Lady Ambulance Officer by Miss Barclay. No.3 DISTRICT (EASTERN), S.J.A.B. PETERBOROUGH NURSING CORPs.-At a dance organised by this Corps, held on Monday, January 30tll, Lady Corps Supt. Mrs. Milton was presented with a grandmother clock on her retirement after 25 years' service in the Brigade. Mrs. Holmes, who presided at the presentation, thanked all present for attending, particularly the Mayor, who had so many engagements. She said that in contrast to the prizes to be awarded for playing games during the evening-, Mrs. Mil,ton was to receive a Ie prize" for 25 years of hard work, which had always been done devotedly and loyally. In her uphill task, Mrs. Milton had broug-ht the Peterborough Corps to seven Divisions with 112 memhers. Mrs. J. E. S. Perkins, who was predecessor to Mrs. Milton, was then asked to make the presentation. She said that Mr.s. Milton fully deserved all the kind things that had been said of her. Mrs. Milton thanked everyone for their beautiful g-ift. As she watched the hours go by she would think of the pleasant times they had had together. Mrs. Milton was accorded musical honours, and given three hearty cheers. Dr. W ..Peach Hay then announced that he was Roing to make a gift to every lady (at which someone remarked that that would be very expensive). Mr. Peach Hay assured the interrupter that there was no need to worry as he was a Scotsman! He was presenting to Mrs. Holmes, as repre-

•

FIRST

AID

AMBULANCE SISTER.

senting the Nursing Division,· a silver rose bowl for team competition in first aid. \VELLlNGBOROUGH NURSING DrvIsIONs.-Resig-nations of three officers of the Welling-borough Nursing Divisions have led to a number of changes and promotions. Lady Corps Supt. Miss A. Smith has resigned the position after 37 years' service; Lady Div. Supt. Miss 1. Page, Headquarters Division, has been transferred to Reserve; and Lady Ambulance Officer Miss Bland, Headquarters, has also resigned. Lady Div. Supt. Mrs. A. S. Campbell, Victoria Nursing Division, has been appointed Lady Corps Supt. to succeed Miss Smith; Lady Ambulance Officer Miss A. M. Rowlatt, Victoria Nursing Division, has been appointed Lady Div. Supt. in charge of that Division; and Lady Alnbulance Officer Mrs. Olive Adams, Victoria Nursing Division, has been appointed Lady Div. Supt., and transferred to Headquarters Nursing Division, in charge. The officers affected by these promotions are original members of the Victoria Nursing Division, which was formed in 1919. Mrs. Campbell became Lady Ambulance Officer, and succeeded Mrs. Pickerin~ as Lady Div. Supt. when that lady left the town in 1923. She has been connected with a number of charitable organisations, and is a member of the Wellingborough Cotta~t: Hospital Manrlgement Committee. For some years she served on the old Board of Guardians. Miss Rowlatt was appointed Lady Ambulance OFficer in 1923. and has taken great interest in competition work. In 1933 the Victoria N using Divi=iion team achieved the distinction of winning the "Perrott" shield under her leadership. A great honour was accorded the winning- team by Lady District Supt. Mrs. Harvey Reeves, who presented a shielJ to be held by the winners of the District competitions, in memory of her husband who was the District: Commissioner. The iIlustration on the shield was a copy of a photograph of the Victoria Nursing Division's team at work. Mrs. Adams was a member of the team under Miss Rowlatt. She was appointed Lady Ambulance Officer in 1935, herself taklnR the leadership of the Divisional team in competitions. In addition she has done considerable voluntary nursing work, and is one of the secretaries of the Welling-borough Clinic of the Manfield Orthopaedic Hospital. All three ladies hold t he Service Medal of the Brigade. Miss Smith was one of the founders of the I (")cal Nursing Divisions. joining the Brigade in 1901. In 1906 she took charge of the Headquarters Nursing DiVIsion. When Voluntary Aid Detachments were formed she became a member. and during- the Great War was Commandant of the V. A. D. Hospital at Wellingborough. In 1911 she was on duty at the Coronation of King George V., and was awarded the Coronation Medal. In 1921 Miss Smith was awarded a Vellum Vote of Thanks and the Service Medal, and further honour was accorded her when, in 1928. she was admitted as a Serving Sister of the Order of St. John. Her appointment as Lady Corps Supt. WaS made in 1928,

AID

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ST. MARYLEBONE OPEN FIRST AID COMPETITION. The Second Annual Competition will be held at The Portman Rooms, Baker Street, W.I, on THURSDAY, MARCH 30th, 1939. Open to All Teams of Men in the City of London, Metropolitan Police and No. 1 District S.d.A.B. Areas.

Entries Close on March 1st, 1939. TROPHIES TO BE COMPETED FOR: CHAMPIONSHIP AWARD "STILES ALLEN" CHALLENGE TROPHY. (Presented by Alderm an R. Stiles Allen . D.L.. J.P.) RUNNERS UP AWARD "SELFRIDGE" CHALLENGE SHIELD. (Presented by Sel ridge & Co. Ltd .• London .) BEST TEAM LEADER "FIRST AID" CHALLENGE CUP. (Presented by the Publishers of "FIRST AID" Journal.)

Entry Forms and Full Particulars from

Mr. W. V. M. ALLEN, Honorary Secretary, Western District Post Office, W.I.

Home study is the short cut to experience and success and an expert knowledge of Swedigh Ma~s~ge and Anatomy can lead to cnnge " ial occupation of usefulness and untold value to your Firsl Aid unit. Tht' scope and prospects for th e Train ed Masseur in con· neclion with his or her work for First Aid, or in a pri\ate capacity, is considerably enlarged-Ductors, Nur!-ing Homes, lI ydros , Sports and Athlelic Clubs, are consrantl y in need of Iheir services. Spare Time or whole Time Occupation

You can make Massage a ~pare time or who e tim" o,cupa· tion and remember that wi th the SMAE Ins itutc you ha\'e nothing to lo;;e as it guarantees to coa ch you until successful at theeximination and your Diploma secured or returns your ree~ in full. Write for this Booklet without delay-it; will be sent free

This BuoK williell you hllW )OU can commence your tralD ing in c:,wedish M~ssage in your home wilhout interfering With your present Occupd.tion and huw you can ~ta rt a private practice nf ynur own. Write to the Secretary. 50. SMAE Institute. Leatherhead. Surrey (or this Free Book" MAn ipulltive Therapy as a P' ofession." which will be sent free and post free and which involves you in no.obligation whatsoever.

212

FIRST

Miss Page's connection with the Brivade dates from 1903, but three years later she took up training to become a qualified nurse. During the War she assisted at the Welling-borough V. A. D. Hospital. Later she re-joined the Brigade as Nursing- Officer in Headquarters Nursing Division, becoming Lady Div. Supt. in 1928. Miss Page is a founder-member of the College of Nursing, and was one of the founders of the Wellingborough Infant Welfare Clinic. She is also vice-chairman of the Wellingborough Nursing Association, and has spent much time in giving- lectures for the S.].A.A. on home nursing. Mrs. Bland joined the Headgnarters Nursing- Division in 1914, and throug-huut the War took dUlY at the V.A. D. Hospital. In 1927 she became Lady Am bulance Officer, receiving the Service Medal in 1930. In 1934 her work was recognised and she was admitted as a Serving Sister of the Order of St. John. No.

-j. DISTRI CT, S.J.A.B. Teams from towns in Lancashire, Cheshire, Cumberland and Westmorland took part in the annual competitions for Nursing Divisions, held at Blackburn on January 28th. The" Colonel Trimble" Shield for team work was won by Blackpool, with Birkenhead second and Liverpool North third. The "Haworth" Rose Bowl for individual work was won by Birkenllead, Kendal were second, and Ashton-underLyne third. The "Officers' Peace Trophy" went to Mrs. D. Williams of Birkenhead, with Miss B. Hall, Blackpool, second, and Miss E. Harrison, Preston Cadets, third. Birkenhead are to be congratulated on having carried off three of the trophies, although they were not successful in securing the main one. Mrs. Aitken of Blackburn presented the trophies, Mr. W. G. Smith, O.B.E., County Commissioner, presiding for this part of the proceedings. The judges were Assistant Commissioner Dr. R. Clegg, Nelson, Corps Surgeon Dr. R. J. Clarke, Div. Surgeon Dr. ~1ulholland, and Lady Div. Surgeon Dr. E. Cunliffe.

LIVERPOOL NURSING DIVISION.-This Division held a very enjoyable and successful dance in aid of Divisional Funds on January 28th. During the evening, Mr. VV. J. Grace, President of the Ambulance Corps, on behalf of the Nursing Division thanked those present for their support, also the band, and the energetic M.C., Ambulance Officer A. Gourley. Mrs. Grace, Vice-President of the Liverpool Exchange Nursing Division, presented spot waltz prizes, and also Grade II A. R. P. Certificates to A.S. I. M. Williams, C. Isherwood and A. Seddon. She was thanked by Lady Corps Officer Miss Bellasis for doing so. Among those present were Corps Supt. F. Williams and Mrs. Williams, and Supt. A. Hignett. Light refreshments were served by the Entertainments Committee, and vocal items were rendered durin..,. an interval in the dancing by Miss Blodwen Williams, A.L.C.M. Little Gwen Hughes entertained with imper"onations and dancing. PRESTON CORPS.-The Annual General Meeting of the Nursin~ Divisions of this Corps was hdd on January 31st. Mrs. H. Riddeli, Div. President, who presided, congratulated the members on the awards gained, and stressed th~ need for continued enthusiasm, particularly as the BrigAde was recognised as an important part of National Service. The Annual Report was read by Miss K. W. Turnbull, Lady Corps Secretary. A year of satisfactory work and frogress had been completed. The total number enrolled

AID uuring 1938 was 178, and each Division had held not less than 38 drills, which had been well attended. The work of the members had been carried out with efficiency. Since the National Crisis, several officers and members had given their services as instructors and assistants to the classes formed for training recruits to the casualty services in Preston and district. A satisfactory financial statement was presented by the treasurer. Awards were presented by Mrs. T. II. C. Derham. These included Officers' Warrants to Div. Surgeon G. F. A. McLean, Lady Amb. Officer Miss F. Fielding, and Lady Cadet Officer Miss H. Barton j also Medallions, A. R. P. Certi ficates and Vouchers. In the absence of Dr. Sharpe, M. O. H. for Preston, Dr. H. RidJell distributed A.R.P. Badges. Lady Corps Supt. Miss Moore thanked the members for their services, and Mrs. Moore proposed a vote of thanks to 1\1 rs. Riddell and Mrs. Derham.

FIRST

WIMBORNE V.A.D., B.R.C.S. An inspection of V. A. D. Dorset 48 was held in the Drill Hall, Wimborne, on January 21st, by Lt.-Col. R. F. Woodward, County Director, who was accompanied by Mrs. Woodward and Miss Beausire. The latter inspected uniforms. Demonstrations in first aid, home nursing and gas drill were given, and a small display was arranged illustrating hygiene and sanitation. Several tests to teams of three members were set by Mrs. \Voodward and Miss Beausire, the examiners giving useful hi[lts on competition work Lt.-Col. Woodward addressed the members, and then presented service medals and bars, and certi ficates and badges to those who had won them. During the past three months the detachment has put in over 200 hours work in Wimborne Cottage Hospital.

2 13

~-----EVERYTHING-------.

you need to know about Health & First Aid THE HOUSEHOLD PHYSICIAN describes in simple language with helpful coloured plates and diagrams

The COMPLAINTS OF MEN, WOMEN AND CHILDREN,

No.6 DISTRI CT, S.j.A.B. BEVERLEY NURSING DIVISION.-The first annual g-eneral meeting of this Division ~ as held on January 17th. Miss Barra::, Lady County Officer, attended, and the chair was taken by Div. Supt. Miss Plimpton. The Divisiun was formed in February, 1938, and now has a membership of 21. Fifty-four certificates have been gained during the year, including A. R. P. Certificates, and 93 public duties have been performed. This Division, all of whose members are now in uniform, atlended the annual inspection at Hull last June, and were complimented on their smart appearance. V. A. D. MIDDLESEX 4-1-, B. R. C. S. 1\1rs. Harvey, now resident in Southgate, London, was an ambulance driver in Serbia during the last war, serving with the Scottish Women's Hospitals. On January 26th she told, and illustrated, her experiences at a meeting organised by V.A. D. Middlesex 44 in connection with the Area's A. R. P. scheme. Miss Cooper, introducing Miss Harvey and Miss Marks (who operated the lantern), said that both ladies had been ambulance drivers in Serbia and were decorated for their services by the Serbs and by tbe late King George V. She added that Miss Harvey was also mentioned in despatches, and had promised to help with the formation of the Southgate Ambulance Unit. Miss Harvey's talk was informative and graphic, her pictures illustrating the trying and dangerous work which the women ambulance drivers bad to do-coaxing old type Fords up and down a mountainside on a road or track little more than car-width, with sheer drops only a matter of feet away. She also told her audience a good deal of Serbian history.

AID

Their with

Cause, Treatment

complete

instructions

and Cure on First Aid.

The 500 illustrations and full-page Plates and the Anatomical Models showing the Organs of the Human Body exactly as they overlay each other makes the reading matter more easily understood.

ACCIDENTS A few of the Subjects tlgeated:

First Aid, How to Treat Accidents Influenza,Colds,etc. Measles, Mumps Treating Diseases by VV ater H Herb" Root and Salt Remedies Corns and Warts Dieting for Disease Treatments for Beauty Physical Culture Exercises for all Purposes What to Do in Emergencies Treatment for a" Skin Diseases The Lungs, Pleurisy Hygiene, Anatomy, Pharmacy The Principles of Nursing Brain and Nervous Diseases Diseases of Old Age Diseases of Infancy The Principles of Phrenology Diseases of Hair and Head Sleep, Beds and Bedding The " Eye, the Ear The Throat, the Nose The Chest, the Heart The Stomach, the Liver The Teeth, the Muscles I nfant Welfare The Expectant Mo,ther Homrepathy, Neurasthenia Family Medicine Chest 375 Prescriptions, etc., etc.

vI/hat

case

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Bodily Injury, Burns and Scalds, Clothing Alight. Foreign Bodies in Eyes, Ears, Nose, Throat. Machinery Accidents, Electricity Accidents. Drowning, Suffocation, Bleeding, Poison, ~ro~en Bones, Fractures, Dislocations, Sprains, Fainting, Concussion, Etc.

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FIRST

~14

BATTERSEA AND CLAPHAM

DIVISION,

B. R. C. S.

The Annual General Meeting- was held at Battersea on January 23rd. The chair was taken by Miss M. E. Paton, O. B. E ., Vice-Chairman and Vice-President, in the unavoidable ahsence of the Rev. thtl Hon. St. Maur Forester. The annual rerort g-ave a record of thE many activities of the m embers of the Division, including attendance at the dispensary in the Kent hop gardens, first aid duties at sports, Ralas, etc., conducting- instructional courses for junior org-anisations, and g'iving- courses of lectures to the local Women's Auxiliary Fire Brig-ade and the Women's Auxiliary Service. Very great use had been made of the services of members as instructors in practical first aid. The "Swallow" Challeng-e Cup for the detachment enrollin~ the g-reatest number of recruits during- the year had been won by V.A. D . London 65. with 28. The runnersup were V.A. D. London 122, with 1R. The chairman, vice-chairman, secretary, treasurer and auditor were all cordially thanked for their services, and unanimously re-elected.

------ .--.------

A.R.P. Topics. H.E. BOMBS. The question of protection against Incendiary and H.E. Bombs is to be included in future A.R.P. Instructors' Courses. We understand that all instructors who have attended the Home Office schools and local gas schools will be given fresh instructions. To assist readers whose job it is, or will be, to instruct wardens and others, we have pu blished in booklet form notes of a lecture given by Mr. F. Wrigglesworth (C.A.G.S. Special). These notes include description, action, scale of attack, powers of penetration, precautions and control of incendiary bom bs; types, destructi ve effects and structural protection of l:igh explosive bombs, and is published at 3d. post free for single copies. and special prices for quantities. We feel that these notes will be of the greatest value to all who wish to keep abreast with A. R. P. matters. They will also be a valuble adjunct to "Gas-a synopsis of defence against," by Dr. J. Fenton. INCENDIARY AND

RECENT GOVERNMENT PUBLICATIONS.

On January 26th three A.R.P. circulars were published, one dealing with" Organisation of Air Raid General Precautions" (2~d. post free), another on "Air Raid General Precautions in Rural Areas" (1 ~d. post free), and the third "Courses of Instruction in First Aid" (2td. post free). The first two do not concern us as first aiders, but it is well to keep in touch with the frequent changes which are now taking place in the proposed protection of the civilian population in times of war. The third circular, however, IS definitely in our province.

F IR ST

AID A full course of first aid will be required by (1) all personnel of First Aid Posts. including personnel employed in cleansing duties, but excluding storekeepers, telephonists and domestic staff ; (2) all personnel of Fir~t Aid Parties; (3) Ambulance attendants. It is not proposed to introduce a new manual, but to recognise the full course o~ the St. John Ambulance Association, the British Red Cross Society, and the St. Andrew's Ambulance Association. A short course will be required by the following classes of volunteers: (1) Personnel of First Aid Posts who are not required to take the full course; (3) All Air Raid Wardens; (3) Ambulance Drivers; (4) Members of other A.R.P. services who are considered to require a knowledge of first aid. The M.O. H. will be responsible for organising classes for both courses, but whilst in the full course an examination to obtain the certificate of the first aid organisation concerned is necessary, it is not proposed to hold an examination at the conclusion of the short course. The short course will be of four sessions, each consisting of a lecture followed by practical work. Each session will be approximately of one hour's duration. A syllabus for the short course is included in the circular, together with a schedule showing which portions of existing first aid textbooks (St. John, B.R.C.S., St. Andrew's) are dealt with. A new booklet on training is "Training of Air Raid Wardens" (2!d. post free). This contains particulars of individual and collective training. The first is divided into eleven headings, such as local A. R. P. organisation, relations with police and public, fitting and distribution of respirators, warning, protection against H.E. bombs, methods of dealing with incendiary born bs, A.F.S. organisation, damage to water, etc., mains and sewers, warden's post equipment and first aid. Collective trai n i ng incl udes worki ng of a post, reporting, incidents, and action after a raid. ~

•

DESIGNATION OF INSTRUCTORS.

In view of the extended courses of training now being introduced at Home Office Schools at Falfield and Easingwold, students passing through these schools, and the local instructors who are giving the extended training, will, we are in formed, be known as I nstructors (A. R. P. s.) and (L.A. R. P.) respectively. thus doing away with "C.A.G.S." and "L.A.G.S." E xis tin g C.A.G.S. and L.A.G.S. instructors will be given the opportunity of qualifying for the new titles.

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FIRST

216

FIRST

AID As you rightly state, the abdominal wound is the more serious injury and demands priority in treatment. In these circumstances no harm can result to the fracture if you quickly control the broken leg- with splints and bandages and then support the lower limbs, flexed at the knees, upon a box or other similar object.-N. C. F .

which has stood the test . for over 25 years.

TREATMENT OF H EATSTROKE OR SUNSTROKE.

DOES NOT STAIN, BURN OR IRRITATE AND IS NON-POISONOUS.

G.C. (St. Pancras).-Under the treatment of Heatstroke or Sunstroke the Revised Textbook tells us to give the patient, when conscious, a tablespoonful of Epsom Salts or Glauber Salts and also to give him drinks of cold water freely. I take it that the former is given to lower the body tem perature and the latter to relieve thirst. Please tell me if I am correct. A full dose of Salts is given for the purpose of causing free purgation and cons~quent reduction of congestion of brain and spinal cord, while, as you rightly state, free administration of small quantities of cold water at frequent intervals will alleviate the patient's thirst. - N.C.F.

No fault can be found with your captain's decision and action. The fractured spine is the more serious injury and demands priority in treatment. Consequently, the instructions of the Textbook with reference to the fractured patella must be modified lest the injury to the spine be aggravated. In other words, the lower limbs must not be raised. When, however, the patient has been placed on the stretcher, you may raise the foot of the stretcher as part of your treatmenl for shock.-N. CORBET FLETCHER.

ACUTE ALCOHOLlSilJ AND FRACTURE OF

RIBS.

c. W. (Westbury).-While trying to arrange some tests for practice one evening I thought of one something like this ; Supposing a man, having consumed an excessive amount of alcohol, after leaving the inn staggered into the road, was knocked by a car and sustained COL11plicated fractures of the 7th and 8th ribs, I imagine that he would develop into collapse very quickly. I put forward this opinion bearing in mind the effects of a hypnotic poison on the nervous system and also of the complicated fractures of the ribs, which WJuid produce s igns and symptoms of internal hremorrhage. 1 should be very interested to know what signs and symptoms this condition would produce before collapse set in and if the treatment of collapse was successful, what treatIllent would be best to follow for both. Thanking you and looking forward to your reply . A<; acute alcoholism is liable to be complicated by collapse, it is clear that in your supposed case the signs and symptoms would be those associated with this condition-as the result of the alcoholism, the accident and the complicated fractures of ribs. If, therefore, you had to treat such a patient, you would have to concentrate on the treatment of s hock and collapse as laid down in the Textbook.-N.C.F.

PLAINTS OF A COMPETITOR.

M. R. (Cannon-st. ).-During a recent examination I asked a candidate to tell me the threF. varieties of insensibility; and I was profoundly amused when she answered"Sleep, Stupor and Death I "

F. D. (Leicester).-I am enclusing a copy of the marking sheet used in a recent competition and I shall be much obliged if you will give me your criticism as we are not satisfied with the judging. In the first place you will see that we were told by the Judge that there were no signs of fractures. Yet we were expected to diagnose fractures in the lower limbs; and marks awarded for same. In the second place, we were required to make the diagnosis of insensibility as being due to a fractured base of skull. Yet the history and the signs and symploms do not coinciJe. For example, on questioning the Jud ge as to whether or not there was blood issuin g frolll the nose the answer was" no." Then after a while I was told that blood was being brought up in masses. I again repeated my question regarding blood from nose but was still answered in the negative.

Next, please! !-N.C.F.

WOUND OF ABDOMINAL WALL AND FRACTURED LEG. E.A. (Lancing).-A point has arisen with regard to a case of a wound of the abdominal wall with bowel protusion accompanied by a fracture of the leg. The discussion in this case was as to whether or not the treatment of the leg. could be modified to allow for the flexing of the lower lImbs to ease the tension on the musr:les ot the abdomen, in view of the fact that the abominal injury is the more serious.

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FRACTURES OF SPINE AND · PATELLA. E.A. (Lancing).-In the chapter on "Shock" the Textbook, in Rule 6, states, " Raise well the 10wF.r limbs." Also it says that in cases of fractured patella the injured limb should be raised. Recently, in training, we were given a team test in which the patient was supposed to be suffering from a fracture of the spine and was unconscious. He also had a simple fracture of the patella. After the patient had been placed on the stretcher in the face-upwards position , our captain did not raise the lower limbs either for the treatment of shock or for the fractured patella, fearing aggravation of the fractured spine. It was, however. appreciated that shock must be very great in a fractured spine. After the test a discussion took place as to whether or · not the patient's lower limbs should have been raised. As opinion was divided in our team on this point, your valued authority would be greatly appreciated.

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FIRST

21-8

So how could the blood have got to sloma-ch, which was not injured, except by swallowing? In pointing out to the Judge, when he gave his adjudication, that the signs of fractured base of skull we not present he referred me to page 70 of the Textbook which says :-" Blood or fluid may issue from the ear channel, escape from the nose, or it may pass down to stomach." So his argument was that, if these things may happen, it was also likely they may not happen, which in our opinion was not a fair test. Your complaints are not upheld; and, in my opini on, the decisions of the Judge were perfectly correct. When you take charge of a parient, it is quite possible that the signs and symptoms of fractures would not be apparent. Neverthdess, it is your duty as a first aider carefully to examine the patient, especially when he is unconscious and consequently cannot tell you about his pains which are the best guides to local injuries. In this way you may discover unexpected injuries. Further, I note that the marking sheet does not specify any de.finite fractures but only several possibilities which you ought to have eliminated by examination. With referen ce to your second point, you forget that with fractured base of the skull there may be no external escape of blood from the nose and that, as in your test, blood may be passing freely down into the stomach.-N.C.F.

HUMOUR IN

FIRST

AID.

0.5. (East London). -A 6rst aider was asked to treat a nervo us patient who was suffering much discomfort from particles of dust in his eye. Before, however, he had touched the eye, the patient let out a yell. "I have not touched you!" protested the first aider. " You have," came the repl y, "and you aTe still standing on my corn'!" Good!

Next, please! !-\'.C. F.

FRACTURED THIGH IN

PHONE PATIENT.

H. P. (Bristol). - Will you please tell me what is the correct treatment ~or a patient. who is found lying on his face and suffenng from Simple fracture of femur and supposing that there is plenty of h elp available? In a rec~nt competition some teams strapped feet, knees and thighs and turned patient on his back before applying splint and bandages, whereas others tied only the feet togeth~r. One team, however, applied the splint and ban.dag-es 111 correct order before turning the patient on to .hl.s back and placin g him on the stretcher. In my.oPlI110n this was a mistake, because the leg was out of lme as the toes in this way of treatment kept the front leg bone in the air. ,

The first method appeals to me as most likely to , prevent aggravation of the injury" (Textbook p. 15) and consequ~ntly the one which should be adopted by first aiders. In.CldentaIly, th~ugh I might suspect a fracture of the f~mur I~ a pr~ne patIent, I would not like to make a positive dla~l:osls untIl after I had examined him in a recumhent posltlOn. - N . C. F.

TREATMENT OF DOG-BITE.

G.C. (St, Pancras).-In a recent team test we had to treat a man ,:,ho, during a fight in the street with another man, was bitten in the right leg by a dog. We were told that both men had been drinking heavily of spirits. We sent for a doctor who was not available for half an hour. So we administered treatment on general lines

FIRST

AID as laid down in the Textbook but withheld brandy on the grounds that the patient had had enough already. Was I correct in withholding- the brandy and should I have given hot coffee in place of brandy provided that the patient was conscious? Your kind ruling- will be much appreciated. You acted wisely in \Vithholdin~ the brandy because the T ext book does not advise administration of brandy in the treatment of wounds even when the result of do.u--bite unless th e dog is known to be suffering from rabies. As your card of instruction did not state that this was the case, you hac1 a lucky escape! Incidentally I have ere this set such a problem in competition and caught out some expert teams! Supposing, howe ve r, that the d og had been declared rabid, then I agree with you that such a patient had had enough brandy and that "anotller little drop would not do lIluclz good. " - N . C. F.

\\'. S. (West Bromwich).-A point was raised among my colleagues concerning the turning of the patient's head to one side during- insensibility. The query is, would it do more harm than good to turn the head (having diagnosed a fracture) and risk injury to the brain, or let the head remain and risk him choking? My view is that a fracture affecting the brain orthe the spinal. c?rd, would cause paralysis in the reg-ions below the lI1Jury, and that the head will automaticallv fall to one side. . ~o possible

injury can be caused by ge ntly turning to one Side the hea d of an unconscious patient suffering- from fractured base of the skull. Indeed, if you do not do so, then, as you state, the patient may run the l-isk of beingchoked. . . Also, there is no justification for your theory that with bra111 and spinal cord injuries the head automatically falls to one side. -VVere that so, the Textbook would not be so insistent on the rule to turn the patient's head to one side.N .C.F. INSENSIBILITY D URING TREATj\'I ENT

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. The rules concerning the transport of cases of fn_ctured spme, seem. to me to have been drafted on the understanding that 11rst al~ers may r~a~onably have difficulty in diagnosing the actual sIte of the lI1Jury. In the circumstances named by you, however, the diagnosis is definitely established. Conseque~tly, the fact that the patient loses consciousness be~o~e belI1g loaded on the stretcher should not, in my Op1l1lOn, .affect the treatlllent and the patient should be removed m the face-downwards position. - N.C.F.

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W.J. (Ho.rsha.m).~As. difficu.lty has arisen in practice, resultmg 111 dl verslO n of vIews on the following subject of method of carrying with fractured spine, we should greatly value your ruling on this point. The. instructions in the Textbook are, to carry in the (supIne) face upwards position, if patient is unconscious, or if situation of injury is not clearlv defined. If, on. arrival, the patient was conscious and was clearly suffenng from fracture of spine in the lumbar reo-ion and if before loadin g , the patient became unconscious: should he be carried face upwards or face downwards (prone) position, in view of th e fact that the situation of the injury h tl d already been clearly defined?

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NOTICE

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MARCH, 1939.

TO READERS.

OF THI S NUMBER.

E DITORIAL ;-

Whither Bound? St Andrew's Ambulance Association T he Revised Textbook- What it Means to First Aiders S.J.A. B. Headquarters and District Reports Priory for Wales Durham, Cleveland and Westmorland Districts Ambulance League The Hospitallers' Club... Railway Ambulance News Hospital, Nursing, etc., Exhibition Police Ambulance News St. Marylebone Open First Aid Competition Our Nu rses' Pages A.R.P. Topics Coming Events

cal pro, ession ana 1_ _ _ _ _ _ __ membe1's oj the medi· to nurses and hospital ollicials wh.o enclose the i r projessional ca,ds.

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Treatment of Fractu red Kneecap Examination Howler Special Bandage for Fractured Forearm Treatment of Fractu red Leg Fractu red Spine and Delayed Insensibility Humo ur in First Aid Simple Fracture of Clavicle and H u merus Hot Water Bottles with Fractured Ribs Bu rst Varicose Vein a nd Fractured Patella Artificial Resp iration for Infan t P atient

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EDITORIAL.

FIRST A ID is published on the 2 0th of eac h month . Th e Annual SUbscription is 3S. 6 d . post free; , ingle 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 12th of each month, and must be accompanied (not necessarily jor 1!Ublication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communicltions connected with FIRST AID should be forwarded to the Publishers. D.\LE, REYNOLDS & Co., LTD., 46, CANNON STREET, LONDON, E. C.4. Tel/graphic Address-' , Twentv-/our, London. " Tellphone-City 37IO.

CONTENTS

BOVE are the three septics. This is apprereasons whyGermo- ciated most in dealin g lene Ointment has been with children. Ma n y medical authoriunive rsally accepted as the finest skin h ealer ties use and recomme nd Germole ne Ointme ntobtainable. Its unique ( Aseptic' actio n offers coun tless ho mes have benefited by its effecyou the undoubted adtiveness . A t rial tin vantage of PAIN- FREE will conV I nce healing - doing away with the FREE you. Take fl dTh.e manufacturers van tage of our smarting associ~ will be de<ighted to a trial sample, ated with Anti- und offer N O'V ! free of charge, to

~e )nb~pmhtnf Journal for

241244 244 24-1 2-+6 2-+6 2-+6 2-+6 246 .246

year 1938 saw Boroughs using increasing numbers of BOUND? the St. John Ambulance Brigade for teaching volunteers In the First Aid Party Schemes. In numerou s instances the Boroughs have been very appreciative of the work done, but in many other cases the attitude has savoured of the ordering about of paid servants; and a good many members have, to say the least, felt a little sore about it. The demand for skilled instructors has denuded many divisions of the very peopl e who should be working in their own units to raise th e efficiency of their members. Now it would seem that, in the L.C.C. area at least, according to a recent memo, Di vision s are reg uired to take over the continued trainin g of First Aid Party Volunteers and be responsible for seeing that they put in 12 hours practi ce per year. The grant which is given for such classes covers but little of the extra expenses incurred , and this at a time when already divisions are find ing it hard to meet increased expenditure. Officers-in- Charge will have extra work thrown on them. They will be required to supply records sheets of attendances and training and other information, required not by his own officers but by a new officer who is to be Commandant in charge of all First Aid Parties, including the St. John Ambulance Brigade units. I n other words the Brigade is to be handed over to an organisation whom they do not kno w and who does not know them! Have the Senior Officers of the Brigade suddenly become inefficient? Is the organisation failing? \Vere the Senior Officers approached to ascertain whether they would be able to carryon the work of the Brigade in an emergency? I n the L. C. C. area the Sen ior Officers are all TH E

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war-time officers of experience and one would have thought that they would wish to contribute their little bit again if the necessity arose. However, it may be the offer of pay that holds them back. Having been voluntary workers for so many years the idea of being a paid Commandant does not appeal to their Brigade principles. Voluntary organisations can do much-they have done much-but there comes a time when surely they are asked to do too much. Pin pricks become nasty sores in time and can eventually become almost unbearable. Time marches on !

St. Andrew's Ambulance Association. BEITH.-Members of the Beith Co-operative ambulance class and friends met at Harriers' Hall for the annual social. Mr. Philip Douglas, manager, Beith Co-operative Society, presided, supported by Mrs. Douglas, Commandant 1<. Nicholson and Mrs. Nicholson, Dr. McLauchlan and others. To show his practical interest in the activities of the sick-nursing class, Mr. Douglas offered three prizes for first year students. Mrs. Nicholson presented class awards whilst Mr. Nicholson, on behalf of the members, asked Dr. McLauchlin to accept an attache case. Dr. McLauchlin had rendered g-reat service not only to the class but to the community of Beith. After an excellent repast dancing was continued till a late hour. The "Cowan" Cup, competed for annually by teams in the Western District of Scotland, was held at Glasgow, on March 4th. Twenty-two teams entered, the winners being Motherwell L. M. S. No.1, who secured 272 marks out of a possible 300. Bridgton L.M.S. were second (265l) and Queen Street Station, third (253t). Col. D. J. Mackintosh, Chairman of the Council, S.A.A.A., presided, and the prizes were distributed by Lady Helen Wilson. The arbiters were Dr. R. G. H. Cunningham (general knowledge). Dr. A. M. M'Clure (practical) and Dr. Thomas F. Greenhill (transport).

---.--.-----Owing to the Easter Holidays will readers please note to send in reports as early as possible for the April issue. CONGRATULATIONS.-We extend hearty congratulations to Colonel Charles Joseph Trimble, C. B., C. M. G., V. D., T. D., L. R.C. P., who celebrated his 83rd birthday on March 16th. Colonel" Paddy" Trimble, the" Grand Old Man of First Aid," is now Inspecting Officer on the Chief Commissioner's staff of the St. John Ambulance Brigade, but for many years he was Comm issioner of the No. 4 District. Long may he live to set an example of voluntary service to mankind.

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The Revised Textbook-- What it Means to First Aiders.* By N. CORBET FLETCHER, M.A., M.B., M.R.C.S. THE title of my talk to you this evening is the choice of your Committee, and it is my privilege, as on several previous occasions, to carry out their request and to consider the Revised Edition of F£1~st At'd to the Injured from the point of view of first aiders. HISTORICAL NOTES. Before doing so, I would remind you that the Textbook is the first of the modern manuals devoted to instruction in first aid and that it was first published in 1878. After the death of Cantlie, chance brought me into contact with Dr. Mitchell Bruce, a well known physician, from whom I learned that Dr. Peter Shepherd, just before his departure to South Africa on active service, left the rough notes of his projected textbook with Drs. Mitchell Bruce and Cantlie (who lived together at that time) and asked them to polish them up for publication. In this way I discovered the identities of the "kind and able coadjutors" to whom Shepherd refers in his preface to the original issue. In 18~0 the first Textbook Revision Committee was established under Dr. Robert Bruce, concerning whom the records are otherwise silent; and it has been practically in perpetual session down to the present day. In 1917 tradition was broken by the appointment of a layman as Chairman of this Committee in the person of \Villiam Rea Edwards to whom-instruction in first aid apart-the Association and Brigade owed much of their early success. Whether or no a layman should be Chairman of such a body is a matter of opinion about which most of you know my views. WHAT THE REVISED TEXTBOOK MEANS TO FIRST AlDERS. When I considered the problem which your Committee set me, I came to the conclusion that the Revised Textbook means much to students of first aid in the following three ways :-1 st. Increased Instructz'on. Students are faced with a wider range of instruction, since there is more matter to be learned as is shown by an increase of :30 pages (and of 14 diagrams) in the body of the Textbook. 2nd. Alte1'ed Instruct£on. Students will have the difficult task of forgetting many of the old instructions and of learning new methods, *A lecture given to members of the Hospitallers' Club on February 10th, at the Bonnington Hotel.

FIRST since the Revision Committee has sought to bring the Textbook up to date with modern methods of treatment and thereby earn our cordial thanks. Incidentally, the 39th Edition is remarkable in that the names of two great pioneers now disappear from its pages-'--:'namely that of (Sir) James Cantlie who coverted a heterogenous collection of facts and instructions into the science of first aid and that of (Sir) John Furley who invented many appliances and wrote the first set of drill instructions for ambulance purposes. Jrd. Improved InstructtOns. During the past few years the emergency treatment of certain injuries and conditions has been under consideration and much discussion has arisen. The net result is an improvement in instruction notably with reference to the treatment of burns, scalds and spinal injuries. Again, X-ray pictures and actual photographs now figure in the Textbook; and these are beyond doubt a real help to students. The Principles now recognise that in all cases provision of medical assistance and treatment of shock are essential. Lastly, the Revision Committee has joined hands with the Royal Life Saving Society and now teaches the method of artificial respiration which Professor Schafer himself approved in 1931 and which differs in certain particulars from that originally suggested by him in 1903. CRITICISM OF REVISED TEXTBOOK. Your Committee further asked for a frank criticism of the Revised Textbook. At the outset, therefore, and without hesitation I tell you that, in my opinion, the Textbook, as it was the first, is still the best of all the other official and non-official manuals of first aid. It teaches first aid and first aid only. Further, the scheme issued by Cantlie has been extended; and first aiders are taught to apply the General Rules in accordance with Principles by the exercise of certain Qualifications. How Ie r s are conspicuous by their absence, although some of you will remember the 32nd Edition (1917) in which, immediately after publication, I tabulated a long list of howlers, the result being that a pam phlet correcting most of these errors was forthwith issued and a new (35th) Edition was published two years later. At the same time, I note in places a lack of precision, the term" arm" being too often used when" upper limb" is more correct and" wrist" when "lower end of forearm at wrist" is more exact anatomically. Also, I consider that with two inj uries the Textbook exceeds the needs of first aid, namely fracture of forearm and fracture of patella, for the control of which fantastic figureof-eight bandages are now deemed essential! Finally, I regret that the opportunity was not taken to show the link between the sympathetic and the cerebro-spinal nervous systems, the result

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being that first aiders are still taught that there are two systems of nerves whereas these are parts of the Cen tral Nervous System. CHIEF CHANGES IN REVISED TEXTBOOK. Now as to the chief changes which must be noted and studied : Chapter I.-I note with pleasure that first aid is at last recognised as a special science which must be studied alike by surgeon-lecturers and lay persons and that it is no longer described as "a branch of practical medicine and surgery." At the same time I regret the lengthy definition which figures in the Textbook; and I prefer to teach that first aid is the immediate temporary and efficient assistance rendered by trained lay persons in cases of accident and sudden illness. Chapter II.- The Principles have been increased to the hateful num ber of 13 by the addition of one dealing with fractures, this having previously been included under" Rest." Also we have the welcome general instructions about doctor and shock to which J have already referred. Lastly, we must still turn to Principle No.9 to find out the objects of treatment of poisoning by the mouth. ChaPte1~ IV.- This excellent Chapter on Shock would be improved by additional sub-headings which constitute a praiseworthy feature elsewhere in the Textbook and are so helpful to earnest students of first aid. Candidq.tes in competition, if asked to specify a definition of Shock, the causes of its aggravation, its signs and symptoms, its objects of treatment, and its treatment on the spot and after removal of patient to shel ter, will be tempted to send indignant letters to FIRST AID about the unfair questions set by the judge; and yet these are the five sections dealt with in detail in the Chapter. Chapter v.- This Chapter now contains a useful description of dry and wet dressings. Incidentally, I do not know how a hot compress is to be wrung dry unless we exercise our nursing knowledge and enclose it in a wringer of suitable material. To me this fact is a further reason why members of Ambulance Divisions should be encouraged to take their home-nursing certificates.

(To be concluded.)

------.--.-----The annual dinner and dance of the Bullcroft Main Corps, S.]. A. B., was held on February 18th. Corps Supt. J. Le Brun presided.

Kidderminster won the Worcester County S.lA. B. "Lewis Trevis" Cup Competition held at vVorcester on Saturday, Ft:bruary 11 tho The judges were Drs. l\leikle and Scott of Malvern.

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St. John Ambulance Brigade Headquarters and District Reports. Brigade Headquarters BRIGADE FINAL CO:\IPETITIONS.-The final competitions for the "Dewar/' "Perrott" and other trophies will be held on Friday, June 9th) at the Great Central Hotel, London. H.R.H., The Princess Alice, Countess of Athlone G.B.E., V.A., has graciously consented to present the trophies and prizes. A.R.P.-The Chief Commissioner, Sir John Duncan, has issued the following instructions:"All courses and examinations for Grade 1 Instructors Certificate) including externals, are suspended as from March 1st until further notice. The records at Headquarters show there are sufficient Instructors e.A.G. S., L.A.G.e., and Grade 1 belonging to the Brigade to meet its req uirem ents. " During the suspension only cases specially approved by me shall be permitted to sit for the Grade 1 examination, and then provided only the nominee is a member of the St. John Ambulance Brigade. I make this exception in order that new Divisions may obtain an Instructor if one is not available."

No. I (Prince of Wales's) District SPECIAL NOTIcE.-The headquarters of the No. 1 District are now situate at 97, St. John Street, Clerkenwell, E.e.1, and all correspondence should be addressed there and not to Briset Street. The 50th anniversary concert of the No.2 Haggerston Division was held last month. The Mayor of Shored itch (Alderman J. Abrahams, J.P.) presented awards and congratulated the division on the fine achieve ments, long history and record as pioneers of the movement. He specially thanked them for the splendid work the members did in the crisis last September and for the lead they were giving in A.R.P. Services. Staff Sergeant Jaggers (officer-in-charge) said the history of the division went back to 1885-1886 when thc ?r~g~nal members met for the purpose of first aid before Jommg the Brigade in 1889. Members had served with dis tinction in the South African war and the Great war. .. 1.'he n~w headql;larters of the No. 16 (New Cross) DIVISIOn wIll be offi1clally opened on Sunday, April 2nd. The No. 27C Mitcham Cadet Division will be holding

tl'~c annual competition for the" J. M. Davies ') Invitation

CHallenge Cup o~ Saturday, ~pril 22nd at the Wesleyan Church Hall, FaIr Green, MItcham, commencing at 3.30 p.m. Cadet lea.n~s wishing to enter should send applications to the competItIOn secretary at 59, Steers Mead, Lavender Avenue, Mitcham.

The No. 1 District Final Competition will be held on Saturday, April 22nd) at the Northampton Institute, Clerkenwell. The No. 64 (Kent ish Town) Division are holding a grand carnival dance in aid of divisional funds, on Saturday, April 6th, at Chester Road, L.e.e. Schools) N.19.

No. ill District. NORTHAMPTON.-The annual report for 1938 of the Northampton Corps (includ·i ng the Invalid Transport) which consists of divisions at Brackley, Daventry, Earls Barton, Towcester, Weedon, Northampton Headquarters and Northampton Kingsley Park Club) was submitted on February 10th and it is satisfying to record an all-round increase in membership, the total of officers and men being 267 an increase of 48 over the previous year. During the twelve months over 3,500 cases were treated by the Headquarters Division. The ambulances at Northampton} Daventry and To\\,cester carried 2,672 cases, attended 244 accidents and travelled 22,099 miles this being an increase of 67 cases, 13 accidents and 2,609 miles over the previous year. Removals included those to mal1Y d·i stant towns. On May 2nd, 1938, the Northampton Town Council passed a resolution commending the members of the St. John Ambulance Brigade for their diligent and courageous conduct in rendering assistance at a Fatal Sewer Accident in Countess Road, Northampton on March 3rd; whilst the Board of Management of the Northampton General Hospital expressed their grateful thanks for the very kind and courteous way the work of the removal 0 r patients in and out of the Hospital had been carried out. During the year a number of other letters of apprc-ciatioll had been receiyed. During February the "Wilkinson" Cup CompetitIon of the Northampton Headquarters Division for individual efficiency was held. The competition is in two parts: on the fi.rst evening every competitor had to answer eight questIOns on paper. The eight men gaining the highest number of marks then compete in an individual practical test. Div. Surgeon H. Maguire set and judged the competition. For the third year in succession the cup was won by CorpI. H. York, followed by Pte. F. Shortland, Ptes. G. Clue and R. Tarry tied for third place. Supt. H. 1. Edwards stressed the importance of every member striving to keep up an high standard of individual efficiency which was more necessary to-clay than ever ;n the history of the Brigade. . Corps SU,Pt. E. Edwards presented the Cup and prizes, comphment111g the men on the high number of marks gained.

w,.

WELLINGBOROUGI-l.-Supt. J. Steer Parker presided at

the annual meeting of the Wellingborough Headquarter Division supported by Div. Surgeon A. e. R. Walton, Amb. Offi~ers G. e. Pow,is and H. H. Barlow, Corps Sergt.-MaJor J. W. FranCJ.s (treasurer) and niv. Secretary J. Earby. The Secretary reported that morc commodious premises had been acquired owing to increased membership. The division had fulfilled with competency the various duties. Special reference was made to the splendid work of CorpI. T. H. Roberts and Pte. S. Jennings on the occasion of the tannery disaster when they upheld the good name of the Order of St. John. In the "Dewar" Shield Competition the division again reached the final round and the team was wished good luck this year. Owing to the Crisis and A.R.P. work other competitions were unfortunately abandoned. Sergt. W. J. L. Gotch (Transport Officer) gave a detailed account of department concerned. He thanked the members for their co-operation and also the members of the Nursing Division and the Auxiliary drivers. Supt. Parker, referring to the accounts, pointed out the policy of the division was, and always would be, to

AID also have been the epitome of the movement in the whole of the North-East of Lancashire because Nelson's eXI?erience represented very closely what all the other unIts had done. ~ome of the oldest units of the Brigade were to be found 111 North-East Lancashire, most of them dated from aro~nd about 1887, and they were still working as hard and domg as much good as they ever did. A toast to the Lady District Superintendent, Mrs. E. A. TweedaIc, C.B.E., A.R.R.e., J.P., was proposed by Lady Supt. Mrs. Sutcliffe, of Toclmorden, who said that no one was held in higher respect. Mrs. !weedaJe said she was proud of her women, not only 111 the North-East Lancashire but throughout the county. Asst. Commis<.;i0ner W. G. Pape (Chief Commissioner's Staff) brought greetings from Sir John Duncan. Proposing a toast to the visitors, Asst. Commissioner Dr. R. Clegg, who has been associated with ambulance work for 45 years, spoke of a class at Burnley Grammar School in 1882-83. The headmaster, Mr. J. Langfield Ward, who lived until he was 94, was the secretary. The Duke of Buccleuch was president of the Burnley Centre

South A~rican Re-union at Nelson, Lancashire. Seated at the table: Assl. Chief Commissioner Col. G. A. Moore, Asst. Commissioner Dr. R. Clegg, Col. C. J. Trimble (Chief Commissioner's Staff), Asst. Commissioner W. H. Gasta!!. convey patients as required because the patient was essenti ally the first consideration and not whether the chargcwould be met. The question of the celebration of the Division's J ubilee was discussed and various suggestions put for ward which were left for the diyisi'0nal committee to consider.

No. IV District LANCASHIRE. On Saturday, February 4th, the dinner of the officers of the No.1 Area, No.4 (Lancashire) District, was held at Nelson. Mr. J. H . S. Aitken, e.A.) president of the Nelson Division, proposed a toast to County Commissioner W. G. Smith, O.B .E., and the Commissioner in reply said that the Lancashire District had been called-quite deservedly he thought-the cradle of the ambulance movement. A short time ago he received a souvenir handbook of the Nelson Centre which showed the growth of the movement in Nelson from 1888 onwards. He thought it might

for a year, and the second president, who had held the office for 54 years, was Lord Shuttleworth, now aged 94, Noone, therefore, who did ambulance work continuously need be afraid of dying young. The Bishop of Blackburn (Dr. P . M. Herbert) responded. An excellent entertainment followed the feast. Two bullet riddled flags that flew over a field hospital in the South African War were presented to the No.4 North-Western Area on Saturday, February 11th. They were brought from London by ~olonel G . 1>:. :Moore, e.M.G., D.S.O., M.D. (Assistant ChIef Commls.sIOner) and presented to members who served in the camp~lgn, at a reunion held in Nelson. The flags accompal11ed the 2nd Bearer Company, of which Col. Moo~e had charge at Bethlehem, South Africa. About elgl~ty men f~om Nelson, Colne) Barnoldswick, Shipley, Skipton, Accnngton, Fleetwood, Blackpool, Haslingden, Lytham St. Annes and Wigan were welcomed by Dr. R. Clegg, the Commandant, and they included some who had not seen each other since the Boer War. Councillor T. Walker, who proposed" The St. John

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Ambulance Brigade," said that if there were more ~nstitu tions like it there would be no more wars and nothmg but peace and friendship . Dr. Clegg in reply said that unfortunately the C()~nty Commissioner was unable to be present. He gave partIculars of the events which led up to the re-union and paid lribute to the work done by Corps Supt. Heap. Over a hundred letters had been sent out and whilst no doubt some had been 'Omitted as no records were to be found of the men who had served. He read a telegram from Lord Baden-Powell as follows: "Cordial -greetings and good wishes to ambulance veterans of South Africa. Cheerio. Old comrades never die." Corps Supt. Graham (Haslingden) proposed "The Guests." Col. Moore was no stranger to them whilst Col. Trimble required no introduction.

Al I)

AID Bronze Shield: 1) Hetton-Ie-Hole; 2, Murton. " Palme r " Trophy: 1, Hetton-Ie-Hole; 2, Dean and Chapter" A "; 3, Chestcr-Ie-Street. H Gibbon" Bowl: 1, Hought'o n-Ie-Spring; 2, Chilton Colliery; 3, Dean and Chapter" B." The final competition for the "Coroner Graham" Shield took place on Saturday, February 25th when, by a margin of 'One point, Cr-ockhall Colliery defeated the holders, Eppleton "D" Colliery. The complete placings were: I, Crockhall Colliery, 304 points; 2, Eppleton "D" Colliery, 303; 3, Le.L (Billingham) "B," 287; 4, Darlington Division, 284; 5, Harrington Colliery. Dr. J. Main Russell and Dr. K. M. MacDonald judged the team and individual tests respectively.

Cup and prize) Hon. Sergt W. Hooks, runner-up, Pte. L. Hedges; "Cadets" Cup, Cadet R. Harman; Cadet Competition Cup, Cadet D. Lemon; "Nurscs" Cup (presented by Dr. Harmens), Miss Franklyn, runner-up Miss Ellis. MAIDSTONE.-Corps Supt. H. Clinch reported at the annual meeting of the Maidstone and District Corps that the number 0'£ cases reported by the Transport Section was 5,012, made up as follows: Cases attended 75 . invalid removals, 4,534; road accidents, 285; 'othe; accidents, 118. Miss Vyvyan, a member o£ the Nursing Division had presented the Transport Section with a Novox resuscitator. In the near future it was hoped to replace one of their older ambulances with a new and up-to-date vehicle. Mrs. Bossom, wife of Mr. A. C. Bossom, M.P., President, presented awards including the "Monckton" Cup, for most points gained in Brigade competitions, Pte. Nicklin; " Deans" Shield, for boy cadets, Cadet Hanford' " Bossom" Shield,' Mrs. Webb; "Martin" Trophy, Cadet Lily Dadson.

No. IX Di strict

No. 1 Area, No. 4 (Lancashire) District Officers' Dinner. Seated: Commissioner W. G. Smith, Lady District Supt. Mrs. Tweedale, Asst. Commissioner Dr. R. Cleg-g, Bishop of Blackburn, Asst. Commissioner W. G. Pape (Chief Commissioner's Staff), Asst. Commissioner Major J. A. Mackenzie.

Col. Moore said it was splendid that so many men should turn up after 40 solid years. The work done by the " St. J ohners," all North of England men, under his command got a fine name for the movement. They were the pioneers in days when the movement had only been going a few years. " You did all you were called upon to do," continued Col. Moore, "and I have great pleasure in presenting to you these flags which flew over men like you in the South African campaign." Col. Trimble also replied. He was proud of the fact that of the 2,000 ambulance men who went to South Africa, 1,000 of them were from the No.4 District. He was wearing the Order of the C.M.G., but it was men like his hearers who got it for him and everyone of them deserved this medal instead of he.

No. VI District The Durham County Finals were held last month at Houghton-Ie-Spring with the following results : -

The trophy and medals were presented by the Mayor of Sunderland (Councillor Myers Wayman) who declared that the importance of ambulance work could not be overstressed. Altogether 22 teams took part in the competition proper, preliminary rounds being held in Sunderland, South Shields, Ferryhill, Darlington, and Consett areas.

No. VIII (Duke of Connaught's) District CHERTsEY.-Mrs. Harmens, wife of Dr. W . Harmens (Div. President) presented awards at a display given by members of the Chertsey and Addlestone Division. Those present included Dr. Harmens, Div. Surgeon J. D. Vaile, Div. Surgeon Crickmay, Supt. R. J. Gristock, Lady Supt. Mrs. Lamden, Capt. A. H. Brooks (A.R.P. Officer), Admiral H. Rodham and others. The awards in addition to certificates, etc., were: "Dr. Harmens'" Cup f.or general efficiency, Corp I. R. Balchin; runner-up Pte. J. Ayling; "Mrs. Gristock's"

CORNWALL. L1SKliARD.-Mr. F. Temple Roberts (President) presided at the annual meeting of the Liskeard Division, and congratulated the division on the magnificent work done during 1938, and also Looe on being raised to the status of a division. Supt. H. H. Wenmoth pointed out the need for a larger ambulance station as the present room was not big enough to accommodate those attending first aid and home nursing classes. During 1938 the division dealt with 282 removals (mileage 5,144), 27 road accidents (mileage 404) making a total of 309 patients and 5,548 miles. Lady Supt. Mrs. J. M. Thomas reported that members of the nursing division attended 29 public duties, 39 duties at the orthopaedic clinic and 57 attendances with the ambulance. Reports were presented by Transport Sergt. S. C. Sanders, Hon. Secretary C. Wainwright and Hon. Treasurer A. Hugh. Div. Surgeon B. B. Metcalfe thanked those who had gone out with the ambulance so frequently. Fractures had been efficien tly ,s plinted, haemorrhage attended to and sho'ck treated. On behalf of the members be expressed thanks to the Presidents (Mrs. Young and Mr. Roberts) and members of the Committee. DEVON. The following is the present composition of the Brigade in the North, East and Mid-Devon Area: County Staff-One County Commissioner, three Asst. Commissioners, three County Surgeons, one Lady County Superintendent, two County Officers, two Lady County Officers, one area Corps Offilcer and one County Sergeant Major. Divisional-Three Corps with eleven officers, 35 Ambulance Divisions wilh 99 officers and 811 other ranks, cleven Nursing Divisions with 36 officers and 223 other ranks, 16 Ambulance Cadet Divisions with 28 officers and 273 other ranks, 'six Nursing Cadet Divisions with six officers and 117 other ranks. There are altogether 71 units, with 180 officers and 1,424 other ranks. County Officel- David Jones, who is now 111 business

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in Paignton, has been transferred from the Merthyr Tydfil County to the Mid-Devon Area attached to the staff 0.£ ~ounty Commissioner H. ]. Vick. The County COllllmsslOner for Wales stated in a letter-" County Officer Jones rendered yeoman service to the Brigade in Wales and we shall deeply regret his leaving." . Asst. County Commissioner G. W. Hingston, of Palgnton, has been appointed Ambulance Officer for the Torbay A.R.P .. Area (T~rquay, Paignton and Brixham). Under the N atlOnal ServIce Scheme County Officer H. J. Vlck represents the St. John Ambulance Brigade on the County Committee, and Assistant Commissioner Hingston on the Torbay Area Advisory Committee. Dr. G: E. Sawd?n, Divisional Surgeon, Paignton, has been apPol11ted MedIcal Officer in charge of the Paignton First Aid Station. ILFRACOMBE.-Three features of the progress of the work of the I1fracombe (North Devon) Association and Brigade. emphasised at the annual general mecting were the effiCIency of the members of the Brigade, their keen interest in A.R.P. work, the enthusiasm of the Cadets, and the fine work done at Woollacombe First Aid Hut. It was reported that the members had done over 1,200 hours of duty in 1938. A happy co-operation existed between Not a single members of the Brigade and Red Cross. duty had been missed during the year. The Cadet Division was justifying its existence, with 15 boys in uniform and eight recruits. Miss Dean (Red Cross Society Commandant) reported that 473 cases were dealt with at Woollacombe. Dr. G. E. Sawdon (Paignton), Corps Offi·cer S. Leece (Teignmouth), and Supt. G. Passmore (Coombemartin), have attended the Home Office Anti Gas School at Falfield and have obtained their eA.G.s. certificates, thus bringing the total number of instructors in Devon who hold this certificate to six.

No. X District HATFIELD.-The annual meeting of the Hatfield Division was held last month. The Hon. Secretary (11r. S. W. Cull) said that personnel had increased by five and all members, with one exception, passed their re-examination. Twenty-three members held A.R.P. Certificates and three were Grade I instructors. The Division had done well in their work and during the crisis had assisted in assembling, fitting and demonstrating respirators for 228~ hours. The Nursing Division, begun in May, 1938, had received every assistance from members and the nurses had also been of great service to the division. Two teams were entered for the competitions held in October last and the first team retained the cup for the third year in succession. GORLESTON.-The annual dinner of the Gorleston Division, and Nursing Division B.R.eS., was held last month. Commandant Nlrs. A. S. K. Anderson, B.R.eS., presided supported by the Mayor and Mayoress of Gorlesto~ (Mr. and Mrs. A. "vV. Hollis,) Div. Surgeon Anderson, Dr. Buncombe, B.R.eS., Supt. R. e Hannant, Amb. Officer Burtenshaw and Diy. Secretary A. E. Long. After the dinner the company enjoyed games and dances to a late hour.

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Priory for Wales. In view of recent developments, A. R. P. training must now be considered to rank as a definite Brigade duty; and Officers in charge of Divisions have been reminded that anti-gas training must be included as part of their normal acti vi ties. The following table serves to show the ground still to be covered in this direction, while it speaks well for the pioneer A. R. P. Instructors of the Brigade who qualified to instruct at no little expenditure of effort and often money: A.R.P. AWARDS ISSUED IN WALES. 0 rade Centre.

Anglesey Brecknockshire Caernarvonshire Cardiganshire Carmarthenshire Denbighshire Flintshire Glamorgan : Aberavon Bridgend Caerphilly Gower L1antrisant Neath Pontardawe Pontypridd Merionethshire Monmouthshire :Bedwellty Gwent Trevethin Montgomeryshire Pembrokeshire Radnorshire Aberdare Cardiff l\1erthyr Newport Rhondda Swansea Total

Grade A R.P. Cerl s.

A.IZ.P. Vchrs.

G.P. GP. Certs. V cbrs

9 38 14 1 -13 19 2.f

2 15

10 222 21

36 31 1

68 75 20

24 20

162 9 11

18 58 27 9 8 37 12 6 8

13 42 42 2 6 19 6 31

85 162 177 31 25 178

35 352 20 1

42 41 16 3 27

16 26 17

81 197 129

1 7

38 33 26

111

920

33 64 9 9 60 68

27 14 16 12 59 9

201 191 106 41 256 88

6 39 16

182

16 17

122 62

703

451 2,534

3 1 19

69 17 23

225 15

193 2,345

PRIORY HEADQUARTER MEETINGS. Dr. D. Rocyn Jones, C. B. E., and Professor George Knox, M. 1.~. E., F. G. S., respectively, presidEd at the monthly meetlOgs of the Council and Ambulance Committee of the Priory for Wales, Order of St. John, held at Priory House on Thursday afternoon, February 28th. The formation of Pant Dowlais Ambulance Division (Merthyr Ty~fil Centre) and L1angenny Nursing Division (Bre~knockshlre Centre) was sanctioned and the respective appolOtments approved. The Committee received with regret the resignation of Mr. Lemuel Jones, the octogenarian Assistant CommiSSIOner ?f t~e Aberavon County Area, who felt himself unable to do J,;!st!ce to the increasing work at his advanced age. AppreCIatIve .refere.nces were made to his long and meritorious connectIon Wlt~ amb~lance work extending back to 1890. In connectIOn WIth the All-Wales Inspection by H.R.H.

the D uchess of Kent, at Cardiff Castle, on J u ly 1st, it was decided to arrange a meeting of Commissioners and Asst. Commissioners on March 28th. The programme fo r the visit of Her Royal Highness will include meeting of General Assemby, at which an Investiture of Members of the Order on the Roll of the Priory will be held, and an A. R. P. Demonstration, in which the Cardiff City Council is cooperating, prior to the Brigade Inspection. On the morning of July 1st, tht Sub-Prior, the Earl of Plymouth, P. C., will preside over meeting of Chapter. During the month of January, arrangements were made for 50 First Aid Classes to be examined. On the application of the Commissioner for Aberdare, Dr. J. P. Mu r phy, Surgeon to the Penrhiwceiber Colliery Division, was appointed an Honorary Life Member of the Priory in consideration of his gratuitous services as lecturer. In approving minutes of the Finance Committee, held on the 27th February, at which the Accounts for 1938 were approved, the Principal Secretary (the Hon. John H. Bruce, ] . P., D. L.) was congratulated on tht: considerable ·extension of activities reflected in the increased turnover. Members of the Chemical Warfare Protection SubCommittee, which met earlier in the afternoon, were addressed by Mr. R. 1. Hicks, A. R. P. Officer, Glamorgan County Council, who clarified certain points of misconception regarding the recruitment and tra;ning of the Casualty Services Personnel. He outlined proposals for securing closer co-operation throughout the county between the Local Authorities and the Voluntary Organisations as far as the Casualty Services are concerned and assured the Priory that the Glamorgan County Council was genuinely anxious to work in closest harmony in the matter of Air Raid Preca uti ons.

MONMOUTHSHIRE COMMISSIONER'S REPORT. Capt. S. T . Beard, O. B. E., Commissioner for the Monmouthshire Centre of the Priory, reports as under on the work of the past year ; The Ambu lance Halls at Pontnewynydd, Risca and Beaufort have been completed and opened, they are now being found of great benefit by the Divisions concerned. It is hoped to have an Ambulance Hall in the near future at Ebbw Vale, where it is greatly needed. Our work has been greatly retarded by the lack of Ambulance Halls, which with the added responsibility of A. R. P. become more of a necessity than ever. Our first County Cadet Competition was held at Blackwood, where the Ebbw Vale Cadet Ambulance Team succeeded in gaining first place; and together with the Pontnewynydd Cadet Nursing Team represented this Centre in the Priory for Wales Cadet Competitions at Cardiff in February. At the senior county competitions, held at Pontypool on March 26th, the Tredegar ambu lance team again attained the premier position. They competed in the Welsh Brig~de finals on April 9th, when second place was gained by thIS team and by the Pontnewynydd nursing team in the nursing final. ' During the year inspections have been held throughout the Centre at which the inspecting- officers have been invariably satisfied. The percentage of members on parade was very good; and with few exceptions all were in uniform which was in most cases in good condition. Units are t~

FIRS T be congratulated and especially those members who have taken a prominent part in raising the nece::.sary finances, on maintaning etliciency so well in such matters. Thanks are also due to the Commissioner tor \-Vales for g-rants which he has obtained for various units, grants which have been of great help and much appreciated. Thanks to the grant aid, our Medical Comforts Depots have been increased in number; and 'existing Depots have had their equipr:!ent augmented. I desire to place on record our appreciation of the good work of those members who devote so much of their time to enable these Depots to function. Splendid work is being done by the ambulance cars at Monmouth, Abergavenny and Usk. Members and others who by their efforts make this possible are deserving of great praise for their labours. Aid Raid Precautions continue to occupy a prominent place in our operations. Frequent classes are held in various pa rts of the County, a large number of our members have qualified as A. R. P. instructors, and approximately 25 per cent. of our adult members have obtained A. R. P. certificates. It is hoped the remainder will qualify as soon as possible. U nits are being gradually linked up with the Local Authorities, and members are undertaking to serve in those duties co nnected with A. R. P. for which they are so well qualified. I am afraid that it is not sufficiently realised by Authorities, that in our members they have a body of men and women ready trained for service. and that this has been accomplished by voluntary effort, the cost of this being subscribed by all ranks of society. I am very grateful to all those who have helped and supported me in this work, without such assistance the work in this Centre would not make the progress that it does, and I deeply appreciate their help. FORTHCOMING OPEN COMPETITIONS. The Abertillery Ambulance Competition Committee desires to announce to ambulance teams that the "Ince" S hield Competition, which has gained considerable popularity as an annual event, will take place as usual on Easter Monday, April 10th. Mr. Ivor Venn, 34, Vivian-street, Abertillery, will be glad to receive entries.

Durham. Cleve land and Westmorland Districts Aillbulance league. The final competitions were held at Durham on March 4th. Altogether 56 teams (27 senior, 29 junior) ent~red and the leading five in each section contested the final round. The judges were Dr. W. F. J. vVhitley, Newcastle, and Dr. J. Brown, Bedlington (seniors); Dr. D. F. O'Kelly, Boldon, and Dr. A. Woodward, Sunderland (juniors). Mr. W. J. Charlton, H. M. Inspector of Mines, Chairman of the League, presided. Mr. George Watkin, of Murton, the Secretary, announced the results : Senior Section: " Donald Bain " Shield and gold medals E ppleton. 230 points; "Committee" Cup, Dean and Chapter, 220; ., Heath" Cup (for stretcher work), Blackhall. Eppleton also won the" Dillon" Cup. Junior Section: "Elizabeth Bain" Shield and gold medals, Ushaw Moor, 253 points; "Donald Bain" Cup, North Skelton" G," 230. The latter trophy is a new one this year and was presented by Mr. Donald C. Bain, a g randson of the founder of the competitions. Sir Frank R. Simpson, of Wylam, presented the trophies a nd medals. After mentioning that he gained his first certificate in 1888, he con~ratulated all concerned on a good entry of teams and spoke of the immense value of a knowledge of bl-st aid. Thanks were expressed to the judges by Mr. W. B.

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229

Brown (Inspector of Mines), to the Chairman by Mr. D. R. Brooks, and to Mr. Watkin, the Secretary. Mr. Watkin has been the Secretary since 1922 and before that he was Class Secretary at Murton for 38 yearsa total of 56 years in ambulance work, which is a magnificent record.

The Hospit aller~'

Club. MR. G. c. GREEN (President) and Mrs. Green welcomed some 140 mem bers and guests at the 20th Annual Dinner held on February 18th. Captain W. Goodley, O.B.E., M.C. (Commissioner No.1 District S.J .A. B.), in proposing" The Hospitallers' Club," said the Club had been doing good work, which was most useful to the Brigade. Its objects were to promote and foster friend ship and hrotherhood. In an organisation like the St. John Ambulance Brigade, discipline could not be secured by fear of punishment but must be brought about by harmony, loyalty and aff~ction. He appreciated the work don e by the Club, and he wanted the brotherhood and friend ship of the Club to be radiated to members under their charge. 1\1r. Green, known to all present, was an example to all. Strictly and wholeheartedly he carried out the duties entrusted him, and never once had his loyalty and devotion to duty faltered. Mr. Green thanked Capt. Goodley for his expressions of appreciation and referred to the origin of the Club, which was first suggested by Mr. Liddell, an old member of the No.1 (St. John's Gate) Division. Mr. ]. Kemp (Vice-President) proposed "Our Guests," mentioning especially Brigadier W. B. O. Barne, C.B.E., D . S. O. (Secretary, Order of St. John), Capt. Goodley and Mrs. Goodley, Lady District Supt. Miss Walker and l\lrs. Green, the mother of the President. Brigadier Barne, in a few well chosen words, said it was a great pleasure and an honour to be present. The Brigade was one of the finest examples of Social Ser vice worked voluntary, and, on behalf of all guests, expressed thanks for the very excellent evening. Mr. Standingford, immediate Past President, proposed " The President." Mr. Green had a long association with ambulance work, having joined the Brigade in 1902 as a mem ber of the historical division of Ashford , Kent, OGe of the first divisions of the Brigade. After a short period in America, he returned to this country and became attached to the No. 1 District, and now occupied the position as Public Duty Officer. He had been a member of the Hospitallers' Club from its earliest years, and had certainly done a lot of good work for the Club. The speaker also referred to Mr. Gre~n's association with the St. !\lartin's Limbless Ex-Service Men's Pilgrimage, and concluded the toast by asking all to be upstanding and drink to the health of Mr. Green, and also Mrs. Green, who takes a great interest in the work. " If by my work in the Brigade and the Club I have been instrumental in helping onl" single person," said 1\1 r. Green in reply, "then it has been worth while." It was in 1898 that he took his first course in first aid, the fee being paid by his mother, and he was pleased that she was present to know what that expenditure had brought forth. He referred to his pleasant association with Mr. Standingford, for whom he deputised at last year's d.inner. . During the evening a splendid programme was ,gwen by various well-imown artists, and thanks were ex.tended to Mr. Stallard for arranging this part of the proceedIOgs.

FIRST

2jO

All)

-----------~~----------------------~.

~--~~----

R~iIway Ambulance News. Great We stern. WOMEN'S COMPETITION.-The second annual ambulance for women employees for the "Florence M. Lean" Cup will be held in the General Iv1eeting Room at PaddingtGn station on March 29th, when Dr. VV. J. Crawford of Southall will act as adjudicator. Mr. F. R. Potter, Supt. of the Line, will preside at the subsequ~nt presentation proceedings. 11r. Potter has recently gwen, on behalf of his wife, a silver cup for the runners-up in the Competition, to be known as the "Mabel A. Potter" Cup. GOWERTON.-The annual presentation of awards to members of the Gowerton Joint (G.W.R. and L.M.S.) ambulance class took place in the Rechabites Hall, Gowerton on February 1st. Mr. T. J. James, M.A., Headmaster of Gowerton County School, presided, and the presentations were made by Mr. H. Williams, Divisional Superintendent, and Mr. E. D. Jones, Commissioner for Carmarthenshire and Knight of Grace of the Order of St. John. In addition to examination awards, the presentations included gold efficiency medals and bars, and also examination awards to members of the Gowerton Division of the St. John Ambulance Brigade. HO~OlJRs.-In recognition of special services rendered in connection with the wreck of the ss. Alba at St. Ives on the night of January 31st, 1938, the Vellum Vote of Thanks of the Order of St. John has recently been awarded to the St. Ives Division of the St. John Ambulance Brigade. Included on the Vellum are the names of two of the Company's employees, ::\([r. E. E. George, Signalman, and Mr. P. N. Cortis, Lengthman, both of St. Ives.

LAl\IPETER.-Members of the Lampeter ambulance class held their annual dinner recently at the Black Lion Hotel, when ::\1r. H. C. Cooper, Station Master, presided. Among the guests were the Mayor and Mayoress of Lampeter, Alderman and Mrs. D . Edwards, Dr. and Mrs. A. Evans, and Mr. Alfred Evans of Aberystwyth. The presentations of class awards were made by Mr. Lloyd, Inspector, and tokens of appreciation were given during the evening to Dr. Evans and Mr. E . A. Rogers (class lecturer and secretary respectively on behalf of the class members. A presentation of a fountain pen was made to Mr. Aubrey Thomas, a member of the class now stationed at Lampeter. In making the presentation the Mayor paid tribute to his qualities as friend, former town councillor and as mayor of Lampeter.

ceremony and announced the result, which was: 1st, St. Albans, 204~; 2nd, Camden Goods A, 204; 3rd, Watford A, 155. Stoke won the" Holmes" Cup of the No . 10 District competition held at Newcastle, followed by Alsager, and Burton" c." Dr. P. Seager and D . A. P. Spark judged the tests. The South vVales District competitions were won by Hay and were awarded the" Ernest Goulborn" Shield. Blackwood No. 2 was second and Tredegar No . 2, third. Ten teams competed in the No. 10 District competitions, the three leading teams being Brighouse, gaining the "Carter" Shield, Mirfield No.1, and Huddersfield No. 1. Teams from Derby gained first, third and fourth places in the No . 12 District competitions. Derby C.M.E. Boiler team gained the "Duke of Portland" Challenge Shield follo\tved by Masboro' "A" and Derby C.M.E. " A" (last year's winners). Burton C. and W. department won the" Blakesley" Challenge Cup at the District competitions held at Coventry. Tamworth and Nuneaton "A" were second and third respectively. The" Dean" Shield competition was held at Blackburn on February 22nd, and was won by Accrington C. and W. department who retained the trophy. Accrington Loco were second and Blackburn Traffic No.1, third. The Division 1 competitions of Birmingham and District were held 'on February 27th when New Street Traffic gained first place followed by New Street Class No.1, and Saltley Traffic No. 1. LANCASTER.-The Carnforth team were successful in winning the ambulance cup for the second year in succession with Heysham "A" second and L ancaster (Castle), third. The Mayoress of Morecambe (Miss M. M. B. Williams) presented the t rophy.

London and North Eastern. london, Mid land and Scottish. The No. 1 Divisional competitions of D istrict No. 1 were held on February 14th, when Capt. A. C. W hite Knox (team) and Dr. Megaw (individual) judged the work of 14 teams. Mr. G. L. Darbyshire presided at the presentation

The first competItIon open to L.N.E.R. Police was held at King's Cross on Friday, February 17th. Capt. W. Goodley, O.B.E., M.C., judged the team test and Mr. F . W . Isern-Smith (District Officer S.J.A.B.) the individual section. A close contest resulted in a win for Parkston, w ho gained 254 marks. Bishopsgate were second w ith 247,

FIRST Grimsby Dock, third (176) and King's Cross fourth ( 174). At the conclusion of the competition Mr. R. R. Pettitt, Chi ef of Police, Southern A rea, presented the prizes. It is hoped that the inauguration uf this competItIOn will stimulate first aid among the officers and men of the police Force.

The Group competition, when the winning teams of the Great Central, Great Eastern, Great Northern and North Eastern Centres competitions compete for the honour ·o f representing the L. & N .E.R. in the InterRailway Competition, will be held on Wednesday, May 3rd. GREAT EASTERN CENTRE. Twenty-nine teams competed in the G.E. Centre preliminary competitions held at Stratford on February 28th, March 1st and 2nd. The judge was Captain F. E. Bendix, M.R.C.S., L.R.c.P ., and the seven teams to compete in the final competition are as follows: Bishopsgate "B," Parkeston "B," Parkeston "A," Stratford Printing Works, March "A," Cambridge, and Bishopsgate "A," who finished in. that order.

The final competition for the Challenge Cup will be held at the L. & N.E.R. (G.E.) Mechanic's Institute, Stratford, on Wednesday, March 29th, commencing at 12.30 p.m. Sir Gerald F. Talbot will present the trophies and prizes. GREAT NORTHERN CENTRE. The annual competition .of the No. 1 (London) District was held on Monday, March 6th, when the work of four teams was judged by Dr. J. Stanley Davies. Mr. H. W. Harvey, District Secretary, announced the result which was: 1, King's Cross Locomotive (Shed), 22H; 2, King's Cross Locomotive (Shop), 16H; 3, Tra.ffic Department, 152; 4, Stationery Stores, 133. Th~ W1l1nmg team has now been successful on four succeSSl"ve years and will represent the District in the G.N. Final competition. In the unavoidable absence of the Centre Secretary (Capt. W. Goodley), the silver bowl (presented by Mr. F. Liddell Steel f.ormer President of the Centre) was handed to the winning team by Mr. J . F. Sparke, District Locomotive Supt. Dr. Davies reviewed the work done and gave some practical and helpful advice. A vote of thanks was accorded the doctor on the proposition of M r. A. E. Brown (Secretary, No. 2 District) seconded by Mr. Atkinson, Chief of Homsey Locomotive Department. The W est Riding (No.6 District) competitions were held on February 28th when teams competed for the Officers' Shield "Cro~ther" and "Read" Cups. The judges were D'r. W. W . Ba1lardie (team) and Dr. H. Stansfield (individual). The r esult was: 1st, Ardcsley Loco, 165; 2nd, Dewsbury, 15n; 3rd, Lofthouse, 148; 4th, Bradford Goods, 126. The troph ies were presented by Mr. D .. C. .Fl etcher, Dist ri ct Loco . Su pt. Mr. W . E. Green, DIStflc t Sup t., was the Ch airman, and Mr. F. Longbottom, the Competition Secretary.

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23 1

Ardsley will represent Officers' Cup Competition.

this

District at the G.N.

The final competition of the G.N. Centre for the Officers' Challenge Cup will be held at Liverpool Street, on March 21st. Sir Ronald W. Matthews, President of the Centre, will p resent the cup and prizes.

L P. T. B. (Metropolitan). The annual competition for the Director's Shield was concluded on ::\larch 4th, when four teams competed at Baker Street Station. The judges were Capt. A. C. 'White Knox (team) and Capt. F. E. Bendix (individual, practical and viva voce), whilst the Competition Secretary was Mr. J. A. Gravestock. For the team test the bar of the dining club, in which the test took place, was utilised. The team were engaged in a darts match and a bystander commenced an argument with the bar attendant against the team's throwing until the attendant lost his temper and smashed a jug over his head. Injuries sustained were concussion developing into coma, wound on forehead with depressed fracture, fracture of right scapula, right lower ribs and left patella. The individual test was that of a patient suffering from internal haemorrhage and fractured right forearm; and the question" How would you treat a wound on the left leg which has been caused by a venomous snake." Mr. A. J. ·Webb, Chainnan of the Centre, presided at the presentation ceremony, supported by 11r. Evan Evans (President), Mr. F. 'vV. Wilkins (Vice-President), Mr. A. W. Mawby (Vice-Chairman), the judges and others. The judges in response to a vote of thanks spoke of the good work done by the teams and congratulated the members on their efforts. :;VIr. Webb announced the results which were: 1st, No.4 Team, 49.+ marks; 2nd, K o. 1 Team, 414; 3rd, No.2 Team, 360~; 4th, No.3 Team, 293-}. Individual: 1st, J. Warden; 2nd, ]. Mitchell; 3rd, F. Edwards. The winning team consisted of Messrs. G. ·Waldoch, R. Thurlow, R. Wilson, ]. Mitchell, F. Ed\\-ards. Mr. Evan Evans presented the awards and said he was greatly impressed by the realism displayed. The value of competitions were that they b~ought out shortcomings which could be overc.ome. I?unn.g last year m:er 240 first aid passes were obtal11ed, thIS bel11g nearly tWIce as many as the previous year. The Board greatly appreciated the work clone. He thanked Mr. Gravestock for the energy expended in arranging the competition. Mr. Gravestock said that thanks were due to the Officers and men for their co-operation and without them there would be no Corps or Centre. He thanked the President and other officials for their presence that afternoon.

M. & G. N. Joint. The annual competitions were held in the Lads' Cl~b, Norwich, on February 22nd, when Cap~. ~'. C. WhIte Knox, M.C., M.B., judged the team and 1l1dIVldual tests. Capt. W. Goodley, O .B.E., M . ~. (Centre Secretary) w.as th e Competit ion Secretary, aSSIsted by Mr. Wardle l J\Il S Pratt 'a nd class secretaries.

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23 2

The individual tests were held in the morning. Nos. 1 and 3 had to deal with a man who was suffering from concussion, fractured jaw and simple fracture right forearm; Nos. 2 and 4 had to treat a man suffering from arterial haemorrhage left palm and venous haemorrhage left elbow; whilst No.5 had a patient suffering from a fractured patella. The team test was staged in the afternoon. A man working on the mof had fallen through a glass window to the floor 15 feet below and on examination the patient was found to be suffering from fractured base of skull, stupor developing into coma, with signs of compression, impacted fracture of both thighs, woundroded arterial haemorrhage on face and capillary haemorrhage from hand wounds. At the conclusion of the tests Mr. J. E. Sharpe, M.B.E. (Asst. Supt., Eastern Section, L.N.E.R.) presided, supported by the Chief Constable (Mr. Dain) and Mrs. Dain, Mr. E. F. Greenfield (District Supt., Norwich), Mr. G. Sutcliffe (District Supt., Cambridge), Mr. W. H. Statham (District Goods and Passenger Manager, Norwich), Mr. L. J. Clements (Goods Agent and Station Master, Norwich City), Mr. B. V. Smith (Goods Agent and Station Master, Yarmouth Beach), Mr. H. J. Goff (Station Master, Holbea'ch), Mr. W. A. Thomas (Station Master, Moulton). Capt. Goodley announced the results which were: 1st and Championship Cup, Moulton, 243! marks; 2nd and Shield, Melton Constable, 223t; ' 3rd, Holbeach, 220!. Other teams were Sheringham, Eye Green and Yarmouth. Mrs. Dain presented the trophies and prizes and was thanked by the Chairman. Mr. Sharpe said he was pleased to note that the M. & G.N. had progressed and is still progressing. A total of 119 passes had been obtained against 95 of the previous year. Two gold medals and one gold bar for 20 examinations had been gained. He congratulated the winning team on their success and the other teams on their creditable efforts. He hoped the winning team would gain first place in the UngroU'ped Inter-Railway competition and thus go forward to represent the M. & G.N. in the Inter-Railway Final Competition. Capt. White Knox in response to a vote of thanks said that the standard of work was very high. He emphasised the importance of allocating injuries, if more than one be present, in the individual tests. In the team test he was astounded at the excellent work done. He thanked Capt. Goodley and his staff for the splendid arrangements made. The Chief Constable was thanked by Capt. Goodley for the use of the Lads' Club; also the stewards, patients and staff of the Oub.

Southern. The Southern Railway Final Competition will be held on Tuesday, May 2nd, at Southern House, Cannon Street, Lond.on. Admission is by ticket only, and which may be obtal11ed from Mr. E. A. Richards, Centre Secretary, General Manager's Office, Waterloo Station, S.E.l. ~r. J. B., Ell~ott, Asst. General Manager, will present the Dlrectors Shleld and other prizes. Much interest has been evinced in the Divisional Competitions and it is gratifying to find 'a n increase of 17 teams over the number last year. One hundred and thirty-five teams, which constitutes

FIRST

AID a record, have signified their intention of competing for the Group Cups and useful prizes awarded by the Directors.

Police Ambulance News. POLICE

PooLE.-The annual dinner of the Poole Class was held on March 1st, when Mr. C. N. Anderson (Asst. Div. Supt.) presided. Mr. E. Hight (Div. Supt., Southampton) presented the awards which included six 14 years' service medals. On behalf of the class he made a presentation to Mr. E. A. Stempt, in appreciation of his services over 13 years as Secretary. Mr. Hight welcomed Mr. Uzzell (Welfare Officer, Waterloo) and also Mr. Geo. Bishop. Mr. Uzzell said that the Directors were most anxious to further ambulance work. Last year ambulance awards amounted to 3,800 and he hoped they would increase to over 4,000 this year. He had noted the 14 years' service medals presented that evening and reminded his listeners that in the Company there had been presented 670 gold medals for 21 years' service. In Poole they had received a total of 187 awards which was fairly creditable. He hoped this number would increase.

NATIONAL

FIRST AID

COMPETITION.

WELL DONE CITY OF LONDON.

For the first time in the history of the competition the " Pim " Trophy has found a home in the" square mile" of the heart of the British Empire. The win was well deserved but, at the same time, we extend a word of cheer to Birmingham who tor the second year in succession gained second place. Throughout February 24th the Central Hall, Westminster, London, was the scene of great activity. Representatives of many police forces were present and also followe rs of the actual teams competing.

AID

233 PRESENTATION OF AWARDS.

.The Earl of Shaftesbury, K.P'I G.C.V.O., C.B.E., preSIded, supported by Sir Samuel Hoare (Home Secretary), Col. J. T. Woolrych Perowne, Sir Percival \Vilkinsoll (Secretary General) and the judges. Sir Percival Wilkinson announced the result, which was ;Team. Ind. Team. Total. 1 City of London 193 192t 385t 2 Birmingham City 205 169! 374t 3 Durham County 172 179t 351t 4 Gt. Yarmouth Borough 347 192t 15 4t 5 Yorkshire West Riding 167 166t 333t 6 Kent Countv 176 149 325 7 Plymouth COity 167 154 321 8 Breconshire 166 145t 311t 9 Preston Borough 152 148t 300t Maximum 250 250 500

Hospital, NurSing, &c., Exhibition. THE 29th annual Hospital, Nursing, Midwifery and Public Health Exhibition and Conference was held in London from February 13th to 17th. The exhibits were numerous, and those of interest to readers being very varied. Messrs. Reckitt & Sons, of Hull, and 40, Bedfordsquare, London, W.C.1, had on display "Dettol," the modern germicide which needs no introduction; also " Dettolin" (mouth hygiene), ' Dettol Obstetic Cream" and " Steradent " denture cleaner. Nurses uniforms were displayed by Robinson & Cleaver Ltd., of Regent-street, W.1, and E. nnd R. Garrou Jd Ltd., 150-162, Edg-ware-road, London, \'\T.2, whilst texthooks and general nursing books were displayed by H. K. Lewis & Co. Ltd., 136, Gower-street, London, W C.1: BaJliere, Tindall & Cox, 7/8, Henrietta-streeL, London, W. C. 2 ; Hnd Faber & Faber Ltd., 24, Russell-square, London, W.c.1. On the stand of Messrs. T. J. Smith & Nephew, of Neptune-street, Hull, was displayed their well-known " Elastop1ast" Bandage, Plasters and Dressing-; also " Cellona " Plaster 0'£ Paris Bandages and Slabs, "Elastocrepe" Bandage and" Zoff" Plaster Remover. Other exhibits of interest were; "Neko" Germicidal Soap (Pa,rke, Davis & Co.), Tannic Acid J elly (Crookes Laboratories), Milton Antiseptic (Milton Proprietory Ltd.), "New-Monsol " Antiseptic (Fassett & Johnson, Ltd.). During the run of the exhibition many conferences were held covering a variety of subjects appertainin<Y to the work. Films were also shown on certain subjects. h

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City of London Police "Pim" Trophy Winners. Seated; P.C. Henley, P.C. McDermott (captain), Sir Hugh Turnbull (Commissioner), Inspector Mumford (Ambulance Committee Chairman), P.C. Morton. Standing; P.C. Walk~r (reserve), Sergeant Rose (secretary), P.C. Bugden, P.C. May. After watching some of the teams at work it was thought that the work did not seem up to the usual high standard and the result bore out this contention. Not that the work was badly done; but it seemed, in the majority of cases, to be a little slipshod. However, those who attended the final certainly increased their knowledge of first aid. The judges were Dr. G. D. E. Tullis, of Hereford (team and No.1) and Dr. A. M, Pollock, 0f Tunbridge Wells (Nos. 2, 3, 4 and 5). Mr. D. G. Monteith (Competition Secretary) is to be congratulated on the smooth-running arrangements he made.

A great cheer arose on the announcement of the winning team and congratulations \vere showered on the members. The Earl of Shaftesbury welcomed Sir Samuel Hoare. He referred to the long-established connection between the Police Forces in the country and the Order of St. John. It was in 1878, when an ambulance section of the Metropolitan Force was started, that the Order brought out a textbook for the members' use. The Chairman also expressed thanks to the judges, to Mr. and Mrs. John Maxwell, for the splendid staging, and to the stewards for their great assistance. Sir Samuel thanked the Order of St. John for the

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assistance they had given to the Police Forces throughout the country. He congratulated the winning team and emphasised the importance of the work in which all teams were eng-ag-ed. It was, said the Home Secretary, essential that Police Forces in the country should be efficient in first aid. Dr. Tullis and Dr. Pollock addressed the competitors and also expressed appreciation to Mr. Monteith for the smooth running of the competition THE TESTS. The team test setting represented an exterior of a lockup cafe in a country town, with No.4 on his beat. No.2 is on his way to relieve No.4, whilst Nos. 1 and 3 are at the station a i-mile away. No.4, on hearing a scream, investigates the cause, and a man jumps out of the window and rushes off. On entering the cafe a charwoman is fou nd I yi ng on her back on the floor. Close by is an overturned bucket, tin of soft soap, open safe, set of hurglar's tools. The cafe had all the necessary equipment of such a business, including a counter, tea urn with gas ring, empty bottles, gas fire, refrigerator with ice, crockery, butter, etc. A police box was erected close by. The card of instructiol1 given to No.4 and the maximum marks in the team test were as follows : Card handed to No.4 (who is in the road near the cafe). Early on a summer morning in a country town you are passing a lock-up cafe. You have been on night duty, and are just coming to the end of your beat before being relieved. You know that your relief is not far away. The only other police officers available are at the police station, quarter of a mile away. There is a police call box near by. When you hear a scream and a loud crash act as you think necessary. A minute is supposed to elapse between the scream and the crash. Time allowed, 20 minutes, beginning when you hear the crash. The maximum marks and details were:Approach house quickly ... 1 Notice escaping burglar with scarlet kerchief 1 Blow whistle 1 Try door and enter, find woman lying on' back on flo~~ and notice surroundings ... 2 No.2 having heard whistle joins No.4 Rapid explanation by No.4 Speak to woman (no reply) Notice colou r of face (livid) ... And enquire if breathing (just) Feel pulse (fast and weak) .. . State of skin (cold and clammy) Quickly loosen clothing round neck, chest and waist Observe linger marks on neck Has the woman false teeth (yes) Remove false teeth Ask if breathing better (no) .. . RAPrD EXAMINATION FOR SrGNS OF FRACTURE OF : Arms (none) 2 ; Spif1e (none) 2 Ribs (none) 2 ; Pelvis (none) 2 Left lower limb (none) Right Lower Lim b. Any visible h<elTIorrhage (yes, as marked) Note large lacerated wound of right calf, high up As~ character. of bleeding (bright and spurting) '" QUickly examll1e for fracture of right thigh or leg (none) TREATMENT. Immediately elevate the limb .. . Expose wound ... .. . Immedi.ate digit~l pressure on pressure p;i'nt 11 ImprOVise tourniquet Apply tourniquet correctly

4 4 2 3 2

2 3 3 3

5 3

AID Apply temporary covering to wound, e. g. clean serviette or handkerchief 4 Ask jf allY bystanders ( no) ... 1 Send other bearer to telephone police station for help 2 Detailed telephone message to police station asking for help and first aid equipment 2 Decide inadvisable to turn patient over 4 Other bearer returns. Ask about breathing now (the same as before) 1 Colour of face (as before) ... ... 1 State of skin (as before) 1 Other members of team arrive. Four minutes after telephone call. Decide on Silvester's artificial respiration 2 Cover patient warmly above and below... :1 Carry out Silvester's artificial respiration properly 6 If Schafer's method used efficiently, 8 Ask colour of face after one minute (judge wipes blue chalk off: very pale) ... 1 Ask re breathing (rather hurried and laboured) 2 Head low and to one side ... ... 1 Test for Consciousness. Speak to her (mumbles, rather restless) 1 Test eye reflexes. Touch and light (faint response) 4 Examine pupils (dilated, owing to fright, and equal) 2 Test pulse again (rather fast and weak) ... ... 2 TREATMENT OF UNCONSCIOUSNESS OBVlOUSLY DUE TO: H~morrhage from lacerated wound of leO' 2 Partial asphyxia ... ... ~.. 2 Shock... 2 Warmth-blankets; hot water bottles improvised, tested and wrapped 3 Light gas fire, and also gas ring under urn to obtain hot water 2 Keep patient's head low and to one side ::: 2 Plenty of air-open windows, do not crowd round her 3 Raise and support left lower limb 3 Test and apply smelling salts... 2 Careful watch on tourniquet ... 2 Further Examination in Detail. Head (nil) 2 Neck (bruises over wind pipe) 2 Upper limbs (nil) ... ... ... ... 2 ... ... 4 Abdo.men, (nil) 2 ; left leg (nil) 2 Ask if patient returning to consciousness (patient says faintly" Oh my leg" and" I'm so thirsty") 2 Ask if par.ient still so restless (not quite) ... 2 Further Treatment of Shock. Encouraging words ... 1 Avoid discussing seriousness ... 1 Give hot strong tea or coffee with plenty of sugar, after testing ability to swallow 2 Is tourniquet in place (yes) ... 1 Is patient's condition improving (yes) 1 Treatment of Lacerated Wound of Right Calf. Are there any foreign bodies in wound (no) 2 Is w.o,und obviously dirty (yes, soft soap and rust) 2 Stenllse water by boiling over gas ring ... 3 Gently but freely pour it over wound when cool 3 Apply a~tiseptic all o.ver wound and surrounding skin 3 Cover WIth dry dreSSIng, using all precautions to keep clean ...... 3 Cover dressing with cotton wool 2 Apply bandage lirmly over dressing 2 Relax tourniquet and note if bleeding has ceased (no) 3 Retighten tourniquet 2 Afford support to leg by splints and bandages, or by tying legs together ... 3 Treatment of Bruises of Neck. Ice compresses 2

FIRST Or hot external applications ... Ice to suck, 1 ; butter to take, 2 Keep neck at rest... GENERAL. Telephone police station for doctor and ambulance, giving address and nature of case. Reply states no doctor available. Ambulance will come in five minutes Warn police re burglar at large with red kerchief ... Ask police to communicate with proprietor of cafe and to get in touch with relatives of charwoman TRANSPORT, ETC. Appreciating difficulty in carrying loaded stretcher via front door Prepare stretcher in passage (or room) Arrange blankets, 4 thicknesses beneath and 2 above patient Load stretcher very carefully either by carrying her on blanket to passag-e to prepared stretcher Or by lifting on to stretcher in room (3) Send bearer to see if ambulance has arrived (ambulance just arrived) Either carry stretcher via front door into road (3) Or hoist stretcher through window to be received in front of house. Marching to ambulance Re-examine to be sure: j. Tourniquet in position 2. Patient not relapsing 3. Patient warm enough Ask patient if she wishes to travel head or feet first in ambulance Loading into ambulance Leave one man in charge of premises And to report to police station by telephone departure of ambulance... And so avoid the possibility of a doctor l1eing sent when available Extra efficiency marks

2 3 2

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235

and his left leg and right arm are slightly burnt. to be rendered in 8 minutes.

First aid

JUDGES' COMMENTS. THE TEAM TEST. 2 2 By G. D. E. TULLIS, M. B., CH. B., OF HEREFORD. 2

3 2 2 6 1 6 4 2 2 2 2 4 2 2 2 20

Total 250 The individual tests were : No.1 is required to state for what different purposes a triangular bandage may be used. Time allowed 4 minutes. Nos. 2 and 3 are walking, off duty, in a narrow country lane on a line summer afternoon. A man on a bicycle overtakes them, travelling very fast, and disappears round a sharp bend fifty yards away. They hear a crash, and on running to the spot lind him lying on the ground under his bicycle. Visibility in each direction twenty yards owing- to bend in lane. There is a cottage near by, and an A.A. telephone box i of a mile away. On examination the cyclist is found to be unconscious and suffering from concussion due to a suspected fracture of the skull. First aid to be rendered in 8 minutes. No.4 is on holiday in the country and is watching the local Hunt pass. There is one stragf,{ler far behind, and just before he reaches No.4 his horse stumbles, he falls off, and his horse gallops away. There is no house within five miles and there are no bystanders. It is a fine morning. On examination the patient, who z's very bad tempe1'ed, is found to have fractured his left collar-bone. First aid to be rendered in 8 minutes. No. 5 is walking along a quiet country road. A thunderstorm has just passed over. A boy runs up to him and tells him that his father has been struck by lig-hting by his cottage up the road; he says he is going for the doctor and rushes 0[[. On going to the cottage No. 5 finds a man lying by the pump, with an overturned bucket near him. His wife is bending over him. She says he was drawing water from the pump when he was struck by lightning. On e~amination the man's breathin o ' is found to have stopped)

Fortunately or unfortunately lirst aid work like medicine is not an exact science. If it were there would be no interest in competitions. Every case, every injury has to be considered on its own merits (al ways, of course, using the knowledge found in the Black Book as the guide), whether in real life or in the competition room. This makes it extremely difficult for a judge to adequately assess what in the circumstances is the actual procedure to he adopted by the team. One must refrain from being too dogmatic, and one must allow play for resourcefulness and discrimination. One has always to bear in mind that the Safe, Careful, and Expeditious handling of a patient is the Alpha and Omega of perfect lirst aid technique, always remembering the general principles as laid down in the First Aid l\lanual. Now, you may ask, why all this preamhle when I have been asked to write a critique of the work done in tl;e Police Final team test. The reason is that there were several points which were controversial and it was very interesting to me to see how the various teams treated their patient. Please remember there is always a patient as well as the injuries! The test set was devised to bring out the best in the teams in the foilowing points. Howat first one and then two members of a team without the assistance of their captain or equipment could save the patient's life (a) by controlling immpdiately the arterial h~morrhage from the leg and (b) be re-establishing normal respiration. These done efficiently the rest of the team had a perfectly straightforward case with routine work to do, whereas without the efforts of Nos. 4 and 2 being done properly the other members were handicapped, and in several cases this was shown by unnecessary repetition work in the examination of the patient, which was simply a waste of time. Now, what was No. 4 faced with when he got to the patient? An unconscious woman who was bleeding profusely from a deep lacerated wound in her leg; she was livid in the face, was only just breathing, and had marks on her neck of having been nearly throttled. The amount of blood she had lost was clearly indicated by a large area of red paint on brown paper and looked like about half a pint -in fact it was poured out of a half pint tin. What should be his first thoughts. I I This woman is in a very bad way, she cannot afford to lose any more blood without seriously endangering her life, she is unconscious and hardly breathing," Immediately arrest the bleeding by digital pressure at the groin to the femoral artery, having summoned the only help available (No. 4's relief-No.2) by whistle. This was done promptly and efficiently by all teams. l\lust make the arrest permanent so as to attend other urgent matters-breathing, etc. Therefore ifnprovise a tourniquet from the only available material-serviette or tablecloth, but before applying it making sure that there is no fracture of femur, bearing in mind that digital pressure compresses artery against pelvic brim, whereas it is impossible to apply a tourniquet (and especially an improvised one) so high up, I noticed that in most cases the femur was examined after the tourniquet was applied! What next-I' Is the breathing better and is the colour of the face less livid?" I did my best to indicate that things were no better but probably worse. The patient's condition was ob\'iously critical a?d she was unconscious, due to (a) loss of blood; (b) partial asphyxia, and (c) shock, both physical and mental (eyes

FIRST dilated due to fright). Quickly remove obstructions from airway in mouth, colour-no better; breathing-no better. Therefore artificial respiration indicated. Now 'here comes one of those points to which I referred above in which the discrimination of the first aider has to be Should the patient under these circumstances be used. SUbjected to turning over and Schafer's method ad~pted or should Silvester's be applied? Remember we arc stIli dealincr with a pat£ent and not merely a condition calling for ar~ificial respiration. My view is that owing to t.he following reasons Silvester's method should be used. a. The patient has lost a great deal of blood and possibly if she were to lose any 1110re she would die. b. As the tourniquet was only improvised, turning her over might cause it to slip and so cause another hremorrhag-e. c. She was still "just breathing" and therefore great force or persistence would not be necessary to reestablish normal breathing. d. She was unconscious and had bruising of the neck, which had to be watched and treated. Th ese I think should have been the arguments of the first a ider in favou; of keeping her on her back. Added to this I may add that if a patient stops bre::tthing on the operating -table it is Silvester's artificial respiration which is always adopted and usually with complete success. But let us be fair; aRainst all this the book says " Silvester's method to be used if only when it is z'mpossible to turn the patient over on his face." It is really the interpretation of the word" impossible" that is the crux of it all. Whether it m eans that the space is too small . as for example in a mine gallery, or whether it means that the patient's conuition renders it impossible (or inadvisable). So in case some (thl:! majority) of the teams who kept strictly to the lette r of the book s hould be worried, the same maximum marks were allowed for do ing either method perfectly, but those who thought it "inad visable to turn her over" got 4 more added to them. E a rly 'phoning the rest of the team was essential in order that the test might be finished in time. I purposely arranged for the telephone to be energised and implement a loud speaker so that the intelligence of the message was patent to all includin g those at the "police station." It is much easier to speak into a dummy telephone at competitio ns than into a rea l one. Early li ghting of the g-as ring was imperative for (1) sterile water (2) hot water bottles (3) hot applications to the neck a nd (4) hot tea. Some for get to cool the water before" applying" it to the wound, but would have found the refrig-erator useful for cooling it in a very few minutes. Some excellent butter was there also for t he patient to swallow to ease the bruised throat. I was deli g hted to see one team take off their pullo\'ers and wrap the improvised hot water bottles in them before ap plying them to the patient, but I was distressed to find only one team light the splendid Ras stove provided. It was early morning- and therefore pretty cold. Another alternative question that had to be decided was whether it was best to prepare stretcher in the lobby (it was quite impossible to carry loaded stretcher via both doors into street), an d carry patient on outer door on the stretcher, or else loading prepared stretcher in the room and hoisting her through rather an awkward window. Equal maximum marks were allowed for either method. The standard of work was excel len t throug hou t, most markedly so in the winning team. Several little points were missed . vVhy not a blanket under the patient as well as above in tead of letting her lie all the time on the cold floor or the cafe? Why not immobilise the leg by splints, a leg which wn.s lacerated and the cut extending almost to the bone? Why not put the injured neck at rest by pads each side to keep it still as patient was restless? And why (I am afraid many of the competitors will be applying for

AID

FIRST

a new issue of trousers) not mop up the blood with the floor cloth provided? I know full well how easy it is to be wise after the event and also how useless competitions are with. out a lot of littie details which serve the purpose of making the treatml:!nt more complete and also in separating th e marks for each team. I apologise for this long dissertation and the Editor has my permission to "cut" it so long as he leaves the real meat on the bone! THE INDIVIDUAL TESTS. By A. M. POLLOCK, M.A .. M. B., CIl. B. OF TUNBRIDGE WELLS. The individual tests for Nos. 2 and 3, Nos. 4 and 5 were straightforward and comparatively simple. As a result, the marks obtained were high. In that for Nos. 2 and 3, the fact that the accident happened on a sharp bend giving poor visibility on both sides was not appreciated and few competitors utilized conspicuous objects such as the bicycle and a helmet as warnings to possible traffic. The use made of the facilites for removal and for shelter was good, and no one had doubt as to the diagnosis, except for omission of fractured skull as a possibility. The test for No.4 had improvisation and tactful handling as the keynotes. Both were very \\'ell done, particularly th€' latter as the patient was most unobliging and most uncrrateful. The long tail of his hunting coat really made an ~xcellent support for the forearm of the dam aged side, but not one competitor used it, the majority relying on pinning the sleeve to the shirt. Good, but not nearly so secure as the other would have been. The stock acted as a very useful broad bandage. Some competitors obviously were at their wits ends to know how to get on without standard equipment, and made poor attempts to utilize what material they had. But no one lost his temper! Finally, No. 5 had artificial respiration to do and two small superficial burn s to treat. There was some slowness in realising that breathing was absent and some slowness in starting it, but the application of Schafer's method was the best I ha ve seen yet, in every way. The new Textbook had been well studied, as no competitor was put out when he found there was no soda bicarbonate available, and all immediately asked for tea. Time was wasted by some in asking the patient's wife to help carry into the house. The patient was deliberately the smallest and lightest at our disposal and was easily handled by those who tackled him single handed; and, after all, he had to be carried only five yards. I thought that there was no doubt that the general standard had risen; everything was done thoroughly and there was surprisingly little "examiniti~." Much of this, I am sure, was due to the smooth way in which things ran, and great credit is due to the Competition Secretary (Mr. Monteith) and his excellent staff. METROPOLITAN. On Saturday, February 11 th, the annual" G " Division competitions were held, the judges being- Dr. M. M. Scott (team) and Mr. G. E. Craft, of FIRST AID (individual). Five teams competed and some very good work was done. Supt. Franklin announced the result, and presented the Divis ional Cup to Commercial-street A whC' gained 223t marks. Other placings were Commercial-street B (210t) , Dalston (1S8t ), Old-street (174) and City-road (172). Thanks were extended to the judges and stewards for their assistance. Both judges addressed the competitors, pointing out where marks had been lost. Chief Inspector Carter was the Competition Secretary.

Three teams competed in the "E" Division Inter_ Station competition h eld on March 7th, when Dr. M. 1\1. Scott (team) and Mr. G. E. Craft (individual) judged the work done. This is the first time a Divisional competition has been held by this Division and it is hoped that by such events a higher place will be gained in the Metropolitan Police competitions. The result was announced by Supt. Bolton, who informed the competitors that a further competition would be held in July and th e team th e n ha ving been awarded the highest aggreg::tte marks would be the h old ers of a new cup. King'S Cross-road £;ained 217t marks, Grays Inn-road 205 and Bow-street 198t. Both judges addressed the competitors and congratulated them on their work. The n ee d for such competitions was stressed. Thanks were exte nded to the judges and to members of " G " Division who had acted as stewards.

The St. Mary'ebone Open First Aid Conlp~tition. FORTY-O:-JE teams, an increase of five, entered the 1939 compet Ition, an d as the res ult of preliminary heats the following will contest the final-"G," "M," "V" and "w" Di vis ions of the Metropolitan Police, City Police "A," a nd Bishopsgate "A," L. N. E . R. A very representative ent ry was received, th ere being 14 Railway. 9 Pulice. 9 St. J ohn Ambulance Brigade, 6 Special Constabulary. 1 R::tilway Pnlice and two unattached teams. The Committee wi"h to thank all memhers of the teams for their support, and a lso the judges who participated in the preliminary round· - Drs. R. V. Steele, B. Steele, Sir Henry H. B;lshford. E. J. Selhy. C. C. Chavasse. W. Megaw, B. Rosefield, G. E. Graves Peirce, H. A. Fenton, J . Fraulo, ]. Newton Hud son and G. R . H. Wranghi'lm. The nnal competition will be held on March 30th at the Portman Rooms, Baker-street, W.1, commenci ng at 7.30 p. m. Lord Horder has kindly co nsented to present the prizes, whilst Capt. F. E. Bendix (te::tm) and Capt. A. C. White Knox (individual) will be the judges. Admi..;sion is by ticket. price 6d., which ca n be obtained from the H on . Secretary, \tV. V. 1\1. Allen, Western Di strict Post Offict', W.1, or at the door on the evening of the competition.

Mr. Dudl ey Joel, M. P . for Dudley, presented awards to the Black County Division of the Midland" Red" St. ] ohn Ambulance last month. The annual open competition for the "Huntingdon Brewery" Rose Bowl was held at ·Whittlesey. March with 122 marks were successful in winning the trophy, Westwood Works being second . Messrs. E. & S. Livingstone of 16 and 17, Teviot-place, Edinburgh, have just issued a new list of th eir publications, many of whlch are of interest to those engaged in first aid and nursing work. Copies will be sent on application. Mess rs. Roberts, McL pa n & Co. Ltd., the specialists in Air Raid Precaution instru,ctional appliances, have mo ved to more commodious premises. Their new address is Chisbury House, 14. Clliswell-street, London, E. c.1. Telephone: National 5741 (3 lines).

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237

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2.- It is doubly effective in preventing SEPSIS. T.C.P. has a double action in preventing- or clearing up sepsis, when applied to any injury:(a). It acts as a powerful penetrating g-ermicide-and eflecti\ ely sterilises t he affected ti~sue s. (b) . It actually stimulates the activity of the leucocyte blood cells in the area, ilnd thus increases the resistance of the tissues themselves to infection.

3. - lt relieves PAIN Applied to any painful injury-a cut. burn or bruise- T. C. P . has an almost immediate pain relieving action-in valuable in cases of "shock."

4.-lt promotes faster and cleaner HEALING. T.C. P. promotes particularly clean and rapid h ea ling, because it actually stimulates the formation of healthy gra nul ation tissue. Does the Antiseptic which you are at present usin g offer you these 4 big advantages? If not, writ~ to-d ay for a trial sample and copy?f t~e T. C. P. First Aid Book, sent FREE on appltcatlOn to : British Alkaloids Ltd .. Dash\vood House, Old Broad Street, London, E. C. 2.

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CAMP FOR NURSING Dn'ISIONS, S.lA. B. A camp will be held for the nursing personnel of the Brigade at Rossall School, between Fleetwood and Blackpool, from August 5th to 12th. The cost per head for the week, inclusi ve of board and lodging, will be 37/6 for officers and 35/- for members. Rossall School is most delightfully situated. One can walk from the large courtyard through the archway on to the private beach of the School. The windows of most of the bedrooms look right out to sea. There are also tennis courts, large playing fields and a swimming pool. . ~-here ~vill be lectures and practical work each day, but as It IS realtsed that many members make this their holiday, ple?ty of free time will be given in which they may follow their own pleasure. Regulation indoor and outdoor uniform is essential. F?r lectures.and practical work the plain grey camp overall with black tie and belt and soft white collar is r ecommended. Muftie may be worn during free time. Those attending the camp must provide their own soap, towels and bedroom tumbler. Cookery classes will be held. Those who wish to attend must provide themselves with oven cloth tea towel small saucepan, small pie dish, tablespoon, fork' and knife: Any officer or member who owns a gas mask should take it. . All ~pplicatio~s ~ust be accompanied by 5/- deposit, whlch will be forfeited If the applicant cancels her application after being accepted. The balance due must reach the Lady Superintendent-in-Chief not later than July 22nd. The full payment for the week will be due unless an appli~ant cancels her applicat!on not later than July 29th, except m the case of sudden dlness, when a docto r's certificate must be submitted. Offi cial application forms can be obtained by Officers in charge of Divisions from tl1e office of the Lady Supt-inChief. They must be returned to that office by June 30th but applications reaching there after that date will not b~ refused unless the camp is full. No application can be considered after July 29th.

No. 3 (EASTERN) DISTRICT, S.lA. B. COUNTY COMPETITIONS AT WELLINGBOROUGH.-Teams from Welling~oroug? .H.eadquarters, Rushden and Higham Ferrars NurslOg DIVISIOns competed at Wellingborough Am.bulance ~eadq.ua~ters for the honour of representing their coun!y 10 Dlstnct Finals. The team test and after ~ar~ :-rere Judged. by Dr. L. A. Daly and Mrs. Daly; the mdlVldual first ald by County Officer F. Hejo-ate Smith M: B. E. ; and bedmaking and uniforms by Lad/Corps Supt: MISS Bradford. The winners were the Headquarters team under the leadership of Lad.y D~v. Supt. Mrs. Adams, 'who lately transferred from V lctona Nursing Division. Of a possi ble 320 marks they secured 246. Rushden were second with 213!, and. Highan: Ferrars third with 195!. C:0~slder.able lOterest was taken in the competition, and the VIsitors lOcIuded Lady District Officer Mrs. Harvey Reeves, A. R. R.C., and Lady Corps Supt. Mrs. Camphell.

After the wmpetition a presentation was made by Mrs. Harvey Reeves, on behalf of the Wellingborough Corps, to Miss A. Smith, until recently the Lady Corps Superintendent. It was in recognition of her work in the Corps which she served for 37 years. Mrs. Harvey Reeve., reterred to her valuable assistance during the time she was in the Brigade. No. 4 DISTRICT, S.]. A. B. BIRKENHEAD N li RSING DIVISION.-Following upon their success at Blackburn some weeks ago when this Division won three trophies in competition there, the Division has now been awarded the District Nursing Challenge Bowl (horne nursing) in the competition held at Tottington. So close were the markings of the teams that entered, that no fewer than four tied for second place. Birkenhead are to be congratulated on this latest victory. No.5 DISTRICT, S.J.A.B. ECCLESHILL NURSING DrVISION. -At a recent competition held at Leeds, this Di vision won first place and the" EIlison " Shield. The results of the tests were:- Eccleshill, 225 points; Leeds Victoria, 21Ji; Bolling, 204t; Burley and Kirkstall, 170!. The winning team now competes ill the District Finals for the "Birkbeck " Bowl and the honour of representing the District in Brigade Finals for the" Perrott" Shield. KmSGROVE NURSING DIVISION. - To mark a successful year, a dinner was held at the La wton Hall Hotel, Ambulance Sister M. Lacey presiding, supported by the Corps and Divisional Officers. During the evening, Mrs. Peters was presented by Captain Bailey with a badge and certificate as President of the Nursing Division, and Lady Div. Supt. L. Cooper asked Div. Surgeon Pet~rs to accept a Macdonald travelling rug as a token of appreciation of his services to the Division. Floral gifts were made to the Lady Superintendent by the members of the Division. Captain Bailey also presented certificates and other awards gained by members during the y~ar. Last year the Kidsgrove Nursing Division won the challenge cup presented by Mrs. E. W. Montford at the first annual competition open to Nursing Divisions in North Staffordshire. No.8 DISTRICT, S.J.A.B. DOVER NURSING DIVISION.-A very interesting evening was spent at Divisional Headquarters on February 21st when the Divisional competition was held. Three teams competed for the "Bromley" Cup, being judged by Dr. C. M. Callendar, O. B. E. (first aid), and Lady Div. Supt. Miss Dyer (home nursing). When the tests were over, Lady Div. Supt. Mrs. Tee thanked the judges, and asked Dr. Callender to pres~nt the cup and miniatures to the winning team. Dr. Callendar said she was very sat isfied with all she had seen that evening, and considered all the teams put up a

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FIRST good show. She c:mgratula.ted. them all, and had. much pleasure in announcIng the WInnIng team and prese n.tmg the trophy to Ambulance Sister Mrs. Horton (captam) and Amb. Sisters Curd, Vanson and Sanders. Dr. Gertrude Toland thanked the judges, and alsf) congratulated the teams. She .~elcomed such a large gathering of Corps members and VIsitors. . Among those who attended was Lady District Officer Miss Curzon Smith . TUNBRlf)GE WELL" NURSING DIvrsIoN. - At the annual dinner held on February 24th. Commissioner E. A. Richards presented a silver cup to Amb. Sister M.iss Rose. D~J;ond, given by Lady Supt. Miss Gwladys EllIson for mdlvldual efficiency. The first aid test was set and judged ?y Lady District Officer Miss Hubbard, and the home nursmg test by Nurse Eeles of the Division. Medallions were also presented to successful members. No. 9 DISTRICT, S.J.A. B. PARKSTONE NURSING DIVISION, POOLE CORPs.-This Division re"e ntly held a competition for a cup kindly presented to them by Nursing Officer Miss Le Blanc. Three teams competed, the winners being Ambulance Sisters T. Barnes (captain), H. Cattle, N. Roberts and M. Vick. Lauy Kemnal of Canford Cliffs, kindly attended and cut the christening cake for the trophy. The judges for the test 'w ere Dr. D. F. Morgan (team test), Dr. Laura Maule Horne (home nursing), and Lady Corps Supt. Mrs. Boyle (uniforms).

WEYMOUTH NURSING Drv IsI0N.-On Wednesday, February 15th, the annual presentation of awards took place at Di\'isional Headquarters. The Mayoress kindly presented 32 first aid certificates, 21 home nursing certificates, -+ medallions, 24 pendants and 23 labels to members, auxiliary reserve, . and others who had attended courses of instruction given by Divisional Surgeon Cooper and Nurse Choules; also Grade I Instructors' Certificate, vouchers and A. R. P. certificates to members of the Divi sio n and those of the general public who had passed the examination following a course of lectures given by Mr. Cox. I t was reported that mem bers of the Division had attended 505 public duties, and 119 hospital duties during last year. The number of cases treated during that period was 884. The Division were the proud holders of the Perrott" shield and other trophies gained in competitions. Vice Presidents' badges were presented to Mrs. Davison and Mrs. Biles, who are both keenly interested in the . Division. The Ambulance and Nursing Divisions asked Dr. Cooper to accept a silver cigarette box. suitably inscribed, as a mark of their appreciation of his valuable help. II

B. R .C. S. COMPETITION AT BRIGHToN.-The Annual County Competitions were held at the Royal Pavil ion, Brighton, on March 1st. The competition room had been set out to represent a small marquee, the first aid post at the Mudshire Agricultural Show. The detachment arrive late, owing to an accident to their 'bus (in which the M,O. was seriously injured). As a result of the accident they have no equipment, yet they are soon called upon to treat Farmer Giles who has been kicked on the shin by a refractory horse and is bleeding from a burst varicose vein, and has sustained a compound fracture. Then Mrs. Murphy, screaming in terror, rushes oul with her apron blazing, whi le P.C.

FIRS T

AID Tru nchon has dis located a sho ulder while trying to stop a runaway horse. There were eig-ht competing teams. The first prize, the" Thomas-Stanford" cup, again went to Hastings and St. Leonards, who have been the holders since 1929 Ar u ndel were second, and Eastbourne third. The other detachments represented were Brighton and Hove, Chichester, East Grinstead, Horsham and Worthing, and Lewes and Rye The .. Beaumont" Cup, for individua l merit, was awarded to Miss Stafford of Hastings and St. Leonards, the runner-up being Miss Rister of East Grinstead . . Colonel H. E. Weekes, O. BE, County DIrector and County Controller, presented the awards, and in a few remarks asked all members to be loyal in their support of the changes which are likely to result from the recasting of the V.A. D. constitution. He also thanked all concerned with the competitions for helping to make them a success. The jud~es, who gave a short criticism on the general standard of the work, were: uniform, Mrs. Adair, Assistant County Direct()r, West Sussex; team test, Col. E. A. C. Fazan, M.C., T.D., D.L., Assistant County Director, East Sussex (first aid), and Miss Dyke, Matron, Bexhill Hospital (home nursing); first aid oral, Dr. Helen Noakes, Lady District Officer, No.8 District, S.J.A. B.; first aid practical, Dr. C. B. Slater, Vlce-Presid pnt, Worthing Centre, and Medical Officer V. A. D. Sussex 78; home nursing oral, Mrs. Venn Claydlm. Vice-President, vVillingdon Centre; home nursing practical, Miss Ashbee, Matron, New Sussex Hospital, Brighton. CHICHESTER DIVISION, B. R. C. S. Arundel V.A. D. carried off both cups in the annual competitions of the Chichester Division held at the Midhurst GrC:lmmar School. The winners scored 602 marks, with Bo~nor Regis (cup holders) second with 585. Then came Chichester, 527~, Midhurst, 46-+, and Ferring, 457~. In presenting the trophies, Violet, Lady Beaumont, Deputy County President, congratulated all the teams on their work. Thanks were expressed to Lady Beaumont, the judges, and all who had helpet: at the competitions. PRESENTATION OF AWARDS AT SOUTHWICK.-Miss Gore Browne, Deputy President of the Brighton and Hove Division of the B. R. C. S., presented 100 badges and certificates to Sussex 90 and Sussex 43 at Southwick Town Hall, on February 22nd. Mr. S. W. A. Cushman, Chairman of the local Urban Council , presided, and among those supporting him was Major F. Eastwood, T. D . , Assistant County Director, B. R C. S. Miss Rose. reporting on Sussex 90, r~ferred with satisfaction to the fact that they had" Kingsfield," The Green, as A. R. P. Headquarters. They had -+2 enroIled members of whom 20 were fully qualified, 17 attending hospitals every day at the Royal Alexandra Children's Hospital, and two evenings a week and Sunday mornings at South lands Hospital. They had 22 probationers being trained who would soon be qualified, and there had been several national service a ppJ ications. The Deputy President said that since January. in the whole Division, 150 people had come forward to take up Red Cross work, and they now had 500 members as again~t 100 two years ago. Major Eastwood gave an address on Red Cross work, and said the country required 6,000 mobile members. Suitable for this branch were young unattached" members, who had the spirit of adventure. The Chairman referred to the suggested Socia l Club for all engaged in A. R. P . matters, and which wo uld have its headquarters at Kingsfield. II

AID

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FIRST

A.R.P. Topics.

AID

FIRST

The foregoing particulars are contained in Ministry of Health Circular 1764, Air Raid Precautions Act, 1937, " First Aid Post and Am bulance Services" (1 !d. post free).

FIRST AID POSTS.

According to a circular recently issued hy the Ministry of Health, the experience of the organisation of the hospital service over the last half year has suggested the desirability of certain developments in the organisation of first aid posts. One of the prime objects of a first aid post is to intercept the "walking wounded" and unwounded contam inated cases which do not req u ire hospital treatment as " in patients." At the September crisis large general hospitals, exposed to air attacks, were of the opinion that their proper work in dealing with severely injured might be hampered by a rush ot walking wounded. It is desirable, therefore, that a doctor shoulu be stationeu at each first aid post so that medical attention could be given, and thus ease the position of hospitals. Aid posts should be capable of fu nctioning at short notice, and such can only be effected at buildings which are in regular use for medical purposes. The Home Office suggest that it is desirable that an aid post should be attached to, or in close proximity to, all hospitals. The out-patient department could be enlarged and turned into an aid post, provided it can be shut off from the hospital. Small hospitals, clinics and health centres are suggested as suitable premises for aid posts. In less densely populated areas the consideration of mobile units should be considered to set up an aid post as and where required. These would supplement the fixed posts. 3'

•

otE

AMBULANCE SERVICES.

Two types of ambulances will be required for the casualty organisation: large, which can carry a number of stretcher cases, and will be used in hospital evacuation schemes j and small to be used in picking up street casualties. ' !he larger type, it is suggested, can be imprOVised out of single decker buses. The smaller type, although actually in existence would not be available in sufficient numbers in times of emergency, and suitable vehicles are to be ear-marked as auxiliary vehicles. To run the service in war ti me, it would be necessary to have an offic;:er in charge, and every County and County Borouah Council has been asked to designate an office/=>for this purpose now. . Emergency ambulance stations, emergency vehicles and ambulances, fitments and trainina of ambulance drivers should be arranged as pa~t of the present scheme.

•

RECENT PUBLICATIONS.

Coming Events. The Editor will be pleased to receive particulars 01 forthcoming 'events for inclusion (free of charge) under this heading.

MARCI-I.

24- Ungrouped Railways Inter-Railway Preliminary Competition. 25-" Stanley Round.

Shield,"

B. R.C.S.,

Men's

Eliminating

2S-Hagg-erston Division, S.].A. B., Jubilee Dance Shoreditch Town Hall. ' 25-Middlesbrough District, L. N. E. R. Competitions. 26-Devon County, S.J.A.B., Nursing Competitions, Torquay. 27-L. M. & S_ Railway Preliminary Competitions, Derby and Southport. 29-G.W_R. Women's Competition, Paddington SLation. 29-Great Eastern Centre, L. N. E. R. Competition Finals, Stratford. 30-St. Marylebone First Aid Open Competition Final, Portman Rooms, Baker-street, W.1.

Ambulances BEDFORD

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22-No. 1 District, S.J.A_B., Final Competitions Northampton Institute_ ' 22-Sussex County, S. J. A. B., Com petitions, Hastings. 22-Mitcham Cadet Division, S.J.A.B., "Davies" Challenge Cup Competitions. 29-No. 9 District, S.].A.B., Final Competitions, Plymouth.

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ST. JOHN AMBULANCE ASSOCIATION ST. JOHN AMBULANCE BRIGADE ST. JOHN AMBULANCE BRIGADE BRITISH RED CROSS SOCIETY BRITISH RED CROSS SOCIETY ARBROATH TOWN COUNCIL ASKERN AMBULANCE COMMITTEE BEDFORDSHIRE COUNTY COUNCIL ATHERTON URBAN DISTRICT COUNCIL BLACKBURN AIRCRAFT CO. LTD. BEDDINGTON & WALLINGTON BOROUGH COUNCIL BRIDLINGTON CORPORATION BOLTON CORPORATION BURNLEY CORPORATION CHERTSEY & ADDLESTONE AMBULANCE COMMITTEE CARDIFF CORPORATION CHESTER CITY COUNCIL CARDIFF ROYAL INFIRMARY CITY OF LONDON POLICE CHELTENHAM AMBULANCE HEADQUARTERS CROYDON CORPORATION DEVON COUNTY COUNCIL, EXETER DERBY BOROUGH POLICE EAST RIDING ISOLATION HOSPITAL DUNST ABLE CORPORATION EASTBOURNE CORPORATION EAST SUFFOLK AND IPSWICH HOSPITAL COMMITTEE ESSEX COUNTY COUNCIL FELIXSTOWE URBAN DISTRICT COUNCIL HARPENDEN URBAN DISTRICT COUNCIL FLACK'S AMBULANCE SERVICE, EPPlr G HEREFORDS HIRE RED CROSS SOCIETY GREAT HARWOOD URBAN DISTRICT COUNCIL HOVE CORPORATION GT. YARMOUTH POLICE LUTON BOROUGH COUNCIL HARROW SCHOOL LYSAGHT JOHN LTD. HESTON AND ISLEWORTH COUNCIL MANSFIELD WOODHOUSE MINERS' RESCUE STATION ILFORD BOROUGH COUNCIL NEW NORTHFLEET PAPER MILLS LEICESTER FIRE BRIGADE NEWCASTLE MUNICIPAL AERODROME LIVERPOOL CITY POLICE NEW QUAY URBAN DISTRICT COUNCIL MACCLESFIELD CORPORATION NORTH BUCKS. JOINT HOSPITAL BOARD MELTON MOWBRAY AMBULANCE COMMITTEE PEMBROKE COUNTY HOSPITAL NEWCASTLE-ON-TYNE FIRE BRIGADE RAMSEY AND DISTRICT HOSPITAL OGMORE AND GARW URBAN DISTRICT COUNCIL ROYAL HANTS COUNTY HOSPITAL ST. THOMAS'S HOSPITAL, LONDON SANDWICH CORPORATION SCARBOROUGH POLICE SOUTH YORKSHIRE MENTAL HOSPITAL SPANISH MEDICAL AID COMMITTEE, MANGIESTER SOUTHAMPTON CORPORATION WALSALL CORPORATION TAUNTON AND DISTRICT HOSPITAL W ANSTEAD AND WOODFORD COUNCIL UXBRIDGE URBAN DISTRICT COUNCIL WATFORD BOROUGH COUNCIL WATFORD BOROUGH COUNCIL WEST DEAN RURAL DISTRICT WORCESTER COUNTY COUNCIL COUNCIL WORKSOP AND DISTRICT WORTHING POLICE HOSPITAL COMMITTEE AMBULANCE COMMITTEE P RIC E S Bedford Ambulance Chassis -

Bedford Service Ambulance -

1- " Stanley Shield," B.R.C.S., Women's Second Eliminating Round. i-Devon County, S.].A.B., Men's Competitions, Exmouth i-Surrey District National Fire Brigade Association Competitions, Reigate. 1-No. 64 (Kentish Town) Division, S.].A.B., Grand Carnival Dance, Chester-road L. C. C. Schools. 2-0pening New Headquarters No. 16 ( New Cross) Division, S. J. A. B.

243

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FIRST

244

Queries and Ansvvers to Correspondents. Queries will be dealt with under the following rules ; 1.-Letters containing Queries must be marked on the top left-hand corner of the envelope" Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C. 4. 2. -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. 3.-The Textbook to which reference may be made in this column is the 39th (1937) Edition at the S,l.A.A. Manual of First Aid to the Injured. TREATMENT OF FRACTURED KNEECAP,

F.]. (Widnes).-Will you please settle the question of whether there should be a pad under the knee in the treatme'.1t of fractured kneecap? Some doctors and first aiders say this should be done, as under General Rules it states pad the natural hollows of the body, but I maintain that the Textbook does not show padding under the knee, that it is against the principle of the teaching, and also that jf a sufficiently large pad is placed under the ankle to raise the heel off the splint, as you havE-: previously described, there is no hollow under the knee.

The main object in the t,reatment of a fractured kneecap is to prevent further se paration of the broken fragments. Consequently, a pad beneath the kneejoint is definitely contraindicated. In other words, I agree with you. - N. CORBET FLETCHER .

EXAMINATION HOWLER.

G.C. (Sutton).-In a recent examination the doctor asked a candidate what she would do if she had to treat an infan t who was in state of convulsions. He did not look pleased when the candidate replied :- " Turn the baby upside dow n and tltump its back. "

FIRST

AID welfare of a patient that a bandage which is certainly complicated in its method of application should have been laid down as the ideal method of treatment. Surely with a forearm rt:sting on a table or other flat surface, it would be much simpler to pass three bandages once or twice round the splints and limb, instead of the bandage applying in this manner and, further, one which necessitates several turns round the limb, and, in addition, requires a good deal of practice properly to apply it. Arising out of this, may I mention that at a recent re-examination one of the candidates for a voucher applied three bandages for a fractured forearm. ] afterwards asked the Examiner (my Divisional Surgeon) if he had deducted any marks by reason of the instructions in the Textbook not being strictly followed; and the reply given was, "Certainly not. These men must be trained to render first aid in the street where splints and bandages are not readily available. In dp.aling with such a case as this he would probably use three pocket handkerchiefs. Is it reasonable to expect a first aider to tie two handkerchiefs together so as to exactly follow the Textbook? I consider that the candidate was quite in order to use three bandages, as it showed me that he would be able to improvise in the case of necessity. " My surgeon's views certainly seem to me to be another argument against the two bandage treatment, and I shall be o~liged if you would let me have your views. Meanwhile, accept my thanks for your assistance in the past. Elsewhere I have stated that it is not my intention to plough any candidate for Association awards if he (or she) fails to apply correctly either the special bandage in the treatment of fractured forearm or the double figure-of-eight bandage in that of fractured kneecap. Like your Divisional Surgeon, I shall be quite content if the candidate controls the fracture with splints and bandages in such a manner that he prevents aggravation of the fracture. For competition purposes, however, I shall keep strictly to the instructions of the Textbook, even though I consider that with these injuries the Revision Committee has exceeded the needs of first aid by the introduction of complicated methods of treatment. -N. C. F.

Next, please! !-N . C, F.

SPECIAL BANDAGE FOR FRACTURED FOREARM.

F. B. (Downhills Park).- Your very interesting replies to questions raised by correspondents in FIRST Am have always been carefully read by me, and a special interest has been taken in the matter of the treatment of a fractured forearm and of the application of the second or special bandage. I note with sympathy your condemnation of the special bandage, and your suggestion that three bandages would be the better treatment. It has al ways been my practice when instructin<Y classes as to how this injury should be dealt with, t~ see that the patient lays his iniuled forearm on a table or form, so that the limb may be at rest while the splints and bandages are being obtained. With- the forearm in this position it is easy to pass three bandages round the injured limb without causing any appreciable amount of movement. It is hardly within my province to criticise the eminent gentlemen who constitute the Revision Committee ; but I do suggest that it is not conducive to the

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G. R. (Tottenham).-In practising the treatment of fracture of leg (Fig. 51), our instructor recently insisted that the bandages above and below the fracture should be 100p bandages, as shown in diagram. Now (1) I question if they are loop bandages, and ask you kindly to decide this point. Also (2) he instructed us that when we do up this fracture single handed, the bandages A Band C are to be loop bandages, and round tlte injured limb only. I tried to do this, and as, of course, the feet had already been tied together it was not easy, and did appear to cause some movement of limb. The instructions quite clearly state, when single-handed, "pass bandages round both limbs." Also (3), we were instructed to carry out as per Textbook if patient was a female, but if a male round injured limb only. Finally (4), what would happen at examination or a competition if our instructor's instructions were carried out, please? (1) If you compare Fig. 34 and 51 you will obtain visual proof in confirmation of your opinion that Fig. 51 are not of the loop variety. At the same time, no objection can be

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FIRST raised against the use of loop bandage if such should prove " more convenient" (last par. on p. 68 of Text book). (2) As you say, the Textbook specifically states that the bandages are to be placed round both limbs. (3) The Textbook does not discriminate between the sexes when first aiders are called upon to treat for this injury without other assistance. (4) If the fracture is treated by other methods than those taught in the Textbook, then you may expect to lose marks in examination, and still more in competition in which Te?Ctbook instructions must be strictly followed.N.C.F. FRA CTU RED SPINE AND DELAYED INSENSIBILITY.

G. C. (Rhondda). - Please tell me how we should act if, after we have treated on the lines set out in the Textbook (pp. 73 and 74), a conscious patient for fracture of spine in the cervical region, the patient during transport becomes totally unconscious from the effects of the accident and shock. Should we remove the pads under and on each side of his neck and turn the patient's head to one side to prevent his tongue falling bar kwards and choking him, or should we detail a member of the team to hold the tongue and pull it forward in the event of it falling backward? Your second suggestion is the correct one. - N.C.F.

HUMOUR IN FIRST AID.

D. B. (Horsham). -Herewith one more joke for your collection and a true one! A short sighted Divisional Surgeon reading his "lecture" from the Textbook, p. 171, said :-" Get rid of the poison by g iving ETHER." Then came a long pa use and a worried look; and at last he added :-" I am salTy. My spectacles are not quite ?'ight. Get rid 0/ the poison by giv ing EITHER lIlusta?'d or salt." Good!

Next, please! !-N.C.F.

Sn'I P LE FRACTURES OF CLA VICLE AND HUMERUS.

A. E. (Rhondda).-Would you be kind enough to teII me what, in your opinion, is the correct treatment for fracture of the cl a vicle and of the humerus, both fractures bein g simple and on the same side? Also, please state which of the slings-St. John or small arm- would be most efficient with such a patient. This combination of fractures pre-supposes a serious accident and a gra ve degree of shock. The patient, therefore, would have to be kept Rat and removed on stretcher. Consequentl y I should control the fractured humerus (which is the more serious injury and demands priority in treatment) with splints and bandages, and I should then keep the upper limb in close apposition to the body-flexed at the elbow or extended, as the patient prefers-whereby the fractured clavicl e would be protected from risks of aggravation. In brief, I would use neither of the arm slings named because there are objections to each with this combination of fractures. -N. C. F. HOT

W A'fER

BOTTLES WITH FRACTURED RIBS.

H.M. (March).-At a team practice two days ago we were asked to treat and transport to hospital a patient who ~as suffering fro.m a sim pIe fracture of the right upper nbs and a com pltcated fracture of the lo\-ver ribs of the same side, involving the liver. There were definite signs given of severe internal h::emorrhage and the patient gradually became worse and the pulse altogether disappeared at the wrist.

FIRST

AID We were told that the hospital was twenty minutes ride and medical aid could not be obtained until we go t there. The patient was 1n an open yard and the weather was fine. A slight difference of opinion arose as to the correct position to place hot water bottles, which were available. Some of the team wanted to place them a t the sides, between the lower limbs and at the feet. I did not agree with the placing of the bottles on the right side of the body, because the heat from th e bottles would melt the ice which had been placed over the injured part, and thus lesser: its effects. I also disagreed with placing the bottles at the feet, thinking that this would tend to draw the blood down to the lower limbs. I had in mind the effect of placing the feet in hot water in the case of severe bleeding from the nose. Your valued opinion and advice will be much appreciated. While I can see no objection to placing at the feet of th e patient hot water bottles which will not act as you suggest, I agree with you that care should be exercised to prevent the hot water bottle coming in contact with the ice dressin~. N.C.F. BURST VARICOSE VEIN AND FRACT U RED PATE LLA.

C. V. (Southampton).-At a practice class the other night I set our members to treat a case, in which the patien t was supposed to be suffering from a burst varicose vei n in the calf of the left leg and a simple fracture of the left patella. 1\1 uch discussion arose as to the correct treatment of this combination of injuries. I would, therefore, be glad to know if you consider that I was right in sayin g that the limb must be raised in such a case in view of the fact that the treatment laid down in the Textbook for each injury reads: "Ele\'ate the bleeding part except in the case ot a fractured limb." As the Textbook specifically tells you to raise the lower limb in your treatment of fractured patella, it definitel y cancels General Rule No.2 on p. 128 in this connection. I n these circumstances your ruling was correct.-N.C. F.

AID

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O. M. (Southampton). - At our last Divisional meeting a query was raised as to the correct method of artificial respiration which one should use when dealing with a child of one year or under. Suggestions have been made as follows : 1. Place the child on its stomach across the knee and gently roll it backwards and forwards. 2. Place the child on its back and gently press its stomach down and relax. 3. Labordes method. We would be much obliged if you would give us a ruling from a first aider's line of action. Thanking you in anticipation. Clearly by reason of its omission of reference to age and size the Textbook intends you to adopt Schafer's Method , which you would perform with due allowance for the small and fragile body of your patient. Personally, however, I favour the adoption of Silvester's Method which you would modify by getting an assistant to fix the infant's lower limbs, and which you would perform with similar allowances.-N.C. F. COLLIERY, NOTTLNGHAM. BESTWOOD ANNUAL OPEN AMBULANCE COMPETITION . Saturday, 6th May, 1939. Entrance Fee 4/- ptlr team. 1/entry for Individual Competition. Valuable Prizes. Particulars from Ambulance Competition Secretary, B. A. Collieries Ltd., Bestwood, Nr. Nottingham.

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THIS

NUMBER .

E DITORIAL : -

Full Trainin g The Revised Textbook- What it Means to First Aiders Na tional Road Passen g er Transport Ambulance Associa tion S. J .A. B. Headquarters a nd District Reports I nter Railway Competition, 1939

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P riory for Wales T he Hospitallers' Club ... Coming Events Railway Ambulance News St. Marylebone Open First Aiel Competition St Andrew's Ambulan ce Association The Supine Position in Emerg en cy Treatment of Patients with Fractured Spine

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Our Nurses' Pages A.R.P. Topi cs Reviews

249

250 251 252

256 257 258 258 25 9

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Treatment of Ammonia Poisoning

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F IRST AI D is published on the 20th of e a ch month. The Annual SUbscription is 35. 6d . post free; single copies 3 d • Its aim and object being the advancement of Ambulance Work in all its b ranches , the Editor inv ites 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 ad dress below, and should reach him before the 12th of each month, and must be accompanied (not necessarily jor tJublication) by the name and address of the Correspondent. Subscrip tions, Advertisements and other business Communications connected with FIRST AID should be forwa rded to the Publishers. DALE, REYNOLDS & Co., LTD. , 46 , CANN ON STREET, LONDON , E · C.4·

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Examination Howler Treatment of Acid Poisoning Treatment of Fractures of Spine and Elbow A Competitor's Dilemma H u mour in First Aid Complicated Fracture of Clavicle Transport Face-Downwards of Spinal Injury . .. Bandages in Treatment of Fraclured Leg

272 272 272 272 272 274 274

274 274

THE num ber of letters received from readers referring to the F U LL March issue Editorial has been TRAINI~G. amazing. It is apparent that once again we have aired a grievance not only of the rank and file but also of many senior officers, a nd that clearly the issue is not merely local but has a national aspect. Having voiced our opinion regarding the F irst Aid Personnel, we now consider the training given to \i\Tardens in the subject of first aid . They attend what is known as a "Short Course," which consists of four sessions of about one hour's duration, and at the end of such courses they are expected to have an elementary knowledge of the subject. Elementary knowledge is righ t! How can they be expected to be able to p ut what knowledge they have gained into operat ion a fter but four hours training ? " A little knowledge is a dangerous thing " is an old but, nevertheless, true saying and this especially applies in this case. If it is necessary for Wardens to receive first aid training why not give a full course of 12 hours during which time they have a fair amout of practical tuition. There should be no half-way line; either they should be trained, really trained, first aiders, or else the subject should be left alone. We are by no means attacking individual Wardens. They have to receive tuition as laid down by the authorities concerned; and many to ou r kn owledge have taken a full course at their own expense. It is the principle of the thing which we attack . Full training or no training should be laid down and not an intermediary course which may cause some grave misgivings among the fully trained personne l.

FIRST

25 0

The Revised Textbook-What it Means to First Aiders. * By N. CORBET FLETCHER, Al.A., l\l.B., ]\.1. R.C.S. Conc1udedfrolll page 22.].

Chapter Vl.-The new definition of a fracture does not seem to have carried us forward; and in my own lectures I teach that a fracture is a break in the width or length of a bone. ,Vith reference to signs and symptoms it is noteworthy that "deformity" still applies only to the limb; and it is a trifle presumptious for the Committee to say that crepitus and un natural mobility "should be sought" by the doctor. I wonder how many do so in these days of X-ray examination! Surely the choice of the most suitable method of transport should be an object of treatment of fractures, more especially as, in the days before the Association began its benificent work, the conversion of a simple into a compound complicated fracture of the thigh was almost an everyday occurrence owing to the choice of a fourwheeled cab as the best method of conveyance of the patient to hospital. It is a joke against the Revision Committee that, having defined a splint as "anything firm, long and wide " it starts its list of such apparatus with "a walking stick, urn breI la, billiards cue " and ends it with articles which are really useful for the purpose and conform to its definition. The Revision Committee merits our thanks and congratulations on the clever way in \Vhich it has met widely divergent opinions with reference to the treatment of Fractured Spine. Loading a stretcher with patient face-down is not easy and calls for much practice. In these circumstances we are grateful to Dr. A. C. ,Vhite Knox, who, as a member of the Committee, gave the Surgeons at their 1938 Week-End Conference the following five useful rules : t.

Do not turn patient too far on his

face. n. Push lower pole of stretcher close to patient. nt. Hold lower pole in position with your foot. iv. Lower the stretcher well over the patient. v. Do not load the stretcher too slowly. The measurements of the pad which must be *A lecture given to members of the Hospitallers' Club on February 10th, at the Bonnington Hotel.

AID used in treatment of Fractured Clavicle are now gi\'en in three dimensions j and the pad is precisely the size of the clenched fist of a man of average size, though" from front to back" would he a better and more anatomically correct term than "across." \i\Tith Fractured Arm the limb is to be placed in a sling at the outset of treatment, the results being that the error in the 38th Edition is now eliminated and the splints are placed on "the fron t, back and ou ter side of the arm." \Vith Fractured Arm at elbow and with Fractured Hand a figure-of-eight bandage is now to be used. You should note, however, that the bandage, though similar, is put on differently in each case. Personally, I do not know why it was ever introduced into the Textbook and what advantage the figure-of-eight has over two bandages unless it be for competition purposes to discriminate between the teams! In my earliest days as a Divisional Surgeor. I saw it used on public duty by a member of my unit, who told me that thereby he was able to save a second bandage and that he did so because patients, treated on public duty, never returned the splints and band-3.ges ! ! \Vith Fractured Knee-cap a pad is now to be placed in the hollow below the ankle" to raise the foot well of the splint." Thus far in examination I have not seen this done, nor have I seen the double figure-of-eight bandage correctly applied ~ Chapter VII.-The introduction of X-ray photographs in this Chapter is a real forward-step. I can not, however, approve the new instruction on which a first aider can justify himself if he exposes a sprained joint in the middle of a busy street. Clzapter IX.- The definition of a wound is now'added and that also of the ideal antiseptic. The net re5ul t is that the surgeon-lecturer must now tell his class what is the best antiseptic for first aid purposes, whereby continuity of instruction is lost! As a fact, most candidates for Association awards, in my experience, content themselves by saying that they would use an antiseptic and are flummoxed when I insist upon their naming the one which they would use! ! The Aorta is now stated to end" below the second Iurn bar vertebra" in place of the old" at the navel." With an incised wound of the cheek pressur~ on the Facial Artery usually fails j and Fig. 61 is strictly correct in showing the first aider compressin g the pressure points of both arteries. Compression of the Axillary Artery is a great stumbling block to most candidates in examination whose difficulties have not been lightened by Fig. 66. The armpit, being small in size and triangular in shape, will not admit anything larger than

FIRST a billiards or golf ball; and, the less clothing which intervenes, the easier will it be to introduce the pad into the armpit. So why the patient is shown wearing a sweater, I do not know! ! For compression of the Palmar Arches the words "Apply a dressing" have been added. This seems in many cases to be read as "Omit use of antiseptic" whereas" After dressing wou nd " would have been perfectly clear even to students preparing for their first examination. The instructions for treating a Burst Varicose Vein have been duly amended by the correction of certain errors of omission in the previous Edition. Chapter LY.-If you analyse the signs and symptoms of Bleeding from an Internal Orga.n (Concealed Bleeding is the better term because It covers injury to the large blood vessels as well as the internal organs) you will find that No.2 refers by general effects ; ~os. 1 and 4 to those a~ecting the respiration and No.6 to those affecting the nervous system-a proper jumble! Personally, I teach the general effects and then those affecting the several vital functions in sequence. Chapter XI.- The method of artificial respirat ion now taught is that which was approved ?y Schafer in 1931 at the instance of the Royal Ltfe Saving Society and involves certain differences from the 1903 method which most of us learned originally. . The aside position of the operator IS recommended for continuous individual effort, and the hands are placed just clearing the crests of th.e ili~c bones (or" top of pelvis "), the fingers beIng In apposition and the thumb unstretched. If y~u meet a pal and pat him on the shoulder, you wdl find that your hand is as now required for the performance of artificial respiration. As a practical tip I suggest that you start the movement ~fter having squatted on your heels and found the nght position for your hands. Silvester's Method is now restored to the body of the Textbook' and the pad beneath the patien t's shoulders must 'be" small and firm." Slip off your coat and fold it tailorwi.se. ~hen you will have a pad which will do what IS req~lred! nan:el.r' throw back the patient's head and stick hiS chIn In the air. Start the movements as the Textbook suggests with inspiration, the patient's upper limbs being flexed across his chest j and do not forget to force his elbows firmly on the ground. Chapter Xv.- The treatment of Bu:ns and Scalds is radically altered; and your actIOn n.ow depends on whether or no medical. aid or hospItal is readily available. If such help IS ne~r at hand, the injury is to be covered and the patIent moved without delay. . It is interesting to note that bIcarbonate of soda solution is still the dressing of choice for Burns and Scalds, and that warm strong tea

AID

25 1

(which is said to have been used by the Chinese for thousands of years for this purpose) now finds a place in the Textbook. Chapter XVI.- The introduction of a definite scheme for the routine examination of a conscious or unconscious patient is a pleasing feature of the new Textbook and will lighten the task of those who are starting to learn how best to prepare detailed marking sheets for competitions. It is curious, however, that enquiry as to the proximity of medical aid has been omitted from the scheme, because on this stands or falls the need to render first aid. Chapter XVII.-In the opening list of ~Iethods of Transport reference to the Fore and Aft method is still omitted j and I wonder why this is so because it is not a handseat ! Two years ago-after 28 years of lecturingI suddenly realised that though first aiders and non-first aiders know what is meant " ,hen told to " grasp the wrists," yet this term is anatomatically incorrect! The wrist is the heel of the hand; and in point of fact no one can grasp his wrist. In these circumstances I now teach that, when formina the four-handed seat, the bearers must grasp . " an d " bthe lower end of the forearm at t h e 'iHIst, that, when forming the three-handed seat, they must grasp "the lower end of the forearm two inches above the wrist." The Human Stretcher was not of much use for the transport of heavy-weight patients and has • been deleted.

National Road Passeng~r Transport Ambulance Association. THE 1939 eliminating contests for the "Stirk" trophy, presented by 1\1r. J. H. Stirk, J. P .. , chairman, Tra~ ~ Commissioners, East Midland Area, wIll be held as follo\\ s . l\lidland Area.-At Derby, on Sunda y, May 7th. Northern Area.-On Sunda y, :'IIay Hth, at a yenue to be decided. South :'Ilidland Area.-At Birmingham, on Sunday, May 21st. The final competition will take place at \\' alsall, on Sunday, July 2nd. P~rticulars of the Association will be forwarded to any road passenger undertaking- on applica tion ~o Mr. 'N. E. ~forse (hon. secretary ann treas~rer), 2, SpnngfieJd Court, Stratford-road , Hall Green, Birmmgham, 28.

SOCIAL

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Samples will be sent on request.

FIRST

AID

St. John Ambulance Brigade Headquarters and District Reports. Brigade Headquarters BRIGADE FINAL COMPETITIONS.-These will be held on June 9th, at the Great Central Hotel, London. H.RH. Princess Alice, Countess of Athlone, has graciously consented to present the trophies and prizes. Application for tickets should be made to the Brigade Secretary, St. John's Gate, London, E.C.1. RN.A.S.B.R ENRoLMENT.-The Royal Naval Auxiliary Sick Berth Reserve Waiting List is now open and applications for enrolment should be submitted on Form SBR 1/2, to which should be attached Birth Certificate and E.D. 60 with Section 2 completed. E.D. 60 marked for part time service only, precludes the enrolment in the RN.A.S.B.R, and forms SBR 1/2 should not be completed, but applicants are advised to volunteer for local A.RP. Casualty Services. Forms SBR 1/2 can be had on application to Brigade Headquarters. FouND.-King George V Coronation Medal engraved Private T. Broscombe. Will owner please apply to the Secretary, St. John Ambulance Brigade, St. John's Gate, London, E.C.l.

No. I (prince of Wales's) District A demonstration in post-instructional training of A.RP. First Aid personnel by the Westminster Division, consisting of No. 137 (Westminster) Ambulance, Craig'S Court, Whitehall, Temple, Victoria, and Westminster Nursing Divisions, was held at the Grosvenor Hall, Buckingham Palace Road, on March 15th. About 400 volunteers attended. Asst. Commissioner Capt. H. A. Fenton was in charge and gave a running commentary during the demonstration. District Officer T. McBride was in charge of the Guard of Honour. There were many representatives of the Westminster City Council present including Major Rogers (Chairman A.RP. Committee), Councillors Edgson, Sparks and Russell, The Hon. Arthur Howard, Dr. Shinnie (M.O.H.), Dr. Thomson, Dr. Hardy, Mrs. Parker Morris and Lady Bradford. Brigade officers present included Lady District Officer Miss Walker, Lady District Officers Mrs. Morrish and Miss Rodick. There were twenty-two casualties dealt with und er the supervision of County Surgeon Russell Steele, Div. Surgeons Beam and Talbot. Demonstrations included assistance to casualties following a street explosion; dealing with casualties at a .first-aid post; dealing with gas casualties; and dealing With severe cases by doctors with a view to transport to a casualty clearing station. . ~he general ?rganisation was worked out by Lady Dlstnct Officer MISS Tuckwell and Miss G. O. TuckweH whilst pistri<;:t Staff Officer W. A. Roust and his staff

were most helpful in staging the various scenes and In arranging the supply of the necessary stores. FINCHLEY.-The annual dinner and dance of thc Finchley Division was held on March 14th, the Mayor of Finchley (ColU1cillor J. Hugh Joncs, Ll.B.) presiding. Following the loyal toast, Aldermal1 A. T. Pike, O.B.E., J.P.) proposed the" No. 93 (Finchley) Division." He referred to the excellent work of the members and to the A.RP. arrangements in the Borough. Supt. ]. W. Tayler, in reply, said that the division was formed as a section in 1924) being made a division in 1927. Since that date over 8,500 cases had been treated by members. In 1929 a section was formed in Edgware and in 1930 the Southgate Division came into being. In 1932 the Finchley and Southgate Nursing Division was formed, whilst 1937 saw the inception of a section of the Brigade in Friern Barnet. During the past 15 years 28 Association classes had been held and over 600 certificates gained by students. Of the classes given Div. Surgeon J. D. Holmes had been the lecturer to 16. "The President and Vice-Presidents" was given by Dr. Holmes, to which the Mayor responded. The Council required 300 stretcher bearers and they were to be drawn from such organisations as the Brigade. The work of the Division was of the greatest importla nce and he was pleased to be associated with it. Amb. Officer F. W. G. Dines proposed" The Ladies and Visitors," to which Col. G. Beach, CB., O.B.E., T.D., J.P., replied. All speeches were kept short but there was no shortage of humorous reflections in them. Dancing continued until midnight. The guests included the Mayoress, Councillor J. E. Pickering (Chairman Friern Barnet, U.D.C) and Mrs. Pickering, Dr. Turner (M.O.H.), District Staff Officer Franks and Mrs. Franks, District Staff Officer Green and Mrs. Green) District Officers Standingford and Claridge, and Mr. C. T. Osborne. HAGGERSTON.-On Saturday, March 25th, the No.2 (Haggerston) Division held a dance at the Shoreditch Town Hall in aid of the 50th anniversary celebrations. Asst. Commissioner Capt. H. A. Fenton 'and District Officer T. McBride were present; and some 500 persons danced to the music of Bert Morrison and his Swing Band. The function was a great Is uccess and Staff-Sergt. Jaggers, officer-in-charge, together with his entertainment committee, must be very pleased with their efforts. NEW CROSS.-Yet another Division is the proud possessor of its own headquarters. On Sunday, April 2nd) Sir John Duncan, Chief Commissioner, officially declared open the new headquarters of the No. 16 (New Cross) Division. Supt. Webb ,a nd his men are justifiably proud of their new home which is situate in Amersham Grove. On

FIRST acquiring the building, which was in a very derelict state, the members worked with a will) painting, glazing, cleaning, etc., and the result of their effo rts were loudly acclaimed not only by Sir John Duncan but also by Capt. A. C. White Knox, Asst. Commissioner, and the Mayor of Deptford. Tribute was also extended to the womenfolk of the members who literally scrubbed the grime-covered floors snow-white. Sir John referred to the voluntary and self-sacrificing work of the Brigade, the members of which during 1938 rende red assistance on 688)000 occasions. The new building would be of the greatest assistance to the New Cross Division which was formed in 1895 and now had a personnel of 151. The Mayor (Councillor E. C Sherwood), who obtained his first aid certificate in the '90's, welcomed the opportunity of saying how much the Borough of Deptford owed to the members of the Brigade. Capt. White Knox, who presided, on behalf of the Southe rn Area and especially the New Cross Division, thanked Sir John and the Mayor for their presence. He

AID fu nd of the Southall Division. A most enjoyable evening was spent and Supt. J. E. Taylor expressed thanks on hehalf of the Division. When presenting awards to the H eston Section the Mayo r -of Heston and Isleworth (Ald. F. C. Green) J.P.), paid tribute to the work done by the No. 55 (SouthallNorwood) Division, which had rendered inestimable service to the Borough in connection with the training of volunteers for National Service. County Councillor T. H. Bisgood (Chairman, Borough A.RP. Committee and Vice-Chairman, Middlesex A.RP. Committee), said that the St. John Ambulance Brigade was one of the finest voluntary organisations in the country. SOUTHGATE.-The Mayor of Southgate (Councillor Robert Grant, J.P.), distributed trophies to members of No. 28 Southgate Cadet Division at a recent social. The Mayor, who was accompanied by the Mayoress

Asst. Commissioner Capt. H. A. Fenton g iving ~ runnin~ .c~mmentary at the A. R. P. demonstration of the Westmmster DIVISIOns. also welcomed Capt. W. Goodley, O.B.E.,. M.C .(S::0mmissioner), and representatives. of. the PolIce, MllItary, and Air Force and other orga11lSatlOns. . .. He 'a lso congratulated Supt. Webb on the acqulSltlOn of the new premises. During the proceedings the Chief Commissioner presented CorpI. W. Keeping with his certificate of promotion to Sergeant. Among those present was Lady District Supt.. M~ss Walker District Staff Officer G. C. Green) Lady Dlstnct SUD t. Miss Grindley, Div. Surgeon G. H. W. Allen and the" Father" of the New Cross Division, Dr. Stanley J. Davies, who for many years was Surgeon and Superintend ent of the Division. SOUTHALL.-Last month the Sanders Recreation .Club held a dance in the ballroom of the Seagull Hotel, kmdly loaned by Mr. S. PalmerI manager, in. aiel of the buildin~

(Mrs. Robert Grant), was received by Amb. Officer P. H. R Hayman and inspected the Cadets under Cadet Supt. P. A. Stacey. His Worship congratulated the Cadets and said that the work of mercy undertaken by the members was of great usefulness in everyday life. The trophies distributed were:"William Neill" Shield, won in competition against the ,o ther cadet teams in No.1 District. Team w~s composed of CorpI. R L. McQueen, Cadets R Flemmg, D. Lucking ,a nd D. Maitland. " Dr. Crameri" Trophy, won by the te.am compos~d of Cadets R Fleming, leader, J. Warnasunya, D. Maitland and G. Boreham. "Wauthier" Efficiency Cup: CorpI. McQue~n and Cadet T. Taplin tied for first place and ~ach Will h?ld the trophy six months. The fonner receIved a replIca fiS last year's winner,

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Cadet J. G. Neville gained the First Year Efficiency Medal and Cadet P. Laver received a replica of the "Mrs. Blagg" Trophy, which he won last year. First aid awards were also presented. No. 107 (YORK ROAD, L.N.E.R.) DIVISION.-This Division lost, by death, their bcloved Supt. H. H. Dye, on March 22nd. Supt. Dye, who passed away after a short illness, joined the Brigade on March 8th, 1902) as a member of the No. 13 (King's Cross) G.N.R.) Division. He passed through the ranks of Corporal (1907), Sergeant (1913), Staff Sergeant (1921) to Ambulance Officer in 1922. On March 21st, 1930, he transferred to the No. 107 Division as officer-in-charge and on October 30th, 1930, was promoted to Superintendent. His services were recognised in 1931 by the Order of St. John, being admitted as a Serving Brother. He received the Service Medal in 1919 and 'a t the date of his death had just completed 35 years' efficiency service. He also held the Gold Medal and four bars awarded by L.N.E.R. Since 1920 he acted as class secretary and instructor to L.N.E.R. classes held at Finsbury Park,and for several years he trained competition teams. The funeral took place on March 27th. Over 60 officers and men attended to pay their last respects to one whom they had beloved. The L.N.E.R. Co. was represented by Mr. W. Sheppard (Asst. Yardmaster), Mr. S. Hall, representing Mr. F. C. Robbins (Goods Agent) and the clerical staff, whilst Mr. R. A. Davies represented the uniform staff. The coffin was draped with the Brigade Flag and was borne by six members of the Division. Amb. Officers S. E. Dearmer and E. VV. Waygood, together with Supts. F. VV. Bishop and N. Ware, acted as pall bearers. The men, under District Staff Officer W. Roust and Amb. Officer H. Durnford, headed the cortege to the church and thence to Tottenham Cemetery. Buglers of No. 1 District Band sounded the Last Post.

No. m District. Results of the Bedfordshire County Competitions, held at Stewartby, were :-lst, Bedford) 340 marks; 2nd, Vauxhall Motors, 298~; 3rd, Electrolux) 268t Six teams competed. The judges were Dr. McCoan (team) and Drs. Dockrell and Fildes (individual). Sergt. McEvoy, of V'a uxhall Motors, won the individual test. The Northamptonshire County Competitions were held at Wellingborough. The judges were Dr. W. P. Blackstock (team) and Dr. J. W. Notley (individual), and the result was :-lst, Northampton, 162; 2nd, Wellingborough, 154; 3rd, Desborough, 150. Dr. Blackstock presented the "Markham" Cup to the winning team. County Commissioner Dr. L. W. Dryland, County Surgeon G. F. P. Gibbon, Corps Supt. F. Sewell and other officers were present. The arrangements for the competition were made by Corps Supt. J. Marshall Bailey, assisted by Div. Supt. Parker. YVELLINGBOROUGH.-At a recent practice of the Wellmgborough Headquarters Division, Supt. J. S. Parker presented to Amb. Officer H. H. Barlow a silver tankard suitably inscribed, as a token of the appreciation of th~

AID members of services rendered to the Division. Making the presentation, Supt. Parker spoke of Amb. Officer Barlow's sterling work and wished him every success in the future . Amb. Officer Barlow) who is returning to Market Harborough after four years in Wellingbo rough, has served in the Brigade for 25 years.

No. IV District LANCASHIRE. LIVERPOOL.-The annual competition for the" Lister " Cup, open to teams of the Liverpool Ambulance Divisions, was held on March 18th. Asst. Commissioner Col. C. H. S. Redmond judged the team test and Div. Surgeon J. R. Burrows (St. Helens Nursing Division) the individual section. T,h e team, test dealt with a supposed accident in which a motor-cycle had skidded and collided with a wall. The driver and his pillion driver were seriously hurt, The driver and his pillion passenger were seriously hurt) the injuries including a fractured spine, fractured hand and bruised knee. County Surgeon W. Murray Cairns presided at the presentation ceremony and informed the gathering that two members of the Liverpool North team-Messrs. Farrington and Pendleton-whilst on their way to the competitions were called to attend a woman who had fallen downstairs in her home and sustained an impacted fracture of the humerous. The result of the competition was: 1st, Liverpool Gas Co., 197 marks; 2nd, Exchange Division, 192; 3rd, Central Division, 168. West D erby and Liverpool North also competed. Col. Redmond presented the cup and prizes. Th e teams had, he said, acquitted themselves well. Corps Supt. W. E. Searl and Div. Surgeon W. Duncan (Liverpool Gas) exp ressed thanks to the judges and to the County Surgeon for presiding. The "Grace" Shield Novices CompeLiLion of th e Liverpool" A " Corps, was held on March 19th. The result was: Exchange Division 1st and 2nd teams occupied first and second place followed by Mersey Dock and Harbour Board . Mr. W. J. Grace (Group President) asked Commissioner W. Smith to accept the shield, which he would like to present to the "A" Corps for annual competition. Commissioner Smith thanked Mr. Grace for his generous gift which would assist the work in many ways. Mrs. Grace graciously presented the trophy and p;rizes to the successful competitors. Corps Officer R. Anthony commented on the work done and congratulated competitors on their efforts. Those present included Supt. T. Armitage) Supt. F. Williams, Supt. L. R. Lewis (Exchange Division) and Supt. W. Latchford (Everton). The Exchange Cadet Division held their annual presentation of awards on March 24th, when Mrs. Grace (wife of "A" Group President) distributed the awards, including warrant of promotion to Cadet Officer to Vv. Spencer, the 1937/1938 medals for the" Lutas" Cup Competition and eight individual awards for the same trophy. Incidentally, Mr. W. Spencer was for the past six years 'a cadet in the Division and it is the first time that a Cadet has been promoted to Officer in Liverpool and possibly in all Lancashire.

FIRST ' AID More than 40 new cadets received first aid awards, and 49 A.R.P. certificates were issued.

No. V District On Saturday, March 25th, a Memorial Window was unveiled at St. Cuthbert, Sheffield) to the memory of Captain Oswald Frank Buxton, late Asst. Commissioner So uthern Area West Riding of Yorks, whom the No.5 District lost by death on April 2+th, 1936) at the early ag-e of 52. The stained glass window was the gift of the officers and men of No.5 District. Asst. Commissioner Dr. K. H. Beverley unveil ed the memo rial, whilst the R ev. H . C. 1\{ason (the Vicar) conducted the service. Following the dedication, Asst. Commissioner H. C. Else (Chid of Staff No. 5 Di strict), addressed the gathe ring. The laLe Capt. Buxton, who 'was beloved by every man amI woman who kn ew him , was a valuable officer who neve r tired oE his \\-'ork for the cause. In 1900 he join ed the Sheffield Corps as a private and by m erit he rose to the rank of Corps Superintendent, the high est honour the Corps could confer on him. La ter, the Commissioner of the District, J\Ir. Sydney \V. Malkin, made him an Assistant Commissioner in ,ha rge of the Southern Ar ea of Yorkshire, .W est Riding. Tn 1932 he was made treas urer of the district, and these two high offices h e held until his death. The Order of St. ] ohn conferred upon him the honour of Commander (Brother). During many Di strict Camps he acted as Quartermaster and there was no man in No.5 District eyer held in higher honour and esteem than Asst. Commissioner Oswa ld F. Buxton. On the outhreak of the Great War he joined the army as Lieu t.-Q ua rtermast er in the T erritorial Field Amhulance, out owing to his training as an engineer in Cl\' i! life he was iran ferred to the Royal Army Ordnance Co rps and sent to France as an in specto r of machinery \\ ith the rank of Captain_ Capt. Buxton, continued 1\1r. Else, was full of human kll1d ness and \'\'as never tired of rendering service to others. Those present at the senice included Asst. Commissione r H. C. Chamhers, District Surgeon T. C. A. Sweetman, County Surgeon F. VV. Sullivan, D!strict Office rs L. W. Walters and C. H. Forster) Lady DIstrict Office r Miss G. Ashb erry ancl Corps Supt. J. VV. Gilling. Capt. Buxton was Master of vVhite Rose. of York :\Iasonic Lodge in 1933 and the Sheffield Mas ol11c Lodges we re repres ented at the unvei lin g ceremony. PONTEFRr\CT.-The annual dinner of the officers of the Pontef ract Corps \Vas helel on 1\Iarch 16th, when Corp SupL T . C. Amery, who presid ed) described th.e first aid training for A.R.P. wardens as "a waste 0 f tIme and a danger to the public." . Mrs. G. E. Guest proposed " Pon tcf ract and DisLnct Corps," and declared that no ohservant person could hil to notice the tremendous amount of work done by amb ulance men work for which no paym ent \Vas received. Lady Distl:icl Officer Miss Ashberry, in reply, said that there were not enoug:h V.A.D. and ot her voluntc ers in Northern Districts. Outside people had little idea of the scope of ambu lance w9rk, but more recruit were enrollino' because they realised the knowledge was valuable h in their own homes. Corps Supt. Amery also responded. A new Division

255

-the Upton Ladies' Division-had been created during the year and there was an increase of 105 members. In public duties 17,000 hours were put in and the Pontdract ambulance removed 1,389 cases from their own area, 609 from Feath erston e area and 92 from other divisions. Over 40 miles of main roads were looked after and 106 motor accidents were dealt with. The speaker referred to A.R.P. work and especiall y that done during the crisis, when 250 members were ava ilable for duty. Div. Supt. Tagg proposed" Th e Mayor, Corporation, Local Councils and Vis ito rs. " The 1ayor, in reply, agreed with Corps Supt. Amery that the training (of A.R.P. vVardens) was \\ holly inadequate. H e was surprised by the figures given regarding the Brigade and hoped a vigorous response would be made to the appeal for more men to join. 1\1r. J. E. J'\elson, who received his badge of office as President of the Hemsworth Colliery Division, also replied. Lady Di\'. Supt. Miss Brovvn proposed "O ur Hon orary Surgeons," to which Div. Surgeon Hilda Burnett replied. Prescntations wcre made as follows:Shield for the most efficient Division, Knottingley; " Lil y Sides" Cup, Pontefract Nursing Division; " Pontefract Industrial Co-operative Society" Cup, Pontefract Cadet Diyision. We extend to Dr. John K. A. Beverley our heartiest congratulations on his recent marriage to 1\liss Freda Harri son. Dr. Beyerley is the elder son of Asst. Commissioner Dr. K. H. BeYC'rley and :\lrs. Beyerley, of \Vorsbro' Dale, whilst his bride was formerly Sister at Sheffield Royal Hospi tal and Rotherham Ho pita!, and only daughter of 1\1r. and )'Irs. F. Harrison, of Xottingham. The wedding took place on Saturday, April 1st, at St. Luk e's Church) Heage, Belper, and a sup rise awaited the couple as they left the church. Members of the Worsbro' Nursing Division, under Lady Supts. 1\liss Foulstone and ~1iss Marsland travelled, unb eknown to the bride and bridegroom, to the church and formed ag'uard of honour, much to the couple's surpris e and pleasure. The honeymoon is being spent in Torquay. Among the numerous presents were those of ambulancc classes and hospitals.

No. VIII (Duke of Connaught's) District ADDISCOl\IBE.-The annual general meeting of the Addiscombe Division was held last month. District Officer E. ]. Prew presided, supported by Amb. Officers A. Scott, 'vV. ]. Rose and C. L. Crispen. . . Cases dealt with during 1938 was 2,-+33, whilst 111. the John Jetton Dressing Station a further +96 cases received attention, mostly at the hands of Amb. S;ster G. Prew. Public dutics at theatres, sports grounds, fetes, etc., numbered 5,555. Thanks to increasing mcmbersh:p, and to the keenness of the men) there has been no difficulty 111 acceding to requests for assistance. The Dil'ision has 8 Gracie One and 12 Gracie Two A.R.P. Instructors. The motor ambulance sen'ice transported 933 patients to yarious destinations, covering a mileage of 21,852. Over fifty necessito us cases wcre carried free of charge over 899 miles. It is ho peel to purchase a new ambulance during the currcnt year. CITERTSEY.-On March 9th The Airscrew Co., Ltd.

FIRST urcranised a dance in aid of Brigade funds as a mark of appreciation of the help and service given by memb.ers of the Chertsey Division to employees of the firm 111 the formation of its section and training of personnel. Mr. J. D. Titler (Managing Dir~ctor) 'vvelcomed District Officer Hannam. A men's sectlOn had actually heen formed from the works personnel and he was proud to be the President. A \yomen's section was to be formed. District Officer Hannam stressed the fact that first aid had an cycryday u e. Hc then mentioned acliyitics of the Order of St. ] ohn no\\' being carried out in Jerusalem. ;\lrs. Tiller presented the a\\arcls gaincd at the examination. Dr. Watts thanked Mrs. TitleI' for presenting .the awards, also Miss Tickner for organising the functlOI1. He also paid tribute to Dr. l\lcQl1ade as lecturer and Supt. R. ]. Gristock as lay lecturer. DEAL.-The 19th annual dinner of the Deal Di\'isiol1 was held on 1Iarch 27th, when Sir Gerald 'Wollaston, K.C.B., K.C.V.O. (president of the Diyision) presided, supported by Lady Wollaston) Alderman E. Cavell (Deputy 11ayor) and Mrs. Cayell) Ca~on C. F. Tonks ~nd Mrs. Tonks) Div. Surgeon W. A. DaYles and Mrs. DaVIes, and many other representatiYes of the ciyic and local organisations. Alderman Cavell proposed « The Borough of Deal Division." He remembered the starting of the Division when a few gathered together at the railway station ~nd formed a small brigade. Deal could be proud of hav1l1g such an organisation in the district. Last year the shilling a year scheme brought in £ 125, but it \'Vas not enough, and the figure could easily be doubled. It was a great pleasure to the Council to allocate £5 to the Brio'acle funds from the Sunday Cinema Fund . . Sir Gerald vVollaston, in reply, told his listeners of the wo·rk done by the Brigade in the September crisis. The Division had had several changes in the personnel. Mr. Pocknell, one of the founders of the Division, and its superintendent for 14 years, had retired. His services had been recognised by the Order admitting him as a Serving Brother. Amb. Officer Gage, a foundermember, succeeds him and Transport Officer \Vickens hecomes Ambulance Officer. The latter is a first class Falfield instructor. Dr. Davies proposed "The Ladies and Visitors," mentioning many friends present. Mr. R. M. Bourne replied and expressed thanks for the invitation to be present.

No. X District The Norfolk eliminating competitIOn for the "East Anglian" Cup was held at N orwichJ on Saturday) March 25th. Norwich Lads' Club Division gained first place with 472~ marks, being 88! marks in front of Yarmouth, who gained second place. County Secretary B. Sewell organised the compel ilion, assisted by members of the staff.

ST. ALBA ' S.- The Mayor of Sl. Albans r. T. F. Elm) presided at the annua l meeling- of the St. Alballs Division. The Hon. Secretary (Sergt. A. A. Kitching) rep ortec1 an increased membership of 9 and, in addition, 10 probationers who would become full members on passing their examination. There was also an A.R.P. reserve personnel

FIRST

AID of 23. During lasL year -1-25 cases had been tre.ated, of which 89 were road accident cas es . Over 900 duties were performed. The financial statement was presented by the Hon. Treasurer (Mr. E. G. Williams). Corpl. G. \V. Parker) reporting on A.R.~. traini!lg, said that 60 persons had passed the exam111atlOns dunng 1938 and that 40 were attending courses of instruction now in progress, in addition to the Post Offi~e Volunteers, whose training had been entrusted to the Bngade. The 1\1ayor paid a warm tribute to the ,york whic h (he Brigade is cloing in connection 'w ith A. R.P. The cit) were deeply indehted to the members and were thankful to haye a body of men upon whom they could rely to do their duty in any emergency. Supt. G. Anderson handed Dr. D. H. Kinmont h is certificate of appointment as Divisional Surgeon an d alluded to the valuable assistance which they \ve n' receivin o' from him. He congratulated Sergt. Goodspeed upon pa~sing the examination for Ambulance Officer an d Corpls. F. \V. Stock and F. A. Haines on their prumotion. Appreciations were expressed to Mr. William s (hon. treasurer) and to 1\11'. \Villiam Mercer for. ag~i n auditing the accounts. He congratulated Sergt. Kltchmg upon his appointment to succeed Mr. C. J. Stock as h on. secretary. The THayor, on behalf of the members, made a prcsentation to Mrs. 1\lc air for her organisation of whist dri\'es in aid of divisional funds. The Mayor a lso distributed certificates, medallion s and labels.

I ntel"- Railway Competition, 1939. The preliminary competition for Ungrouped Railways was held on March 24th) at St. John's Gate; Dr. M. 1\1. Scott set and judged the tests. The result was: 1st, Midland and Great Northe rn Joint, 293! marks; 2nd, Metropolitan Line) L.P.T.B.) 289; 3rd, Cheshire Lines Committee, 286~; 4th, Southern an e! L.1\1. & S. Joint (Somerset and Dorset), 259. After being 20 marks ahead on the individual tes ts 11etropolitan Line failed rather badly, and surprisingly in the team test, consequently being beaten by the M. a nd G.N. who gained ISH in the team test out of a possihl e 200. The final competition will be held on May 24th, at the Great Central Hotel, London, when two teams fro m each of the four Group Railways will compete togeth er with the winning team of the Ungrouped Railway competition. The judges will be Captain F. E. Bendix, M.R.C.S . L.R.c.P. and Dr. G. S. Phillips, of Gwaun-Cae-Gurwell.

Ms. A. D. Butterley, general manager of Wesford Colliery, presented awards to employees and remarked tha t it should be compulsory for everyone to take a course of first aid. Tha death is anno un ced of Mrs. Brice, of Stuart-street, Warwick-road, Eastvil le, one of the first women in Bristol to receive the medallion of the St. John Ambulance Associ atio n. Her husband is ex-S uperintende nt F. W. Brice, who was associated with the St. John Ambulance from its inception. He retired in 1936.

AID

Priory for A RE CORD YEAR.

The summaries of the activities within the several departments of the Priory for the year 1938 reHect the unparaJleled demands which the gravity of the international situation caused to tax the resources of ambulance organisations to the utmost capacity. Thoug-h the results of first aid classes formed in connection with A. R. P. organisation will have a larger effect upon the 1939 figures, the awards in first aid and home nursing issued in the Centres classified below total 16,368, being an in creas~ of 1,030 on the 1937 figure : NUMBER OF CASES AND AWARDS County.

F irst Aid.

49 Anglesey 293 Brecknockshire 150 CardiQ"anshire 207 Caernarvonshire Carmarthenshire 338 269 Denbighshire 233 Flintshire 1,251 Glamorga n 247 Aberdare 292 Cardiff 115 :'I lerthyr 530 Rhondda 182 Swansea 574 f\lonmo uthshire 89 Newport 130 Merio nethshire 36 l\1ontgo meryshire 1+7 Pem broke shire 97 Radnorshire 7 Unattached 100 Marine Candidates 18 First aid in Mining Total

Home Vchrs. Nursing.

27 43 120 79 111 103 101 208 39 66 11 83 56 135 59 59 69 43 5

182 21 15 92 7 383 109 149 56 188 69 79 11 18 5 33

GAINED. !\Jeds.

Labs.

Total .

10 35 121 H 294 856 90 204 585 93 226 620 100 +t7 1,088 62 240 674 45 520 134 253 1,579 3,67-l43 269 707 79 543 1,129 472 274 16 61 353 1,215 333 43 683 166 1,164 2,118 278 485 48 195 45 H7 125 79 5 40 470 181 11 187 36 4 74 58 100 18

5,354 1,417 1,417 1,2586,92216,368

The final figures for the Brigade strength will undoubtedly reveal a distinct increase on the total of 12,386 as at the en d of 1937. The Medical Comforts Depots operating under the Priory were increased to 86 from which 7,616 articles of invalid equipment and sick room requisites were issued on loan in 1938. The expansion in this department was made possible by a grant from the Special Areas Fund negotiated by the South Wales and Monmouthshire Council of Social Service; and great credit is due to the Brigade personnel for the readiness with which they have undertaken the onerous uuties involved in the working and maintenance of Depots a nd the acceptance of certain conditions imposed under the terms of the grant to en sure the proper utilisation of an adeq uate s uppl y of Comforts for the sick. The motor ambulance transport service has contrib uted to the record of achievement set up by the Priory last year, the total number of 18 761 cases carried by the ambulances stationed at the following places being 5io more than the removals undertaken in 1937 : -

Does your colleague read FIRST AID, if not, send us his address and we will post him a copy.

Wales. Station. Cases. Aberdare 1,4-86 Ammanford (accident) 267 Ammanford 1,647 Bryn 571 Cardiff 2,562 Clydach (from 22 8 38) 156 Coedely 951 Crosskeys 4-12 1,089 Cwmllynfell Cymmer 732 G-owerton 677 G waun-cae-gurwen 1,656 Kenfig Hill 735 Llan bradach 425 753 Llanelly 689 Pen coed t,007 Pontardulais 479 Pontypridd 986 Trimsaran 1,481 Tumble

1iles. 11,605 7,077 25,071 10,556 28,382 2,278 20,526 9,04-8 23,H1 19,4-51 9,502 24,987 14-,880 7,935 5,061 18,074 17,053 9,295 2 t ,467 27,305

18,761 312,994Total The stores department at Priory House dealt with an unequalled demand of first aid and home nursing textbooks of which 10,556 were sold during the year, as compared with 4,024 in 1937, the increased sales being due, mainly, to the publication of the 39th edition of " First Aid to the Injured. " ROAD TRANSPORT Ar.lBULANCE COi\JPETlTION.

On Wednesday, April 5th, the Welsh National Road Transport Ambulance Competition Committee met at Priory House, preceded by a meeting of the Cardiff and District Committee. 1\11'. W. E . Gough, A.:'I1. lnst. T., presided, supported by representati\'es of the Cardiff Corporation Transport Department, The 1 e"yport Corp?ration Electricity Department, The \Vestern 'Welsh Om11lbus Co. Ltd., and the Griffin Motor Co. Ltd., Brynmaw1'. Four years have passed since the Priory first encouraged the study of ambulance work among the employees of Passenger Transport undertakings by means of. a \Velsh National Competition, for which the CommerCial. i\lotor Users' Association presented a troph1; and. as l~ w.as thought that the number of competltors might J~stlfy district competitions, trophies were secured and Comm.. tt~es set up for Cardiff and District and Aberdare and Dlstnct competitions. Unfortunately however, the n~J11ber of teams showincr interest has diminished rather than !I1creased with the resul~ that it has been decided to run the National competition only this year; and a sub-committee consisting of 1\11'. H. Goold ( ewport Corporation Electricity Department), :\11'. F. J. Price (Cardi{l Corporation)! and Mr. ~. E. \Vinniatt were appointeci to approach possl?le competItors with a view to increasing the number of entnes. The date oi the ! ational competition was fixed for October 11th or 18th, on the understanding tl~at the Committee would be considering at a future meetmg the time of the year best suited to the e\·ent. The cup award:d to the Cardiff competition would be awarded to second In order of merit while the trophy presented for the Aberdare Contest will b~ presented to the team with the bighest marks

FIRST from among those who have never taken any prizes in any ambulance competition.

PE:>IRHIWCEIBER ~URSING Dn'Ts wN's Loss. 'VVe regret to record the death of Mrs. Kitty Morgan, Supt. of the Penrhiwceiber Tursing Division. By her death the Division and other organisations, have lost a very acti\"e member. Greatly interested in St. ] ohn work she was promoted to ursing Officer in 193-+, and on December 2nd, 1935, became Superintendent. Prior to her marriage she was a member of the Staff at the Mountain Ash Cottage Hospital and the Royal Gwent Hospital, Newport, and during the War served at the Edmonton Military Hospital. Her proiessional knowledge of nursing \-vas invaluable in maintaining a very high standard of efficiency in her division. Her career in the Brigade has been cut short by her untimely death; but the infectious quality of her enthusiasm will live long in the memory of those who were pri\"ileged to serve with her. The funeral took place on March 22nd, at Maesyrarian Cemetery, following a sen ice at St. Margaret's Church. OfJicers of the Lower Cynon Valley Corps acted as bearers and a detachment of the Nursing Division, under l\lrs. G. L. Davies, formed a Guard of Honour.

The Hospitallers'

Club. AT the March meeting Lieut.-Col. Hig-ginson gave a talk on "The Imperial War Graves Commission." He was introduced bv the President (Mr. G. C. Green) who said that the Club was indebted to Major T. H. Hague, Secretary-General of the St. Martin Association of Limbless Ex-servicemen, for the speaker's presence. Col. Higginson said that since the Armistice the quiet work of tending and making heautiful the cemetries and preserving for all time the sanctity of the graves had been going on. The wooden crosses had given place to white stone headstones, and where there were little mounds before there are smooth grass walks with rows upon rows of Rowers, trees and shrub borders, making beautiful gardens of the war burial places. The speaker referred to the establishment of the Imperial War Graves Commission, which in the latter part of the War had a military establishment. To Sir Fabian Ware, the permanent vice-chairman of the Commission, is due the formation of the Commission. The services of horticultural officers, architects and surveyors were obtained and the first duty of the experts was to design the present headstone which has been universally admired. Regimental badges added to the attraction. In France and Belguim, where the speaker had worked since 1918 and has been the Commission's senior representative since 1928, there are 930 war cemeteries, not taking into a:;count some 1,200 churchyards and civil cemeteries where small groups of British graves are located. Col. Higginson then gave particulars of some details of the work, the varieties of cemeteries, the iHchitectural scheme, the planting of flowers throughout the seasons. All the staff are British Ex-service men from all parts of the Empire, and the cemeteries shelter and provide perpetual havens of rest for 587,000 soldiers of the British Empire who died in the Great War. The speaker then dealt with specific cemeter ies, their layout, architectural design . etc.

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FIRST

At the conclusion of his talk Col. Higginson passed round two volumns of photographs. Majo r Hague, who also showed a number of photog-raphs illustrating visits of St. Martin members, paid tribute to the work of Col. Higginson which "was really the only good thing which had emerged from the Great \Var." After the Hospitallers' Remembrance the President repeated lines from" For the Fallen."

AID

259

Railway Ambulance News. Great Western.

Calla\:'ay, President of the CIa s, pre'ided oYer the preupported b) :\1r. T. C. B. Da\"1es, A S1 tant Engineer) and other officers. )'1rs. \\ ' allace presented. the Challenge hield and prize to the frrst team and pnze to the runner -up. The" Allman Powell" Cup. a\\"ardecl by yote of the member, \ya presented by :\1r. J one to :\1r. G. H. \\'hitehorn. who i a Serying Brother of the Order of ~t. Tohn and holds the Company's Quarter Century Efficiency ~1edal. :\1r. Da\"ies distributed cia s a\\'arc!s and efficiency medals to memherof the Cheltenham class. . sent~tlOn proceed1t1g , anel \\ a

Coming Events. The Editor will be pleased to receive particulars 01 forthcoming events for inclusion (free of charge) under this heading.

ApRIL.

22-No. 1 District, S.].A. B., Final Competitions, Northampton Institute. 22-Sussex County, S.]. A. B., Competitions, Hastings. 28-Great Western Railway Final Competitions, Paddington . 29-l\litcham Cadet Division, S.].A.B., "Davies" Challenge Cup Competitions. 29-No. 9 District, S.].A. B., Final Competitions, Plymouth . l\lAY. 2-Southern Railway Final Competitions, Southern House , Cannon-street, London. 2-So11th Metropolitan Gas Co. 's "Samaritan" Shield Competition, East Greenwich. 3-London and North Eastern Railway Group Competition , Marylebone. 3-SouthgateAmbulance and Finchley& Southgate Nursing Divisions, S. J. A. B., Birthday Party, Royalty Hall , Southgate. 5-London, Midland and Scottish Railway Final Competitions, Wharncliffe Rooms, London. 6-No. 8 (Duke of Connaught's) District, S.].A. B., Final Competitions, Horsham. 6-Welsh Brigade Final Competitions, City Hall, Cardiff. 6-Bestwood Colliery Annual Open Ambulance Competition. 7-National Road Passenger Transport Ambulanee Association, Midland Area Competition, Derby. ii-British Red Cross Society" Stanley Shields" Competition Finals, Wharncliffe Rooms, London. H-Surrey County, B.R.C.S. Competitions. 14-National Road Passeng-er Transport Ambulance Association Northern Area Competition. 17 -City of London Special Constabu lary "Sir William Smith" Cup Competition . 21-N ational Road Passenger Trans port Am bu lance Association South Midland Competition, Birmingham. 24-1nter-R ailway Challenge Shield F inal, Gt. Central Hotel, London. JUNE. 3-No. 1 (Prince of Wales's) D istrict An nua l I nspection, Hyde Park 9-St. ] ohn Am bu la nce Brigade" Dewa r " and" Perrott" Compet it ion F inals, Gt. Central Hotel, L ondo n.

The second annual competition for women employee of the Great \\Te tern Raih\'ay took place in the General ~Ieeting Room, Paddington) on :\1arch 29th) and attracted con iderable interest. There \"ere fiye entries, from Paddington . S" indon, Slue\\ sbury, Birmingham and ~\\'ansea, and an interesting feature was the fact that the team comprised yarious grades in the serYice, including clerks, typists, a cleaner, a laundress and some French polishe rs. Dr. \V. J. Cra\dord, of Southall acted as adjudicator. ) The subsequent presentation proceedings "'ere prc::.ided o\,er by Mr. F. R. Potter, upt. of the line, who \yas accompanied hy :\1 rs. Potter) and supported among olhers by loIr. J. F. Lean, late Principal Asst. to the General :\Ianager, and :\Irs. Lean. The result of the contest \\as announced by the Centre Secretar\', :\1iss C. A. Ault, a follo\\"5: 1. Paddington, l,\" inl1er- of the .. Florence M. Lean" Challenge Cup, indi\'idual cups and prizes, 166 marks; 2, Shre\\ sbury, \\Tinner of the" :\1abel A. Potter" Challenge Cup and prizes, 161 ; 3, Birmingham, 148. The prizes were presented by their dOllors, first. :\1rs. J. F. Lean and second, :\1rs. Potter. together \yith prizes a\\'arded by the directors. ~1i s R. :\1ar h, \"ho had made ('In admirable" patient," was presented \\ith a handbag in appreciation of her serYices. :\1r. Potter congratulated all the competitors on their \York. OLD O.\K CO~Dfox.-l\1el1lbcr of the Old Oak Common class met in the In titute on Ma rch 21st to recein namination a\\'aI-ds at the hands of :\Ir. H. G. Kerry. Asst. Loco. llPt. The awards included the .. KislinglImy" Cup, presented for indiyidl1al \york, and gold efficiency medals. loIr. Kerry, complimenting the members on their success, mg:ed them to r ecruit other in their ranks, and his remarks \\'ere strongly upported by :\Ir. J. H. Chapman, of the Carriage Department. a \'etcran of the movement. SDII-FIN.\L .\XD FIX.\L A:I[Bl..JL_\XCE COl\IPETITIOX.-The semi-fina l ambulance competitions, held during ~larch. at Bristol, Newport, Birmingham and Paeldington, haH resulted in the selection of the follo\\ing eight teams to compete in the final: Pontypool Road, Shle\\shmy Loco., S\\indon, Kington, Barry Loco., Lampeter, Filton J unction , Banbury. The final competition ,,·ill take place at Paddingto n on April 28th, \yhen the adjudicators \\·i ll be Captain A. C. y"hite Knox) loI.c., 1I.B., and Dr. E. J. Selby, O.B.E. It is underst ood that the trophie and prizes will be presented by the Chairman of the Company, the Rt. Hon. Viscount Horne. CLIELTENlr.\~r.-The annual competition for the " John Player" Challenge Shield was held on i\lareh 30th, when Dr. Bruce Wallace, assisteq by 11r. L. 11. Starr) adjudicated. Four teams participated) the winners being that captained by 1\1r. E. Robinson, and the runners-up Mr. Gorton's team. 1Ir. J. W. F. Jones, representing 1\1r.

GLOliCEsTER.-Aelmiratiol1 for ambulance \yorkers \\"ho ha\"e been doing nalional en'ice for IIp\yards of half a centmy "'as expre ed by peakers at the annual dinner of the G.\\-.R. Glol1ce ter ambulance corp. on atmday. :\Iareh 11th. The function \\"a presided oYer by ~1r. S. G. Hearn, Dn·. Supt., supported by the cit\" member. :;\1r. H. Leslie Boyce. the :;\1ayor (:\1r. Treyor ";ellington). the heriff (Col. ]. H. Collett), Dr. J. F. H. tallman. and past and present officers of the G.\\'.R. The chairman referred to the special natme of the occasion. the Corps haying ju_ t celebrated it juhilee. Dnrillg- thoe ~O \ ear members hael gained no fe\ycr than 2.700 a\\ ard in addition to a large number of competition trophies. The toa t of the eyening' \ya proposed by Mr. Leslie Boyce. \\"ho expres eel admiration and gratitude for the many year of sen-ice rendered by the Corp_, and meIltioned the numbers who had come fOr\\'ard for A.R.P. \,"ork. Examination a\\"ards \\"ere eli tnburecl by the :\1a\or, \\"ho complimented the class on its contil;ueel success. Competition trophies included the" Alice \\'hitky" Cup, presented by :;\1r. \\-hitley, and the .. ~Iorris" CuP., presented by ~Ir. S. ~1orri L

KIXGTOX.-The Kington ambulance team. \"inner5 of the" Horlick" ~ hield. the premier trophy in Class 2 of the Gloucester ])i\"ision. celehrated their yicton' at a dinner held in the Burton Hotel, on :\1arch 31st: \\ hUl Dr. C. D. Edwards presided. Among other pre-ent \\"ere Dr. :\Iacgregor, Dr. \\-. Logan Jack. :\1r. ~. G. Hearn, Di\-. Supt. anel :\1r. L. J. A. Calla\\"ay. District Goods :\ [anager. in acldit"ion to 111e111 bcrs of th c Kington S.J.A.B. The chairman heartih' cong:ratulated the Kington team . on their StlCCCS and -rderr'ed with pleasure t; his long association with first aid ,,-ork in the Stroud Yallc\-. The railways, he aid. made a "alued contribution to the mOHmcnt. - Re poneling·. :;\Ir. C. Y. \\-atkins. captain of the team. exprcs cd appreciation of thc acsistance ginn by the medical profecsion, and said the team \\'ere proud to ha\"e hrought the shi eld to Kington after trying for thirtccn years. ::\le, r . Hearn and Callaway and Dr. ~1acgregor \\ ere among the other peakers.

London, Mid land and Scottish. CmrPETrTIONS.-During· last month preliminary rounds '\"ere held at Derbv' and ... onthport and the fo11o"-ing teams occupied the frr;t nine place and \\"ill therefore

260

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compete in the final competition to be held at vVharncliffe Rooms, l\1arylebone, on Friday, l\lay 5th: \Varrington, Crewe Machine Shop, Camden Goods "A," Windsor Bridge, Uttoxeter, Blythe Bridge, Crewe Copper Shop, Manchestcr, 1\layfield and Derby e.l\I.E. Last ycar's winners, Wolverton, came 14th and did not qualify. WO::lIEN'S CO::lIPETITION.-Twcnty-two teams competed in the women's section and the following teams qualified for the final: Glasgow Loco. Accounts, Preston No.1, London" C," and Broad Street. T\\"ch'c members entered for the Camden Goods Individual Cup Competition, held on Saturday, April 1st. The judges werc . 1\1r. G. E. Craft, of "First Aid" (practical) and ~1r. S. J. Hattam (viva voce); whilst Mr. W. J. Taylor was competition secretary. Mr. VV. T. Salisbury, with 84 marks out of 100, gained first placc, followed by his brother, last yea~s winner,

AID At the close of the No. 22 District Ambulance Competiti-ons presentations were made to threc retiring C0111 mitteemen of that district by Mr. F. G. Adams. Each of these gentlemen has between 35 and 40 years' service in the Ambulance Movement and they have all been recognised by the Order of St. John in the grade of Serving' Brother. The recipients were :-Mr. \lV. Swarbrick, who has now retired from the service-clock; Mr. G. Rae, wh o rctires shortly from the service-easy chair; and Mr. L. Stamper, who rctires shortly-vacuum cleaner.

DERBy.-The annual dinner of the e. and W. Corps was hcld recently and Dr. Mandall Coates, in replying to the toast to "The Visitors," proposed by Mr. W. Sinclair, asked for a better response from thc younger men. Mr. E. Pugson, who referred to the splendid work of Mr. T. Allen (Secretary) and other officials, presented an Elizabethan tumbler to Dr. W. St. A. John (Lecturer) .

St. Albans" A" Team receiving No.1 District, No.1 Division Championship Cup from Councillor John Spermi, Deputy Mayor of St. Pancras. Mr. H. E. Salisbury, who obtained 82 marks. Mr. H. C. Aldridge was third with 76 marks. The cup will he presented at the annual social. Eleven members competed in the Camden First Year Students' In~ividual Competition, held on Saturday, March 18th. The Judges were Messrs. W. Taylor and F. Tull. Mr. E. Hall gained first place (silver medal with gold centre), Mr. F. e. Hedges was second (silver medal) and Mr. J. H. Langridge third (bronze medal). ' At the concl L1sion of the No. 6 District Ambulance Competition, Mr. W. E. e. Lazenby presented a gold watch to Capt. S. T. Beard, O.B.E., Commissioner for Monmouthshire, and until recently secretary of the L. M S No.6 District. . . ~r. Lazenby said that Captain Beard had an outstandmg record in railway ambulance work holdinomedals and bars representing 40 years' service 'whilst h~ had been District Secretary for nearly 13 year~.

HOR.WICII.-Mr. P. A. Buchan presided o\'er the prize ceremony, Mrs. Buchan presenting th e followll1g awards :-13 certificates 6 vouchers 7 111eclal1ior:s, 57 labcls. Gold Medals.~R. Ainscoug-h, S. R. BaIley, J. Blackburn, J. Davies, J. Humphries, G. Isherwood, R. S. J erams, S. Percy, J. W. Rylance, W. Wilkin son, e. Yates. Long Service Gold Bars.-J. W. Ball (35 years), e. Sharples (35 years). A vote of thanks to Mrs. Buchan was proposed by Mr. J. Atherton and seconded by Mr. S. R. Bailey. Messrs. J. W. Rylance and G. A1croft expressed thanks to Mr. Buchan for presiding. .

tllslnulll10n

STRATFORD-ON-A VON.-Twenty members recently a supp~r. to cel~,brate the winning of the No.2 Dlstnct 2nd DlvlslOn ShIeld. A" knock-out" darts compe.tition gave .plenty of ~un, Mr. W. Prentice being the wll1n~r. MUSIcal enterta111ment was given by Messrs. A. Harns, H. Poole and J. T. Duckett. atten~ed

FIRST

london and North Eastern. N ORTII EASTERN AREA. The six district competitions of the orth Eastern Area Centre have now been held; with the following results : DARL~NGTON DIsTRlcr.-Sc\,en teams competed, the judges be1l1g Dr. R. G. Russell, of Blackall, and Dr. T. Russell, of Trimdar Colliery. Shildon vVorks gained first place, District Engineers" B " being the runners-up. Mrs. J. Anderson presented the District Shield and Cup. l\"EWCASTLE DrsTRlcr.-Tyne Dock, doughty fio-hters in this area, gained an impressive win by 39 mark~ over Gateshead Greensfield Loco. The judges ,vere Dr. E. J. Burnett, of Saltburn, and Dr. H. Fallows, of Redcar. 1\1r. L. Hallan presented the District Shield, "George J ackson" Cup and" Burrows" Shield. LEEDS DrsTRlcr.-Nine teams competed at Harroo'ate Leeds L.N.E.R. Passenger team being adj udged t> th~ winners by Dr. C. D. Wilson, of Darlington, and Dr. E. B. Appleby, of Newcastle. In the team test the patient was suffering hom severe muscle strain with rupture of muscle aboye right knee, but only one team diagnosed the injury correctly. The Mayoress of Harrogate, 1\lrs. Herbert Dawson, presented the District Shield and cups. HULL DrsTRlcT.-On March 15th nine teams competed at Hull befor.e Dr. VV. A. Hogg and Dr. W. J. Payne, hoth of Darlll1gton. Paragon No.1, with 2381 marks, gained first place, Dairycoates being second with 235. \Irs. J. S. Harper presented the District Shield. 1\lr. S. Cooper, Centre Ambulance Secretary, presented framcd \~otes of Thanks on vellum to 1\lessrs. F. H. Charlton and J. H. Rawson; also a Long Service Gold Medal to H. Smith. YORK DrsTRICl'.-The Railway Institute York "yaS the scene of this district competition. Ten' teams) competed, the winning team being York Station "A." York e. and W. No. 1 were second. 1\Ir. R. S. Jackson, Yardmaster, York, presented the District Shield and Police Cup, the judges being Dr. F. J. Mulholland, of Sacriston, and Dr. W. C. Murray, of North Shields. 1\IIDDLESBROUGH DrsTRlcT.-On March 25th eight teams competed at Redcar before Dr. L. L. vVestrope, of Gateshead, and Dr. G. P. Harlan, of Newcastle. l\Iiddleshrough, with 183 marks, were placed first, followed by "Vest Hartlepool Loco., 1671. 1\1r. O. P. Hutchinson, District Loco. Supt., Darlington, presented the District Shield. The finalists in the Area Competition will therefore be Shildon Works, Tyne Docks, Leeds L.N.E.R. Passenger, Paragon No. I, York Station "A" and Middlesbrough. SOUTHERN AREA. The 38th final competition of the Great Northern Centre was held on March 21st, when the six district winners competed for the cup presented by the officcrs of the old Great Northern Railway. The judges were Dr. M. M. Scott (team) and Dr. J. A. Dawson (individual), the competition secretary being Captain W. Goodley, O.B.E., M.e. (Centre Secretary). Some very interesting work was witnessed by a good gathering and in the team test the injuries were deep cut over right temple with arterial hcemorrhage, compound fracture right arm with bonc protruding and venous hcemorrhage, simple fracture right leg, whilst the patient was also suffering from concussion. Mr. V. M. Barrington-Ward (Supt. Western Section) presided at the prizc distribution, supported by Sir Ronald Matthews (President of the Centre and Chairman of the

AID L.N.E.R.), 1\1r. e. H. ewton (Chief General 1\lana o er) Col. H. H. l\Iauldin (Diy. General Manager), l\Ir~ H: ('or~le (Asst. to Chief General :"lanager), :"1r. R. R. PettItt (Chief of Police), Dr. S. Cooper (T.E. area Ambulance Secretary) and many other officers of the Company. Sir Ronald said it was a great pleasure for him to be prcsent and gave particulars of the year's \\'ork. Awards gained \\'ere 998, an increase of 111 but whilst the increase was satisfactory the proportidn of efficient first aiders to the number of staff employed 011 the whole system was still low. Since the formation of the Centre 156 LonD' Service Gold l1edals for 15 years' efficiency and 120 G~ld Bars, representing efficiency up to 35 years, have been i sued. Of this number 16 Gold l1edals and 16 Gold Bars were presented during 1938. Sir Ronald thanked the lIedical Officers District and Class. Se.creta ries. and Instructors for their u~tiring efforts, mentlOnmg especially Capt. Goodley, the Centre Secretary. . He co~gr~tulated the teams 011 their work and hoped that the w111n111g team would do well in the Group Final. The result of the competition " 'as: 1st and Championship Cup, King's Cross Loco., 346~ marks; 2nd and c, Tom Smith" Cup, Boston "A," 301; 3rd, ottingham Victoria, 3952; 4th, Ardsley Loco" 280~; 5th, Doncaster Traffic, 2801; 6th, Hitchin, 235. The President presented the trophies and al 0 individual prizes to all competitors.

On \Vednesday, March 29th, the 42nd annual Cup Final of the Great Eastern Centre was held at Stratford. when the seven leading teams of the preliminary round presented themselves before Captain A. C. \Vhite Knox, M.C., 1\I.B., \\'ho judged the team test, and Dr. \V. D. Jenkins, who took the illdiyidual section. The team test setting represented a pumping rOOlll and a man \\'hil t attending the engine \vas hit by the crank and thrown violently bach.-wards. On examination the patient was found to be suffering from concussion. wound on forehead with arterial hcemorrhage, simple fracture of right clavicle, of left ribs, and of left clayic1e. The indiyidual test \vas a case of a patient suffering from hypnotic poisoning. incised \\'ounds 011 both ,\"fist. one having arterial hcemorrhage and the other capillary hleeding. 1\lr. J. E. Sharpe (Asst. Supt. G.E. Section). \\·ho presided at the presentation ceremony, stated that during the year ended Septemher 30th, 1938, the awards gained were 953, also 14 Gold Medals and 25 Gold Bars. Since 1929 the total number of Gold l1edals a\\'arded was 259 and in addition 241 Bars. Capt. Davis had been admitted as an Officer of the Order of St. John and Dr. Phelan. hon. surgeon Parkeston Division, an Honorary Life Member of the St. John Ambulance Association. During the past year Mr. A. J. Garrod, Supt. Dept., Thetford, 11r. A. T. Paige, Goods Dept. Bishops Stortford, and 1\lr. W. e. Cro\\'e, Supt. Dept., March, were admitted as Serving Brothers of the Order of St. J Ohll, Capt. VI. Goodley, O.B.E., M.e., announced the results, which were: 1st and Championship award, Bishopsgate" B," 283~ marks; 2nd and" T. O. l\Iein" Cup, Parkeston " B," 270~ ; 3rd, Bishopsgate " A," 269 ; ·Hh, Parkeston" A," 228; 5th, Cambridg-e, 222 ; 6th, Stratford Printing Works 210' 7th March" A," 19U. Best individual, W. UlIme:, No.' 5 Bi~hopsg-ate " B" Te~m. Sir Gerald Talbot, K.e.V.O.) e.M.G., President of the Centre and a Dircctor of the Company, presented lhe l rophies and prizes.

FIRST Capt. Goodley announced that he had received , from a source which had requested to r ema in anonymous, a certain sum of mon ey for prizes and that gifts had been purchased for the team's spare mall and also team sec r eta ries. A , 'ote of thanks to the judges was proposed by I\Ir. Hibhard, captain of ,,,inning- team. In reply the doctors congratulated the comp etito rs on their excell ent work and paid tribute to the efficient running of the competition. Bisbop gate" B " ", ill represent the G. E. Centre in the L.N.E.R. Group final to be h eld 0 11 May 3rd.

Souther'n. FIN,\L COl\fPETITION.-Th e "Southern" Final will be held at Southern House) Cannon Street, on Tuesday, 1\1ay 2nd. Admission is by ticket only, which may be obtained from the Welfare Assistant, General J\Ianager's Office, Waterloo. Mrs. J. B. Elliott, wife of the Assistant General J\Ianager, will present the Directors' Challenge Shield and other prizes. The following teams will compete: Yeoyil "B," Exmouth Junction No .1 , Eastleigh Running Shed o. 1, Southampton Docks "E," Bricklayers' Arms No.1, Victoria o. 2, Ashford Works No .1, Gil lingham No.1, Waterloo "A," Havant, H orsham No.1, and H or sham No.2. WOMEK'S CO:\IPETITION.-Nine teams competed in the " Southern" Women's test, held at Brighton, and for the third time Eastleigh were successful in winnin o ' th e Challenge Shield. The previous wins were in 1935 and 1937. The winning team was composed of 1\Iisses G . 'vV. Aitken (captain), L. M. Blackman, E. L. Rogers, E. Green, R. M. Blay and P. Woolcock. London Bridge "A" and " C" were second and third r espectively. Mrs. :V[oo re} wife of '2\!J:r. E. S. Moore) \ i\1estern Div. Loco Supt., pr esen ted the trophy and prizes. The )udge.s were Dr. Ronald Matthews (Crawley), who officlated 111 the team test and Dr. J. A. Richardson (Hoye), who judged the individual section.

St. Marylebone Open First Aid Competition. THE 1939 competition was brought to a succtssful conclusion

on March 30th, when the six finalists competed for the championship awards. Ther.e was a huge crowd ~f spectators present, among them being Lord HordeI', Sir John Duncan Brigadier Barne, Sir Hugh Turnbull, Dr. N. Corbet Fle'tcher, Capt. W . Goodley, the Mayor of St. Marylebone (Councillor A Douglas Waite), Dr. Bulman Alderman Dean Mrs S H' Fitz Maurice, of .Orkney, M~. W. E. Lazenbj~, and ~an~ other personages 111terested in the function. Capt. F. E. .Bendix, M.R.C.S., L.R.C.P. (team) and Capt. A.. C. White Knox, M.C., M.B., Ch.B. (individual) were the Judges; the secretary being Mr. W. V. M. Allen. The team test was excellently staged, thanks to Mr. J.oe Grossman and the Associated British Picture CorporatIOn, Elstree, and represented a luggage office at a station. f\s the members of the team went to leave their equipment 111 the office a bomb ex ploded wi th disastrous effects on the attendant. The injuries included small wound right ear

AID (capillary hcemorrhage), bruise back of head, wound front of left forearm (arterial hcemorrhage), simple fracture right femur, shock and concussion. There was one very unintelligent bystandEr who became quite a nuisance to the teams whilst at work. The individual tests were varied, and competitors had to work quickly and with great knowledge to complete them. Alderman R. Stiles Allen, D.L., Chairman of the Committee, presided at the presentation ceremony and welcomed Lord Harder. He brieAy referred to the objects of the comper.ition, which, although only in its second year, was established as the leading open competition in London. The Competition Secretary (Mr. Allen) announced the results as follows :-1st, and "Stiles Allen" Trophy, "G" Division, Met. Police, 268 marks ; 2nd and " Selfridge II Trophy, "M II Divisioll, 264; 3rd, " V" Division, 26J~; 4th, City of London Police, 248 ; 5th, Bishopsgate A, L.N.E.R., 219~; 6th, "W" Division, 218~. "FirstAid" ChaIlenge Cup for best team captain was won by Mr. Greig of " V " Division. Lord HordeI' presented the trophies and prizes, and congratulated the teams on the fine show. Subsequently, his Lordship sel1t a letter to the Chairman expressing his pleasure at being able to attend, and paid tribute to the excellent arrangements. Dr. M. M. Scott proposed an omnibus vote of thanks, to which Capt. F. E. Bendix and Capt. A. C. White Knox replipd. Brigadier Barne, on behalf of all present, proposed a vote of thanks to the organisers. Alderman Stiles Allen replied and paid tribute to th e support given by the competitors and spectators.

St. Andrew's Ambulance Association. KIRKCALDY. - The annual competition for the" Nairn " trophy, organised by the Kirkcaldy Branch, was held on March 25th, when Dunfermline L. N. E. R. No.1 (the holders) Ios.t the trophy to Thornton by the narrow margin of one POIl1t. A record entry, 19 teams, was received. The captain's prize was awarded to James Hutt of the Dysart Co-operative team. LADYBANK. -On March 19th the annual competition for the" Morris" and Vice-President's cup, and also efficiency tests, were held at Ladybank. Seven teams were examined in oral and practical by Dr. A. Gordon, of Markinch, who congratulated the competitors on their efficiency. The \' Morris II cup was won by No . 2 team (W. B. Walker, captain) ; whilst Mrs. Scott won the Vice-President's cup. Commandant W. B. Walker thanked the doctor for his assistance.

FIRST The cup and prizes were presented at the annual general meeting held on April 2nd. Dundee \-Vest with 226 marks were successful in winning the "Sir Harry Hope" ambulance trophy, at the co mpetition held at Forfar, last month. Dundee Tay Bridge a nd Montrose, each with 222 marks, tied for second place. Seven teams competed. The arbiters were Dr. Cadenhead (oral), Dr. H. Laidlaw (practical), and Dr. Hay (transport). Bailie A. C. Smyth, of Forfar, presented the prizes.

The Supine Position in Emergency Treatment of Patients with Fractured Spine. * By GEOFFREY HYMAN, M.B., Ch.B., F.R.C.S. Orthopaedic Registrar, General ll1jirlllary oj Leeds.

THE prone position for the transport and emergency treatment of fractures or fracture-dislocations of the dorso-Iumbar region of the spine was advocated by Watson Jones in 1931, and has been widely adopted since. Most modern textbooks, however, while paying great attention to the pathology and final fixation of the injured spine, either omit emergency treatment or dismiss it in a few lines: this important part of the treatment is not even mentioned by one well-known authority on the treatment of fractures. The initial management of spinal injuries has its own peculiar difficulties, which must be emphasised. I shall endeavour to . show that adoption of the prone position before final immobilisation of the spine in plaster has many disadvantages, and that use of the supine position, subject to the precautions to be described, is preferable. \Vith regard to the rationale of the prone position, it is advocated that because the spine is held hyperextended the fragments are unlikely to be displaced and to injure the cord or, if the cord is already injured, further damage will not take place. There are disadvantages, however. DISADVANTAGES OF THE PRONE POSITION.

Diagnosis of the Origz"nal Leszon.-Diagnosis LEITH.- The annual competition of the Leith District (L.N.E.R.) ambulance section for the inter-team cup, was held 011 March 26th. The arbiters were Dr. W. Wilson (oral), Dr. J. B. Annan (practical), and Dr. Angus Walker (transport). EI~ven team; took part, the cup being won by "L " team With 233 POll1ts. The team consisted of John Paterson (captain), Margaret Jacob, Bella Anderson, Ed. Mackenzie an? A. Dorward, Jr. "C" team (T. Ramsay, captain) gamed second place. The arbiters expressed their satisfaction on the work done; they were impressed with the manner in which the various tests were carried out.

of a fractursd spine made either at the time of the accident or in the casualty department of a hospital may be incorrect. Fractured pelvis, with or without intra-abdominal complications, and fractured ribs have often been the cause of error, and on such occasions use of the prone position may be harmful. Moreover, in spite of insistent instructions to the contrary, a patient with a fractured cervical spine is occasionally brought ioto hospital in the prone position because of the association of

* Reprinted from the B7-ilish lV.fedical Imt1 nal.

AID ~h~ posture

with the first aid treatment of spinal

Injuries.

Associated In/uries.- The prone position is contra-indicated in the treatment of head injuries. fracture of the ribs or of the pelvis, fractured legs, and abdominal injuries, any of which may complicate the treatment of a fractured spine. Transjol't.-If the prone position is used the patient is moved bodily on several occasions from one site to another without any adeq uate fixation of the spine. The number of transferences may vary from five to eight. The patient is first lifted from the ambulance trolley on to his bed, then subsequentl y from his bed on to the trolley again to be taken to the X-ray department. In most hospitals lateral radiographs of the spine cannot be taken satisfactorily with a portable X- ray machine and must be done in the X-ray department; four transferences will be req uired for radiographic purposes alone. After the patient has been wheeled back to the ward three more movements are necessary before he can be immobilised in plaster. Nursing - The prone position is not easy to maintain, and constant supervision is essential fO'r its success. Nursing is much more difficult when the patient is prone, especially if acute retention supervenes and the patient has to be catheterised. Comfort of the Patient.-The prone position is not well tolerated by many patients, who consequently lie curled up on their sides, and there is little doubt that they are far more comfortable when lying supine, and fixed in the manner to be described, than when they are prone. The advantages of the fixed supine position are more especially noticed in those patients with complications. TREATlIIENT OF THE SPINE POSITION BY MEANS OF A SPECIAL FRA:\IE. The frame first used was a modification of the Bradford frame. It was made of well-padded metal tubing covered with stout canvas in two detachable sections, with a six-inch gap between for nursing purposes, and was angulated opposite the dorso-lumbar region of the patient (the commonest site of the fracture) sufficiently to h yperextend the spine to about 25 degs. Special webbing straps were used to fix the patient to the frame. One or two disadvantages became apparent in the use of _the metal frame. .The site of angulation could not easily be adapted to coincide with fractures other than those in the dorso-l u m bar region. The metal bars sometimes obscured the lamince and spinous processes when a lateral radiograph was being taken. These difficulties have been overcome by means of a soecial wooden frame carved longitudinally (Fig. 1). The curve forms a? arc of a circle, such that all regions of the spine of a

FIRST patient lying supine are thrown into a moderate degree of hyperextension. The use of wood in

AID

F IRST

whatever the complications or associated injuries may be, should be fixed on the frame as soon as possible after receiving the injury (Fig. 3). Transport is extremel y sim pIe, and there is no occas ion to disturb the patient from this time until his spine is finally immobilised in plaster. Nursing problems

Our Nurses' Pages. COMPILED

FI G. 1. - The Curved Wooden Stretcher Frame

the construction of the frame permits satisfactory radio g ra phy of the spine without disturbing the patient. TH E VVOOD E N STRETCHER FR AM E.

The side-pieces are of stout steam-bent ash with the ex tremities moulded to form the handles. The body of the frame is made of five-ply wood securel y fi xed to the side-pieces and foIIowing the sa me curve. An oval window with a shutter attachment on the under surface of the stretcher is placed in the midline at a suitable distance from th e head end for nursing purposes (Fig. 2) j this meas urement is thirty-four inches. Four webbing straps secure the patient to the frame; one is

FI G. 3. - Showing t he Patient Strapped in PosiLion.

are reduced to a minimum. The method described has been used at the General Infirmary at Leeds in all cases of suspected spinal injury, and has proved of real value. During the past two years eightytwo cases of suspected or definite spinal fracture have been treated in this manner from the time of their admission to hospital j fourteen of the patients were fixed on the wooden frame. As yet the frame has not been used for cases before admission to hospital, but permission has been obtained from Dr. Jervis, the medical officer of health for Leeds, for it to be given a trial in the Leeds municipal ambulance service. CON CL US ION S .

FIG. 2. -The Infe rior Surface of the Frame.

placed at the end of the nipple line, another at the lev el of the wai s t, one midway down the thighs, a nd a fourth midway down the tibiae. Two solid ru hber wheels are fi xed at each end, and are so si tua ted that a distance of twenty-one inches se parates the axle centres, thus enabling the s tretcher to be used in the standard ambulances. ~he over-all length of the stretcher is eightytwo Inches , the curved length of the body is seventy-three inches, the width nineteen inches and the maximum depth twelve inches; thus it i~ large enough to accommodate any average adult ale , n:os t of the patients under discussion coming Into thIS category . The weight of the frame is 21 .lb. , which is appreciably lighter than the regulatlOn ambulance stretcher.

M ET IIOD OF U S IN G THE FRAME.

Any patient with a suspected spinal InJury,

The supine position is to be preferred for the transport and emergency treatment of patients with fractured spines, provided that the spine is hyperextended and immobilised at this stage of the treatment. A special frame should be used. It is suggested that the method be adopted in first aid treatment in mines and other centres where fractured spines are likely to occur, the frame being used instead of the customary stret~her. The frame may also find a place in the routine equipment of the larger ambulances. I wish to thank Mr. Broomhead for his permission to use the method in the orthopaedic department of the General Infirmary at Leeds.

Major Malley, R.A. M.e., Woolwich, inspected the Kent 108 (Orpington) Detachment, B.R.C. S. , on April 1st, and expressed ;1is satisfaction with all he had seen and heard.

Members of the Cobham Division, S.]. A. B., durin g 1938 attended 222 cases, removed 130 patients, whilst road a ccidents numbered 48. The ambulance had travelled 3, 333 miles, of which 2,851 applied to patie nts moved and 352 to road accidents.

A ID

BY AN AMBULANCE SISTER.

No. 1 DISTRI CT, S.] .A. B. No. 74 (FI NCHLEY AND SOUTHGATE) N URSING DI \,ISION.- The Annu a l Dance of this D ivision was held on Saturd ay. Ma rch 18th, at the Church H a ll, Frie rn Ba rn et, w hen a m erry thro ng da nced to the mu s ic of the Meltonian Band. Th e g uests included Distri ct S taff O fficer G. e. Gree n a nd Mrs. G ree n, Distri ct O fficer S. H. Collins a nd Mrs. Collins , Div. Surgeo n D. W. R eid a nd Mrs . R eid , S u pt. J. W. T ay ler (Am bula nce D ivisio n) , a nd L a dy Di v. Su pt. Miss Vicary (H eadqu a rters S taff, A. R . P.), w hile Corps Officer S. J. Still well a bly carried out th e du ties of M. e. During a n inte r val, Distri ct S taff O fficer Green presented S upt. T ayler with a Swa n foun tain pen from the mem bers of t he Nurs in g Di vis ion as a toke n of their ap preciatio n a nd reg:=t rd. Thro ug h out t he seve ll yea rs of th e D ivision's ex is tence, Supt. T ayler h a d been its treas urer, bu t unfortu nately t he time h a d ar ri ved w he n he had to resig n thaL position . Su pt. T ayler, w h o was ve ry moved by the g ift, t hanked the m embers . The wo r k ha d been a pleasu re to him, and he wish ed them every su ccess in t he fut ure.

PORTSMOUTll URSING CAOI£,[ DI\·lSlON.-The annual distribu tion of awards to the nursing cadets took place on Friday, March 10th, at Southsea . The Lady Cadet Superintendent gave a b rief repo rt of the previous year's activities, after which l\liss T. Trave rs, Vice-Plesident, distributed the a wards. T hese included efficiency stripes and proficiency badg es, a nd cer tificates fo r child welfare, public service, handi cra ft , sw imm ing and li fe-saving, and signals.

No.2 DISTR ICT, S. ]. A. B. EAST LEIGH N URS ING D I\'lS ION .- T he Second Annual Ball held by the Di vis ion a ttracted nea rl y 300 da ncers to the Town H a ll. Those wh o took parties incl ud ed th e Mayor a nd Mayo ress of Eastleigh (Councillor a nd Mr s. J. G . H. Treherne), Dr. R . R. Ga rrett (Assistan t Cou nty Commissioner) , Mrs . R. R. Ga rrett, J. P. (President of Lhe D ivision), D r. Clay re (Co un ty Surgeo n) a nd Mrs. Clayre, Dr. A. G. P rover bs (Div. Surgeo n ) and Mrs. Proverbs, Dr. and Mrs. L. E. Green, Mrs . E. R. Bath o, and th e Depu ty Mayo r and Mayo ress (Alde rm a n a nd Mrs. R. H . R oberts) . Alder man C. A. Soa r, J . P ., a nd Mr. H. B. Coates s ha red the du ties of M.e. Bou q uets we re presented to the lVI ayoress and Mrs. Ga rre tt by t wo nursin g cadets, Olive Man n a nd Ba r bara N u ttall, while Mrs. Ga rrett mad e a s imi lar prese n tat ion to Lady Div. Supt. Miss G . W. Aitk en. Th e Mayo r appealed for rec rui ts for t he D iv isio n, and spoke of the importa nce of the work. H e co ng rat ul a ted the me mber s on their effic iency. Mrs. Ga rrett sai d s h e was pleased to see the Di vision received the support of the town. At t he Annual Genera l Meetin g of th e Eas tl eig h Nursing Division the ch a ir was ta k en by Di v. Surgeon A. G. Prove rbs, in the a bsence of the L a dy Div. Presid ent, Mrs. R. R. Garrett, J. P. The re port of the yea r's work proved most satisfac tory. Dr. Proverbs presented A. R . P. a wa rds as foll ows:G rade 1 Instructors' Cer t ifica tes-A mbo Sisters A. Durra n t, R . Blay a nd W. D a wson. Gra de 2-A mb. Sis ters L. Blackman, E . NuLtall, W. White , J. D aco mb and P. Mars h. A. R . P. Certifi cates-Am w. Sisters 1\1 . Dea n, K. Ma nn a nd G. Bishop. A silver cup recently presenLed to th e Divisi o n by Mrs . Garrett wa s won for the year 1938 by Amb. Sister E. Nuttall.

!\I ARKET HARBOROUGII NURSING DI\'ISION.- This Division held its annual dinner on l\larch 22nd, at the ambulance headquarters . I n the absence of Lady Div. Supt. l\liss E. Nicbolson, Lady Ambu lance Officer Mrs . Maycock presided, supported by L ad y County Supt. Miss G. Partridge, County Officer T. G . Lowe, Div. Surgeon S. P. Stokes and 1\1rs. Stokes, urs ing Offieer Mrs. G. Duckmanton. Nursing Sister l\1iss E. Wrathall, Nurse Harris, Supt. C. :'laycock and Sergt. A. Bird, of the Ambulance Division. Lady Cou nty S upt. Miss Partrige prese~t~d. awards gained by members and cong ratulated the DI~IslOn upon t he a dvancement made du ring the three years It had been established .

No . 3 (EASTERN) DISTRICT, S. J .A. B. N ORTHA;\IPTONSH IRE COMPETITIONS.-Teams from Peterborough, Kettering, Welli ngborough and Northampton took par t in the County competitions held at Kettering, on Sat urday, :VI a rch 18th. The maxim um marks were 270, and those gained by til e competito rs were: 1, Bur ton Latimer (Kettering Corps), 208t j 2, Nort hampton H eadquarters (Northampton Corps), 200~ j 3, Well ing-borough Headquarters (Wellingborough Cor ps), 18-1- j 4, Peterborough Headquarters, 182.

O. 8 D ISTR ICT, S .].A.B . B RIGADE ACTIVITIES IN GUERNSEY. - The Annual Report of the N ursing D ivision and Nursing Cadet Division shows t hat good progress has been made thro u ~hout the year. A total of 43 pract ices was held "nth 390 attendances, w hil e 169 du ties ha d been u ndertaken at va rious cinemas. Severa l membe r s h a d crossed to the mainlan d with patients or broug h t the m back from the ma~nland, which service ha.d bee n greatly app reciated by the patients t ~lemselves and theIr fri ends. Valuable help had a lso been g Ive n at the Welfare Ce ntre. Th e Nurs in g Cadet D ivision now had 16 member~ . ALte nda nces du rin g the year had been very good, and ~hIs year it was h oped tha t the st ud y of A. R . P. would brmg ad di tiona l interest to th e yo un g people. . Appreciation was ex pressed to the G u er~sey RaJlw~y, P a ragon, Blu e Bird, th e Wayfa rer a nd L~ R a~ l de Companies fo r providin g free tra nspo rt to members I n Unifo r m.

FIRST

266

AID

FIRST B. R.C.S. COMPETITIONS AT BARNSTAPLE. The" Dunn" Cup was competed for by members of Devon 42 (Barnstaple) on March 20th. The winners were Misses Heberden and Easterbrook. rhe judging was undertaken by Dr. Brook (first aid) and Miss Wright, Matron of the N. Devon Infirmary (home nursing. The Cup was presented by Mrs.]. R. Paul, A.C.D., North Devon.

Some officers and members of the No. 6+ (Ealin!S) Nursing Division, No.1 District, S.J.A.B. Divisional President, Mrs. E. H. Brooks, is seated between the officers. This division has now a personnel of 88. CHICHESTER NURSING DlvlsroN. - A meeting of this newly-formed Division of the Brigade was held on Monday, March 13th, at the Lancastrian Senior Boys' School, Supt. H. H. Bridle of the Ambulance Division, occupying the chair. Th e chairman introduced Lady District Supt. Mrs. C. Fal wasser and r ema rked that the occasion was historic in that it was the first time a lady of the Order of St. John had visited Chichester in an official capacity. Mrs. Falwasser spoke of the pleasure she felt in being there, and seeing so many m embers present. She went on to outline the duties of a St. John Ambulance nurse, and said how much the services of those nurses were appreciated on such big public occasions as the Coronation, or the Jubilee, or anywhere where crowds caused casualties among women and children. She also spoke of the work other Nursing Divisions were doing in hospitals, clinics, roadside and beach first aid posts and huts, and in travelling with the ambulances especially when female patients were being carried. After many questions had been answered, the meetingproceeded with the election of officers. Mrs. Thompson, late Div. Secretary to the Winchester Nursing Division, was elected Acting Ambulance Oflicer-in-Charg-e; Miss Downer, was elected Div. Secretary, and a Committee formed including Mrs. Crees, Miss Wells, Miss Daziel, Miss Trott and Mrs. Gibbs. Regular weekly practices were arranged, and it was agreed to hold a jumble sale on April 22nd, to be followed later by a whist dr ive. The meeting closed with a vote of thanks to Mrs. Falwasser for attending and the interest she had shown in them. .

No.9 DISTRICT, S.].A. B. In her report on the Nursing Divisions and Nursing Cadet Divisions of the Brigade in South-West Devon and East Cornwall (including Plymouth), Lady County Supt. Mrs. R. Balsdon says that 2,973 public duties were undertaken last year (232 more than in 1937), incl uding attendances on the occasions of Queen Mary's visit, Navy Week, Bath and West Shows, children's sports, etc. In A. R. P. displays, held during Navy Week, selected officers and qualified members assisted the Naval Staff, and

The

similar displays were given at the Army" At Home" and the Empire Air Display. Specially selected officers and members passed the examination for Grade 1 instructors, A. R. P., and a high standard of efficiency had been attained. Treatment for minor or major injuries at the Plymouth Hoe first aid post had been given to 143 persons. At this post overseas m em bers often called. Hospital duties included 270 attendances, and during the national crisis emergency arrangements were completed at very short notice to staff the Military Families Hospital betwpen the mobili sation of the regular staff and the arrival of the Sick Berth Reserve and Mobile V.A . D., but the situation had eased and the arrangements were not put into operation. Orthopredic clinic work and duties in connection with Open Air School transport were referred to, also the Brigade competitions and Voluntary Aid Detachments.

NOI{THERN IRELAND DISTRICT, S.].A.B. Under the auspices of the Belfast Central Nursing Division, a meeting was held at Brigade Headquarters on \Vednesday, ]\·l arch 15th. Lady Div. Surt. Miss S. J. Irvine, in asking Mrs. W. Hulme to take the chair, said how pleased they were to have her as their President, especially as she had been a V. A. D. Mrs. Hulme expressed her pleasure at being the Div. President, and welcomed Mrs. WalIacp., Lady County Officer for Belfast, and the speaker of the evening, Mrs. Irwin, Lady Warden, Stranmillis Training College, whose talk would be on " Nutrition in the Kitchen," a subject with which she was most able to deal. Miss J rwin gave a most interesting lecture on the value of foods. She told her audience that too often things that lay to hand were despised. Few people realised the value of nettles and dandelions as vegetables, whilst it was a matter of regret that children in the country, as well as in the towns, were so poorly nourished to-day compared with even twenty or thirty years ago. The prevailing diet to-day appeared to be bread fried in the pan and tea. A discussion followed, after which Lady County Officer Mrs. Wallace proposed a vote of thanks to the speaker.

KENT B.R.C.S. COMPETITIONS. Chislehurst V. 1\. D. (Kent 67) won the "Yolland" shield in the County competitions, 11eld at Maidsto ne, on Ma rch 11th. Another notable success was that of the new Petts Wood detachment, whose team won the ,. Daubeney" cup for profici<!ncy in anti-gas at their ~rst attempt: Teams taking part were from Maldstone, Chlslehurst, Sidcup, Sevenoaks, Beckenham, Tunbridge Wells, Whi tstable, Petts \Vood, Rochester, Tonbridge, Hadlow and La mberhurst. Among those who witnessed the tests were Colonel C. Pye Oliver, C.B., C.M.G., M.D., D.L. (Cou.nty Controller and County Director), Viscountess Broome (VlcePresident, B. R. C. S ., Kent), Miss B. Batten, O. B. E. (Ass t. County Controller), Mrs. Falwasse r (Asst. Count) Controller, S.].A.B.) and l\lrs. G. Daubeney. The results were: "Yolland" shicld-1, Kent 60 (C hislehurst); 2, Kent 202 (Petts Wood); 3, Kent 86 (Beckenham); 4, Kent 76 (Sevenoaks). "Daubeney" cup- Winner, Kent 202 (Petts Wood). Chislehurst has held the" Yolland" cup for several years, but this year they entered an entirely new team except for the leader. Petts Wood ha s nO.t before entered for the competitions, and has only been reglstered some two yea rs. They are to be congratulated on t~e double succe~s of winning the" Daubeney" cup and be1l1g runners-up In the" Yolland" shield competition.

WAR OFFICE INSPECTION AT EXMOUTH. Members of Exmouth V. A. D. (B. R. C. S.) were inspected on March 29th, by Col. W. L. Steele, representing the War Office. There was a good attendance of members, und:r Com mandant Miss Landon, and Col. Steele expressed hiS satisfaction with the work of the detachment. Brig.-Genl. W. F. S. Edwards, County Contr.oller, congratulated the detacement on the t~rn-out. He. remtnded the members that they were engaged In work whl.ch would a lways be of value to both their country and their homes. Since last year the V.A. D. organisation had undergone a complete reconstruction. Headquarters .were n.ow concentrating on mobile members, and no more Immobile members would be enrolled throughout the county as the nUI1:bers were vastly in excess of the requirements in case of natIOnal emergency. The detachment would be available for use by the }ocal authorities for A. R. P. and other work in time of natIOnal e mergency.

The Earl of Ancaster, President of the Bourne S.]. A. B., presided at the annual meeting and congratulated the members on maintaining their efficiency. 3

•

The Brenchley and District Division, S.].A.B., has obtained the servicE.s of 'Dr. A. Whittome as Divisional Surgeon. Mr. W. H. Godden is President and Mr. Macintosh Williams, Vice-President.

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FULL Y REVISED ADDITIONS TO RESPIRATOR SECTION DECONTAMINATION OF CLOTHING FULLY DESCRIBED DESCRIPTION OF LATEST TYPES OF ANTI-GAS CLOTHING

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FIRST

268

A.R.P. Topics.

AID

FIRST

The fourth course is for personnel decontamination squads after the full course has been completed.

REVISED SYLLABUS OF ANTI-GAS TRAINING.

According to a recent circular (No. 26/1939, 1 ide post free), it has been decided to revise and extend the scope of A. R. P. Memorandum No. 5 (Anti-Gas Training). A revised edition will be issued shortly, which will shorten and simplify the syllabus of anti-gas training, and include syllabuses of training in elementary protection against high explosive bombs and against incendiary bombs. These new syllabuses should, according to instructions, be adopted forthwith. The previous "modified filII" course has been omitted, and only the foIIowing courses are now recognised for the training of the various A. R. P. Services : (a) (b) (c)

Full Course (9 hours). Short Course (4 hours). Voluntary Aid Course (2~ hours)to be taken in addition to and after (a). (d) Decontamination Course (4 hours) -to be taken in addition to and after (a). A syllabus of each course is incl uded, and a reference is made to the course for the training of local anti-gas instructors and Medical Course laid down respectively in Appendix C and Appendix G (c) of A.R.P. Memorandum No.5 (2nd edition), Instructors (C.A. G.S.) or CA. R. P .S.) or I nstructors (L.A.G.C.) or (L.C.R.P.) are permitted to give the new full course, but only the former may conduct the Decontamination Course. Instructors for the Voluntary Aid Course and (he Short Course remains as at present. The Full Course is for the Constabulary, Fire Service, 'Nardens, Rescue Parties, Decontamination Squads, Outdoor Repair Staffs, Messenger and Casualty Services. In addition, Decontamination Squads will be given the Decontamination Course j whilst First Aid Personnel and undressers should, in addition, be given the V.A. Course. The Short Course is for Report Centre Staffs and other indoor workers. .The Voluntary Aid Course is for all casualty service personnel, who will also take a fulI course in first aid as particulars given in A. R. P. circular No. 16/1939. The V.A. Course is to be in addition to, and after, the fuII anti-gas course. We are prepared to supply Ambulance Secretaries and others with specimen copies of this Journal for distribution among their members. Apply to the Publishers, FIRST AID, 46, Cannon St •• London E.C.

AMBULANCE SERVICES.

A further circular (No. 1787, 2~d. pest free) has been issued under date March 24th, 1939. In this, supplementary observations are given to the Emergency Ambulance Service as stated in Circular 1764, dated January 10th, 1939 (which was referred to in our March issue). Reference is made to the functions of the Ambulance Officer, who will be largely concerned with the organisation and war-time control of the ambulance service primarily as a transport system. Training of ambulance personnel in driving alld in general service duties is also included in his duties, and the use of peacetime trained staff associated with ambulance services is suggested. Other subjects referred to in this circular are operational plans j relationship of ambulances to first aid parties j number of ambulance vehicles and personnel; earmarking of vehicles; war-time duty of personnel j disposition of ambulance vehicles during raids; control; maintenance of communications; recruitment j and training of personnel.

FIRST AID POSTS AND

POINTS.

A new circular (No. 1789, 3~d. post free) has been issued and refers to (1) Surgical and Medical Equipment, (2) Mobile Units, (3) Personnel. The schedules of the stores and equipment for first aid posts have now been revised following on the decision that a doctor should be in attendance at such posts. The definition of a mobile unit is now given, together with suggested equipment, which includes cupboards and other furniture. The personnel of a mobile unit is suggested should number 18, excluding doctor and trained nurse, on the assumption of three shifts. All such personnel should be women auxiliaries. Included in the Circular are two appendixes setting forth the list of drugs, dressings and splints, instruments, utensils and heating and lighting unit j equipment for a mobile unit, which also includes drawings of cupboards, etc. NEW GOVERNMENT A. R.P. SCHOOLS.

Ten new Government A.R.P. Schools are to be opened in various parts of the country. Tv. 0 will be in London, and other centres, we understand, wiII include Manchester, Glasgow, Newcastle and Doncaster.

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FIRST

The schools are primarily for the 5,000 instructors who have already passed through Falfield and Easingwold, but who now require instruction against high explosives and incendiary bombs. The curriculum at the present two schools has been altered to include fire and explosives, but they cannot cope quickly enough with the instructors who require the additional training. Each new school will have accommodation for about 20 persons at a time, and the course will extend over four days. Whilst awaiting the training in Incendiary Bombs and High Explosives, we recommend instructors to obtain a copy of the Notes of Lecture on this subject by Mr. Frank \Vrigglesworth (C.A.G.S. Special), which is published at 3d. post free. All orders should be sent to Dale, Reynolds and Co. Ltd., 46 , Cannon-street, London, E.C.4. Q C ESTION S AND ANSWERS.

This month we publish a few answers to queries asked at the S.J.A.B. Gas Courses and answered by Dr. \V. C. BentalI. Q. Would the outlet or overflow pipe from a cistern have to be stopped up to prevent water being poisoned? A. No, because war gases are heavier than air, and there is no upward sucti.o n in an overflow. Q. Is blanket efficacious at window if not soaked or wetted with chloride and water? A. Dry blanket- is good; wet blanket better; wetted with bleach best. Q. To what exten t can a cellophane covered window actually resist the blast of an H.E. Bomb ? A. It prevents cracked glass from falling out. The extent of its success depends on the proximity of the born b. Q. How would you decontaminate the fabric roof of a car w hich is not detaehable for boiling, etc. A. Smear with a bleach paste, leave for 15 minutes , hose down and leave to dry. Q. Is waterglass to be considered as a temporary measure. ,Vould it have to be removed after and the concrete tfeated with bleach paste? A. Yes to all three questions, for complete safety. Q. Where can gas indicator paint be obtained? A. It is only given to those whose responsibility it is to use it. Q. What is meant by equal parts of glycerine and 50 per cent. caustic soda for gross tear gas? A. The 50 per cent. caustic soda is a solution which contains the amount of caustic soda

FIR ST

AID

stated. To this prepared sol ution is added an equal amount of glycerine. For example, if a pint was required, you would take t pint of 50 per cent. caustic soda solution and ! pint glycerine.

Reviews. PRACTICAL BANDAGING . By Eldrige L. Eliason, A.B., M.D., F.A.C.S. London:]. B. Lippincott Company. Price 7s. 6d. n et. This is the fifth edilion of a most useful book which was first publi s hed in 1914 and is devoted to bandaging in all its fo rms, including the ap plication of adhesive and plaster of pari s dressings. It is di vided into 5 parts and illustrated by 1 SO diagrams and photographs. All the recognised classical bandages in common use are described in detail. In addition, the author, who is Professor of Surgery of the University of Pennsylvania, has added illustrations of methods and turns which in his experience, have been found to be more effectual. Further, he rightly pleads that every banda g e, properly applied, takes less material, retains its pla ce better and gives a more pleasing impression than one improperly applied. A part is given up to miscellaneous bandages and dressings, and includes handkerchief bandages, cravats, slings, swathes and various specially constructed dressings in more or less common USE:'. In the last part students are shown every step from the m a king of individual plaster of paris bandages to the appli cation of the completed dressing and finally its removal. The book closes with a most serviceable index. In brief, this is indeed a practical book on bandaging, and from it readers of FIRST AID will learn much concerning the art of bandaging.

Stratford-on-Avon L.M.S. ambulance team lost, by six points, the Evesham ambulance cup to the Worcester County PolicE:'. 3

•

The County of London Branch, B.R.C.S., has trained 12,000 persons in first aid, home nursing and anti-gas dnrin~ the past 15 months and was finding nursing members for the Ri ver Thames ambulance ships in the event of emergency.

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Over 350 people attended the dance of the 83 (Highgate and Crouch End) and 109 (Homsey British Legion) Divisions, S.]. A. B. The function was organised by Sergt. A. Stagnell and Pte. L. Hawkins (83) and Ptes. H. Braham and H. Woods (109).

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A few ,pecial features of t~e . Austin Ambulance: .B ody of besr E nglish ash and oak, .allin/wHln/. pal/elled for d~lrabllllY alld easy cleanlllg . Sem l-elhpuc ::;lI.,c- llICedeat'ed sprll/gs 01/ 111:)//Illbricared shackles, for rh. pauems' IIrmoS( comforr . lfl,d,', IInobst rue/ed dool'"UJay for Qllick emry and ex/{ of srretchers. A mple vem ilar iol/. FilII qnd officially-approved tr/rerior e.qllipmenr. Special jittings as .ref}//Ired. /\lay we send you a prlc. lIsr al/1 sp eciji<'a rions <lnd, If YJII tush, arrange {/ delllollSrnuwn for YOII ~

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Queries and Ans\Ners to Correspondents. Queries will be dealt with under the following rules : l.-Letters cOI1Laining Queries must be marked on the top ldt-hand corner of the envelope" Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C.4.

AID

FIRST

corrosive acid we should give plenty of lime water and when this is not available, we should administer plaster scraped from the wall. Now, up to the concrete age, lime plasters were mostly used. To-day, however, building jobs are speeded up so much that this plaster would be far too slow in setting. Consequently, modern buildings are plastered with the new gypsum plaster which sets quickly and firmly. In these circumstances, it would be most difficult to get a powdered alkali from modern wall plaster.

Every nurse has

4. - The Textbook to which reference may be made in this column is the 39th (1937) Edition ot the S.J.A.A. Manual of First Aid to the Injured. TREATMENT OF AMMONIA POISONING. l\1.E. (AlLon).-l am a member of St. John and have charge of the first aid box in the Engineering- Department of a Br~wery.

Under my charge as first aider are men working on an Ammonia Plant; and, whilst we are charging this plant or working on it, I always have vinegar or lime juice ready to give if needed. During a recent discussion, however, I was told by a man (who, though not a first aider, has been connected with ammonia plan ts for a long time) that beer is the best remedy for cases of poisoning. I n these circumstances, I would like your ruling on this point. As a St. John man you should stick to the instructions of the Textbook. - N. CORBET FLETCHER. EXAMINATION HOWLER. G.C. (Sutton). - ln a recent examination I asked a candidate the names of Lhe bones which entered into the formation of the knee joint. I was much amused when slw answered :- " Fimal', Tibulal' and Flotilla! "

Every

Good!

Next, please! !- N.C.F. TREATMENT OF ACID POISONING.

C.O. (Earlsfield).-Please tell me why the Textbook does not advise us to administer bicarbonate of soda in a case of acid poisoning, as it is more commonly found in the avera ge household than whitening, chalk or magnesia. Because the carbonic acid gas, which would be given off as the result of their combination, would cause distension of the stomach even to a dangerous degree especially if the stomach wall were almost perforated by the acid.-N.C.F. PLASTER IN TREATMENT OF ACID POISONING. P. W. (Forest Hill).-I am an interested reader of FIRST AID and find plenty of information in your answers to queries. Being a plasterer by trade I think that I ought to call the attention of your readers to the following fact : We are told in the Textbook that when we have to attend a patient who is known to have swallowed

A COMPETITOR'S DILEMMA. F. S. (Douglas).-In the Isle of man we are not members of the Brigade but just members of an Ambulance Class; but we all study the Revised Edition of the Textbook. I tell you this because, during our recent practices for a competition, I obtained some copies of FIRST AID for the instruction of the members of my team. Now, however, our instructor has told us not to take any notice of the tests which are published in the Journal from time to time. In these circumstances I ask (1) if the hints on competitions and the tests which appear in FIRST AID cover all first aid work and (2) if we would do right in making a complete examination (with diagnosis) of a

First

Aid

BAILLIERE'S DICTIONARY

TREATMENT OF FRACTURES OF SPINE AND ELBOW.

There is another possibility which seems to me more suitable for this combination of injuries, and that is to treat the fractured arm at elhow with splint and bandages and then to place the limb abo\'e the patient's head as shown in Fig. 39 on p. 77 of the Textbook. I appreciate that this will require great care; that a bearer must be detailed to control the fractured arm until the patient is on the stretcher, and that such action is forced on us because the fractured spine, as the more serious injury, must have priority in treatment. I cannot approve the suggestion that the patient should lay on his fractured upper limb.-N.C.F.

have

So too has

Your interesting letter is much appreciated and gives us all cause for thought.-N.C.F.

E.H. (Bradford).-l should be obliged if you will give me your ruling on the following case which caused a good deal of discussion at a recent class meeting. Along with three other members I was called upon to deal with a man who had, supposedly, suffered a fracture of the spine in the lumbar region along with a fracture of the right arm involving the elbow joint, the patient being conscious. My colleagues and I were of the opinion that, in view of the fracture of the arm, and the danger of making a simple fracture a complicated one, we should modify the usual face downwards treatment of the fractured spine and carry the patient by the method laid down in the Textbook page 74 (face upwards) having, of course, applied the necessary splint and bandages to the fractured arm. Some of our members, however, were of the opinion that this should not be done, but that in view of the serious nature of the spinal injury that should be d€alt with as laid down in the Textbook, page 76, the patient laying face downwards upon the fractured upper limb after the fracture had been duly splinted. This school of thought was of the opinion that the two pads (under shoulders and hips) would lift the patient's weight off the injured arm, and that no damage would result as it was already fixed by the required splint and the patient could thus be safely carried face downwards. Your kind ruling on this matter would be much appreciated.

MEDICAL DICTIONARY

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.

AID

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FIRST

274

patient in a competition, even thoug-h the injuries were set out in the card of instruction. Please help us all you can. If truth be told, most competitors study the published marking sheets of individual judges, purely to learn their personal peculiarities and with a view to playing on these when competitor and judge lneet in the competition arena. Now as to your queries : (1) Most, if not all, of the detailed marking sheets are published in FIRST AID because these ha ve been used in Association or Brigade competitions; and so, because they present tests and their solutions, they may be most useful as part of the training- of a team. In short, had your instructor told you not to pay too much att e ntion to published marking sheets, I would ha ve ag-reed with him. (2) Cards of instruction used in com petitIOns vary considerably in style and quality. Some are long and verbose, and specify the injuries which are to be treated; and they may be followed by others to indicate changes in picture, patient, part and surroundings. Others are brief and serve onl y as an introduction to the the test, all details being marked on the patient or in the staging of the test. So this answer to this query depends on the type of card of instruction handed to you. In most competitions to-d ay, complete examination of the patient is expected to be made by competing teams.-N.C.F.

HUMO UR IN FIRST AID. G .C. (Sutton).-A certain publishing house was having an examination for first aid certificates. One bright lad, on being asked" What is the usual method of artificial respiration used," readil y responded: "Su 1aJfer." A number of thin~s can be placed against a certain writer whose name that is, but I think artificial respiration is not one of them. Go od!

Next, please! !-N.C. F.

COMPLICATED FRACTURE OF CLA VICLE. F . e. (Hastings).-At our last Di visional Practice I asked some of our members to treat a patient for a complicated fracture of the clavicle whi ch had penetrated the lung. Then (1) the question was raised as to how we should arrest h <:D morrhage if the clavicle had also severed the Su bclavian artery, seeing that the Carotid artery is not connected with the Subclavian. Also (2), if the clavicle had actually severed the Subclavian artery without breaking the skin, a further question was raised as to how we should diag-nose h::emorrhage from the artery seeing that the patient was also suffering from h::e morrhage from the lungs. \Ve thank you for your kindness in answering both queries.

(1) If the fractured clavicle actually severed the Subclavian artery, a first aider can do no more than treat as laid down in the Textbook for 'f Hremorrhage from an Internal Organ" (p. 136). (2) If the fractured clavicle actually severed the Subclavian artery, then you would have reason to suspect this complication because (a) the signs and symptoms of internal (and concealed) h::emorrhag-e would become rapidly and progressively more marked; (b) the pulse would be absent at the wrist on the affected side even though it might be perceptible at that on the other side, and (c) a swelling, due to blood escaping from th~ artery and possibly pulsating, would probably be seen and felt at the site of injury. - N. C. F. TRANSPORT FACE-DoWNWARDS OF SPlNAL INJURY. B.S. (Ontario, Canada).-I am an instructor of a team practising for a competition and have encountered

FIRS'!'

AID difficulty during practice of the face-downwards lift for a spinal injury. Each time we complete the movement, we find that the patient, instead of lying in the centre of the stretcher, is lying close to the side near the stretcher pole. This, of course, calls for some adjustment before we are able to lift and carry him away. We ilave found it necessary to give a slight lift to the patient while on his side and during the rolling onto the stretcher, in order to overcome this difficulty. As nearly all my men are over 200 lbs., this lift is no cinch. I have ordered the lift stopped for the time being, as no mention is made of such a thing in the Textbook. It may be a bone of contention in the coming corn .. peti[ion and I would like authority for whatever extras are included in the movement (if any). The photos are of little use. In fact they only add to the confusion as they show the patient lying on his side on part of the blanket. How did he get on to the blanket? The Textbook states to roll and support the patient on his side, the stretcher and blankets not coming in contact with him until later. As for the blankets being of any use if used in such a manner, we have found that they are too easily dragged off the stretcher by the weight of the patient and are very unreliable help. I think that the Revision Committee of the Association made a mistake by includin g thi., work in the bod y of the Textbook. Such should have been placed in the appendix , where it would come within the scope of " Organised First Aid," where it belongs. Hoping that you will be able to help us out of the muddle, and in anticipation of your early reply, I tender many thanks from us all. Doubtless you have read ere this the reply which I gave in the January issue of FIRST AID to another correspondent on the first point in your query. It is not an easy operation and requires much practice for its efficient accomplishment. As for your second point, idle rumour has it that certain members of the Committee, like you, held the vipw that the fa ce-upward., method ~'as best for the majority of first aiders ; and that the face-downwards was forced into the Textbook by reason of the Home Office instructions to those who render first aid in mines.-N.C. F. BANDAGES IN TREATMENT OF FRACTURED LEG. G.G. (Fetcham).-The Textbook in Rule 2 on p. 88 under Treatment of Fractured Thigh states- " Pass seven bandages under patient in the following order . . . " and again in Rule 4-" Secure the splint by tying the bandages in the same order." Further, under Treatment of Fractured Leg, the Textbook in Rule 4 on p. 92 states- " Secure the splints by bandages (A) above; (B) below the fracture . . ." In the light of these instructions I shall be grateful for your ruling whether or no the bandages used in the Treatment of Fractured Leg are to be tied as soon as they are placed in position or whether they are first to be placed in position and to be tied afterwards as in the Treatment of Fractured Thigh. I think that, while the Textbook allows freedom of choice as to the method, your second suggestion is the correct one. Certainly, most first aiders find the method laid down under Treatment of Fractured Thigh more convenient when they have to treat a fractured leg; and, having placed the bandages in position, they tie them in the sequence laid down in Rule 4 on p. 92. - N.C. F.

ESTWOOD COLLIERY, NOTTINGHAM. ANNUAL OPEN AMB(JLANCE COMPETITION. Saturday, 6th May, 1939. Entrance Fee 4/- p~r team. 1/ entry for Individual Competition. Valuable Prizes. Particulars from Ambulance Competition Secretary, B. A. Collieries Ltd., Bestwood, N r. Nottingham.

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A"I D

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FI RST AID is published on the ~oth of each month. The Annual Subscription is 3s. 6d. 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 add ress below, and should reach him before the 12th of each month, and must be accompanied (not necessarily tOY (;ublication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communic Hions connected with FIRST AID should be forwarded to the rublishers. DALE, REYNOLDS & Co., LTD., 46, CANNON STREET, LONDON, E·C.4.

CONTENTS

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HOVE

EDI TORIAL : -

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cal pro. ession and • membe,'s o.J the medi· to nurses and hospital otlicials wAo enclose tit f! i r pro.fessional ca,ds.

Something- Done Concussion and Compression-The Reason Why S.J .A. B. Headquarters and District Reports Priory for Wales Coming Events Railway Ambulance News A. R.P. Topics 5th International Congress for Life-Saving and First Aid to the Injured ... Police Ambulance News Home Service Ambulance Committee " Invicta" Ambulance .. . Th e Hospitallers' Club .. . Our Nurses' Pages National Road Passenger Transport Ambulance Association Readers' Opinions

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277 278 279 284 285 286 290 290 291 291 292 292 294 298 298

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No. 539.-VoL. XLV. NOTICE

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300 300 300 300 300 300 300 300 302 302

302 302 302 302 302

IN our March Editorial we referred to the appointment of a Commandant who would, in the event of an emergency, be in sole charge of First Aid Parties, including St. John and British Red Cross Units. This appointment was not acceptable to the voluntary units because the suggested Commandant was not connected with the organisations concerned; neither was it ascertained from the senior officers whether they would be available to take over this work. We aired this grievance in our March issue, and it was very apparent, from the letters received and the expressions verbally given, that the first aid movement as a whole were very disgruntled. However, we now learn that this appointment has now been cancelled, and that new arrangements, under local authorities, will be substituted. Thus it will be possible for local officers to be in charge of their men, which, in our opinion, is as it should be. Officers and men having worked together in peace time, and gained valuable experience of each other's capabilities, will mean increased efficiency in local arrangements should an emergency arise. We modestly suggest that this alteration is due in no small way to the publicity given by this Journal. VI e are here to assist the voluntary ambulance army in all its spheres, and the support ,ve receive from the members is a sure sign that our efforts on their behalf are appreciated. But w~ would point out that we do not undertake to take up items of an individual nature. Some readers write US on, say, a Brigade Regulation of which they do not agree, when it affects them personally. Regulations are made for the good of the cause, and whilst they are sometimes not as clear as they might be, the official ruling must always stand. SOMEHING DONE.

FIRST

Concussion and Compression-The Reason Why. By

CAPT.

WHITE

KNOX,

M.C., M.B., CH.B.

" THE Reason Why" must always be an interesting subject, and first aid~rs are continually asking questions as to why certain things take place. Recently the question was put to me : " Why are the signs such as they are in concussion and yet completely opposite in compression?" In order to understand the interconnection between the brain, heart and respiration, we must understand something about the regulation of the heart beat.

Captain A. C. White Knox, M.C., M.B., Ch.B., who was recently privileged to lecture to T. M. the King and Queen, also members of the Household at Buckingham Palace. '

If the ~eart be quickly removed from a sheep or o~her ammal that. has been killed it goes on beating for a few minutes and, in the case of a cold-bloo?ed animal, for some hours, showing that the peculiar muscular tissue of the heart posseses the prop~rty of contracting and relaxing without nervous Impu.ls~s from the ~entral nervous system. In the living body thIs power of automatic movem~nt is modified and regulated by nervous

AID impulses sent out from the brain and spinal cord . The regulating influence is of two kinds: firstly an impulse through the "Vagus" nerve checking o~ stopping its beating altogether and, secondly, an influence quickening or strengthening its beats. For example: Fright or shock or some stron g emoti?n. may cause the vagus to send such stron g restraining Influences that the heart stops beating, and the want of a fresh supply of blood in th e head may then cause a patient to faint, the loss of consciousness being due to the want of pure blood in the brain. On the other hand, strong emotion may p:oduce the rapid beating, called palpitation , by acting through the accelerating heart nerves from the spinal cord. . . Concuss~o.n of the brain or stunn ing is a clinical condItIOn, characterised by a more or less com plete suspension of its functions as a result of injury to the head, which leads to some commotio n of the cerebral substance. When a sevt"fe blow is applied to the skull this necessarily entails a diminution of the crani al capacity, which takes place at the expense of the fluid contents. The whole brain at the moment of contact becomes squeezed like a sponge. The result is a widespread anc.emia and this produces unconsciousness of varying degree. The restrain ing action of the vagus nerve on the heart is los t and it beats more quickly and more weakly. The result of the weakened action of the heart and the brain. a~c.emia gives the pale face, and the poo r functlOnlIlg of the respiratory centre in the brai n makes the breathing shallow. The same poo r heart beat makes the skin cold. In compression a similar condition arises from the blow on the skull for a time, but as the pressure continues and increases so there is obstruction to the v~nous drain ing of the brain , and we get cyanOSIS of the brain with all its accompanying irritating symptoms. The vag~s is stimulcted and slows up th e heart so that It beats slowly and strongly. Thi s strong heart action gives the flushed face assisted ?y the engorged brain. The stertorous breathin g IS due to the temporary paralysis of the soft palate and the loss of power and sensation is due to the co~tinued pressure on the brain, paralysing th e actIOn of that particular part. This of course may be extended to the control of one pupil. . The. reason. ~~y the signs may be delayed fo r a ~lI:ne, IS the 1111tlal concussion signs from th e drIVing of the blood and cerebral fluid out of the skull, but as the pressure continues and the brai n becomes cyanosed from the application of the pressure, so we begin to get all the exciting effects on the nerve centres. Owing to pressure on space many reports have had to be omitted from this issue.

FIRST

AID

St. John Ambulance Brigade Headquarters and District Reports. No. I (Prince of Wale8's) District On Saturday, April 22nd, the Area winners met at the Northampton Institute to decide the homes of various trophies. There was a large gathering present to witness the wo rk done and at the conclusion of the tests Captain W. Goodley, O.B.~., M.e. (Commissioner) presided over the pnze presentatlOns. He welcomed the Chief Commissioner (Sir John Duncan) and Lady Duncan and mentioned that this was t~~ first time Sir John had honoured the District CompetItIOns. . 1: telegram had been forwarded to the Lady Supt.m- ChIe£ (Lady Perrott) and to Lady District Officer Miss Masson, both of whom were seriously ill. Referring to the competitions, Capt. Goodley impressed upon the winning teams the importance of the tasks they had to face. The work of the district was of the highest regarding public duties, but not so good in competition work. He hoped that the teams would work hard and make him a prouder man at Brigade Finals. The work of A.R.P. was also referred to by Capt. Goodley, who said that whilst he was anxious to further the Chief Commissioner's wishes in this subject members must not forget that first aid is the primary obj ect of the Brigade, which has been built up for 50 years by the efficient first aid rendered to the general public. The Commissioner announced that the District Inspection had been postponed from June 3rd to June 10th. District Officer T. E. Walsby (Competition Secretary) ann ounced the following results : " Massey-Mainwaring" Challenge Cup (" Dewar" preliminary): 1, Old Kent Road, 289 marks; 2, Kings Cross, 288; 3, Cricklewood, 284; 4, Barking, 228; 5, Wimbledon and Merton, 227. " Osborn" Challenge Shield (improvised): 1, Shoreditch, 252 marks; 2 (tie), East Greenwich and Cricldewood, 239; 4, West Ham, 235; 5, Willesden, 205~. Results of other competitions held previously: " Ninnis" Efficiency Cup: Toynbee Hall Division. " Sleath Gent" Cup (individual) : Pte. L. G. Parsons, Cricklewood Division. "William Neill" Shield (for Ambulance Cadets): Southgate Cadet Division. The "Rideout" Cup, for the Area securing the greatest numb'er of awards: Central Area (Asst. Commissioner Capt. H. A. Fenton, in charge). (Nursing results will -be found on "Our Nurses' Pages.") Lady Duncan graciously presented the trophies and individual prizes. Sir J olm Duncan, replying to a vote of thanks extended to Lady Duncan, said that Lady Duncan was very pleased to ·be present, as she was extremely interested in the competitions. In the N ationClJI Seryice Scheme the men and women of the Brigade, who had set an example for many years, were a most valuable asset to the Government Scheme. He appealed to all men in the No.1 District to enrol in

the Stretcher Parties organised in London under the Borough Authorities. Sir John also referred to the Civil Nursing Reserve which all V.A.D. Immobile members could join. The usefulness of the Brigade was clearly demonstrated by the fact that during 1938 members had dealt with 688,000 cases. The proceedings concluded by a vote of thanks to judges, stewards and helpers, which was proposed by Asst. Commissioner S. J. Warren and replied to by Asst. Commissioner Capt. A. e. White Knox. BARNIn'.-Councillor Chas. T. Beard (President) presided at the 7th annual dinner of the Barnet Division and Potters Bar Section, held on April 14th. He was supported by Mrs. Beard, Capt. W. Goodley, O.B.E., M.e. (Commissioner) and Mrs. Goodley, County Commissioner H. Langley Jones (Hertfordshire), District Staff Officer G. e. Green and Mrs. Green, Mr. H. W. Fincham (Curator and Asst. Librarian of The Order), District Officers Hart and Standingford, County A.R.P. Officer Widdicombe (Herts.), Div. Surgeon D. e. Lavender and Mrs. Lavender, Supt. A. E. Hawkins and Mrs. Hawkins, Supt. (R.) Martin-Smith. and also vice-presidents and patrons. The Commissioner proposed" The Barnet Division," and congratulated the members-sixty in number-on their loyalty. The division was fo·rmed in 1903 and Supt. Hawkins had been a member since 1911, a fact he should be proud of. During the past twelve months the recorded cases of first aid numbered 357-a record which he hoped would be brought to the notice of those who did not appreciate the magnificent service the division rendered. Capt. Goodley referred to A.R.P. work, and also to the proposed appeal of the Division for permanent headquarters. Such headquarters were essential for a well-governed and well-run division. He also congratulated the Division on the Potters Bar section, which he hoped would soon be large enough to justify the formation of a division. Supt. Hawkins, in reply, thanked the Commissioner for his encouraging words. In A.R.P. 300 persons had taken the full first aid course, whilst 270 wardens, etc., had been through a short course. In addition about 100 were at the moment being trained. All members of the division were holders of the A.R.P. certificate. The Roadside Hut at Bignell's Corner had been handed over to the Division; and he thanked the members of the Nursing Division for assistance rendered. As regards new headquarters, Supt. Hawkins said that the acquisition of same would be of the greatest assistance in running the Division and in its efficiency. In conclusion he thanked the officers, N.C.O's. and men for their co-operation and assistance given at all times. Mr. H. Langley Jones proposed" The President, VicePresidents and Patrons," to which Councillor Beard replied. . . . "The Ladies and VIsItors" was submItted by Capt. Stanmore Lewis (Divisional Treasurer), the response

280

FIRST

being by Mr. Graham Wallis, J.P. (Barnet District Scout Commissioner). Mr. Fincham also replied. During the speeches Mrs. Goodley presented divisional trophies and awards. Following the dinner, which was arranged by Pte. R. Perry, social secretary, dancing was continued until a late hour, with CorpI. H. Waitt as M.C On Saturday, April 15th, the 63rd London V.A.D. held its first dinner. Commandant W. V. M. Allen presided. "The 63rd London" was proposed by Major J. H. Bankes (County Controller) who said he was very pleased to have such an excellent detachment from the Western Postal and St. Marylebone Division of the Brigade. Commandant Allen, in reply, said that the detachment was one of the biggest detachments and that membership was now 49. Major F. A. Bearn, D.S.O., M.C (Surgeon) also replied. Asst. County Controller T. McBride submitted" The Visitors," whom he was very pleased to welcome. Dr. Porter (Cadet Surgeon), who replied, said he was extremely pleased to return thanks for the kind welcome and hospitality extended. One of the pleasant things which had come out of A.R.P. was his association with the V.A.D. and the St. John movement. Submitting the toast of "The Chairman," Alderman R. Stiles Allen (Vice-president, 58/5 Division), paid tribute to the work done by the Commandant. Any job he undertook was always successfully concluded. Commandant Allen said that without the excellent men of the detachment he would be of little use. It was due to them that the detachment was so good. During the evening Major Bankes, on behalf of the Chief Commissioner, presented to Mr. W. L. Davies (Postmaster, Western District) his certificate of appointment and badge of office as President of the Western Postal and St. Marylebone Division. Mr. Davies, in acknowledging the presentation, said how pleased he was to be the President of such an enthusiastic and efficient Division. First aid was of the greatest value and excellent work had been done by members in the Sick Berth at the Western District. Following the excellent repast an enjoyable time was spent by the assembly in community singing; solo items were given by friends of the detachment. Quartermaster R. R. Dare was responsible for the arrangements. A Course of lectures for men on "First Aid to the Injured" commenced at Holly Park School Clinic, Friern Barnet, N.11, on Wednesday, May 17th. Particulars of the remaining lectures can be had of Amb. Officer F. W. G. Dines, 46, Twyford Avenue, N.2. SOUTHGATE.-The annual birthday social and dance of the Southgate Ambulance and Finchley and Southgate Nursing Divisions was held on May 3rd, when a large gathering enjoyed dances, games and other pastimes. The Mayor of Southgate graced the function with his presence and on his arrival at the hall inspected a guard of honour composed of members of the men, nurses and cadets. Owing to illness the Mayoress was unable to attend but her daughter, Miss Grant, deputised for ner. Others present included the Deputy Mayor and Mayoress (Alderman and Mrs. Massa), Alderman and Mrs. Wauthier, Councillor and Mrs. Abercromby, Councillor Peveritt, District Staff Officer G. C Green and Mrs. Green, District Officer Collins and Mrs. Collins, Corps Officer Stillwell, Lady Supt. Miss Vicary of Headquarters, Dr. Westlake (A.R.P. Liaison Officer), Div.

FIR S T AID -----------------------------------------

AID Surgeon Reid and Mrs. Reid, Amb. Officer P. H. R. Hayman (Officer-in-Charge, No. 118 Division), Cadet Supt. P. A. Stacey, Lady Supt. Miss R. Daniel, Cadct Officer Miss Gilbey and other officers of the Brigade. Amb. Officer Hayman welcomed all guests and referred to the winning of the" William Neill" Shield by the Boy Cadets in competition with other Divisions in the No. 1 Division. There were many amusing prizes given in spot dances, competitions, etc., and all too soon the hour of midnight arrived to end a happy evening. The No. 64 (Kentish Town) Division held a grand carnival dance last month. In addition to dancing a firstclass juvenile cabaret was presented by pupils of the Coral School of Dancing under the direction of Miss Coral Halfpenny. Mrs. Wilson, Divisional president, presented a gift to each child, and was herself the recipient of a bouquet presented by Miss Vera .Holman. The occasion proved an enj oyable and successful function. A new ambulance division of the Brigade has been registered in the Borough of Romford with Supt. E. Howard in charge. Supt. Howard has been in charge of the Dagenham Division for many years. It is hoped to commence a nursing division in the near future.

No. IT District EASTLEIGH.-11he first annual dinner of the Eastleigh piyision w,:s held on April 18th, when County COllrlllsslOner Major A. Tennyson Smith presided, supported by the Deputy Mayor and Deputy Mayoress (Alderman and Mrs. R. H. Roberts), County Surgeon R. R.. Garrett and Mrs. Garrett, J.P., c.c. (President, Eastlelgh Nursing Division), Supt. E. S. Guppy, Dr. and Mrs. E. R. Batho, Corps Surgeon W. L. M. Bigby (Southampton,) Dr. and Mrs. L. E. Green, Dr. A. G. Proverbs, Amb. Officer W. P. Pascoe (Div. Treasurer), Hon. S~r~t. E. G. Route (Secretary), Div. Storekeeper R. E. Glll1l1gham and many other friends. Dr. Garrett, who had been Divisional Surgeon since 1912, proposed the "Eastleigh Division" and referred to the presence of Mr. Plews, the first superintendent. In A.R.P. the division had one C.A.G.S., four Grade I and eight Grade II instructors. The members were always ready to serve and from May to September in 1937 two men w~~e on duty every night at the Basque Camp. In competltlOn work many successes had been gained . He hope~ that .n~~t year the diyision and the newly-formed Nursmg DlvlslOn would umte and hold a joint dinner. Dr. Garrett wished the division every success. Supt. Guppy, in reply, paid tribute to Dr. Garrett for the invaluable work and assistance he had given the division. The members were sorry that he had left the ~ivision, consequent on being made County Surgeon, and hIS successor would have a lot to do to beat his record. Dr. Garrett, in addition to financial assistance had O'iven the Brigade and Association a valuable shield' for a~nual com~etition; and the members congratulated him on his appomtment as County Surgeon. Supt. Guppy 3ilso thanked Mrs. Garrett for the interest she took in ambulance work, especially as President of the Nursino' Division. b On behalf of the officers and men of the Division the County Commissioner then presented Dr. Garrett with a travelling trousers press as a token of their esteem. In appointing Dr. Garrett as County Surgeon he had taken the step because he was looking for the right

man for the job, and it was a great relief to him when Dr. Garrett consented to take on such responsible work, for which the County thanked him most heartily. Major Tennyson Smith also presented an inscribed biscuit barrel to Pte. W. Cawte on behalf of the officers and men, congratulating him upon his marriage. A.R.P. Grade II certificates were presented to eight members of the division. Ambulance Officer Pascoe proposed "The Visitors" in a witty speech, to which the Deputy Mayor responded, congratulating the members on their work. Replying to the toast of "The Chairman," submitted by Pte. F. W. Taysome, Major Tennyson Smith said that when he took over the position of County Commissioner in 1935 the membership was between 1,600 to 1,700. On December 31st last the number had risen to 2,600, and in the last two years 17 new divisions had been formed in the county. This success was due entirely to the marvellous work carried out by every division. At the :first inspection he carried out at Eastleigh he was struck by the smartness of the men and the efficiency of their work. It has been the same every succeeding year. The G10ucestershire County Competitions were held at Cheltenham on May 6th. Three ambulance teams competed for the" Hebblethwaite" Cup, the judges being Dr. Wallace (team) and Dr. Richardson (individual). Cheltenham Town Division, with 515 marks, gained first place, followed by Coleford (507) and Gloucester Wagon Works (496). The judges in the nursing competitions were Dr. Hutton (team), Miss Loveluck (home nursing) and Dr. Neill (individual). Cheltenham Central gained the first place, and the " Bledisloe " Bowl, with 271 marks, Cheltenham (256) and City of Gloucester (143) being second and third respectively. The Central Division, represented by Mrs. Roberts and Mrs. Temple, also won the " Carruthers Little" Cup for bedmaking. Miss Carew judged this event. County Commissioner Dr. Barrett Cardew welcomed Mr. D. L. Lipson, M.P. and Mrs. Lipson, who were always willing to help the cause of ambulance work. Mr. Lipson spoke of the pleasure he and Mrs. Lipson had in attending ambulance functions. Ambulance work was a fine example of national service. Mrs. Lipson presented the trophies and wished the winners the best of luck at the District finals. Cadet-Sergt. Evans, winner of the Cadet Cup, received a medal given by Corps Officer W. J. Ball. Lady County Officer Miss Faber voiced thanks to Mr. and Mrs. Lipson, whilst County Officer H. J. Lewis extended thanks to the judges and paid tribute to the valuable work and assistance received from the doctors. The County Commissioner thanked Lady Corps Supt. Miss Garrick Lady Supt. Miss Ward and Amb. Officer Skinner, who'had made the excellent preparations for the competitions; also to the cadets who had acted as patients.

No. m District. BEDFORD.-The annual dinner and presentation of awards of the Bedford Town Division was held on April 27th, when Major-General Lock, President of the Northern Bedfordshire Area, presided. County Commission~r Capt. W. C. Knight proposed "The Bedford Town Division." He congratulated the divisional team on gaining first place in the County II Dewar" eliminating competitions and thanked all mem-

bers for their help during the September crisis. He hoped that they would maintain their efficiency. Div. Surgeon J. C. Boyde responded. Supt. Poulter proposed "Our Guests" to which the Mayor (Mr. A. Braggins) replied. ' ~r. A. J. Whitchurch, Vice-President, presented first aId labels, medallions, vouchers and certificates home nursing pendants and A.R.P. awards. ' . !he" Knight" Cup, presented by the County CommlSSl?ner, was won by "D" team (A/CorpI. Nicholls, captam, Ptes, Woods, Mayhew, Gates and Richardson). The "Boyde" Cup, presented by the divisional surgeon for individual efficiency, was won by A/CorpI. Nicholls after a tie by three members. Cadet Mardle won the" Whitchurch" Cup for Senior Cadets and Cadet Schofield the medal presented by the divisional surgeon for Junior Cadets. STOURBRIDGE.-SUPt. C. Davies presided at the annual dinner and present.ation of awards of the Stourbridge Division, on April 18th, supported by Amb. Officers W. E. Weaver and A. E. Roden (Div. Secretary). The visitors included Corps A.R.P. Officer C. Ollis, Corps Officer W. Ollis, Dr. F. Severne Mackenna (Droitwich), Corps Officer H. E. Allen (South vVorcestershire Corps), Supt. H. G. Mills (Lye), Chief Supt. G. Davis, M.B.E. (Deputy Chief Constable of Worcestershire), Captain G. G. Heathcock, the Rev. W. J. North and Mr. W. A. Parsons (Stourbridge Brotherhood). The Secretary read a message from Dr. Geoffrey Dudley, in which he, as Medical Officer of Health for Stourbridge, thanked the Division for the great help rendered by the officers and men in the organisation of the first aid services in connection with A.R.P. In the 24th annual report the Secretary stated that the strength was 74 members, an increase of 12 over the previous year. Public duties totalled 1,107 and represented approximately 2,600 hours of voluntary service. Members had continued to act as voluntary orderlies on the Stourbridge Motor Ambulances. They greatly regretted the death of their esteemed Divisional Treasurer, Mr. Herbert Hadgkiss, who had been associated with the Division since 1916. Amb. Officer W. E. Weaver had been appointed to succeed him. The annual flag day appeal realised £43 19s. 6d. They were pleased to note the formation of the Stourbridge Nursing Division, which was continuing to flourish. This year marked the 25th anniversary of the Division, it having been registered on September 3rd, 1914, and a~rangen:eI.Its were in hand to celebrate the event WIth a )o1Ot Ambulance and Brotherhood service in the Town Hall later in the year. The Treasurer reported a balance in hand at December 31st of £41 19s. 5d. In a humorous speech, the Chairman recommended first aid work as an admirable aid to romance. Big words, such as haematemesis, haemoptysis, oephagus, and epiglottis never failed to get the ladies. "And if they don't kn~w you better," he added, "they may think you have been to Oxford." The annual awards were presented by Mr. F. S. Bolton, the first Superintendent of the Division, ,,:ho congratulated the Division on haying kept the flag. flY10g for a quarter of a century. ChIef Supt. G. DaVIS congratulated the Division on its ~ne w?rk, and t~anked the members for their eo-operatlOn WIth the pollee.

N o. V District HARWORTH COLLIERY.-The Harworth Colliery Corps held a Church Parade on Sunday, April 30th, at t~e Bircotes Church. The Divisions were under theIr respective officers-Sl1pts. T. Hankin (Bircotes), G. H.

AID Burton (Band), H. D. Price (Colliery), Mrs. MiHs (Nurses), the whole parade being under the command of Corps Supt. W. Wright, J.P. Other officers present included Corps Surgeon J. P. Quigley, Lady Corps Supt. Mrs. Wright, Corps Officers J. H. Pedley and VI. G. Oldfield (Corps Secretary). Maj or McTurk, vice-president, was also present. NOTTINGHAM.-The Central Division held a social recently at which the "Carrier JJ Efficiency Cup was presented to the winner, Corpl. A. Leverton; also replicas to Ptes. J. Gell and A. Hopewell, the runners-up. . It is interesting to record that the Cup was gIven by Corps Officer Carrier, who is not only the "Father" of the Central Division <but also father of the Divisional Superintendent and brother of the Ambulance Officer. On April 2nd the Division held its 12th annual church parade. Despite dull weather 10 officers and 96 men paraded and marched to the Canaan Church, where 60 nurses were assembled.

No. VIII (Duke of Connaught's) District The final competitions of the No. 8 District were held at Horsham on Saturday, May 6th, Corps Officer F. A. Trott being the Competition Secretary. The winning teams of the County competitions were the competitors and their work was witnessed Iby a large crowd of friends and weH wishers. Commissioner E. A. Richards presided over the subsequent distribution of prizes and introduced Mr. Ernest Nethercoat of Holbrook Park, Horsham, who had kindly consented, or as Mr. Richards said "He has been instructed," to present the awards in the unavoidable aJbsence of Mrs. N ethercoat. Both Mr. and Mrs. N ethercoat' take a great interest locally in first aid work. The results were as follows. Men: 1st and "Three Counties" Shield, Brighton Police, 441.2 marks; 2nd and" Cotton" Shield, Ashford Works, 375.5; 3rd, Hastings S.R., 368.4. Nurses: 1st and "Cotton" Shield, Horsham, 301.35 marks; 2nd and "Dr. Chill" Cup, Guildforcl., 299.25; 3rd, Redhill and Reigate, 292.5. It is worthy of record that this was the first year Horsham Nurses had entered for the District competitions. Boy Cadets: 1st and" Mrs. Richards" Cup, Dover Town, 165 marks; 2nd, Chatham, 155; 3rd, Crawley, ISS. Girl Cadets: 1st and" Mrs. Falwasser" Cup, Dover, 17H marks; 2nd, Brighton, 160'; 3rd, Hastings, lSn. After presenting the District and also various County trophies Mr. Nethercoat said that he had greatly enjoyed being present to witness the competitions. He congratulated the Brigade on the humane work which was carried out by a voluntary organisation. The members were doing splendid work. Commissioner Richards extended a hearty vote of thanks to all stewards and patients, paying tribute to Mr. Trott on his organisation of the competitions. He sincerely hoped that after the Brigade finals No.8 District would again be proved the leading district in the Brigade. Dr. Matthews and Dr. Mailer, judges in the men's and women's team tests respectively, criticised the work done, which had been of an excellent character.

annual review. This invitation has been accepted and the provisional date is July 23rd. The Kent Road Collection has been sanctioned for Saturday and Sunday, August 12th and 13th. The County of Surrey Flag Day, within the County of Surrey Constahulary Area, will be held on Saturday, July 22nd. GUILDFORD.-The Order of St. John and more especial1y the Guildford Corps of the Brigade has lost by death one whose services in the ambulance movement covered nearly fifty years. We refer to Mr. Martin Williamson, who died recently in his 75th year. Mr. Williamson was prominently connected with the Brigade, being Superintendent of the Guildford Division at its formation in 1890. He occupied that position for 35 years and then ,b ecame hon. secretary for the Surrey County Section of the Association, a post he relinquished in 1937 owing to age. In 1934 ,h e was invested as a Knight of Grace of The Order, and on his retirement from the Brigade was the recipient of a silver inkstand. The Borough of Guildford Corps was largely repr esented at the 'funeral, members attending under Corps Supt. J. D. Rutter. The bearers were Corps Officers A. Norton, A. E. Davy, S. A. Fossett, Div. Supt. J. E. Cheshire and Amb. Officers W. Whitbourn and F. A. S. Crawt. The coffin was draped with the Brigade flag.

No. IX District

The annual review of the Kentish Units will be held at Dover, by kind invitation of the Dover Corporation, on Sunday, J u1y 9th.

The final competitions of the No. 9 District wer e held at P1ymouth on April 29th, when the County representatives battled for the right to represent the District in the Brigade finals. A luncheon was held previous to the competitions, the Lord Mayor (Mr. G. S. Scobie) presiding, accompanied ,oy the Lady Mayoress. He acknowledged the indebtedness of the public to the Brigade, the member s of which had made themselves indispensCl!ble in every day life and most efficiently undertook duties which would otherwise fall upon local authorities to discharge. Asst. County Commissioners W. W. Johnston (Cornwall) and G. W. Hingston (Mid-Devon) and County Surgeon E. S. Bowes (Dorset) replied. The Earl of Mount Edgcumbe (President, Plymouth Ambulance Service) and Mr. W. E. Beckly, also spoke. County Surgeon Lt.-Col. J. P. S. Ward was the competition secretary, assisted by Lady County Supt. Mrs. R. Balsdon and Corps Supt. W. F. Pethick. At the invitation of County Commissioner Hedley V. Miller the Lord Mayor presented the men's trophies and the Lady Mayoress those of the Nurses. The results were:Men: 1st and" Smerdon" Shield, Exeter City Police, 424 marks; 2nd and "Lennard" Cup, Barnstaple, 423; 3rd, Weymouth. Eight teams competed. Nurses: 1st and "Burn" Shield, Barnstaple, 454-:1 marks; 2nd and "Ellis" Cup, Plymouth Co-operative, 4241; 3rd, Weymouth (last year's "Perrott" Shield winners), 418~. Eight teams competed. Bodmin and Sherwell tied for the "Vosper" Cup (bedmaking) and each will hold the trophy for six months. County Commissioner H. J. Vick proposed an omnibus vote of thanks, which was acknowledged by the Lord Mayor and Dr. Morton-Palmer.

T'h e Worthing Corporation has invited the Surrey and Sussex Units to visit Worthing this year for the

ASHBuRToN.-The members of the Ashburton Division have realised a long cherished dream, and set an example

FIRST Lo many larger divisions, by the provision of new headquarters. F.our old cottages were doomed to demolition uude r the Slum Clearance Act and with originality and enterp rise, in addition to some hard work, these cotlages "ere purchased. Supl. J. A. Mann and his men formed a concert parLy, gave entertainments and raised funds by this meam and also other attractions. Over 200 hours was spent by memhers on removing clirt and dust, interior and exterior decorating, polishing The main structural work of strengthwoodwork, etc. cni ng the roof, etc.) was done by a firm of contractors. Three of the cottages n0'w form the main hall whilst the third provides two offices and also leads to a store above stretching the whole length of the building. The building was declared open, free of debt, by Major 1\1. L. Buller (Devon County Brigade President) on Avril 15th, when those present included the Portreevc of Ashburton (C;ipt. S. T. Stidson, R.N., J.P.) who presided, County Commis'sioner H. J. V ick, Asst. County Commissioner G. VI. Hingston, Dr. Morton Palmer (Sbaff County Officer for A.R.P.) and others. The Portreeve paid tribute to the indomitable energy of Supt. Mann, whilst Major Buller congratulated the members on the work they had accomplished. Mr. H. H. Whitley handed the deeds to the County Commissioner \\ ho c01T1mented on the fact that very few divisions in the County had their own he;ldquarters. The Ashburton Division was formed in 1900; a Nursing Diyision would He also referred to the work of sho rtly be started. Serg t. Snell who had 28 years' service. The Vicar, Rev. L. B. StaHard, the Rev. H. F. Hawkes (Congregational) and Rev. C. W. Jarvis (Methodist) dedicated the building. AXMINSTER.-On Sunday, April 15th, the first ambulance to be owned by Axminster St. John Ambulance was dedicated by the Vicar, Rev. F. H. Sanders, and replaces one hired from the Home Service Ambulance Com mittee. The pr,ovision of the vehicle was largely due to the generous gift of Capt. T. N uHalll, Knight of t.he Order of St. John (President of the Axm111ster ASSOCIation) who donated £100. The total cost was £375, and the balance was obtained by members of the Bng,ade and Association. Divisions were present from Chard, COlytOl1, Exmouth, Honiton, Ottery St. Mary, Sidmouth, Seaton, Cullumpton and Gittisham, and the parade ma rched around the town with the new ambulance, headed by the Honiton Silver Band. Assistant County Commissioner Moors was in charge of the parade, other prominent officers present being Lady County Supt. ;drs. De La Pryme, County Officer E. A. Bowden, and County Su rgeon Majol- E. E. Lightwood. The ceremony was presided over by Major Ormsby Allhuson who congratulated the Diyision on its achievement and regretted Capt. Nuttall could not be present. Rev. E. D. Highes (Congregational) read the Lesson, and a historica~ review of the Order of St. J obn was given by the Vlcar. The ambulance men attended service at the Parish 01ttrch m the evening. WEYMOU'l'H.-A number o£ distinguished visitors assembled at W estway Road, Westham, Weymouth to \\ ioLness the opening of the new headquarters of the Weymouth Division. The openin'O' ceremony was performed by the Earl o£ Shaftesbury~ P.c., who was accompanied by the Countess of Shaftesbury. A procession which left the He,alth Centre included County Commissioner Dr. Rodier Heath, Asst. COlT1missioner Dr. E. S. Bowes, L ord R?ckley, the Mayor and Mayoress of Weymouth (Co1111C111or J T. Goddard, M.C) and Mrs. Goddard), the Deputy

AID Mayo,r and Mayoress (Councillor and Mrs. Bert Biles), Dr. Gordon \Vallace (J\I.O.H.), County Officer Dr. Colin Forbes, Div. Surgeon R. V. S. Cooper, Lady County Officer Mrs. Cooper, Bishop J osclyn and others. A guard of honour \\'as formed by members of thl: Ambulance, Nursing and Cadet Divisions. As the Earl of Shaftesbury unlocked the lloo r the Brigade Standard was broken by Store Sergt. H. Gauntlett, the oldest member of the Division. The main hall was filled to its utmost for the ceremony and a large crowd outside the building had the On the proceedings relayed to them by loud speaker. platform, beside those already mentioned, was the Town Oerk (Mr. Percy Smallwood), Mr. and Mrs. H. A. Baldvvin, 1\1r. and Mrs. E . Glover (vice-presidents), l\1rs. Shewell (president, Nursing Division), Mr. E. A. Baker, Div. Supt. F. A. Fanner, Lady Supt. Mrs. Bartlett, and representatives of numerous organisations. His Lordship in declaring the building open said that being a Dorset man he knew how necessary was the work carried out by the Division, especially in the summer season. Lady Shaftesbury then received gifts from members of the Division \vhich amounted to £180. The Deputy Mayor, who was the originator of the Building Fund, outlined the scheme. The total cost was over £3,000 of which £1)000 was yet to be raised. Mrs. Shewell appealed for help both in money and members. Th e ),layor, Lord Rockl ey, Dr. Rodier Heath and others also spoke. The trophies won by the Divisions were on view, including the "Perrott" Shield which the Nursing Division won last year. A dance was held in the evening to commemorate the opening ceremony.

No. X District NORWlcII.-On April 16th, an antique grandfather clock, with lacquered case and Chinese inlaid drawings, was presented to Mr. S. E. R. Scott who recently relinquished the position of Corps Superintendent and Secretary of the Norwich Corps, positions he had held for the past twelve years. The clock, which was 150 years' olel, had been subscribed for by the Norwich Corps, members of the City Police, and a few personal friends. _ l\Iakino' the presentation, the Chief Constable 0 t Norwich (111'. J. H. Dain) said that since 1903 )'1r. Scott had been engaged on first aid work. During t?e Great War he joined the Volunteer Ambulan~e Sec~lOn. 111 1922, with J\lr. Bradbom) of Carrow FIre Bngade and ambulance section he assisted in r eviving the old St. John Ambulance Brio'ade and in 1927 a Lads' Club Diyision was formed with Nir. Scott as superintendent. Mr. Dain said that M;. Scott had been mosl energetic in the Brigade, not only in forming the City of Norwich Corps, but also in actino- as Corps Superintendent and Secretary for so many y~ars. He had r endered .imme~s~ .help to other towns in the district, where effiCIent dlYISlOnS had heen formed and he had been of great help to the police, the Royal Automobile Club, .tl~e Aytomobil.e Association, and other bodies in their trammg m first ald work. Dr. W. 'L. Hum spoke of Mr. Scott's keenness in first aid work, and Capt. C V..,r. Steel (secretary. Nonyich Di.vision Red Cross), adding a tribute, said he (bel not th111k there wa a place in J orfolk where the St. J oh11 and Red Cross worked more amicably. Sup t. H. 'vV. Ball and ~1r. ~. O. Clark (treas,nrer o_f the Norwich Corps )also paId tnhllte to Mr. Scott s ,,-ork. Expressing thanks, .Mr. Scott sc:id he had ~ot a lot of enjoyment out of first aId work , whIch he had ~dopted as his hobby rather than bowls. football cncket. He acknowledged the assistance he had receIved from thc Chief COl1stahle and Capt. Steel.

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Priory for

Wales.

• PRIORY HEADQUARTER NOTES.

On the recommendation of the Cardiganshire Centre President, the Earl of Lisburne, the~Sub-Prior (the Earl of Plymouth) has approved the appointment of General Lewis Evans, V. c., C. B., D. S. 0., as Commissioner, to succeed the late [\lr. Steven Jones, and Mr. W. R. Lloyd, M.B.E., Town Clerk of Lampeter, as Chairman. While considerable progress has heen made of recent years in extending class and competitive work in the county, there is great scope for further development of ambulance and nursing services; and under such influential leadership the Centre should prosper. In Pembrokeshire, the nursing side of Brigade activities is to be stimulated by the appointment of two County Officers to assist Mrs. Bickerton Edwards, the Lady County Superintendellt, the Baroness de Rutzen and 1\1rs. A. T. N. Evans (wife of the Assistant Commissioner) having accepted office. Within two days the Priory sustained the loss of two distinguished Officers by the deaths of Lieut. -Colonel J. E. H. Davies, D.S.O., M. R.C.S., L. RC. P., Knight of Grace, which occurred on May 1st at Wrexham, and of the RighL Reverend Lord Bishop of L1andaff (Dr. Timothy Rces) a Sub-Prelate of the Order and Chaplain for Wales, who died on April 29th. It is anticipated that over 8,000 members will participate in the Royal Review of the Brigade in Wales by H. R. H. the Duchess of Kent as Lady Superintendent-in-Chief for Wales, at Cardiff on July 1st. The parade will be in charge of Captain T. E. Richards, ]. P., M. E. (Commissioner for the Rhondda), with Dr. Edgar Llewellyn (Commissioner for Cardi!!> as Assistant Officer Commanding the Parade, with Capta111 S. T. Beard, O. B. E. (Commissioner for Monmouthshire) as Brigade Adjutant assisted by Lieut.-Colonel C. G. Cole-Hamilton, C.M.G., D.S.G. (Commissioner for Brecknockshire). The total number of Brigade members in Wales in possession of the Service Medal (awarded for fifteen years' efficient service) is 745 ; and it is good to know that Brigade perso?nel ~n Wales, the majority of whom have a long expenence 111 ambulance work, is responding to the Priory's appeal to all those eligible to enrol under the Local Authority for Casualty Service, in view of the large number of volunteers enrolled for that important duty with the barest minimum of training. . For gratuitous services as honorary lecturers over a penod of years, the following members of the medical profession were elected Honorary Life Members of the Priory by.t he Ambulance Committee on April 25th :-Dr. Joserh Shlbko (Surgeon, Brynhyhyd Division), Dr. J. P. Scales (Surgeon.' Cwm Cynon Colliery Division) and Dr. D. Mackenzie Crooks (Class Lecturer, Carris). .During the March quarter, the Priory ambulances a total mileage of 89,115, an 111crease of 849 cases and 7,452 miles on the March quarter a! 1938. .These figures bring the total number of removals SlOce the IOception of the Service to 140,783 with an aggregate mileage of 2,275, Y29. ~arned 5,785 cases, involving

WELSI!

BRIGADE FINALS.

The following is the interesting team test ~et for the Jlursing competitors at the Welsh Brigade Final Compelition s held in Cardiff on May 6th, when the Clydach and District (Brecknockshire) Ambulance Team and Ffaldau Institute and Garw (Glamorgan) Nursing Team were successful : Synopsis of Test.-Judged by Miss E. A. Gravenor, Matron, Gellygaer Isolation Hospital, and Lady County Officer for Glamorgan, and Dr. G. S. Phillips, Corps Surgeon, Ponrardawe and District Corps. Staging.-Two-roomed cottage, one furnished as a living-room with tables, chairs, couch, fireplace, kettle on hob, sideboard or cupboard with china, teapot, tea, sugar bot water bottles, basins and plates. Other furnished as bedroom with bed, table, two chairs, cupboard with linen, jug and basin, soap dish, nail brush , towels. Roadway running in front of house. Patient to be lying on face near the house on roadway. One lady's and one boy's cycle on roadway. At the other end, screened off from house and roadway, four chairs labelled •• Morris 8 car. " Chairs in twos. Team to be seated on chairs and handed card-You are on your way to this competition in a Morris •• 8 " car which belongs to and is driven by No. 2 of your team. No questions answered; all injuries marked on patient. DETAl LS OF TEST. GENERAL.

Rapid approach to patient Take boy along Question him as to what happened Ask him where patient lives Anybody else in house (no) Where does doctor live (1 mile) Nearest hospital (12 miles) Nearest ambulance (12 miles) .. Is that cycle his (yes) Can he go for doctor (yes) Written message when injuries known Ask him to wire competition secretary Explaining delay of team PROCEDURE IN ROAD.

Test for consciousness By speaking to her (no response) Rapid examination, back, head and spine upper limbs " lower limbs (Fractured tibia found right) Turn over careful I y Care of injured limb Note bleeding wound temple I mmediate digital pressure temporal artery Tie both feet and knees together Pad and bandage temporal artery or maintain digital pressure temporal Remove into house By two-handed scat Third bearer to support legs Place on couch in room PROCEDURE TN HOUSE.

General. Put kett le on to boil

W ipe away hlood from nose Do not plug ear Doctor Arrives Report to doctor with correct injuries General co-operation and efficiency

Obtain basins-cupboard Get rug or blanket To cover patient Open window EXAMINATION OF PATIENT.

General Condition . Colour of face (flushed) Breathing (stertorous) p ulse (60 full) Temperature body (raised) One side body limp (yes) Care in testing Avoiding injured side . Pupils of eyes (unequal) React to light (no) Ears for blood (right) Bloodshot eye (uo) ... Nose for blood (yes) Mouth for foreign bodies (no) ... Mouth for blood Bodily Injuries. Forehead (temporal wound only) Face and lower jaw (nil) Clavicles and upper limbs (nil) R ibs (nil) Abdomen (nil) Pelvis (nil) Lower limbs (right tibia fractured) Ex amination Wound Temple. Sterilise hands Sterilise s.::issors Cut away hair ... .. . Examine for foreign bodies (none seen) Examine for fracture (none felt) Examination Right Tibia.

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After-Care of Compression of Brain Send two of team to make bed Method of making bed Time-4 minutes ... Method of putting patient into bed Turn head to one side Raise head and shoulders slightly (one pillow) Extra blanket Darken room, keep house very quiet Fresh air Two hot bottles-covers Cradle over leg (improvised) Take tern p., pulse, resp. Method of taking ... Read thermometer. If correct! y Scrub own hands ... Keep own hands cold Apply cold compress Lint, J aconette, bandage lightly Preparation for doctor and verbal report, i.e. temp. sub-normal; pulse, slow and full i resp., slow and stertorous, with flushed face and puffing of cheeks. Pupils still unequal Extra marks for general appearance in uniform, efficiency and general co-operation in team work

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2 1 1 2 2 2 3 2 2 1 1

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Coming Events. The Editor will be pleased to receive particulars or forth· coming events for inclusion (free of charge) under this heading. MAY.

T REATMENT.

19 to June 9-National V.A. D. (B. RC.S.) Ca mp, Northwood Park, Winchester 21-National Road Passenger Transport Ambulan ce Association South l\lidland Competition, Bir ming ham. 24- 1nter-Railway Challenge Shield Final, Gt. Central Hotel, London.

H ead Wound Sterilise wound And surrounding skin Maintain pressure artery Clean dry dressing Cotton wool Bandage Relax pressure artery Examine if bleeding controlled

U nconscious State Cover with ru,gs Hot water bottles to feet Tested bare elbow ... Head and shoulders raised Cold com presses to head Renewed frequently to ensure cold Wipe away blood from ear

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Ex pose part By removing shoe and stocking Note hremorrhage ... No te bone protruding

Right Leg Steady and support limb D o not apply extension Sterilise hands Sterilise wound and skin Clean, dry dressing Cotton wool Bandage lightly T wo well-padded splints Correct length F ive bandages correctl y tied

AID

JUNE.

3-County of London B. R C. S. Annual Inspection, Royal

Hospital. ."".." 9-St. John Ambulance Bngade Dewar and Perrott Competition Finals, Gt. Central ~otel) London. . 10-N0. 1 (Prince of 'Wales's) Distnct Annual Inspectloll, Hyde Park. 10-B.R.C.S. South Wales Inspection by H.R.H . Commandant-in-Chief. 16-London and North Eastern Railway International Competition, Glasgow. 17-P. D.A.C. Ltd. (Western Area) Inter-Colliery Competition, Porth. 17 -Royal Halifax Infirmary Demonst.r~tion an~ Gala" Ald. Whittaker" Shield Open CompetitIOn, Hahfax. i8-Somerset Branch B.R.C.S., Church Parade and Presentation of Colours, Wells Cathedral. 20-London, Midland and Scottish Railway International Competition, Glasgow. 24-Barnoldswick Centre S.J.A.A., Annual Open Competitions. 24-Brighouse Infirmaries and Hospitals Committee Open Competitions.

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Railway Ambulance News. Presentation Di n ner to Mr. E. A. Rich ard s. O N fay 21st, 1939, there retires from active Railway First Aid one whose energies in this direction are well knowlJ, and one whose abse nce will be much reg-ret ted by all railway men. We refer to l\1 r. Erne-st A. (Dickie) Richards, who for many years has been the secreta ry vf the Southern Railway Amb ulance Centre. On ;\1 ay 2nd, some 500 well-wishers gat hered at the Coventry Street Corner House, London, to pay tribute to his untiring efforts a nd to wish him 1l1any happy years of retireJll en t. Mr. W. Geo. Pape, Chairman of the S. R. Centre, presided, a nd during- the evening- read ma ny congratulatory telegrams from those who were unabl e to be present.

had been tile right lIl a ll in the Welfare department. He hoped that Mr. Richards would leave behind that wonderfu l cheery spirit and that keenness and enthusiasm for the work which was always shown by him. Miss W. Grindley, supporting the motion, emphasised the fact that the size of the gathering was a sure sign of the popularity of Mr. Richards and the deep regard they had for him, their chief for many years. H e ""ould be missed, and they were salTY to lose him. Dr. J. N. Robins, on behalf of th e I'Iledical Profession, also paid tribute to 1\1 r. Richads, whom he first met some 33 years ago. All who had met him had the greatest admiration for his sincere devotion to the work. He would leave behind him many happy reRect ions. Mr. Pape announced that members of the S. R. Ambulance Centre had subscribed to a gift for IVIr. Richards, and he had the greatest pleasure in asking him to accept a ticke t for himself and wife for a trip round the world. Mr. Richards, on risin g to reply, received a wonderfu l reception, includin g musical honours. He was deeply touched by the kindness shown and by the magnificent gift and sentiments so ge nerously ex pressed. He was deeply conscious of the fact that he had been but the figure head , and paid tribute to the medical profession, district and class secretaries and his personal staff for the assistance they had rendered. H e mentioned especially Miss Grindley-a wonderful wom a n and a born organiser. His successor would be fortunate in having such a worker on his staff, also the services of Mr. F. A. Trott. Mr. Ri chards referred to the valuable friendships made during hi s term of officefrom lampboys to Superintendents, saying-Life is sweet because of the Friend s we have mad e, And the things which in common we s hare. We want to li ve on, not beca use of ourselves, But because of the people who care. I t's giving an d doing for sombebod y else On that all life's spiendour depe nd s, And the joys of the world, when you've s ummed it all up, Are found in the kee ping of Friends.

Mr. Ernest A. Rich a rds. Dr. R. B. Duncan , in proposing "The Southern Railway Ambulance Centre," paid tribute to the vast amount of hard work done quietly and efficiently by the Centre Committee, a nd a lso to the activities of the Centre, which was formed in 1925. During- the 14 years of its existence the numb~r of awards has increased every year, and the grand total 1S now 44,477. Cases reported treated has also in~ rea sed. In 1938 the number was 36,000 as against 13,000 10 1927. In competition work, the Southern had won the Inter- Railway Shield nine tim es during- the last 13 years and on three occasions had their two teams placed first and second. Mr. Pape, in reply, said that althoug-h increases had been experienced each year, the present n~mber was but 5 per cent. of the total employees. .. Make it 55 per cent." urged Mr. Pape in conclusion. ' Next came the toast of the evening :- " Ernest A. Ri ch~rd s. " The .Chairman said that the higb state of efficiency tn the first aid departm ent of the Southern was due in no small part to the high enthusiasm of IVIr. Richards, who

In conclusion, Mr. Richards said 1hat he was ca rryin g away many happy re co llecti ons of hi s te rm of a t-1i ce, and hoped to meet them all on the road of life in the future. As everyone left the function, Mr. Richards gave a handshake of frie ndship, and many expressions of g'ood luc k were extended to him and Mrs. Ri chards.

Intel"·Ra ilway Fin al, 1939. As previoLlsly anno unced lhe Inter-Railway Final will be helo on May 24th at th e Great Cent ral HOlel, MarylelJUll C, the judges being Dr. F. E. l ~c ncli x (tea m) and Dr. c;. S. Phillips (individual). The following teams will c01l1pete :Great Western: Barry Dock and Ponlypuol R uau. L ondon, Midland and Scottish: Crewe li"?[achinc Shop and Camden Goods. London and North Eastern: Tyne Docks and Tuxford Lo co. Southern: H o rsham No.1 and W aterloo" A." Ungroup'ed: Midland and G r eat Northern J oinL.

Great Western. The General Meeting Room, Paddington, was the scene of the Final Ambulance competition on April 28th, when from 9.45 a.m. onwards the contest attr acted the inte rest of many spectators, includ ing some of the chief office rs of the Company. The adj udicato rs were Captain A. C White Knox, M .C) for team work and Dr. E. J. Sel by for individual tests: At the suhsequent pr esentation proceedings, the Rt. Hon. Viscount Horne, Chairman of the Company, pre sided, and was supported by 1\1Ir. R. Carpmael, Chief Engineer, Dr. H. Cavendish Fuller, Chief 1\ledical Officer, 1\1r. H. Adams Clarke, Staff Assistant to the General ,Manager, and other officers of the Company. The result of the competition was announced by the Centre Secret1.ry, Miss C A. Ault: 1st, Barry Loco (Directors' Challcno'e Shield), 235 marks; 2nd, Pontypool Road ("Carvell" Cll~), 234; 3rd, Swindon) 223L 4th; Lampeter (prizes), 223. Other competing teams were Filton, Kington, Banhury and Shrewsbury. Lord Horne congratulated all the teams on their work, and extended his best wishes to the Barry Loco, and Pontypool Road teams \\"ho would represent the Company in the Inter-railway competition. He paid tribute to the aum irable spirit of railway ambulance worke rs. Lord [-lo rne then presented the Challenge trophies and prizes to inclivicJualmemhers of the first four teams, and the "Butt" (hallen <Ye Bow l for t he hest beginners' team, to Kington. i\c1 vanl;o'e was'taken of the occasion to present prizes won by the Cardiff and" Nor th ern" teams in the .G.W.R pol ice amhulance competition. Before present1l1K the Co mpany's gold, silver and bronze medals, Lord Horne <tskecl Dr. Cayendish Fuller to giye his comments on the cases selected. Dr. Fuller mentioned that the premier awa rd was for a case where a man had been called upon tl) administer first aid, in a serious road accident, to four patients more or less simul taneously. Other cases revealed 110 less cooln ess al1d forethought, and the w~rk \\as done in a first rate manner. The awards, whIch \\ere distributed lw Lord Home, were as under:Gold Medal - Award: Arthur Williams (Wag.on Repaire r), Oxford. Silver Medal Award: John R. DaVIes Bronze ~1edal (Sig'nalm a n ), Tohnslown and Hafod. !\\\:a rc1 : John A. Jones (Foreman), Gobowen. CertIficate Awa rds: Arthur Clarke (Clerk) . Johnsto'wn and Hafod; Walte r Avery (Porter ), Gobow~n: hOt: Blatchford (Gang'e r), Trelhomas; William F. GIbbs (Pollee Sergeant), Ca rdiff Docks; Sidney Grinnell (Po r ter), Brettell. Lane Goods' William E. Harries (B lacksmIth), Whltland; Emlyn' Lewis (Ganger), Pengam: Albert G:. Long (Shunle r), Swansea High Street; J:'-uhrey J. RIchmond (Goods Guard), Stoke Gifford; Edw1l1 E . Ayers (Wagon Repairer), Kingsland R~ad;. ~amL1el G. Sheppar,d (Shunter), G loucester; Leshe Wilhams (Carpenter), New port; Alfred T. Gardner (Lad Porter), O~f.ord; Arthur Woodley (Fireman), Oxford: Loui J. Phdhps (Po r te r ). Pemhroke. A vote of th anks to the adj udicalors w as p~oposed l)y Mr. Ca r pmael , and Dr. White Knox) replymg on hehalf of hims elf and hi s colleague, .commented on the hi~'h standard of wo rk, heing partIcularly t ruck, h e added. wilh the g'ood com~non. sense of t?e treatment g:ive n by the leams, and theIr .ql1let and effi'Clent methods. The proceedino's concluded WIth a vote o~ thank.s .t~ the • t'"> d h y M' ChaIrman propose . I. W . F ' Wills , DlvlslOnal ambnl a nce secretary of B nstoL HONouR s .- Foll owing recom111endations made b~ the Gr('(l t ' ;Vest('rn Railway Central Ambulance CommIttee,

AID the following members of the staff have been selected as serving Brothers of the Order of St. JOhl1 of ] erusa1em : Mr. J. Hall (Foreman, Engineering Department), Lostw ithiel; Mr. Mornington ]. Rich (Clerk, Traffic Department), Drinnick Mill; NIr. Ernest E. Jakeway (Signalman, Traffic D epartment), Bristol West Box; i\Ir. William ]. Smith (Signal Lineman's Assistant), Landore; ),[r. Thomas A. Forster (Booking Clerk) Aberdare High Level; Mr. Albert E. Hazell (Yard Inspector), N ewporl East Usk; Mr. C H. Hopkins (Sub-ganger, Engineering Department), Newport. Mr. G. S. Hodder, Divisional Ambulance Secretary, Bristol, has been promoted to thc gradc 0 f Officer (Brother) of the Order. and the Vellum Yote of Thanks has been awarded to 11r. J. A. ;"Iartin, Diyisional Ambulance Secretary, Chester. 1\11'. C A. Cox) Diyisional Superintendent of the London Diyision has also been admitted to the Order of St. John in recognition of his services in the furtherance of the ambulance moyement In his Division. SWINDo~.-Inau gurated two season ago the Swindon and District Amhulance League, under the auspices of the G.vV.R. Swindon Division) has completed a successful programme. Fifteen team (including 3 ladies'), competed in a fixture list of weekly matches extending oyer a period 0 f th r ee months. A final match v,as held on April 12th between 1\1:r. J. Dixon's and 1\1r. R. Ellis' teams as leaders of the two divisions formed. The former team were declared the winners haying gained 260 points again t 235i. Dr. and Mrs. R. B. Hick, Mrs. A. Tapley, ::-1r. D. Sinnett and a large gathering witnessed the contest at the close of which the League trophy was presented to the w inning team by Mrs . Hick. Thi s is the second year in succession that l\rr. Dixon's team has heen the League champions.

l ondon, Mid land and Scottish. Two teams, Crcwc ::Vlachin~ hop and Camden Goo~s tied for first place in the final of the L.1\I.S. fin~ls held 111 London on May 5th. As Cre\\'e, hOv"ever, obtallled more individual marks lhan Camden they were placed first. This was an unusual r esult for a final in \\ hich all teams did exceedingly good work. There was a grand attendance of team follo\\"ers to encouraO'e the teams: also many officer of the Company 'w hose p"'resence was a sure sign of the interest taken by the L.1\I.S. in first aid. Capt. A. C White Knox, l\I.C. l\I.B., Ch.B.! ~f London (team), Dr. F. H. Edwards of Sh.rewsbury (mdlvidua l practical) and Dr. K. H. Beverley ot Bar~lsley (Y1\'<I voce) officiated as judges, whilst 1\11'. G. S. Hlll was lhE competition secretary.. . . In the team te t the patIent had sLlsta1l1ed conCUSSlOlI, a r te ri al hacmorrhage from a wound on the f~rehead, and s impl e fractures of the right cIayicle, left nbs ~ncl l~ft patella. One team captain ohtained applause by hiS qUlck r eply to lhe j l1dge who had state? '.' The Doctor has a rriv ed." After reporting the 1l1Junes the team \\'as instructed to load ambulance and when the leader asked whether « Head or feet first ," the judo-e re~.Iied, "Plea.sc yo urself." Quickly came the resp~nse, . qh n<? SIr. you're in charge now-and even the Judge J01l1ed .m t~e iau ghter. Neverth~less th~ captain was ·h ut beanng 111 mind the lextbook 1l1strnctlOns.

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FIR ST

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Dr. Coruet Fletcher addressing the competitors at the compkLion of the tests said the work, ()n thc whole, had been well done. He always admired Railway Ambulance wo rk and his only r eg ret \\'as that he was unable to assist more. Capt. Goodley announced the result as follows: 1st, Tyne Dock, 286~ marks; 2nd, Tuxford, 281 ~; 3rd, Kings Cross Loco.) 274!; 4th, Bishopsgate "B," 25M. Sir Ronald Matthew (Chairman of the Company) thanked Dr. Corbet Fletcher for his assistance. lIe admired the doctor's definite rulings and the way in which they were given.

London, Midland & Scottish Railway Competitions. London "C" receiving the womens' championship Lady Stamp ·presenting the men,,' championship Cup from Mr. W . R. Wallace (Chief Civil Shield to Crewe Machine Shop. Engineer). The individual tests and the questions fully taxed the knowledge of the competitors. Mr. G. L. Darbyshire (Chief Officer, Labour and Establishment) presided at the subsequent prize distribution and welcomed Lady Stamp who always took a great interest in the work. Referring to the L.M.S., Mr. Darbyshire stated that over 25,000 employees were trained in first aid; the average nW11ber taking the examination each year being about 10,000. In the competitions this year 489 teams entered; whilst last year L.M.S. teams gained the premier awards in all competitions. The L.M.S. had prepared for emergencies and the magnificent total of 40,000 employees had been trained in A. R. P., many key men being members of the ambulance centre. The result of the competition was announced as follows : 1st, Crew Machine Shop, 36n marks; 2nd, Camden Goods, 36n-; 3rd, Uttoxeter, 361; 4th, Manchester, Mayfield, 355!; 5th, Crewe Copper Shop, 352; 6th, W~rrington, 33n-; 7th, Windsor Bridge, 31Ok; 8th, Blythe Bndge, 308; 9th, Derby C.M.E. "A," 307. Lady Stamp presented the championship awards and individual prizes and congratulated all teams on their splendid work. She wished to give a special token of appreciation to the patient in the team test· this announcement being greeted with applause. ' The judges, in reply to a vote of thanks, paid tribute not only to the competing team on the excellence of their en~e~vours but also to the efficient running of the competItIon, thanks to Mr. Hill, which made their job a pleasure. The four leading teams in the L.M.S. Women's competition preliminary met at Euston OJl Apnl 14th to.c?ntest the home of the championship award. Dr. G. S. ~htl1tps (team) and Dr. C. G. Lewis (individual) were the Judges, Mr. G. S. Hill being the competition secretary. In the team test competitors had to deal with a \,,:oman who, ~fter papering.a room, attempted to hang- a plcture hut hIt her thn111h 1l1stead. This caused her to fa~l off a chai: on :'Jhich she was standing, and feeling fall:t,. drank, 1n mistake for brandy, some iodine. Tn aooltlOn to the poisoning the 'Patient was suffering' fr0111 a Iraclnred fihula" contused wound of thumb, and' shock. Am~ulance

The individual tests, including viva voce, were varied character. Mr. G. L. Darbyshire, Chief Officer, Labour and Establishment, presided at the subsequent presentation of prizes, and gave encouragement to the competitors. The result was announced as follows: 1st, London C, 32n marks; 2nd, Preston No.1, 324; 3rd, Glasgow Loco. Accounts, 312; 4th, Broad Street, 264. This is the second year in succession that a team from. London C have carried off the cham.pionship award. The winning team consisted of the Misses P. Matthews, E. Wright, W. P. Seed, E. Dowsett and 1. H. Saunders. Mr. W. K. Wallace (Chief Engil1eer) presented the trophies and individual prizes, congratulating the compe6tors on their efficiency in first aid. Glasgow Loco. team received the Rose Bowl as the leading team in the preliminary round. Both judges agreed that the work of the teams had been well done. Miss Gatto (Chief Women's Welfare Supervisor) proposed a vote of thanks to Mr. Wallace and Mr. Darbyshire for their presence and their assistance given to firs t aid. Among those who witnessed the tests were Mr. W. E. C. Lazenby, Mr. W. O. Davies (Commercial Asst. D.G.M.), Col. Mackintosh (Chairman, St. Andrew's Ambulance Association), Dr. Archibald, offi'cers of th e Company and class secretaries. 111

london and North Eastern. The Group competition of the L.N.E.R. to decide the two teams to represent the Company in the Inter-Railway and in the England v. Scotland competitions, was held on May 3rd when Dr. N. Corbet Fletcher judged the work of the four Centre teams. Capt. W. Goodley was the competition secretary assisted by Mr. S. Cooper (N.E. Centre Secretary). The team test setting was that of the room in which the competitions actually took place) the injuries being slight concussion) bleeding from palm of hand, fractured right wrist and sp-rained ankle, The injuries in the indi vidual tests included fractured clavicle, patella and leg.

The final of the North Eastern Area competitions was held at York on April 15th) when Capt. A. C. White Knox, M.C., M.B., judged the work of six district teams. The team test setting was that of a Sl1ow-covered slop e down which a number of people had tobogganed. A boy had overturned his toboggan and was found to be suffe ring from a wOlmd on face, fractured right clavicle anel left leg, also shock. The result was: 1st and "Wharton" Shield) Tyne Dock, 30-+ marks; 2nd and "Hornsby JJ Ohallenge Cup, Paragon, Hull) 28H; 3rd, Shildon, 237! ; 4th, Middlesbro ugh, 2'14; 5th, Leeds Passenger, 212~; 6th, York Statio n, 194. Mr. C. M, Jenkin Jones (Divisional General Manager, York) presented the trophies and medals. Mr. S, Cooper (Centre Secretary) was r esponsible for the arrangements which were the final event of a session which has seen 188 classes formed. as compared with 172 last session. The number of successful candidates during the session was 2,261, as compared with 2,225 during the previous year, whilst the number of teams taking part in the district competitions being 50, an increase of 5.

Southern. Once again the (. Southern" will be represented in the Inter-Railway by H orsham No.1 and Waterloo" A " the two teams which have possibly appeared in the final more times than any others. At the final competitions of the Sou thern Railway, held on May 2nd, the judges were Dr. F. C. Cozens and Dr. D. A. Lubbock of Herne Bay (team) and Dr. G. D. Tullis of Hereford (individual). As is usual the team test setting was of the best and rep resented a clock tower, in the entrance to a station, unde r repair with steel scaffolding, etc., in correct proportion and position. Members of the team on their way to take up duty stopped to admire the Memorial Clock Tower. Two workmen) one on the top staging and one on the ground, had a general conversation and at 9 o'clock, the man on the grolilld-level entered the well of clock, sat down and prepared to eat his breakfast. Almost immediately the pendulum of the clock fell and severed the man's right thigh just above the knee. His mate, hearing the cry for help, hurried down a ladder, tripped ov~r a hucket and fell, face dowl1wards) on the centre stagmg. This patient was slightly concussecl and had a simple fracture of the left arm. Actually tW9 men were nsed for the first patientone acting the part on the floor and the other, w~o actually had had his leg amputated above the knee, actmg as the injured person. It was a most realistically staged injury the only faking necessary being the haemorrhage. To test whether the pressure in the groin and also the tour-

AID niquct was being c;orrectly applied a piece ot material was placed along the line of the artery and if the judge was able to pull il away when pressure \\·as applicd then marks ",ere lost for bad application. The individual tests were, as is usual, conducted in priYate. l\1r. Gilbert S. Szlumper (General Manager and President of the Centre) who presided at the subsequent presentation ceremony, supported by many officers of the Company, said how pleased he was to see so many present. Since the Southern Railway Ambulance Centre was formed, in 1925, over -+4,400 first aid awards had been gained; the figures for 1938 being 3,800 of which 807 were first year men, Last year 36,000 cases, unfortunately, received attention, which emphasised the importance of first aid. In competitions 132 teams entered this year and the Chairman hoped that a " Southern" team would again win the Inter-Railway Shield.

Southern Railway. Captain of Horsham No.1 receiving the champion~ ship Shield from Mrs. J. B. Elliott. 11r. Szlumper also referred to the last appearance of 11r. E. A. Richard, in an official capacity, at the competitions. H e could not express in words the appreciation of the continuous hard work Mr. Richards had put in for the furtherance of first aid. Mr. Richards then announced the result \\"hich was: 1st Horsham No.1, 33n; 2nd, Waterloo " A," 324; 3rcl, Ea~t1eigh Rng. Shed No. 1, 296~; 4th, Bricklayers' Arms No.1 , 238; 5th) Ashford Works No. 1, 236~; 6th, Yeovil "B," 234; 7th, Exmouth Junc. No, 1, 229l; 8th, Horsham No.2, 22M; 9th, Havant, 226; 10th, Southampton Docks E, 213!; lIth, Gillingham No, 1, 196~; 12th Victoria No.2, 158. Mrs. J. B. Elliott, wife of A~sistant Ger:eral 1Ianager, graciously presented the trophIes and prlzes,. and was herself the rec ipient of a bouquet whIch l\Ilss. G. W. Aitken, Captain of the Eastleigh women's team \\'~lch won the \Nomen's championship, presented on behalt of the Centre, Dr. Cozens and Dr. Tullis both addressed words of advice and encouragement to the competitors, The proceedings closed with. a vote of thanks to ::VIrs. Elliott and to l\'fr. Szlumper whIch was proposed by Mr. A. Harran.

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The first annual supper of the Nobel Chemical Finishes Division, S.J.A.B., was held on '!\pril 25th. Dr. G. 0 , Wills, works manager and divisional president, presided.

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A.R.P. Topics. Al\1BULANCE SERVICES.

Referring to paragraph 22 of Circular 1764, 10th January, 1939, a further Circular (No. 1794, 2i-d. post free) has now been issued which gives particulars of carrying fitments for small ambulances. The stretcher carrying fitment is of all-metal construction for use in converted small commercial vehicles. It forms a unit designed to carry two stretchers, but if the vehicle converted is large enough, two units side by side would increase the number to four. The fitment is to be screwed into the floor of the vehicle; and it is suggested that vehicles which can accommodate two units are preferable. The weight of two units is about 88 lbs; whilst the minimum internal dimensions of vehicles should be 8 ft. long, 5 ft. wide and 4 ft. 6 ins. high. To the Circular is attached diagrams of the suggested fitment.

avoided; size and capacity of shelters; shelter In existing buildings, and shelter independent o f buildings. It is interesting to note that the area suggested per person in a gas-tight shelter, for 3 hours occupation, is 75 square feet. Particulars are included of thicknesses of material to resist splinters and incendiary bombs and the strengthening of the ceilings of shelters. Further pamphlets on shelters are" Air Rai d Shelters fot Persons Working in Factories an d Commercial Buildings" (6 ~ d. post free), an d " Report of the Lord Privy Seal's Conference o n Air Raid Shelters " (6~ post free). The first deals with the protection of employees, and gives standards of protection required to be provided unde r the Civil Defence Bill. Such protection includes lc:tteral and overhead, debris loading, and space required in shelters. Particulars are given as to how the required shelter may be obtained; an d illustrations are given of many layouts includin g trenches. The second pamphlet deals with the advan tages and disadvantages of shelters in all aspects , and many issues are fully discussed.

INCENDIARY BOMBS AND FIRE PRECAUTIONS.

RECENT PAMPHLETS.

A. R.P. Handbook No.9" Incendiary Bombs and Fire Precautions" (7d. post free) has now been issued Chapter I deals with the light magnesium (electron) bomb: its description, functions, method of attack, incidence of fires, effect on hitting a building; and protection against. Chapter II tells how to deal with the born b and the resultant fires, whilst Chapter III is on "Other Incendiary Bombs." Fire fighting hints are given in Chapter IV, including rescuing persons, fainting, treatment of burns. In the latter it is interesting to note that the baking soda solution, as advocated by the St. John Textbook, is gi\'en should tannic acid jelly not be available. Other chapters are on practice incendiary bombs; emergency fire precautions; penetration trials; appliances; fire parties and drill and, lastly, hazardous trades and occupancies. There are are some 15 ill ustrations, some of which are reproduced from the Home Office Handbook, "Fire Precautions in Schools."

Three further pamphlets referring to f\.R.P . issued are: " Provision of Air Raid Shelter" (No . 91/1939, 2td. post free), which deals with the policy of the Govern ment as to the provision of ai r raid shelters; " Air Raid Precautions in Schools " (2~d. post free), which has been issued by th e Board of Ed ucation ; and the second edition of the "Certification Mark for Filtration Plants Givin g Protection Against Poison Gases Used in \!\Tar " (2!d. post free).

SHELTERS.

A pamphlet on "Shelter from Air Attack" (price 2~d. post free) deals with structural precautions and are based upon answers to enquiries received by the Home Office. The subject will, however, be dealt with comprehensively in Handbook No.5 which is in preparation. The contents include bombs and gas; standards for practical adoption; choice of shelter; ~helt~r in new buildings; structural fixtures to be

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AID

5th I nternational Congress for life Saving and First Aid to the Injured. As previously announced the above Congress wil l be held at Zurich and St. Moritz, Switzerland , from July 23rd to 28th. Circular No. 2 which has just been issued gives particulars of the various corn m ittees; COli rse s of the Congress; demonstrations; inspectors ; visits; also general information regarding badges ; costs; fees, etc. All papers to be read must be sent in noi: later than May 25th, and the following countries have subscribed: Belgium, Bohemia, Denmark, Egypt , Frc:tnce, Germany, Great Britain, Holland, Hungary, Italy, Rumania, Sweden, Switzerland, an d the United States of America. Full information can be obtained from the Secretary of the Congress, Dr. H. Spengler, Schmelzbergstrasse 4, Zurich, Swit7.erland.

Police Ambulance News. CITY OF

LONDON

SPECIAL CONSTABULARY.

The annual spring examinations were held at Headquarters on April 17th to 19th, the examiner being Dr. N. Corbet Fletcher. Although the official notification of the results is not yet to hand, the examiner expressed his opinion of the high standard ot efficiency shown by the members. Owing to increased recruits and also to the number of first aiders wh'" were unable to attend the above examinations owing to duty calls, a further course will commen ce shortly with Capt. F. E. Bendix, Asst. Honorary Medical Officer, as lecturer. METROPOLITAN. The annual" C" Division competition for the" DaltonSagar-Musgrave" trophy was held un April 15th, when tea ms from Vine-street, Great Marlborough-street and the Special Constabulary presented themselves before District Officers T. E. Walsby (team) and E. W. Haines (individual), both officers of the No.1 District, S.].A. B. The competition was witnessed by a number of persons including Chief Constable Dalton and Commandant SagarMusgrave (joint donors of the trophy), Supt. Cole and other divisional officers. The result was: 1st, Vine-street, 199 marks; 2nd, Gt. Marlborough-street, 189 ; 3rd, Special Constabulary, 176. The Chief Constable, after thanking the judges and the various officers for their work in connection with the competi tion, presented the trophy and individual prizes to the first and second teams. Commandant Sagar-Musgrave addressed the gathering and hoped to be present at many more such competitions. Six teams competed in the fifth annual" F" Divisioual Inter-Station competition held at Hammersmith Drill Hall on April 20th. The judges were Dr. Thomas, Div. Surgeon (Police) Chiswick Sub-Division (team) and Me G. E. Claft, of FIRST Am (individual). Those present included Chief InspeLtors Elliott and Pollock, Sub-Inspectors Mortimer, Fraser, Smith and McKechnie, Inspector Shirley and many interested friends. The result was: 1, Hammersmith, 228t marks; 2, Kensington (A), 221 ; 3, Kensington (B) , 216t ; 4, Chiswick, 212; 5, Notting Hill (A), 195t; 6, Notting H~lI (B), 182. Best individual pair: P. S. Murphy and P. C. Smith of Hammersmith. Each Sub-Division has now won the trophy. The' Major Tomm" cup and prizes were presented to the winning team by Chief Inspector Elliott, also prizes to members of the second team. The team test dealt with a man riding a bicycle, who had been knocked down by the team's car, and sustained a wound of left leg and fracture of right tibia and fibula. Th e individual injuries were apoplexy, dislocation of shoulder and hernia. I

METROPOLITAN

SPECIAL

CONSTABULARY.

The annual first aid competitions were held at Peel House on April 16th, when 21 divisional teams took part. Sir Walter Allen, Commandant-in-Chief, and Commandant Ernest Brown, Director of A. R. P. and Ambulance Trainina were present lhroughout the day, whilst Capt. A. C. Whi~~ Knox. Capt. F. E. Bendix, Capt. H. A. Fenton, Capt. R. V. Steele, Dr. W. D. Jenkins and Major E. J. Selby, of the S.J.A. B., were the judges.

AID The results were announced as follows : Senior Competition: 1st, " Gollin" Cup and miniatures, " M Division, 298 marks; 2nd, "St. Clair" Cup and medals, "P ,. Division, 241t; 3rd, "R" Division, 239. Eleven teams competed. Junior Competition: 1st, " Ritchie" Cup and medal s, "X» Division, L34 marks; 2nd, medals, Y" Division, 223t; 3rd, "A" Division, 222i. Ten teams co mpeted. The Efficiency" Cup, presel1led by the Director for the Division with the highest percentage 01 first aid qualifications, was won by " T " Division. Addressing the competitors, Capt. White Knox said the standard was so much higher than it was before that there was hardly a ny comparison, and from a competition point of view the work had advanced out of all knowledge. l\h!jor Selby stated that he had been impressed by the keenness of the teams as well as by t he work. The trophies and a\,ya rds were presented by Col. the Hon. Maurice Drummond, Deputy Commissioner, Metropolitan Police, on April 23rd, at a parade of representa tives of all divisions. First aid work in this Force is receiving splendid su~port from tl1P members. Approximately 4,000 members hold the St. John qualification and 4,600 have the Commandant-inChief's A. R. P. certificate. Nearly 2,000 passed their first aid examination during the year ended March 31st, 1939, and of this num ber 1, 616 were for the certificate, \,"hich is a very healthy s ign of activity. I)

WEST

SUSSEX.

On i\lav 4th Supt. B. C. Gee, of the Arundel Police Division, retired after 27 years in the Force. Supt. Gee was well-known to first aiders and as the leader of the West Sussex team which "yon the" Pim " Police N alional Trophy on two occasions and gained tIle runners-up position three times. He was also interested in the S1. John Ambulance Briaadf' and, with Mr. David Bryce (now Asst. Commissioner h No. 8 District) formed a di vision in Horsham which is now well-famed for its competi tion successes. We hope Supt. Gee will long be spared to enjoy his retirement.

Home Service Ambulance COlllnlittee. At a meeting held on April 17th the Committee accepted, with deep regret, the resignation of its Director and .Secretary, l\lajor E. W. Paget, C. B.E., after ~O years' ~ervlce . . The Committee have decided to abolIsh the DirectorshIp of the Department and to appoint i\liss Hilda Attenbro\\: and i\lr. Henry T. Ferrier as ] oint Secretaries to the Committee. This appointment commenced on May 1 st. Accordin(T to the annual report for the year ended December 31~t, 1938, there were 132 stations equippe? by the Committee with, in addition, 275 alllbulanc:s affilIated to the Service. During the year 170,878 patIents. were carried (44,837 during the Decembe~ quarter) makll1g a grand total of 2,056,797 since the ServIce was set up. The annual report also gives a short history o~ ~he Service and it is interestin a to note that the first half-mdlton cases carried by the Sef\'i~c was recorded in March, 1927, with a year average of 240 cases per ambulance, and the first million in June, 1931. The yearly average per ambulance had by that time risen to 391 cases. In September, 1938, when the two million mark was reached, the average per ambulance had mounted to 420 cases.

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The vehicle we inspected was an excellentlyfinished job, very suitable for the first aid unit with little money to spend but which wants a reliable, smart and durable ambulance.

" Invicta" Ambulance. A FEW days ago we were taken for a ride. No! not in the gangster sense, but in a new" Invicta " ambulance. We were able to note for ourselves the smooth running, quick acceleration, and aood braking; also the comfort whilst travelling at high speed. . Th~ chassis is a Ford V.8., whilst the long, Impressive, welded all-steel body attracted immediate attention. Wide doors, low running boards and unobstructed floor for ease of entry and exit were points noted, also the low loading gear whereby the patient is kept horizontal. This loading and unloading gear, whilst it is simplicity itself, enables the loading and unloading of a patient without the bearers having to enter the ambulance itse.lf. Briefly, the gear is an all-metal tray, eastly pulled out, on which the stretcher rests. When the tray is extended the stretcher is lifted out with great ease.

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AID

;gnuieta /

The low loading gear of an "Tnvicta" ambulance in operation.

. The "I.nvict~" ambulance, completely equipped, painted In any colour, is priced at £375, and we can recommend it for emergency am bulance work and private patient conveyance. Full particulars are obtainable only from the Invicta Motor Ambulance Engineerin-g Works Ltd., of Canterbury and Margate, who will be pleased to forward a brochure on application.

Hospitaller~'

Club.

. One organisation, having used this gear, has WrItten to the manufacturers as follows : "The stretcher loading gear is a great improvement on the old style and the ease with which the patient is loaded is a big asset to our work . • . with only a nurse and driver in attendance. " . The in.terior was of mahogany, French polIshed, with two lockers -fitted behind the driving partition. Four windows, with winders, room for second stretcher, tip-up seat for attendant and first ~id kit were among the things we noticed: One special feature was a rear flood light. Should the attendan.t forget to switch off the light this was automatically done by the closing of the rear doors. ~rhe three main objects of the manufacturers are: .Comfort of patient; Comfort of driver and attendent; Value for money.

293

Am6111anee

The

Interior of an "Invicta" Ambulance.

AID

THE last meeting of the session was held on April 21st when the President (Mr. G. C. Green) introduced Brigadier W. B. O. Barne, C.B.E., D.S.O. (Secretary of the Order of St. John), who gave an interesting talk, illustrated by lantern slides, on the Russian Revolutien. He took his listeners through the conditions which prevailed in Russia how the army rebelled against its officers how 4 000 officer~ of the White Army fought against 150,000 me~ of the Red Army, and how the map of Europe changed. Brigadier Ba:~e told of servic.e he saw, as a representative of the BntIsh Government, m the Russian Army, on the actions of the. people, how discipline and cohesion were conspicuous by theIr absence. As the people became demoralised so the P?sition ?ecame. worse and worse. The speaker referred to hiS meetmgs with the officers of the White Army and the admiration he had for at least one of them. . More coul.d be told on this interesting subject but space w1ll not permit; but so interested were the members that Brigadier Barne was asked to give another talk later in the year. A ?~arty vote of thanks was given to the speaker on the propos1tIon of Mr. Standingford, seconded by Mr. Liddell. Mr. Green wished all members a pleasant and enjoyable summer.

Lymington Nursing Division (Hants 70 V.A. D.) was

tnspecte~ recently by Major W. D. Newland (Netley Hospital)

and Major A. Tennyson Smith (Hampshire County Commissioner, S.J.A.B.).

AMBULANCE OFFIOERS You've asked for it! Here it is. A fully equipped up-to-date Ambulance at a low cost.

The following features are included.Comfortable and silent body with smart appearance. Easy loading and unloading from outside vehicle. Room for second stretcher in en1ergency. Constant flow of fresh air through body. COlnfortable springing and silent engine. Complete equipment including Bell, Fog and pass lamp. Two Mirrors, Trafficators, Ambulance Sign, First Aid Kit, Fire Extinguisher, Rear Flood Light, Special Stretcher Gear, etc.

The' INVICTA' Ambulance has all these for the inclusive

NETT PRICE OF

£375

(ex Canterbury)

Painting (choice of colour) with badges and lettering included.

Extra Stretcher Gear and Stretcher £ I 5.

Obtainable only from

THE INVICTA ,MOTOR ENGINEERING WORKS, Ltd., Canterbury & Margate Send for Brochure to-day.

FIRST

294

FIRST

AID

Our Nurses' Pages. :3

COMPILED

No. 1 DISTRICT, S.].A. B. District Final Competitions were held on Saturday, April 22nd. In the events open to women members the results Kere as follows : "Macfadden ,. Challenge Cup (for teams).-1, Civil Service, 286{1; 2, Ealing, 264t; 3, Lewisham, 2551; f, Barking, 231! ; 5, Tudor, Enfield, 221t. "Mountgarret" Challenge Cup (for bedmaking). - 1, Wimbledon and Merton, 57!; 2, East Ham, 49! ; 3, Lewisham and Gopsall St. (tie), 48t; 5, Hampstead, 42. "Brooks" Efficiency Cup.-1, Ealing-. Nursing Bowl.-A/S J. F. Woolford. The trophies and prizes were presented by Lady Duncan.

Following Mother's Footsteps.

A/S J. F. Woolford, winner of the No.1 District Nursing Bowl. Her mother, Lady Ambulance Officer)\1rs. Woolford, won the Bowl in 1932.

A/S J. F. Woolford is possibly the youngest member ever to have won the Nursing Bowl. She is 19 years of age,

•

AMBULANCE

SISTER.

an d has only been in the senior Division one year. She is also holder of the ., Pap worth " Cup, which is competed for hy members of the East Ham ~ursin g Division in first aid. It is interesting to note that her mother, Lady Ambulance Officer Mrs. Woolford, won the Nursing Bowl in 1932. No. 2 DISTRICT, S.J. A. B. BOURNEMOUTIJ.- Major A. Tennyson Smith, C.M., M. D., County Commissioner for Hampshire, in spected the Corps at the Town Hall on April 19th. He was assisted by Lady County Supt. Mrs. Hayes. There were 215 nurses and 62 cadets on parade rerresenting Bournemouth, Southbourne, Meyrick, West bourne, North Bournemouth, Talbot, Alexandra and Highcliffe Nursing Divisions. After the inspection the cadets were the casualties for a demonstration of flrst aid and nursing. In the lounge an A. R. P. cleansing- and first aid station had been planned. Some~ of those taking part wore Service respirators and heavy anti-gas clothing. The Mayoress. Miss M. Dickinson, presented the " Filleul" Cup, awarded for efficiency, to Mcyrick NursingDivision. ~ The l\Jayor, who had taken the salute at the march past, confessed that he did not have a full appreciation of what the Nuring Divisions were doing until that night. For 28 years, he learned, they had been doing a national !>ervice. He congratu lated them most sincerely. They must look to the future and always be prepared to be of service in case of emergency. It was a very great source of satisfaction that there were organisations like the Nursing Divisions prepared and making themselves more efficient. Major Tennyson Smith thanked the Mayor for his presence. and said that his report to the Chief Commissioner would be as it wa:; last year-" All is well with the Nursin<Y Divisions of the Bournemouth Corps. They are maintai; ing, and 1lI0re than maintaining, that high level of excellence that has always been expected of them." The County Commissioner congratulated the Divisions on the hard work that had been done since his last inspection. He spoke of their duties on the beach during the summer, when some 3,500 cases were treated. He mentioned their work as A. R. P. instructors, and of their efforts during the crisis of last Se~tember, when they arranged for and were ready to equip ten dressing stations in different parts of Bournemouth. Those present at the inspection included Asst. County Commissioner C. L. Dunn, Lady County Officer Miss Hayes, County Officer Commander P. Filleul, County Surgeon F. Bottomley, and County Officer Capt. ). A. Coghlan. No.3 DISTRICT (EASTERN), S.].A.B. WELLINGBOROUGI'I CORPS. - Three Wellingborough ladies have been honoured by the Order of St. John for their services in the St. John Ambulance Brigade. H. M. the King has graciously sanctioned admittance to the Order of St. John as Serving Sisters Mrs. M. Campbell, Miss I. P. Page and Miss A. M. Rowlatt.

"FIRST AID"

WALL

AID

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(Size 2 ft. 2 ins. by 3 ft." ins.) Complete Set of 19 sheets on tough cartridge paper, with Roller. 42/- net. Post 9d. ; or mounted on Linen, 70/- net. Post 1/-. Adopted by the War Office, the Admiralty and the British Red Cross SocietY,etc.

.(;.P.

Special Set of 6 Sheets for the use of

Re1 d

LECTURERS & A. R. P. CLASSES

as their First Aid Antiseptic.

comprising Anatomy, Physiology, Haemorrhage, Dislocations and Fractu res. Mounted on linen with roller, 21/6 net; postage 6d.

16th Edition. 187thThous. Fully revised and enlarged. WIth 311 illustrations Some coloured.

WARWICK

TUNSTALL'S

328 pages.

"FIRST AID" ;'/6

0 ::::

TO THE INJURED & SICK.

Postage 3d. An Advanced Ambulance Handbook. Edited by F. C. NICHOLS, M.C., M.B., Ch.B., late Capt. R.A. M.C.(T.) The chief feature of this edition is the much fuller account given of Gas Poisoning in Warfare. FIRST AID jOUR.-" One of the most concise works on the subject published at a popular price."

JOHN

WRIGHT & SONS BRISTOL I.

LTD.

Dressings of any length can be eut in an instant from the 'Elastoplast' Dressing StTip,

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The 'Elastoplast ' Surgery Case contains one each of the thTee widths; price 5/3d complete.

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HETHER they make aircraft or motor-cars, safety glass or window frames, steamships or razor blades, you will now find T.C.P.-the really SAFE Antiseptic - being used in the First Aid Departments of many of the biggest Works in the country. Why? Simply because, in actual First Aid practice, T.C.P. has been proved to give-better protection against sepsis. -quicker and cleaner healing of all injuries. Just glance through this list of a few of the hundreds of famous firms who are users of T. C. p. : Baldwins Ltd., Belliss & Morcom Ltd., Calico Printers Association Ltd., Crittall Manufacturing Co. Ltd., Gillette Industries Ltd., Handley Page Ltd., Humber Ltd., Imperial Airways Ltd., Lancashire Dynamo & Crypto Ltd., Joseph Rank Ltd., Rolls Royce Ltd., Triplex Safety Glass Co. Ltd., United Steel Co. Ltd. Remember that T.C. P. exactly fulfils the requirements for a First Aid Antiseptic laid down in the new S.}. A. A. Text Book. It is absolutely SAFE, non-irritatinO' non-staining, non-inAammable-so s'lfe in fact:that it can b~ given internally. Yet it is' an eff~ctive and deeply penetrating antiseptic, which rapidly sterilises both the wound itself and the underlying tissues. In addition, T.C.P. has a marked power of relieving pain and stimulating healing. So if you are qualified in First Aid and ha\'C not yet tried T. C. P., send to-day for .a tr.ial bottle and a First Aid Book. F RE E on applIcatIOn to :-

BRITISH

ALKALOIDS

LTD.

69, Old Broad Street, London, E.C.2.

FIRST Mrs. Campbell is Lady Corps Superintendent, a position to which she was appointed at the beginning of the year following the retirement of Lady Corps Supt. Miss A. Smith. Previous to that she was Lady Div. Supt. of Victoria Nursing Division, a position now occupied by Miss Rowlatt. Both ladies have been members of the Brigade for over 20 years. Until her transfer to Brigade Reserve at the end of last year, Miss Page was Lady Div. Superintendent of Headquarters Nursing Division. LUTON AND DUNSTABL8 NURSING DI\·ISION.-Eleven members of this Division competed on April 24th for the Florence" Cu p, a warded for first aid. The test was held at Brigade Headquarters and was judged by Div. Surgeon Rosamond Bischoff. The visitors included the Mayoress of Luton, Mrs. J. Burgoyne, Lady President of the Division, and Mrs. C. C. DillinElham, the Deputy Mayoress, who has al ways been interested in the work of the Brigade. The winner was A/ s. vVaddington, who C::l.me to Luton a year ago from Burnley, where she had been a member of the local Nursing Division for the previous two years. She gained 29 marks out of a possible 39. The runners-up, A/ S. Robinson and A/ S. Horton, received 27 marks each. The standard reached by all com petitors was good, everyone passing the 50 per cent. mark. I I

No. 4 DISTRICT, S.J.A. B. The Sladen competition, open to teams in the \Vestmorland and Cumberland District, was held at Ambleside on Saturday, April 1st. Six teams entered for the Shield, one each from Kendal and Ambleside (S.].A. B.), Teba)' L.M.S . Station, Kendal Nursing Division, and Orton Women and IHorland (B.R.C.S.). County Commissioner Dr. W. B. Cock ill judged the team test, Dr. W. H, Mylechreest the individual practical, and Dr. A. F. Quarm by the oral. Kendal Nursing Division were the winners with 159 !\larks. It is 10 years since they carried off the trophy before. The Banne~ for cadets was awarded to Kendal Nursing Cadets who gamed 90 marks in a competition judged by County Officer J. Wright. Mrs. Garthwaite of Kirkby Lonsdale presented the trophies, and spoke appreciatively of all she had seen. . !he " Collinson" Bowl and the" Cockill " Cup comrE'tltlOns were held at Kendal on Saturday, April 22nd. Six teams entered. County Commissioner Dr. W. B. Cockill announced the results as follows: "Collinson" Bowl--1 Kendall' 2, Carlisle No.1 team. "Cockill" Cup-1 Cariisle No 1 : 2, Windermere. , . , Dr. Cock ill introduced Mrs. Howard Somervell, who rresented the awards and also the certificates for the " Sladen" Shield and the "Sladen" Banner, which had been won by Kendall three weeks before. She congratulated the teams on their work which she had watched with great interest. . The i~dges were Dr. Lamberton, for the team test; D~s. Cocklll and Patterson, individual first aid; and Dr. OlIve Buckley and Matron Brady, home nursing. No.5 DISTRICT, S.J.A.B

~JIEFFIELD NURSING DIVlSION.-The annual general meetmg was held at Headquarters, on April 29th, when, in the absence through illness of Asst. Commissioner H C Else, Lady District Officer Miss G. Ashberry presided.' . The ~eport o~ the year's work was read by Lady Duty Officer MISS D~nlel ; the Div. Secretary, Miss L. Booker who had occupied that position for nine years, having died last January.

FIRST

AID

A.ID

297

It was reported that there were 56 members at the end of 1938, an increase of 5. Awards due to members were: Service Medal for 15 years' efficient service, Mrs. H. Peckett ; Third Service Chevron, for 9 years, Mrs. A. Taylor and Miss B. Taylor; Second Service Chevron, for 6 years, Mrs. M . Lockwood. Eight members qualified for medallions, and 14 for labels and pendants. These were presented by Miss Ashberry. Last July Lady Div. Supt. Mrs. Windle, Lady Duty Officer Miss Daniel, and Lady Ambulance Officer Miss Beaumont were admitted as Serving Sisters of the Order of St. John. The Lady Duty Officer's report showed that 1,964 duties (8,087 bours) had been undertaken, and 1,992 cases treated. A report of the year's activities of the recently formed Sheffield Nursing Cadet Division was read by Nursing Cadet J. Rodgers. A vote of thanks to Miss Ashberry for presiding was proposed by Lady Div. Supt. Mrs. Windle and seconded by Nursing Officer Mrs. M. Bayley. 1\1rs. \Nindle was congratulated on her recent promotion to the position of Lady Corps Superintendent. No.9 DISTRICT, S.J.A. B. POOLE CORPs.-A new Nursing Division has been formed in the Canford Cliffs area of (he Borough, enrolments being made on Thursday, April 20th. Meetin~s will be held each Tuesday at 2.30 p. m. at The Myrtles," Maxwell-road, Canford Cliff(by the courtesy of Miss Johnston), when lectures will be given by Surgeon Rear-Admiral Thomas. II

YO U,

too, can easily become an expert practitio?er of Swedish Ma.ssage and enjoy the s tatus, remuneration and comforts of the professIOnal worker If you are prepared to study for an hour or so each day.

Your knowledge of First Aid will be considerably enhanced if you wear the badge of the S i\lA E Institute, which is recognised as an emblem of sound and efficient training in scientific subjects. The holder is thereby known to have satisfied a Board of Examiners that he or she possesses a most comprthensive knowledge of human anatomy and physiology and can satisfactorily treat all the hundreds of conditions that are amenable to Massage and manipulative Therapy.

V. A. D. INSPECTION AT NEWARK. The Annual War Office Inspection of the Newark detachment of the B. R. C. S. took place on Sunday, April 16th, at the Technical College. The Inspecting Officer was Lt.-Col. J. G. Gill, D.S.O., O.B.E., M.C., Northern Command. He was accompanied by Col. J. Jardine, County Controller, Dr. Blandy, Assistant County Direc~or, and Miss J. Bright, County Secretary. The detachment paraded about forty strong, under the command of Miss Asbury (Commandant). The members were tested in first aid, including the application of a Thomas splint, home nursing, A. R. P. \.\ ith respirator drill. The Inspecting Officer expressed his satisfaction with the work done, and com plimented the members on their general smartness.

Tremendous opportunities lie before you in this uncrowded field which is now open to you without having to leave your present work until you qualify as an expert and can command an expert's pay.

If you are interested in First Aid you will at once 3Hreciate the value of Massage, realising that whilst exercise is the finest me a ns of r~taining

healthy muscles in good tone, that fatigue products in the tissues.

Massage will build up the muscular and nervOUS S)SllmS in t l\ a ctl) the same way as exercise; but does not incur any waste rrodu cts and even removes them when they are present. It is then -the most valuable asset and a wonderful treatment for injured and sick. FILL IN AND POST THIS COUPON

~~- ---------------

SUSSEX 172 (ROTTlNGDEAN) DETACHMENT, B. R.C.S. This detachment was inspected by Col. H. E. Weekes, O. B. E., County Director, on Friday, April 21st, at the White Horse Hotel, Roltir,gdean. The occasion was the presentation of chemical warfare and first aid certificates to successful candidates by Miss Gore-Browne, O. B. E., Deputy President. of the Bright.on and Have Division. Miss]. C. Strafford, Commandant of Sussex 172, presided, supported by Major F. Eastwood, T. D., Assistant County Director, Me B. L. Earle, Assistant Anti-Gas Officer, Mr. F. C. Pond, H. T. D., and Mrs. Becheno, Vice-President. Mrs. Gore-Browne stated that they were now to be part of the Royal Auxiliary Nursing Service. Members were required t? ~old first aid and home nursing certificates, and to do a minimum of 50 hours in a hospital. She considered that these few hours spent in hospital were worth more than many lectures. In the county 2,000 auxiliary nurses were wanted t.o h~lp civilian hospitals, auxiliary hospitals, first aid posts, dlstnct nurses, minor ailment clinics and first aid points for villages.

it does produce ( Ombu 5tlon and

COUPON To The Secretary, The SMAE Institute. Leatherhead, Surrey . Please send me without obligation, a copy of your free Booklet .. Manipulative Therapy as a Profession."

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The proper study of mankind is man. Study the most absorbing subject in the world in good company under the guidance of the S.M.A.E. Turn your interest in First Aid work and your hobby into channels that mean money for you-health for othe~s. ~et this Free Book" ManIpulatlve Fill in Therapy as a Profession" and the Coupon learn how you can en ter the (or this profession with a future. Fill Free in the Coupon and post withBook out delay.

FIRST V.A.D. INSPECTION OF HANTS 90, B. R.C.S. Avenue Hall, Southampton, was converted into a temporary hospital on April 25th, for the War Office Inspection. The Inspecting Offlcer was Major H. C. Godding, M.C., R.A.M.C., Royal Victoria Hospital, Netley. He was accompanied by Surgeon Rear-Admiral W. W. Keir, R. N. (rtd.), County Controller, and Mr. A. Moray Williams, O.B.E., Asst. County Controller. After inspecting the detachment on parade, Maior Godding walked round the improvised hospital ward and casualty department, and saw the practical side of the work. He then inspected those members who had been trained in anti-gas measures. The Inspecting Officer congratulated the detachmt'nt on its work, and expressed his pleasure that eleven of them had undertaken the mobile obligatioll. The County Controller added his congratulations. Mr. Moray Williams said that the changes contemplated by the War Office were not so drastic as might be imagined. Units were now being organised on a wider basis to include a civil as well as a military side. The former was every bit as important as the latter. Awards gained by the mem bers were then presented by the County Controller. On behalf of the detachment, he also handed to Miss Miller a purse and an album containing the names of the subscribtrs in recoKnition of her services to the British Red Cross Society for upwards of 22 years, and for many years as Quartermaster of Hants 90 from which office she recenlly resigned. Miss Miller suitably returned thanks, and said she regretted she had had to give up the work. Her advice to her old colleagues of the detachment was" Carryon."

National Roall Passenger Transport Ambulance Association. Midland Area eliminating contest was held on May 7th, at Derby, the Tren t Motor Traction Co. Ltd., organising the event. Five teams competed, the placings being: 1 st, Walsall Corporation Transport Dept., 351 marks; 2nd, Trent Motor Traction Co. Ltd., 338~ ; 3rd, Nottingham City Transj:ort Dept., 315t ; 4th, Barton Transport Ltd., 29q ; 5th, \"l est Bridgford Passenger Transport Dept., 288~. The first and second teams will compete in the final of the "Stirk It Trophy competition to be held at \i\TalsaII on July 2nd. THE

The Hull Docks Division, S.l .A. B., have carried off the " Robert Anderson" Cup, the" Gibbon" Bowl, the Yorkshire Bronze Shield, were placed second for the Silver Challenge Shield, whilst Mr. W. Charlton, a member of tbe division, was successful in the Silver Cup competition for the highest individual marks in the District competiLions. Wath Main, winners of the "Wood" Shield in 1937, recaptured the trophy from the holders (Pontefract) in the final of this year's competition held on May 6th. A. Stott of Hickleton gained first place in the" Osbert Peake" Cup after a tie with R. Cunningham of Pontefract. Both competitions arc organised by the Yorkshire Collieries Ambulance League.

AID

FIRST

Readers' Opinions. We have received many letters from readers regarding editorials in the March and April issues and the following are extracts from some of them. Miss B. M. Hossack (C.A.G.S.) of Ips~'ich. " May 1 say '10W wE::lcome your March editorial was. am sure it expresses the feelings of many of us. We are to deal with yet more filling- in of forms. These are becoming a real burden, what with Brigade montbly returns, annual returns (and in certain cases, V. A. D. returns), continual statistics for the local M.O.H., National Service, etc. All require returns' at once'- all require different particulars and no one seems to realise we have no staff of clerks, but that these things are dClI1e by hand, voluntary and in our , spare' time . . . and always at our own expense. "Then comes the question of the short course. The Home OJJice Circular 16/ 1939 states any person may give these lectures. Surely a happy medium between the doctor and any person would be a qualified lay lecturer? .Isn't it time the Brigade established a system of biennial examinations as lay lecturers in first aid and home nursing? This subject has been ventilated by me before and probably will again. I feel that the present circumstances strengthen my claim Lhat thi:, is a pract'ical and useful suggestion. We have in our ranks many capable of taking both full and short courses, but public authorities and the general public would have more confidence in the lecturer if they knew he or she had a definite teaching qualification. " One begins to wonder if the Brigade, as we know it, is going to cease to exist! II Mr. J. Read, London. " How can people become fully trained in a few hours when we St. John men and women have to take an examination annually al'ld practice every week. I understand that St. John fY!en are the parent body and these elementary fJrst aiders are to be placed under us . . . we are in for a good time! Would the certificate given these people allow them to join the Brigade? Cut out this half-way line." (Persons taking the short course do not sit for an examination at the end of the course.-EDITOR.)

AID

299

VAUXHALL PRODUCTS

fo r all-round Suitability and

J'vlr. H. Harrison, A.R.P. StaffOfficerS.W. Area, W.R. Yorks., S.J.A.B. " I disagrec 'vvith your cditorial and with Corps Supt. Amery. I put it to you: '\Vhat about no knowledge at all?' Is not that v.'"orse still? I maintain, Mr. Editor, that even a little knowledge of the pressure points is going to help to save more lives on the roads . . . The people who die as the result of accidents do not pass out straight away, but in a great number of cases bleed to death, simply because well-meaning but totally untrained people will dash about doing all sorts of unnecessary things instead of controlling the bleeding- first. The little Blackbook lays it down clearly , Bleeding,' . Shock,' , Sepsis,' and if the lecturer emphasises these points even the four hours' tuition (and they get more) will be better than none at all. There is always ano.t ller point of view-and I 3m sure you would not want us all to be ' yes' men.)! (We welcome Mr. Harrison's letter and whilst we aKrce that a little knowledge may be put to use should an emergency arise, it must be borne in mind that A. R. P. wardens are" key II men in local authorities' schemes, and therefore should be fully qualified. If longer time than four hours is taken to instruct a short course then it does not comply with the regulations; and we still contend that in four hours' instruction it is not possible to impart enough knowledge for emergency first aid. -EDITOR.)

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BEDFORD

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Bedford Ambulance Chassis - - £ 198 Bedford Service Ambulance - - - £309 Bedford Standard Ambulance - - £406 Bedford De Luxe Ambulance - - £478 *Bedford " F" Type Ambulance - - £493 Bedford De Luxe Fever Ambulance £496

Other Vauxhall Products specially designed for municipal purposes include Refuse Wagons and Gulley and Cesspit Emptiers. Vauxhall Motors ~td., Luton, will be pleased to supply full details or to arrange demonstrations.

300 .

FIRST

Queries and Ansvvers to Correspondents. Queries will be dealt with under the following rules ; i.-Letters containing Queries must be marked on the top left-hand corner of the envelope II Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C.4. 2.-All Queries must be writte n 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 39th (1937) Edition of the S.J.A.A. Manual of First Aid to the Injured. TREATMENT OF D ISLOCATED SHOULDER. C.S. (Stratford-on-Avon).-At a recent Brigade Com petitio n 1 was asked to treat a patient for a dislocated shoulder out-of-doors. NaturaIIy, I made no a ttempt to reduce it, but having secured the upper limb to the body by a broad bandage to lessen effects of jolting during transport, I supported it in a s mall arm sling and removed him to shelter. After seeing the markin g sheet, I was very much surprised to find that I had lost 5 marks for not using a St. John sling. According to the Textbook, there are only 3 cases in which a St. J ohn sling is used, viz., fractured clavicle, fractured scapula, and bleeding from palmar arches. Was this an error in the marking sheet or otherwise ? I should very mu ch aprreciate your ruling on this matter. As the Textbook limits the use of the small arm-sling to fractures of the humerus, it foIIows that both the marking sheet and you failed to treat your patient as required by the Textbook. In other words, you should support the upper limb of a patient suffering from a dislocated shoulder in a large arm-sling.-N. CORBET FLETCHER. EXAMINATION HOWLER. G. C. (Surbiton). - In a re cent examination, the doctor asked a candidate how she would treat a case of irritant poisonin g . She replied that she would at once administer an emetic. The doctor then asked what emetic she would g ive, and he almost collapsed when she said- " T w o teaspoonsful oj lysol z"n half a tumbler oj w ate?' /" Good! Next, please! !-N.C.F. TREATMENT OF COMPOUND FRACTURE. N. K. (Brisbane, Australia). - After an absence of some years I am again a subscriber of your little Journal. I am keenly interested, as always, in YOLlr Queries and Answers columns; and I ask your kind ruling on the following point. In General Rules for Treatment of Fracture on p. 66 of the Textbook, Rule 4 prescribes ; II With great care, etc., etc .. " and concludes with; "Do not attempt extensz"on in the case oj" a compound jracture, when the bone protrudes. " Kindlyadvise if extension should be undertaken with a compound fracture when the bone does not protrude,

AID and if it is ever permissible to apply extension in the case of a compound fracture." The application of extension to any fracture is not th e simple operation which many believe after reading th e Textbook. Personally, I am firmly of the opinion that fir st aiders should not attempt to apply extension in actual circum stances, though I realise that the Textbook allows them so to do-(1) with great care; (2) without using force and (3) without letting go till the limb is splinted-except when th e fracture is compound and the bone protrudes.-N.C.F. GSE OF A TRIANGULAR BANDAGE. B. P. (Slough).-The No. 1 Test given at the Police Final states that a triangular bandage can be used, among other things, as a means of lifting a patient with fra ctured spine and as a pad in axilla in fractured clavicle. In my humble opinion this test is wrong because for a fra ctured spine five bandages must be used and for th e clavicle pad two bandages make the correct size. Th e question should have been put in the plural and not singular. Do you agree? Yes.-N.e.F.

- - - -- - - - - - - -

FIRST

Confidence in An tisepsis

Your difficulty is not appreciated. To me the instructions of the Nursing T extbook on this point are perfectly clear, and you do not tell me in what way C I doctors and nurses differ in their opinions."-N.C.F. TREATMENT OF COMPLICATED FRACTURE. N.K. (Brisbane, Australia).-In the treatment of a com pound fracture, when no mention is made of arterial ha:: morrhage, is it necessary to place a tourniquet (untightened) in position on the pressure point concerned as a precautionary measure? Should a team which did this secure an advantage oVer one which omitted to do so ? Should a tourniquet be used (tightened or not, as circumstances demanded) at all t£mes in the case of a compound fracture? Your kind decision will be welcomed. Tut! Tut!! Can it be that you are querying the treatment of a compound and /or complicated fracture? Be that as it may, if in competition there is "no mention made about arterial ha::morrhage," and if no hint of such complication is given to the competitors, then the application of tourniquet is definitely not indicated, and no advantage should accrue to the team which placed a tourniquet in position.-N.C.F. VAGARIES OF A SURGEON-LECTURER. G. D. (Hoddesdon).-In a recent lecture on first aid one of the members asked the Doctor a question with reference to the treatment of a patient for a fracture of the spine

301

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TREATMENT OF FRACTURED WRIST. M. e. (Kentish Town). -Could you please settle this argu ment. Do we do up a fractured wrist as a fractured forearm or as a crushed hand? Also, if we only use one splint do we cover the thumb as for a crushed hand or treat as for fractured forearm with one splint? The wrist being the "heel of the hand, 'J I would treat as for crushed hand (Textbook p. 86). - N.C.F. BED FOR ACUTE RHEUMATISM. e.e. (Barnstaple).-Please describe the detailed method of making a bed for a s ute rheumatism (Nursing Textbook p. 67), as doctors and n IJrses vary in their opinions on this matter and we are rather at sea.

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302

FIRST

face upwards. The Doctor said that he did not agree with the treatment laid down in the Textbook and that he would fail anyone treating a patient in that way if h~ was examining the class. He also said that some of th~ fractures described in the Textbook should not b~ treated by first aiders, who should merely secure t~e patient's feet and wait for the arrival of the Doctor. Being a first aider myself who has done 7 years' service and as one of those helping to instruct this class, I think that the Dor-tor was in the wrong in saying this because the members keep reminding us about it. I think that they should do as the Textbook says and that then we shall not go wrong. Will you please give us a ruling on this? On your statement of facts I agree with you and refrain from further comment !-N.C.F. EpSOM SALTS IN PHOSPHORUS POISONING. C.Q. (Earlsfield).-Please tell me why in phosphorus poisoning Epsom or Glauber Salts is to be given, when phosphorus itself is obtained from Calcium Phosphate which is an alkali. The Salts are given for their purgative effects, for which reason a full dose is specified in the Textbook, p. 174.N.C.F. PREPARATION OF STRETCHER FOR SPINAL INJURY. G.G. (Fetcham).-The Textbook in Rule 1 on p. 76 under Transport of Spinal Injury in face downwards position states :- " Arrange blankets as on p. 208 (Figs. 91 and 92)," namely the usual method. Then in Rule 2 on p. 74, under Transport of Spinal Injury in face upwards position, it states :-" Lay blanket or rug folded smoothly on a shutter, &c." Are we to understand that the latter instruction indicates some different method of blanketting an improvised stretcher or that it refers to the orthodox one which is now usually adopted? Your kind ruling will be appreciated. The Textbook being now insistent on the need to "wrap patient in blanket II and not merely to cover him, I take it that the orthodox method is to be adopted whenever possible but that if this is impossible the blanket or rug must at all costs be "folded smoothly." - N. C. F. ApPLICATION OF ST. JOHN TOURNIQUET. J. T. (Huddersfield).-On p. 112 of the Textbook we have directions for the application of the St. John tourniquet. Why have the Revision Committee given us two different descriptions? For, if you consult the first impression of 100,000 copies of the Revised Textbook you will find that the description is the same as that which appeared in the 38th Edition, whereas the third impression of 100,000 gives a widely different description. .From a competition standpoint this is very misleadlOg ; and I welcome your views on the matter. Upon enquiry I find that the change in the text in the ~hird impressi~n of the Textbook is c~nsequent on recent Improvements tn the St. John tourniquet which now has a serrated edge in place of teeth. In these circumstances I cannot agree t.hat the Te~tbook should be kept out of date by reaso.n of pOSSIble complatnts from competitors, especially as the difficulty can be met by having both the old and the new tourniquet available for use in competition.-N.C.F. LOADING STRETCHER PATIENT FACE-DOWNWARDS. J.T. (Hu~dersfield).-When we have to place a patient suffenng from fracture of spine in face-downward

FIBST

AID position, the turning of the patieut on to his face may be assisted by the bearers pulling on the edge of the blanket under him. Does this mean that a blanket should be placed under the patient before treatment commences? If so , do you not think that this might aggravate the spinal injury? Your opinion will be welcomed by us. It is not necessary to place the patient on a blanket before commencing treatment; and, as you rightly suggest , it is far too risky to pull on the blanket for the purpose of loading the patient on stretcher in face-downwards position . Indeed, I think that it is much to be regretted that Fig. 88 was photog-raphed with the patient lying on a blanket. In an article published in the April issue of FIR ST AID you will find a useful set of rules which were suggested by Dr. White Knox for the loading of a stretcher with a patient in face-downward position. - N.C.F. TREATMENT OF PHOSPHORUS POISONING. J.T. (Fetcham).-Under the Treatment of Phosphorus Poisoning the Textbuok in Rule 1 on p. 174 srates"Adopt the general rules which apply." Turning to p. 172 I find that Rule 5 states-" In all cases give milk, raw eggs beaten up cold milk " Then as a footnote to the Treatment of Phosphorus Poisonin g the Textbook (p. 174) gives a special warning against giving oil or fat in any form. Surely this is very contradictory! Certainly not! The Textbook gives you certain General Rules for all cases of poisoning; and then under the treatment of Phosphorus Poisoning it tells you that you should apply those General Rules" which apply." With the latter it adds a specific warning against the administra tion of " oil or fat in any form." So what more could you wish? Alas! You have forgotten the scheme of the Textbook , which is that first aiders must apply the General Rules in accordance with certain Principles by the exercise of the ir Qualifications !-N.C. F. BUCKLE END OF SUNG. H. P. (Wigston}.-I have read through the Stretcher Exercises, and can find no definite information as to which is the buckle end of the sling. Am I right in saying that the buckle end is the large loop end of the sling , and that the transverse strap is attached to the opposite end of the sling? This is probably but a minor detail, but I hope that you can find a space to answer it, and set my mind at rest. The buckle end of the sling is the end through which the sling can be lengthened or shortened to suit the heigh t of the bearer. It has no reference to the transverse strap which is used to fasten the sling on the closed stretcher (Textbook, last par., p. 204).-N.C.F . TREATMENT OF FR ~CTURED FEMUR AND LEG. B.T. (Measham).-Please tell us what treatment you advise for a patient who is suffering from a fractured left leg and also a fractured right femur, both being simpl e tractures. Some instructors recommend two long- thigh splints, one on each side, but our instructor tells us to treat the fractures separately, using two splints for the fractured leg and one splint for the fractured femur. In these circumstances we ask your kind help. I agree with your instructor. Further, by treating the fractures separately you will facilitate the work of the doctor who subsequently takes charge of the patient-a most commendable object I-N. C. F.

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OF THIS

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EDITORIAL ; -

Annual Report of the S. J. A. B. St. J ohr Ambulance Brigade Final Competitions S.J.A. B. Overseas The Eight-Pointed Cross S.J.A. B. Headquarters and District Reports Coming Events Railway Ambulance News Emergency First Aid Instruction Christmas Cards Police Ambulance News Our Nurses' Pages Voluntary Aid Detachments ... ... Amb ulance News Cuttings from the Press A. R. P. Topics Collapse on Hot Days Sewer Gas Poisoning Natio nal Road Passenger Transport Ambulance Association Practical Points

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GEORGE

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THE an n ual report of the Chief ANNUAL REPORT Commissioner, Sir John Duncan, OF THE S.J. A. B. for the year 1938, contains many points of interest, the first and foremost being that for over 50 years the Brigade has been an example of National Service. To the general public National Service stands for something new; something instituted but a few months, and they overlook the fact that such a service has been carried out continuously by members of the Brigade since 1887. Over 2,000 reported cases per day received attention, the exact figure being 752,748. Over three-quarters of a million cases voluntary treated! Surely no finer service exists. Motor ambulances too were busier than ever. Nearly 150,000 cases were carried and for each case the average mileag~ was over 9 miles1,414,000 being actually covered. Roadside huts were more numerous. Some 358 new posts were established, the cases dealt with being nearly 25,000. During the September CflSIS 96 per cent. of the R. N. Auxiliary Sick Berth Reservists arrived at their destination and the Home Secretary, Sir Samuel Hoare, thanked the Brigade for the " reassurance that if the need had arisen, a first aid system would have been brought swiftly into existence. " In A.R.P. the Brigade continued its activities in arranging special Local Anti-Gas Instructors Courses and Grade 1 Instructors classes. Up to the end of 1938 the number of certificates granted was 142 L.A.G. Instructors, 5,122 Grade 1 Instructors, 5,092 Grade 2 Instructors; whilst37,196 Rank and File and 38,520 General Public certificates were issued. These magnificent services could not be carried on without increasing personnel. During

3 06

FIRST

1938 the num ber of units grew rapidly until the total reached 3, 256; the total personnel being 89,745, an increase of 5,326. To all members are due grateful thanks of the general public for their untiring and 'toluntary work.

St. John Ambulance Brigade Final Competitions. THE culminating efforts of the District teams, both men and nurses, were given before a large gathering on June 9th, at the Great Central Ho tel, London. As is usual the set pieces were excellently staged and the actors entered into the spirit of their roles, playing their parts in a realistic manner. The competitions were und er the direction of :'IfajorGeneral Sir John Duncan (Chief Commissioner), assisted by Dr. , . Corbet Fletcher (S urgeon-in-Chief), and Major P. G. Dan'il-Smith (Brigade Secretary), Asst. Brigade Secretary H. A. J . Wriggles\1,'orth being the competition secretary. The judges were : Men.-Team Test, C. RusseJl Corfield, M.D., Corps Surgeon, o. 6 District, and F. W. Hebblethwaite, M. B., Ch. B., Di v. Surgeon, No. 6 Dist rict; Practical Tests with oral questions, Offi cer, E. Fraser Brown, 1. B., 1\1. R. C. S., Corps Surgeon, o. 3 (Western District), and J. Camac, M. B. , Div. Surgeon, No.3 (Eastern Dist rict); Bearers 1 and 3, Major J. Ewing, L.S.A., L.M.S.S.A., Corps Surgeon, No.2 District, and H. S. T aylor Young, F.R.C.S., Di v. Surgeon, No. 2 District; Bearers 2 and 4, L. F. Wilson, M.B., Ch.B., Corps Surgeon, No. G Distri ct, and P. M. Gettleson, M. D. , Di v. Surgeo n, No.5 District; Uniforms, Capt. W. Goodley, O. B. E., 1. c., Commissioner No. 1 (Prince of Wales's) District, and S . J . Warren, Asst. C'lmmissioner, No.1 ( Prince of Wales's) District. Nurses.-Team Test, First Aid, G. S. Phillips. M.D., Corps Surgeon, Priory fCJr Wales, and Marcus Scott, M.R.C.S., M.R.C.P., Div. Surgeon , No.1 (Prince of Wales's) District; ursing, Miss C. E. Walker, Assistant Matron, The London Hospital; Practical Tests, with oral questions, Officer, 1ajor E. J. Selby O. B. E., M.A., M.R.C.S., L.R.C.P., Div. Surgeon, No.1 (Prince of Wales's) District, and H. L. Groom, M.R.C.S., L.R.C.P. , Div. Surgeon, No. 10 District; Sister No.1, Miss M. M. Ingman. Matron, St. Mary's Abbott's Hospital; Sisters 2 and 3, Miss E. M. Elmes, Sister, Middlesex Hospital' Uniforms, Mrs. E. A. Tweedale, C. B. E., A. R. R. c., Lad; District Supt. No. 4 (Lancashire) District, and Mrs. M. Harvey Reeves, A.R.R.C., Lad y District Supt., No.3 (Eastern) District. . The Referees were Capt. A. C. White Knox, M.C., M: B.! Ch. B. Asst. Commissioner, No.1 (Prince of Wales's) Dlstn~t , for the men, and Asst. Surgeon-in-Chief W. C. Bentall, O . B. E., for the nurses. Throughout the day great crowds witnessed the work and on more than one occasion the remark was heard" How well the patients play their part "-especially in the men's team tes~ which appeared to attract most this year. Dunng the afternoon H . R. H. the Princess Alice Counte~s of Athlone, C. B. E., V. A., was welcomed by th~ Sub-Pnor (Earl of Scarbrough), Sir Percival Wilkinson (~ecretary-General), ~rigadier W. B. O. Barne (Secretary), Slr John Duncan (Chlef Commissioner), Col. G. A. Moore ~Asst .. Chief Commissioner}, Dr. N. Corbet Flelcher (SurgeonlO-Chlef), Dr. W. C. Bentall (Asst. Surgeon-in-Chief), Lady

AID

FIRST

District Supt. :'I1rs. Tweedale (rep resenting Lady P errott, Lady Supt-in-Chief) and other officers. On arri\'al Her Royal Highness inspected a ~ u a rd of honour com posed of members of :\0. 1 ( Prince of \\'ales's ) District under the command of Asst. Commissione r Capt. \V . •-\. Rees and then witnessed a men's and nurses' team at work. PRESENTATIOK OF TlWP H1ES. The Earl of Scarbrough presided at the subsequen t announcement of results and presentation of trophies, and on behalf of the Order welcomed H er Roya l Highness and extended thanks to her for the personal interest take n in the work. During the past 50 years the Brigade has been carrying out a national service and last year oyer 750,000 cases receiyed attention and 35,000 on the road. This work has been an example to the Countr}·. During the past three months it has been shown that in this country there is a valuable organisation of 80 to 90,000 strong standing read y at the disposal of the Government. His Lordship also referre d to the work done in the September crisis and the grea t demand placed on the Brigade by local authorities for first aid training- and anti-gas instruction. In conclusion Lord Scarbrough thanked all members of the Brigade for their fine example of \'oluntary nation al sen'ice. Sir John Duncan then announced the results , which were : -

1 2 3

5 6

8 9 10 11

" D EWAR" CHALLENGE S HIELD . Team. District. Brighto n Police 8 Hetton-Ie-Hole 6 Exeter City Pelice 9 2 Bristol (Fishponds) 4 Crewe "A" Goldthorpe and Barnboro' 5 Birmingham (Mitchell and Butler's) 3 10 March 1 South Met. Gas Co. Corps Clydach and District Wales Shrewsbury 7 Maximum marks

rc Ellis' Cup (best team leader) : Lady .-\mb. Officer R. Shaddick, Barnstaple. The results showed that once again ~ o. 8 D istrict had secured the double for the second time in three years. Horsham ;\urs in g Di\'ision are to be congratulated on their win in this thei r first attempt, more especially as the Di"ision has not yet r eached its first birthday. Rega rding the men' res ult,> it seems as though the Police teams have taken a leaf o u t of the R ail way teams' books. In the past w e ha"e had Cre\\'e, Horsham and \Vol ver to n as winners ot the " De\yar," most of the members beino- also members of the raihyay teams of the same name. b Princess .-i..lice graciously presented the trophies and prizes with a word of congra tulation to all members. A h ~arty laugh was raised when it was noticed the members of t he ~1i tchell and Butler's team recei,'ed sih'er tankards j the fi rm being large brewers in Birmingham!

THE TESTS . For the men the team test was : Il\'TRODUCTION TO TEST.-You ha\'e been detailed for a mbulance duty at an exhibition ,,'hich is beino- held in Jonsgate. Two of you haye been at the roll er sk;ting rir.k

AID

30 7

humerus at the elbow i int and from fractured base of -kull . and she is lying on he~ back totally uncon ciou thr uCThout test. The other ha- a _imple fra~ture of rio-ht 113nd ~nd is \'ery hysterical, and she is sitting on the O'r~und beside her companion. All fractures are r~pre -ented on patient, the fractured base with bleeding from right ear indicated. The nurse team te t (fir -r aid portion) wa INTROD(;CTlOX TO TEST. -You are mem ber of the J onsgate ;\ursing Di\'i ion, and ha\'e been detailed for dULY to-da y at the zoological garden in the \'illage f Firsted', where a fete is being held. Haying arri\'ed early you report at the ecretary's offi -e. There you were allotted two boy - as me - engers, and you were asked to go to the ambulance rl~om - \\'hich i- SO yard from the monkey house-and get it ready f r the da y's w rk. To this end you have just sent the boys for water. You know that Jonsgate is 5 miles from Fir ted (to w:lich you travelled to-day by t;le two-hourly bus en'ice) ; that the ambulance of the J onsgale Cottage Hospital will not be a\'ailable for -e\'eral hours, and that your Diyi ional urgeon hopes to join you later. If an acc ident occur -, a ct as you see fit.

l'Ifarks. 457

427 382'75 382'4 377 374

367 353 349

338 302 540

" Dewar" Challenge Shield: Brig-hton P olice . "Symons Eccles" Challenge Cup (runners-up) : Hetton· Ie-Hole. "Trimble" Trophy (highest individual aggregate): Brighton Police. "Ellis" Cup (best team leader): Corpl. N. McLean, Brighton Police. "PERROTT " CHALLENGE SHIELD. District. Marks. Team. 419 1 Horsham 8 2 Barnstaple 9 408 2 397 3 Bournernouth (Meyrick) 4 London Civil Service 1 385 4 366 5 Todmorden 5 365 6 Spalding Wales 358 7 Ffaldau Institute and Garw 354 7 8 Shrewsbury No.1 3 348 9 Birmingham (Mosele)) 346 10 Ipswich (Air Duties) 10 324 11 Cottingham 6 " Perrott" Challenge Shield: Horsham. "Corbet Fletcher" Trophy (runners-up) : Barnstaple. " Chalmers" Trophy (highest individual aggregate) : Barnstaple. " Lady Mountgarret" Cup (bedmaking) : Todmorden.

St. John Ambulance Brigade Final Competitions. H. R. H. Princess Alice, Countess of Athlone, Presenting the" Perrott" Shield to the Horsham Nursing Division and t he " Dewar" Shield to the Brighton Police Division. since early m orning ; and you are expecting to be relieved as soo n as your leader arrives with the other members of your team . You know that there is a hospital in J onsgate and that an ambulance ca n be obtained therefrom. If an accident occ urs, act as you see fit. ACTION OF TEST. -Upon arrival, a steward takes Bearers Nos. 1 and 2 to the rink, seats them and hands them the card of introduction. He then returns to the leader, hands hi m a similar card and tells him to wait until his co-members call him. As soon as the bearers are seen, the skaters commence action. Two minutes later they collide and fall to the g round. The skating mistress is available and willing to ass ist, though she knows no first aid. No other person is prese nt. Ambulance arrives 5 minutes after call. Time limit, 20 minutes. Warning at 15 minutes. STAGING OF TEsT.-Arrange set as skating rink behind which an ambulance is hidden; and alongside fit up a small amb ulance room in which place all requisites, including haversack, blankets, and telephone. One skater is suffering from simple fracture of right

ACTION OF T EsT.-Upon arrival the team is taken d irect to the ambulance room where lhe card of introduction is given to the leader. Meanwhile the boys advance, each with water-can , enter the monkey house, and start to walk along the safety-bar, each from opposite ends. Meeting half-war they struggle and fall into the arena. Six minutes after te t starts two keepers arrive on the scene. The Divisional Surgeon does not report for duty. STAGlNG OF TEST.-The scene is a monkey house with safety-bar in front of cage. Fifty 'ards off is the ambulance room (with remo\'able front) in which are bed, bedclothes. two rugs, hot-water bottles, stretcher, haversack, and_ oth~r nursing material. Off the set is the secretary's office tn which is a telephone. Both boys are lying flat on their backs. One is unconscious and also suffering from simple fracture of left patella, while the other is fully co ns cious , has a contused wound of forehead, and a simple fracture of the left clavicle. Fractures and wound are represented on patients. After the first entry, visits to the amb ul ance rooUl will be ruled as occupying two minutes.

FIRST INDI"IDUAL AND DUAL PRACTICAL TESTS. Time limit, 15 minutes; warning at 10 minutes. OFFICER OR MEMBER-IN-CHARGE. (Ambulance and Nursing team). I 'TRODUCTION TO TEST.-You are spending the weekend with your married sister at he.r lonely cottage .thr~e miles from Jonsgate. Your brother-lO-law has gone III his car to the town for provisions and is expected back shortly. At this moment (8 p. m.) you are in your bedroom talking to your sister \\'ho is about to give her small boy his evening bath. You know that no one else is available and that there is no telephone in the cottage. If anything unusual occurs act as you see fit. Injuries dealt with were partial asphyxia of the boy and an epileptic fit by the sister. BEARERS Nos. 1 AND 2 I NTRODUCTION TO TEST. -To-day you are to take part in a Brigade Review at J onsgate. As you live in London, you have spent the night with a friend in his flat. At this moment (8 a.m.) you are in the sitting-room, fully dressed and ready for the Review; and through the doorway you are chatting with your friend who is dressing in the bathroom. If anything unusual occurs, act as you see fit. The injuries were electric shock and burns, together with contused wound on right cheek and simple fracture right forearm. BEARERS Nos. 3 AND 4. INTRODUCTION TO TEST.-It is 6 p.m. ; and you are walking down a street of small houses on your way to a Cinema duty. Glancing through a window, you see a man paper-hanging his front room, 8nd you note that the steps on which he is standing are awkwardly placed. If an accident happens, act as you see fit. In this test the injuries treated were compound complicated fracture of leg and severe shock. SISTER No.1. INTRODUCTION TO TEST.-Your sister is at home in bed and is suffering from a lacerated wound of her left forearm. Your doctor is calling lo-day, and he has asked you to sterilise his instruments (which he left with you) and to assist him in dressing the wound. Act as you should. SISTERS Nos. 2 AND 3. INTRODUCTIOn TO TEST. -You three live alone in a flat. Yesterday your sister was taken ill. The doctor has just examined her and said that she is suffering from acute rheumatism. He added that he would send along a State registered nurse, and suggested that, pending her arrival, you should arrange the bed and bedclothes suitable for your sister's condition.

Eppleton 0 ambulance team added to their laurels when they were successful in winning the " Lord J oicey " challenge cup competition. Elemore A gained second place and the" Altred Urwin" cup which had been presented this year by Mr. Alfred Urwin, of Newcastle. 3

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The Hendon Cadet Division, No.1 District, S.J.A.B., entered the Hendon and District Junior Football League and were successful in winning the League championship shield, their opponents in the final being the 5th Hendon Boys' Brigade. To celebrate the event Cadet Supt. Hurford and Mr. Douglas Martin (vice-president) entertained their members at the Royal Tournament, Olympia.

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S.J.A. B. Overseas. II'\DIA, I'\O. 3 DISTRICT. The annual inspection of the Bombay Corps ,vas held on March 25th and was carried out by His Excellency the Governor of Bombay, Sir Roger Lumley. The Governor was met on arrival by Asst. Commissioner Sir Gilbert \-Viles, District Surgeon F. N. Kapadia, and District Supt. lajor F. T. Deatker. After inspecting the parade, which included eight ambulance, two nursing and two cadet divisions, and witnessing displays, H is Excellency expressed his appreciation of the work witnessed and eulogised the Brigade's assistance in alleviating the suffering of the distressed. Sir Gilbert Wiles reported on the work of the District during the previous year. During the communal troubles four divisions sent out squads and treated a considerable number of injuries. Over sao cases were treated on public duty and 1,241 removals were made by the ambulances. The Parsi ~uring Division celebrated its Silver Jubilee with an exhibition, to which about 40,000 visitors attended during the ten days it was open. A. R. P. instruction had been extended to many commercial firms, doctors and others and a simple form of training for the Brigad p personnel was being devised. Qualified instructors now number over SO. During the year the Red Cross Society presented the District with three motor ambulances and full use is being made of them. The foundation stone of the new Headquarters was laid by His Ex<.:ellency and the building has now been completed. Sir Gilbert thanked the Parsi Division for placing the Lady Willingdon Building at the disPQsal of the District for numerous functions; and congratulated the Parsi Cadet Division on winning the" Chetwode" Shield in the All-India Ambulance Competition and the Parsi Nursing Division on winning the" Panthaki " Challenge Shield. In conclusion Sir Gilbert referred to the visit of the Hon. Mrs. Copland-Griffiths (Acting Lady Supt-in-Chief, Brigade Overseas). During the proceedings the Governor presented awards and certificates to numerous members.

St. John Ambulance Brigade Headquarters and District Reports. N o. I (prince of Wales's) District Hyde Park has been the scene of many inspections but none have been more spectacular than that of the !\o. 1 (Prince of Wales's) District, which was held on June 10th, when some 6,000 men, nurses and cadets (a record number) paraded in eleven battalions consisting of 92 companies. One of the most pleasing aspects of the parade were the number of recruits and non-uniform members present. The inspecting officer was Field Marshal Sir Philip W. Chetwode, Bt., O.M., G.C.B., K.C.M.G., D.S.O., and he was received by the Sub-Prior of The Order (Earl of Scarbrough), Sir Percival Wilkinson (Secretary-General), Brigadier W. B. O. Barne (Secretary), Sir John Duncan (Chief Commissioner), Col. G. A. Moore (Asst. Chief

service to the public for very many years. We who know it admire it more than we can say, and know well that in these dangerous times that voluntary preparations and service are of inestimable value." The marching at the march past was excellent; and for the first time was in double columns of fours. The ambulances, which brought up the rear, were led by the new " Invicta" ambulance of the Ley ton and Leytonstone Division, which was greatly admired. The annual Western Area Church Parade will be held on Sunday morning, Sept ember 24th, at Holy Trinity Church, Prince Consort Road, Kensington, by kind invitation of Canon J. O. Hannay. The mayor of Kensing-

Th e Eight- Po inted Cross. With OBSERVATION most carefully note All causes and signs, however remote . Then TACTFULLY question all those who stand by, And quickly decide on whom to rely. With RESOURCE you must use the best thing at hand, To prevent further damage, and help Nature to stand. With DEXTROUS care to avoid giving pain, You must handle your patient, and meanwhile explain, In an EXPLICIT way to those who stand near, How best they may follow your instructions clear. DISCRIMI ATE quickly, if injuries are great, Which need early treatment, and which ought to wait. PERSEVERINGLY work, and never despair, The mischief that's done you can help to repair. Then, with SYMPATHY sure and much allayed, Await for the Doctor and his Medical Aid. FLORENCE A. WEDLOCK.

Field :'Ilarshall Sir Philip Chetwode, accompanied by Commissioner Capt. W. Goodley, inspecting members of No.1 (Prince of Wales's) District. Commissioner), Dr. N. Corbet Fletcher (Surgeon-in-Chief), and others . After the general salute, the national anthem and breaking of the flag, Capt. W. Goodley, M.C., O. B. E. (Commissioner), was presented to Sir Philip, who then carried out the inspection. In the broiling hot sun the parade presented a very smart appearance and Sir Philip gave the following message at the completion of his tour : " I am sorry that the rules of the Park prevent my addressing the parade. The voluntary effort made recently by men and worn on all over the Empire to prepare against the threat of war has excited the admiration of the nation and the world. The people of this country are apt to forget that the St. John Ambulance Brigade kas offered voluntary

ton, Sir All en P owell, C.B.E., J.P., has intimated that he will attend the service. The annual dinner and dance of the No. 70 (Royal Borough of Kensington) Division was held on May 30th. Diy. Supt. Sier presided, supported by the. ~ayor and Mayoress, Dr. Fenton (M.O.H.), Asst. CommisSlOner S. J. Warren and Mrs. V'Iarren, Police Inspector Fraser and Mrs. Fraser, and others. The Assistant Commissioner, in reply to "~he Wes~ern Area" drew attention to the O"reat work done m Kensmgton b~ the Ambulance and Nu~sing Divisions. Sir Allen Powell expressed on behalf of the Borough their debt of gratitude for the very valuable work done

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by the Brigade in A.R.P. instruction in the district under his control. t d b Divisional trophies and a wards were presen e y Mrs. Warren.

who have thirty-five years' service each to their credit. The parade re-assembled and marched to the Co-operative Hall for tea.

An afternoon service was recently held at t~e Chapel Royal, Hampton Court, by members of the TWIckenha~ Divisions. The service was c.onducted by the Rev. Canol M A and a stirrmg sermon preached by the · F ermmger, .., d h f t th t Rt. Rev. Bishop Hill, D.D., who referre t? t e ac .a the Chapel was believed to have been hUllt on the sIte of a former Conventual Church of the Order of St. John. The well-attended parade was under the comma.nd of Asst. Commissioner S. J. Warren, who was accompallled by Robinia, Viscountess Mountgarret, .O.B.E. . Supt. G. Willoughby was responsible for the orgalllsation of the event, which was attended .by mem~ers of the No 84 (Twickenham), No. 63 Nursmg (Twickenham), under Mrs. Mason, the Twickenham Boy Cadets and the Molesey Ambulance Section.

No. IV District

On Wednesday, May 31st, the Mayor of Battersea (Councillor W. J. McIver) distributed awards. to members of the No. 38 (Battersea) Division, inclu~hng a seven years' service medal of the Southern RaIlway to Pte. Balkwill who is one of the Mayor's works' colleagues. Cou~cil1or Dr. H. L. Gulati presided and ~eferred to the self-denial and self-sacrifice membership of the Brigade entailed. . Corps Officer A. Ansley said that Dr. Gulatl gave up his Wednesday evenings to teach the .members .and the 100 per cent. passes obtained was a tnbute to his wo~k. On behalf of the members Dr. Gulati was presented With a silver pencil.

LANCASHIl<E. BLAcKPooL.-On May 22nd, Asst. Commissione~ V!: H. Gastall inspected members of the Blackpool DlvlslOn. Supt. G. Wilson, assisted by Amb. Officer J. Ha~tley, ¥:,as in charge. Demonstrations inc1l!ded A.~.P., m whl.ch l2 men fully equipped in protectIve cloth1.llg, dealt WIth casualties. . A Service Medal was presented to Pte. C. Hl~dl e, whilst service bars were handed to Amb. Officer Bnggs, CarpI. Adair, Corp!. Watson and Pte. T: Duckworth (21'l:d). A letter of appreciation of the serVIce rendered durmg the recent back-out, when 40 men were on duty, from the Medical Officer of Health (Dr. E. W. Rees Jones) was read during the evening. The 38th annual review, inspection and competitions of the South-East Lancashire Area was held on Saturday, May 20th, at Tyldesley. Col. J. L. Sleeman, C.B., C.M.G., C.B.E.,. C.V.O. (Chief Commissioner, Briga~e Overseas), ~a~ the mspecting officer, being accompallled by CommlSSlOner W. G. Smith. Over 2 000 were on parade, the Todmord en Ambulance Division being awarded the "Daniel Hall " Trophy for smartness and efficiency.

N o. V D istrict No. m District. Over 1,000 members of the Warwickshire. units paraded in Rugby on Saturday, May 20th, for the mspection carried out by Dr. W. C. BentaJl, O.B.E., Asst. Surgeon-in-Chief and A.R.P. Sta~ Officer. On arrival at the RecreatlOn Ground the par~de was inspected, the inspecting officer. being accompamed by Commi~sioner Major J. Orton, Major C. G. E. Kea~e, R.A.M.C., Mrs. Copland-Griffiths (Asst. Lady Supt.-mChief, Brigade Overse~s), . Lady County Office~ Lady Willoughby de Broke, DIstnct Officer W. A. Jennmgs. Selections were played by the B.T.H. Band under Bandmaster Jeffery Baxter. Following the inspection and after the !Darch pa~t, demonstrations of stretcher and company dnll, first aId, etc., were given. Later the members were warmly congratulated on their smart turn out. Mrs. Copland-Griffiths praised the nurses saying it was most gratifying to know that the wome~ were prepared for every kind of war emergency, and were anxious to join that ancient and very honourable organisation, the St. J ohn Ambulan~e Brigade. . Dr. Bentall conveyed the good WIshes of MaJ or General Sir John Duncan, Chief Commissjoner of the Brigade. He said he was particularly struck by the number of veterans on parade, and by the large number of young people who had joined the mo."ement. He was especially pleased with the stretcher dnll. Thanks to the inspecting officers were expressed by Major Orton who also presented three awards. He decorated cpi. J. Parkes (Longford), with a long service medal and handed ·five years' service hars to Supt. J. Davenport and Supt. (R.) W. H. Sefton, both of Longford,

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The annual competitions of the Lincoln Corps were held on May 14th, for the "Lambert" Rose Bowl and . the "Trafford" and "Newsum" Cups. Pte. T. North, with 44 marks, gained first pla~e m the individual section, being followed .by Pte. G. Klrk~y and Pte. H. Pain. The team captamed by Pte. Pam o'ained first place, whilst Pte. Greenfield's was second and Pte. Buttery, third. Corps Surgeon J. A. Hadley was the judge. . Lt.-Col. F. S. Lambert presented the trophIes, also a third Service Bar to Sergt.-Major J. Dawson and Service Medals to District .Officer F. F. Gibson, Sergt. Ingham, Corpl. T. J. Watson and Nurse Markham. Dr. Lambert recalled that it was in 1887 that he, with ex-Corps Supt. Trafford, started the wO.rk of t~ e Brigade in Lincolnshire. He still felt a keen mterest 1ll the work which was not only a department of the oldest Order of chivalry in the world, but also probahly the most useful. . Mr. Trafford presented prizes which were gIven by an old member, Mr. J. Appleton, to the winners of the " Trafford" Cup. Corps Secretary A. Hackford mentioned that the Spalding Nursing Division, under Nurse ?arvey, had won the "Bjrkbeck" Bowl for the second time. It was decided to send a message of congratulation to the Asst. . , Commissioner, Capt. G. B. Armstrong, of Spalding. Mr. Hackford stated that since the September cnSlS the members of the Lincoln Corps had given first aid instruction to 300 people, and 160 were to take courses shortly. The annual inspection of the North Staffordshire

Area was held on June 4th, on the Uttoxeter Cricket Gro nn J. lVLre t han cleven hundred men, nurses and cadets were on 1,aradc, under the command of Asst. Commissioner 1::. F. Dudley. The para~.: c, fe ll-in" at the Uttoxeter Railway Station and marched to the centre of the town, where Mr. G. W. F. Mosel ey, Chairman, Uttoxeter U.D.C., extended a civic welcome. The inspecting officer was Commissioner Sydney W. Malkin, who was accompanied by Mrs. Malkin, County Surgeon J. Manuel and Lady District Supt. Mrs. Birkbeck. Following the inspection and march past, at which Commissioner Malkin took the salute, the inspecting officer hriefly addressed the parade. He was pleased with what he had se':'l1 , especially the large number of recruits. Mrs. Birkbeck al:;o expressed her satisfaction and congratulated the D; ursing Divisions on their increased personnel. WETIIERBY.-The annual inspection of the Wetherby Ambulance, Nursing and Cadet Divisions was held last month in the grounds of Castlegarth House, lent by Dr. and Mrs. E. H. Lodge. The inspecting officers were Asst. Commissioner Lt.-Col. W. Scatterty and County Surgeon E. H. Lodge, both of whom commented very favourably on the smart appearance of the three divisions. Officers on parade were Supt. F. Eielsdale, Lady Supt. Mrs. E. H. Lodge, and Cadet Supt. Mrs. Beedleston.

N o. VI District On Sunday, May 14th, members of the Mid-Durham Corps attended service in Durham Cathedral. Corps Supt. J. H. Pigg, assisted by Corps Offic~rs G. Robinson and G. Dobson, was in charge, there bemg present many officers, including surgeons, superintendents and cadets. WelcominO' the large assembly, which numbered some 350 members b Dr. Cyril Alington, Dean of Durham, contrasted m~ny features of present-day life with those of distant days. In the great movement of the car~ for the sick and suffering, the St. John Ambulance Bngade takes an honourable place. The annual inspection of ambulance and nursing divisions in the East Riding was helel on Sunday, May 21s t, when County Surgeon N. Jennings was the inspecting officer. On his tour of inspection, Dr. Jennings was accompanied by the Mayor and Mayoress of Bridling-ton (Alderman J. W. Robson and 1\.11's. Robson), Sir A~thur Atkinson (President, Hull S.J .A.A. and East Rldmg County Centre) and Lady Atkin~on. Others on parade included County Officers Capt. Nicholas and H . .Bartrop. Following the insp ection an ambulance display, a demonstration of A.R.P., and the march past was held.

No. VIn (Duke of Connaught's) District BRIOHTON.-The annual dinner of the Brighton TOWll Division was held at the Old Ship Hotel. Mr. A. V. Nicholls (President) presi,ded, supported by Mrs: Nicholls, Div. Surgeon W. Fairweather and Mrs. FaIrweather, District Officer W. J. Noble and Mrs. Noble, Corps Officer C. Leslie Hughes and Mrs. Hughes. .. Mr. Nicholls said he was proud to be assocIated WIth

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an organisation which worked so quietly, without thought of reward, for the benefit of fellow citizens. Corps Officer Hughes said that he was proud to be in charge of such a division, which gave so freely of its best to whoever needed help. District Officer Noble congratulated the Division on the record of duties covered last year. The results of various competitions were announced: Intersection Cup, B Section; the "Baker" Cup, once again by CorpI. L. Sanderson. In asking Mrs. Nicholls to present the awards, Corps Officer Hughes also asked her to present wedding presents to Mr. and Mrs. Brown and Mr. and Mrs. E. Sanderson, who had recently married. GUERNSEY.-On May 12th ninety members of the Guernsey Divisions were inspected by Asst. Commissioner W. G. Pape (Chief Commissioner's Staff). The parade was under the command of County Surgeon W. B. Fox, the divisional officers being Supt. F. W. Bush, Lady Supt. Mrs. A. H. Hickey, Cadet Supt. T. R. Marquand and Cadet Officer Mrs. P. Girard, Jun.f. The inspecting officer gave messages of good Will from the Chief Commissioner and also Commissioner E. A. Richards, and at the conclusion of the inspection expressed satisfaction at all he had seen. A challenge shield, made by Pte. John Parsons) was offered to the inspecting officer for competition among girl cadets in Guernsey. It was gratefully accepted and handed over to the Girl Cadet Officer. GUILDFORD.-The annual report of the Guildford Corps sets forth another year of increased activity in all branches. Cases removed by ambulance were 353 accident, 617 distant invalid transport, 842 local invalid transport and 234 patient removals, a grand total of 2)74) an increase of 184. 56 fire calls were answered, 191 attendances were made at clinics, 131 duties at the Royal S~rrey County Hospital, 546 public duties. attended, 644 patIents treated on public duties, 170 pa~lents treated off duty, whilst 502 medical comforts were Issued. The total figure is 2,988 against 2,699 for 1937. The mileage covered by the motor ambulances was 21,193, an average of 9.8 per call. The above record is one of which all members of the Guildford Corps, which now has a personnel of 134, can be proud. . During the year the ~xtenslOn s~heme to ~he headl[uarters was completed Without maklllg a speCial p.ubIlc appeal The Corps has four ambulances and one trailer. T; subscribers of lOs. a "Letter" is issued.. Such " Letters" cover cost of ambulance removal ~or a distance of ten miles or to defray cost of hire of me~lcal comforts. Under the A.R.P. scheme, 325 reservists have been enrolled. . . The report also includes an l11ustratlOn of t~e. ~rst horse-drawn ambulance of the Guildford DIVISIOn, together with a reproduction 'Of the modern fleet of ambulances belonging to the Corps. Corps Supt. J. D. Rutter is to be congratulated on having such an excellent body of men and women un.der his command. We must not forget the Cadet SectlOn, which is now 16 strong. TUNBRIDGE WELLS.-The annual i~spect~o~. of the TunbridO'e Wells Ambulance and Nurslllg DlvlslOn was held on May 31st. ~

3 12 Supt. S. Billenness was in charge of the men and Lady Supt. Miss Ellison in charge of the nurses: . The inspecting- officers were Asst. CommIssIOner Lt.-Col. C. C. II. Brazier) who was accompanied by District Officer W. Hancox) and Lady District Officers Miss :May and Miss Hubbard. The function was witnessed by the Mayor (Ald. C. E. WesDbrook, O.B.E., J.P.), Mr. ·A. R. Kelsey (President, Ambulance Division), Mr. E. B . Snell (Vice-President), Mrs. J. B. Snell (President, Nursing Division), and the Chief Constable (Mr. Guy Carlton). Col. Brazier congratulated a ll members on their very nne turn out. He knew their work and from the insp ection found that all was as he had expected in respect of drill, smart equipment) well-kept accounts and increased personnel. They appreciated the interest taken by the Mayor and Mayoress and others present and for their enthusiastic encouragement in the work. Miss May expressed pleasure at the increase in nursing personnel.

No. X District Close finishes in the Ambulance and Nursing Competitions were in evidence at the annual competitions of No. 10 District, held on Saturday, May 13th. March and Hatfield tied in the men's tests but the former were placed first because of better individual marks, whilst 1st Ipswich Air Duties secured a half-mark win over Chelmsf.ord. From each of the five counties, Suffolk, Norfolk, Essex, H ertfordshire and Cambridgeshi r e, came the county champions, ihis being the first year the competitions h ad been run on the county basis. The judg es were: Men) Dr. Ryder Richardson (team), Dr. Bree (individual), and Dr. P. Weiner (viva voce); Nurses, Dr. Lloyd (team), Miss Fletcher (after ca r e), Miss Worley-Jonson (home nursing). The results were:Men: 1st, March) 285 marks; 2nd) Hatfield, 285; 3rd, NOf\vich Lads' Club, 273; 4th, Felixstowe) 234; 5th, Chelmsford, 218. Nurses: 1st, First Ipswich Air Duties, 185 points; 2nd, Chelmsford, 1842; 3rd, Letchworth, 171; 4th) March, l24l At the conclusion of the competitions the cups were presented hy the Mayor of Ipswich (Alderman E. L. Hunt), I",ho was supported by the Mayoress (M rs. Hunt), Alderman and Mrs. T. R. Parkington, County Commissioner Dr. Cloudes ley Smith, Counly Surgeon W. F. Fryer, the Assistant Secretary (Miss Co ulcher), Lady County Officer Miss Parker, and others. The Mayor said he was pleased to be present. Tn Ipswich they were proud of the St. John Ambulance but they could not be proud of their headquarters whic h was a disgrace to a progressive town. He hoped to place a concrete proposal before the town before the end of hi s yea r of office. In addition to presenting the cups, His Worship presented Vellum Votes of Thanks to Dr. P. W ein er, Mr. Melton (the Assistant Treasurer ), and Amb. Offi ce r Oliver; certificates of appointments as L ady Divisional Superintendents to Mrs. Palmer and Mrs . Aldous, and a Service Medal to Mrs. F. A. Cracknell.

Northern Ireland (Ulster) District. The annual competitions were h eld at B elfast on Saturday, May 27th, when teams from Dublin also competed.

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The results were:Belfast Challenge Cup (senior men): 1, Heysham Steamers, 320; 2) City of Dublin, 315; 3, Broadstone G.S.R. "A," 312. Lord Mayor's Cup (novice men): 1, East Belfast, 330; 2, Belfast Central, 328; 3, Lurgan, 322. " Whitaker" Memorial Cup (senior nurses): 1, H arcourt (Dublin), 245; 2, West Belfast) 237. The Nursing (Whitaker) Cup (novice nurses): 1, West B elfast" B," 312; 2, North Belfast, 272; 3, Belfast Central, 275. District Surgeons' Cup (boy cadets): 1, Belfast Cent ral " A," 340; 2, Banbridge "A," 298; 3, Banbridge

"C." Co ronation Cup (boy cadets, open): 1, Belfast Central " A," 340; 2, Banbridge " A," 298; 3, 45th Co. Belfast Boys' Brigade, 288. Girl Cadets Cup: 1, Banb rid ge "A,". 330; 2, Ballbridge" B," 312; 3, Banbridge "C," 311. At the conclusion of the tests Lady Dunleath presented the trophies. Commissioner Tan F rase r, M.D., F.R.C.S., and District Secretary A. W. Mann were among those p r esent.

Coming Events. Tile Editor will be pleased f o receive particulars 01 forthcoming events for inclusion (free of cbarge) under tbis beading.

J U l\E. 2-+ - Barnoldswick Centre S.J. A. A. , Ann ua l Open Competitions. 2.f- Brighouse Infirmar ies a nd Hospitals Committee Open Competitions. 24-Devon Branch, B. R. C. S., Annual Inspection, Exeter. 25- Central Area, No. i District, S.J.A.B., Annual Church Parade. 26-A nnual Service Order of St. J aIm. 27-British Red Cross Society Flag D ay. J ULY.

i -All Wales S.].A.B. Inspection by H.R . H. Du chess of Kent, Cardiff Castl e. i - Great Central Centre (L. N. E. R.) "Bartholomew" Bowl Competition, Hinton. 2- National Road Passenger Transport Ambulance Association, "Stirk" Trophy Final, \Valsal!. 2- Middlesex Branch B.R.C. S., Church Parad e, Horn sey Parish Church. 8-Elland Demonstration and Gala Annual Open Competition, Eiland. 9-Annual Review Kentish Units, S.].A.8., Dover. 9-South Worcestershire Area S.J.A. B., Annual Inspection, Kidd erminster. 13 to 29-Scottish V.A. D. Training Camp. 16- Little Coates Hospital Challenge Shield Competition, Alexandra-road Rooms, Grimsby. 22- No. 1 (Prince of Wales's) District, S . J.A.B., Annual Fl ag Day. 23-A nnual Review Surrey and Sussex Units, S.J.A.B. Worthing. AUGUST.

5 to 12- Nursing Personnel S.J.A. B. Annual Camp, Rossall School.

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Railway Ambulance News. I nter- Rai tway Fi nat, 1939. L.M.S.

AGAIN

SUCCESSFUL.

For the second year in succession a team representing the L.M.S. gained first place at the Inter-Railway Final, held on May 24th, at the Great Central Hotel, London. Ca mden Goods, first time in the final, crowned their comp!:!tition efforts by an excellent win over Horsham (So uthern), bein g 15 marks in front. For a few years this team has been" knocking at the door" of t he competition wo rld and by co nstat.t stu dy and practice the members have come out on top. Congratulations! Two experienced judges, Capt. F. E. Bendix of Lpndon (team and No.5), and Dr. G. S. Phillips of Gwaun-caeGurwe n (indiv idu a l, Nos. 1, 2, 3 and 4), were present to adjudicate on the work; whilst the excellent arrangments were in the efficient hands of Mr. D. G. Monteith, the com petition secretary. The visitors d id not number so many as in previous years , possibly ow in g to a great national event (the Derby) but, nevertheless, the railway stalwarts were there in force a nd recounted for the benefit of "you young-sters" the fights held long ago for the Inter-Railway Challenge Shield. PRESENTATION TO Mr. E. A. RICHARDS. During the luncheon interval a pleasing ceremony took place. At a meeting of Railway Ambulance Centre Secretaries an d a few friends Mr. T. O . Mein, on behalf of the secretaries, asked Mr. Richards, who retired on May 31st from the Southem Railway, to accept two Daulton fig ures a nd also a handbag for Mrs. Richards in recognition of the long association they had had together in railway a mbulance work. Mr. Richards had been connected with the mo vement some 40 years, during which time he had seen man y cha nges and had been engaged in great humanitar ian work. He and his wife was deserving- of the s incerest thanks for the assistance given to the movement. Mr. Richards feelingly returned thanks for the gifts a nd kindly sentiments expressed. Since 1898 he had been associated with first aid but every moment had been a real joy. Th e encouragement received from the R a ilway Ambulance Secretaries had made his job much easier. PRIZE DISTRIBUTION. Colonel ]. T. Woolrych Perowne (Hospitaller of The Order) presided at the s ubsequent distribution of prizes, sup ported by the Viscount Horne (Chairman of the Great Western Railway), Sir Ron ald Matthews (Chairman of the Lo ndon a nd North Eastern Railway), 1\1r. Gilbert S. Szlumper (Gen eral Manager of the Southern Railway), Mr. W . E. C. Laze nby (L. M. & S. R.) and the judges. Sir Percival Will inson (Secretary-General) a nnounced the result as follow s : Team. Tota!. Ind. Team. 203 16-+~ 36 7t 1. Camden Good s (L. M.S.) 167 352t 185i 2. Horsham (South ern) 346 184 162t 3. Tyne Dock (L.&N. E.) 343 159 184 4. Moulton (M.&G.N.) 195 H6t 3 41 t 5. Crewe Works (L.M.S.) 183 333t 150t 6. Pontypool Road (G.W.R.) 155 331 176 7. Waterloo" A " (Southern)

312 t 309 250 500 Trophies: "Inter-Railway" Shield, Camden Goods. " Corbet Fletcher" Cup, Horsham.

8. 9.

Barry Loco (G. W. R.) Tuxford (L.&N.E.) Maximum

187..l 158t 250

125

150~

Great applause welcomed the result and, whilst we do congratulate all teams on their excellent work, we would give an extra word of praise to members of the Horsham team on gaining second place in spite of the fact that their usual leader, Mr. F . A. Trott, is not now a member of the team. Lord Horne presented the individual prizes and also the trophies. When handing the prizes to Pontypool Road he said he had hoped to see them earlier. Referring to the railway ambulance work, Lord Horne said that not only were the members of great assistance to the railway companies but in the event of a national emergency arising they vvould be of the greatest use to the State. Votes of thanks were extended to Viscount Horne, to the judges and to the stewards. Also to Mr. John Maxwell (Chairman, Associated British Pictures Corporation, Ltd.) and l\Irs . l\laxwell for again providing the stage setting.

THE

TESTS.

The team test setting depicted a stone quarry at which blasting was taking place. There was a deaf old man looking after the ambulance room (in the absence of the ambulance attendant) ; weather was cold and damp. Full equ ipment and telephone was available in the alllbulance room. \Vhilst the team were talking to the man an explosive charge blew up prematurely and a quarr) ma n was badly injured. Twenty minutes was the time allowed to render 6rst aid. Marks available were :One member detailed to :2 (a) Bring equipment ... ... .., (b) Telephone for medical aid, etc. (no doctor available for half an hour; hospital 2 miles a way, will admit 2 case; ambulance will arrive in about fifteen minute!.) 2 Rapid approach and warning patient to keep still ... Investigation and inquiry in regarJ to further danger 2 (no, definitely) ... .., Speak encouragingly throughout + Gently restrain patient's movements, and steady and -+ su pport him from now on wards 3 Convulsions (no) ... Early a nd tactful inquiry from patient :(a) Where is the pain (right arm) ... Steady and support right upper limb and maintain (b) Any pain elsewhere (left side) ... (c) How do you feel (weak, giddy, and faint) (d) Any other pain (no) ... ... . .. Careful and cornplete examination for signs of hrel11orrhage, over and under Noting early :(a) H re morrha ge right arm in front (b) Hremorrhage right arm behind

1 3 1 1 2

4 1

FIRST (c) HGemorrhage behind left side of chest... Is there pallor of face and lips (yes, and sih-ns of severe shock ) lrvIMEDI,\TE TR EATMENT OF SnocK. Arrest llGemorrhage Examine right upper limb : Swelling (yes) Can yo u move yo ur arm (no) ... .,. Is there deformity (yes) ; is there irreg ularity (yes) Unnatural mobility and crepitus. Mentioned only Avoid elevation or undue movement of limb Expose wounds carefully Is blood bright red (no) Is blood dark red (yes) ... Flowing steadily from side further fro m hea rt (yes) Size a nd characte r of wounds : (a) In front (large, lacerated) .. (b) Behind (small , punctured)... Foreign bodies (none visible) ... State, d o not search for foreign bodies Avoid direct digital pressure ... Remove elastic armlet now Firm bandage, near wound, side away from heart, maintained For speed in arresting h;:emorrhage Apply temporary dressings and bandage lightly Carefull y expose wound back of chest Nature of hccmorrhage (slight) Size and character of wound (small, punctured) E licit swel lin g, deformity, irregularity Is pain sharp and c uttin g (yes) Especially on attempting deep breath (yes) Foreign bodies (no) "\pply temporary dressing and bandage lightly Carefully lay patient on his back on a blanket, steadying and supporting upper limb a nd chest Head lo w Turned to side an d maintained Loosen clothing neck, chest and waist Ensure free circulation of air... Secure right upper limb to trunk, two bandages, avoid fract ured rib Cover well with blankets or coats Raise well the lower limbs Eliminate signs of head injury Apply smellin g salts to nose, after testing Use encouraging words Ensure freedom from excitement and worry Do not discuss patient's condition in his hearing TRANSPORT TO AMBULANCE ROOM. Nos. 2 and 4 prepare stretcher Test stretcher Arrange blankets . .. Correct positions for loading, No.1 on right, Nos. 2, 3, an d 4 o n left ... Lifting patient, 3, placing stretcher, 1 ... Lowering patient, 3, care of injured parts, 3 Covering patient, 2, lifting stretcher, 2 Adjusti ng slings Advancing, No.1 on right of No.2 at foot, No.3 on right of No. "" at head Halting, 2, lowerin g stretcher, 2 All orders given by No.1 For speed in re movin g to shelter (deduct ~ point for each minute) GENERAL EXAMINATION OF PATlENT_ Pulse.-Correct examination... Rate (rapid) 1, s tre ngth (weak) 1 ... Breathing.-Rate (hurried) 1, depth (laboured) 1 Accompaniments (yawning and sighing) ... ... Air hun ger, throwing arms about, tug~ing at clothing-. calling for air (yes) ... ... ...

3 2

1 1 2 2 3 2 1 1 2 2 2 1 2 I:

2 3 3 2 1 1 2 3 2 2 1 ?

3 1 2 3 1 2 2 2 2 1 2 2 2 2 1 3 2 4 6 4 1 4 4 2 10 2 2 2 2 4

FIRST

AID Odour of breath (as you find it) Mouth.-Blood, vomited, coughed (no) Ears and nose. - Blood (no) Further examination of trunk, head, and limbs unnecessary, patient very de6nite, no other pain Pupils.-Patient draws his head away and will not tolerate examination Skin. - Cold (yes) 1, clammy (yes) 1 Beads of cold sweat on forehead (yes) Has patient vomited (no) Repeat examination of pulse and inquire if failing (yes) Decide b mm orrhage from internal organ (spleen) Em phasise urge nt necessity for am bulance and medical aid Is patient becoming listless and apathetic (no) TR EATMENT OF SIIOCK ON ARRIVAL AT SHELTER.

2 2 2

Ins line patient towards left side and support Ice (not available) .". Apply cold compress over region of spleen Left arm in large arm sling ... Hot water bottles to sides of body, bet ween legs and to feet ... Avo id tea or coffee.. . EXAMINE AND TREAT ALL INJURIES Avoid unnecessary handling or exposure of injured parts Carefully prepare materials for dressings . .. Sterilize fingers By application of an antiseptic which does not stain, burn . or irritate and is non-poisonous (not available) Use normal saline solution, correct proportions, 1 teaspoonful of salt to 1 pint of sterile water Remo ve bandages a nd temporary dressings, alld steady and support upper limb Are wounds obviously dirty (no) Normal saline solution to w ounds and surrounding skin Apply dressings, 3, cover with cotton wool, 3 Bandage lightly TREATMENT OF FRACTURE

2 1 2 3

Carefully place forearm at a right angle Support wrist wiLh small sling, now Apply splints, w ell padded Shoulder to elbow, front, back, and outer s ides Bandages above and below fra cture Careful watch for improvement in patient's condition:Is pulse improving (yes) Is colour returning to face and lips (yes) ... A.re beads of sweat disappearing from forehead (yes)... Examine and inquire re h re morrhage (still controlled) Ambulance arrives

2 3 3 J 2

Total

2 1 2 2 2

patient was suffering from compression of the brain, due to a fractured base of the skull owing to a fall from the tree and No.4 had to demonstrate how he would find out th ~ cause of the patient's unconsciousness and to state what he was doing during his diagnosis. No. 5 had to des cribe and demonstrate in detail Silvester's method of artificial respiration. Each test occupied 8 minutes. JUDGES'

COMMENTS.

TEAM T EST AND No . 5, By F.

l~.

BENDIX, M.R.C.S.

3 2

3 3

"" 3 2 -J.

2 3 1 2 6 2

1 2 2 2 250

The indi vidual tests were : Nos. 1 and 2 were on duty at a small station on a cold winter's night. The last train was just steaming out whe n a man was seen running over the station bridge and dow n the steps. Nearing the bottom he crien out and fell dow n and on examination was found to be suffering from epilepsy and compound fracture of the right lower leg. No.3 whilst walking along a lonely road on a summer evening is passed by a cyclist travelling at a fair speed . Applying his brakes sharply to avoid a dog the cy clist was thrown over the handlebars and sustained a fractured jaw and a dislocated left elbow. The patient had two triangula r bandages in his pocket and was wearing a scarf. No.4 came across a farm worker lying unconscious at the foot of a hedge along a country lane. Broken tree branches and a wood chopper were lying alongside. Th e

The team test was a straightforward accident case, the detailed marking sheet being based upon the general rules for the treatment of severe shock and demandin g the im mediate arrest of hcc morrha ge, the temporary, but efficient immobilisation of fractured parts and EARLV transport to ~ place of shelter. The patient, who acted his part in a very realisti c manner, was conscious and quite prepared to disclose the position of the injuries IF ASKED, whilst his subsequent simulation of the signs and symptoms of h ccmorrhage from an internal organ left little to be desired. Furthermore it was apparent that the patient had his back turned towards the ch arge when the explosion occurred. It was somewhat surprising to enco unter considerable delay in arriving at a complete diagnosis and to find that the wound at the back of the upp er limb a nd the wound over the region of thE: spleen were overlooked on many occasions, a lthough the presense of r ents in the clothin g and copious grease paint should have made the task a very easy one. The weather unfortun ately was damp a nd cold but, in s pite of this, there was unnecessary d elay in remo ving the patient to the very con veniently situated amb ul ance room and many valuable marks were lost in consequence. Detailed local first aid treatment was of a high standard in most instances but there was room for improvement in the method of pa dding splints and in the general neatness of folding and tyin g ba ndages, whilst in the treatment of the venous h remorrhage Rule 5 was omitted in far too many cases. It is my constant endeavour to adhere strictly to the teaching of the Tex tbook but I find that competitors are not so meti culous, and when one meets with digital co mpression of the ve ins for venous h cemorrhage, testing the ability to swallow, bandaging the limbs for co ll apse a nd the like, one pauses to consider the reaction of the judge who may approve of certain of these methods bu t cannot, in strict fairness, award marks for such procedures. Criticism has been received in regard to "NOT STATED IN THE BOOK IN THis CONDITION," the contention bein g that a competitor is entitled to re ceive a definite reply to a ny question, but experience has shown me t hat a reply which is not contained in the Textbook may mislead the most efficient first aider. With regard to the individual test for No.5, I would rather not discuss this matter at length because the co mpetitors themselves appreciated th eir shortcomings in regard to the description and demonstration of Silvester's Method of artificial respiration. Th e anatomical structure and contours of the patient provided may have contributed towards the difficulties experiellced, but there is little doubt that future demonstrations of this method, in the competition world at least, will be of a much higher standard. The general arrangements for the competition left nothing to be desired, and the staging was excellent, making the judge'S task very much smoother and more pleasant, and Mr. Monteith is to be congratulated upon the splendid organisation for which he was responsible.

AID INDIVIDUAL TESTS, By G. S. PiliLLIPS, ~l. D. Nos. 1 and 2.-The ch ief fau lt here was lack of care in readin g- the ca:d and lack of visualising the test. Competitors wer~ told It was a dark cold winter's night and yet very few carned out a rapid tern porary treatment and then conveyed the patie~t to shelter and warmth as soon as possible. The lam ps prOVided were not used by many of the com petitors to th e best advantage, while others did not use them at all. No . 3.-Th e patient was sitting in the middle of the road a~d was ther~fore in danger from traffic. Only one competItor moved him to the side of the road when he found ~h~ man cons.c ious and. a?le to assist by supporting the 1I1~ured arm WIth th~ uninjured hand. Several competitors fad:d to correc~ly diagnose the elbow injury owing to not test1l1g for fiXity. Not one competitor elicited the man's name and address by asking him to write it down, "'hich he co uld have done with his uninjured right hand. No . 4.-Thi s was a plain straightforward fractured base of skull from a fall while lopping trees. Most of the competitors did really well on this case but some diagnosed apoplexy even though there was bleeding from the ears. Marks were lost through lack of detailed examinatiun, most particularl y in examination of the eyes, pulse, and mouth. The test was moulded around the chapter of the " Black Book" on examination of an unconscious person. Generally, the actual first aid work was well-very well - d one. Marks were lost through not digesting the card properly and lack of detail in examination and treatment. In conclusion may I again express my pleasure with the general standard of the work and my thanks to Mr. D. G Monteith and his efficient staff of helpers for a smoothrunnin g organisation which materially added to the pleasure of the e,"ent.

Great Western. GOLD MEDALLISTS' OUTING.-Some 500 holders of the Company's gold medal for 15 years' and upwards ambulance efficiency, \\"ith their wi\'es, assembled at Gloucester on Saturday, May 20th) for their seventeenth annual "Gold Medallists' Outing." The party, including medallists from all parts of the Great vVestern Railway system, met for luncheon at the Cadena Cafe, when Mr. S. G. Hearn, Div. Supt., who was accompanied by Mrs. H earn, presided. Among the guests were the Mayor and Mayoress of Gloucester eMr. and Mrs. Trevor Wellington), the City Member, Mr. H. Leslie Boyce) 1\.Ir. H. Adams Clarke) Staff Asst. to the General l\1anager, and Mrs. Adams Clarke, Mr. S. Morris, former Div. Supt., and :\1iss C. A. Ault, Ambulance Centre Secretary. vVelcome to the historic city of Gloucester \"as extended by the 'Mayor, \vho congratulated the medallists on their achievement, and said it was an amazing thing that nearly 8 000 members of the staff had qualified for awards last y~ar, 800 being recruits to the movement. As Chairman of the National Service Committee he could not tell them how hearteninO' such a record was. Mr. Leslie Boyce a lso referred i~ warm terms of the service rendered by ambulance men to the community. During the afternoon the party made a motor tour of the. lovell CotswoI.d villages, reassembling for tea b.efore dlspersmg to theIr far-fiung destinations. The outmg was m all respects a most successful one and was organised by Mr. \V. E. J. Parks, Divisional Ambulance Secretary, and his Committee. PADDINGTON.-The annual presentation of awards to

3 I6

FIRST

members of the women's ambulance class took place on May 23rd, when Mr. R. A. P. Setterfield, Manager, Hotels Department, presided. A display of team wor.k. was gIven by the winners of the premier women's competItIOn trophy, Lhe "Florence :i\l. Lean" Cup. Mr. Setterfield congratulated the class on its 100 per cent. success and was pleased to learn of the formation of a new class. The awards Nere distributed ,by Mrs. Setterfield, who was made the rccipient of a bouquet at the hands of Miss Attwooll, .:lass secretary, who also received a gift in appreciation of her services.

DORcIIEsTER.-Members of the Dorchester ambulance class met on May 9th for their annual concert, when Mr. A. Adams Clarke, Staff Assistant to the General Manager, . . presided, and awards gained in the recent eXam1l1atIOn, together with gold efficiency medals, were presented by Tribute was paid to the high Mrs. Adams Clarke. percentage of men maintaining efficiency at Dorchester, and Mr. 1. Launchbury, class secretary, was congratulated on the success of the class. An appeal was made for recruits by Mr. D. Jackson, A.R.P. Officer for Dorchester.

AID WORCEsTER.-An enthusiastic gathering took place in the Guildhall Worcester, recently, when members of the \'arious amb~lance classes in the Worcester Division assembled under the presidency of Mr. J. E. Potter, Div. Supt., to receive their awards. Among those present were the l1ayor and Mayoress of Worcester, Dr. and Mrs. W. E. Moore Ede, Mr. R. J. Armstrong, Div. Loco. Supt., and Mr. J. A. Warren King, District Goods Manager. The Chairman welcomed the Mayor and Mayoress, and apologiscd for the absence of Mr. F. R. Potter, Supt. of the Line, owing to indisposition. H;e cor;gratu1ated t~e members on their progress and paId trIbute to theIr divisional secretary, Mr. W. J. vVaite. The awards, which 'were presented by the Mayor, included competition trophies, the Honeybourne team receiving the" Kilbourne Kay" Shield for advanced workers and the Malvern team the "Kilbourne Kay" Cup for beginners. A number of o'old efficiency medals and bars were also presented. Lt.-Col. Goddard, the examiner of the Worcester class, was made the recipient of a suitcase in appreciation of his services.

FIRS T The prize winners were :-1) J . Worthinton; 2, Mr. E. Ki rhy. Mr. J. T. Wiggans presented the prizes, Mr. W. Ashurst presidino-. Mi. J. Travnor (instructor) expressed thanks to Dr. Horrocks and Mr. Wiggans. DERBY.-At the annual meeting and presentation of awards of the C. and W. Works Ambulance Corps, held all May 17th, Mr. E. Pugson, Supt. of the C. and W . Works, appealed for greater interest in ambulance competitions. Mr. Pugson, who is president of the Corps, presented the awards: 19 certificates, 12 vouchers, 4 medallions, 59 la,bels. In addition a gold medal for 15 years' service was presented to Messrs. A. E. Ashley, G. Clarke, T. Clarke, R. Hilliarcl and J. Lawrence, and a gold bar for 20 years' service to Mr. H. Parnsworth. Winners of the individual competitions were :-First Year-I, G. Warrington; 2, N. Quier. Second Year-I, J. Parker; 2, A. Wright. Seniors-I, G. Woodbridge; 2, S. A. Jackson. Mr. G. Warrington also won the medal given by Mr. Briers for the best first year student.

"ROBINS BOLITHO JJ SHIELD COMPETITION.-The annual contest for the trophy given by the late Mr. T. Robins Bolitho for teams of G.W.R. ambulance men employed at stations in West Cornwall, took place at Penzance, when four teams competed, the adjudicator being Dr. W. Blackwood, County Commissioner, S.J.A,B.

At the sub-

sequent presentation proceedings the teams were entertained to tea at the Western Hotel by Mrs. E. H . W. Bolitho, Mr. A. W. H. Christison, Div. Loco. Supt. presiding. Among the guests were the Mayor and Mayoress of Penzance (Councillor J. Birch, J.P., and Miss Dorothy Harvey). The result was :-1, St. Ives, 90 marks; 2, Truro Traffic, 79; 3, Truro Loco, 72; 4, Penzance, 62. The challenge shield was presented to the winning team by Mrs. Bolitho, who congratulated them on their success. A vote of thanks was extended to Mrs. Bolitho, the Mayor and Mayoress, Mrs. G. B. Morris (who was responsible for the tea arrangements) and other supporters.

KIDDERMINSTER.-The annual presentation of awards to the Kidderminster class, took the form of a smoking conce~t. .:;\l1r. H. G. Simpkins, station master, presided. EXam1l1atlOn awards were distributed by Mr. J. A. Wa~ren King, District Goods Nlanager, and gold effiCIency medals by Mr. A. G. Snell, Asst. Div. Loco. Supt. An interesting report on the work of the class during the past session was given by Mr. R. H . Rogers, and Mr. Y'(. J. \i\'a~te, ~he Div. Amb. Secretary, referred to the spmt 0 f gIVIng mherent in the first aid movement.

London and North Eastern. CAl\1DEN.- A concert and dance was held on May 19th when Mr. C. Nixon (Goods A gent, Camden), presided, supported by Mr. A. L. Castleman (District Goods Manager), Mr. H. Tandy (Goods Agent, St. Pancras), Mr. F. W. Reynolds (Yardmaster, Ca mden), Mr. E. T. Milburn (District Ambulance Secretary), Mr. S. A. Purves (Class Secretary), and others. . Mr. Nixon congratulated Camden on thell" good work in the L.M.S. finals. Mr. Purvis gave a report of the 'w ork during the last session when 82 awards were gained as against 42 in 1933 si~ce which date 484 awards had been gained. , had also gained 21 gold medals for 15 years ' The class service ' 13 bars for 20 years, 6 for 25 years and one for 30 and' 35 years. He thanked members of the committee and also Mr. Harwood (Chairman) for their great assistance. Mr. Castleman presented the awards and also competition trophies. He also paid tribute to the Camden team, of which he was very proud, and thanked Mr. Purves for the splendid work he had done. Mr. W. J. Taylor thanked Mr. Castleman for presenting the awards and for the assistance given to the ambulance movement. TERAY.-Th e annual supper, presentation of awards and dance was held recently, the attendance proving a record. Mr. Little presided and Mrs . King presented the awards, which consisted of 1 certificate) 4 vouchers, 2 medallions and 18 labels. Mr. Rae, who is retiring after 26 years as Ambulance Secretary, received a Gold Bar. A..vrBERGATE.-Members had an enjoyable evening at a supper presided over by Mr. J. Hitchcock. Dr. Grey distributed 9 certificates, 4 vouchers, 2 medallions and 10 labels and Mr. Allen handed a fountain pen and pencil each to Dr. Grey and Mr. Hitchcock for the services they had rendered. KIRKHAM AND WESTJAM.-The 3rd annual competition was concluctecl by Dr. G. B. Horrocks, 01 Wesham.

Emergency First Aid In stru ctio n. By

CAPT.

A. C \VHITE M.C . ,

London, Mid land and Scottish. VVEYl\fQUTH.-Mr. R. G. Pol e, Div. Supt., presented awards to the Weymouth Quay classes on May 12th. Mr. T. F. E. J akeman, station master, presided, and was supported by the Mayor of Weymouth (Councillor J. T. Goddard), the deputy Mayor (Councillor Bert Biles), Drs. F. H. Rodier Heath and R. V. S. Cooper and local officers of the Company. An interesting item in the proceedings was the presentation of the Royal Humane Society's parchment testimonial to Mr. Philip Beauchamp for the rescue of a man from the dock at vVeymouth in December last.

AID

DEwsBURY.-The annual presentation of awards of the Dewsbury class was held on May 12th, when Mr. W. Ramsbottom, station master and class secretary, presided, supported by Mr. P. Pearson, Goods Agent, and Dr. W. R. J ubb, class lecturer. Mr. J. G. Crabtree, chairman of the West Riding Ambulance Committee, presented the a wards and congratulated the class on winning the "Crowther" Cup at the recent West Riding competition. WEST HARTLEPOOL.-In connection with the newly formed station class, Mrs. VY. Irving, wife of Dr. W. Irving, class lecturer) presented 8 certificates) 1 medallion and 10 labels to successful candidates. The" Laurence Dresser" Cup for the student gaining highest marks in the first year individual test was gained by 1\1r. W. Garthwaite. Mr. K. P. Walker) Middleshro' District Presid ent, congratulated the class members and wished them every success. Mr. T. Atkinson, Class Chairman, who presided, moved a vote of thanks to Mrs. Irving, and remarked that the class members appreciated Dr. Irving's lectures. The function, which included a dinner and concert, was a great Sllccess) thanks to the excellent arrangements made by the committee with Mr. E. Williams as class secretary. ---.~.-

T he new St. J ohn Ambulance H ut at Bra n ksome Chine, BO'l rnemouth, was formerly dedicated on Satu rd ay, May 27th.

FLAG

DAYS.-The attention of the general

p ublic to your needs can be attractively arranged by purchasing copieB of the Poster advertised in this Journal for your Flag Day and other activities. Samples will be sent on request.

M. B . ,

KNOX,

CH.B.

THE quest ion of abridged first aid !'or use in e merge ncy is a fascinating one. There is little doubt that a great proportion of first aid is just com mon sense, and the remainder being fundamentals which must be learnt. I n my opinion there is no difficulty in teaching emergency first aid as used in the national sch eme for protection of, and attention to, the civi l population in four lectures, each of one hour's d u ration and four hours practical work. The first lecture stands as it is in the text book, only less attention should be paid to the defin ition of shock and more to the fact that all cases must have the full shock treatment. The principles are important and should have their full em phasis. The practice of the triangular bandage is obvious. The second lecture stands though it need not be elaborated to the extent that some of the treatments are carried to. I should like to see all fractures of the spine carried face upwards. Fractures of the thoracic and lumbar region being loaded on to a stretcher with two transverse rolled blankets placed in the m iddle. This would appear to give even better hyperextension of the bod ies of the vertebrae than the present method gives, and the lift is much easier. Pupils should be taught where possible to fix the fracture above and below and also the nearby joints. Methods should be elastic in their applicatio n. The third lecture on bleeding I should like tJ see started by the description of the circulation with the course of arteries and veins, and the treatment described from simple ~apillary bleeding as follows ; Elevate the bleeding part, expose the wound, re move foreign body if present, apply direct p ressure, pad and bandage firmly. If the bleeding is arterial immediately apply indirect pressure and proceed as before. I would not be greatly concerned about the correct application of tourniquets. The short tim e for which tourniquets wiIl be applied would make a tiaht bandage round the limb on the heart side perf:ctly efficient. In fact it is frequently used in hospital operations. The bandage round the limb on the side of the wou nd away from the heart in venous hcemorrh aae is good routine. The use of antiseptic is b a lso good routine , but its use at this stage is of doub tful value.

FIRST The importance of internal hcemorrhage should 1)e stressed. The fourth lecture is introduced by a definition of insensibility but no differential diagnosis is entered into. The pupil is simply taught that if the patient is not breathing he must do artificial respiration and remove his patient on a stretcher with the head low if the face is pale and the head high if the face is flushed. Scalds and burns should be elaborated fully and a more concise tannic acid treatment used. The pupil should then practise artificial respiration and meth(i)ds of transport. This article is purely suggestive and the criticism of those who maintain that emergency first aid cannot be cut down from the regular course. In practice, as was well illustrated in the Great \Var, theory proves a very fickle guide. [We appreciate the foregoing contribution by a member of the medical profession who actually started his first aid training by taking an examination under the auspices of the St. Andrew's Am bulance Association at Aberdeen. He emphasises an emergency training is definitely established and the suggestions contained in the article will be helpful to lecturers. Readers may like to praise or criticise the doctor's views, so therefore do not be afraid to forward your opinions. -EDITOR.]

Christmas Cards. ALTHOUGH there is still six months before Christmas is with us, it is not too early to make a note to order the beautifully coloured new card issued by the Order of St. John. It is a real work of art, and one that will be kept long after the festivities. The new card is the reproduction of the Altar piece in St. John's Church, Clerkenwell, London, and comprises a central picture with two doublesided wings. The wings (part of the original Triptych presented by Grand Prior Sir John Weston in 1480) were lost during the dissolution, but were recovered in 1915. The paintings on these wings are Flemish, whilst the central picture is a copy of the original, which is in St. Peter's, Rome. Cost of the card is 1s. each, plus postage j names and addresses can be added at extra charge. Previous cards issued are still obtainable at 6/6 per dozen post free. The sale of these greeting cards are not restricted to members of the Order, but can be purchased by Association members and Brigade members. All orders and enquiries should be forwarded to the Stores Dept., St. John's Gate, London, E.C.l

FIRST

AID

Police Ambulance News. POLICE NATIONAL FIRST AID COMPETITION. Individual tests set in the final were : No. i.-For what different purposes maya triangular bandage be used? Time allowed, 4 minutes, beginning when you receive this card. To keep a dressing in position 2 To support an injured part 2 For tying feet together in fractured thigh, etc. 2 For fixing fractures without splints; pelvis, humerus, ribs, etc. 2 For fixing splints to patient 1 For tying splints together to form a right angle 1 Large arm sling . .. 1 Small arm sling 1 St. John sling 1 When spread out to lay dressings on 2 Emergency dressings for wounds 2 If bandag-e clean and dry 2 For making cold applications 1 For making hot applications ... 1 As a wringer for latter 1 As a means of lifting a patient with fractured spine 2 As a pad for the arrest of h<emorrhage (direct or indirect) 2 2 As a pad in axilla in fractured clavicle As a pad in mouth in epileptic fit 2 As a rin g pad for fractured skull 2 As a ring pad for arrest of hcoemorrhage in scalp 2 As padding for splints 2 For improvising a tourniquet for controlling arterial hcoemorrhage ... 2 As a fan for creating a current of air 2 As ligature for treatment of burst varicose vein 2 As ligature for cutting off circulation in snake bite ... 2 As a mask (if wetted) for nose and mouth when entering a room full of smoke or gas 2 As an improvised rope to drag patient from water or " live" rail 2 As an emergency mask for burns on face... 2 Total

Nos. 2 and 3. - You are walking, on duty, in a narrow country lane on a fine summer afternoon. A man on a bicycle overtakes you, travelling very fast, and disappears round a sharp bend fifty yards away. You hear a crash, and on running to the spot find him lying on the ground under his bicycle. Visibility in each direction twenty yards on account of bend in lane. You know there is a telephone at an A.A. box a quarter of a mile away. The nearest hospital an d ambulance are three miles away, and the nearest doctor four miles away. There is a cottage twenty yards down th e lane. Act. Time allowed, 8 minutes, beginning when you receive this card. NOTE FOR JUDGE.-Patient, motionless, with pale face, lying on face under undamaged cycle, bruise marked on hi s head (crown). Near patient: "Cottage," hurdle in front ; ~ehind sign, woman, bed, fire, bucket marked 'e cold water, " lmen cloths, cup and saucer, teapot, blankets. Approach scene of accident, appreciate poor visibility 2 Place cycle at one bend and helmet at other so that they will warn oncoming traffic 5 Ask if any bystanders or witnesses (no) ... 2 Speak encouragingly, warn patient to lie still, say you are first aiders .. . .. . .. . 3

Exam ination. Does patient respond to speech (no) Is there visible hremorrhage (no) Is breathing present (yes) Is breathing failing (no) Nature of breathing (shallow)... Nature of pulse (quick and weak) Colour of face (pale) Nature of skin (cold and clammy) Ex.amine head, find bruise on vault Examine ears, nose, mouth (no hcoe morrhage, Auid, froth or foreign bodies) Are pupils equal (yes) ... ... Do pupils respond to light and touch (sluggishly) Quickly examine for further injuries (none) Treatment. Gently place patient on back, head to one side Head and shoulders low, feet raised Undo all dothing at neck, chest and waist Inspect cottag-e, appreciate hurdle as stretcher Ask woman for hurdle, and linen cloths soaked in cold water Apply cloths to head Lift man on to hurdle, tran s port to house Ask woman if patient may be brought into house (she says you may put him on the bed) ... . . Transfer to bed, raise feet, adjust cloths, cover warmly darken room ... Finding cycle is undamaged, decide to use it to telephone for doctor and ambulance Competitor to be absent two minutes. On his return : doctor and ambulance will be here in an hour. Carefully watch patient, continue cold applications to head At two minutes to go, Judge says, "There is a change in the condition of the man" Further Examination. Is face becoming flushed (yes) Is pulse becoming full and slow (yes) Is breathing becoming stertorous (yes) Have the pupils bec'Jme unequal (yes)

2 1 1 1 1 1 1 1 3 4 1 1 6 3 3 3 4 4 2 8 2 6 5

1 1 1 1

Treatment. Raise head and shoulders, 10'wer feet Continuously renew cold applications ... At half a minute to go, Judge says" \Vhat have you diagnosed" Concussion passing into compression, suspected fracture of skull General c;martness

Total

100

No. 4. - You are on holiday in the country and are watching the local hunt pass. There is .one straggler far behind, and just before he reaches you hiS horse stumbles and he falls off, landing on his outstretched left hand. The horse then gallops away. You know there is no house within five miles and have no idea of the whereabouts of telephone docto; or ambulance. It is a lovely morning. There ar~ no bystanders. Act. Time aIlowed, 8 minutes, beginning when you receive this card. NOTE FOR JUDGE. Patient (in breeches, spurs, tail coat, stock with pin, top hat, large handkerchief in br~ast pock~t, left coll.ar-bone padded to represent fracture) IYlOg on hiS back wlth outstretched left hand. Examination. Does patient respond to speech (ye~, h~ swears). ... Encouraging words, wa~n hi~ ~o he std.l, .tell 111m you are a first aider (patient lOSISts on Slttll1g up) 2

AID Where is there pain (left shoulder) Is bre morrh age present (no) ... otc attitude assumed by patient-head inclined to injured side, right hand supporting left elbow Is there pain, loss of power, deformity (yes) SweIling (no) ; irregularity (yes) (Patient says he heard bone snap) Find ends of left collar-bone over-riding Diagnose fractured left co llar-bone Treatment. Try to remove coat (patient refuses to have coat taken off) Gently unfasten stock and shirt Unfasten braces left side Use handkerchief as pad for armpit Use tail of coat as St. John sling Use pin to fix sling Use stock as broad bandage ... Passed round elbow and trunk to lever out and draw back shoulder ... Ascertain if pulse is present Tighten sling ... ... ... (Patient says he is goin~ on and gels to his feet) Offer to go with him (he refuses) vVarn him he has a fractured collar-bone ... Tactful handling of difficult patient and general efficiency Total

2 2 2 3

2 1

2 1 2 3 2

3 3

1 1 4

1 6

No. S.-You are walking on a quiet country by-road, just after a thunderstorm has passed elVer, and meet a boy runnin g towards you. He pants, "Please will you go to our cottage just up the ro ad . Father has been struck by lightning. I'm going- for a doctor." He rushes o~. Ac~. Time allowed, 8 minutes, beginning when you reCClve thl'i card. NOTE FOR JUDGE. Small light man lyin g on back outside sign" Cottage." Pump and bucket beside him. Coat marked "\Vet." Woman bending over him, wringing her hands. Smell of burnicg-. Inside cottage: bed, basin, cup and saucer, teapot, hot water bottles, blankets, lin en, cotton wool, bandages. Hasten to cottage, encouraging words to wife Ask her to stand by ; tell her you are a first aider ; ~sk what happened (she says her husband was draWIng water from the pump and v:as struck by lightning) Is breathing present (no) Ensure clear air passag-es ... At once perform artificial respiratiom Stoop at side; place patient's arms close to bo~y Cross far leg over near leg; prolect face With one hand ... ... With other grasp clothing at hip of opposite side; pull smartly over ... ... . .. Kneel at side facing head, sitting on heels Hands on sm'all of back, lower edges just clearing top of pelvis, \vrist nearly touching, thumbs as near as possible without strain ... Fingers together, pointing towards gr.o~nd Bend from knees, arms straight and ngld No exertion-two seconds ... ... . .:. Swing body slowly backwards, keeping hands 10 POSItion, three seconds Repeat rhythmically tv.'elve times a min~te (~fter o.ne minute judge says, "Natural breath 109 1S begmning") ... ... Regulate movements to correspond . Direct wife to fetch blankets to cover hun And to rub limbs towards heart, avoiding any hurnt parts

1 1 1 1 2

1 1 2

1 1 1

1 1

FIRST

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Ask how long before doctor can arrive (not readily available) Does patient respond to speech (yes, feebly) Ask if any pain (left leg and right hand) ... Gently turn on to back, carefully watching breathing Examine left leg and right hand, find slight burn of front of left leg belo.v knee, and back of hand ... Any blisters (no) ; clothing adherent (no) Cover burns temporarily with cotton wool Ask wife if any bedroom on ground floor (patient's own room five yards away) Instruct wife to prepare bed and put in hot water bottles Quickly exclude further injuries Remove to shelter by cradle ... Passing one arm well round beneath two I{nees Other well round back, avoiding burns Place on bed Remove wet clothing Cover warmly, watch breathing Ask wife for bicarbonate of soda (none) Warm strong tea (yes, teapot full) Cut up linen to form strips; soak in tea Apply to hand and leg; allow to dry Cover with cotton wool; bandage lightly Give strong tea copiously with plenty of sugar Is general condition improved (yes) General efficiency.. .

1 2 2 1 1 1 2 1 1 1 1 1 1 1 1 3

Total

CITY

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AID staff (Commanders Emery and Craft), members of the regular police, and others who had rendered assistance. Sir Charles McRea presented his cup to the winner, and also the" Sir William Smith" cup j and offered to provide a further trophy for annual competition between teams of the Regular Police and Special Constabulary. Capt. Davison apologised for the abstnce of the Cummissioner who would, he was sure, be pleased to accept Sir Charles McRea's new trophy. Commandant Foxen, on behalf of the Special Constabulary thanked Sir Charles for his offer.

On May 24th" A" Division held its first Inter-Group competition for the trophy presented hy Asst. Div. Commander W. G. C. Lovell. One team from each of the three groups competed and, after an interesting test, Group 1 were declared the winners. The team was composed of Sergt. Churchill (captain), Commander G. Miller and S. C. 's Brunger, Fibbens and Coppock. Group 3 (captain, A/ Sergt. Hattam) was second, and Group 2 (captain, A/ Sergt. Potter) third. Capt. White Knox, who judged the team test, congratulated the captains on their good leadership. Assistant Div. Commander Lovell presented his cup to the winning team and also spoons (the gift of Divisional Commander Hayton) for the individual members. He congratulated all meml:..ers on their good work and thanked them for the time they gave to first aid. He also thanked Capt. White Knox and his staff for arranging the competition.

CONSTABULARY.

The annual competition for the individual championship was held on May 10th, the judges being Capt. A. C. White Knox (viva voce) and Dr. W. D. Jenkins (practical). The result was 1st, A/ Sergt. ]. Quick (L1oyds Company, " C" Division), 60 marks; 2nd, A/Sergt. J. G. Barker (" A " Division), 52t; 3rd, Commander G. Miller, 51. The viva voce marks gained in the above were also for the inter-divisional competition, the team test of which was held on May 17th. The teams are given a card on which all injuries are given and at the word" Go " the mem bers set-to and do the job efficiently and neatly in the guickest possible time. Pena!t;es for wrong treatment, bad handling, etc., are added to the time taken. At the conclusion of the tests Capt. White Knox (Chief M. 0.) announced that "C" Division, represented by A/Sergt. Quick (leader), Sergt. Banks S. C. 's Bailey and Minchin, were the winners for the second time in succession. Commandant G. T. Foxen presided at the subsequent supper, supported by Capt. Davison (Asst. Commissioner) Alderman Sir Charles McRea, Mr. D. G. Monteith (Com~ pe.tit~on Secretary! ~.J.A.A.), Capt. W. Goodley (Comml.sslOner No.1 Dlstnct, S.J.A. B.), Chief Inspector Hayes (CIty), Asst. Commandant Penman, Chief Staff Officer Major Chalk, and other officers of the Force. The 00mmandant paid tribute to the work done by Capt. White Knox j and congratulated the winning team on its performance. Capt. White Knox referred to the year's work. Sixtveight passes were obtained in the Autumn Course and 83 in the Spring Course, a total of 151, which figure was nearly SO per cent. more than the previous year. He thanked the members for their support but emphasised the importance of obtaining new members to take up the work. He cong:atulated " C" Division and also A/Serg t. Quick on winnmg the trophies j also "A" Division for entering three teams. He asked for greater support from other divisions. In conclusion, he thanked Headquarters, members of his

METROPOLITAN

SPECIAL

COl STABULARY.

To celebrate the success gained at the recent Metropolitan Special Constabulary first aid competition, "1\1" Division held a grand concert at Gilmour House, Kennington-lane, on June 5th. Commandant C. F. Matthews engaged the" Splinters" Concert Party and a very enjoyable evening was spent. During the interval Commandant Matthews said that the winning of the cup had been brought about by hard work over a number of years. About five years ago Commandant Brown took an interest in the team and he was followed by Dr. Scott. Both gentlemen were deserving of sincerest thanks for their assistance. Then, through Supt. Briggs, P.C. Covey, a member of the" M" Divisional team, became trainer and the result was the gaining of the first place. On behalf of the members of the team he asked Mr. Covey to accept a silver cigarette case as a token of their appreciation for his assistance. Mr. Covey, in acknowledging the gift, said that the winning of the cup had been through team work and comradeship. He thoroughly enjoyed assisting them and congratulated the members on their excellent work. He had witnessed them at the competition and he hoped to see them competing in open competitions with equal success. Supt. Briggs, in a few words, said it was a pleasure to welcome the winning team and he hoped they would be successful on future occasions. Commandant Ernest Brown, Director of A. R. P. and First Aid, said that since the inception of the competition two teams, " P" and" S," had shared the honours. "M" had at last broken the continuity. It was not a good thing for one team to hold the cup too many years. The standard of work had been very hig:h and he congratulated Commandant Matthews on the success of his Division. Commandant Matthews thanked the speakers for their presence and also welcomed other officers and friends, including Mr. T. G. Gibbings, M.B.E., J.P.

AID

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Our Nurses' Pages. COMPILED BY AN AMBULANCE SISTER.

No.1 DISTRICT, S.J,A.B. It was with sincere regret that No. 1 District learned that Robinia, Viscountess l\10untgarret, O. B. E., had tendered her resignation as Lady District Officer, Western _~rea, as from June 26th. Lady Mountgarret came to the District in January 1928, a nd was appointed to Western Area in June 1933. She has a lways entered wholeheartedly into any work she has undertaken, and her untiring efforts and kindly help so freely given have been very much appreciated by officers and members a like. Lady Mountgarret is retiring to her home in South Stainley, near Harrogate, and will take with her the very hest wishes of all ranks in No.1 District.

Bowl, given by Dr. 'vV. Peach Hay, was won on Sunday, May 14th, by the .'Ilellows Nursing Division. The competitIOn is open to teams of ladies who have not completed more than two years first aid \\'ork, but this year the rules were waived. It is hoped that in future entries will be forthcoming- from non-uniformed first aiders. Eight teams competed, the judges being D;-. H. Hobson (team test) and Dr. A. Phillips (oral).

WESTERN AREA.-The Assistant COITlmissioner, accompanied by Lady District Officer Lady Mountgarret and Lady Supt. Mrs. McKenna, inspected No. 64 (Ealing) Nursing Division on Tuesday, l\lay 9th. The main inspection took place in the grounds of the \Varwick-road Institute, where the Division was drawn up in three detachments under Lady Div. Supt. l\liss Baxter. The space available enabled the Division to give a disFlay of marching, and after re-assembling in the Hall demonstrations of bandaging and bedmaking were Riven. The nursing cadets were also present under Lady Cadet Supt. Miss 'Wilder, and their bandaging reflects great credit. They are also to be congratulated on securing their objective of 100 active members. No.2 DISTRICT, S.J,A.B. SOUTHAMPTON CORPs.-Major A. Tennyson Smith, M.D., C.M., County Commissioner, carried out the Annual Inspection in shed 103 of the new docks. Southampton, Woolston, and Calmore Nursing Divisions were well represented, as well as Nursing Cadets from these three Divisions. The Inspecting Officer was accompanied by Lady County Officers Miss Hayes and Mrs. Heseltine, the Mayor and Mayoress (Cr. and Mrs. A. H. Powdrill), the Sheriff (Cr. R. N. Sinclair) and Mrs. Sinclair, Alderman H. Chick (Deputy Mayor), The Dowager Lady Swaythling (Lady President of the Nursing Divisions), 1\1r. R. P. Biddle, J. P. (Docks and Marine Manager) and Mrs. Biddle. Following the inspection, there was an impressive march past, and subsequently many kinds of injuries were treated by the mem bers. The Mayor congratulated the Divisions on their parade, and Major Tennyson Smith thanked His Worship for the inspiration of his visit. Corps Supt. Thomas voiced the thanks of those present to Mr. Biddle for the use of the shed for the parade, and to the Docks and Marine Band which played under the conductorship of Mr. S. G. Wilson. No.3 (EASTERN) DISTRICT, S.].A. B. COMPETITION AT PETERBOROUGII.-A handsome Rose

The late Lady Supt. Mrs. Kitty Morgan of Penrhiwceiber Nursing Division. The results were ;1, 1\l('lIows N. Division, 71t marks; 2, Itter N Division, 68t; 3, Warrington N Division, 59. The l\layor, Mrs. L. V. Bryant, presented the Bowl and miniatures to the winners, and cut glass vases to the runners-up. She thanked the members of the Brigade f?r their help in A. R. P. work and other emergency measures 111 the City.

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FIRST

A:vote ~of thanks to the layor, Dr. Peach Hay, the judges, and alJ who helped at the competition was proposed bY,Mrs. A. E. Holmes.

No. 3 (WESTERN) DISTRICT, S.].A. B. BJR:llINGHA~[ NURSING CORPs.-Teams from this Corps took part in the annual competition for the" Lady Ford" Rose Bowl on Saturday, June 3rd. Owing to the many other calls on their time at present, particularly in connection with A. R. P., only three teams were able to take part. The trophy was gained by Bourneville Nursing Division with 1454 marks. Small Heath was placed second with 134, and \Vinchester House third with 118. Dr. C. St. Johnston, Corps Surgeon, acted as judge for the team test, and Div. Surgeon Dr. V. Parkes fo r the dual practical first aid. Miss E. 1\1. Locker and Mrs. F. J. 1\1. Frew awarded marks for uniforms. At the conclusion of the competition, Lady Ford presented the Rose Bowl to the winners. Colonel Sir Bertram Ford, County Commissioner, thanked Dr. St. Johnston and Dr. Parkes for the care with which they had worked out the tests, which were so framed to teach a great deal. He was very disappointed that so few teams had been able to enter, as he believed that there was no better way of learning- than through reasonable competitions. These tests helped to engender all exceedingly good spirit and encouraged healthy emulation.

. 0.4 DISTRICT, S.J.A.B. \VEST CUMBERLAND V.A. D. '5.-The annual parade of the St. John V.A. D.'s in ,Vest Cumberland was held on Sunday, May 21st, at Maryport. Led by the Dearham Subscription Band augmented by members of the Maryport bands, nurses and cadets from Cleator, Crossthwaite, Whitehaven, Maryport, Flimbyand Frizington took part in the parade. They were under the command of Lieut.-Col. J. Lamberton, the new Commissioner, who was attending his first public function in West Cumberland. All the detachments attended the service at St. Mary's Church, by kind permission of the Rev. E. G. H. Hymas, Vicar of Maryport. The Commissioner read the lesson during the service.

No. 8 DISTRICT, S.].A. B. CHICHESTER NURSING DIVISION.-The two efforts organised by this newly formed Division for the raising of funds have proved very successful, thanks to the helpful cooperation of its many friends. The jumble sale held on Saturday, April 22nd, realised .£25 12s. and from a whist drive held on Thursday, May 8th, a further sum of .£21 was added to the funds. For the successful result the members of the Division wish to express their gratitude to the donors of the prizes, the Boy Scouts, the Chichester Gas Co., Mr. Heaver of Chichester Dairies for milk and butter, and all others who contributed to the success of either of the two functions.

NORTHERN IRELAND DISTRICT, S.J.A.B NORTH BELFAST DIVISION.-The annual social reunion and distribution of awards was held last month. The chairman was Dr. E. ]. A. Dougan, and he was supported by Me A. Mann, Assistant Commissioner, Capt. Morledge, and Mrs. Dougan, Lady Div. President. During an int~rval in a long and varied musical programme, presentatlOns were made to Dr. Dougan by Mr. Mann on behalf of the Nursing Division, and to Mr. Ben

AID White, of Belfast Central Fire Station, who acted as instructor to the Divisional team which gained second prize in the novice women's section at the recent competitions ; also to Miss J. Standfield who helped with the training of the team. Certificates and medallions were also presented by l\1rs. Dougan to those members of the Division who bad passed their first aid and home nursing examinations during th e year. At the conclusion of the propramme, bearty votes of thanks were accorded to the artistes.

V.A.D. INSPECTION AT BARNSTA PLE. The annual War Office inspection of Devon 42, B. R.C. S., took place at the detachment's headquarters. The Inspecting Officers were General W. F. S. Edwards, County Director, and Col. Archer for the 'vVar Office. The Detachment was drawn up under the command of Commandant l'drs. O. McWbinnie. Mrs. Paul, A.C. D. , was present, accompanied by Mrs. J. R. Chanter, who i<; takilJg over the post of A. C. D. on 1\[rs. Paul's retirement. The Inspecting Officers expressed themseh'es as \'ery pl eased with the smartness and efficiency of the detachmen t.

ILFRACOMBE V.A.D ., B.R.C.S. The interior of the Drill Hall at llfracom be resem bled a casualty dressing station when members ot Devon 64, und er their Commandant, Miss Dean, were inspected by Colon el Archer, on behalf of the War Office, and General Edward s County Director. The three sections of the detachment were g-iven test s, both practical and oral, at the co nclusion of "'hich Colonel Archer complimented them on their efficiency.

INS PECTION AT SIDCUP. The Annual War Office I nspection of the Sidcup Detachment of the B. R. C. S. was held at the Manor Hall on Monday, fay 15th. The J nspecting Officer, Colonel Carr, M. C. , R. A.1\L C., accompanied by Miss Batten, O. B. E., and Miss Payne (Assistant County Controllers), witnessed a practical demonstration, during which three casualties were admitted to a first aid post and were then taken to hospital where treatment was continued. In addition, a case of acute rheumatism was treated at the hospital. At the conclusion of the inspection, Col. Carr addressed the officers and members of the detachment, and congratulated them upon their streng-h in numbers and upon their high standard of efficiency. He expressed his entire satisfaction with the way in which the practical demonstrations had been carried out.

BISHOP'S WALTH A,'V I, V.A.D. The Annual War Office Inspection was held at the Market Hall, Botley, on Tuesday, May 16th. The detachment lined up under the Commandant, Mrs. H. C. Dolphin, for the inspection by Lt.-Col. Ballinghall , who was accompanied by Surgeon Rear Admiral W. W. Keir, County Controller, B. R. C. S., and Me Moray Williams, County Director. Among the spectators was Major C F . Randolph. Subsequently, Surgeon Ri!ar Admiral Keir presented badges and other awards gained by the members. WAR OFFICE INSPECTION OF V.A.D. HANTS 180. Air Raid Precautions were included for the first time in

FIRST the vVar Office Inspection of King-'s Somborne detachment hel d on \Vednesday, lay 24th. First aid and home nursing were also demonstrated to the inspecting offices, Col. A. J. i\lacN ab, C. B., C.1\L G., Assistant County Controller, and :'lr. A. Moray Williams, O. B. E., County Director. Both officers congratulated the nurses on their excellent performa nce. Col. l\IacN ab said it was the fourth occasion he had vis ited the detachment and as usual he found their work very creditable. He would have liked it better, however, if the display had not been rehearsed beforehand. He was very g lad to hear that they had doubled their number of mobile me mbers. 1\lr. 'Williams said that he was always struck by the way in which t he inhabitants came to support their local detachll1en ~ t its inspection. He hoped that some members of the a udience would become recruits of the detachment before the next inspection. Speaking of changes made in the policy of V.A. Os., Mr. \Vill iams remarked that it would not make very much difference to their work, and they would be able to remain in the same detachment in war time. Those who had not taken the mobile obligation would probably serve in the ho me defen ce under the Civil Nursing Reserve Scheme. The latter was being divided into mobile and immobile detachments on the same lines as the military units. l\leJ1lbtlrs of this branch would probably be formed into a group to be drafted to places in the district where they were most urgently required. . 1\1r. 'Willi ams also added congratulatory remarks to the detach ment . Certificates ""ere then presented by Col. 1\lacKab to members who had gained them. BOSTON V.A.D Need for more mobile units of V.A.D. of the British Red Cross Society was emphasised by Lieut-Col. Dudding of L incoln who inspected the det achment on !\lay 25th on be half of the War Office. It is very necessary, he said, that tbe authorities should k now that they have a c~rtain number of mobile members to draw upon from the detachments in the County, so that they can be ear-marked beforehand and sent off at short notice. If members have to be selected and chosen at the last moment, there is going to be chaos. Col. Dudding inspected about 60 members ot the detac hment who paraded under the command of the Com mandant.

Voluntary Aid Detachments. THE V.A.D. Council has requested that (1) Encouraaement should be given to enrol Mobile membbers of all categories and endeavour to induce I mmobile members of the correct age to undertake Mobile obliaation. (2) To release all Immobile Nursina Me~nbers from their V.A.D. obligations, b except specialists. (3) Further enrolment of Immobile members should cease. Those members of the Immobile section who do not wish to undertake the obligations of l\Iobile mem bers will be free to join other National Service schemes. Mobile members are req~ire? to sign an undertaking to report for service In a National Emergenency when called upo~ to do so under the authority of the Army CouncIl.

AID

Ambulance News Cuttings from the Press. Tbe Editor invites Readers to send newspaper cuttings on matter of general interest for inclusion in this column.

FELL 90 FEET- UNHURT. A neighbour's dog he was taking for a walk on a lead gave chase to a rat, and pulled a ten-year old boy, of Old-road \Vest, Gravesend, over the edge of a chalk pit 90 ft. deep yesterday. Workmen called an ambulance and hurried to the bottom of the pit. They found the boy and the dog unllurt.Sunday Pictorial.

FELL 1 FOOT-DIED. A little iive-year old girl, who fell only one foot to the ground from a chute in a Cambrid~e children's playground, dislocated her neck and ,,,as killed. The coroner, at the Cambridg~ inquest yesterday, recording a verdict of accidental death, said that there was no blame attached to the Com mittee of the Corporation who maintained the playground. .\ doctor said that the girl must have fallen on the back of her head, which, in conjunction with an injury some 18 months old, caused death. -Daily Sketc/t.

CHOKED BY \VASP STING. .-\. sting from a wasp which he swallO\yed caused a man, aged 38, of Raunds, Northamptonshire, to be. choked to death. His windpipe swelled acutely after the stmg. His wife stated at the inquest that they and their three sons were in Skegness on holiday. Her husband returned from a walk feeling thirsty and drank lemon squash from a bottle. Suddenly he said: "I think I have wallo~"ed a pip." He was sick -and threw up a wasp. A~most Immediately he was unable to speak, collapsed and ~Ied . . Death from misadventure was the verdlct.-E'vellmg ~\ re2(,s.

A R O\'lNG CORPSE. !\lotor-cycle and push-cycle had collided and their ride rs lay on either side of the London road near Portsmouth. A police sergeant called to the scene was told that ~he cyclist was dead. So he de\'oted himself to the m.ot.or-c)'chst, who had a broken skull. \Vhen he had got the IOjured man a\.vay by ambulance, he t urned to deal with the corps.e . ,( But I could find no trace of him," he said, tellIng the story at H a\'a nt Police Court yesterday. He added t~at later he traced the' ( dead" man LO his home and found hlln in a dazed condition. The alleged corpse was told by the chairman of the Bench that it should be a lesson to hun: . ' . The cyclist had pleaded guilty to ndtng a ~IC'yc1e negltgently, causing hurt and damage, and to n~lng on the wronG' side of the road. He was fined £, 1 on each

sumr:;ons.-Dai~l' E.\press~

We are prepared to supply Ambulance Secretaries and others with specimen copies of this Journal for distribution among their members. Apply to the publishers, FIRST AID, 46, Cannon St .. London E.C.

FIRST

A.R.P. Topics.

FIR S T

AID

The Board of Ed ucation has issued a circular, No. 1469 (2td. post free), regarding the educatio n of evacuated school children.

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TRAILER AMBULANCES.

At a recent meeting of the National Service Committee of the Retail Motor Ind ustry it was suagested that trains of light trailer ambulances b . . towed by private cars to remove wounded In tImes of emergency wo uld overcome the shortage of suitable vehicles wh ich could be used as emergency am bulances. It is further suggested that the trailer ambulances should be of pressed steel, each accommodating two stretcher cases and costing about

£25. Six months ago, in our January issue, we gave particulars of such a vehicle and expressed the opinion that, in addition to overcoming the shortage of suitable vehicles for removal of stretcher cases, such trailers would always be available for training purposes. Further, the trailers we inspected, manufactured by the Invicta Motor Engineering \i\T orks, Ltd., of Canterbury, would prove an asset to any unit undertak ing road-side duty where, owing to fu nds, it was not possible to have an ambulance on duty. Therefore we recom mend such trailer am bulances, not only from an A. R. P. point of view, but also for general first aid work.

GOVERNMENT PUBLICATIONS.

For those who wish to keep their files up to date here is a further list of recent pamphlets issued by H. M. Stationery Office. Circular 1800, "Government Evacuation Scheme" (1 t d. post free), sets out ~he ge~eral scope a nd objects of the scheme, and In conJunction with this Memo. Ev. 4 (3td. post free) should be studied. A.R.P. Memorandum No. 10, "Provision of Air Raid Shelters in Basements" (Sd. post free), gives the scope, standards of accommodation and protection, recommendations for strengthening floors over shel ters, and provision of shel ters in basements. Numerous illustrations are included. "Directions for the Erection of Domestic Surface Shelters" (2td. post free) includes the necessary details of erection of shelters in brick, mass concrete or concrete block masonry. Circular No. t 10/ 1939 (2 ~ d. post free) deals with "Provision of Air Raid Shelter," wh ilst another new booklet deals with war-time lighting restrictions (" \i\Tar-time Lighting Restrictions for Industrial and Commercial Premises," 2t d. post free).

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QUESTIONS AND ANSVlE RS.

Here is a further batch of answers given by Dr. W. C. Bentall to students at Brigade classes. Q. Does not mustard gas penetrate through a blanket or paper? A. Only after a long time and in high concentration.

Q. If a group of people are infected by carbon monox ide, perhaps through the release of a high explosive, and the danger is real ised , what protection can be afforded until they get fresh air? A.

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At the thirtieth annual ambulance competition of the Birmingham City Police, held on May 17th, "B" Division, with 235 '78 marks, won the com petition for the fi rst tim e since 1927, and were awarded the "Rowland Mason" challenge cup. The" Tailby" cup (individual) was won hy P.C. Loxham, "D" Division, whilst the "Nelson " Memorial cup, for the division with best ambulance record for the year, went to " R" Division.

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FIRST

Collapse on Hot Days. \VHENEVER hot days follow in succession it is usual to read in newspapers a list of people who have died as the result of the heat and of others who have been prostrated. Heat prostration or heat exhaustion is a coll~pse due to the effect of high temperatures on the body, and IS most apt to occuc when one has undertaken heavy or unusual physical exercise. It is milder in form and less serious in its after-effect than sunstroke, which is usually caused by prolonged exposure to the rays of the sun. I n cases of heat exhaustion the tem perature of the body rarely rises above 103 degrees Fahr., and may be below normal. The skin is cool and covered with a clammy perspiration. Sunstroke, on the other hand, is mark~d by a very high temperature, flushed face, hot and dry sk1l1, and unconsciousness may be immediate. In heat prostration remove patient to a cool place, placed Aat on back with head low and a light covering placed over the patient, and administer mild stimulants. In cases of sunstroke, however, an effort should be made to lower the temperature by applying ice packs to head and sponging cold water on the body. Medical assistance should be sent for immediately. On recovery to consciousness drinks of cold water should be given freely.

FIRST

-------

AID

National Road Passenger Tr a nsport Ambu lance Association. THE Northern Area eliminating contest for the " Stirk " Trophy was held on May 14th at Derby. Nine teams competed, the first three--Stockport Corporation Transport Dept. (193~), Manchester Corporation Transport Dept. (186t) and Preston Corporation Transport Dept. (171l)-going forward to the final. The South Midland Area will be represented by Birmingham and Midland Motor Omnibus Co. Ltd. and Cardiff Corporation Transport Dept., having gained first and second place respectively at the competition held at Birmingham on May 21st. As already announced, the Midland Area will be represented by \Valsall Corporation Transport Dept. and Trent Motor Traction Co. Ltd. The fi nal will be held at Walsall on Sunday, July 2nd.

Sewer Gas Poisoning. MANY gases are evolved in sewers owing to decomposing matter, but the most dangerous is sulphuretted hydro~en which is heavier than air and may lie in strong concentratIOn in cesspools or wherever putrefaction of organic matter occurs. In strong concentration it is a very deadly gas, colourless, with a somewhat sickly, sweet taste and an extremely offensi ve odour similar to rotten eggs. A weak dose will cause alarrr:ing attacks of headache, dizziness and fainting; stronger doses cause great irritation of nose, throat and lungs, severe cough and shortness of breath. In strong concentration the action is very rapid. - After a few breaths there is a violent onset of coughing and breathlessness, the patient will stagger about hlindly, lose control of the muscles, fall down violently convulsed, and become unconscious. In mild cases the symptoms may be delayed. First aid treatment is immediate removal into fresh air, artificial respira tion, warmth, and all tight clothing undone. The inhalation of ammonia (smelling salts or sal volatile) gives relief to the nose and throat irritation but care must be taken not to give the vapour too strongly. The mouth, which is usually dry and foul, should be washed out frequently with tepid water. Thirst is often very great but large drinks must not be given. Sips of warm water or tea will give relief to this condition.

------.--.------The Chichester Corporation are to subscribe £50 to the funds of the Chichester Division,S.]. A. B., and to consider the Division's need for garage space when erecting the new fire station in Market-avenue. Sir Arthur EboralJ, of Frinton, volunteered as an ambulance driver but found there was no ambulance to drive. He has, therefore, decided to present one to the Frinton and Walton Division of the S.J .A. B.

Practical Points. The Editor invites Notes on actual Cases-with special reference to good and bad points in Treatment-for inclusion in this Column.

POLICE CONSTABLE SA\'ES MAN. A short time ago a police constable was called at 11 p.l11. to a house where he found a man suffering from the effects of Iodine poisoning. There being no starch available, he decided to use whiting- and water as an antidote, but was puzzled to know where he could find whiting at that time of night. Looking round he noticed that painters had been at work in the house and had been using whiting for a ceiling. So he quickly prepared his antidote and administered it to his patient, \\'ho was fully conscious and able to swallow, and who quickly recovered.-P:C., Bermondsey.

In a private car dependability is desirable-in an ambulance it is the first the vital essential. In choosing an ambulance you cannot affo;d to run the risk of even minor mechanical troubles which may cause dangerous delay. In the circumstances your choice is obvious

DOG SA\'ES Boy. Recently a small boy, aged 8, carelessly ran into the roadway just as a car was turning a corner on the Littlehampton to vVorthing road. At the crucial moment a dog, a black mongrel, which was apparently a stranger to the boy, caught hold of his clothes and dragged him to the side of the road. Thanks to his prompt action, the motorist was able to swerve his car and to avoid running over boy and dog. The latter, his good deed well done, trotted off seemingly unconscious of having done anything extraordinary! !-A. T., Littlehampton.

Wath Main Colliery won the" Godfrey Brooks" shield at the competition held on June 3rd. The individual winners were: 1, E. Hessom, Wath Main; 2, S. Green, Wath Main; 3, J. Potts, Pope and Pearsons ; 4, E. Purcell, Wath Main; Special, E. G. Benton, Dinningtun . Eighteen teams com peted.

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FIRST

3.-A11 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 39th (1937) Edition of the S.].A.A. Manual of First Aid to the Injured. PATIENT'S HANDS IN ARTIFICIAL RESPIRATION. W. B. (Harpenden). - Will you please inform me whether the patient's hands should be extended as far as possible above his head or just above his head with the upper limbs bent at the elbow as shown in Figs. 75, 76 and 77 of Textbook? We know that the photographs of the illustrations were taken under the personal supervision of Mr. A. C. P. Handover, of the Royal Life Saving Society. Consequently we know that the position of the patient's hands are strictly correct and so provides another point of difference from the 1903 Schafer method in which the hands were fully extended above patient's head.-N. CORBET FLETCHER.

FIRST

AID ARTERIAL BLEEDING WITH FRACTURED PELVIS. T. S. (Poplar).-At practice the other night I was asked how to deal with profuse bleeding from a fractured pelvis. On enquiry, I was informed that the crest of the ilium was the situation. I immediately answered that I would apply pad and bandage; but as I was told that the bleeding was arterial, I confessed ignoran ce and surprise. I would appreciate your ruling on the following questIons : (1) Would it be possible to have arterial hcemorrhage from that region, and would pad and bandage provide sufficient control? (2) As arterial bleeding would come from the iliac artery, would it be permissible to pu t pressure with the fist in the abdomen? (3) 'Would that treatment come within the provin ce of first aid? Somebody seems to have let his imagination run rio t The iliac arteries start at the middle of the body of the four th lumbar vertebra, and are roughly two inches in length. Further, as the Textbook definitely states, the blood vessels which may be injured with fractured pelvis are within the pelvis. So how pressure on the crest of the ilium cou ld possibly control bleeding- from the arteries or their main branches, I do not know! I fear that from such a com bination of inj uries, first aiders can do little except treat as laid down in the Textbook for Hcemorrhage from an Internal Organ (page 136). As for a possible pressure point for the iliac artery, my memory recalls an old manual of surgery which figured a patient lying on his back and a surgeon standing on a stool on the left of his patient and pressing his right clenched fist into the patient's abdomen at the level of the fourth lumbar vertebra. Memory also tells me that the surgeon was lean ing against the table with his right leg crossed over his left -presumably to increase the pressure.-N. C. F.

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COMPOUND COMPLICATED FRACTURE. N.K. (Brisbane, Australia).-In the setting of a team case for competition, is it permissible to use the term " compound complicated fracture," when wishing to describe a supposed injury say, to the 7th rib, which has received a blow from a sharp instrument. causing a wound, fracturing the rib, and forcing one end of the bone into the lung? Some contend that the term "complicated" would cover the issue; but I disagree, as I contend that the term complicated is not comprehensive enough to indicate the external wound. The mere term "complicated fracture of the 7th rib" would be probably regarded as a fracture in Vv hich the broken end penetrates say, the lung, without any indication of "a wound leading down to the seat of fracture." Your Answers to Queries are a boon to us students in clearing up contentious points. ' It is not only" permissible" but strictly correct to call the fracture described by you a "compound complicated fractu reo "-N . C. F.

FRACTURES OF BOTH COLLARBONES. K. H. (Lee).-I am so sorry to trouble you with my query, but a difficulty has arisen, which I feel that only you can settle. What are the correct bandages for fractures of both collarbones? At a certain class, my friends were shown to put a pad under each arm. They then secured the end of a bandage to each arm just above the elbow. Drawing the arms back to the correct position, the bandages were crossed at the back. The forearms were kept a t right angles and these two bandages were brought over the hands and forearms and secured in front. Another bandage was taken round to give further support. Now, I can see that it is an excellent way of dealing with such an accident; but what I want to kno w "is the St. John method as directed by our Textbook? " I shall be S0 glad to receive definite instructions from you that will settle this dispute. Thanking you so much for your trouble. The 39th Edition of the Textbook is silent concerning the treatment of fractures of both collarbones; and consequently there is no St. John method to-day. To the best of my knowledge, this combination of injuries was last described in the 20th Edition j and as the treatment there given differs somewhat from that demonstrated to your friends, I reproduce here the instructions, as follows :" When both collarbones are broken, keep the shoulders back by narrow bandages tied round each arm, close to th e shoulder, passed across the back, over the opposite arm and tied together in front. The forearms should be raised and supported by the bandages. "-N.C. F.

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33 0

FIRST

TREATMENT OF FRACTURED SPINE. F.N. (Manchester). - Will you please give your ruling on the following two points : (1) In the case of a fractured spine, the patient being unconscious and the exact position of the fracture being clearly defined as in the thoracic region, is the patient to be transported in the prone position or the supine position? (2) Is it to be understood please that when the patient is unconscious that he should be transported in face-upwards position irrespec tive of which region of the spine is injured? (1) If the fracture is definitely known to be in the thoracic region, then the Textbook requires such patient to be removed in the face-downward position, in accordance with its instructions in Rule A on p. 73 and Rule B (ii) on p. 74. (2) Rule A reads "if patient is unconscious or if (my italics) the situation of the injury is not clearly defined_" Consequently all unconscious patients suffering from fractured spine must be removed face-upwards , unlt::ss by some miraculous chance (as in your first query) the exact site of lesion is known. - N.C. F.

HEART DISEASE OR NERVOUS SHOCK. F.A. (Stoke).-A case came to my notice of a lady who was said to have fainted in a concert. Afterwards I was told by a bystander that she" went stiff" and then fell forward. I said this was probably heart and was told by a relative that it was very probable it was heart. On the other hand her small daughter, for the first time, was presenting flowers to one of the personages present, and the lady was very excited as to whether the child would make a mistake. Please be good enough to tell me whether this was crise-de-ne1'fS or heart attack and if treatment to stimulate the heart would be the correct line to take? It is quite impossible to make a positive diagnosis on hearsay evidence. Usually, however, the patient who faints as the result of heart disease" crumples up," whereas the patient who sustains some nervous shock" goes stiff." So there I leave your problem !-N.C.F.

ARTIFICIAL RESPIRATION WITH FRACTURED RIBS. N. K. (Brisbane, Australia).-A man effecting repairs to the rigging of his launch, slips and falls into the water. After being submerged for a few minutes he is removed ~rom the water. An examination shows that breathing 1S not present; that a compound fracture of the right leg is evident and that the ribs on the left side are badly jraclU1ed. The point raised is : What method of art if}cial respiration should be performed? Would Schafer's be too severe in view of the fractured ribs? Or should Silvester'~ be used, which may produce satisfactory :esults wlth less chance of causing further injury to the 1I1ternal organs on account of the fractured ribS. Your kind ruling is eagerly awaited. . ~f course you realise that the diagnosis of fractured nbs 111 an asphyxiated person is a most difficult proposition an~ that they are. often missed in ,an emergency! Be that as It may, I conslder that Schafer s Method is the correct meth~d of artificial re~piration in the treatment of a person ~uffenng from asphyXia and fractured ribs, because pressure 1S exerted on the loins and not on the ribs. On the other hand, Silvest.er's ~ethod, properly applied, results in a big pull on th~ nbs, W1t? the consequent risk of simple being converted mto complIcated fractures of the ribs.-N.C.F.

FIRST

AID FIRST AID OR No FIRST AID. F.A. (Stoke).-A child had a sore throat and the mother rubbed it well with Sloane's liniment, binding it u p. It burnt so much that the child had little sleep during the night, and in the morning the sl<in showed signs of redness and cracking. Please say what the first aid treatment would be in this case? Do nothing except tell the mother to cover the neck with a clean dressing and take the child to her doc tor. Otherwise you will convict yourself of practising meddleso me first aid.-N.C. F. PREPARATION OF STRETCHER. T.M. (Burton-on-Trent). - Should the blankets mentioned in Rule 5 of Stretcher Drill in the Textbook be used in every instance or should they be used only for the removal of cases of fractured spine? I ask this question because one of our teams w as disqualified in a recent competition for preparing the stretcher in this way before the injuries had been diagnosed. As soon as the surgeon-judge saw Bearers Nos. 2 and 4 arrange the blankets on the stretcher he disqualified the team; and afterwards he said that it was a " funny thing" for a team to prepare a stretcher for a fractured spine before its mem bers knew that this injury had to be treated. As a fact, they did not! Frankly, I think that the judge acted rather harsh ly in disqualifying the team as he did; and I ask yo ur opinion on this point, please. The preparation of the stretcher now necessitates the use of blankets as laid down in Rule 5 on pr o 206 and 20i and as demonstrated in Figs. 91, 92 and 93 of the Textbook. Also this preparation has to be made in all cases for which use of the stretcher is indicated ; and it is not reserved for transport of patients suffering from fracture of spine. On your other point and on your statement of facts , I am in full agreement with you. Nevertheless, there m ay be some other explanation -N.C. F. WOUND OF ABDOMEN WlTH PROTRUSION OF ORGANS. N _K . (Brisbane, Australia) _-A patient is suffering from a wound (with protrusion of organs) in the fron t wall of t he abdomen, as a result of which accident he is in a state of profound collapse. Would the correct treatment be to raise the head and shoulders and draw the kne es well up (vide Textbook p. 131) or, in view of the collapsed condition, would we leave the head low an d turned to one side, and raise the lower limbs-vide Rules 2 and 6 of p_ 44 ? Your second suggestion appeals to me in the circum stances named. Nevertheless, I consider that from the first aid standpoint you would be well advised to treat such a patient strictly in accordance with the instructions of th e Textbook.-N . C.F.

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LLAND DEMONSTRATION AND GALA. - The Annual Open AmbulanceCompetition for the "Dempster" Ambulance Shield will take place on Saturday, July8th, 1939. First three prizes to the value of £10; if more than 20 entries four prizes. Three special prizes will be awarded to th e individual competitors gaining the highest number of marks outside the prize winning teams. Entries close July 5th, 1939. Entry forms on application to S. Norcliffe, 109, Parkroad, EIland, Yorks.

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J ULY, 1939.

No. 541.-VOL. XLVI. NOTICE

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Report of the B. R. C. S. The O rder of St. John ... Death of Lady Perrott, R_ R. C. S. ] .A. B. Headquarters and District Reports Com ing- Events S. ]. A. B. Overseas . .. .,. ... . .. The Eight Pointed Cross and the Brigade Finals . .. National Road Passenger Transport Ambulance Association Railway Ambula nce News P ioneer R escue Workers Letters to the Editor A. R . P. T opics O ur Nurses' P ages

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H a nds in Artiflcial Respiration E xamination Howler Awa rd of Labels ... Treatment of Complicated Fractured Ribs Treatment of B urned and Crushed Hand Diagnosis of Fract ured Spine Treatm ent of Heart Attack ... T extbook of Surgery for First Aider ... Diag nosis of F ractu res Com plicated F ract ure of Femur I ce in T reatme n t of Hremorrhage St ra ig htening Fractu res Course' of Sciatic Ner ve H a nds Above H ead wit h Bleeding Nose Treatment of F rac tured Femur Treatment of Mo nkey Bite ...

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F IRST AID is published on the 20th. of eac~ month . T he Annual Subscription is 3s. 6d. post free; slOgle copies 3d. I ts aim and object being the advancement of Ambulance Work in all its b ranches, the E ditor invites Readers to send Articles and Reports on subjects pertaining to the M ovement and also welcomes suggestions for P ractical Papers. All Reports , &c., should be addressed to the Editor at the add ress below, and should reach him before the 12th of each month, and must be accompanied (not necessarily lor tJuolication) by the name and address of the Co rrespondent. Subscri ptions, Advertisements and other business Comm~nications connected with F IRST AID shoul d be forwarded to the PublIshers. D ALE, REYNO L DS & Co., LTD. , 46, CANNON STREET, LONDON, E . C.4.

CONTENTS

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THE an n ual report for 1938 sets out some interesting facts relatTHE B.R.C.S. ing to the work of the British Red Cross Society during that year_ The total number of V.A. Detachments was, at D ecember 31st last, 158 men (personnel 4,244) a nd 912 women (personnel 23,498), some 40 of which had completed their quota of mobile mem bers. The B.R.C. Detachments numbered 134 men a nd 207 women, with a personnel of 5,856. Thus the total strength of B.R.C.S. and V.A.D. members was 33,598, exclusive of A.R.P. Reserves. In June the So€iety acted as hosts to the 16th In ternational Red Cross Conference, which was ope ned by H.R.H. the Duke of Gloucester, Cha irman of the Council of the Society. Sixty Red Cross Societies, Governments and Kindred Org anisations were represented. During the September crisis increased activity was experienced and some 3,000 members were warned for duty at short notice, whilst others were actually mobilised with anti-aircraft units. Three courses were held at Civil Anti-Gas Schools, the result being 139 officers qualified as Instructors Special or 1st or 2nd class. At a course held at the Anti-Gas School, Winterbourne Gunner, 44 officers qualified, eight receIvIng ,. Distinction." The total number of A.R.P. certi ficates issued is 282 C.A.G.S., 116 M.A.G.S., 1,687 Grade 1 and 58,461 elementary. Up to the end of 1938, 3,250 Service Medals had been awa rded for 15 years' active efficient service and 2,128 clasps for 20 or 25 years' service. A t the Clinic fo r Rheumatism 88,671 attendances were made in the Gene ral Department with 135,760 trea tments and 7,881 attendances in the Private Patie nts' Depa rtment with 10,698 treatR EPORT OF

FIRST ments. Only 1 per cent. were worse after treatment. The Blood Transfusion Service received 6,628 calls, an increase of 1,006 over 1937. Volunteers had a net increase of 233, the total being 5,142. The total number of Junior Links and Cadet U nits now number 666, nearly 450 of which are in England and Wales. The report also records statement of accounts, Branch reports and numerous other departments of the Society's work. ------.--.------

The Order of St. John. INSTALLATION

H. R. H. THE DUKE 0[<' GLOUCESTER AS GRAND PRIOR.

AT the annual service of The Order, held on ] une 26th, the Duke of Gloucester was installed as Grand Prior in succession to the Duke of Connaught, who had been compelled owing to ill-health to resign from that office. A Guard of Honour, composed of members from No.1 (Prince of Wales's) District, was drawn up outside" the Gate" under the command of Capt. W. Goodley (Commissioner) and District Staff Officer G. C. Green. His Royal Highness and other members of the ChapterGeneral, preceded by the Choir of His Majesty's Chapels Royal and the Chaplains, walked in procession from the Chancery at St. John's Gate to the Grand Priory Church, where the Rev. Prebendary L. ]. Percival, Sub-Dean of His Majesty's Chapels Royal, conducted the service. The Grand Prior presided at the subsequent General Assembly. Major-General Sir Percival Wilkinson, SecretaryGeneral and Director of the Ambulance Department, commented on the proposed new buildings in St. ] ohn's Square and the urgent need for extra accommodation owing to the great expansion of the work of The Order. He informed the General Assembly of the proposed Concert to be held on October 26th, in the Albert Hall, to which The King and Queen and Queen Mary have graciously promised their patronage. It had been found necessary to add a new wing, at a cost of £12,000, to the St. John Clinic in Pimlico. Regarding the St. John Ambulance Association certificates, the issue has increased in the last six months some five times and at the present rate will be well over 200,000 per annum in England and Ireland alone. Overseas the Association was progressing in almost every part of the Empire, more especially in Singapore and British Malaya. Colonel J. T. Woolrych Perowne, Chairman of The Order's Ophthalmic Hospital at Jerusalem, reported on the year's work at the Hospital, whilst Colonel E . J. King, the Librarian, reported on the department under his control. Maior-General Sir John Duncan, Chief Commissioner, St. John Ambulance Brigade at Home, reported considerable increase in the members of the Brigade which is now 100,000 strong. Particulars of the various activities, as given in our June issue of this Journal, were also referred to. Colonel J. L. Sleeman, Chief Commissioner, Brigade Overseas, reported with regret the resignation of Mrs. Dent as Lady Su perintendent-in-Chief Overseas after 17 years of service. He took the opportunity of welcoming the Hon Mrs. Copland-Griffiths who had succeeded Mr'). Dent and who had already visited several of the Colonies as Mrs,

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AID Dent's deputy, with the greatest success. He praised especially the work done at Hong Kong during the difficult times there, for which Mr. Alfred Morris, Mrs. Langley and Professor Gerrard deserved the utmost praise. Among the many increases Overseas those at Singapore, Malaya, Burma and Ceylon call for special mention, the success being largely due to the devoted services of the representati ve of The Order in these places. The Grand Prior, in replying to a vote of thanks for presiding, said it gave him great pleasure to be present. He had been greatly impressed by the favourable reports of the work of the various departments of The Order during the past year. He wished The Order and all those responsible for its many activities contin ued prosperity during the years to come.

Death of Lady Perrott, H. R.C. WE regret to annouce the death of Lady Perrott, R. R. c., Lady Supt.-in-Chief, S.].A. B., which took place at Withypool, Minehead, SOll1erset, on July 4th. Lady Perrott devoted 29 years to the Service of the Order of St. John and the St. John Ambulance Brigade, during which time she endeared herself to the nursing personnel of the Brigade and with all whom she came in contact. Wife of Sir Herbert Perrott, who was at one time Secretary-General of the Order, Lady Perrott realised the possibilities for improvement in the nursing service of the Brigade and, on February 21st, 1911, was appointed the first Lady Supt.-in-Chief of Nursing Corps and Division and and Lady Commcndant-in-Chief of Women's Voluntary Aid Companies, later to be known as the Voluntary Aid Detachments. She re-organised the nursing service, instituted a more suitable uniform and ll1ade a personal inspection of every Nursing Division of the Brigade throughout the country. Each time London Divisions ~'ere on public duty she made a point of inspectin~ them. In 1913 she held a conference of nursing officers with the object of securing a more uniform standard of work. She had already been successful in obtaining permission for nursing members to work in the Wards and Out-Patients' Department of many of the London Hospitals and later obtained similar concessions in the provinces. At the outhreak of the Great War she was able, at 48 hours' notice, to despatch 80 trained nurses to Belguim and a furth~r 40 left a few days later. She provided two hospital units at Antwe rp, organised a department for makin g bandages, was the ll1eans of collecting £17, 000 for the support of the Brigade Hospital in France. In 1915 her services were recognised by the honour of R. R. C. First Class. After the war her interest was as keen as ever and, in 1921, she presented a shield in the names of Sir Herbert Perrott and herself for annual competition among Nursing Divisions of the Brigade. To-day that shield is known as the" Blue Riband" among Brigade nursing personnel. Lady Perrott instituted annual camps for nursin g members which have proved a great success. Those attending looked forward to the visit of their" Chief." In 1928 she was made a Dame Grand Cross of the Order. No one has done ll10re to encourage a knowledge ot first aid and home nursing amongst the voluntary nursing services than Lady Perrott. Her devotion to duty has not only always been admired by all but has been a wonderful example to others. Lady Perrott will be greatly missed -; and we extend our sincerest sympathy to her two daughters, the Lady Forester and Viscountess Maitland, who are both officers in the Brigade, on their bt;!re~vel1lent,

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St. John Ambulance Brigade Headquarters and District Reports. Brigade Headquarters The Chief Commissioner has issued the following information : .c Regarding the compulsory military training of yo ung men between the ages of twenty and twenty-one. who are now members of the St. John Ambulance Brigade, the Chief Commissioner has be~n informed by the Director of Recruiting and OrganisatIOn, War O£?:ce, t hat as far as numbers permit men who have recelVed t raining in First Aid and Medical Duties will be posted to units of the Royal Army MedIcal Corps. As .far as the exio-encies of the service permit, every effort WIll be made to ;ost men to Corps and Regiments of their choice, and in which their services will be most usefully employed." PRELIMINARY NOTICE.-The annual week-end confer ence of Brigade Surgeons will take place on October 14th and 15th at the Great Central Hotel, L ondon. Full particulars will be issued in due course; meanwhile all Surgeons are asked to book the dates now. The attendances on previous occasions have been very satisfactory; but an increase. this yea~, especially among members in the Home CountIes, WIll glVe pleasure to the Surgeon-in-Chief.

No.1 (Prince of Wales's) District Members of o. 1 (Prince of Wales's) DlyislOn han> learnt with much pride the fact that their Commlssl.oner (Captain W. Goodley, O.B.E., 1\1.c.) has been appo111ted a memher of Chapter General of The Ord e r. The anllual Ch urch Parade n f the Central Area was held on June 25th when some 320 memhers were on parade. " d h d Assembling in Lincolns Inn FIelds the para e n:a~c e to the Church under the command of Asst. . CommlsslOner Capt. H. A. Fenton, who was assisted by h1S Area Staff. During the service the Lessons were read by Col. J T Woolryeh Perowne (Hospitaller of The Ord~r) and 'N Corbet Fletcher (Surgeon-in-Chief), whIlst the Re~. C;:ousens Petch, 1\1.A. .(Chaplain of The Or~J;~ gave 'an 1I1terest111g and ll1spInng- sermon. . The p holds the Service Medal of the ~)rder .al?~ 1S fully conversant with the Brigade and all Its actIVIties. . h After the service the parade reassembled 111 t e Judges' Quadrangle of the Law Courts, wher.e Col. G. ~. Moore. C.M.G., D.S.O., M.D. (Assistant ChIef Commls ~i(mer) inspected the parad e and took the salute at the march past. f h The Area Standard was carried to and rom t e Church.

On 1:'uesday, June 20th, members of the N o. 3~ Ambulance No. 76 Nursing, Nos. C23 a~d CN22 Cadet ) d also of the British LegIOll Maccabean · . . D IVlSIOns an

Section, assembled in the large playground of the Free School, Middlesex Street) E.l, for the annual inspection hy Asst. Commissioner Capt. H. A. Fenton, who was accompanied by L ady District Supt. Miss A. 11. ·Walker, District Officer T. McBride and Lady District Officer Mrs. A. F. Tapley. Supt. D. Stitcher was in charge of the parade, the Companies being under Amb. Officer A. E. Shinegold (N o. 30), Lady Supt. Miss F. A. Minot (No. 76N), Sergt. B. Stitcher (Section)) Cadet Officer W. Golding (No. C23), Lady Cadet Supt. Miss M. Claridge (CN22) and Amb. Officer A. Goldstein (A.RP. Reserves). Following the inspection and march past, 1\1rs. Lionel de Rothschild (Hon. President To. 76 ) presented awa rds, including: The "President's" Cup to Pte. Eric 1\1. Stitcher. The .. Hayman" Challenge Shield to Pte. H. Horowitz. .. Silver Jubilee" Cup to Cadet R Feldman. The "Shandel" Trophy, presented by the Rev. E. Lipson (Han. Vice-President Ko. C23) and competed for by Cadet teams, to o. 2 team led by Cadet CorpI. S. Jones. . . Short displays were glVen and much apprecIated by the guests, amongst whom was th~ 1Iedical Officer Health for Stepney (Dr. F. R. O'ShIel), 1\Ir: J. SpanJer (Hon. President o. 30) and rvIrs. Spanjer, Dnr. ?urgeons M. B. Jay, J. M. Raphael, .1. • Pines 'and J. Selde~berg, Dr. E. Bernstein (Headmaster, Free Sc~ool), 1\hss S. Samuels (Headmistress), the Rev. Levwe and 1\1rs. Levine the Rev. Zeffert and Mrs. Zeffert, and others. C;pt. Fenton took the opportunity of investing l\~rs. D. Stitcher with her Badge of Office as Hon. V1cePresident I o. 76N Division, and also congratulated the parade on its smart and effi~ient wor~. . 1\Irs. Lionel de Rothschlld, Dr. 0 Shlel~ Mr. Spanjer and Supt. Stitcher also addressed the g-athenng.

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The newly-acquired ambulance. of the ~ o. 83 ( orthern Heio-hts) Division was dedIcated last month by th e Rev. W. Howard (Vicar), in the forecourt of St. Michael's Church, Highgate. Supt. John J. Ascott was in charge of the ambulance personnel, and Lady Supt.. ~Iiss Saunders, together \nth Lady Supt. 1\Irs. Webber, 111 charg~ of the nurses. Led by the Sah'ation Army (HIghgate Central Band) the parade numbering some 100 members, marched from orth Hill' to the church. There the ambu1a~ce, a 25 h.p. Vau.-xhall fully equipped with latest contr.lvances, \,,:"a~ dedicated "to the glory of God. to be used 111 the serVIce of the sick and suffering." The ne," ,'ehicle. which is in the c~arge of T /Sg:t. VV. T. Puddifoot) replaces the nne whIch has heen In sen'ice since 1931. .' Offi C Those present included DIstnct Staff cer... Green District Officers G. P. Hart and S. H. Co111ns, Corps' Supt. A. E. Wells CA.RP. Officer) Central Area). Supts' J. W. \Valker and A. Bishop, R/Sup~. J. J. Ascoti' Amb .. Officers A. A. George (Northern Helg-hts) and V,. G. Dines CFriern Barnet).

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FIRST The first aid post which ha s ,been equipped by the Moreton Am bulance and Nursing Divisions, was offered for public service by Mr. F. Davenport, President of the Moreton Division. The service which followed was cut sho rt owing to heavy rain. Complimenting all concerned on the good wo rk they we re doing and the national service they were rendering, the Mayor spoke of the g r eat advantage of being prepared to give efficient h elp in emergency. Thanks were acco rded to all on behalf of the Bngade on the proposal of County Officer ]. Cotler. LANCA S lll hE.

Exchange Division, Liverpool Corps, S. J. A. B.

No. n District The annual inspection of the County of Hampshire Ulnits was held at Clarence Barracks, Portsmouth, by kind permission of the Officer Commanding, 1st Batt. K.O.S.B., on Sunday, June 25th, the Inspecting Officer being Col. the Rt. Hon. Lord Templemore, K.C.V.O., D.S.a., O.B.E., D.L., the County President. Prior to the inspection an official reception and luncheon was given by the Lord Mayor of Portsmouth, at which the Deputy Lord Mayor presided in the unavoidable absence of the Lord Mayor. The parade, which numbered 1,63 1 drawn from all the 93 divisions-'ambulance, nursing and cadet- in the County (which now has a personnel of 2,700), were drawn up in five long lines, a sixth being made by ambulances and stretcher-bearer parties. County Commissioner IVIajor Tennyson-Smith was in charge of the parade, with the Asst. County Commissioner, Eastern Area, Dr. Glen, as second in command. County Officer Col. Marshall was Brigade Major; Lady County Supt. Mrs. Hayes in charge of ursing and Cadet Nursing Divisions; and County Officer Holt, Record Officer. Also on parade was County Surgeons Col. C'o ok, Clayre and Garrett, Lady County Officers Mrs. Heseltine and Miss Hayes. The Inspecting Officer was accompanied during his inspection by the Deputy Lord Mayor of Portsmouth, the Mayor of Gosport, Surgeon Rear Admiral VI. W. Kei r, CM.G., County Controller V.A.D., Brigadier T. L. Hunton, O.B.E., commanding the Royal Marines, and Lieut. Col. Lake, commanding the K.O.S.B. After the inspection and march past the parade marched to Divine Service, one half proceeding to the Cathedral, where the Lord Bishop of Portsmouth gave the sermon; the other half attending the Royal Garrison Church where the Rev. C. C. a-b. Thacker preached the sermon. At the termination of the Services, the 'parade reformed in the High Street, the Colour being Troop ed, and the whole marched to the United Services R ecreation Ground for dismissal and for tea. The numbers on parade constitute a r ecord, an increased roll call of 200 over any other previous inspection. The Inspecting Officer complimented the County Commissioner, not only on the smart turn out, but also on the

steadiness of all ranks during the inspection and 111 the march past.

No. ill District. WELLINGBOROUGII.-The annual inspection of the Wellingborough Corps was carried out recently by County Commissioner Dr. L. W. Dryland, who was accompanied by Lady District SupL Mrs. W. Harvey Reeves, County Officers J. Cairns Parker and F. Holgate Smith, Supt: W. Claypole (County Secretary) and Lady Corps Officer Miss Dickson. The parade, -tOO strong, was under the command of Corps Supt. J. Marsha ll Bailey, 11. assisted by Corps Secretary Mr. O'Collnor and Corps Sergi-Major ]. W. Fran6s. Lady Corps Supt. Mrs. A. S. Campbell was in charge of the nurses. The Commissioner, aft er the inspection and march past, said he was very impressed by the mag'nificent turn out and congratulated officers and m em bers of the divisions. He appealed to th~ Nursing Divisions for more members for the Civil Nursing- Reserve; it was necessary that they should have a strong body should the occasion arise. He was pleased to note the number of members 'wearing A.R.P. badges. Dr. Dryland also referred to the fact t hat the inspection was the beginning of the] ubilee Celebrations 'Of the Headquarters Division. Corps Sergl.-Major Francis) the olde t service , mall on parade was presented with his sixth Service Medal Bar, Sergt. H. . Parker, received his third har, whilst Amb. Ofiicer G. C. Powis (Headquarters Division) and Lady Amb. Officer Miss Priestley (Rushden) received Service Medals.

c.,

No. IV District CHESHIRE.-A first aid post at CJladwick Street, Moreton, was dedicated by the Rev. C E. Wormell, Rector of Moreton) and formally opened by the Mayor of Wallasey, Councillor Frank Pullen, on Sunday, June 18th. The Guard of Honour (supplied by the Wallasey Ambulance and Nursing Divisions) was in command of Corps Officer T. Armitage who was also responsible for the day's arrangements.

LrvERPooL.-At the annual distribution of awards of the Exchange Division, Supt. L. R. Lewis stated that the division in its 11th year, had gone from strength to strength, and referred to the efficiency and enthusiasm of the members. Mr. W. ]. Grace, President o. 1 Group, presented the awards and spoke of the success of the Division. He congratulated the members on obtaining so. m~ny Grade I certificates; and expressed thanks for the 1l1Vltation extended to Mrs. Grace and himself to be present at the function. Dr. Condie, newly appointed Divisional Surgeon, expressed his pleasure at being presen.t. . Supt. Lewis r efe rred to the reSl 0 'natlOn of Sergt. Bresnahan as Treasurer, an office he had held since 1927. Ill-health was the cause of resignation, and he asked Se rgt. Bresnahan to accept a wrist \yatch and also an umb rella for Mrs. Bresnahan. Sergt. Bresnahan, who was taken by urprise, returned thanks for the gifts. After the presentations a dance and social followed.

N o. V District On Salurday, June 17th, Dr. . Cor.bel }letchel: (Su rgeon- in-Chief) carried out t~le annual 1l1Spe.ctlOn at the Midland Area of the West Rldmg of Yorkshire. He was accompanied by Asst. Commissioner H. E. Else, County Surgeon C. C. Hargreaves, Dr. Sweeney, Cln.d Lady Distriot Supt. Mrs. Birkbeck. The Lor? 1\la)'or ot Bradford (Alcl. T. ]. Robinson) and the Chlet Constable (Capt. T. Rawson) were also present. . . Asst. Commissioner Dr. VV. N. \Vest-'Watson was 111 cha rge of the parade, as isted by Dis.tric.t Officers T. J. Allen and R. H. Baker, and Lady Dlstnct Officer l\lrs. Geldard. Th e inspection took place at Lisler Park, Bradford, the r e hein o' 700 officers and members on parade. After ,-, the inspection and march past, Dr. Cophet Fletcher expressed his pleasure at the smart appearance of the parade and thanked the members !or the great work they were doing on behal{ of .h~lmamty. Mrs. Bi rkbeck expressed 11cr satls±actlon of. v:'hat she had seen with the Nursing and Cadet DlvlslOns on pa rade. . " f The Lord Mayor expressed hI S great appre~latlon 0 the work of the members in the Braclfor~ dlstnct. Certificates of Appointment as Servmg Brothers of The Order were presented by D.r.. ~orbet Fletcher to Serot. Ralph Dixon (Castleford Dn'lsl.on) and Sergt. 'vV. C Earle (Yeadon Division ?f the ?hl'pley Corps). Th,e recipients will be invested wlth the 1I1s1gt11a at St. John s Gate, Londoll ,in the n,ear future. NOTTINGIIAM.- The annual church 'Parade of the Nottingh am Corps was held on June 25th. Over 200 men

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and 33 cadets marched to St. Andrew's Church, under the command of Corps Supt. Ibbottson, where the parade was met by 135 nurses, under Lady Corps Supt. Miss Oldfield. Those attending the service included Commissioner Surgeon-Commander A . La Touche Darley, County Officer H. C. Ratcliff, Lady County Officer Mrs. Paling, Corps Supt. F. Wilson "N1oulds, Drs. Tichlin and Denham, Corps Officers West, Lewendon, Dawson, Cuckson, Carrier and Potts, and Lady Corps Officer Mrs. Wyse. The service was conducted by the Rev. R. Deaville, who was for several years a member of the Brigade. H e spoke of the excellent work of St. John throughout the world, and gaYe a brief history of The Order. Corps Officer A. R. Cuckson read the lessons. Part of the collection has been handed to the Corps for its funds . A fter the service the Commissioner inspected the pa rade and took the salute at the march past. WETIIERBY.-On Sunday, ] une 25th, was held the first Church Parade of the Wetherby Ambulance, Nursing and Cadet Divisions. O,'er 150 members, including representatives from Harrogate and Tadcaster Divisions, assembled at Castlegate, the Divisional Headquarters, and led by the Wetherby Silver Band, marched to St. ] ames' Church for Divine Service. Th e Vicar, the Rev. L. P. Milnes, addressing the congregation, gave an outline of the history of the Order of St. ] ohn, and described the aim of the Knights Hospitallers. He showed how present day members of the Brigade still stroye to carry out that aim under modern conditions, and commended their work as being extremely worthy of support by the public. At the conclusion of the service members marched back to headquarters where County Surgeon E. H. Lodge hriefly addressed the parade and thanked the \Vethe rhy Silnr Band for so generously g-iying their sen'~ces. County Surgeon E. II. Lodge and Lady Dl\'. SllPt. )'lrs. E. H. Lodo'e have ju t re turned from Doncaster, where they haye ~ompleted a course of t raining in "Hig-h Explosiye and Incendiary Bombs." Their preyiou CA.G.S . Certificates han no\\' been endorsed A.R.P.S.

No. VII District On Sunday, ] uly 2nd, the annual insp~ction. of Shropshire Units was held at Ludlo\v. rr:he 111spectmg officer was Dr. N. Corbet Fletcher, Surgeon-m-Ch?ef, \\'ho, on arrival, was met by County Commissioner LIeut.-Col. C. 'vV. Eames, County Surgeon F. H. Edwards, and other members of the County Staff. Divine Service was held in the Parish Church where the Vicar (Preb. F. G. Shepheard) welcomed the parade and paid tribute to the work done by the members. After the service the parade marched through the town passinO' the Mayor, who took the salule. Later th~ parade reformed in the grounds of Ludlow Castle, where 374 members attended. In addition there was present a company of units from Herefordshlre and representatives of the Ludlow B.R:CS. Dr. Corbet Fletcher, accompamed by Col. Eames and his staff inspected the ambulance units, and then the nursing .personnel, accompanied by the ~layor, Lady upt. Miss Corser, and Lady Connty Officer .Lady Forester. The inspecting officer. was much lmpres~ed by :he smart appearance and bearing of all ranks, whIch sho\\ ed enthusiasm and efficlency. He took the salute at the

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march past, and addressing the parade, conveyed the Chief Commissioners thanks to the members and congratulated them on their excellent work and marching.

No. vm (Duke of Connaught's) District FOLKESTONE.-Over 250 members of the Folkcstone Corps attended the annual church parade held on Sunday, June 25th, under the corrunand of Corps Officer L. B. Easton. Led by the Folkestone British Legion Band (Bandmaster J. Pettitt), the parade marched to St. John's Church where the Vicar the Rev. T. S. Adams, conducted the Service. He ga;e a sincere welcome to the Brigade and spoke of the work of John the Baptist. Lessons were read by Corps Officer R. Moat.

HORSIlAM.-District Officcr F. Trott presided at the annual meeting of the Horsham Divisions, supported by Supt. W. E. J upp and Mr. H. L. Gregory (Hon. Treasurer ). Supt. J upp extended congratulations to the Nu.rsing Team on their very fine performance at the Bngade Finals, where they won the CI Perrott" Shield. The 12th annual report stated that 1938 was one of the busiest years in the history of Horsham. The ambulance had conveyed 453 patients (mileage 11,360) including 131 accident cases; 190 patients had been ~onyey.ed under the "letter" scheme. All manner of publIc duties had ,been undertaken, and the total number of 'h ours (10,529) was equivalent to 30 eight-hour days per member. The new headquarters were now completed and \\"ould prove a valuable asset to the Division. Mr. Gregory presented the various accounts.

MONGEllJ\M .-At the annual dinner 0 r the J\loIH;ehalll Uivision, over which the Rev. C. J. E. Peshall presided, Supt. E. A. Dando presented to Div. Surgeon C. p, E. Boulden. in appreciation of his work, a silver cigarette casco Mr. R. Fowler, on behalf of the vice-presidents, gayc the doctor a framed photograph of himself. Dr. Boulden thanked the Division for the gifts, and expressed his appreciation of the work of the 'officers and members at all times.

No. IX District The largest paradc ever held hy the County oi Cornwall took place on Sunday, June 25th, when nearly 900 members attended the annual (County) inspection and church parade at Falmouth. The parade, in charge of County Officer Land ry assisted by Corps Officer Tresidder and Supt. J. Jackman, marched to the parish church, where the service was conducted by the Revs. D. C. Puleston and T. H. Elkington, Canon H. R. Jennings, of Madron, was the preacher. The Mayors of Falmouth (Ald. W. Reep), Penryn (Coun. J. G. Pellowe), Truro (Coun. J. Delbridge), Pellzance (Ald. C. W. Curnow), were present in their robes of office) and were accompanied by the Mayoresses. After the service the parade marched to the Town quarry, where Asst. County Commissioner W. W. J ohnston inspected the parade and took the salute. He was accompanied by ex-Co unty Commissioner E. Trounson, and the various Mayors.

The Mayor of Falmouth said the ambulance men were doing a very fine work; he gave the members a hearty welcome to Falmouth. Mr. Johnston expressed his sorrow at the unavoidable absence of County Commissioner Col. W. Blackwood, who sent his best wishes for a successful parade. The atten dance that day was the largest in the history of the Cornish Divisions. He congratulated the officers and men on their smart appearance and fine turn-out. Mrs. P. Lanyon, of Falmouth (a member of the County Council and a magistrate both for the Borough of Falmouth and East Kerrier) was presented with a Service Medal.

No. X District On SW1day, J UllC l~th, thc new ambulance, presented by Sir Arthur Eborall, C.B.E.) to the Walton and Frinton Division, was dedicated by the Rev. D. Ashford Smith, Rector of Frinton, and formally handed over to the Division. A special service was held at the Frinton Parish Church, where the Vicar of Walton, the Rev. B. J. Edwards, gave an address in which he traced the history of the Brigade in the district. At the dedication service Lady Eborall presented thc keys to County Commissioner Col. J. L. Hamilton, who passed them on to Capt. S. M. Gillett, President of thc Division. Capt. Gillett presented Lady Eborall with a hasket of carnations, and Sir Arthur with a yiccpresident's badge. lIc then handed the keys to Supt. F. Putman. After the cercmony ahout 350 people were the g uests o£ Capt. Gillett and ~1rs. Gillett at tea. Col. Hamilton a[ter ',-iviIl'" an intcrestill()' account of the origin of th~ Rrigaclc, said that the)' had. . two men 'who were living up to the tradili()l1s of the past-Sir Arthur Ehorall and Capt. Gillett. On hehalf of the vValton and Frintoll Divisioll, Col. ] Tamilton presented Capt. and Mrs. Gillett with a silver case role to commemorate the 20th anniversary of their \veclclinO'. The President exprcs ed his appreciation of thc gift. Supt. Putman. assisted by Amb. Officer R. Margerum. was in chargc of the parade. Others prcsent include d County Officer J. Ratcliffe, Div. Surgcon B. G. Wheatley, Supt. H, Bowden (Harwich), Supt. C. Chcclcl (Clacton).

Coming Events. The Editor will be pleased to receive particul;trs 01 forthcoming events for inclusion (free of charge) under this heading.

JULY. 2-No. 1 (Prince of Wales's) District, S.] .A.B., Annual Flag Day. 22-County of Surrey,S.J. A. B. Flag- Day. 23-Annual Review Surrey and Sussex Units, S.J.A.B. Worthing-. AUGUST. 5 to 12-Nursing Personnel S.J.A. B. Annual Camp, Rossall School.

Walton and Frinton Dn.·ision, S.J.A.B. Seated: Supt. F Putman, County Commissioner Col. J. L. Hamilton, County Ofi'icer ]. Ratcliffe. Sir Arthur EboralJ, donor of the new ambulance is second from the left, \vhilst Capt. S. H. Gillett, Di\,. President, is on the extreme left.

S.J.A. B. Overseas. INDIA. BOIl1BAY.-The 35th report of the Parsi Division has recently been issued by Div. Supt. D. F. Panthaki, 1\1.B.E., ]. P., and contains particulars of continued proRress. At December 31st, 1938, the total personnel was 117. Public duties we:-e undertaken on numerous occasions, incl uding the Black-out in Bombay, Parsi ~ational sports, Bombay Riots, and also sports meetings, exhibitions, etc. Nearly 450 calls were answered, including- 360 ambulance removals. The ambulances travelled 4,871 miles involving 1,100 hours of voluntary duty. Of the number of patients carried 127 were removed free of charge. The twelfth annual camp of instruction was held at Versowa \;<.,here special lectures, demonstrations, drill, etc., were arr~nged. District Surgeon Captain F. N. Kapadia, 1\1. D., and Ag. District Su pt. Major F. T. Deatker visited the r.amp and expressed their pleasure at the arrangements. Six Officers and six N.C.O.'s attended the camp of instruction for Officers and N. C. O. 's of the Bomba>' Divisions, which was the first of its kind to be held. The Parsi NursinO' Division celebrated its Silver Jubilee by organising a He;Ith, Maternity al!d Infant Welfare Exhibition. Over 50,000 persons patrorlised the show. Members attended the inspection of the Bombay Divisions by Major-General E. W. C. Bradfield, C.l.E., O.B.E:, K H. S., 1. M. S. (Surgeon-in-Chief BriRade Overseas 111 India), and also that of His Excellency Sir RORer !--l!~ley, Governor of Bombay, on April 2nd. The annual dlvtslOnal inspection was carried Ollt by Asst. Commissioner Sir Gilbert Wiles, KC.I.S. C.S.I., I.C.S., assisted by Di8tric~ Surgeon Captain F. N. Kapadia and Ag. District Supt. MaJor F. T. Deatker, who exprpssed satisfaction at the smartness and efficiency of the member~. . Divisional competitIOns were held dunng the year; whilst in the All-India ambulance competitions a team representing the Parsi Cad~t Divisio? won the shield. Cadet teams also gained thIrd places In the Bombay Provincial Centre competitions and the" Sir Frederick Sykes" Ambulance ChaIlenge Cup. . . The I:eport contains many other mterestmg features which space will not permit us Riving in full. We do, however, congratulate the members, under Supt. Panthanki, on their excellent work

ZEALAND.

WELLlNGTON.-The seventh annual report of the National Blood Transfusion Service of New Zealand (vVellington Branch) for the year ended :'IIarch 31st, 1939, sets out some interesting facts. The Service, which is under the auspices of the Order of St. ] ohn, has a membership (in Wellington) of 204- males and 64- females from all 'walks of life. During 1938-1939 over 314- calls were answered, 24-5 being at the 'Vellington Public Hospital. The peak hours were between 12 noon and 5 p. m' l when 38 '86 per cent. calls were answered. Of the personnel, one has served no less than 22 times-a magnificent voluntary effort. That the Service is of the greatest use can be gauged by the fact that in 77 per cent. of the cases a satisfactory improvement was reported following the transfusion. The injuries for which calls ,,"ere made ",ere numerous, anaemia receiving the greatest number. SOUTH

AUSTRALIA.

NORWOOD AND ST. PETERS Dn·IsION. -During past seasons this Division helel fortnightly dances at St. Peters to auO'ment funds with areat success. In 1\Iay a similar functi~n was held in N~rwood undpr the supervision of Amb. Officer Heanes. The l\Iayor and J\layoress of Norwood and Kensington (1\1r. and 1\Jr5. Dankel) fa\'oured the function with their presence, and were welcomed by Supt. Moores and Amb. Officers S. ation and Heanes. 1\lembers of the Division were present at the annual inspection held at Government House gr~unds on] u?e 14th 'when the Governor General, Lord Lowrte, was the ll1specting officer. The annual re-examination was held on June 5th, when the examiner, Dr. P. \V. Rice, comme.nted on the efficient manner in which the members carned out the work. We are prepared to supply Ambulance Secretaries and others with specimen copies of this Journal for distribution

among their members.

Apply to the

Publishers, FIRST AID, 4 n, Cannon St .. LondoD E.C.

FIRST

The Eight Pointed Cross and th e Brigade Finals. By B. M. HOSSACK. So another year passes by-and again the g-rea.t day has come and gone. Come with its high hopes and Its fearswith its happy meetings of old and new friends - come with its first freshness to some-and to the" Hardy Annuals" with its feeling of beino- ever the same, yet ever different. Having been pre;ent at all but the first "Perrott," I have become a "Hardy Annual" myself, and find I enjoy the day more each year-and still can find points for criticism -both good and bad. Last year there were several little irritating facts-this year the irritations have nearly all gone. The return of the stage meant that all had a chance to see, though little could be heard. Injuries were more recognisable and more up to the "ld standard. We used to be irritated by a frequent demand to show our tickets, and were continually chivvied out of one of the few seats where we could see and learn, to make way for some one with a ticket of a more favoured colour-some one \\'ho possibly was more important socially, but who had not struggling teams at home waiting for the latest news. This year one was greeted with a smile-an offer of a program me (usually there are not enough to go round) and gracious stewards pointed out spare seats. This was Tact, because one felt flattered at the care for one's comfort-and g-angways were kept clear. Explicitness was surely rather overdone in the programme. Does it really matter with whom yo u are staying or for how long-whether houses are large or small-whether you are going to cinema or football duty? These points are not essential but in discarding them you may discard a point that matters. Several experienced competitors drew my attention to this. A little more Dz'scri71lz'nation in these introductions would help teams. Perseverance was called for in artificial respiration-but judging from some of the efforts it would not have produced much result. Really, some of the attempts were not worthy of the newest recruit. Sympathy was shown to the weary competitors and anxious audience in the cutting out of speeches-but a few remarks from the Chief on the year's work would have been appreciated. I taxed the Resoune-and resources-of the Brigade! Having torn the quick of a nail I approached a steward for treatment" to prevent further tearing. What a commotion my simple request caused! Nothing suitable to apply could be found. A sergeant came to the rescue and fetched a haversack. This brought a Corps Surgeon on the scene, but he seemed disappointed to find so little amiss. After much searching, lint and strapping were applied to my minute but annoying injury. I suppose I ought to be tactful and not mention that the lint was applied wrong way down, but merely voice my thanks for the dexfer£ty ! Observation showed one some amusing interesting things. One officer, who shall be nameless, rushed at a County Commissioner and embraced him. He did not seem to mind, which may have been tact-or he may have felt that after watching policemen and skaters locked in firm embraces, he was lucky to get off with an affectionate hug. The ever-sprightly Mrs. Porter was observed to be as sprightly as ever. You should have seen her spring up for "The King "-and heard her sing! I wonder what her eagle eye thought of the curtseys? Some were very wobbly bobs-some in succession like little ships on a rippling pond and some so stiff jointed that one thought of rheumatic joints. Spalding deserved a special trophy in their beautiful dip-all together and all the same depth. I.

FIRST

AID One last observation, if your perseverance still hold s out. How should you write of a Lady Officer? All th e Ladies of Rank who served as stewards are Lady Count y Supt. Miss so and so . Team leaders (very humble folk, of course) are neither Mrs. or Miss but first Jones, Thomas, White. I often puzzle over this point, for locally the nurses put ., Miss" after my rank- but the men leave it out. \Vhich is correct? One notices gaps among the familiar faces; and this year we missed our Lady Supt.-in-Chief. We hoped we should see her again, but now comes the news that this is not to be. We shall miss her most sincert:ly. for she always had a kindly welcome to county cousins and a Ro!,al memory for our names and districts. To those who, like myself, had received many kindnesses at her hands, it is a real and personal loss. To the Brigade the loss is ever great:r. ~ et " loss" is not the word, for her work and example lIve still. Our sympathy goes to those of her fa~ily who shared h er life and interests. May they long be With us to carry onas youth must do in its turn-the good work and man y kindnesses of our much loved Chief Lady.

National Road Passenger Tr ansport Ambul ance Associati on. The final competition of the" Stirk" Trophy was held at Walsall on Sunday, July 2nd, when the area representatives presented themselves before Dr. A. C. Daws (teal;' ), Dr. W. R. A. Line (individual) and Dr. G. H. Parkes (viva voce), who officiated as judges. The teams were placed in the following order of merit - 1st Birmingham and Midland Motor Omnibus, Co. Ltd ., -1-43 ~arks; 2nd, Trent Motor Traction Co. Ltd., 360; 3rd, Stockport Corporation Transport Dept., 328. Other team s were representatives of the transport departme? ts of the \Valsall Corporation, 327~ ; Manchester Corporat.lOn, 323~ ; Cardiff Corporation, 310t; and Preston CorporatIOn, 290t. Alderman Pat Collins (lVlayor of vValsalI) presented the trophy to the Birmingham and Midl~n.d l\loto.r team, also gold medals to the members, and m1l11ature sIlver c~ps. to the runners-up. Prizes were also presented to the wlI1nlng teams in each of the area competitions. Those present included the Lord Mayor and . Lad y Mayoress of Birmingham, Councillor Hale, J.P., Chairman of the Waisall Transport Committee, Mr. O. C. Power, J.P., Traffic Manager, Birmingham and Midland Moto r Omnibus Co. Ltd . ; Mr. A. B. Baker, General Manager , Birmingham Corporation Transport Dept., and a number of other transport managers. Mr. O. C. Powers, J. P., the Traffic Manager of the Company whose team was successful this year, automatically becomes President of the Association for the next twel ve months. P3.rticulars of the Association can be obtai ned from I\I r. W. E. Morse, hon. secretary, 2, Springfield-court, Stratford road, Hall Green, Birmingham, 28. Asst. Commissioner W. H. Gastall inspected the Lytham St. Annes Ambulance, Nursing and Cadet Divisions of tne S.J.A. B. on July 3rd, and expressed satisfaction at their efficiency and smartness. The eighth annual competition of the Warwickshire C~Ilieries Ambulance League for the Miners' Welfare Shield

was held at N uneaton on June 24th. Coventry Colliery gained first place, followed by Haunch wood.

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Railway Ambulance News. I nter- Rai Iway Fi nal, 1939. INDIVID UAL TESTS.

Nos. 1 and 2. -Yo u two are on duty at a small station on a cold dark winter's night. The last train is just steaming out when you see a man of about 4S years of age come running over the station bridge and down the steps. At the third step from the bottom he cries out and falls down. Treat him. A telephone and first aid equipment are available . Noone else is about. Time allowed, 8 minutes, beginning when you receive this card. Staging. -l\lan to be lying on his back across the three bottom steps. Frothing at the mouth (soap). Generally convulsed. Face Rushed. Right leg made up for compound fract ure lower end tibia and fibula with protruding bone. Patient to be instructed as to convulsion and confusion after fit. Rap id approach to patient Carry ing lanterns with you Place lanterns to give best light Raise head and shoulders Suppo rt head ... ... Place hard substance in handkerchief Ho ld between back teeth Do not restrain movements Take care he does not injure himself Undo tight clothing Co nvulsion ceases. 1 Speak to patient ... ... ... . ... Ask him if in pain anywhere (too confused to be relta ble 2 in his information) 1 Exa mine for injury ... 2 Head for swelling or bleeding (nil) 4 Ears, eyes, nose, mouth for h<elTIorrhage (nil) 2 Lift eyelids and examine pupi~s (nor.mal) ... . 3 Exa mine spine for fracture, dislocatIOn, or w~und (~tl) Examine upper limbs for fracture, wound, or dislocatIOn 3 (nil) ... Exa mine ribs and sternum for fracture, wound, or 2 dislocation (nil) ... ... ... 2 Exa mine pelvis and abdomen for injury (:-:il) . . Exa mine lower lim bs for fracture, wound, or dl~locatlOn (compound fracture of right tib~a a nd fibula found) Im mediately steady and suppor.t 11mb As k if bleeding is severe (no, sltght) Decide to remove to waiting room Tem porarily cover wound Tem porary cover secured Tie thighs, knees, and feet together .... Im provising bandages from h.andkerchlefs or ties, or bandages obtained from equipment Remove by two-handed se~t ..... . .. Place on blanket on table 111 waltlng room Raise head and shoulders Remove temporary bandages Steady the right leg ... . ... Ask if wound is obviously dirty (as you see It) Sterilise hands with antis~ptic Apply antiseptic over wound .,. And surrounding skin ... Lay a clean triangular bandage out Pla.ce dressings on this

Dry dressing to wound Care in handling dressings to avoid sepsis Large pad cotton wool Bandage lightl y ... . .. Examine if bleeding controlled (yes) Do not apply extension Padded outer and inner splint from above knee to below foot Bandages. A bove fracture Below fracture Above knee Figure-of-eight around ankles a nd feet Around both knees Treat shock by : Covering patient warmly Smelling salts to nostrils First tested Ask for hot tea (none available) Give sal volatile and water One teaspoonful to half tumbler water One bearer goes to telephone . .. For services of a doctor Giving history and injuries .. Epilepsy and compound fracture of tIbia and fibula (doctor will be here in half an hour)

2 1 1

2 41 1 1 1

Total 100 No. 3.-You are walking along a lonely road one summer evening when a cyclist passes you travelling at a fair speed. Suddenly a dog runs acr~ss the road and the cyclist applies his brakes sharply. be1l1g thrown over tl~e handle bars on to the middle of the road. Noone else IS about. You have two triangular bandages in your pocket. Treat him. Nearest house 800 yards away. Time allowed, 8 minutes, beginning when you receive this card. Staging.-Patient to be seated in mi~dle of road. Bicycle also near him on midd~e of road.. Patient unable to speak with jaw dropped. Sltght bleedlI1g from corne.r of mouth to be indi cated . Left arm made up for elbow dislocation. Patient wear ing square murRer." At six mi.nutes, i. e. when warning "two minutes to go given, patient to start retchin g. Rapid approach to patient Warn him to keep still Ask him where he feels pain (points to jaw and left 2 arm)... ... ... 1 Note mouth open and jaw dropped 1 Note bleeding from gums ... .. . 1 Examine teeth for irregularity (irreg~lar) ... . Ask exact site of pain in arm (patient P01I1ts to left elbow) Examine left elbow Is there swelling (yes) Is there deformity (yes) Is there a wound (no) Test for fixity ... ... 2 By asking him to move joint (fixed) 1 Get him to support left forearm 1 With right hand ... ... 1 Ask him if pain elsewhere (no) Rapid examination for further injuries (no further iniuries)

FIRST

Ask him if able to stand (yes) ... Bearer supporting jaw ... And patient supporting forearm Assist patient to stand And remove to side of road Seat him down at side of road Treatment. Lower jaw Palm of hand under jaw ... Press it gently against upper jaw Narrow bandage under chin . .. Tie above forehead arrow bandage in front of chin Tie at back of neck Tic ends of bandages tog-ether

1 1 1 1 1 1

1 1

1 1 1

1 1

[~ lbow

Place arm in large arm sling in a position of cOlTlfort Using patient's muffler to improyise sling ... Inquire of patient if comfortable Shock Undo tight clothing Reassure patient ... Cover with your coat General Move cycle to side of road .. . Ask him if his address is in pocket (no) Give him pencil and paper ... Ask him to write name and address ... (At" two minutes to g-o " patient starts retching) Remove jaw bandages ... . .. Support jaw with hand Turn head to one side (At "one minute to go" judge says" retching- has ceased") Replace ja w bandages Ask if able to walk (yes) Assist to house Total

1 1 1 1 1

t 1

1 2

1 1 1 1 1

1 50

lireat Western. EXETER.-The first competition for the Interdepartmental ambulance challenge cup, presented by Mr. J. G. \V nght, Area Superintendent, Road Transport Department, for G.\¥.R. ambulance workers in the Exeter Di"ision, to~k ~lace on June 2nd, when Dr. M. Y. Paget acted as adJudicator. The arrangements were in the hands of Messrs. R. A. Newson and J. Huish. The trophy was won by the Road Transport Department, who scored SO marks, Traffic Depa~tment being- runners up with 70 marks. Other competltors were the Chief Mechanical Engineers and Goods Departments. . At the subsequent p.re~entation proceedings, over v.:hlch Mr. A.. W. H. Chnstls?n, Divl. Loco. Supt., preSIded, Mr. Wnght presented his trophy; and examination awards, 100 in number, gained by members of the Exeter class,. were distributed by Mr. R. W. Higgins, divisional sup~rmtendent, who also presented a number of gold effiCIency awa rds for 15, 20 and 35 years' service. The la~t-n.amecl award was gained by Mr. W. Williams. Mr. H Iggl11S congratulated the recipients, and particularly appealed for fresh recruits to the ambulance movement.

AID

FIR.ST

and three representing Scotland, competed, the anbit ers being Dr. J. Rodger Sutherland of Glasgow (team), Dr. Wm . Duncan of Liverpool (individual practical), and Dr. Thos. G. Rennie of Glasgow (vivcL voce). Mr. G. S. Hill, General Ambulance Secretary, was responsible for the competition. T 'h e team test dealt with a man who had been Ovcrcome in a greenhouse and sustained heatstroke, hernia and compound fracture of foot. The individual tests were varied, as were the questions set. Mr. Charles K.er (Chairman, Scottish Committee L.M.S.) presided at the presentation of prizes, sllpportc(l by many railway officials. He referred to the satisfactor) number of awards gained by the staff in first aid the total bei~g S,499 in England and Wales, and 2,157 in'Scotland dunng 1938. In competition work over 3,300 memb ers participated; whilst 4,333 medals for 15 years' efficienc\ had been issued, together with 3,828 bars for fur the·r periods of five years. Mr. J. H. H. Henderson (General Secretar) , S.A.A.A.) announced the result as follows: I, Cre\\ e Machine Shop, 476 marks; 2, Uttoxeter, 472~; 3, Mos,end, 463; 4, Camden, 452~; 5, Motherwell, 441; 6, Du n· dee West, 440. The Crewe team have now won the championshi p trophy on four occasions, and their latest win is all the more creditable because their captain, Mr. A. V. Gibson, was unable to take part in the competition owing tll indisposition. An English team has now been successfl1l on nine occasions. Lady Greig graciously presented the championsh ip award and also 'individual prizes to each member of th e teams. She expressed her pleasure at being present anci congratulated the teams on their work. Mr. Henderson, in reply to a vote of thanks assured his hearers that the St. Andrew's Association w~s alwa\ 'i ready to forward the work of first aid and it was alwa) 'i a pleasure to help, especially in the railway departm ent. He invited the members present to inspect the head quarters and also ; l1e flcc·t of ambulances. Dr. Sutherland replied on behalf of the judges.

The annual ·o uting of the L ondon District Goods wa s held at Headstone Lane on June 27th. The main part of the proceedings were first aid competitions. Fourteen teams entered for the team co mpetition, 20 members for the senior individuals and 23 for the novices. . Dr. J. Robson (team) and Mr. G. E. Craft (indiVIdual) were the judges in the team competition, Messrs. Bendall, Green, Smith, Taylor and Tu11 officiating in the individual section. .Mr. A. L. Castleman, District Goods Manager, preSIded, supported by Mrs. Castleman, Miss Catto, Miss Brennan, and Mr. Blake of the Welfare, Mr. Langridge (Labour and Establishment), Mr. W. W. Sharp Mr. Hewitt (Ohairman D.G.M. Ambulance Committe e), Messrs. G. Galloway, W. O. Davies, W. Eastland, also Goods Agents from various depots. Mr. S. A. Purves, who was responsi1ble for the arra ngements, announced the results:Team Competition: 1st, Broad Street B, 266 marks; 2nd, Camden A, 245!; 3rd, Broad Street Ladies, 234. Senior Individual: 1st, W. Peyton (Camden), 2nd, A. J. Woods (Camden Accollnts), 85~; 3rd, Mi ss Al1enby, 82. Novices Individual: 1st, K. Small (Maiden Lane), S4~; 2nd, S. Mitchell, 63; 3rd, Miss Groom, 61~. Mrs. Castleman presented the prizes and also tho se gained at the s-ports.

sn ;

london, Mid land and Scottish. On June 20th the eleventh International Competition of the L.1VI.S. was held at the St. Andrew's Ambulance J-Iearlquarters, Glasg"ow, Six tea.ms) th rce ' from England

Mr. Castleman paid tribu te to the work in the District. The nU1~1bers were increasing eYery year. He also thanked the Judges and those who had assisted in making the function a success. On show was the Inter-Ra ilway Shield, which the Camden team won in May last. · COLNE.-At a social held reccntly, at which f\1r. F. N. IJ'o dn:ore presided, supported by Dr. Cleo-o- and 11r. Cow llshaw, Mrs. Nadin, wi~e of the station bl~aster, presented Mr. II. Brownblll WIth a 25 year Gold Bar, and :'I1essrs. W. Bracken, J. R. Beales, C. Binns and Vi. Hu ff \\'ith a 15 year 1edal. Eleven bars , one medallion and two vouchers were also presented.

WIGAN.-Mr. Sherrington presided over the annual distribution of. awards, whilst Mr. J. C. Darbyshire presented 16 certificates, 23 vouchers and 75 labels to successf ul members. J\'l essrs. W. K.enyon, F. Hall, C. E. Lee, E. Hogarth, R. Livesey, A. Marsden and T. H. Burns rece ived 15 year Gold Medals. F. S. Cleave and J. Higham Go ld Bars for 20 years' and W. ~10ss and F. Bould Gold Bars for 25 years' service.

london and North Eastern. HONoURs.-Mr. C. H. ewton, Chief General i\Ian ager, and 11 r. C. :'.1. J enkin Jon es, Divisional General Ma nager, York, have been admitted as Officer (Brother) of the Order of St. John. Both gentlemen are keenly mte res ted in first aid work, especially among the employees of the L.N.E.R. At a recent investiture, Dr. E. J. Burnett, Saltburnby- the-Sea, received the insignia of Officer (Brother) hav ing' been promoted from Associate.

The thirteenth England \'. Scotland compehtlOn was held in Glasgow, at the St. Andrew's Ambulance Association Headquarters, on Friday, June 16th, when Dunday Tay Bridge and Dunfermline for Scotland, and Tuxford and Tyne Dock for England competed for the championsh ip. The arbiters were Dr. Hugh W. O. Frew, of Glasgow (team), and Capt. A. C. White Knox, of London (indi vi dual), the arrangements being under the supervision of ~1r. J. H . H. Henderson, General Secretary of t h e S.A.A.A. The team test dealt with a railway accident in which a man was pinned down by fallen debris, some of which was pressi11g firmly on his abdomen and chest. Being unconscious and not breathing immediate artificial respiratio n was necessary; Silvester being the method required. Other injuries were simple fracture right tibia, fractured pelvis, arterial haemorrhage from wound below right knee but not in contact with fractured tibia. The individual tests were varied and included frac tured pelvis, fractured humerus, dislocatecl right hip and fractured knee} a lso one question to each bearer. It was apparent from the work done that the Scottish teams had taken the trouble to study English methods, and they were thus able, to gain valuable marks. Mr. T. · E. Heywood, Divisional General Manager, Edinburgh, presided at the subsequent presentation cere mony, s upport ed by the judges, Mr. Henderson, and ya rious officers of the Company.

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I i

The result was: 1st, Dun ferm line, 351 marks' 2nd ~undee Tay Bridge, 3l2~; 3rd, Tyne Dock 31 n'· 4th' 1 uxford, 276. ' ~, , . Scotland has now won the championship five times, wh11st England has been successful on eight occasions. Mr. Hey,,:",ood congratulated the winning team and handed the shield to the members, amid applause. Mr. Hunter (Solicitor, Scottish Area) proposed a vote of th~nks to the Arbiters, to which Capt. A. C. White Knox rephed. Both judges agreed 'on the winning team. Mr. Henderson, in reply to a vote of thanks Lo the St. Andrew's. Ambulance Ass?ciation proposed by Capt. Perry. (Manne S~lpt., ScottIsh Area), said that the l\sS?CIatlOn do ~helr best for the movement and appreCIatIOns of their work are very gratifying. At the Headquarters 1,000 persons per vveek \\"ere being trained, and from Septemb er last to l\Iav 31st some 28000 certi , ficates had been issued. Capt. W. Goodley, Ambl1lance Secretary, Southern Area, . expressed ~hanks, .on behalf of the English repres~nt~tlves) to theIr ScottIsh colleagues, for the kind hospltahty extended . Mr. R. S. Beveridge, ~dinburgh, was the competition secretary; othe~s present mcluded Dr. :'vlcBride (York), Dr. ~unn (Edmburgh), Mr. S. VV. Smith (Secretary, SpeCIal Ambulance Committee, York), Mr. S. Cooper (Ambulance Secretary, Korth Eastern Area). Mr. T. \Vright (Ambulance Secretary, Aberdeen), and 1\1r. T. n. Mein. I ORTH EASTERN AREa. The following members of the staff have qualiGed for ambulance service medals and bars :-

Allinson, T. C. Arnott, R. W. Ayre, F. M. Baldwin, B. E. Beedle, L. E. Bielby, F. R. Belben, C. W. S. Birdsall, G. A. Bond, T. S. Burton, J. F. Coatswith, H. W. Cotson, ]. \V. Davidson, A. N. Dean, J. W. Elstob, J. E. Emerson, A. Gibson, W. Glaves, R. Gray, A. Hill, G. Leek, W. Lillico, F. Lonsdale, ]. J. MacIntosh, G. McKeown, ]. Mowatt, ]. W. Oldfield, S. Patterson, iV. G. Pend ri ch, S. Pig-g-, S. Plater, H. R. Plews, W. R. Pratt, T. Riches, A. Robinson, J. W. Rowe, ]. C.

MEDALS. Shunter. Electrician. Fitter. Wagon Repairer. Clerk. Machinist. Pipelayer. Sig-nalman. Hoilersmith. Fireman. Clerk. Platelayer. Fitter. Lengthman. Plumber. Signalman. Fitter. Fitter. Porter Signalman. Guard. Sawyer. 'Wood Machinist. Timber Issuer. Signalman. Crane man. Machinist. \Vireman. Striker. Metal Machinist. Boilerwasher. Chain Inspector. Engine Driver. Waterman. Wood Machinist. Signalman. Stationmaster.

Darlington. York. South Gosforth. Walker Gate. South Bank. Hull. Darlington. Gascoigne Wood. Blyth. Kirkby Stephen. Tyne Dock. iVest HartIepool. Walkergate. Darling-ton. West Hartlepool. Saltburn. Gateshead. York. High iN esbNoud. Newport. West Hartlepool. v: al kergate. 'vVal kergate. West Hartlepool. Gateshead. Darlington. Darlington. Walker Gate. Gatesllead. Darlington. Hull. \Vest HartIepool. Hartlepool. Darling-ton. Willington. Thorne orth.

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Tweedmou th. Darlington.

Russell, J. Scarr, J. H. Simpson, T. W. Smith, H. G. Sparke, T. W. Strickland, F. Sweeney, A. True, H. Watts, W. E. Westerman, T. W. Wilson, W. 1\1. Wood, H. Woodhouse, R. vVray, R. C.

Fitter. Blacksmith Striker. Labourer. Steamraiser. Fitter. Relayer. Electrician. Assistant Fitter. Blacksmith. Goods Porter. Signalman. Guard . Goods Guard. Goods Guard.

Bland, A. Cockerill, L. Gibson, S. J. Grosert, Vi. Purves, A. Stockdale, T. Studd, F. Ternent, W. T.

20 YEARS BAR. Driver. liddlesbrough. Grade 2 Porter. File\,. Am bulance Attendant Vvalker Gate. Lineman. Ferryhill. Guard. South Blyth . Guard. South Stockton. Boilersmith. Darlington. Parcel Foreman. K ewcastle.

Darlin~ton .

West Ha r tlepool. Darlington. York. Newcastle. Heaton. Gateshead. York. Stockton. Newport. Darlington. York.

GREAT CENTRAL CENTRE. The 25th ann ual competition for the" Bartholomew" Bow l was held on July 1st, in the grounds of Hinton House, Woodford, thro ugh the li:indness of Col. the Hon. Marcus H. Pelham. Mr. W. E. Hobbs, the indefatigable secretary, must have been more than pleased that, on this memorable occasion, there was a good company of spectators, that it was a glor ious day and that some good first aid work was demonstrated. Eleven teams completed, the judges being Capt. W. Goodley, O.B. E., M.C., and District Off-icer T . E. Walsby (No.1 District, S.J.A. B.). The result was: 1st, Grimsby, 343 marks; 2nd, New Holland Ferry, 332 ; 3rd, ·Woodford, C. M. E., 320. At the close, Miss Murland, of Woodford, presented the "Bartholomew" Bowl to the Grimsby team, the " Pelham" Shield to New Holland Ferry and the" Butler Henderson" prizes to Woodford; also miniature cups to the first and second teams. Capt. the Han. Eric Butler Henderson, Director of th e L. N. E. R., was an interested spectator and expressed his pleasure with the organisation and good work done. Others present included Dr. Clayton (Woodford), Miss Alex Hays,

North Eastern Area, L.N.E.R. Ambulance Secretaries. Standing, from left: S. P. Thompson, Darlington; A. Kirk, Middlesbroug-h ; J. W. Beer, Leeds; G . H. Oakes, Hull. Seated, from left: A. E . Armstrong, Newcastle; Sidney Cooper, Centre Secretary ; A. Atkinson, York.

Barbour, W. Beaty, C. H. Chambers, A. B. Clark, J. S. HomIer, M. I\'eson, C. McDougall, W. Robinson, W. Studholme, G. Wright, A.

25 YEARS BAI~. Tinsmith. Station 1nspector. Millwright. Fitter. Electrician. Examiner. Painter. Checker. \~lagon Repairer. Foreman.

Darlington. Newcastle. York. Tweedmouth . Kirkby Stephen . Kirkby Stephen. Darlington . Kirkby Stephen. Kirkby Stephen. Newcastle.

Hobkirk, W. D. M. Jobson, E.

30 YEARS BAR. Tinsmith. Plater.

Darlington. Darlington.

Carter, G.

3S YEARS BA1~. Labourer.

York.

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Capt. F. Spurgeon and Mrs. Spurgeon, 1\1r. and 1\11'5. Nicholls, Mr. and Mrs. White, Mr. and Irs. Shaw, Mr. and l\1 rs. Gent, Mr. Gardner (Grantham), Mr. and nIrs. S. B. Wilson (Sulwell), 1\1r. and Mrs. G. Dawson (Grimsby), Mr. W. A. Adams (Woodford). Following the presentation the judges addressed the com petitors . Capt. Goodley spoke of the unique position of the competition and of the great help which they received from the Pelham family. They were grateful to them for their continued kindness and hospitality. Mrs. Pelham, in the unavoidable absence of Col. Pelham, thanked all present for the appreciations. They were only too pleased to help on the ambulance movement.

Does your colleague read FIR.ST AID , if not, s end us his address and we w ill post him a copy.

Southern. The Centre Committee Certificate for long and meritorious -first aid service has been awarded to G. C. Wateridge, Engineers' Dept., Redbridge \;Yorks. MERITORIOUS CERTIFICATES: These certificates for meritorious first aid have been awarded to : Inspector B. Record, Orpington) who rendered first aid to Guard Capon. The injuries including arterial haemorrhage and fractures; equipment having to be improvised. Labourers A. J. Parker and S. Sims, of Meldon Quarry who rendered assistance to Underman Meardon. Unfort~nately their skill in treating the multiple injuries and in getting the patient to hospital was of no avail. Mr. W. Baker, Engineers' Dept., Brig'hton, whilst on his way home was called to a house where a woman had put her head in a gas oven . Although suffering from ~Cl~te Muscular Rheumatism) Mr. Baker performed artifiCIal respirati'on and was successful in restoring breathing.

A.ID Long Service Medals were presented by Mrs. Uzzell. Mr. Uzzell, in reply to a vote of thanks proposed by )"Ir. Trott to himself and l1rs. Uzzell , cong rat ulated the recipients of the awards, which number ed 349 including 64 certificates. He alluded to th e usefulness of first aid and appealed for new members throughout the district. Mr. A. Goddard (District Secret ary) thanked illr. Pape for presiding. The Chairman, in reply, expressed his pleasure in being able to help th e memb ers in the movement.

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Pioneer Rescue Workers. TilE accompanying illustration is not of an A. R. P. Squad, as might be thought at first glance, but one of the earliest teams of trained" Mines Rescue :-'Ien." This team, of the Hickleton Main Colliery, Yorkshire, completed training in 1908 at the Wath-on-Dearne Station; the apparatus shown being of the" Draeger" type. Each memher of the team is worthy of the name " Pioneer." Sergt. Winch, now in retirement, was instructor at the station and trained hundreds of Rescue I.\Ien.

Hick1eton Main Colliery Mines Rescue Team. Rear: Sgt. W . \Vinch, W. H. Gawthrope, S. 1\1 00re, C. Hanmer. Front: W. White, ]. Criddle. The sccoml annual prcscntation of awards and conccrt of lhc No. +A Districl was held at Hon, on J unc 15lh, when Mr. W. Geo. Papc (Chairman of the S.R. Centre) presided, supported by 11r. E. Uzzell (General il1anager's Office) and Mrs. Uzzell, M1'. F: A. Trott (A.R.P. Inspector), Mr. A. H. Wratton (StatlOl1 Ma.ster) Hoyc) and Mr. G. P. Binstcad (Goods Agent, vVorth1l1g). Mr. Pape emphasised the importan.ce of first ~lld 011 the Railway and pointed out that dunng the pen?d .of 'o vember, 1938 to April, 1939, members of the dIstr~ct had treated, 3)26 cases. He hope~ that when the offiCIal fio'ures wcre available it will be eVIdenced that therc was a b greater percentage of first ~iders on the staff <?f the ,onthem Railway. He cOJ11pllmente~ the classes 111 thc district on their high standard of effiCIency. . The awards were presented by Mr. Uzzell, whll t

1\1r. H. Gawthrope became a Colliery l\1ana~er in Ne\\' South Wales and advocated and promoted first aid and mines rescue in his district. 1\1r. Sidney foore later became 1\1ines Rescue Instructor at Bristol and gained distinction in mines and docks before his dealh. 1\1 r. \"1. \Vhite emig-rated to Canada, where he spread the work, later meeting his death in a mine disaster. 1\1r. John Criddle was an enthusiastic ambulance promotor. From mine worker he became l\Ianager and later an Agent to one of the largest groups of collieries-:-the poncaster Coal Owners' Association. Although now 111 retirement, he is still an ambulance enthusiast. . LRstly we come to 1\1r. Charles Hanm er who.ls perhal?s the best known of the group, and whose record 10 first aid makes excellent reading.

FIRST In 190b he gained of first aid certi I1cate and in 1908 his Rescue certificate. At the Cadeby Colliery explosion in 1912, when there was a death roll of nearly 100, he captained the Rescue team. AI. 0 during this year he gave his first illustrated am bulance lecture in Barnsley, the slides being made by himself. At the outbreak of the Great 'Var he joined the B. E. F. but was subsequently recalled to conduct recruiting first aid lectures throughout the C nited King-dom. During 1918 lw was admitted as a Serving Brother of the Order of St. John and appointed Onicial Tourin~ LectureDemonstrator of the Order; also District Officer of the St. John Am bulance Brigade attached to Headquarters. Then followed eleven years of intensive propaganda work in every department, conducting exhibitions in L1lost of the principal towns throughout the country. In order to enable him to de\'ote more time to the making of films in some of the deepest coal mines in the country, ;\1r. Hanmer resigned his post of Lecturer-demonstrator in 1929 but continued to give his ambulance exhibitions. Cnfortullately, in 1935 his health broke down and a complete rest was ordered. During the time of enforced idleness :'Ilr. Hanmer "'as able to recall many activities-explosions, fires, wars, lantern lectures, making and exploiting eight films all on tirst aid, including the world famed" Black Diamonds." No',,\' to 1939, when we again tlnd Mr. Hanmer restored to health and ready to carryon hi:; work. He will be pleased to hear from old and ne\,v friends (The Studios, Goldthorpe, Rotherham) and to gi\'e particulars of his new recruiting and fund raising programme.

curtailme.nt of practice or theory. 'Ve are dealing with human lives. We cannot be slipshod in our methods, emergency or otherwise. A rigid adherence to the syllabus of instruction must be the rule. Again, it is suggested that the correct application of tourniquets needs no great consideration. I agree that a tight. b~n~age would serve the purpose in an emergency. But It IS Il11portant to know w/zere to apply a tourniquet and why. For his fourth lecture Captain \Vhite Knox would <Yi\'e a definition of insensibility, but no differential diagn~sis. The treatment of all cases of insensibility would be the same. So that if a man was suffering from sunstroke or diabetic coma, he would be afforded identical treatment! I would suggest to Captain White Knox that a class should be taught to endeavour to ascertain the cause of illsensihilit}, if only for the patient's sake! Briefly, tben, we find that in four lectures of one hour's duration, a lecturer is expected to deal with the entire essentials of first aid. 111 four hours' practical work a class woul.d be exp~~ted to be able to <'lppl)' triangular bandages In all positIOns; to be able to deal with every type of fract~r~; to apply artificial respiration; and to transport an ll1Jured person. It is manifestly impossible for the ordinary indi\'idual to accomplish so much in so little time. . \Ve are told that in practice theory proves a fickle gUIde; a great proportion of first aid is common sense. But at least, then, let us ha\'e the practice of sufficient value that a first aider can use his com mon sense to good purpose. Yours faithfully, B. ROSEFIELD,

Letters to the Editor.

Div. Surg. 1 o. 44 Acton and Hammersmith N. D.

vVe are in no way responsible for the opInIOns expressed, or the statements made, by Correspondents.-EDIToR. EMERGENCY FIRST AID INSTRUCTION. SIR,I was more than interested in the article entitled " Emergency First Aid Instruction," published in the June issue. I was more than amazed that so experienced a lecturer and examiner as Captain vVhite Knox should suggest that first aid could be taught in four lectures and four practicals, each of one hour's duration. If we are to have people" qualified" to render first aid, le~ u~ be sur~ that they are fit and competent to apply the prt nCI pies efficlen tl y. ;\1 ore harm than g-ood will result from the. zealous, t~10ugh misguided, efforts of an inadequately tramed first alder. The many instances of "meddlesome first aid JJ so often referred to by Dr. Corbet Fletcher in bis articles, and the experiences of any doctor, will show the folly of whittling clown the recoCTnised lectures of the Association. b Let us examine Captain White Knox's points in detail. He agrees to allow the First Lecture to stand as it is. I cannot see why he should pay less attention to shock and its definition than to any other subject in the Textbook. Shock is present in major or minor degree in all injuries and sud?~n illnesses. ~t is important to understand why the conditIon. of shock anses in order to treat it properly. He con:lders th~L the treatment of fractures requires !ess el~boratlOn than IS deemed necessary. It is practically Impos,~I~lc for any conscientious lecturer to cover "fractures 111 one lecture alone, and I maintain that it is es')ential to deal with the fractures thoroughly. More time than usual should be devoted to classes learning first aid for the first time. ' Captain White Knox recommends an elasticity of application in the treatment of fractures, and presumably of all other p<'lrts. of the course. First aid is a subject of such tremendous anportance that it will not permit of any

FIRST

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Slf~,-

It appears to me that Capt. 'Vhite Knox has missed the point at issue when he states that it is quite possible to teach the necessary essentials of first aid in four one-hour lectures with an additional four hours ror practice. . No o?e with a kno.'~\'ledge of Dr. White Knox's qualificatIOns will attempt to Join issue with him on this statement but I would suggest t hal he is viewing th is matter from th~ standpoint of the l.octurer rather than from that of the p~pil, and that w~1ile it would no doubt be quite possible for him or some of 11Is colleagues to deliver an abridO'ed course along the lines laid down, I very much doubt th; ability of t~le a\'er~ge pers?n t.o completely absorb in the stipulated tlm~ t~e 1l1fOrmatlOn 1m parted by the lecturer, much less to retam It afterwards. If, however, the lime limit for the short)) course must be adh~re~ to, ma~ 1 sug-gest that it would perhaps be better to restnct 1I1structlOn to treatment of those conditions \'vhich constitute a dang-er to life unlec;;s treated rapidly, i.e., h;-emorrhag-e, asphyxia and shock, together with the basic rules for the treatment of fractures, wounds and burns, Surely a sound understanding of these fundamentals would be of greater value in an emergency than a sketchy knowledge of the 'w hole subject. As for the rest as Dr. White Knox himself points out, common sense con~titutes a large part of First aid treatment. - Yours, etc., . litre-court, F. H. VINCENT. E.C.2.

A.R.P. Topics. COLLECTIVE TRAI:\fING FOR FIRST AID POST .

A circular issued on June 22nd (No. 1831, 1 ~d. post free) sets out proposals of the ~linister of Health for collective training of personnel attached to first aid posts. A doctor, who will be responsible to the Medical Officer of Health, will be in complete charge and it will be his duty to arrange and conduct collective training in such a way as to reproduce as realistically as possible the conditions which may· arise in times of emergency. Training exercises, it is suggested, should take place at intervals of not less than one month and in cooperation with other services where necessary. At such exercises the opportunity should be taken to give instruction on some particular aspect of first aid. It is further suggested that the" patients" should wear a label bearing details of signs and symptoms of the supposed injuries and present themselves at the entrance to the post straggling or crushing in, in a manner in which walking casualties might be expected to arrive. The personnel are also to be given training in the handling of contaminated cases. A trained nurse should be placed in charge of the reception room and describe which of the cases should be seen by a doctor. Such cases are taken to the treatment room and thence to the rest room before being sent home or to hospital. Stretcher bearers should receive practice in loading ambulances; and collective training undertaken by mobile units. The Minister of Health is prepared to agree that local authorities may spend up to £6 on supplies in respect of :lny building or mobile unit for equipment to be used for training purposes. Consumable supplies provided centrally should not be used.

------.--.------The annual competitions of the Nottingbamshire Branch,

B. R. C. S., were held in the grounds of Clifton Hall, on Satur~ay, June ?4tb. Over 900 meln bers com peted, representatlve of 24 detachments.

A.R.P.

INsTR

CTIONAL CHARTS.

A new set of lecture charts has been sent us by Messrs. Jordan & Sons, Ltd. '. 116, ~hancery lane, London, \,v.C.2. The set IS of SIX charts: (1) Fighting Incendiary Bombs;. (2) Shell .and Bombs Compared; (3) Effects of HIgh Explosive; (4) Classification of \Var Gases; (5) Persistence of Gases; (6) Respirators, Selection of Size j ~nd each are accompanied with lecture notes whIch should prove of great assistance to those undertakina such lectures. The illustrations are clearly b ' defined and include comparisons between certaIn types of bombs and the effects of high explosive. The complete set, printed in two col~urs on stout linen-lined paper mounted on rollers, IS 30/ -, whilst single charts are available, unmounted, at

AID 5 - each, or mounted 7/ 6 each. The charts measure 30 ins, by +0 ins. There is also a set of reproductions of the charts, 9 i ins. by 121 ins., printed in one colour on imitation art paper, at the very reasonable price of 6d. per set. These would be of great use to distribute among students. L ' DUSTRL\L A.R.P. SERVICES.

A prel iminary l\Iemorandum on the Organisa~ tion of Air Raid Precautions Services in Industrial, etc., Undertakings and the Training and Equipment of Personnel has jtlSt been issued (price 3!d. post free). This outlines the organisation and facilities which industrial and commercial undertakings, wh ich em ploy more than 30 persons, will be required to give effect under the Civil Defence Bill, 1939. All employees must know what to do in the event of an air raid and all necessary personnel for first aid, anti-gas measures and for fire fighting must be trained and equipped. First aid parties are to consist of four men and such parties distributed at suitable points. Each party must be equipped with a first aid haversrtck or box and two stretchers. Each man must have in addition a first aid pouch. Appendix A gives the number of persons to be trained; Appendix B, the equipment for first aid pouch and ha\'ersack ; Appendix C, equipment for decontamination squads j Appendix D, fire fighting equipment, \\'hilst Appen.dix E ?,ives a suggested scale of personal protective eqUlpment. STR GCTURAL DE F ENCE.

Handbook No.5 (price 2 '2d. post free) has just been issued and deals . with '" ~tructu.ral Defence," and is the result of 1 nformatlOn whIch has become available from various sources. Chapter 1 deals with Ballistics, characteri,stics of high explosives, detonatioll, action of explOSIves, sequence of events ,vhen a bomb detonates, typ~s of bombs, etc., and includes numerous tables 10 this as well as other chapters. In turn High Explosive Bombs, Structural Defence, S?e~ter Requirements, New Buildings and EXIst10g Buildings are discussed in subsequent chapters. :'IIembers of the \\' estbourne Division, S.J.A . B., which was formed but a short time ago, ha\'(~ a fairy Godmother." He or she ha. undertaken to provide 24 men with their uniforms, free of charge. I I

Harworth ' 0 . 1 won the" " ' right)) Shield (after a tie with Ireland No.1); Ireland ~o. 1 the Nottingham General Hospitill Cup; Bolso\'er TO. 1 the" Portland)) Shield; and ~lr. lV. Webster (Glap\yell Colliery No.1) the "Felto~" Cup, at the final competitions of the atts and Derbyshire Collieries Ambulance L eague held on June 17th, at Welbel'k Abbey.

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FIRS T

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Our Nurses' Pages. 3

COMPILED

BY AN

It is with very g-reat regret Lhat members of the St. John Ambu lance Brigade will have heard of the death of Lady Perrott, R. R. c., their Lady Superintendent-in-Chief, which occurred on Tuesday, July i-th, at Minehead. Lady Perrott was no mere figure head. She herself was a keen and efficient first aider, and had carried out the same hospital duties as many hundreds of ambulance sisters of the Brigade have and are doing to-day. An inspection by her was a thorough examination, and a lth ough she ne ver failed to give words of encouragement, she would note any mistake in treatment of a supposed case, and would at times herself demonstrate the correct method. In this way she did much to keep alive the keenness and efficiency for which the Brigade is known . The Annual Camp for officers and members of NursingDi~i~ions .had her warmest support, and she invariably paid a VISit to It. Important duties found Lady Perrott goi ng the round of the First Aid Stations, and those on duty were always encouraged by her friendly interest in their wotk and wellbeing. . The late Lady Superintendent-in-Chief will be very much missed hy the members of the Nursing Divisions, an d the deepest sympathy of all will go out to her daughte rs, the Lady Forester and Viscountess Maitland, who have themselves always taken a keen and active interest in the work of the Brigade. No.1 DISTRICT, S.J.A.B.

SOUTHERN AREA.-T he Mayor of Lewisham, Cr. H. E. awards won by members ir, competttlOn and at the annual re-examination on Thursday, June 29th, at the Algernon-road Congregational Ch urch Hall Lewisham. ' Following the presentation, nine-years-old Brenda Robson, dressed as a nurse, handed bouquets to the ~ayoress and to Lady District Supt. Miss Walker. A display was then given by the members of the Division a nd the proceedings closed with an enjoyable concert. Trophies gained were : ".Hayes" Cup, for drill-Ambulance Sisters J. Fielder (captain), F. Roffe)', E . Aylott, C. Wilkinson, M. Salmon, L. Chambers, C. Roles, E. Edmonds. Four teams competed. . " Webb" Cup, for first aid team work-Ambulance Sisters 1. Bowles (captain), L. Chambers, C. WilkLOson, M. Salmon. Seven teams competed . Bedmaking Cup- Ambulance Sisters E. Edmonds and 1. Jarvis . . "Mills" Shield, for individual first a id - Ambulance Sister 1. Bowles. ~r.o wn, ]. P., presented

•

AMBULANCE SISTER.

Members of Lhe Nursing and Cadet Nursing Divisions, under Lady Supts. Miss Baxter and Miss Wilder, formed a g uard of honour as the bride and brideg room left the church. Gifts to the bride included a clock from the Ealing ursing Division and a tray cloth from the Nursing Cadets. V.A. D. INSPECTION AT TEDDINGToN. - Some frank advice was given to the nurses at an inspection of V. A. D. Middlesex 38 and 136 which took place on Friday, June 2nd, when about 60 members paraded under Commandants Mrs. P ope and Mrs. Cooke. Major]. Hare, O . B.E., was the Inspecting Officer, others presen t bein g Viscountess l\lountgarret, 0. B. E. (County Controller), Lieut. -Col. Shepherd, D . S. 0 ., the D e puty Mayor and Mayoress of Twickenham (Alderman and Mrs. E. Ollis), and the Rev. Russell B. White. Following the inspection, demonstrations of first aid su rgical and medical nursing and anti-cras work were erive~ by the members, and Major Hare complimented both detachments on their efficie ncy which, he said, was all the more creditable in view of the short time both detachments had been in existence. " Go to yo ur local hospital as often as you can, and concentrate on the surgical rather than the medical ward" M~jor Hare added. "If war should unhappily come,' I thlOk the medical and anti-gas duties yo u will be called upon. to perform will take a secondary place. It is the nurse who IS capable of dealing with severe cas ualties who will be the most useful." Lad y Mountgarret urged the members to make as much individual effort as possible in order to become efficient and not to fall into the habit of leaving everything to their Commandant. ~

Your knowledge of First Aid will be considerably enhanced if you wear the badg-e of the Si\lAE Institute, which is recognised as an emblem of sound and efficient training in scientific subjects. The holder is thereby _k nown to have satisfied a Board of Examiners that he or she possesses a most comprehensive knowledge of human anatomy and physiology and can satisfactorily treat all the hundreds of conditions that are amenable to Massage and manipulati.ve Therapy. Tremendous opport unities li e before you in this uncrowded field which is now open to you without having to leave your present work until you qua lify as an expert and ca n command an expert's pay. If you are intereste d in First Aid you will at once appreciate the value of IVIassage, real isin g that whilst exercise is the finest means of retaining h eal t hy muscles in good tone, that it does prod u ce combustion and fat ig ue products in the tissues.

Massage will build up the muscular and nervouS systems in exactly the sa me way as exercise; but does not incur any waste products and even removes them when they are present. It is then the most valuable asset and a wonderful t reatm ent for injured and sick.

No.5 DISTRICT, S.J.A.B. WETIIERBY N URSIN G DIVISION. - A very successful Garden Fete was held on Saturday June 17th in the beautiful grounds of Castlegarth House, the I;ome of County Surgeon E. H . Lodge and Lady Div. Supt. Mrs. Lodge. I.ntroducing the opener, Col. L. Hopner, J.P., who is the :,~ce-President of the Division, Mrs. Lodge spoke of the ambitIOn of the Nursing Division to have a fully equipped road hut on the Great North Road. B~fo~e he declared the fete open, Col. Ropner spoke a~p~e~lat~vely of t~ e great amount ot work done by th e DlvlslOn 10 ~onnectlOn with the training of National Service Volunteers 10 the Wetherby Rural District. No.8 DISTRICT, S.J.A. B.

WESTERN AREA. No. 64 (EALIl\'C) NURSING DIVISION.-Miss B. ]. Shephard, for many yea rs connected with this Division was married at Ealin g on Saturday, Jun e 24th, to Mr. W. Chapman. ~he h:i~e. was one of the first m em bers of the Cadet NursLOg DIVISion, of which s he was s ubseq uently an actiner officer. 0

OU, too, ca n easily become an expert practiLioner of Swedish l\1assage and enjoy the status, remuneratio n and com fort s of the professional worker if you a r e prepared to study for an hour or so each day.

. HOVE, N~RSIr-::G . DIVIsION. - In view of the appeals for NatIOnal SerVice, It IS encouraging to find that this Division has mo~e than doubled its strength during the past year. ThiS was reported at the annual distribu tion of awards presided over by Canon F. ]. Meyrick Vicar of Hove o~ Saturday June 24th. ' , . It was stated in the Annual Report that members had given treatment to 370 cases during the year. The work of

F I LL I N A N D P O S T THI S COUPON

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COUPON To The Secretary, The SMAE Institute, Leath'e rhead, Surrey. Please send me w ithout obligation, a copy of your free Booklet " Manipulat ive Therapy as a Profession."

Na me . .......................... . Address ........................ ..

" F.A." July , 1939.

The proper study of mankind is man. Study the most absorbing subject in the world in good company under the guidance of the S.M.A.E. Turn y our interest in First Aid work and your hobby into channels that mean money for you-health for others. Get this Free Book" Manipulative Fill in Therapy as a Profession" and the Coupon learn how you can enter the for this profession with a future. Fill Free in the Coupon and post withBook out delay.

FIRST

the movement is of the hig-hest importance, and it was stressed that there is room for sufficient volunteers to double the present strength of the Division. Seventy-three awards were presented to members by Mrs. Offord, Han. Secretary of the Auxiliary Nursing Reserve. The chairman was supported on the platform by Lady Div. Supt. Miss E. M. Worseldine, Miss Butler (Div. Treasurer), Mrs. Rose (Div. Sccretary), Lady Ambulance Officers Atkins and Draper, and l\liss A. Field Comber (ExLady Div. Superintendent). Tableaux representing nursing of the past, present and future were staged by ursing Cadets, and a charming play was presented by members of the Nursing Division. DO\' ER NURSING CADETS.-On \Vednesday, June 22nd, the members of the Nursing- Cadet Division held their yearly bedmaking competition at Headquarters. It was very interesting to watch the girls at work, the time allowed for ea ch pai r to make the bed bei ng four minutes. The prize winners were: 1, Patricia Abbott and Eileen Payne; 2, Kathleen Cotton and Audrey King. The judging was undertaken by Ambulance Sister Mrs. Hollands. The Nursing Cadets are now preparing to hold a team competition in first aid and home nursin~. No.9 DISTRICT, S.].A. B. WEYMOUTH NURSING DIVIsION.-Ambulance Sister Green who was married on June 25th to Sergeant E. Glover of the Ambulance Division, was presented with a cut glass salad bowl and servers, a wedding gift frol11 her fellow members, on Thursday, June 22nd. The presentation was made by Mrs. SherwelJ after she had carried out an inspection of a uniformed parade of the Division which was drawn up under the command of Lady Div. Supt. Mrs. Bartlett. Mrs. SherwelJ wished Ambulance Sister Green every happiness. She congratulated the Division on a smart turnout, adding that in her long association with them she had always been very proud of the members. DEMONSTRATION BY V,A.D. KENT 62, B.R.C.S. Interesting demonstrations of the treatment of cases of mustard gas poisoning, erysipelas, broken leg and bronchial pneumonia were given by V.A. D. Kent 62 at Sidcup Green on June 24th. Two beds in a single ward accommodated the erysipelas (sixth day) and bronchial pneumonia (tenth day) patients. ::;even nurses were in attendance, those with the former patient wearin~ masks as a protection against infection. Oxygen was being administered to the pneumonia case, and a steam kettle was also being used. Proper diets were at each bedside. The mustard gas patient had received vapour contamination on the sleeve of her coat. On reporting to the cleansing station her clothes and gas mask were immediately removed by a nurse in protective clothing, and placed in an airtight bin to be decontaminated later at a special laundry. The main object of treatment, it was explained, was to prevent burns such as were illustrated by a chart displayed. These casualties were prevented by the use of bleaching powder, by washing the p<'ltients thoroughly with soap and water, and applying vaseline to the eyelids. This was elementary treatment. More severely injured cases would be dealt with at hospital. Six nurses attended the case of compound fracture of the femur with bone protruding through the skin Sterile application was made to the wound, and a Thomas splint carefully adjusted in position. Hot water bottles and blankets were used to com bat shock.

FIRST

AID Directing the demonstrations were the Commandant, Mrs. Barnard, with Assistant Commandant Mrs. Murgatroyd and the Medical Officer, Mrs. Hewl~tt, M.R.C.S., M. R.C. p. V.A. D. HANTS 2, B.R.C.S. Very satisfactory progress is heing made by this detachment and the members received warm praise at the Annual Inspection held on June 1-+th at Southampton. The Inspecting Ollicer was Major-General Sir Richard Luce. K.C.M.G., C. B. (former County Controller), tl1(' detachment parading;n the grounds of GlenbourtlE', vVe!:>tend , hy kind invitation of 1\lr. and Mrs. Charlier. The nurses were questioned extensively on a variety of subjects. In addition to first aid nnd A. R. P. work, th e treatment of cases of illness in hos]lital was dcmonstrateu , and there ,,"as also a display of invalid cooking, Sir Richard told the de tachment that he had been VCf\ highly impressed by their efficiency. He: urged them ( ~) continue to support the unit, which, apart from its peacetime activities, would be of invaluble service in time of war. He particularly commended their first aid work. It was \'ery gratifying' that so many women were joining th e detachment. Describing the V.A. Os. as the first line civilian nursin g service in time of war, Mr. Moray Williams, County Director, B. R. C. S., emphasised the need for further recruiting. Th e medical services of the town would depend very largely on the V.A Ds. in war-time, and il was imperative that the detachment should not rest on its laurels. In Hampshire they had doubled their numbers since last Septemher, bu t they must not relax their efforts. The Mayor and Mayoress (Cr. and Mrs. Powdrill) '.vere among those who watched the nurses at \\'ork, anJ th e Mayoress presented a large number of proficiency certificate s.

P atz'ent's Tribute TO

VAUXHALL INDEPENDENT SPRINCINC

AID • I

.I feU and damaged my Lejt side-J was

in intense pain when moved. I was put into the Vauxhall and brought home at once. The Doctor wished me to be X-rayed and I was driven into Alnwick again by t!~e Vauxhall-i4 mz'les from here without a single jolt or jar, simply marvellous. I t was found I had cracked my kip. I s lzould l£ke to make yoztr independent wheel springing compulsory on all Ambulances. " H. H. R., Northumberland

BELFAST BRANCIJ, B. R. C. S. The Annual Home Nursing Competitions organised by this Branch of the B. R. C. S. were held in the Husban d Memorial Hall, Belfast, on Saturday, June 10th. They aroused a keen interest among the teams entered from th e various detachments throughout the Branch. Senior and novice tests were given, and resulted a s follows :- Senior- 1, Belfast V. A. D. 2; 2, BEJfast V. A. D. 12. Novice- 1, Belfast V.A.D. 14; 2, I3elfast V.A.D. 2 ; 3, Belfast V.A.D. 1. The judg-es of the various tests were Miss S. Woodhouse, Miss F. H. Airey, Mrs. Carr, Mrs. ]. Saunders, Dr. ;\lary Marshall, Dr. Mary Erskine, and Mr. ]. C. Hamilton .

The Medical Department of the Admiralty, includin g the Inspecting Medical Officer R. N. A. S. B. R., has been transferred to Queen's House, 64, St. James's-street, London, S. W.1. Telephone: Regent 7481. Mr. G. P. Watts, formerly Red Cross County Director br Cheshire, collapsed and died at a Red Cross garden party held at Burgess Hall, Sussex, on July 1st. The meeting was immediately abandoned. The annual inspection of the County of Dorset S.J. A. B. was held at Poole on Sunday, .T uly 2nd. County Commissioner for Hampshire, Major A. Tennyson-Smith, was the inspecting officer. Nearly 700 were on parade. Pontefract Colliery won the "Elliott" Cup in the \Vomb"vell Ambulance annual competition held onJune 24th. Mr. H. Wood (Pontdract) was successful in winning the " Eric S. Roberts" Cup in the individual section.

The above testimon ial refers to a Vauxhall car. Vauxhall Ambulances , designed specifically for the. c?mfort of invalids, achieve an even higher standard of rldmg smooth ness: Independent springing _ rubber cushioned 25 h.p. O.H:V. engine _ smooth, quiet transmission _ double-actmg hydraulic rear shock absorbers _ low pressure t yres. Vauxhall Motors Ltd., Luton , will gladly supply literature and demonstrate. " s " Type Ambulance, illustrated , £693. Others from £575.

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AMBULA NCES

FIRST

Queries and Ansvvers to Correspondents. Queries will be dealt with under the following rules : i.-Letters containing Queries must be mar1{t~d on the top leEt-hand corner of the envelope" Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C. 4. 2.-AIl Queries must be written on one side of paper only. 3.-AIl 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 39th (1937) Edition of the S.JA.A. Manual of First Aid to the Injured. HANDS IN ARTIFICIAL RESPIRATION. P. N. (Coulsdon). - On page 145 of the Textbook we are instructed to I I Place your hands on the small of the patient's back, their lower edges just clearing the top of the pelvis . . ." So I ask you if you will please tell me how we can place the" lower edges" of our hands in tbe required position, because anatomically the lower edges are surely the finger tips! Tut! Tut l! FLETCIIER.

How can edges be tips ?-N. CORBET

EXAMINATION HOWLER. G.C. (Surbiton).-In a recent examination the doctor asked a candidate to name an emet ic. \Vhen she suggested the use of salt, he immediately asked her how much salt she \-"ould administer as an emetic. To the constern<ltion of all wil hin hearing, the candidate replied: " Two buckets to one oj water!" Good! Next, please! l-N.C. F. AWARD OF LABELS. T.L. (Notts.) - \Vill you please tell me in which year the Association first awarded labels for proficiency in its annual re-examinations ? In the early days the Associat ion regarded possession of its medallion as the final proof of individual efficien cy in first aid. The keenness of its certificated pupils, however, forced the Association to go a step further. Consequently in June 1905 it introduced annual re-examinations in fir!:.t aid with "label" awards for holders of medallions.-N.C.F.

FIRST

AID

increased activity of the sound side which must not be handicapped in its movements. Consequently the patient is to be inclined" toward" the injured side and supported in that position. I tralJslate this" toward" of the Textbook as a blanket folded three (or at most four) times and placed lengthwise along the patient's back.-N.C.F.

• GET A

TREATMENT OF BeRNED AND CRUSHED HAND. L.S. (Norwood). -S upposing that a person, working- a bakelite press (in which the mould is heated), had his hand caught between the two sections of the mould and that the hand, besides being crushed, was burned, wha t would be the best first aid treatment to relieve the bum and the crushed hand? I should like to express my appreciation for you r help and answers to problems in FIRST AlD. Clearly the indications are first to treat the burns and, this done, to carry out the instructions on p. 86 of the Textbook with reference to crushed hand. - N.C. F.

SPARKLET RESUSCITATOR Dressings of any length can be cut in an instant from the 'Elastoplast' Dressing Strip, which is elastic, adhesive and antiseptic. In Ii", 3t" and 3" widths , 1 yard long. Prices from 1 /3 d. each. The ' Elastoplast' Surgery Case contains one each of the three widths; price SJ3d complete.

DIAGNOSIS OF FRACTURED SPINE. G. L. (Sherwood).-vVith regard to the treatment of a fractured spine, if the patient is unconscious please tell me how we may diagnose the presence of such an injury other than by sense of touch (in the "Routine Examination ").

Write for further details to T, J. SMITH & NEPHEW, LTD. (Dept. F.A.2) Neptune Street, Hull.

Innumerable caseS: of death from GAS POISONING, SHOCK, DROWNING, etc., could have been prevented by prompt use of the SPARKLET RESUSCITATOR. SPECIAL WORKS OR AMBULANCE OUTFIT 85-. Write for leaflet on the" Prompt First Aid Treatment of Asphyxia and Other Respiratory failure Emergencies" and booklet describing this and other resuscitation outfits to Sole Makers: Dept. 42.

You would have to rely on the history of the accident and on the surroundings which are the external circumstances associated with the patient, the (injured) part and the pla ;:;e of the emergency.-N. C. F.

S PARKLETS TREATMENT OF HEART ATTACK. G.L. (Sherwood).-Please tell me if, as a result of a heart attack, the patient's breathing- appears to be failing, it would be wise to perform artificial respiration. As patients s uff~rin g from heart attacks are not likel y to present signs of failure of respiration except when they are £12 extremis, I fail to see what good would be done by the performance of artificial respiration. - N. C. F.

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TEXTBOOK OF SURGERY FOR FIRST AIDER. G. L. (Sherwood).-In add ition to my preceding queries, wonder if you could give me the name and cost of a textbook on surgery, please. It is my privilege, along with ot.hers, to attend our local General Hospital, and there 1 see quite a lot of surgery in the Casualty Department. So as I wish to be able more fully to appreciate what is being done, I have asked the above.

Apart from Cups and Medals, Alexander Clark always have an enormous range of util ity Prizes and Gifts su itable for Ambulance Competition Prizes .

Your quel'y cannot be a nswered because your request is beyond the scope of first aid and all columns of FIRST AID. Further, yo u forget the old saying-" Cobbler, shck to your last/"-N.C.F.

Catalogues and Wholesale Terms allowed bona-fide First Aid Societies, gladly sent upon request.

TREATMENT OF CO:\IPLICATED FRACTURED RIBS. A. H. (Goole). - Would you please inform me what is meant by inclining a patient towards the injured side in fracture of the ribs penetrating the lungs? Also, what is the object in doing so ? The argument used against me in our Division is that the patient should be bent inwards whilst still on his back. I deny this and say that patient should be slightly tilted over towards the injured side and supported in that position. When the ribs of one side are broken. pain will cause a d~minished range of movement. For the proper supply of air and oxygen, therefore, the patient is dependent on an

DIAGNOSIS OF FRACTURES. B. K. (Hendon). - I had a case the other day. A young lady slipped and kl10cked her hand against some rails. When I examined her, the only signs were a very slight swelling of the wrist, and the only symptoms were just a littl e pain in the wrist. That is all the signs and symptoms there were. She could move her hand, and even grip Illy hand tig-htly witho ut hurting- herself _any more. I app lied a cold dressing, and bandaged it firmly, and I think, fortunately put the arm in a large slin g. J told her that jf it hurt or became more swollen, she shou ld go to a doctor. 1 was very surprised to hear

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FIRST

that on the following day the hand began to hurt her, and that the doctor sent her for X-ray examination to hospital, where it was found that a bone was broken in the wrist. Will you please tell me where I was wrong-, and why there were no signs and symptoms of a fracture? Meanwhile I thank you in anticipation. You were not in the wrong; and your first aid treatment was perfectly correct. From personal experience you have now learned that the diagnosis of fractures is not always as simple and t"asy a matter as you once thought; and that X-ray examinations will often demonstrate fractures wbere all the signs and symptoms are sugg-estive only of sprains. Consequently you now know why doctors always send such cases for X-ray examination. - N.C.F. COMPLICATED FRACTURE OF FEMUR.

A. H. (Chesterfield).-At our annual re-examination held last week one of our members was asked to say what kind of a fracture it would be if the femur was broken and the femoral artery was torn, and he answered a complicated fracture. The member was somewhat surprised when the examiner said that it was a simple fracture. At the end ot the examination the examiner, in the course of his remarks, referred to this question and confirmed that the fracture was, practically speaking, a simple fracture. He also added by describing a complicated fracture as b<:-ing where the bone is broken and is piercing some internal organ, such as heart, lungs, liver, spleen, etc. In the Textbook it definitely states that a complicated fracture is one in which a bone is broken and is piercing some internal organ or damaging an im.porlanl blood vessel or nerve. The opinion was the examiner's and did not affect the member's examination marks. In view of this, arguments have taken place between our members, and I have been asked to write for your kind ruling on the matter.

On your statement of fa cts I agree with you.-N .C. F. I CE IN TREATMENT OF H lEMO RRHAGE.

A. I\1. (Poplar). - Why does the Black Book teach us not to give ice to suck in hcemorrh age from an internal org-an, except from the lungs (Rule 3, p. 137)? Would it be injurious to do so and why? There are two reasons why I ask these questions : (1) Recently I attended a person with hcemorrhage from the stomach, and, as a St. John man, had to persuade helpers not to !Sive the patient ice to suck, although the patient begged for it. The subsequent treatment by the doctor was iced water to drink. (I expect the patient now thinks that I am a poor first aider. ) (2) In two different first aid manuals I have read both give instructions to give ice to suck in alJ cases of internal hcemorrhage, presumably to control bleeding and to relieve thirst. The only conclusion that I can reach is that a first aider cannot tell the extent of the damage done and is taught in the St. John Textbook not to give anything by the mouth to be on the safe side. . I would appreciate any comments by you upon thIS. . Tot knowing, I cannot say. So perhaps your suggestion IS correct. Personally I would allow first aiders to administer sips of cold water or to g-ive ice to suck except when the hcemorrhage comes from the stomach.-N.C.F. STRAIGHTENING FRACTURES.

K.M. (Brixton). - If, in the case of a fracture of the arm,

FIRST forearm, thigh or leg, the limb is bent at the point 01 fracture, would it be correct for a first aider to straighten it and then apply splints in the usual way':' One of my friends said that this should not be done in any case, but hearing in mind the instruction: "With great care and without using force place the limb in as natural a position as possible" (Textbook, p. 66), it seems to me that it would be permissible to do this, unless the bane protrudes (I presume there would be danger of drivin g the broken ends hack into the limb if straightening were attempted in a case of protusion). Your guidance 111 this matter would be much appreciated. Rule 3 on p. 66 of the Textbook is strictly limited to fractures of the lower limb, and your argument is weaken ed by this fact. Theoretically, straightening- a fractured limb is a simple matter, but practically it may be difficult and even dangerous especially if attempted by a first aider. Consequently the verdict is against your suggestion, and you should stand by Rule 1 on p. 66 and be content to render th e limb as immovable as practicable by splints or other means of restraint.-:\!. C. F. COURSE OF SCIATIC NERVE.

L.D. (Richmond). - I shall be much oblig-ed if you will tell me the full course of the sciatic nerve. Please accep t thanks for all the help you give us. The sciatic nerve is the largest nerve in the body. It is the main termination of the sacral plexus, and commences at the lower border of the great sacro-sciatic formaner. It is directed vertically down the thigh and terminates a little below the middle of the thig-h by dividing into th e external and internal popliteal nerves. Now you know ! N.C.F. HANDS ABO\'E HEAD WITIl BLEEDING NOSE.

FOR DIFFICULT CASES. ometimes it happens that an otherwise simple complaint will not respond to treatment because of parallel conditions militating against cure. I n these circumstances Sphagnol Peat Ointment frequently proves succes~fuJ. We have on record a case in which a patient, in addition to the V.D. for which he was attending the clinic, had a long standing eczema of the arm. Splza,E{nol Ointment cU1'ed the f'cze ma in a week.

TREATMENT OF FRACTURED FEMUR.

TREATMENT OF MONKEY BITE.

N.L. (Southampton).-Recently a member of our Division was c::tlled upon to treat a Monkey Bite; and conflicting opinion arose as to the correct treatment. One opinion expressed was that the bite should definitely be cauterised. The opposing opinion was that, as a monkey is not subiect to rabies, the general rules and treatment for wounds should be applied. Your views as to the correct method of treatment would be a pprecia ted. As no suggestion was made that the monkey was suffering from rabies, the treatment should be for an ordinary wound. J n other words the suggestion, that the special treatment for rabid animal bite is indicated, is contrary to fact and the Textbook. - N.C.F.

FIRST AID

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K. M. (Brixton).-Would you please tell me the reason for the instruction to raise the hands above the head in treating hcemorrhage from the nose (Textbook, p. 136). Elevation of the upper limbs above the head causes enlargement of the chest cavity and consequently expansioll of the lungs. When this is done with haJ morrhage from the 110se, pressure on the l a r~ e yeins at their entry to the right <-l.uricle is lowe red, the results being- (1) that these vessel s dilate; (2) that the return of the venous blood to the hear t is facilitated; and (3) that the bleeding from the nose is lessened. - T.C.F. C.G. (Surbiton).-Have you noticed that in the long splint which is figured on p. 88 of the Textbook for treatment for fractured thigh, the join is right opposite the fra cture? Please tell me if this is correct. Chance placed the join where it is ; and I can see no signiGcance in its position. In fact, the splint, if properly joined, will be firmer at that point.-N.C.F.

AID

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SHELL AND BOMBS COMPARED. The diagrams illustrate the comparative charges in a shell, a bomb and an armour-pier~g bomb. The construction of botb percussion and delayed action fuses is shown. Ch,lri No.2 . EFFECTS OF HIGH EXPLOSIVE. The effects of different types of H.E. Bombs are show~: (r) illustrates the eff~cts of a General Purpose bomb; (2) a LIght Case bomb.; (3) Tlme Fuse bomb after falling through five storeys; (4) TIme Fuse bomb exploding near the foundation of a building. Char! No. J. CLASSIFICATION OF WAR GASES. A Pictorial presentation of this information classified by effects on the body. Chart NO·4· PERSISTENCE OF GASES. This chart very de.verly shows at a glance in pictorial form the reason for the perSIstence or nonpersistence of the known war gases. Chart. l\'o. 5· RESPIRATORS-SELECTION OF SIZE. A ta.ble is shown o-iving the usual sizes of the three types of Respirators found ~ecessary for Men, Women and Youths. There is al~o ~ large illustration showing the range of vision when the correct Slze IS fitted and also when too large or too small a size is fitted. Chart. No. ~. PRICES. Complete set of six charts (30 in. by 40 in.), pnnteTIeI~ two colours on stout linen-lined paper, mount~d at .top on ro . 30s. per set. Single charts (30 in. by 40 in.), prmted ~n tw°iliolours on stout linen lined paper, unmounted. 5s. each. Smgle arts as above but mounted on rollers top and bottom. 7s. 6d. each. Complete set of reproductions of above ~ha.rts. in book form (9t in. x 12* in.) printed in one colour on Imltat/~n art paper, by post 7'2 d • per set. with lecture notes. JORDAN &

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Editor:

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A local printer can fill in the blank space with any required matter.

NOTICE

TO READERS.

THIS

NUMBER.

E DITORIAL ; -

Annual Inspections SL John Ambulance Association... Stretcher Drill S. J .A. B. Headquarters and District Reports G oing Up ! Coming Events Priory for Wales One Private to Another Police Ambulance News Railway Ambulance News I nstruction of First Aid Ambulance News Cuttings from the Press Insensibility ... A. New Trailer Ambulance A. R. P. Topics Wounds and Their First Aid Trealment Convulsions . .. Reviews L etters to the Editor ... Our Nurses' Pages

1._______

_ _ _ _ _ _ _ _ members oj the medi· cal pro, ession and to nurses and hospital I· olficials who enclou the j r proJessional ca,ds.

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38 39 40

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F IRST AID is published on the 20th of each month. The Annual Subscription is 3S. 6d. 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 12th of each month, and must be accompanied (not necessarily jar bublication) 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., LTD., 46, CANNON STREET, LONDON, E.C+

CONTENTS

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CRAFT.

ON LV

30 in. x 20 in. & 20 in. x 12 in. Printing Spaces-16 in. x 14 i.n. &. 9 in. x 8 in.

A BaVE are the three septics. This is apprereasons why Germo- ciated most in dealing

or all Chemists throughout the British Empire

AUGUST, 1939.

No. 542.-VOL. XLVI.

Telegraphic Address-" Twentv-tour, London." Tel,phone- City 37£0.

•

30urnaI for

rbe ~mbulance nub JJlursing ~~

STOCK

PR/CE.s, post free: MEDIUM 3/3 per DOZEN. SMALL 2/3 " Remittances must accompany all orders.

DALE, REVNOLDS & CO., Ltd., 46, Cannon Street, London, E.C.4.

Blanketting a Stretcher Examination Howler Lifting Cases of Spinal Injury Face Upwards... Ways of Some Surgeon-Lecturers Arm-Sling with Injured Elbow Fractures of Both Clavicles... Complicated Fracture of Ribs Treatment of CalciuT? Carbide Poisoning Emetic with Corrosive Poisoning Treatment of Diabetic Coma Humour in First Aid

+8 +8 +8 48

48 48

50 50 50 50 SO

DURING the past month there have been numerous inspections and reviews of ambulance personnel and we have been asked: " Is it worth while holding these functions? Are they of any use? " \iVithout considering the subject one might easily answer "No" to both questions, but further consideration would brin g to light items which at first may be overlooked. Let us consider for example the largest of these functions. We refer to the inspection of the Welsh Brigade personnel by the Duchess of Kent. This inspection, the largest parade ever held of ambulance personnel, was attended by thousands of sightseers, a blaze of press publicity, and reports in National and local papers. How does this help the movement? For far too long the voluntary work undertaken by members of the great army of first aiders has been hidden" under a bushel." J ow , thanks to such functions as inspections, the general public are awakening to the fact that in their midst is a body of men and women, and even boys and girls, whose object is to render assistance to those who are striken with sudden illness or accident. Therefore, we emphatically give our opinion that inspections, even those of small divisions, are the greatest value to the movement. "It pays to advertise" is a well-known slogan; and the ambulance movement, with its increased activities, especially in A. R. P., needs all the publicity it can get. And it will get it providing those in charge will only make use of the press. Invitations should be sent to persons of standing in the district and also to representatives of the press. See also that full particulars are available for the press; that a list of visitors is prepared; and that correct ranks and other designations are available. ANNUAL INSPECTIONS.

FIRST

Stretcher Dri II.

S1. John Ambulance Association BRISTOL. - The annual co mpetitions were held at the Zoological Gardens on July 23rd, when. in srite of inclement weather, 51 teams competed for six trophies. The results were :" Beavis" Cup : 1, G. W. R. Pilning, 193 marks ; 2nd, Fishponds "A," 190! ; 3rd (tie), W. Butler & Co. and J. Robinson & Co., 183. Judges, Dr. H. G. Kyle and Dr. S. Datta. " Mather" Cup: 1, W. Butler & Co., 180 ma rks; 2, L.M.S. Loco Novice, 16i-; 3, P.A.C. Division, S.J.A.B., 157. Judges, Drs. Moore and Hailwood. " Laving-ton" Cup : 1, G. W . R. Pilning-, 199 ma rks; 2, Fishponds "A," 180 ; 3, L.M.S. Loco I\ o. 1, 179. Judges, Drs. J. Lanson Roberts and S. B. Green. "Novice" Cup: 1, W. Butler & Co., 176 marks; 2, Clifton Division, S.J.A.B., 175; 3, I.C.I., 172. Judges, Drs. N. S. B. Vinter and D. Hall Beatson. " Squire" Cup: 1, G. W . R . Pilning, 185 marks; 2, Fishponds "A," (handicapped 3!); 3, Clifton Division, S·J.A.B., 154. Judges, Drs. H. H. Strong and J. V. Lucas. "Walker" Cup: 1, Fishponds 1 ursin g Division, 151 marks; 2, Clifton Nursing Division, 139; 3, No.1 Nursi ng Division , 130 (handicapped 3) . Dr. H . G. Kyle, Chairm a n of the Centre, presided at the ~ubsequent presentation ceremony at which Mr. R. E. Bush (Knight of Grace) distributed the trophies and other awards. Mr. Bush congratulated Bristol upon posses sing such an organisation as the St. John Am bulance Association in its midst. Mr. A. M. Champion, Cha irman of the Ken ya St. John Centre, was among those present a nd s poke of the g reat interest taken in first aid in the part of Africa where h e ha d settled. A vote of thanks to the judges was expressed by Lady Corps Officer Miss Sarah, whilst Mr. Harding proposed thanks to Mr. W. G. Hawkins (treas urer) a nd his staff and the Centre Secretary, Mr. M. R. Fair. It is worthy of note that s in ce O ctober 1st, 1938, over 180 classes have been registered; the previous record was 69. BIRMINGHAM.-The employees of the Birmingham and Midland Motor Omnibus Company take a great interest in first aid work. In 1931 Mr. O. C. Power, J . P ., the Company's Traffic Manager, appealed to the Traf-fic Staff to take up the work, and to-day there are 1,969 Traffic employees in possession of 6rst aid certi6cates and other awards. Co ntinuation classes are held each week at the Company's 28 garages. Each year an inter-garage compe lition is held fo r a trophy which was put up by Mr. Power, who incidentally was r~ce ntly made an Officer (Brother) of the Order of St. John. Six eliminating tests are held a nd the winners compete in the final. This year the final was held on July 19th, when the following Midland "Red" Garages competed and were placed as shown :-Stafford, 230 marks; Worcest.er, 225 ; Digbeth (Birmingham), 217 ; Ru gby, 206 ~ ; Bromsgrove, 196 ~ j and Sutton, 190. The Lord Mayo r of Birmingham presented the Shield and medals to the winning team and prizes to the oth er teams. Those prese nt included the Lady Mayo ress, 1\1r. R. J. Howley, C.B.E., Cha irman of the Company, Mr. O. C. Powers, J. P., Traffic Manager, and Col. Sir. Bertra m Ford, T. D., D. L. , County Commiss ioner of the Birmingham Counly S.]. A. B.

FIRST

AID

ONE of the

needs among Divisions is for practice in stretcher drill, and this may be given a little more attention. A close study of the drill manual must be made by instructors to ensure that their words of command are correct before taking over th e instruction. The following points may be stressed . Collect Wou,nded.-Bearers will double by th e shortest route to the patient, halting one pace away from the head of the patient, and with the stretcher in line with the patient's body. This is not merely a piece of finesse in drill but facilitate s the placing of stretcher by No.1. P1'epare Stretcller.- This should be immediately ordered by No. 1 when he has decided that removal by stretcher will be necessary. Nos . .2 and 4 will, after opening the stretcher, see that th e slings are placed across the handles with the loo p over the near handles and close up to the canvas of the stretcher. The reason for this is that th e slings will not so easily falloff when the stre~che r is lifted by No. 1 b~fore placing beneath the patient. Load St1'etclzer.-It is well sometimes to practise this with a fairly heavy patient, as in actual work we are not able to select light-weigh t patients. Special care m LIst be shown to inj ured parts. I n addition No.4 bearer must see· that the head of the patient does not" flop." Marcll. - We all remember the need for broken step, so it will not be necessary to stress this. Unless the nature of injury calls for haste a stretcher sq uad should never double, as this will considerably shake the patient. The alternative , a very slow gait, is also to be discouraged as this will ti re the bearers. This is a section of our train ing which can be better practised in the open air than in a small headquarters. As a change we might practise the carriage of a stretcher over som e obstacle, e.g., hedge, wall or river. As a variation from the usual four-bearer drill it may be worth while occasionally to !;ive a thought to carriage with three or two bearers, or the loading and unloading of ambulance car. It is to be recom mended that stretchers should be preserved in good order. Canvases should be in good repair, and stretchers provided with slings. Transverse bars should be attended to so that the stretchers may be opened without undue difficulty. In reading up this subject reference must be made to the First Aid Manual and also to the official Manual of Drill and Camping. Batley "B" team won the "Hammerton" Shield Competition held las t month, beating the holders, Birstall, by 52 marks. Batley" A " were third.

A."I D

St. John Ambulance Brigade Headquarters and District Reports. Brigade Headquarters SURGEONS' CO. FEREXCE.-As mentioned in our July iss ue, the Surgeons' Week-end Conference will be held on October 14th/15th, at the Great Central Hotel, Mary lebon e, L ondon. It is antici pated that the principal guest at the Annual Di nn er wi ll b e Lord Harder. A f ull agenda is assured and included in the demonst rations is one on the use of the 'I'h omas Splint with talks by two experts. Further items for discussion can still be included if submitted by an early date. A printed circular will be sent to every surgeon, th r ough Itheir County Surgeon, within the next few weeks, and it is hoped that the response will be larg-cr than usnal. The cost will he 305. inclusiyc; but if surgeo ns unable to ,attend the full course desire to attend the annual dinner, the cost will be lOs. 6d. Speeches at the dinner will be curtailed to leave time for a dance which is to fo llow.

No. I (Prince of Wales's) District No. 2 (HAGGERSTON) DIVISloN.-On July 9th, a Church Parade was held to celebrate the 50th anniversary of the Division. Staff-Sergt. A. E. J agg'ers was in command of the Division and Lady Supt. Mrs. Milburn in ch a rge of the No. 62' . Division. R('prese~talives fr?m other D ivis ions also p,araded under thelt· respectIve officers. Lady Di strict Supt. Miss Walker and. District Offi.cer McBride were a lso present, and follow1l1g the serVIce, w hich was held at All Saints' Church, inspected the parade. . Th e Vicar (the R ev. W. R. Gdl) ~o.n?ucted the se rvice and traced the history of the DlVlSlO~1. ~he Division was formed by a body of club men tollowll1g riots in Trafalgar Square, and later formed themselves into the Borough of Hackney Ambulance Corps. . On July 1st, 1889, the Corps joined the then :\Ietropohtan Co rps of the Brigade. In 1901 they became the To: 2 Division and since that date the members had carned out exceiIent work. In 1927 the No . 62 Nursing Division w as form ed and the pr esence of such a large number of nurses that day proved that it had been a successful venture. No. 23 (NORWOOD AND CRYSTAL PALACE) DIV ISION.On J ttly 7th, Sir Henry Buckland, general rnanager of the Crystal Palace, was presented by Div. S1:lpt. John S. Harbe r with his badge of office as Presldent of the Division. . Afte r 40 years' service Supt. H arb er ~s ~etmng from the Brigade, and to mark the occasion SIr Henry Bnckl,and, on behalf of the Trustees of the ~rystal P~I~ce, presented Supt. Harber with a We.stmll1ster Chlmll1g clock; and als.Q a pai r of gold cuff-lmks to J::?r.. ;E. A. Ensor as a mark of appreciation from t~e DlVISlOl1 of his se;vices as surgeon, a positi on from whle-h h e h as nOw retlrec1 after 18 years' service.

Si r Henry spoke of the self-denial of those \vho attend events where crowds gather, and personally thanked Supt. Harber for his services and co-operation. Dr. Ensor, in reply, praised the work of the members. Supt. Harber hoped that the men would rally loyall) to Amb. Officer W. J. Gladden, who was succeeding him. No. 58/5 (WESTERN POSTAL AND ST. MARYLEBOKE) DrvISIO f.-At the annual outing of poor children , a rranged by the clientele of the" Fitzroy Tavern," \Vindmill Street, on August 2nd, a detachment from this Division accompanied some 600 boys and girls to Boxmoor. A special trailer ambulance was put to use for the first time and proved of great service in dealing with numerous cases. On September 7th, a Home Nursing Course will commence at the No.3 Health Centre, Paddington Street. This course is for men only, the lecturer being Dr. 1\I. 11. Scott. Fee is 5/-. A course of first aid to the injured (mixed class) will commence on September 8th at the same address. Lecturer will be Dr. Beam. Fee 5/6. Full particulars of both courses can be had of Di \'. Supt. ·W. \ -. :'If. Allen, ,,' e, tern Di<;trict Post Office. \\1.1.

No. m District. The combined inspection of the North vVorcestershire Corps and the Dudley and District Corps was held at Halesowen on July 8th. . Owing to almost continuous downpour of .ram the demonstrations were cancelled and the lI1spectlOn took place in the works of Messrs. Stewarts and Lloyds. In spite of the rain there was a record number on parade .. Corps Supt. D. M. Chapman (North \Vor~estershlre Corps), was in command of the pa:ade, whIlst Corps Supt. A. Winbow commanded the n1l1e ambul.ance and five nursing Divisions of the Dudley and Dlstnct ~orps. Asst. Commissioner Dr. D. McColl, aCCOl~1pal11ed by Co unty Officer Christopher, was the inspeC't111g office~. Other officers present included County Surgeon D. (.,. Campbell and County Officer Schofield. Tea was partaken before the inspectio~, in the h<;>pe that the weather would improve. At t.h~s. proceed1l1!?,' Corps Supt. Chapman welcomed the vlSltl11g officers. whilst County Officer Schofield gave a message of good will from 1\1r. F. F. Le Souef Simpson, former As t. Commissioner. . Dr. ~1cColl spoke of the good work car.ned o.ut by the members, and urged them to increase their effiCiency. The inspection followed,. but ~he march past hael to be abandoned. After the l11SpectlOn,. Dr. 11cCo11 COllg ratulated the various Divisions on t~el.r s1!1artness and emphasised the need for increased actIvity 111 ambulance work. Th e annual inspection of the South ' Vore-estershire Corps was h eld at Kiddenninster on July Qth.

FIRST

Dr. N. Corbet Fletcher (Surgeon-in-Chief) .and Miss E. Lethbridge) M.B.E., were the Inspecting Officers, being accompanied by District Commissioner Major J. Orton, County Surgeon F. L. 1 ewton, County Officer l\Iajor P. R. 'W. Carthew, Lady County Supt. Mrs. C. H. Lechmere, Lady County Officer Miss E. C. J eakes, ,Co rps Surgeon C. Petvin Porter and District Staff Officer E. T. Milbum. After the inspection the Surgeon-in-Chief took the s<llute at the march past of the Corps, which formed in a hollow-square for the inspecting officer's address. Dr. Corbet Fletcher said that Nursing Divisions were passing through a sad time. During the past week they had lost their Lady Superintendent-in-Chief. For 29 years Lady Perrot'!: had worked heart and soul for the Brigade and none realised how much she had done. She would be sadly missed; she would never be replaced. He congratulated the parade, which numbered 460, on the day's work) and said) " You ambulance men in the small villages are 'Putting up ,a splendid show. I congratulate you, I thank you, and I wish you God Speed." Alderman H. W. Cheshire, Mayor of Kidderminster, welcomed the Corps) making special reference to the 11alvern Nursing Cadets. The parade then proceeded to the Town Hall for tea, the ~1ayor taking the salute as the members marched past the Town Hall steps. He was supported by the Inspecting Officers) Major J. Orton, Mr. 'Walter Todd (President, Kidderminster Ambulance Division), the Chief Constable (Mr. Harry H odgkinson) and County Officers. The District Commissioner thanked the Inspecting Officers for their presence) and recalled how the Southern Area of Worcestershire had started with one ambulance and one nursing Division at Malvern) but had g rown to its present-day strength chiefly through the endeavo ur of County Surgeon F. L. Newton. DUDLEy.-The .annual church parade of the Dudley and District Corps was held at Lye. The parad e, which was under Corps Supt. A. Winbow, was inspected by County Officers Schofield and Christopher before proceeding to Mount Tabor Methodist Church. The Rev. Michael Featherstone based his sermon on First Aid Pioneer," illustrating it with the parable of the Good Samaritan. Following the service the parade reformed and proceeded to the Divisional Headquarters of the Lye Ambulance and Nursing Divisions, where Corps Supt. Winbow expressed thanks to all who had made the parade so representative. He welcomed County Officer Schofield, a former member of the Lye Division, and County Officer Christopher, of Wolverharripton. Refreshments were served by members of the Lye Ambulance and Nursing Divisions. Supt. H. G. Mills (Lye) was responsible for the lo'cal ·a rrangements. rI

NORTilAMPToN.-The annual inspection of the Northampton Corps was held on July 2nd, the Inspecting Officer be1l1g County Commissioner Dr. E. W. Dryland, assisted by Lady District Supt. Mrs. M. Reeves, A.R.R.c., and accompanied by County Officer W. H. Percival and Lady County Officer Mrs. L. E. Mawby, M.B.E. The Corps, under C011pS Supt. W. E. Edwards, l\1.B.E., paraded on the Market Square, and headed by the He,adquarters' Bugle Band) under Bandmaster W. George, marched to the Territorial Headquarters. The nurses, with Lady Corps Supt. Miss K. Bradford, A.R.R.c., in charge, headed by B.B. Bugle Band, followed. On arrival of the Commissioner, he was received witl1 the General Sahlte ,and then proceeded to inspect the par'ade.

AID ---

FIRST

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Dr. Dryland expressed his satisfaction at the smart turn-out, and also the number on parade (which totall ed 51-+, a record for the Corps). The inspection was followed by the dedication of two new Motor Ambulances (one having been presen ted by F. W. Panther, Esq., and the other purchased by the Transport Department of the ,Corps to replace the one now unserviceable) by the Rev. Canon J. Trevor Lew is ' M.A., Sub-Chaplain of the Order. . . The i.nspec~i'o n was witnessed by a good assembly 0 r VlsI'tors, 1l1clud111g Mr. ,and Mrs. F. W. Panther and Mrs. Irene Butler) Mrs. W. H. Percival, Dr. C. Gardiner Hill (County Commissioner, Oxfordshire), 'l:r. G. C. Wells, County Officer C. W . Curtis, County Officer F. Holgate Smith, M.B.E.) and Mrs. Smith, Div. Supt. E. Claypole (Commissioner's Secretary). A detachment of the Northampton Borough Poli ce, under Inspector Goodwin) were also on parade. STRATFORD-oN-AvoN.-The 15th Anniversary of the Stratford-on-Avon Division was celebr,ated by holdin'" an informal gathering on July 11th. ;:-, . The President (Councillor R. M . Smith, J.P.) preSIded, supported by the Mayor and Mayoress (Councillor and Mrs. T. N. Waldron), Councillor E. P. Ray (VicePreSIdent), Mrs. Klbler Morgan, S.R. T. (Lady Supt., local V.A.D., B.R.CS.), Mr. J. E. P,arker) J.P. (Chief A.R. P. Officer for the Borough), together with Supt. Warmin gton, Amb. Offi'c er W. Cockings and other divisional officers. Many members) their wives and friends were present, the whole party numbering about 50. After the company had sat do~n to refreshments, the Mayor distributed certificates, vouchers, medallions. and l,a bels. .He congratulated the Division on attaining its 15 th anmversary and remarked that out of all his public engag~ments, none were more enjoyed by the Mayoress and hImself than when they were guests of the Bri g.ac1e. The Mayoress presented Mrs. Kibler Morgan wi th an engraved fountain pen "as a little acknowledol11ent from the Home Nursing Class." b Councillor Ray, endorsing the Mayor's remarks said that since the inception of the Division, two mel~ ha c! remained with it-Supt. W·a rmingt.on and Amb. Officer Cockings. Mr. Parker took the opportunity of thanking those m~mber~ who had rec e ~tly been instructing classes of AIr RaI~ Wardens, partIcularly Messrs. CockinO"s, Ash field, SmIth and Bullingham.

No. IV District L ANCASHIRE.

The annual inspection of the Brierfield Ambulance and Nursing Divisions was held on August 1st, upt , W. Whalley was in charge of the men, and Lady Supt. Mrs. Binney the nurses. The Inspecting Officer was Asst. Commissioner Dr. R. Clegg, who was accompanied by District Officer Dr. J. B. Aitken. The men demonstrated bandaging, drill, hand-seats, and stretcher work, whilst the nurses did triangular and roller bandaging. Dr. Clegg expressed his pleasure 'at the smartness of the parade, and complimented Ithe members 'on their efficiency in drill and bandaging. On July 9th Asst. Commissioner W . H. Gastall inspected Divisions from Fleetwood Thornton Pressall and Cleveleys . Some 200 members p~radec1 on t1~e Thom-

ton Cricket Ground and 'they were congratulated by the Inspecting Officer on their smart wo'rks. The Mayor and Mayoress of Fleetwood (Alderman and l\1rs. C. Saer), the Chairman of Thornton Cleveleys Council (Councillor ]. H. Catterall) were among those present. The Poulton-1c-Fylde Ambulance and ursin o' Divisions w.ere inspected las't month by County Suq;eo~ J. Mackenzle . Demonstration of hand seat drill trian o-ular han dao'ing, artificial respiration and resp irat'o r driil were give~.

N o. VIII (Duke of Connaught's) District The annual rev iew and church parade of the Kentish Units was held at Dover on Sunday, July 16th, when some 2,000 men, nurses and cadets, a record for the County, paraded for the inspection by Surgeon Vice-Admiral Sir Percival Nicholls, K.c.B., M.R.C.S., L.R.c.P.

AID

Sir Percival said ~hat there were nearly 2,000 members of the Bngade 111 the Nayal Auxiliary Reserve and without them the medical services could not function. Commissioner. Richards thanked the Mayor for hi encouragement. If there V\ as one thino- that counted to-day, it was fidelity. He was proud to ~tate that every man and 'woman of the Brigade was faithiul to him elf ' his friends and hi s work. During 1938 in Kent, 13,000 cases of accident and illness were treated hy members, and 16,000 cases of patients were rem oved by am bulances \\" h ich con: red 250,000 TIl i 1es. There were oyer 2,000 road accidents. That said little of the hours and sacrifice of the members. In coneIu ion the Commissioner said that he had the g reatest respect for every man and woman in his charge. Followmg the I ul1cheon the inspection was held on the sea front where thousands of visitors witnessed the ceremony. The Insp ecting Officer was greatly impressed by the smart appearance and marching of the parade; and to a representative of FIRST AID he expressed his amazemcnt

Review of Kentish Units. Surg-eon V ice-Admiral Sir Percival Nicholls, accompanied by Commissioner E. A. Richards, inspecting the Kentish Units at Dover. Corporation of Dover gave a civic lun cheon to some 80 guests, the chief g uest being Sir Percival Nicholls, who was accompanied by Lady Nicholls. Th e Mayor (Alderman J. R. Cairns) presided supported by Mrs. Cairns, Sir George and Lady \i\1011aston, the l\Iayors and Mayoresses of Folkestone, Hythe, and Queensborough, Brigadier J. G. W. Clark (Officer Commanding Dover Garrison), L td .-Col. and Mrs. Brazier, Commissioner E. A. Richards and Mrs. Richards, Major Noble, Lady District Supt. Mrs. Falwasser, Asst. Commissioner H. J. Wrig o·lcsworth and Mrs. "Wrigglesworth, and members a E the Co rporation. The May or welcomed the disting uished visitors and sa id , "vVe deem it a special privilege to entertain you in Dover to-day because it enables us to pay tribute to the valuable work which ) fO nr organisation is carrying on throllo'hout this county in a purely voluntary capacity. We, i~1 Dover, are particularly proud of the efficiency of the loca l Corps ."

at the bearing of all ranks and at the excellent arrangements made by the Brigade Staff. . The inspection was followed by church serVIce, one half of the parade going to St. Jame 's Church where Canon C. F. Tonks, Vicar of \Valmer, gave an address, and the other half to 1. 1Ian"s where the Rey. H. D. Bowen, Vicar of Ashford, \V-as the preacher. Follov;ing the services the parade proceeded to tea at various venues; the Iayor accompanied by the Inspecting Officer, yi iting each building. Three items contributed to the success of the day(1) the splendid organisation, (2) the weather~ and (3) ~he excellent train cnice o£ the Southern Ra!1way whlch ran many" specials" for the convenience of the ambulance workers. On Sunday. July 23rd, some 2)000 members .of the Surrey and Sus ex units pa raded for the annual ll1spection, this year held at Worthing.

FIRST

The Mayor of Worthing (Alderman E. A. Brackley) en tertained the inspecting officer 'and officia ls at luncheon when Commissioner E. A. Richards introduced Major P. G. DarviI-Smith (Brigade Secretary) who .vas deputising for Brigadier Barne, Mrs. Darvil-Smith and members of his staff. The Mayoress, Mrs. Darvil-Smith and Mrs. Richards were presented with bouquets by Nursing Cadets G. Set'ace, R Gunter and P. Ayling', members of the Worthing Cadet Division. Following the luncheon the Inspecting Officer, accompanied by the ~1ayor and Mayoress) the Town Clerk (Mr. J. Kennedy Allerton), Alderman A. Chambers and Councillor E, R Willoughby, proceeded to the Manor Sports Ground where an impressive, and a record number of members paraded. The threat of rain compelled the Inspecting Officer ·to hurry the actual inspection but nevertheless he was quick to note many interesting items. After the march past, at which Major Darvil-Smith took the salute, the parade proceeded to the Town Hall , which was filled to overflowing, for a service conducted by the Rev. E. W. D. Penfold, Vicar of Durrington and

AID attendances had been made at Hospitals hy members of the Nursin g Divisi'o ns. The parade was then entertained to tea by the C0111 missioner and his staff) after which the homeward tr ek began. Most of the members took ad vantage of th e excellent electric train service of the Southern Railwa y which ran several ambulance specials trains for the COI;venienee of the Brigade personnel and their .friends.

ADDIscoMBE.-The annual inspection o f the Addi s combe Division was held last month in the Park T-lill Recreation Grol1nd. District Officer E. J. Prew was in command of 1hl' parade which numbered 92, an excelle.nt example to th e public. The Insp ecting Officer was District Staff Officcr J. S. Hannam, and the visitors included Mrs. Hannam, Mr. L. W. Vicars, Mr. and Mrs. McDiarmid, anclmany friends of the Division. Practical first aid was demonstrated efficiently, also stretcher drill, artificial respiration, hand s scats. etT.

The Brierley Hill Cadet Division. Rural Dean of Worthing, and the Rev. W. Ridley Chestert-on) Worthing Baptist Minister. At the close of the service the Mayor gave a welcome to the members. . Major Darvil-Smith congratulated No.8 District on Its very smart turnout-the best he has seen for many a long day. The District should be proud of its achievements which were due to the Commissioner and his staff the ,co-operation of officers and the support given by th~ rank and file. He referred to the support given by local authorities, especially that given by Worthing. . Co~missioner Richards in thanking the speakers for theIr kind words referred to the Horsham Nursino' Division, winners of the "Perrott" Shield and th~ Brighton Police, "Dewar" Shield winners. The Brigade was a happy family, due to the fact that members were able and ready to render service to others. During the past year the Brigade in Surrey and Sussex attended 13,000 cases, undertaken 16,300 removals, the ambulance had travelled 200)000 miles whilst 1 960 road accidents had received attention. In addition 2>60

The Inspecting Officer congratulated the division on its smarU1ess and precision, an d the splendid way the members had demonstrat ed its activities. H e also re marked on the numb er of members who had continued active work over many years, and made special reference to Ambulance Officer E. J. Prew who had been award ed the Service Medal. He was also impressed by the enthusiasm with which the Division had tackled A.R.P. and anti-gas measures ill addition to the ordinary first-aid duties, and noted with pleasure that several members had qualified a'S instructor s in this new branch of the work. Many of the public took advantage of the opportunity to inspect the two motor ambula.nces on view, and showed c,o nsiderable interest in the valuable work which the Division underlakes for the benefit of those who need its help.

CHERTSEY AND ADDLEsTONE DIVISION.-The men and cadets of this Division held their annnal inspection las t

FIRST 1110nth, the Inspecling Officers being District Officer Capt. F:lIcis and Supt. Daniels. The parade, which incliided t.he Airscrew Section, the Woodham Section and Cadet, was under the command of Supt. R. J. Gristock assisted by Amb. Officer Keene and Sergt. Hampshire. 1\1rs. Titler presented A.R.P. certificates to members of the Airscrew Works; others present included Mrs. IIarmcl1s (wife of the President), Councillor VV. H. Payne (Chairman, A.RP. Committee), Capt. A. H. Brooks (A.R.P. Officer), Div. Surgeon Crickmay, Lady Supt. 1\Irs. Lamden and others. Capt. Ellis. a ftcr setting' various tests, complimented the members on their \\ork and congratulated the Di\'isiol1 un the A.R.P. ,\ ork they had clonc HORSfl \~r.-OJl J ul) 18th t he TT l'adqnancrs of the Horsham Di\' isions were officially declared open hy lIn (;race the Duchess of Norfolk. On arrival IIer Grace was \\ elcoillcd by Dr. E. C. Bradford and inspected a guard of honour formed hy Il ursing pl'rsol1nel. She formally declared the building opened and said it was a great pleasure to llerform the opening ccremony of the new headquarters. Commissi()l1l:r E. A. Richards said it was a great vri\'ilege and pleasure to accept the headquarters w,hich \\ cre the product of much hard work 011 the part ot. the Illembers () r the ])i\'i"iol1s and tIle generous support of the public. . ' ;.Jearl) 40 V'uests attended the receptlOl1 at the Dl'I11 Hall 0 f the Ro~~d Sl1ssex Regiment where arrang:ements had becn made' for the Duchess to recei\ e purses. On the platform ,,'ere displayed the various shields and trophies held by thc Diyisioll, Her Grace " 'a s accompanied by Dr. E. C. Bradford: 1\Ir, ~. L. Gregor). Commissiol1er Richards, Asst. CommISSIoner D . BrYl'c, Supt. J l1PP, allel other <1l11hulance officials. In a spel:ch of welcome ill the Duchcs.,s, Dr. Brat.l£on~ referred to the tics which existed between the Duchy 0 t I'\orfolk ane! Horsham. Supt. JUPll outlined the history of the Division since its formation in 1926. and mentioned the nameS uf those \\'ho had been chieAy r espons ible in I>ring-in?,' it tD its pr esent high stancla:-cl of streng·th and efficiencv. The Di\'ision had started \nth 20 members ane! he was 'prol1d to say that C\'en of those men \\ ere stIll serving. I D'" Since 1930, he said, the amhulanccs of t le l\'ISIOIl had covered approximately 85,000 111.i1es and about 1,600 of the patients had been carried cntlrely free of charge. Tn 1937 a women's section was fonnec!. Supt. JuPP recalled the. champi onship successes of the Division. They had tWIce he en . ~1~-Ell~land .Champions and this year the Iursing DIVISlOll III "t heIr .first year uf competitl'on \\'urk hac! ])eco111e ;.Jabonall hall1jllons. The Duchess then recti \'ed 81 purses. Mr. 11. L. Gregur) said hl' hopcd that the CLllltcnts of the purses would pay 011 the deficit of the heac~quartcrs, The lmilding wOllle! cost £3,.;O() and towards thIS £3,100 had already been raisecl. It. \\ as later announced that £310 had been the contents or the purses. Commissioner Richards thank ed the Duchess for her presence; and in reply J:Ier Grace exp.ressed her th:1I1],:, for the wonderful receptIOn they had glyen her. Among t.hose llreSe)lt \\ ere Lady lJistrict Supt. 1\1 ['S. Falwasser ' District Officers BOrIle and P.re\\·. COl1llty Suro'con \iVitchcr, Lady District Officer 1\I1 s lay, Dr. C. IIcy-l\ Iilnes, the Rev. and }\irs. R VV. D. Lee.

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Going lJp! DURING the first six months of this year the circulation of FIRST AID increased by 12~ per cent.-and it is still on the upward trend. This increase can be accounted for by the greater interest taken in the work by those who have joined the A.R.P. auxiliary reserves and also to the fact that FIRST AID does cater for all whose interests lie in helping suffering humanity. On numerous occasions it has been our pleasure to receive complimentary letters on the varied contents of each issue, and an extract from a recent communication reads: "As a reader of FIRST AID for 13 years I would like to thank you for the great hel p that it has been to me both in study and com petition work." Our slogan has ever been" FIR T AID for the first aider"-and we are proud to serve such a body of men and women and to do our best to add to their knowledge and so keep them abreast with the ti meso Readers should remember that we are always pleased to receive suggestions for future articles whether for the begin ner or experienced worker. So if you have a suggestion, or even a grouse, send it along.

Coming Events. The Editor will be pleased to receive particulars at forth, coming events for inclusion (free of charge) under this heading.

SEPTDIBER. 2-1-Western Area No.1 District, S.lA.B., Annual Church Parade, Holy Trinity Church, Kensing-ton. 30-Haggerston Division, S.J.A.B., Jubilee Dinner. OCTOBER. 3 - " E" Division l\Ietropolitan Police First Aid Competitions. 7-58/ 5 Di\'ision No.1 District, S.J.A.B, Annual Dinner. H-vVestern Area No.1 District, S.JA.B., Annual Social. Caston Hall. H & 15 - S.]. A. B. Surgeons' Conference, Gt. Central Hotel, London. 26 - Order of St. John Concert, Albert Hall. 29-S. J. A. B. Commissioners' and Assistant Commissioners' Conferenc ~ , Gt. Central Hotel, London. A division of the St. John Ambulance Brigade is to be formed at Beighton. 3

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The !lag day helJ in Brighton on J uly 29~h in aid of the local B.R.C.S. and S.JA.B., resulted in £,251 11s. 11d. being raised.

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Priory for Wales. MEMBERS of the Priory for Wales had the honour of welcoming H. R. H. the Duchess of Kent on her second visit as Lady Superintendent-in-Chief for Wales on Saturday, July 15th, when she participated in presentations made at General Assembly and conducted a Review of Members of the Brigade in Wales. One thousand members and representatives of the Priory from every county in Wales attended the ceremony in the Assembly Hall, which began with the procession of members of the Chapter in their picturesque black cloaks bea.ring the white cross of the Order. After they had taken theIr seats, the Sub-Prior's procession entered in the follow-

By Coul'tesy]

The Bishop of St. Asaph led the prayers, commencing with one for" Peace, rest, and cO!1cord to all faithful Christians. " The Sub-Prior, in ~is address, said the picture of ambulance work to-day In its many manifestations had to be l?ainted a~ainst a background of intense national activity dUring- a period of moral and material rearmament and the direction of endeavour has had inevitably to be reorientated towards war-time in place of peace-time preoccupations. The class and examination work of the St. John Ambulance Association reAected the enhanced interest of the public in first aid and home nursing instruction. While

[TiVertern Mail & South Wa1es Echo Visit of H. R. H. the Duchess of Kent.

T?e Sub-Prio.r (t!,e Earl of Plymouth P. C.) investing Mr. F. LIewellin Jacob WIth the InslgOia of a Commander (Brother) at the Investiture held at General Asserr:bly o~ July 15th, at which H. R. H. the Lady SuperintendentIn-Chlef for Wales, presented Votes of Thanks. ing order :-The Director of Ceremonies (Mr. A. G. E. J. Fudg.e). the acting Cha~lain .(Bishop of St. Asaph) resplen. dent JO full robes and WIth hIS crozier borne before him the Lady Staff Officer for Wales (the Hon. Mrs. John H. Br~ce) the Lady Superintendent for Wales (Lady Howard d~ Walden and Seaford, C. B. E.), the Lady-in-Waiting (the Countes.s of Breclmock, w~o was in khaki A. T.S. uniform), the ASSistant Lady Superlntendent-in-Chief for Wales (the ~oun~ess of Plymouth), the Assistant Lady SuperintendentlO-Chlef for :Vales (R.et.) Lady (Herbert) Lewis, O.B.E., the Duchess 111 the ul1lform of the Lady Superintendent-inChief for Wales, the Sword Bearer (Capt. J. MacLeod Carey,. O . B.E.), the Sub-Prior (the Earl of Plymouth, P.C.), the .Prlnclp~1 Secretary (the Hon. John H. Bruce), and the ASSistant Director of Ceremonies (Mr. R. Wilson Bartlett).

attention had shifted lately from the dangers of chemical warf!lre to. the need. for protection against high explosive and lOcendlarJ: bombing-that was to say, from the handlingof Fas con~am1l1~ted cases to th~t of wounded and injured in ralds, the InclusIOn of an A. R. P. course in the curriculum on. a. volunta~y basis has widened the scope of Brigade tra1l1111g and .1~parted greater responsibilities towards the Local AuthOritIes under the Home Office scheme . The maintenanee of first aid work in each district at a l11gh .s~a ndard of efficiency resolves itself into a problem of acqulrlng Hea~q.u~rters, as a focal point of local interest in amb.ulance actlV!tles and a pivotal centre from which vital services may radIate. The acquisition of a home of their own guarant~es ~he perma.nence of a Divisional membership and the contlnulty of theIr specialised contribution to th e

FIRST ge neral welfare. Sound reasons exist for equipping the majority of our male senior Divisions-of which there are 270 to-day-with halls of suitable size and appropriate equ ipment; and the number of Headquarters vested in our Priory Trustees has been doubled during the past two years - largely by means of a 50 per cent. grant-in-aid from the Special Areas Fund. The work was being perpetuated, though at a reduced rate of progression, through the good offices of the Joint Committee of the South Wales and Monmouthshire Miners' Welfare Fund; and together with a few halls vested in local Trustees, the total will shortly reach 100 Headquarters. The supply of Medical Comforts to the sick in their own homes-through the medium of Depots staffed on the voluntary system by Divisional memhers at considerable expenditure of time and hard work-had been extended to cover the whole of the Special Areas of South Wales; and there are now 86 St. John Depots run in close co-operation with County and District Nursing Associations. Of the Motor Ambulance Transport Service, the SubPrior said that in six years the number of cases carried and mileage had been more than doubled; and that the greater calls were being made upon the 20 stations, served by 26 cars, now running an average of over 1,000 miles a day, so that available funds had to be diverted to cope with wearand. tear in place of makin15 necessary but expensive extensions to the co-ordinated chain of linked stations. In concluding the Sub-Prior said he was proud to conduct an Investiture on behalf of His Royal Highness the Prior ; and assured the Duchess that the value of the occasion, particularly for those awarded certificates or badges which they would be privileged to receive at her hands, was greatly enhanced by Her Royal Highness's presence. The" Exhortation" was then read to the membe rs whom the Sub-Prior invested. The Duchess presented Vellum Votes of Thanks, Priory Votes of Thanks, Certificates of Honorary Life Membership; also the first Grand Prior's Boy and Girl Cadet Badg-es issued in "Vales to Benjamin George Pointer (Goodwick) and Miss Phillis Williams (Bargoed). At the conclusion of the presentation the Duchess said: " It has given me Q'reat pleasure as Lady Superintendent to make these presentations, and I am very happy to be here to-day in the unavoidable absence of your Prior (the Duke of Kent). " A parade of over 9,000 members of the Brigade representative of every County in Wales was inspected by the Duchess after tea at Cardiff Castle, where a large party of members of the Priory were the guests of the Marquis and Marchioness of Bute. The persollnel was drawn up in ten Battalions, and the Brigade Headquarter Staff were in attendance on Her Royal Highness on the tour of inspection by car, in the following order :No. 1 car, the Duchess of Kent, the Hon. John H. Bruce. the Counttss of Brecknock (Lady-in- Waiting). No.2 car, Mr. A. G. E. J. Fudge, Dr. D. Rocyn Jones, C. B. E., Sir Leonard Twiston Davies, K. B. E., Major A. W. Anderson. M. B.. Ch. B. No.3 car, Lady (Herbert) Lewis, O. B. E., the Countess of Plymouth, Lady Howard de Walden, the Hon. Mrs. John H. Bruce. Her Royal Highness took the Salute from the Dai~, the March Past being led by the Commissioners and ASSistant Commissioners, followed by a Company of Brigade Surgeons. The large number of spectotors were deeply impressed with the striking exam pIe of service demonstrated by the am bulance men, women, boy and girl cadets, who had travelled from far and near to take part. . The Earl of Plymouth in his subsequent remarks saId: " I desire to thank Your Royal Highness very cordially and sincerely for the great honour you have ~one the Prio.ry by conducting a Review of Units representat.!ve of the. Bngade throughout the Principality. This is the first occaSlOn upon

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which Your Royal Highness has been afforded an opportunity of inspecting the Brigade in 'lv'ales as a whole; and the function is also memorable as constituting a high water mark of achievement in parading the strength of the Brig-ade from our 19 Centres, including all the 13 Counties of Wales and Monmouthshire. There have been combined inspections before- two at Tredegar Park, two at Chirk Castle, one at Margam Castle-but never before have more than half-a-dozen Centres participated to the extent of turning out a personnel of 3,000. To-day three times that number have volunteered from as far afield as Holyhead, some travelling all night by train and bus. That is an inspiring' record of keenness. Two·thirds of our Welsh strength has responded regardless of expense to the Li nit and individu al concerned." Continuing- to address the members, the Earl of Plymouth said: "You are to be congratuled not merely upon a loyal response to the call of duty in attending- your annual inspection, but upon the efficiency in first aid and home

B)' Cuul'tesy]

[vVestern ilIad &> South n'ales Echo

Royal Review of the Brigade in Wales by H. R. H . the Duchess of Kent. Left to right: H . R. H. the Lady Superintendent-in-Chief for Wales, the Commissioner for Wales (the Hon. John H. Bru.ce) and the Sub-Prior (the Earl of Plymouth, P. c:.). S.t~nd1l1g in rear: The Countess of Brecknock, (LadY-II1-Walt1l1g). nursing which the wearing of the black and. white uniform of an ambulance volunteer denotes. The Bngade .at Home attends to three-quarters of a million cases of aCCident a~d sudden illness annually, of which 75,000 are recorded 111 \V'al es-a splendid contribution to welfare. You are also serving the Country through the Military and Taval Hospital Reserves, Voluntary Aid Detachments. and n?w. by means of the Civil Nursing Reserve and A. R. P. org-ant:atlOn of the local authorities. We are looking forward to a dIsplay

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by the City of Cardiff A. R.P. Serv ices, under Capt. G. V . Jones, with keen interest. Parti c ular thanks are due to the ste\vards and guides and the staff at the ambu lance tents j and we are grateful to the t~·o bands (Rhondda Centre and Pontypridd County Area) for an excellent performance throughout the proceeding-so In tbanking Her R oya l IIighn ess once again for ha ving- come to perform this Inspect ion to-day, I have pleasure in informing you that Her Royal Highness has graciously consented to address a few words to the parade." Loudspea k e rs carried the following welcome words of the Duchess to the ears of the whole parade: "It has given me great pleasure to inspect the Brig-ade in Wales to-day, and I have been very deeply impressed by all I ha ve seen . T am proud to have had the privilege of cond urt ing a review of men as well as of women, and of hoy cadets as well as of g-irl cadets. I would like especially to thank the Nursin g Officers, Sisters a nu Girl Cadets for their attendance, and to compliment a ll rAnks on th eir smar t appea rance a nd effective bearing." Finally, Lady (Herbert) L ew is, O. B. E., \\ ho that day had relinquish ed the office of Assistant Lady Superintende ntin-Chief for Wales, bade farewell to the Brigade, after a close association extending back 34 years, first as the wife of the first Principal Secretary and Comm iss ioner for Wal es, the late Sir Herbert Levyi s, K. B. E.

One Private to Another. AFTER several years active service "vith the St. John Ambulance Brigade, my business has forced me to assume the role of spectator. I must say that, from the on lookers point of view, the majority of St. John men are smart and efficient. but there are a few who let the Brigade down. Unfortunately these few are apt to attract the atte ntion of the gener~ 1 public and create a bad impression. Very often It IS not the new recruit but the man with service chevrons who is at fault. During local ce lebrations I noticed Brigade men on duty not on ly w ith dirty buttons, but with unshaven faces. Now cleanliness is all important, not o nl y for the sake of appearance, but because it is a surgical necessity and a patien t has more confidence ina man. w~o. is smart. So before going on duty, even If It IS only at the local cinema, make sure that your buttons, haversack and hatband are clean, your uniform brushed, a crease in your trousers, and boots we ll pol ished. If you prefer shoes, don't we~r light co loured socks. ~1any mem.bers, incIu?in g officers, do not pay suffiCIent attentIon to theIr personal cleanliness. Please do not report for duty until )'oU have shaved and made sure that your fi ngernai-Is are short and we ll scrubbed. Endeavour to keep yo ur finaers free from tobacco stain. b I have often thought t hat it wou Id be a aood thing if the powe rs that be organised phy~ical culture class~s for.Brigade members, because man y men,. \phe? In unIform, walk along as if they are ?eficlent In backbone. This posture does not Illcrease the public's respect or confidence.

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Try and avoid wearing a g reatcoat Over eq uipment, it makes it very difficult to get at your water-bottle and pouch a nd also looks untidy. \ V hile on this subject, I consider that it would be a great advantage if greatcoats were made with flaps so that equipment worn underneath would be accessible w ithotlt unbuttoning the coat. When there is a di ffere nce of op ini o n re ga rdi ng a method of treatment, do not a rgue about it within the hearing of the patient or bystanders. Should an office r or N. C. O. tell you to treat a patient in a certa in way, carryon and do it , even if you believe the treatment to be wrong. The first aider is just as m Llch a specialist in a branch of med ici ne and surgery as, for exam p Ie, is the dentist or oculist. Just as the dentist will study the teeth but does not attempt to attend to his patient's eyes, so the ambulance man should confine himself to first a id and not try to treat a case th at should be left to the care of a doctor l r train ed nurse. Now one fina l point. When on public duty, you are there to render first aid, not to get a free show . So don't grouse when you are left on th e Station . or are on duty all day without a case . Remember, " He also serves who only stands and waits. " In writing the foregoing, I have tried to poin t out some of the s mall details that men are inclined to overlook but which, when attended to, help to increase the prestige of the St. John Am bulance Brigade.-J.C. B.

Police Ambulance News. CITY

LONDON

SPECIAL

CONSTABULARY.

Owing to age limit the Force has lost an enthusiastic first aider in Commander C. G. Emery, who for the past eleven years acted as hon. secretarY to the first aid and ambu lance section . Since 1928 the" number of members obtaining award s increased each year and was due to his untiring enthusiasm. In 1938/1939 the figure was 151 , nearly 50 per cent. increase over the previous year. On Jul y 21st, 1933, he was invested as a Serving Brother of the Order of St. John, an honour well d ese rved. During Jul y the examination of s tudents attending- th e secon d course of the year was held. Dr. W . D. J enkins was the examiner a nd he expressed his pleasure at the high stan d ard of efficiency in the p ract ical work carriej out.

Railway Ambulance News. Inter-Railway Final, 1939. INDI\'!DUAL

TESTS.

No. -t. -You are walking- along a country lane when yo u come across a man who is obviously a farm worker lyi ng un conscious at the foot of the hedge. How would you find out the cause of his uncons cious ness? You will state what you are doing as you proceed. Time allowed, 8 minules, beginning when you r eceive th is card. Staging.-I\lan to be lyin g- alllong- broken branches with a wood chopper lying- alon!{side him as if he has been loppi ng trees. Atropine one eye to produce un equal pupils. Bleeding from ears to be indicated. Face llushed. Breathing stertorous. Rapid approach to patient 1 Quick note of surroundings 1 Note branches of trees 1 Note wood chopper 1 Ask if severe h m morrhage pre ent (n o) 1 .\s k if breathing- (yes) 1 Ask character of breathing (stertorous) 1 Feel the pulse (if properly examined judge will state: 60 full) 2 Note colour of face (Rushed) ... 1 Exam ination of head for injury (no injury) 1 E~a mina tion of ears for bleeding (noted) ... 2 Examination of eyes for bleeding j bloodshot (no) 1 Examination of nose for bleeding- (no) 1 Exallli nation of mouth for bleeding (no) ... 1 Examination of mouth for froth (no) 1 Exa mination of mouth for stains or burns (no) 1 Exam ina tion of mouth for foreign bodies (no) 1 Raise eyelids to examine pupils 2 Note inequality of pupils 2 Test for touch reflex (if properly tested, absent) 2 Test for lig-ht rel1ex (if properly tested, fl.-ed) 2 Is there any vis ible deformity (no) 1 Exam ine spine for fract ure, dislocation or wound (nil) 3 Exa mine chest for fracture or wound (nil) 2 Exa mine upper limbs for fraclure, dislocation or wound (nil) 4 Examine pelvis and abdomt'n [or fraclure or wound (nil) ... 2 Examine lower limbs for fract llre, dislocation or wound (nil) 4 Co mpare both sides of body for limpness (if properly tested, rig-ht side more limp than left) 1 Test condition of skin (hOl) 1 Diag- nos is. Compression of brain, probably due to fractured base of skull from a fall 5

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We are prepared to supply Ambulance Secretaries and others with specimen copies of this Journal fo r

No. 5.-Describe and demonstrate in detail Siln~ste r's Method of artificial respiration. Time allowed, g minutes, beginning- when you receive th is card. , Method only used when impossible to turn on to face

distribution among their members. Apply to the Publishers, FIRST AID, 46, Cannon St .• London E.C.

1. Adj u st patient's position Wit hout wasting a moment

Continuation classes are now being- held until Autumn when new fu ll course classes will be started.

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Place patient on hi s back 01'1 a Ilat surface ... Inclined if possible from feet upw ard' Undo all tig-ht clothingRaise and support shoulders ... On small firm cushion or folded article of dress Placed under shoulder blades... 2. l\Iaintain free entrance of air into windpipe Assistant to catch hold of tongue with handkerchief ... Draw it forward as far as possible and hold in that position If this is not done there is danger of l)bslruction to windpipe By tongue falling back over top of it 3 . r Illitate movements of breathing (a) Induce inspiration Kneel at convenient distance... Behind patient'S head Grasp forearms just below elbows Draw a rm s upwards, out"'ards and towards you \Vith sweeping movement ;\Iaking elbows touch ground ... Ca\'ity of chest thus enlarged... ,\nd air is drawn into lungs (h) Induce expiration Bring patient'S flexed arms Slowly forwards, downwards and inwards Press the arms and elbows .lzrlll~1' Oil che t On each side of breast bone ... By this means air is expelled frolll lungs... (c) R epeat thesp moyements ... Alternately, deliberately, perseyeringly About twel\'e times a minute ... The rhy thm is-pres ure t\Yo seconds R elaxati on three seconds " 'hen natural breathing begins Regulate mo\ ements to correspond Promote ci rcu lation By rubhing limbs vigoroLlsly to\yards heart .-\ nd by applying \\'a rmth vVal ch patient carefully for some time To see that breathing does not fail ... 1f il does, at once resort to Clrtificial respiration Artificial respiration mLlst be continued perseveringly until respiration is restored... . .. Or until a doctor pronounces life to be extinct

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Great Western. ST. BL.\ZEY.-A presentation was made recentl): to Dr. and )'lr . R. ),1. S. l\IcConaghey, ,,·ho \\ ere leaY111g- the district, after being closely associated ,,·ith the ambulance movement, and the t. Blaze), G. \Y .R. cIa 5, . for "ery many years. Dr. l\IcConaghey was presented \\:lth a case of pipes and 1\1rs. l\lcConaghey \\"it~ a ch.ro.n~ILlm g~~1g, the latter gift being from the ursmg. D"' lslOn. Ihe presentations were. made by :f..lr. \V. Hill, J.P:, and l\Irs. K. Bartlett rcspectl\ ely, who, on behalf of their members.

FIRST expressed appreCIatIon of all that Dr. and Mrs. McConaghey had done to further the movement, and wished them all happiness in the future.

THE YEAR'S PROGREss.-As we go to press the annual reports from the various divisions are being received, and a tentative estimate reveals that once ag~in there will be a substantial increase in the number of successful examinees to report. During the past twelve months the Great Western Railway Centre has instituted a specialcampwign for the enrolment of recruits to the movement, which has been stimulated by the distribution of an attractive pamphlet entitled" This Concerns You," urging members of the staff who have not yet acquired a first-aid training to do so, and invitin o ' them to join the classes organised by the Company. Th~ distribution of this pamphlet has synchronised with the A.R.P. activities throughout the country, which have themselves broug·ht home the advantages accruing to firstaid training- to all and sundry, quite apart from the effort which has been made to enlist them into the movement as railwaymen.

Secretary of the Southern Railway Centre of the S.J.A.A. Miss W. Gr,i ndley has been a'p pointed Assistant to the Welfare Officer and Assistant Centre Secretary. Mr. Uzzell has been actively associated with the St. John Ambulance Association for 30 years. Upon transfer from General Manager's Office to Southampton Docks in 1924 he was largely instrumental in resuscitating t.he ambulance movement amongst the Docks Staff and has been Chairman of the Southampton Docks Committee since 1924.

LrvERPooL.-The Liverpool Exchange No. 2 team were adjudged the winners of the "Tempest" Cup al the first at?-J.?-ual 'c ompetition held recently, The cup is for competltlOn am'0ng ambulance men employed at Liverpool Exchange Station. Drs. Duncan and Wilson adjudg-ed the initial tests. Mr. and Mrs. Tempest were present and presented the trophy and prizes to the successful team.

NORMANTON.-At the fourth annual competition held recently Mr. J. E. Hill gained first place with 46 points, followed by Mr. H. Selway (42). Mr. H. Smith was awarded a prize for the best first year man. . S:r. HE~,ENS.-At the annual competition for the PIlkmgton Cup, open to teams in the St. Helens District of the ?J.A.A.) the St. Helens Junction Depot L.M.S. team gamed :first place and thereby retained the trophy won last year.

SUTTON OAK.-The members of the Sutton Oak Coach and Traffic Departments celebrated their success in ambulance competitions by holdi.ng a social evening at the Glassmakers' Arms. Those present included Mr. G. S. Hill, General Ambulance Secretary, Mr. Healey, Mr. C. E. Mascord who presented the awards, and others. ' Thanks were ~xpressed to Mr. Mascord and to Mr. ~. Flowers, captam of the competition team and hon. mstructor to the class.

competitIon, whilst Dr. H. Marshall officiated in the competition for first year students. The results were:Teams.-l, Hull East, 316 marks; 2nd, Hull Go'ods, 297; 3rd, Dock Engineers, 279. Seven 'teams competed. First Year Students.-l) J. Glen, 47 marks; 2, J. Train, 46~; 3, E. Oliver, 46. Thirteen competitors entered. Mr. E. V. Taylor (District Goods Manager and Vice-President of the Council) presided at the distribution of awards by Mrs. Todd, who presented the "John Larder" Challenge Trophy and other prizes. Also present were N r. T. Johnston (Asst. District Supt.), Captain G. W. A. Todd, Mr. C. H. Nicholson (District Docks Machinery Engineer), Mrs. icholson, Mr. W . Garden (Works Supt., Dock Engineers' Department), Mr. G. Thompson Hedon, and other interes''.:ed friends. Responsible for the arrangements was Mr. G. H. Oakes (District Secretary), assisted by Council members. PrCKERING.~Dr. T. J. Muir recently presented medallions and certificates to members of the Pickering Class. Mr. E. Tindall, Stationmaster, presided and said that they were exceptionally fortunate in having Dr. Muir as Lecturer and Mr. Hansell as Class Lecturer. Both were very keenly interested in ambulance work. He also thanked Mr. Walker for his assistance with the clerical work. Dr. Muir, on behalf of the members of the class, presented ::vir. Hansell with a smoking cabinet, and spoke of the very good work done by the recipient, not only in connection with the railway class, but in public classes. Mr. Hansell, who is a Serving Brother of the Venerable Order of the Hos'Pital of St. John of Jerusalem, suitably acknowledged the gift. Mr. Walker and )'1r. Monaghan expressed ' .:hanks to Dr. Muir for making the awards.

london, Mid land and Scottish.

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Post ers fo r Pu bl icit y. Mr. Edgar Uzzell. Welfare Officer and Centre Secretary of the Southern Railway.

In 1935 he was admitted as a Servino- Brother of the Order of St. J'0hn. b A na.tive of Exeter-is a keen West Countryman and w~s Presl~ent of the""'! est Country Association in HampshIre dunng CoronatlOn year. To commemorate his successful yea.r of office, and to show their regard for his love of. first~aId work, the Association presented a handsome sllver ,cup for competition by ambulance teams in Southampton Docks. By his, new appointment Mr. Uzzell will not only be responsible for the organisation of the ambulance movement thro·ughout the Southern Railway but also for the training of A.R.P. 'p ersonnel throughout the system.

Southern.

london and North Eastern.

. In consequence. of the retirement of Mr. E. A. RIchards the followmg appointments have been made ._ Mr. Edgar Uzzell to W c]fare Officer and Cen·tre

The annual field day competitions of the Hull District Council was held on July 8th at Hedon. Dr. N. Jennings and Dr. Verhendt judged the team

FOLLOWING the request of many users a new size has been introduced in the Stock Posters advertised in this Journal. In addition, owing to increased demands, we have been able to reduce slightly the price of the small poster from 2/6 to 2/3 per dozen, post free. The new size is a double-crown, which measures 30 in. by 20 in., and we feel sure users will find this a very acceptable size, and the price (3/3 per dozen, post free) very reasonable The two sizes now available are: Medium, 30 in, by 20 in. j Small, 20 in . by 12 in j the prices being 3/3 and 2/3 per dozen, post free, respectively. Remittances and orders should be sent to Dale, Reynolds & Co., Ltd., 46, Cannon Street, London, E.C.4. Does your collea gue read FIRST AID , if not, s end us his address and we w ill post him a c opy.

AID

I nstruction of First Aid.* (As CARRIED OUT BY THE ST. JOHN AMBULANCE ASSOCIATION AND BRIGADE.) By CAPTAIN A. C. WHITE KNOX, M.C., M.B., CH.B.

(1) llfethod of Lectu1"£ng to Begznners in First A 1"d. I t is essential that a lecturer on first aid shall know his subject, so that he may have a free delivery and be able to stress important points as they come along. Continued reference to textbooks or elaborate notes prevent the continuity of the various parts of the subject on which he is talking. On the other hand the lecturer must follow a regular routine and not flit about from subject to su bject. He will usually give the theory of the section on which he is talking, then the general principles, and finally the particular points. He must ever remember that, though his own ideas may be good, and he WOuld dearly like to teach them, the ideas in his Textbook are the result of much thought by many people and must be the basis on which he shall lecture. Failure to abide by this rule must surely cause chaos in the ranks of his pupils . . The full use of charts in demonstration, and the ability to draw simple diagrams on a blackboard, will keep his audience interested, and such simple experiments as demonstrating the action of oxygen and carbonic acid gases on blood will keep the point in the pupil's memory for ever. The lecturer shall teach first general diagnosis, then individual diagnosis~ following which, general treatment and individual treatment, so the pupil will be led up to the commencement of the application of his individual treatment.

(2) P1'actical Tea clz ing. It is essential that all first aiders should have a thorough grounding in the practical side of the work . . Under the guidance of a medical man, skilled instructors demonstrate concisely the various methods of dealing in emergency with sucdden accident or illness. So many instructors are content to stand in the middle of a crowd of pupils and simply apply the particular treatment in question. A limited number of pupils should be allotted to each instructor. I suggest ten or fifteen at the outside. They should be placed in two rows *A lecture delivered at the Vth r nternational Congress for Life Saving and First Aid to the Injured, at St. Moritz on July 28th, 1939.

FIRST facing inwards, or in a circle with the instructor in the middle. Having shown clearly the method to be practised, drawing special attention to difficult points, the instructor should then see that half his class applies the treatment to the other half, following which he reverses the sequence. He must go round his pupils and see personally that they are doing the work correctly. He should never be afraid to draw attention to errors, for it is possible to learn much from mistakes. Above all he must keep his class working in unison, and not have everyone practising different things. IIe must encourage questions, and be prepared to answer any question on the subject which is being demonstrated.

(3) Fz'rst Aid Ce7'tz/icate. \Vhen a pupil has fulfilled the requirements of a regulation course, he sits for the Association Certificate and when he obtains it, he is, if he so wishes, entitled to join the uniformed branch, which is the St. John Ambulance Brigade, a body of men (Ambulance Division) and women (Nursing Division) who give their services voluntarily and gratuitously for the benefit of the public. Tursing sections ha\'e to obtain a Nursing Certificate as well as a First A id Certificate before being able to join the uniformed section. It is interesting to know that in England in the last six months 150,000 have taken the St. John Ambulance Association examination.

(-/) Association w.ztlL a Brigade Division. A mem ber of a Division attends h is Divisions' regular practice nights, and there practises his work in order to fit himself for public duties. He applies treatment after treatment until he feels himself efficient. He practises all kinds of transport work both with hand-seats and with stretchers and finally learns the discipline of foot drill and stretcher drill. The Brigade is a disciplined body and must show itself as such in the performance its duties.

(5) FirstAzd Stations-TlLeir Dzsposz'tion, Personnel

and Equipment. First aid or dressing stations, are points at which first aid work may be carried out under more or less favourable circumstances by first aid units. They vary from those for small duties such as cinemas, theatres, etc., to those for large duties such as big public processions, race meetings, etc. They may be permanent or temporary according to the continuity of the work. Large tern porary stations are allocated by the Police and staffed and eq ui pped by the St. John Ambulance Brigade, with full equipment, sur-

FIRST

AID geons, senior officers, and sufficient rank and file, both nursing and ambulance, to cover the duty. The inexperienced Brigade man usuallv starts on a small duty with experienced members ~ntil he feels able to take his place on one of the bigger duties. No matter how well a member is trained in class, it is essential that he has practical experience of actual cases. He has to become accustomed to being confronted with the sudden accidents and illness which is so different to the practise cases. He usually begins his work in the station and later is put out in the crowds, where he learns individual confidence and has to rely on his own knowledge. He carries sufficient equipment to deal with emergency, then brings his case into the station where the treatment may be elaborated. Experience gives him confidence and ensures him the full support of the public. In the station senior officers decide whether a case may rest in the station to recover or be evacuated to hospital by ambulance. 50 in time we see the first aid man .and woman working wi th that quiet confidence and sure ski II which is a reward to the 5t. John Ambulance Brigade who have turned them out from the raw material which they were to the finished product which they are.

Ambulance News Cuttings from the Press. The Editor invites Readers to send newspaper cuttings on matte r of general interest for inclusion in this column.

bIPRISONI:.D IN CAR

CNDER THAMES.

\Vhile dri\'ing his car along a road near the Thames, 1\1. Dudley Simms, member of l\1aidenhead Town Council, suddenly found himslf at the bottom of the river-still at the wheel! I t had swerved off the road and 1\J r. Sims was imprisoned. He smashed one of the v.'indO\,vs. The inrushing water widened the hole, and he scrambled through. Desperately he swam to the surface then to the bank. "I could see the bubbles of the water through the windows as the car was sinking," 1\lr. Sims told me to-night. " \Vhen I reached the shore I saw the lights of the car still hurning under the water. " It \"as the grimmest experience of my life." Later the car was recovered.-Dairy 111£1'1'01'.

DRO\\'NED IN BATH DURING FIT.

A man, aet 49, was found dead in a bath at a private hotel where he was staying. At the inquest his brother said that the dead man was subject to epileptic fits, and had about 100 of them a year. No other member of the family was similarly affected. The coroner said he was satisfied that the man was drowned during an epileptic fit and recorded a verdict of "Accidental death."-J/orning A d,'erliseI'.

In se 11 sib iii t y. ;;< INSENSIBILITY or unconsciousness is due to interference with the function of the brain. 1. Fainting (Syncope) is the commonest cause. 2. Other causes. (Remember the vowels.) A. Alcohol, asphyxia, apoplexy. E. Epilepsy and electric shock. 1. Injury, especial1y concussion and compression of the brain. O. Opium, or other narcotic poisons. U. lJrcemia and diabetes. \\Then anyone is found unconscious trom an unknown cause, proceed as follows ; 1. Lay the person flat on the back, with the head lo\\'. 2. Undo all tight clothing and allm\' plenty of fresh air. 3. Give nothing by the mouth. 4. Examine the body for injury, especially about the head. S. Treat any injury found. 6. Tote;(a) The general appearance, any signs ot blood or vomit, or paralysis. (b) The condition of the pulse, respirations, skin and pupils. (c) If the tongLle is bitten, the smell of the breath, and if fceces or urine have been passed in vol u ntaril y. 5Yl COPE, or fainting, is produced when there is an insufficient supply of blood to the brain. Causes.-Exhaustion, want of food, pain, hcemorrhage, or nervousness, are common causes of tainting. It also frequently occurs in heart disease, Symptoms.-In some cases insensibility comes on suddenly and the patient falls to the ground without warning. In other cases be complains of aidd i ness and nausea, the face becomes pale, he h . breaks into a cold sweat and then falls unconscIous. The pulse is weak and irregular and the respirations feeble. The attack usually lasts only a few minutes. Treatment.-Place the patient flat on his back, with the head low. Loosen all tight clothi ng. Allow plenty of fresh air-open the windows

- - * Extract from the ~lanual of Instruction for tIle Royal Kaval Sick Berth Staff, reprinted by permission of the Controller of H. L Stationery Office. Copies of the l\lanual can be had of H. 1. Stationery Office, Adastral House, Kingsway, London, \V.C.2, or all)' branch, price + 5d. post free.

AID

and doors, and prevent crowding around the patien t. Sprinkle cold water Oil the face and apply smelling salts to the nostrils. If a man complains of feeling faint. take him into the open air and make him lie down. If seated in a crowded room, make him separate his knees and put his head down between them. Remember that a person may injure himself by falling in a faint. CO~CUSSIO~ OF TH E B t{ .\I:-;, or " stunning," is a condition caused bv a fall or blow, and is due to severe jarring of the- brain. 5ymptoms.-These vary, Clccording to the severity of the case. The injury may result in slight giddiness, followed by a headache, or the patient may be insensible for several days. The face is pale, th~ hands and feet cold. the pulse feeble, rapId and irregular, and the respiratiors so shaIlow that in many cases the patient appears to be dead. As recovery begins, he moans, turns on one side, and dra,,'s up his knees, and can often be roused so as to ans\"er questions. Vomiting is a favourable sign. Dro\\"siness may last for a day or two, or for a week or longer. The pulse and the respirations are now stronger and the skin is \"arm. He can be rouscd for food Clnd by the calls of nature, but is often irritable when disturbed. During convalescence he is at first sleepy and irritable, and may suffer from headache, but gradually returns to health. Remem ber that in concussion there is no paralysis, and the pupils are equal. Compression of the brain may have been caused at the same time, or may come on gradually be replaced by those of compre~sion. . Treatment (First Aid.) - The patient IS kept quiet, \\'armth is applied to the body and c?ld to the head. Give nothing by the mouth WIthout orders. Surgical. - The patient is kept quiet in a darkened room, while blankets and hot water bottles are applied to the body. A strong purge rna}' be ordered. . Food is of little importance at first; later the patient can be roused sufficiently to take it by the mouth. CO:\lPRESSION OF THE BRAIN. This condition is due to pressure on the brain as the result of injury or disease. Causes (1. Injury).(a) Depressed fracture of the skull. (b) Blood clot, the result of hcemorrhage.

(:2. Disease). Tumour or abscess ll1 the cranial cavity, or the brain itself.

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Onset.-It may be sudden or very gradual. When due to depressed fracture, insensibility comes at once;· when due to hcemorrhaae in a 0 , f ew h ours, whtle in cases due to disease it may not occur for several days, weeks, or mont'hs. Sy~ptoms.-When due to injury there will be a hIstory or definite signs of an accident. Insensibility developing shortly after an accident or afte~ concuss~on has passed off, is invariabl; due to Intra-cranIal hcemorrhage. The patient is insensible and cannot be roused. The face is flushed, the skin hot, the pulse full and slow. Respirations are stertorous ~nd the pupils are generally unequal. Paralysis IS present which is not general, but affects only one side, one limb, or one group of muscles. Treatment (First Aid).-If there is a wound of the he~d, dress it .. Undo all tight clothing, put the patIent to bed with the head slightly raised.

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A New Trailer Ambulance. \VE recently inspected the trailer-ambulance or perhaps to be more correct, it should be mobil~ first aid station, which accompanied a children's o~ti~~, being manned by members of the 58/5 DIVIsion No.1 District, S.J. A. B. . The ~ody was made in ash with exterior pa.tnted whIte and kept in the upright position by 4 ]al:ks. The interior wa~ do~e in washable distemper a~d had a. very pleaSIng light and airy appearance. Fltments Included a bed (or stretcher frame) and a seat which would accommodate five persons. U n~er the bed and seat were lockers for blankets, equlpment~ stretcher, etc. At the front interior were two wash-basins with lockers underneath and two Valor boilers

FIRST This mobile aid station IS manufactured by the Ace Caravans Ltd., of Moor-lane, Staines, a.nd should meet the requirements of many diviSIons and detachments whose funds do not permit ~he purchase of an ambulane. The cost complete IS £.130 and the. manufacturers will be pleased to furnIsh full partIculars on application.

A.R.P. Topics. PROTECTIVE HELMET FOR BABIES.

A chal t on the use of the official protective helmet for babies has been issued by Jordan and Sons, Ltd., 116, Chancery-lane, London, W. C. 2, and should be of great service to lecturers and especiall y to those undertaki ng self-protection classes. The chart measures 30 ins. X 40 ins. and shows five clear illustrations together with compl~te instructions for fitting, maintaining, &c. Pnnted on paper the cost is 3s. 6d. ; linen-lined paper, 5s. ; linen-lined paper mounted on rollers, 7s.6d. . ~ repr~duction of the chart (12 i ins. X 181 ins.) IS avaIlable at 4d. post free, and copies of this s~ould command a ready sale among those attending classes. In addition to the helmet nine illustrations on "How to Use a Civilia~ Gas Mask" is printed on the back of the reproduction and, therefore, good value for money is the publishers' aim. We recommend these charts to our readers.

RESPIRATOR DRILL.

Members of the 58/ 5 Divisio n, S .. J A' . B ., WIt. 11 t h e Trailer . . Ambulance in use.

Apply ~ot water bottles to the feet and cold to the hea? :. gIve nothing whatever by the mouth. It I.S Important that medical assistance should be obtaln~d as soon as possible. Surglcal.- ~he general principles mentioned ~bove d .are earned out, the actual treatment epen tng on the cause of the com pression T.h~ skull may be opened by the operati~n of Trephtntng, and attempts made to relieve the pressure.

together ~ith kettles. A 10-gallon water container was also Included. At the rear near and offside corners were two very useful cupboards, which could b~ used for eguipment or personal clothing. Fresh al: was obtaIned by four ventilators in the roof, whIl:,t four side windows, two front windows ~nd two. SIde. glass ventilators also assisted in keepIng the Interior cool. A collapsible table and tipup seat, also lino on floor completed the fittings. Equipment included mattresses on the bed rack and also the seat.

The annual inspection of Arundel Men's (Sussex /41) B. R.~. Detachment was held on August 2nd TI I spectmg Officer was Dr W B H ' . lC o. . . eywood- Waddmoton · I M e d lca Officer of Sussex/ i8 b' . C . ' elng accompamed by ~, Asst ounty Director Sir Georae Maxwell and C d ' R. W. Pearson. n om man ant Dr.

The size of the vehicle is 12 feet by 6 feet with ple.nty ~f head-room and wide rear doors. The :,elght. IS 11~ cwt. and was attached, on our InSpectIOn, to. a 10-h.p. motor-car which at times touched 50 mtles per hour without effort. It has an all steel under-carriage.

There has been a slight alteration made in the drill for the service and civilian duty respirators, For the service type the alert position is gained by (1) service haversack to front of body; (2) slip left arm through sling; (3) undo press buttons with sharp pull; (4) withdraw whipcord and pass through" D " ring on right; (5) raise haversack on chest and drop sling down back; (6) pass whipcord through sling at back and fasten to " D " ring on left with slip knot; (7) fold over flap. When in the" gas" position, from alert, we are now instructed to " breathe out" after adjusting facepiece. The civilian duty drill now contains a "slung" position in place of " normal." In the" alert" position the haversack is now swung to the front of the body with the haversack open to its fullest extent. When " ,gas" position is required the instructions are: (1) stop breathing; (2) remove headwear with left hand; (3) sieze facepiece at container with right hand, pull it out and turn

AID towards face. respirator.

41 Then

proceed as for

service

GOVERNMENT PUBLICATIONS.

Quite a glut of publications have been received from Governm.ent departments referring to A. R. P. Some are of Interest to readers from a training standpoint, others are of a general nature. A.R.P. Circular No. 140/ 1939 (4 ~ d. post free) deals with (1) Training of Instructors (L.A.R.P.), and (2) Training of A.R.P. Personnel and Members of the Public in Elementary Methods of Protection against High Explosive Bombs and Incendiary Bomb Control. In the L.A. R.P. course 22 hours are to be given to Anti-gas, 9 hours to Elementary H. E., and 8 hours to LB. Control, exclusive of examination. !he examination is now in two parts: (a) two WrItten papers, each of five questions. The first paper, for which two hours is allowed will test the candidate's knowledge of A.R. P. Handbook Nos. 1 (less drill sections) and 2, and Handbook" The Protection of Your Home against Air Raid." The second paper, of one hour, will be on elementary methods of protection against explos ive born bs and incendiary born b control. (b) Practical test for teaching of respirator drill, lecturette and demonstration of practical methods of protection against high explosive bombs and elementary fire drill with requisite hand appliances. The course for police, tiremen and wardens should include 3 to 4 hours on Elementary H.E. and 4 ~ hours on I. B. Control; whilst for other vol unteers and members of the general public the time is 2 hours in each subject. . Other publications are: Handbook No. 11 (3~d. post free) which deals with" Camouflage of Large Installations." A. R. P. Handbook No. 12, " Air Raid Precautions for Animals" (3 i d. post free). A. R. P. Memorandum No.2 (3rd edition), " Rescue Parties and Clearance of Debris" ( 2~ d. post free). Circular No. 157j1 939, "Requirements, of Civilian Respirators," (1 ! d. post free). Circular 136/ 1939, "Steel Shelters-Cases of Flooding" (1 i d. post free). Pamphlet on "Statement Rel?ting to the Emergency Hospital Organisation, First Aid Posts and Ambulances" (4 ~ d. post free). Report on " Sectional Steel Shelters" (2~d. post free). ., Civil Defence Act, 1939" (2/ 1d. post free).

The new ambulance provided by the Clacton Ambul a nce Society was dedicated on Sunday, July 30lh, and formall y handed over to the Clacton Division, S .lA.B. The vehicle replaces that which was destroyed io a garage fire last April.

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Wounds and Their First Aid Treatment. * By J.

'v. LITCHFJELD, H.M., B.Ch., lVI.R.C.P.

A 'VOUND is a break in the continuity of tissues. I t rna y let in organ isms or let ou t blood. W ou nds are classified as : (1) incised, or clean cut wounds; (~) lacerateLl, or torn wounds; (3) contused or bruised wounds; (4) punctured, or stab wounds. Incz'sed 'Wounds, being made with sharp edged tools, sever blood vessels but do not cause contraction of their walls to any great extent, and therefore such wounds may be accompanied by severe bleeding; their edges gape. Lace1'ated 'lvou1lds have torn and irregular edges and a considerable area of devitalised tissue. Owing to contraction and retraction of torn blood vessel walls their lumen is much decreased and consequently there is comparatively little bleeding unless a vessel is incompletely severed. Contused wounds are similar to lacerated ones but, in addition, there is an escape of blood into underlyi ng tissues. . Punctured wozt7z~s have a narrow opening Into a deep tract which may readily become infected, or there may be injury to an underlying organ, nerve or blood vessel. A piece of cloth or other foreign body may have been carried to the depth of the wound. FIRST ARREST HLEMORRHAGE.

Fzrst az"d treat?nent of 'lvounds.-First arrest hcemorrh~ge and treat shock.

The dressing of the wound wIll depend upon its type. For a clean wound approximate the edges and apply a dry dressing and a bandage. Lacerated and contused wounds can be treated in the same manner if they can be dressed at once, but if there has been delay since t~eir infliction, or the wound appears grossly contamll1ated, g ross contamination should be removed and the wound irrigated with flavine 1-2,000, biniodide of mercury 1-2,000, or Dettol l- ~O.

These antiseptics are powerful but they do not a.dd greatly to the damage of the already devitalised tIssues. Such wounds may be contaminated with soil, and the danger is then the possilJle infection by the organisms of tetan us and gas gangrene. Both these bacilli are anaerobes and therefore, the best solutions for irrigation ar~ hydrogen peroxide 10 vols:, or J:?ermanganate of potash 1-3,~00, after which a light dressing should be appiled. In the treatment of punctured wounds one

* Extracts from a lect ure give n at Nursing-.

the

College of

AID must consider the position of the limb or part of the body at the time that the injury was inflicted, for the tract of the wound C3.n easily be followed when the part is put in the same position again, and a note should be made of this. If the causatory instrument is still in the wound it may be better to leave it alone until medical aid is obtained as ~ts :vith.drawal may cause serious hcemorrhag~ which IS difficult to control by first aid methods. GIVING OF PROPHYLACTIC SERA. Prophylactic sera are always ordered by the doctor, but it may be the duty of the nurse or first aid worker to give them. All cases in which wounds are contaminated with road or field soil should be given tetanus antitoxin 1,000 to 3 000 inter?ational. units . . (An American unit eq'uals two lI1ternatlOnal units.) In addition, if there is much damage to muscles, anti-gas gangrene serum up to 4,000 units should be given as well. There is only one unit used in the preparation of this serum.

Anaphylactic sllOck.-In a patient with an allergic tendency the giving of a serum will cause an alteration to develop in the tissues within 10 to 14 days, which renders them intoleran t of a second dose, even if this is given some years later. The intolerance is shown in a condition known as anaphyl~ctic shock, the symptoms of which supervene qUIckly after the giving of the second dose. They are those of acute shock which may terminate fatally; there may be sudden and severe dyspnoea, the. bronchioles are ina state of spasm and the patient may asphyxiate. Peripheral blood vessels are dilated, the pulse is weakened and eventually obliterated at the wrist. Blood and mucus may be passed per rectum. In order to avoid this serious complication the patient must be asked if he has, on any previous occasion, been given serum, and also if he has ever had diphtheria- the probability being that he may have been given serum when too young to understand it. TEST FOR SENSITIVITY. Patients with asthma, urticaria or eczema are s~ecially prone to develop anaphylaxis. IE a history of any of these things is elicited the patient must b~ tested.f~r sensitivity before the prophylactic serum IS administered. A few minims of serum shou.l~ .be injected intradermally. If there is SenSltlvl~Y, redness and swelling will appear within a few mInutes and will develop into a wheal in about . ~alf-an-hour. Such a patient must be desenSltIsed by being given gradually increasing doses of the serum hourly until the full amount has b~en given. Treatment for anaphylactic shock IS the hypodermic injection of atropine gr. 1/ 100 and ~dr~nalin m.x. Even if respiration has ceased artifiCIal respiration must be carried out and carbon dioxide and oxygen administered.

FIRST

Convulsions. THE term "convulsions" is more popular than scientific and covers a great number of widely different conditions. Broadly speaking, there are two main forms, infantile convulsions and the convulsions which are a synonym for epilepsy. I n each of these two mai n classes there is an almost infinite variety of diseases whose complete description would require many books. But even in the space of this short article, it should be possible to outline some of the most important and interesting features of these diseases. INFANTILE CON\'ULSIONS. A French medical society has recently organised a system of collective research. A special subject havin g been chosen, the general practitioners of each branch meet locally and pool their knowledge and experiences of this subject. Each branch then sends a report or representative to a general meeting in Paris where the same subject is again pooled, and a summary is made of the observations and general concl usions. In January, 1934, the subject of this discussion at the HotelDieu in Paris was infantile convulsions. Their frequency appears to be declining in many areas thanks to the educational activities of the medical profession, to pre-natal and post-natal welfare, and to the campaign against alcoholism. Though the public is firmly con vinced as to the importance of the part played by the teeth and intestinal parasites in the genesis of infantile convulsion s, medical opinion is still divided on this score. Heredity, however, it is generally agreed, plays an important part, as do birth injuries. Every mother wants to know if her child's convulsions are serious or not, and what the implications are for the future. Are they the forerunner of epilepsy or some other serious disease of the brain? The answer is reassuring. The convulsions which overtake a child between the third month and the third year of life nearly always pass off without serious consequences. But though very few subjects of infantile convulsions become epileptic, many if not most epileptics have a history of convulsions in early childhood. At the time, no one can say whether infantile convulsions are the foreru n ner of epilepsy or not. There is just this safe generalisation: most infantile convulsions lead to nothing worse.

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-1-3

but also its manifestations are most varied. At the one extreme there is the full-Oedged fit (grand mal) and at the other there is the brief moment of mental confusion with automatic acts which easily escape notice. Transien t loss of consciousness without convulsions is commonly known as petit mal. According to Dr. W. G. Lennox, only about 5 pe r cent. of the epileptics in the U.S.A. are in institutions. The maj ority of epileptics when given a proper chance, are able to live fairly normal lives. Iental deterioration is not inevitable. Indeed, it is the exception rather than the ru Ie. And the tendency towards mental deterioration can in some measure be combated by the maintenance of interest in life and by sensible adjustment to the environment. Popular opinion has much exaggerated the importance of heredity. But the heredity factor must not be ignored, particularly when an epileptic contem plates marriage. I n the absence of a family history, and in the presence of some birth or other injury responsible for the epilepsy, the patient who marries is nct more likely than his neighbour to beget epileptic children. Other predisposing causes of epilepsy than birth injuries and accidents involving the brain later in life are certain infections such as men i ngitis, encephal itis, etc. Such poisons as lead and alcohol may also predispose to epilepsy. Once a tendency to epilepsy exists, a convulsion may be precipitated by almost any irritation or stimul us-consti pation, eye strain and the wbole gamut of emotional storms. Here, then, is the clue to preventive treatment. The patient whose environment is harmonious and whose physical and mental health is maintained at a robust level, may pass months and even years without a full-blown attack . The diet should be varied and should include meat. In the case of children, at any rate, a diet rich in fats and poor in starchy foods is often very beneficial. Drugs do not cure, but as sedatives they are often useful in lessening the number and severity of the fits. The choice and the dosage of sedatives mus:t be left to the doctor in charge; and the patient who doses himself with the expensive proprietary remedies advertised by unscrupulous quacks is not only risking his health and fortune,. but is also laying himself open to the charge o[ that mental deterioration with which his fello\\' patients are so often unjustly credited.-Ir/sl/

l VurSl'ng and H()sjlial TVorld. ------ .~. ------

EPILEPSY. Epilepsy is so common that most of us hav e encountered it more than once. Our ancestors traced it to tbe influence of heavenl y bodies or to the invasion of tl~e patient's body by a demon. Many ancient works including the New Testament, give accounts of this disease. Not only its cause,

\B.,

Fifty mcmbersofthe RufTord Colliery Di.\·ision, S.] .• attended a week's ca mp at Rhyl tog'ether With other 'iectlOns of t he BolsO\'er Colliery Comrany. A Baby Show was a leading- feal~re. of the gala held on Aug-ust 7th by the Beeston and. Dlstn.ct Am~ulance and Nursing Di\·ision s. [\Ir.:>. Somerville, wife of Dlv. Surgeon A. Somerville, opened the function.

FIRST

GENERAL NURSING-PARTS I AND II. By Constance Parrey, S. R. N. Edinburgh: E. & S. Living-stone. Price oj Pa1'ts, IS. 6d net eaclz. Questions and answers are a time-honoured and extremely valuabl.e ~ethod of imparting and also of testing know!edge .. TI:ls I.S. the aim of the author of General Nztrsmg which IS ?Ivlded into two separate books. The first was prepa;ed In the hope that it may benefit nurses who .are stu?Ylng for their Preliminary Examination in Nursmg, whIl.e the second is intended primarily for those wl:o are readmg for their Final State Examination. By this means all aspects of nursing are covered. . The books seek t~ help nurses in confining- their attention as c1~sely as possIble to essential facts and in teaching them to discard tl:ose which are irrevelant. These objects are well served ~n the two books, the questions beina accurate and concise. b . !h~ publ!cation of Geneml NU1'Sing is opportune since It comcldes wIth the call for auxiliary nurses and esp~ciall for. women who are members of S.].A.B. and B.R.C.J. UnIts. To the latt~r, therefore, it should make a special appeal and prove of Invaluable assistance.

QUICK AID ANATOMICAL CHARTS. Compiled by C. Douglas Drever, 1\1. B., Ch. B. London: H. K. Lewis & Co. Ltd.

Pn ce 0.( set., IS. net. The co~piler merits congratulations on his charts wh' h measure 10 InS X 7 1 . 'll IC students f fi 't . d '2" Ins., .WI prove most useful to earnest . 0 rs al , and mclude (1) front of skeleton' (2) back of skeleton; (3) front of skull' (4) t' I ' press~re points, and (5) various' fract~~:2a ~:~~mc~:r~ ~tontdaIns ~xplanatory letterpress which still further increases I s e ucatlOnal value. . In these circumstances we commend the t AlD, who will find that the outla/fs

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FIRST

AID

There are also some quaint instructions. For example on p'. 13 we are told that with fractures, if there is an' question of ea.rth co~tamination, the patient is to be advise~ to ask for while . on p 56 ,un d er t reatf antl-tetamc serum, ment 0 ,,~cute ab?on~inal pain, we read these amazin wordsIf the pam IS not relieved in 2-3 hours tell th~ doctor th~,t you have no objection to a consultation with a surReo~ ! Now, we wonder what the author would sa and do If any first aider presumed thus to interfere with th~ after treatment of patients transferred to his care! ! .

Ne~ertheless! apart from these peculiarities the book is

mterest~ng

and mstructive. It sets out in detail the uses and dnll . for the Thomas's SlJlint and I't d escTl'b es two mec methods for the performance of art'fi . I respira. . Ilanlcal h I cIa tIOn, tough we note, in passing, that the details of Schafer's Method are not as Schafer taught.

Letters to the Editor. We are in no way responsible for the opinions expressed or the statements made, by Correspondents.-EDITOR. ' AN APPRECIATIO DEAR SIR,

THE

DOCTOR.

~iIl yo~ kindly ask Dr. Corbet Fletcher to settle the followmg ~OInts which are in dispute? We WIsh you every success and increased membE'rship a~d thank you in anticipation although from 4 to 6 month~ wIll elapse before we will receive his rulina<: This i.s not co~sidered very long, wh;~' I still am able to quote hiS aut.honty from queries answered over 20 years ago. A.ll Quenes and Answers are cut and tahulated then entered 111 a scrap book and indexed for reference.

Yours faithfully, MR. H. KENNY. Mayne-road, Bowen Hills, N.1., Brisbane, Queensland, Australia.

~oon~~

(E.ditor's Note.-The points referred to were queries and wdl be answered by Dr. Corbet Fletcher.)

A COMBINED FIRST AID TEXTBOOK. DEAR SIR,

shoullhav~ aa~~m~:r :~ndt~:u~~ti~I~~gest that each clJart

POCKET

FIRST

tion ?f shock and to attempt the reduction of a stranaulated h Ilernla !

Reviews.

THE

AID

ACCIDENTS AND AIR RAIDS. By Colonel E. M. Cowell, D.S.O., M.D., F. R.C.S. London: George Gill & Sons, Ltd. Pnce IS. net.

BO?k~~i}:~Sl~i~e~~l~~h (::~ ~~::s;~~I~~~~i~nt of The Pocket

It IS divided into two arts P wo years ago. aid treatment which ~ay be art.I s~eks to set out the first dents in the home on the r ~eqUlr~ as the result of acciII deals with first'aid in airo:a.;nd I~ tl~e fa.ctory, while Part Clearly [he author disa r I s a~ c em.lcal warfare. by the Textbook of the St ) e~s ~It\ the lImitations placed the scope of first a'd d ' 0 n .m ulan ce Association on I an on t 1le actIOn of fi t 'd to our surprise the latte lrs al ers, Thus r are encou raged to I . l' PIaster to a recent wound t 1 I app y shc {tng small dos es of morphia by ~;e~t t le edges to!Sether, to give u 1 as one step In the preven-

Atte~ding a course recently at the 2nd lecture the saId adoctor d h'lof a I certain point" the St . ] 0 h n B 00 k says sO ~ so WISt t le Red Cross Book says so a d wlll have t . b i n so, so you o give ot 1 answers at an exam illation " H e was, of course, only joking and some of the stud t laugdhed, but this did not conceal a puzzled expression ~~ goo many faces. Now, Sir, the. differences between the two official textbooks ared not a Joke ' but a1'e and w'll I become more (as :n~re .stu ents enrol) the subject of intense confusion and IrntatlOn. . Your Journal I~as always stood for publishina thinas ~Ital .to the first aId cause without fear or fav~ur b d Ignoim~ a silly ~imidity about offending- this or that int'er:~t. . s.10uld hke to see the combined brains of I~Aue~tIal readers f~cussed on this point, determined ~~~~ t ~. mIn?S of first timers shall not be confused (in the e crItical times) by these non-essentials. s "OLD TIMER."

AID

Our Nurses' Pages. ;r

COMPILED

BY AN

No. 1 DISTRICT, S.] .A. B. NORTHERN AREA. No. 46 (ENFlELD) NURSING DIVISION.-The announcement that Councillor D. P. Bowles had consented to become the first President ot this Nursing Division was greeted with applause at the annual distribution of awards and certificates which was held at the Y. M.C.A. Headquarters, Enfield, on Monday, July 24th. Councillor Bowles presented the awards. Dr. 1. C. B. Brass presided, and in a speech of encouragement told the successful members that because they were to receive a certificate it did not mean thev were going to be let loose on the public. The knowledge they had gained would be a safeguard. When they attended an injured person they would not make matters worse-and that was very much worthwhile. They should be thankful for that ability even when they were not able to give remedial treatment. Urging the members not to be discouraged in their work if they were not always successful in examinations, Dr. Brass said that it was only by continual practise they would become efficient. It was impossible to carry round a first aid bO(lk and to consult it when an accident was encountered; they must have their knowledge at their fingerti ps. Practise was essential. In troublous times like the present they did not know when they might have to do a great deal. They all hoped it would not be necessary, but at the same time it was very important to be prepared, to be quick, and to be efficient. Councillor Bowles warmly commended the work done, and he congratulated the successful members. In anxious times like the present, the work they were doing was of great importance to the country. Lady Div. Supt. Mrs. Phypers mentioned that the Division was formed twenty years ago last April. One of the original members, Miss Florence Hakeman, was still serving. At the annual re-examination all the nurses passed. The Division was inspected on ] uly 17th by Lady District Officer Miss Cherry, who gave a satisfactory report. Up to the end of June members had put in 230 attendances, representing at least 230 hours spent at A. R. P. lectures, teaching and bandaging. Mrs. Phypers thanked Dr. Brass for presiding and for his guidance and lecLUres throughout the year. Councillor Bowles and Mrs. Phypers were thanked by Dr. Brass.

WESTERN AREA. No. 89 (HENDON) NCRSING DIVISION.-A social was held at the Divisional Headquarters on July 24th, at which, among others, Mrs. Ramsay (Vice-President), Lady Div. Supt. Mrs. A. ]. Thwaites, Mr. A. J. Thwaites (Treasurer), District OfTicer and Mrs Hart, Div. Supt. and Mrs. West, and M r. and 1\1 rs. Cowan were present. The evening was spent in games and am usements, and refreshments were served. During- an interval, the Efficiency Cup was presented by Mr. Tbwaites to Mrs. M. H. Evans.

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No.2 DISTRICT, S.J.A. B. WINDSOR AND ETON NURSING D1YISION.-l\1rs. Porter, County Secretary, presented awards to members and auxiliaries of the Windsor and Eton ursing Division at St. Stephen's ~arish Room, on Monday evening, July 17th. ~fter Inspec~ing the Division and watching a demonstrahon of first aid, Mrs. Porter spoke of the Civil Nursing Re~erve, ~nd a;:;?~aled for recruits to sign on and begin theIr hospltal trainIng as soon as possible. Certificates for first aid and home nnrsing such as were held by all members of Nursing Divisions of the St. John Ambulance Brigade, 'w ere a necessary preliminary to the hospital training, which consisted of a minimum of fifty-six hours' \\"ork a year in the wards. The trained assistant nurse would LTive full-time service in the event of war, and would I ecei~e £2 2s. a week payment. At the close of the proceedings, Mrs. Porter congratulated Lady Div. Supt. Mrs. ]. Cox on the general efficiency of the Division. No. -I- DISTRICT, S.].A.B. BIRKENHEAD CENTRAL NURSING DIVISION.-This division was successful in gaining first place at the Royal National Eisteddfod, held at Denbigh, on August 7th, being awarded the" Lady Bute cup and silver medals. The marks ~ained were Birkenhead Central, 255; Abergele (Denbigh / 10 V.A. D.), 195 ; Flintj6 V.A. D., t77t· Il

No. 5 DISTRICT, S.1.A. B. ROBIN HOOD NURSIKG DI\'lSIoN.-Formed in January of this year from personnel enrolled under the Nottingham A. R. P. scheme, this division held a distribution of awards on August 1st. 1\1rs. F. Wilson l\1oulds, who has accepted the Presidency of the Division, was presented with her badge of office by Lady Supt. Mrs. A. l\laskery, who welcomed her on thiS her first visit sillce her appointment. After distributing the awards Mrs. Moulds presented the division with a fine silver cup for annual competition among the members for general efficiency. Bya general vote it l.vas decided that Amb. Sister Mrs. Page should hold the cup until the end of the currE'nt year. In reply to sincere thanks expressed by members, Mrs. Moulds said that it was a privilege to be their President. No.8 DISTR1CT S.1.A. B. CHERTSEY AND ADDLESTONE NURSING DJ\·IsroN.-Lady District Officer Lady Peters inspected members of this Division at the Chertsey Drill Hall on Monday, July 10th, and congratulated them on their proficiency in bandaging. The parade ,vas under the command of Lady Div. Supt. 1\lrs. Lamden, and the application of \ arious bandages was demonstrated. Those present included Dr. Crick may (Divisional Surgeon), Mrs. Harmens, and Div. Supt. R. ]. Gristock. In a sh:Jrt address to the members, Lady Peters said she thought they had made great strides and had put in a

FIRST

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great deal of practise. They had done much practical wor.k at Brooklands and Chertsey Bridge. She praised their bandaging- highly, and asked them to concentrate on stretcher work which was very necessary because of the Jarge number of road accidents nowadays.

Nursing Cadet Joyce Harrison, while a nother bouquet was handed to Dr. Rutledge by Mrs. High, the oldest member in the Division. Among other awards presented by Lady Cook was the Cup for General Elliciency won by Mrs. Kathleen Howes.

~O.

HARROW On'JSION, B, R. C. S. Over 100 nurses in uniform attached to the Harrow Division of the British Red Cross Society, paraded on Sunday, July 9th, and afterwards attended a specia l service at St. John's Church, Harrow. Prior to the parade, the mem bers ot the detachments gaLhercd at the Harrow Co un cil car par k and first aid rost in Station-road. There they were inspected by Lady Symonds, County President, B.R.C.S., for l\liddlesex. She was accompanied by Lic:ut.-Col. C. F. Shepherd, County Director, and l\lrs, R. A. James, Assistant County Directoland County Secretary, The Inspecting- Officers were received by Mrs. R. R. Bennett, Vice-President of the Division, and 1\1 rs. A. Picken, Divisional Secretary. Following this, the detachments, under the command l,f Commandants Mrs. Pinke)', Miss Pennefather, Mrs. Knowles, and 1\1 rs, Miles, and headed by the Pinner Silver Band, marched to the church. i\1ll01lg those present at the church were Cr. A. J. Lambert, J. P., Chairman of the Harrow Council, and l\lrs. Lambert, and Cr. G . F. Telfer. The sef\'ice was conducted by the Vicar, the Rev. H, vV. Beck, who gave :tn inspiringsennor.

10 DISTRICT, S.J.!\.B. lORWICII NURSING [)IVISlON.-Lady Cook, County President of the Nursing Divisions of Norfolk, paid a warm tribute to the work of the Nursing Divisions in Norwichand the county when visiting the Norwich Nursing- Divisions on londay, July 10lh. This was her first visit in her official capacity, and she came to present awards to successful members. The Nursing Di\'ision amI the Nursing Cadet Division, the rm'ljority of whom were in uniform, mustered in full strength to' accord their County Prcsident a very cordial welcome. Supporting Lady Cook on the platform were Assistant County Commissioner Dr. \V. E. Rutledge, Drs. J. S. Whiteside, Christina S. Wehster and Doris Small (Di\'isional Surgeons), Lady Div. Supt. J\lrs. K. L. Morley, and Miss G. J. Waters (Div. Secretary). Lady County Officer Dr. l\lay Rutledge was una\'oidably nhsent. The Nursing Cadets, who wcre under the command of Lady Cadet Supt. l\lrs. H. Denny and Cadet Officers 1\1rs. Lane and Miss Hotblack, now number 50. Lady Div. Supl. l\lrs. 1\lorley, on behalf of the Division, accorded a warm welcome to Lady Cook on her first official "isit to the Division. Lady Cook, she said, took a great interest in the \\'ork of the Nursing Divisions of the Sl. John Ambulance Brigade throughout the county, and she was now endeavouring to form a Division at Sennowe. Referring to the County President's many other activities, Mrs. l\1orley observed that Lady Cook li\'ed up to the Brigade motto, an example they all would do well to follow. ,\fter regretting the absence 0f Dr. ;'Iay Rutledge, I\Irs. 1\[orley welcomed Dr. \Vebster and Dr. Small. Dr. W, E. Rutledge also welcoliled Lady Cook. He said that they were specially honoured at having their County President to distribute the awards. Lady Cook said it was a great pleasure for her to be present, especially as it was her first visit as County President. A.fler adding her personal regrets at the absence of Dr. ;'[ay Rutledge, Lady Cook congratulated all those presenL on their srlendid [urn-out, and especially the Cadets on the enthusiastic \vay in which they had taken up the work of the Brig-ade. "Thi s work is the finest you can do," she said. "Every hour you spend on it will never be wasted. It will be useful to you all your lives.)) After remarking that she herself had become intensely interested in tbe work of the Brigade, Lady Cook spoke of the responsibility which rested upon them in the city, the county, and throughout the country in times of emergency. To provide hospital supplies was an important item in case of vvar or other emergency, and she was glad that the St. Jol111 Ambulance Brigade and the British Red Cross Society had agreed to work hand in hand in the case of emergency. The Brigade looked far ahead, and were showing the right spirit in co-operatin~ with the British Red Cross Society in case of need. In conclusion, Lady Cook hoped that the Norwich Nursing Division would maintain its erficienc)" and would increase in numbers more and more. I r it was possible, she hoped that some time in the future they would pay her a visit at Sennowe. A cordial vote of thanks was accorded to Lad\' Cook on the motion of Dr. \Vehster, seconded by Dr. Sma:'ll, both of whom said they were all g-reatly encourat.;ed by the example set by their County President and Lhey were confident that the Nursing Divisions in the county would continue to progress. A bouquet of roses was presented to Lady Cook by

V.A.D. HANTS 12. An interesting ceremony took place on vVednesday, July 12lh, at Burnaby-road Cymnasium, Portsmouth, 011 the occasion of the V. A. D. I nspectilln, followed by a presentation to the detachment by tile A. R.P. v\'omen's Reserve, in token of their gratitude to Miss Violet \Velldoll, the Commandant. The presentation took the form of a dre<;sing trolley to be used by the members at their headquarters. Mrs. F. Merritt, Head Section Leader of the Women's Branch of A. R. P., asked Miss vVelldon's acceptance of the gift. The enrolled members of the Women's A. R. P. Reserve attached to this V.A.D. now number about 230. S .\NllOWN (1. O. W.) V. A, D, Fine weather favoured an enjoyable party given to the committee and members of V.A,D, 300 (Sandown) B.R.C.S. by Commandant Mrs. Oglander, aL NunwelJ, on Tuesday, August 2nd. I\Irs. Oglander inspected the detachment on the lawn in front of the house, after which a photog-rarh was taken. Games were enjoyed, and after tea Miss Waistell, Assistant County Director, gRVc a talk to the Illembers. The rest of a delig-htful time was spent \\"andering in the beautiful grounds and over the lovely old house. ------- . ~

. ------

Col. C. A. 1\loore insrected members of the Trs\\'ich units S.J.A. B., on SaturdRY, July 22ml, at Christchurch Parle Corps SUpl. F. E. Coddard was in charge of the parade.

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FIRST

AID as was possible, this being the secret of the lift. Of course, the absence of " support" between shoulder-blades and buttocks is deliberate and is intended to avoid pressure on th e injured spine.-N. C. F.

Queries and Ansvvers to Correspondents.

TIlE WAYS OF SOME S URGEON-LECTURERS. B.S. (Kensington).-Being much perplexed, I venture to ask your kind help. 1 am acting as demonstrator to an Association First Aid Class for which the doctor-lecturer seems to delight in pouring scorn on the Textbook and to suggest methods which, in my opinion, are definitel y not those of fir~t aid. The consequence is that when I teach the Textbook methods, members of my class promptly tell me that the doctor condemned the suggested treatment. I retaliate by reminding them that the doctor who examines them will be a member of th e Association Staff of Surgeon-Examiners and that he will expect answers to be given as set out in the Textbook. Please tell me if I can do more than this.

Queries will be dealt with under the foJlowing rules ; 1.-Lettcrs containing Queries must be marked on the top left-hand corner of the enve lope" Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C.4. 2.-All Queries must be written on one side of paper only. 3.-AIl 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 39th (1937) Edition of the S.lA.A. Manual of First Aid to the Injured. BLANKETTIl':G A STRETCHER. F.L. (Consett).-In a recent competition the first two teams placed the blankets on the stretcher crossway but the third placed the blankets lengthwise. The judge told the last team that they were wrong in so doing and that their method was not as laid down in the Textbook. On looking up the Textbook I find that it does not say which way the blankets should be placed. Further, when one considers that the average width of blankets used in ambulance work is S6 to 60 inches, it means that 12 inches of the stretcher is not covered when the blankets are placed crossway on the stretcher. We shall be pleased if you will give you r ruling. As you tell us, the Textbook is silent about placing the blankets crossway or lengthwise on the stretcher because the choice of method will depend on the length of the blankets available. Further, it is immaterial how the blankets are placed providing the patient is well wrapped up in themfour thicknesses below and two thicknesses above.-N. CORBEr FLETCHER. EXAMINATION HO\vLER. M. C. (Kentish Town). - In a recent examination a candidate w~s asked how she would treat a sting. When she said that she would apply freely spirit or sal volatile the examiner asked if she could sugg-est any further t;eatment. To this question the candidate answered ; - " I could place a blue bottle on the sling!" The examiner then asked :-" Is the blue bottle dead 01' alive? " This ~entle sarcasm the lady promptly countered by saying: Oh, zn a bag, 0/ course.l" and she seemed surprised when those within hearing burst into loud laughter. Good! Next, please! !-N.C.F.

LIFTING CASES OF SPINAL INJURY FACE UPWARDS. F.F. (Rickmansworth). - To me as a beginner in first aid and a new reader of FIRST Am, it seems that it would be unwi:e t~ t.ry an~ lift an unconscious patient, who has a splOallnJury, with only five bandages, as laid down on p. p. 74 and 7 S of the Textbook. The result is that there is no support between shoulder blades and buttocks. This arrangement seems quite inadequate. Indeed I have been lifted with five bandages and, to say th~ least, I found the operation very uncomfortable even though my back was alrig-ht. Your personal experience makes me wonder if the Bearers brought the two poles into as close apposition to you

No. Your reply was perfectly correct. Unfortunately these days of rush instruction in first aid there is a popular fallacy that all doctors are first aiders simply because any doctor may give the lectures. The powers-that-be who arrange the lectures fail to realise that first aid is a subject which must be studied alike by doctor and lay person-the f~rmer to bring his knowledge d O\YI1 , and t he latte r to bring hiS (o r her) knowledge up, to the standard which divides first aid from medicine and surgery. It may, therefore, console you to know that to-day one is often told by members of these rush classes that 1hey learned more first aid from the demonstrators than they did from the ductors who gave (and often rea d ) the lecture. N.C.F.

FIRST

AID

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ARM-SLING wITH INJURED ELBOW. E.O. (Oldham).-At a recent competition memLers were told to apply the dressing bandage for elbow. Som e put the arm in a small arm sling; others did not. The judge remarked that the sling was commonsense, but as t he Textbook does not tell you to put one on, and as in competitions you must keep to the Textbook, I shall be grateful if (1) you will give a ruling on this. Also (2) do you continue to pass the ends of the bandage round the arm until you have short ends, or just onre round? Your kind decision will be \velcomed. (1) The Textbook specifies the smal! sling for fractures of arm and for shoulder bandage, and the St. John sling for fractures of clavicle and scapula and fo::- bleeding from palmar arches. It follows, therefore, that the large sling is to be u sed with all other injuries of upper limb. Consequently, with wound of elbow necessitating a dressing bandage you should apply a largE; sling except when wound is accompanied by fracture of arm. (2) The instructions read" cross ends first in front of elbow, then round arm and tie them." In other words you should not apply the bandage" round and round the mulberry bush" as I put it in my lectures.-N.C.F. FRACTURES OF BOTH CLAVICLES. W.T. (Cambridge). - I was interested to see what you say in the June issue of FIRST AID about fractures of both clavicles. I notice that in the 8th edit ion of the B. R. C. S. text book the following treatment is given ; (a) Place pad under each axil!a. (b) Pa ss a narrow fold bandage beneath the armpit and round the shou ld er and form a ring round each shoulder. (c) Under each ring behind pass a narrow fold bandage and pull fairly tight, so as to brace back th e

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11~111I1111111111111111111111111111111111I111I111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIlIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII! 1111111111111111111111 1111111111111111111111111111111111111111111111111111111111111111111111111'11111111111

FIRST

shoulders. Tie in the middle of the back. (d) Cross the hand in front, pass a bandage round the limbs and the chest and tie off in front. Thanks for letter. Another method favoured by some surgeons is to pad both clavicles with cotton wool, apply a well padded splint across both scapulre, and fix this by figure-of eight roIler bandages passed over the scapulre, through the axilla: and thence across the patient's back.N.C.F. COMPLICATED FRACTURE OF RIBS.

C. W. (Manchester).-With complicated fracture of ribs (rextbook p. 80) we are told to give ice to suck and to treat as for hremorrhage from an internal organ. LJ nder the latter (p. 137) we are told to give nothing by mouth except with hremorrhage from the lung-so (t) Should not this proviso be added to Rule 3 of the detailed treatment on p. 80? and (2) why is the administration of cold water deleted from the treatment of h~morrhage from an internal organ? Your kind replies to these two queries will be much appreciated.

AID can you say something for the guidance of those of us who while having taken examinations under both bodies are not members of either? Is the treatment by emetic in these cases the latest form of dealing with them? Your comments would be much appreciated, since it is very hard on us poor laymen when we find such eminent authorities at variance. Oxalic and Carbolic Acid are not as acutely" acid" a s are the other members of the Corrosive Group of poisons. With rhese, therefore, the danger of perforation of the stomach is usually not so pressing; and in view of the fact that they are both complicated by the early and rapid onset of symptoms of grave collapse, certain authorities consider that the administration of an emetic is justifiable provided that such action is taken immediately (or almost immediately) after the poison has been swallowed. This treatment is not new; and most authorities agree with the St. John Textbook that it is wiser and safer for first aiders to withhold an emetic 'with all cases of Corrosive Poisoning. - N.C F.

TREATMENT OF DIABETIC' COMA.

(1) As Rule 4 on p. 80 refers YOIl to the treatment for

hremorrhage from an internal organ, I fail to see what good would result from duplicating one of a series of instructions and adding it to the detailed list on p. 80. (2) Not knowing, I cannot say! Personally, I regard the administration of cold water in sips as excellent first aid for all cases of bleeding except when the stomach itself is the source of origin. After all, thirst is a prominent symptom in all these cases of severe bleeding.-N.C.F. TREATMENT OF CALCIUM CARBIDE POISONING.

L. N. (Rotherham).-Please be good enough to tell me what antidote and treatment is best for a person poisoned by swallowing a piece of Calcium Carbide, as used in old type cycle lamps or acetylene burners. It was suggested in our class that medicinal paraffin might safely be given to such patient, more especially as we cannot give copious draughts of water. Little is known about the treatment of Calcium Carbide poisoning (which may prove fatal in three or four hours), except that treatment must be immediate and prevent the production of acetylene gas. The subject has been under frequent discussion in these columns during the past ten years. The net result of these discussions is that glycerine (which absorbs water) is likely to prove the best antidote in the hands of first aiders, who should administer it freely and thef'l take steps to make the victim vomit to clear the stomach. Elsewhere it has been suggested that medicinal paraffin acts similarly to glycerine except that it is insoluble in water and alcohol. For this reason, I should try the paraffin if I could not oLtain glycerine for administration to my patient.-N.CF. EMETIC WITH

CORROSIVE

POISONING.

W.T. (Cambridge).-In the St. John Textbook we are told never to give an emetic in the case of a Corrosive Poison. This is in accordance with the teaching which I was given when first I did first aid many years ago as a boy scout. Now a number of us have taken examinations under borh B. R. C. S. and S. J. A. A. A friend of mine recently pointed out to me that in the table of Corrosive Poisons given in the B. R.CS. Textbook an emetic is specified as the treatment for poisoning by Oxalic Acid and by Carbolic Acid and its derivatives. Members of the Brigade and Society will no doubt folIow the teaching of their respective text books, but

FIRST

C. B. (Walthamstow). - T have heard recently of several cases of persons suffering from Diabetic coma and Insulin shock. As these conditions appear to be fairly common I should be pleased to know how, as first aiders, we may recognise such cases, and also as to whether or not there is any additional treatment which we may carry out other than the usual for insensibility or shock. I have heard it mentioned, incidentaIIy, that sugar may be given when the patient is conscious. I thank you in anticipation of your kind reply and also for the help which I have derived from answers each month.

The Textbook is silent about Diabetic coma and Insulin shock, probably because the members of the Revision Committee considered these conditions far too technical and far too pregnant with risks for specific action on the part of first aiders. At any rate, I take this view and have nothing to say. Further, I appreciate that first aid stands for pre\'ention of aggravation of injury or condition. So my advice is that you treat the uncon,<;cious state as laid down in the Textbook and get your patient medical assistance as quickly as possible.-N.C. F.

HUMOUR IN

FIRST

Am.

C. H. (Maida Vale).-Possibly some of your readers would like to hear what happened recently when I was conducting an examination for the certificate of the Association. Here are the salient facts :-

Examiner-Tell me what you know about artificial res pira tion. Candidate-Nothing, Sir. Examine1'-But, my dear man, if your \-vife suddenly tell down and stopped breathing, what would you do ? Candidate-Get another from where my present one came! ! Good!

Next, please! !-N.CF.

A• R• P• Organiser for First Aid required by large engineering factory, N. W. London district. Must be capable instructor and have factory experience. Write stating age, qualifications, and salary required to Box 1502, "First Aid," 46, Cannon Street, London, E. C. 4.

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FIRST AID is published on the 20th of each month. The Annual Subscription is 3 8. 6 d. post free; single copies 3d. I ts 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 12th of each month, and must be accompanied (not necessarily /01' 1JUblication) 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., LTD., 46, CANNON STREET, LONDON, E. C.4.

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T HIS

NUMBER.

EDITORIAL : -

Carrying On The Schafer Method of Artificial Respiration Precautions at St. John's Gate ... S.J.A.B. Headquarters and District Reports Bric1-cs Without Straw ... Priory for Wales Ambulance News Cuttings from the Press Railway Ambulance Ne\\'s Letters to the Editor Insensibility ... Our Nurses' Pages Reviews A Joint Appeal of the Red Cmss and St. John Emergency Committee, 1939 First Aid in Fractures _.. B. R. C. S. Blood Transfusion Service Colliery Ambulance News A. R. P_ Topics

• • • • • • • •1 members 0./ the medi-

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SEPTEMBER, 1939.

No. 543.-VOL. X LVI.

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GEORGE

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THE Call has come, and memCARRYING ON. bers of the first aid organisations have responded nobly to their country's protection. Reservists to H. M. Forces have reported at their respective stations, whilst those left behind can be seen any and every day, at any hour, doing duty at the first aid posts under local authorities schemes. The answer to the Country's Call has meant, In many instances, the depletion of divisional strength, re-arrangement of responsibility, and working under difficulties. But all these will be overcome. The men and women of the voluntary first aid army have for years undertaken duties at all times, in all weathers, in all manner of places and under all conditions and circumstancs j and we are confiden t that each and every mem ber, whether an old campaigner or a raw recruit, will uphold the traditions of the organisation to which they belong. To those who have joined the Forces, we send a message of " God speed and a safe return." To those at home we say" Stick to your work, keep the flag for ever flying and so help your comrades who have tem porarily left you." The Prime Minister has said that the work of the nation must be carried on j and it is up to all of us to do our share to carry out his statement. Public duties will still be undertaken and divisional meetings still be held, although in a lesser degree. As far as is possible, this Journal will continue to publish each month. News will naturally be scarce, but after 45 years of publication we wish to keep faith with the thousands of first aiders \\'hom we are proud to call" Our Friends." \Ve shall be pleased to hear from any reader and suggest that those on active service would welcome letters from members at home. In this respect we offer space h" in this J ourna 1 f or " pen- f' f1en d SIpS.

FIRST

The Schafer Method of Artificial Respiration. I NSTRUCTIO;-..rS.

No waste of Hme. THE person needing the app! ication of artificial respiration must be at once placed, belly down, on the nearest flat surface, the head turned a little to one side and the arms laid forwards (Diagram 1). Not an instant is to be lost, even in loosening clothing; artificial respiration must begin without a moment's delay and be kept up as long as may appear necessary j in some cases life has been restored after an hour or more of unceasing work. POSttwn of operator. To perform artificial respiration place yourself on one side of the patient facing the head, in a full kneeling position, with knees and hips bent (Diagram 4). Put your hands on the small of the patient's back (Diagram 2), the wrists nearly

DIAGRAM

touching (Diagram 1), the thumbs as near each other as possible without strain (Diagrams 1 and 2) and the fingers passing over the loins on either side, but not spread out (Diagram 2). Expiration. Then bending your body from the knees and somewhat straightening the hip joints swing slowly forward so that the weight of your body is conveyed to your hands (Diagram 3). No exertion is requ.ired : the necessary pressure is imparted by . the, weight of .your body. In this way the patient s ab?omen IS pressed against the ground; t~e abdominal vi.scera are forced against the diaphragm; the diaphragm rises and air is driven out of the lungs along with water or mucus which may be present in the air-passages and mouth and expiration is produced. Inspirat-ion. . Next, s.~ing your body slowly backwards to Its first positIOn, thus removing its weight from

AID

FIRST

the hands (which are left in place) and relaxing the pressure on the abdomen (Diagram 4). The viscera now resume their former position, the diaphragm descends, the thorax is enlarged and air passes into the lungs, inspiration being produced. Repeat the movements regularly about 12

DIAGRA1H

times a minute, swinging your body alternately forwards and backwards from the knees. Timing. Every such double movement will occupy about 5 seconds-two of which may be taken up by pressure (expiration) and three by relaxation (inspiration); to ensure regularity you may count jive slowly. Your arms should be kept straight the whole time: not bent at the elbows (Diagrams 3 and 4). Continue this procedure until there are signs of recovery, shown by the reappearance of natural respirations. If these are ineffective or tend again to cease, artificial respiration must be resumed. Use oj helpe1's. While the operator is performing artificial respiration others may, if opportunity offers, endeavour to help restore the circulation by applying warmth in the shape of hot bottles and flannels to the legs and feet. But nothing must be allowed

DIAGRAl\l

to interfere with the performance of artificial respiration, nor must the patient be turned on his back or receive any restoratives by the mouth,

unt£l his natural breathing is comptetely reestablished and he is fully conscious. Such change of position may easily block the air-passages and produce fatal asphyxia. Further treatment. When the patient is completely restored and his ability to swallow has been tested by a teaspoonful of warm water, a teaspoonful or two of warm brandy and water may be administered. He may then lie on his side in a warm bed and be encouraged to sleep. But he must be carefully watched for some time to see that breathing does not again fail. Asplryx£a jrom electric shock. In Case of Electric Shock.-Should the patient be still in contact with a live wire, switch off the current or pu II out the pI ug to which the wire is attached. Be careful yourself to avoid contact with live conductors and use great caution

DIAGRAM

AID

hardly any muscular exertion and causes no fatiq ue. 2. It can be carried out by a single operator. 3. It is efficient in effecting an exchange of air. 4. The air-passages are not blocked by the tongue, which falls forward instead of backward, nor by water, mucus and froth, which are expelled through the mouth. 5. There is no risk of injury to the congested liver or to any other organ. N OTE.- The above instructions for the application of the Schafer Method of Artificial Respiration are taken from the actual manuscript (1931) of the late Professor Sir Edward Sharpey-Schafer, F.R.S., of the Physiological Department of Edin burgh University, which was specially written for, and is still in the possession of, The Royal Life Saving Society. These instructions have been adopted by the St. John Ambulance Association. Any tuition in this method of artificial respiration which varies from that contained in this pamphlet is contrary to his teaching. Copies of the pamphlet issued by the Royal Life Saving Society and also particulars of an examination in Artificial Respiration may be had of the Chief Secretary, 8, Bayley-street, Bedfordsquare, London, W.c.1.

Precautions at St. John's Gate. in every procedure. If it is not possible to cut off the current try to pull the patient away from contact, but do not touch him except with rubber gloves or some non-conducting dry material, such as a loop of rope or a woollen garment. If no sign of breathing is observed place the body face downwards on a dry floor or on straw and at once proceed with artificial respiration. Do not delay for a moment and continue as long as there is any hope of revival.

Treatment of burns. IE you succeed in restoring the patien t any burns he may have sustained can be attended to. On no account should oil or grease be applied to the skin; the proper treatment consists in the burns being dusted thickly with a dry antiseptic powder, such as tannic acid or picric acid; they can then be lightly covered with antiseptic gauze to protect them from pressure. Advantages. The advantages of the prone-pressure method are: 1. It is simple, readily learned, requires

ALL departments of the Ordt'r of St. John will continue to function from St. John's Gate, Clerkenwell, London, E. C.1. Some of the treasures of The Order have been rerr,oved from the museum and library to a place of safety. To protect the staff in the event of an air raid, four shelters have been prepared and are arranged in such a way that no member has to g-o into the street to reach shelter. Every member of the staff has been given instructions as to the shelter they must use. Brig-adier W. G. Barne (Secretary of The Order) is the Controller, l\1ajor Darvil Smith, Deputy Controller, i\1r. H. J. 'vVrigglesworth, Organiser, Mr. D. G. lonteith, Chief Warden, Capt. Winterflood, Fire Party Lf'ader, 1r. F. Farrell, First Aid Party Leader. Certain members of the staff take it in turns to do night duty. During the last war, the inhabitants of the surrounding houses took refuge in the" Gate" during air raids. This custom was repeated on the outbreak of the present war and The Order has placed one of its shelters at the disposal of these people. The Brig-ade OHice has mobilised all members of the R. N. A. S. B. R. and 1\1. H. R. The response has been splendid. The V.A. D. 's have been mobilised through the County Controllers.

Does your colleague read FIRST AID, if not, send us his address and we will post him a copy.

FIRST

St. John Ambulance Brigade H eadquarters and District Reports. No. I (Prince of Wales's) District The flagday on July 22nd has resulted in the record sum of £8,415 15s. 11d. being collected. In the letropolitan Police area the collection was £7,8-1-2 15s. 6d., with £626 4s. 4d. expenses; City Police area, £265 15s. 8d., expenses £9 12s. 3d. ; Essex County area, £307 4s. 9d., expenses £22 2s. 9d. The Commissioner (Capt. W. (~oodley, O. B. E., 1\\. C.) desires to thank those who supported the appeal, and also those who assisted throughout the day at the collecting bases. A class of instruction of First Aid to the Injured, men only, will be held at Aldersgate Ward School, 181, Aldersg-ate-street, E.C.l, commencing on Wednesday, September 20th. at 7 p. m. Fee 3 6, textbook, 2, -. Full particulars from Di\". Supt. F. W. Bishop, 208, Downhills Parkroad, N.17. L~INDoN.-Presentation of awards was held recently when Mr. ]. Toomey distributed various awards to successful m.embers of the Laindon Division. He was supported by Dlv. Surgeon D. S. Chowdbary, Supt. H Ginbey, Amb. Officer J. \V. Lambert, and others. It was reported that all the members cf the adult and cadet ambulance divisions who attended for the examinations .h~~ passed successfully. 1r. Toomey congratulated the DIVIsIon on the results, and in a short speech thanked the members for the magnificent work they were doing. Thanks were also expressed to Ir. Toomey and Dr. Chowdhary.

1\1 r. Newport was a mem ber of the Brigade for twentyfi ve years, and at the time of his death was first officer of the Reading Town Division. He took his first certificate in 1903, and was the founder of the Reading Town Cadet Section, of \vhich he himself was first Cadet Officer and then Superintendent. Later he became Ambulance Officer. He was the proud possessor of the service medal and two bars. His long and valued services to first aid were recognised by the Order, and last year he was admitted as a Serving Brother.

No. ill D istrict. DROIT\\'ICH SPA.-The annual presentation of awards to members of the Droitwich Spa Division took place at the Town Hall. Supt. T. Skey welcomed Alderman C. H. Everton (President) and gave a short summary of the work of the Division during the past year. He said how much the Division appreciated the way in which Alderman Everton had taken an interest in them since the formation of the Division, and hoped that the President would be able to come along for mallY years to present the awards. Alderman Everton paid tribute to the work done by the members of the Division, and said he felt proud to be connected with a movement which filled an insistent public need. Alderman Everton presented the awards, which included certificates, vouchers, medallions and labels.

No. IV District No. n District CHELTENHAlll. -

A record number of 350 members Corps, carned out by County Commissioner Dr. A. Barrett Cardew, who was accompanied by County Officer H. J. Lewis and Lady County Officer Miss D. Faber. 1\1rs. Allen, C::unty Director of the B. R.~. S., was also present. The Commissioner congratulated the members on their very fine turn. out and . \~e!comed newcomers-Tewkesbury and Gloster AIrcraft DIVISions. He was certain that they were competent to deal with any serious accident to which they might be called. Corps Supt. th~ ~~v. C. Cousens Petch was in charge of t~1e ,Parade, the dIvIsIons represented being Men's Friendly SOCIeties, .Town Division, Andoverford, Tewksbury and Gloster Alrcra.ft:. Ambulance Cadets: Friendly Societies and Town DIvIsIon. Nursing Divisions: Cheltenham, Cheltenham Central, Cheltenham Nursing Cadet, Cheltenh~~ . Central Nursing- Cadet and Withington Nursing DIvIsIon. ' par~ded for the annual inspection of the Cheltenham

READING.- 'We regret to record the death of l\1r Charles Alfred Newport on August 20th. .

F I RST

AID

LANCASHIRE. BLAcKBuRN.-The annual inspection of the Blackburn Corps was held last month when Asst. Commissioner Major ]. A. Mackenzie, accompanied by the Mayor (Ald. F. J. Greeves), Mr. W. D. Ritzema(President). Dr. V. T. Thierens (M.O.H.), Corps Surgeon R. J. Clarke, inspected the members. Corps Supt. J. Walmsley was in charge, assisted by C0rps Officer G. Hartley, Supts. lercer and Parker, Lady Supts. Dr. Edith Cunliffe and Miss Blackshaw. The Mayoress ( Irs. Lambert), l\Ir. T. R. Thompson anJ Mr. W. H. Marsden, vice-presidents, were also present.

into an ambulance car. It was stated that within two minutes of a bus reaching the depot, it could be prepared for use as an ambulance vviLh accommodation for five stretcher cases together with 25 sittin~ cases. Dr. Clegg said that whatever l11i~ht happen, all ranks of the Brig-ade would stand by and be willing to render duty faithfully and well.

TlIORNTON-CLEYELEYS. - A social event recently organised by Supt. W. McKinley proved a great su('cess and took the furm of a rounders match, the am bulance division versus nurses' division. The men were successful. A supper followed, supplied by friends of the division.

which an address was given by County Commissioner H. J. Vick, who remarked that in providing the oxygen tents the members of the N' ursing Division \,,'ere carrying out the best traditions of the Order of St. John. Dr. . Brown thanked the Rector and the County Commissioner, and, in seconding, Lady County Officer liss \\'hitehead said N' ewton Abbot had a marvellous name in the St. John Am bulance movement while the town possessed one of the best hospitals in Devon.

Bricks Without Straw. PRACTICAL DIPROVISATIO~

The annual Fleetwood Fish i't1erchants' Shield and Medal Competition for Bo), Cadets in the Lancashire District has been cancelled until further notice.

N o. V District HOLSOYER COLLI ERY. - The 13th annual camp of the Bolsover Collierv Co. Ltd .. Ambulance Divisions, was held at the Compan/s permanent camp at Rhyl. Supt. J. H. Hesketh (Bolsover Division) was the Officer Commanding, there being 307 members in camp. Div. Surgeon ] . B. 1cKay (~1. 0.), Amb. Officer H. Godfrey (Adjutant), Amb. Officer J. E. Jackson (Secretary ~nd Quartermaster), StaFf-Sergt. L. Shipstone (Sergeant-Major) were the other officers. The annual inspection was carried out by Asst. Commissiener H. C. Chambers and District Officer :\luschamp, who expressed their entire satis!a.ction. . . During the "'eek many offiCIals of the Company vlslted the camp and partook of camp fare. . __ Ir. J. Williams was in charge of the cool{Jng stall.

lany mem bers of the am bulance mo\'ement, especially those in otting-hamshire, will haye heard \vith much regret the passing of Mr. Arthur B. Gibson, who was much devoted to the ambulance mo\'ement. DurinO' the Great vVar 1\lr. Gibson took a keen interest in ambula~ce work and in his capacity as Asst. County Commissioner, became known to hundreds of men and women tbroug-hout the city and county. He served abroad in an ambulance unit and was mentioned in despatches. In 1911 his services were recognised and he was admitted as an OFficer of the Order. Three years ago Mr. Gibson officially retired fron~ active Brigade work and in i\lay, 1937, a larg~ gat~lenng ~t I ottinO'ham University College presented hIm WIth a sohel silver ~asket and scroll, subscribed for by the officers anel members of the Brigade.

No. IX District BURNLEY.-Assl. Commissioner Dr. R. Clegg inspected members of the Burnley Corps on August 29th, when over 230 were on parade. Dr. Clegg was accompanied by the Mayor of Burnley (Ald. J. A. Sampson, J.P.), and the Deputy Mayor (Councillor A. Green, J. P.). Corps Supt. J. L. Colburn was in command, Lady Supts. Mrs .. Green and Mrs. Arm istead being in charge of the nursmg personnel. Following the inspection, members of the Joint Transport Division gave a demonstration of converting an omn ibus

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EWTON ABBOT.-Two oxygen tents were unveiled at the ewton Abbot St. ] ohn Ambulance Hall, on Monday, August 14th, by Ambulance Sis~er ~li~s.~. Grimbly, the oldest member of the local NurSIng- Dn·ISLOn. They were dedicated by the Rev. C. A.. \V. Russell, Rector of W~l borough. One tent was gwen by 1\lrs. H. Tucker 10 memory of her husband,. \~'hile the o.ther was pro\'ided by public subscriptions, the JOInt secretanes for the ~ppeal f~nd being Cadet Lady Supt: Irs. licholls and 1\1rs. \\ ylly l\la]or, with 1\1r. R. A. Balkw!ll as hon. treasurer. Corps Supt. S. Leece presided at the ceremony, at

FOR

~CRSES.

FEW of us when on parade can fail to \\'ish for Fate to deposit an accident at our feet. Dressed for the part, well-equipped with stores and appliances, our knowledge quickened. to examination standard, we feel we could deal adequately with the most complicated case. But, alas, things never happen like that. The dictionary definition of an accident is " a sudden happening-," to which from our own experience we might add "occurrin~ under the most awkward conditions at the most inconvenient times." People never slip on orange peel when we have the leisure to deal with a fracture. No, they choose a wet night in a deserted street when you, clad in a long dance frock, are rushing for a bus, your only equipment being a vanity baa containing powder and lipstick, or at most a pair of sli~pers. This is an example of real first aid callin~ for all the resourcefulness in your possession. \Vhat would you do about it? The Book is silent in this dilemma. Or, again, an accident may happen in a busy thoroughfare when you, the shopping housewife, are burdened with baskets and carriers, and in addition haye iust drawn a substantial sum from the bank. You are alone, and you need your hands free. Do you pile your parcels in the street, £"iYe your hand-bag into a stranger's care, and do your st~ff, hoping that your possessions \yill be intact at the end? Or do you rush into the nearest shop, dump your impedimenta, leaving your patient at the mercy of the crowd till your return? Again, the Book is reticent. I can think of several more situations where appliances miO'ht be non-existent, such as a casualty on a lonely beach, wid1 patient and helpers in S\Yim-suits ; or among tourists on top of a church tower with nothing but handkercl~iefs to work with. N'aturally \';e should all do our best 10 any emergency, but I query wheth.er su~cient. tho~ght is given on practice nights to such not-ImpossIble sltuatLOns. In all big competitions, "stores ~nd equip~lent." ~re either carried or to be had for the askmg, thus sllnphfpng the actual treatment after diagnosis. ~larks are rarely O'iven for inaenuity. Practical improyisation would be a ~ubject 'North serious consideration in e\'ery di\:ision. If each member was set to sol\'e the problems mentIOned, the solutions would be varied and original . . . per~a~s laughable. But, after all, they m/ght happen, and If It would only make members think for a .time in terms of emergency instead of correct equipment, It would be :\'ell w?rth the experiment. - VVINIFRED LAMB, Ambulance Slster, I. . . mgston Nursing Di\'ision, Hull.

S.J.A.B. SURGEONS' CONFERE1\CE. - "'e are informed by Dr. N. Corbet Fletcher, Surgeon-in-Chief, that the Annual 'Veck-end Conference arranged for October 14th and 15th hac; now been cancelled.

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Priory for NEVER in the history of ambulance work have such enormous demands been made upon the trained personnel of the Voluntary Organisations as at the present moment, when the Medical Officers of Health are depending very largely upon Brigade members to hold the key positions at the first aid posts which are being manned continuously by night and day by public spirited volunteers. In the areas more vulnerable to attack by enemy aircraft the normal strength of existing ambulance units was insufficient to meet the need j and here Brigade members are willingly assisting in the elementary instruction of new recruits. Elsewhere, it happens that in some scattered districts the Brigade is in a position to supplement the officially authorised organisation by setting up, equipping and manning supplementary first aid posts.

Wales.

application for training as Nursing Auxiliary. Such a step on the part of those prepared to render full or part-time duty ensures their skilled services being utilised to the best advantag-e as only those members who have been so enrolled and received the special training in addition to first aid and home nursing are likely to be assigned to important duties at hospitals and posts. Incidentally, the Ministry of Health has laid it down that pay at the rate of £2 a week is allowed for whole time nursing auxiliaries. AMBULANCE WORK AT THE ROYAL NATIONAL EISTEDDFOD. The ambulance competitions which figured this year as usual in the Eisteddfod programme under the direction of the Priory for Wales resulted as under : -

By Courtesy]

[Western Mail &> Echo Royal National Eisteddfod, 1939. Kenfig Hill S.J.A.B. Cadet Team receiving the" Isca" Shield from Colonel H. C. L. Howard, C. M. G., D. S. 0., J. P., D. L. (Commissioner for Flintshire). . Apart from. the organised casualty services, Brigade U?ltS are rende~lOg a valuable contribution to public well?el?~ by ~penlOg .classes .for the instruction of private 10dlvlduals 111 first aid j and 10 some areas special afternoon classes are being held for women not necessarily intending to sit for subsequent examinations. Two direct appeals have been made recently to the ambulance and nursing membership. The one concerns :n en ~etween the a!5es of 21 and 45 not already engaged 10 na~lOnal undertak1l1gs, who are urged to join the Military Hospitals Reserve for service in the Royal Army Medical ~orps. ~ ~rsing :nembers have been encouraged to enrol 10 the ClvIl Nurs1l1g Reserve by completing the forms of

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"Lady Lewis" Cup. -An open competitIOn for men with prizes of 1st, £10; 2nd, £5 and 3rd, £1, and a special medal. 1st, Kenfig Hill, S.]. A. B., 265 marks; 2nd, Monmouthshire Police, 261t; 3rd, Tredegar, S.J.A. B., 251t, Judges: Dr. G. Pari Huws, Old Colwyn, County Officer for Denbighshire ; Dr. 1. Davies, Cerrigydruidion. "Lady Bute" Cup.-An open competition for women with prizes of 1st, £8 ; 2nd, £4 and 3rd, £1, and a special medal. 1st, Birkenhead Central Nursing Division, S.].A.B., 255 marks; 2nd, Denbig-h No. 10, V.A.D., Abergele, 195 ; 3rd, Flint No.6, B.R.C.S., 1nt.

Judges: Dr. G. Stanley Phillips, Gwaun-Cae-Gurwen, Corps Surgeon of St. John Pontardawe and District Corps; Dr. 1. Duff, Denbigh j Miss Owen, Matron, North Wales Sanitorium, Denbigh. " Isca" Shield.-A competition for boys under 18 years of age, resident in 'Wales and Monmouthshire, with prizes of 1st, £3; 2nd, £2 and 3rd, £1, and a special medal. 1st, Kenfig Hill Cadet, S.l.A. B., 241t marks; 2nd, Cwmgwili Urdd, 216t; 3rd, Cross Hands Cadet, S.J.A.B., 214. J ud~es : Dr. G Stanley Phillips, Gwaun-Cae-G.urwen; Dr. Arthur L. Davies, Bala; Dr. T. O. Jones, RuthlO. The Hon. John H. Bruce announced t he results and we1corned Lady Williams-Wynn, wife of the President of Denbighshire Centre, and Colonel H. C. L. Howard, C.M.G., D.S.O., J.P., D.L., Commissioner for Flintshire, Dr. D. Rocyn Jones, C. B. E., Surgeon-in-Chief for Wales, Dr. J. H. O. Roberts, Chairman of the Eisteddfod Ambulance Committee, and others He expressed the best thanks of the Priory to the General Secretary and C:~mmi~tee of t~e Eisteddfod for including- ambu lance competitIOns 111 the lIst of items: the Chairman and Secretary of the Ambulance Committee of th~ Eisteddfod, Dr. J. H. O. Roberts, Dcnbigh, and Mr. D. Cecil Hughes, Llanrhaiadre (Div.-Supt. I?yffryn CI wyd Division), for their untiring efforts in prepanng .for the competitions and first aid duties ;. the B. R .. C. S. nurs1l1g personnel, particularly Mrs. John Rigby. ASSistant County Controller for Denbighshire, and Mr. John Jones, B. R.C.S:, County Secretary, for co:oper~ting with the St. John men 111 Denbitrhshire in connectIon WIth the ambulance duty for the week i~l the Eisteddfod Grounds j the stewards and patients for the assistance ~iven to the Brigade Secretary in .the competitions and Corps Superinte~dent W. T. ~avles, Portdinorwic, and Div. Supt. (retIred) Robert Griffiths, Holyhead, who, with Mr. John Jones had taken charge of the marking sheets. An adjudication was giwn b;r Doctors G. Stanley Phillips and G. Pari Huws on their own behalf and the other doctors who took part. . A large tent divided in two for the re~eptIOn of men and women ratients was available on t~e Elsted?fod grounds, equipped with beds, stretchers, suq;-Ical dress1l1gs, ~tc.; a~d officers and men of the St. John Ambulan~e Bngade In Denbighshire, together with B. R. C. S. nu.rs1l1g personnel were on duty continuously thr~ughout EI~teddfod week, with a medical officer on call durll1g each shift.

Mr. Morris Lindsay and Miss Nellie Aileen Warner, hoth members of the Woking Detachment of the B.R.C.S., were married at Christ Church, Woking, on Sept. 2nd. FOUND.-In Askern, Doncaster, a silver medallion, No. 40136 ; also a bronze medallion, No. 384924. Owners can obtain same on application to Corps Officer A. W. Free, Rockside House, Askern, Doncaster. Under the auspices of the Red Cross Society, a Hospital Supply Committee has been formed at Tunstall, the nucleus being the ex isting Linen Guild of the Burslem, Haywood and Tunstall War Memorial Hospital. '3

The annual ambulance competition for the " 1\1 ars I1 ,. Cup was held at Melton Mowbray. The winners w~re Leicester County Pol:ce, Wigston Magna bein~ second With but three marks behind. The trophy and replIcas were presented by Mrs. Cantrell Hulbersty.

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Ambulance News Cuttings from the Press. The Editor invites Readers to send newspaper cuttings on matter of general interest for inclusion in this column.

DEATH CHEATED DURING RACE TO INFIRMARY. While repairinv a gas main in Cliff-street, Wig-an, on Saturday, James Kay (31), a Corporation employee, was overcome by fumes. Artificial respiration was tried by his mate, William Jolly, without responce. Kay was rushed to the Infirm~ry by ambulance, and on the way P. C.S Banks and. KnIpe worked feveri hly to revive him. The man was admitted to the Infirmary in a serious condition, but yesterday he was stated to be well on the way to recovery. The doctor at the Infirmary said: .. Kay must have been at the point of death when the police arrived."-Daiif Sketch.

SUFFOCATED By TIGHT COLLAR. A tight collar caused the death of an elderly retired schoolma'ster, as was revealed at a Barton-on-Humber inquest yesterday, when a verdict of "Accidental death." was recorded. A doctor expressed the view that a stiff collar which the man was wearing wed~ed tightly into his throat and suffocated him.-jlform·ng rld've1'fz·ser.

HE STOOPED TO DROWN. The body of Alfred Cheshire, 67-years-old farm worker, was found in a crouching position in a cylindrical water tank, which held only 200 galluns, at Egham, Surrey. He must have had great difficulty in getting into the tank, and as the water did not reach a~ove his head he stooped to drow~. These facts were revealed at the inquest yesterday, when It was stated that Cheshire was depressed over the war scare.Sunday Dt'spatch.

GIRL HUNG HEAD DOWN IN SHAFT. Trapped by her legs in the lift of a Glasgow o~ce where she worked, a girl of eighteen was suspended, upsld~ do.\·n, inside the shaft for nearly an hour. In agony, the girl, Jean McInnes, tried to assist her helpers. Her concern was for her mother, who, Jean fpared, would suff~r a shoc~ on hearing of the accident. Workin~ on the hOist mechaOlsm, police and engineers freed the girl, who wa~ ren:oved to hospital where her legs were stitched up. - Dmly Mlrror.

ONE-LEGGED MAN SAVES Boy. A man 'with one leg the other evening saw a sma~~ boy, 10 t uO'glinO' in the river at Chelmsford. v\ Ithout age d ,s r h :-> 1 b l' d fe ce hesitation he ran fifty yards along t 1~ an {, JUI~pe a n , took off his cork leg, dived into the nver, and lifted the boy into a punt which some bystanders had pushed out to. the assistance of boy and man. As the boy was ~ncons.clO.us and not breathing, the bystanders at once ~pphed artifiCial . t' n to which treatment the boy qUIckly responded. resplra 10 , f d t a nbu Without further delay the boy was trans e~re o. an I lance which had been summoned and In which he was removed to hospital, where he subsequently made a complete recovery.-Daily M/rror.

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Railway Ambulance News. Great Western. 'VEST DIU\,ToN.-Awards gained by members of the \Vest Drayton ambulance class were presented by 1\1r. C. T. Cox, Div. Supt., at a function held recently. Those present included Messrs. Gamble, Salmon and Moss, station masters at vVest Drayton, Uxbridge and Cowley respectively. A report of the work done during the session was made by 1\1r. P. Jug-gins, class secretary, who paid tribute to Dr. Bobbett, lecturer, and lVlr. R. Pearce, his assistant. Awards presentE'd included 8 certificates, 2 vouchers, 25 labels and a number of gold efficiency awards for 15 to 30 vears' service. . Mr. Cox congratulated the class on their excellent reconl and, particularly, on the number of men who had gained long service awards.

Mrs. Biddle presented numerous awards, including 14-year medals, and a certiflcate to Mr. P. D. Donohoe f~r passing 31 examinations. .In a neat speech, replying to a vote of thanks for presentll1g the awards, Mrs. Biddle revealed that she had taken up first aid and had recently passed her first examination. 1\1 r. Biddle congratulated the members of the Docks C?entre, being especially pleased to see such a large contmgent present who had qualified and made such a lengthy column to step up for their awards. Mr. L. B. Petty (District Secretary) extended thanks to all for their help during another record year. He referred to the departure of their Centre Committee Chairman (Mr E. Uzzell), who had taken over the duties of Welfare Ofllce~ and Secretaryship of the Southern Railway Centre and wished him every success. '

On August 15th Inspector B. S. Record, of Orpincrton

London, Mid land and Scottish. COVENTRY.-The presentation of awards took place on August 13th, Mr. Barnett presiding. The following a wards were presented :-5 certificates, 1 voucher, 2 medallions and 8 labels. A long service medal was presented to ~lr. H. Tunnicliffe. Local challenge cups ,vere won by the following :-Junior cup, Mr. R. D. Neale; senior cup, 1\1r. \V. "Vashbrook. DERBY. -Awards gained by the North District Engineers' Class were presented recently by Mr. ]. Dickson, who was thanked by Mr. G. Statham. Mr. H. B. Everard presented the following awards to successful members of the South District Engineers' Class: 5 certificates, 2 vouchers, 11 labels. HEYSI1AM HARBOUR. -To encourage interest in the work tl:e Heysham Harbour team recently gave a display of first ald. l\1r. Hulme, captain of the team, also crave an individual exhibition of treatment for injuries as requ~sted by members of the audience. It is hoped to repeat the demonstration at a later date.

~as presented with the Meritorious First Aid Certifica~ fo~ hIS effort to save a man's life in December last. .Inspector. R~cord, whowas also the Superintendent of the ?rpln~ton .Dlv~LOn.' S.J .A. B., found Guard Capon in an InspectIOn pit and dld much to alleviate his pain and sufferino-. Dr. John Grant (Div. Surgeon, Orpington) presided;t the presentation, supported by Mr. E. Uzzell (Centre Secretary, S. R.), Mr. W. Hagell (District Secretary), Corps Supt. A. ]. Green (S.J,A.B.). and other railway officials. Mr. Uzzell related the particulars of the case and on behalf of the S. R. Centre congratulated Mr. Record on his skilful service. Mr. Williams (Oje Orrington Division) said that Mr. ~ecord bad been in charge of the division until 1938 when circumstances caused him to relinquish the position. The Chairm.an stated ~hat Inspector Record began ambu.lance work 111 1908 and 111 1932 was appointed divisional supenntendent. On hehalf of the divisional members he asked Mr. Record to accept a Westminster Chimes clock. .Insp:ctor Record, in reply. said the gift would ever remll1d hIm of the pleasant evenings he had spent with the members. He hoped t:lat the division would be crowned with success in the fllture. Mr. Uzzel l presented examination awards.

L. P. T. B. (Metropolitan). GLOUCE~TER.-~~ emp.l oyee of the Hygienic Laundry,

whose premlses adJoLn one of the L. M. S. signal boxes became ca~ght in some shafting. One arm was severed and the pattent also sustained various other injuries Signalman Heathcote who was on duty at ~he time heard calls for help and went to the assislance of the injured ~lan whom he cut down, afterwards applying a tourniquet o the stump of the arm thus preventing further hcemorrhage.

Southern. .1\Ir. R. P. Biddle, J. P. (Docks and Marine Manager), preslded at the annual concert and presentation of awards of the Southampton Docks District,

At the recent distribution of awards District Staff Officer ]. S. ~annam (No. 8 District, S.].A.B.), addressed the gathenng on the work of the St. John Ambulance Brio-ade. Mr .. Hannam was deputising for Major Darvil-S~lith, (Bngade Secretary) who was detained on duties connected with National Service. Mr. Evan Evans (President of the Met. Centre) presided and thanked Mr. Hannam for his very interesting lecture. It ~as an honour to be associated with such splendid serVlce. Mrs. A. ]. Webb presented the awards which included 48 certificates, 20 vouchers, 11 medallions and 101 labels, a total of 180-45 more than last year. Certificates of merit for the Furtherance of Fil-st Aid were presented to Mr. A. J. \Vebb (chairman) and Mr. C. H. Bowell (treasurer).

Other awards were :-Special certificates for first aid rendered (chosen from 2,000 cases reported during the year ended September 30th, 1938), A. White, A. Hams and G. Kingsnorth ; gold a wards for long service, H. Morgan (35 years), F. Ellement and G. Giles (15 years ea::h) ; " Hally" medals, S. Piddington (first year), E. Males (second year) and C. Morris (third year). Mr. Evan Evans thanked Mrs. Webb for presenting the awards, and pointed out that Mr. J. A. Gravestock, the sectretary of the Centre, had been promoted from a Serving Brother in the Order to the grade of Officer. A vute of thanks to the President, Dr. Echmann, the class secretaries and the committee was proposed by 1\1r. vVebb. Finally, Mr. Gravestock said the Centre was one of many pegs which marked the work of the Brigade. He hoped that the numbers would continue to spread, for he had already received an application to form another division of the Corps.

Letters to the Editor. 'vVe are in no way responsible for the Opll1l0nS expressed, or the statements made, by Correspondents.-EDlTOR. REVIEW

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during that time an ambulance lecture on hccmorrhage was given at Karoonda, a country farming centre. This lecture was followed by a practical demonstration a week later. The man, within a week of leaving the railways, had obtained a position on a farm about 7 miles out, with the nearest neighbour 3 miles away. A stallion had been tied to a fence by a long rope, and this man desired to release it, but upon approaching the horse he put his foot in a loop in the rope. At that moment the horse pulled back, tightening the rope, and severing the man's leg at the ankle, causing arterial h::emorrhage. From the little knowledge he had obtained he was able to apply and maintain digital pressure on the femoral artery, and call to the farmer some distance away, telling him what to do. The nearest doctor was 30 miles away, and a hospital 35 miles. I consider, that the man with his limi~ed knowledge (it must be remembered that he did not have the full course of instruction) saved his own life. Some medical men have maintained that a patient cannot maintain digital pressure on himself, but" >.he proof of the pudding is in the eating." This of course, depends largely upon the patient.-Yours faithfully, R. V. BUDIAN, Ambulance Oftlcer for the South Australian Railways.

CRITICISM.

DEAR SIR, I note in your issue of August, 1939, a brief review of my " Pocket Book of First Aid in Accidents and Air Raids." The crilicisms are not entirely justifiable. (1) Strapping for an incised wound, is only advised "if no surgical help is available." The book has been designed for accidents in the Colonies, where no doctor is at hand. Further comment is unnecessary. (2) Strang ulated hernia- my exact 'w ords are" Do not spend too long- trying to reduce, &c.-Send to hospital for operation." Several thousand cases die a year in this country, through failure to carry out this role. Human nature is such thal someone will try to reduce the hernia. (3) A. T. S. - I maintain the first aider should remind the patient to ask for this. Unnecessary deaths still occur, even in London, through failure to give A. T.S. (-+) Abdominal Pain. As a surgeon, I am constantly being called to operate too lale. This is often the fault of the lay public, sometimes the doctor. If the doctor does not call the surgeon early, surely when a life is at stakethe gentle hint I recommend, cannot offend anybody. Your critic does not spell Sch~ifer correctly-and I have studied the details from copies of the Professor's own letters. Yours truly, E. 1\1. COWELL. -+5, Wimpole Street, W.1. lEDlTOR'S NOTE.-It is regretted that our review has displeased Colonel Cowell. If, however, he will re-read the review he will realise that we compared his methods with those taucrht by the St. John Ambulance Association. The spelling ~f Sci1f1fer was c?rre:t accor.ding to the letters received from the Professor 111 hls later Ide. Also the correct . mt>thod of Schafer's Artificial Respiration is published in this issue by penl1 ission of the Royal Life Saving Society.] EMERGENCY

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DEAR Sw, The Readers' Opinions expressed on page 298 of the May issue of FIRST Auy, induces me to relate the follo'vving case which occurred in South Australia. 'A man was taken all by the Railway Department, to work in a relaying gang for a period of three weeks, and

MINERS'

NATIONAL

C01\H'ETITION.

DEAR SIR,From time to time one reads in FIRST AID of the progress of the National Ambulance Competitions. One point that has struck me is, although we have a St. John Ambulance Brigade Competition, the" Inter-Railway Shield " ~or the Railway Finals, the "Pim "Trophy for the P?l.lce Nationals, together with a National Ambulance ComretttJOn for Passenger and Road Transport men (although thls competition is not run by St. John's Gate), I ha\'e not yet heard of a National Ambulance Competition for Miners. Some of the finest exponents of ambulance work are employed in and about the mines of Great Britain. I am not now a miner, so possibly I rush in ""vhere angels fear to tread," but I would like to. read the views of some mining- ambulance colleagues on thls matler. A doct~r, who was giving' a criticism of a national ambulance competition in first aid on one occasion, penned these words-" Ye that is satisfied will progress no more." Yours faithfully, F. E. WINNIATT, Hon. Sec. Western Welsh Omnibus Co. Ambulance Class and Team (Aberdare Depot).

Eio-ht 10col11oLIve teams of the L. N. E. R. (Great Central Section) took part in the" 1\laclure " cup competition held at Retford Town Hall. Imminghal11 \Vas placed first, followed by Tuxford and Langwith. The judges were Dr. J. Collinson (Retford) and Dr. Coutts vVood (Bulwell). 1\1r. Bl~ck burn, Depot Snpt., Retford, presented the trophy and pnzes. 3'

Twenty-two team entered an open ambulance competition at Coalville on Saturday, August 26th, for a 20o-uinea silver cup and other prizes given by the Snibston Colliery Band. Birmingham Midland Ked gained first lace followed by ,ewdegate Colliery, N uneaton and P , WI" Haninglow B, Burton-on-Trent. 1\1r. 'V. Belcher, 11Lwick Colliery, was the individual competition winner.

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Insensibility.*

Treatment (First Aid.)-Treat as for Co mpression of the Brain.

ApOPLEXY is a condition due to the rupture of an artery in the brain as the result of disease and not of injury. It usually occurs in persons over fifty years of age, and is corn monly called a " stroke." Cause. - The artery itself may be diseased as the result of Syphilis, or the pressure of the blood may be so increased by Chronic Nephritis or Heart Disease that rupture occurs. Sudden exertion or excitement in anyone suffering from these diseases may cause a 'c stroke."

Medical. - Rest in bed, warmth to the bod y, an.d cold to the head, which should be slightl y raised. A purge is usually given. An operatio n is never performed as in Compression, because th e arteries. are diseased and the hcemorrhage occurs in the bral n substance, and not on the surface. EPILEPSY.-This is a disease of the nervous sYEtem, the cause of which has not been discovere d. It nearly always commences before the age of twenty, and consists of sudden attacks of unco nsciousness often associated with convulsions, called

Conditions of Insensibility. Fainting Onset

Sudden

Alcohol Gradual

Epilepsy Sudden

Apoplexy Sudden

Mental Complete Stupor, can Complete Condition unconsci- be partly unconsciousness roused ousness Pulse Feeble Full & Fast Fast

Complete unconsciousness Slow

Respiration Feeble

Slow and noisy \lVarm

Skin

Cold

Deep and noisy Warm

N ois)" frothingatmouth

Concussion Compress'n Sudden

Urccmia

Opium

Usually Gradual Gradual gradual Variable U nco nsci- U ll co ns ci- L' nconsciousness ousness o usness deepening deepenin g- deepening Irregular Gradually Full and Slow slower strong Shallow and Slow and Noisy and Slow irregular noisy diflj :::ult Cold Hot Dry & cold Cold

Sunstroke Sudden or gradual U nconsciousness Fast an d feeble

Very ho t temp. 107 degs. F. Pupils Dilated Equal and Dilated and Unequal & Equal, COIl- Unequal Equal, co n- Small" pin- Equal dilated equal dilated tracted tracted poin t " Paralysis None None None Present, of None Present, of None None None leg, arm or leg or arm face, or all three on o ne side Breath Smells of Smells of Smells of alcohol ammonia drug Special Condition of Absence of (1) Convul- (1) Some- Sometimes Sometic.1es Convulsiolls (1) Needle Points short dura- the smell of sions. (2) times loss eVI'dence o feVI ' d ence 0 f or vomlttng . . pUllctures tion alcohol ex- Involunof speecll Injury to"lI1Jury t 0 may occur 111 . s l' {1O. (2) eludes it as tary pass- on recovery head head Rem ains of poison in a cause, but of urine & (2) Elderly itspresence freces . (3) persons.(J) glass or does not tongue bit- Eyes may bottle prove it ten look to one side

Symptoms.-Are similar to those met with in compression of the brain, but usually corne on suddenly. Paralysis of the whole of one side of the body occu rs, and is often well marked in the face. In some cases convulsive attacks precede the actual " stroke." Complete.or part~~l recovery may take place, but at any tIme a stroke" may prove fatal. Months or years may elapse between each stroke. T * Ex,tract from the Manual of Instruction for the Royal Naval Sick Berth Staff, reprinted by permission of the Controller of H. M. Stationery Office. Copies of the Manual ca.n be had of H. M. Stationery Offi ce , Adastral House, Kmgsway, London, W. C.2, or any branch, price 4/5d. post free.

"Epileptic Fits." These fits occur at irregula r intervals throughout the patient's life. Sym ptoms. - The onset is sudden and occurs without apparent cause. In most cases the patien t receives a short warn ing called an "Aura," which may take the form of tingling sensations, flashe s of light, noises in the ears, or twitching of th e muscles. Immediately afterwards he falls unconscious. The epileptic fit may be divided into three stages.

(1) The Stage of Tonic Convulsions.-The arms and legs are flexed, the hands and jaw clenched, the face becomes congested, and if th e

tongue is caught betwee.n the teeth it will be bitten. The eyes may squint. This stage lasts from a few seconds up to a minute. (2) The Stage of Clonic Convulsions.-The limbs are thrown about in irregular movements, the jaws open and shut, frothy saliva escapes from the' mouth, and the eyes may roll. The tongue may protrude between the teeth and ?e bitten . . Urine and fceces are often passed ll1voluntanly. The face, which is often pale just before the fit, now becomes blue from interference with the respiration, which is stertorous. This stage lasts from one to three minutes. (3) The Stage of Stupor.-When the convul sions cease, the patient is usually very drowsy, and may fall into a deep sleep, w?ich lasts for hour~. The breathing becomes less nOIsy and the cyanosIs of the face passes off. . He often awakes with a headache. There IS risk of suffocation should he fall into shallow water or should his face be buried in a pillow. There are two recoanised degrees of Epilepsy, that described above being called Major Epilepsy. Minor Epilepsy is not accompanied by conv ulsions. The patient loses consciousness for a momen t , usually he does not fall, and the stage of stupor is absent. . . The" Epileptic State" IS the name glve~ to a condition in which fits follow each other practically without cessation. As a rule consciousness is not regained between the fits, and death from exhaustion takes place in about 48 h~urs. . . Post-epileptic State.-ThiS name IS given to a condition in which the patient performs acts unconsciouslv after recovering from the fit. Thus he may u'ndress himself, collect and ~ocket the property of others, strike or even kill anyone standing near. He has no recollection afterwards of what he has done. . Treatment of Epilepsy.-1. Pull the p~tlent away from the fire, the. wall~, or from furmture, so as to prevent his hurting himself. 2. Loosen all tight clothing and allow as much fresh air as possible. 3. Prevent his tongue from being ~itten by introducin a something solid between hIS teeth. This can ;nly be done during the second stage, when his jaws rela,,," A piece of wood, the padded handle of a spoon, or a metal tongue depressor may be used. 4. Restrain the patient but do not forcibly hold him down. 5. After the fit, remove the patient to bed, keep him warm, and allow him to sleep. 6. Never leav~ the patient until he has fully reaained consciousness. Remember the postt:> epileptic state.

AID Between the attacks Bromides are given. Epileptics are always a possible danger to themselves and others, as : 1. They may fall from aloft, or into the sea or a dry dock during a fit. 2. They may have a fit while performing some important duty, and so endanger the ship or the lives of others. HYSTERIA is not usually accompanied by unconsciousness. It may be described as a disease of the nervous system, resulting in loss of control over the emotions. I t is commonest among young females. Symptoms vary considerably, and no two hysterical fits are exactly alike. They never occur when the patient is alone. Almost any for~ <:>f nervous disease may be imitated, but usually It IS epilepsy. The onset is gradual, and can generally be traced to some emotion, such as anger or fear. The patient falls, but is careful neve~ to hurt himself. The limbs are thrown about Irregularly or held in a state of muscular contraction, but not in the way seen in epilepsy. He moans o~ cries during the fit, which lasts for manx minutes. The tonaue is never bitten, nor are unne or fceces t:> passed. Treatment.--The chief point is firmness. Get rid of all sympathising friends. . Talk firmly to the patient and threaten hi r:n with cold water if the fit does not stop. If thiS has no effect cold water should be freely applied to the face. .' . Remember, however, that hystena IS a disease and not the result of mere obstinacy on the part of the patient.

Lad y Mayhew has been appointed head of the Norwich B R C S It is interesting to no te that her mother, · ., . D IVISlOn, . . . . 1\1rs. Colman, held a similar position durin g the Great \\ ar. Lon cyw ith Loco won the fifteenth competition for the Bulwell ;nd District Challenge Cup \yhich took place rece~tly at Bulwell Common. ~lrs. Candlish, wife of Dr. Candllsh, presented the cup and prizes. ;I

•

Plans to push forward the organisa~ion of the recently. I Red Cross Societ v were dlscLlssed at the first forme d I rIS 1 J . . B d · cy f the Society'S Central Counctl held 111 the oart mee tnt:> 0 D bl' Se room of the D epart m ent of Agriculture, u 111, on ptember 8th. 3

•

o Aucyust 30th a successful garden fete was held in the

n ,.., ~1 I ' Congleton cyrounds of the Cra wford Nursing Home, oss e), . c • ' ~ aid of the Congleton S.J.A.B. and 1st Mossle), GIrl GUldes ohnson of Bug-lawton Hall, performed I r sF. .C· J , f un d s. the opening ceremony.

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Our Nurses' Pages. COMPILED BY AN AMBULANCE SISTER.

S.]. A. B. 1\ URSING CAMP. The annual camp of the Brigade nursing personnel was held at Rossall School from August 5th to 12th. The Camp Staff consisted of Lady District Supt. 1\1rs. Tweedale (Camp Commandant), Dr. K. H. Beverley (Home Office Lecturer), Lady District Officers Misses Harvey, Mawby, Johnson a.nd Mrs. Fagner. Mrs. Pitter-Bailey was Camp Matron, assIsted by 1\1rs. Jones, Mrs. Jubb and Miss Johnson j Miss Sutcliffe an indefatigable g.1\I.; whilst l\lrs. Beverl~y, with ~hree others possessing the Royal Life Saving medallIOn, was In charge of swimming parties. l\1iss Lamb was 1\1. C. for entertainment. Throughout the whole week there were lectures, demonstrations, etc., and also social functious. Saturday night a ' whist drive was held. Sunday afternoon a Drumhead Service was held at Fleetwood Beach and was attended by Mrs. Atkinson, the newly elected Lady Superintendent-in-Chief. A collection result.ed i.n £23 14s. 6d. being forwarded to the Ophthalmic Hospltal In Jerusalem. In the evening a Grand Concert was arranged. On Monday work commenced in earnest. There were lectu~es on ~lilitary Sanitation and Anti-Gas, also Cooking by 1\llss SmIth.. Ge~eral Hospital \Vard Work was given a.nd. also practtce WIth the Thomas :)plint. Tuesday was SimIlar to Monday and on vVednesday an incendiary bomb demonstration was given. Wedne.sday was .also "long night" but nearly half the camp remaIned to enloy the fare provided. . A Fie~d Day was held on Thursday. Members had to gIve first aId treatment on the spot and then have the patients conveyed to hospital. ." The" social function of the week was held on Thursday evenmg when the. Fancy Dress Ball provided many clever, ~ond~rf.ul and weIrd costumes. The judges had guite a task 111 decIdll1g the winners. .. Friday ~as. examination day in Cookery, A. R. P. and MIlItary Sanltat1On. Col. C. J. Trimble inspected the camp and took the salute at the march past. On this occasion there were present Assl. Commissioner W. H. Gastall Dr. Beverley Dr. Rawlings (Manchester), Mr. C. E. You~g (Headmaste~ of the Rossall School) and Mrs. Young, Asst. County Controller W. T. Grace (West Lancs. V.A.D.), Ald. J. P. Thomason, J.P. (deputising for the Mayor of Fleetwood) and Mr. L. A. Bampfield (Bursar of Rossall School). . , At th~ mar~h past in previous years the members were accompal11ed WIth a "humming" choir but not this year There was a big drum, trombone, saxophone banjo and even. a b~ndmaster in Mrs. Beverley. The' local press descnbed .It as follows: "The nurses stepped out to the acC?mpanIm~nt of a band formed of kettle drums and to whistles, which played 'I do like to be beside the seaside~ for the march past':' In any case the marching was good and the members dId apprecIate the musical charms of the' comrades. Ir At supper time on Friday presentations were made to Mrs. Tweedale, the Matron and her three assistants, Dr.

Beverley and Miss Sutcliffe. Community singing, dancing, games, etc., completed the evening. All too soon Saturday ar:ived and with it the break-up of the camp after a most enjoyable and instructive week. The weather had been very kind-only one half-day wet. Th.e camp was much larg-er this year, some 255 members bell1§; pres~nt. Nearly 80 Divisions were represented, also present bell1g 15 members from Nonhern Ireland SJ from Eire, and one from Montreal, Canada. The CanacJ{an member, Mrs. J osl, enjoyed being at the camp two years and had resoh'ed to cOl1le a~- ain. So ends 1939 camp- have you booked up the 1940 dates yet.

FIRST asked Mrs. Torrence to accept a wedding present from her fellow-members, with their best wishes. Before her marriage and removal to Eccleston, Mrs . Torrence was an enthusiastic member of the Division .

No.5 DISTRICT, S.J.A.B. WETlIERBY NURSING DIVISION.-Five members of this Division entered the Nursing Competition held at the Knaresborough Carnival on Saturday, August 19th. The competition was an open one, and consisted of two parts, theo retical and practical. The first prize, a silver cup to be held for one year, and replica, was won by Ambulance Sister E. M. Baines, of Wetherby, with 96 marks out of a possible 100. Ambulance Sister Bon~alJ (Harrogate Nursing Division) WRS second with 91 marks, and received a blouse case. Ambulance Sisters D. M. Lee and P. Strothard (both of Wetherby)

AID welcomed her, and also the large audience present, and thanked all helpers and those responsible for an enjoyable evening.

No. 9 DISTRICT, S.lA. B. BARNSTAPLE NURSING DIVISlON.-A garden party organised by the Division was held at Longstone, Fulton, Barnstaple (by kind permission of Mr. and Mrs. R. Berry), on August 23rd. It was graciously opened by Mrs. S. R. Gibbs, who pointed out the voluntary nature of the work of the St. John Ambulance Brigade, and referred to what had been done by its members in that neighbourhood. She congratulated Mrs. Knott on her promotion to Lady Corps Officer for North Devon, and on behalf of the I"\ursing Division asked her to accept a present wi th their best wishes. Mrs. Knott thanked the members for their kind gift

Now that war is again upon us, we women first-aiclers "Whether as have. an opportunity of playing our part. mobde V . A. D.'s, nursing auxiliaries, or assisting at A. R. P. post~, we shall a~l do our duty to the best of our ability, proV1l1g that the tIme spent in learning to serve others has been welJ spent. ~ .

No. 1 DISTRICT, S.].A. B. A Cookery Course for the S.].A.A. certiGcate wilI begin on Thursday, September 21st, 7.30 p.m. to 9.30 p.m., at the L. C. C. Women's Institute, Fairclough-street, Commercialroad East, E. 1. The course wilJ comprise 12 (two hour) lessons in plain cookery; 6 (two ~our) lessons in invalid cookery j and 6 (two hour) lessons m camp cookery. The examination will be held at the end of the course . Fee for ~he course is 4/-. The cookery book, price 3/6, may be obtall1ed at the Institute. Applications for enrolment should be made to Mrs. W. M. ~ooley, ~ead of the Institute, L. C. C. \J\Tomen's Evening Institute, FaIrclough-street School, Commercial-road East E.1 ; or to Lady Div. Supt Miss Minot, 508, Lea Bridge~ road, Ley ton, E.10.

No. 4 DISTRICT, S.J.A. B. EARLESTOWN .NURSING DIVISION.-The "Latham" Cup, ~warded to the w1l1ner of the Annual Divisional Competi~lOn, was presented to Mrs. Sarah Green at a Social Evenmg held at the Town Hall. One of the latest volumes on general nursing was also given to Mrs . Green. The runnerup, Miss .Mabel Dixon, received a useful gift. Makmg the presentation, Dr. W. C. Latham said that the trophy had proved an incentive to the ladies of the town to become efficient in nursinO". . Divisional Surgeon MCl\lasters was also presented with a gIft as a mark of appreciation of his work for the BriO"ade Mrs. Topping, Div. Secretary, made the presentationI:> and' on behalf of the members, thanked the doctor for all he had done for them. . There was another pleasant interlude during the evenmg, when Mrs. Leyland, on behalf of the Nursing Division,

[C. U. R. Cwvell, Deal Photograplt by] Competitions of the Deal Cadet Nursing Division in progress. and another competitor tied for third place with 89 marks j but after a further test the prize, which consisted of a cut glass lemonade set, was awarded to Miss Lee. The Division is justly proud of the way its members proved their knowledge and efficiency against all comers.

and hoped that they would continue to progress under the leade'r ship of Lady Div. Supt. l\1iss Shaddick. A vote of thanks to Mrs. Gibbs was proposed by Councillor Mrs. Berry, who in turn was thanked for throwing open the grounds of her house for the garden party.

No. 8 DISTRICT, S.]. A. B. BOROUGH OF DEAL CADET NURSING DIVISION.- The Second Annual Competition for the Team Shield and Bedmaking Cup was h eld at Divisional Headguarters. " Tact" team was again successful in winning the Shield with 156 marks out of a possible 190. " Resource" was second, "Observation" third, " Perseverance " fourth, and" Sympathy" fifth. The team was judged by Div. Surgeon Davies, Deal Ambulance Division . Sister Baldock, of the Deal War Memorial Hospital, kindly judged the bed making test, and the Cup was won by M. Dando and M. Jenkins, of the" Sympathy" team. At the conclusion, Lady Woods Wollaston graciously presented the awards, together with preliminary first ~i? ~nd home nursinO" certificates won by members of th(' DIVISion. Div. Surgeobn Westlake, Deal Cadet Nursing Division,

THE VAL UE OF A KNOWLEDGE OF FIRST AlD. Lady Lawson, Isel Hall, Cockermouth, journeyed to Penrith on Thursday, August 2fth, to open a garden fete organised by the Women's Auxiliary of the Y. M. C'.A .. Apologising for being late Lady Lawson said It '",'as due to the fact that on the way there they came across a man who had been knocked off his bicycle, and her chauffeur had had to render first aid-which he was very proud to be able to do as he had just passed his examination. This clearly de~onstrated the necessity of having a knowledge of first aid. Speaking of the fete, she. said it was .being held for a cause which was most admi rable at a tIme ,,,hen young men were beinO" called away to serve their country. The Y. M. C.A. did ali it could to provide these young men with recreation, reading a nd hospitality, and she wished the ladies every success in their efforts.

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Lady Lawson was presented with a beautiful bouquet of carnations by the little daughter of the fete secretary.

Reviews.

This is a handy 8-paged booklet intended for the use of students in connection with lectures on first aid. It consists mainly of 4- coloured plates whi ch measure g inches by 4inches. These present (1) the skeleton, the bones being clearly marked; (2) the circulation and the internal organs; (3) the heart, circulation and respiration, and (4) certain fractures and dislocations. Each plate is accompanied by a page of useful notes on the subject; and the booklet should prove useful and popular alike to students and demonstrators.

QUESTIONS

AND MODEL A 'SWERS FIRST AID.

Easy to read, replete with practical suggestions. printed in clear type on excellent paper Nursing- in T£me of vVar truly accomplishes the objects which its aUlhors set before them in its compilation. ).

THE LECTURE POCKET BOOK. By Kenneth Black, M.B . , M.R.C.S. London :- George Gill & Sons, Ltd. Price IS.

By E. S. Bra"vn, M.R.C.S., L.R.c.P. London :- Georg-e Gill & Sons, Ltd. Pn'ce 6d. Within the compass of 30 pages this book sets out 97 questions-80 in reference to first aid and 17 to gases used in warfare-and appends, a concise and aorrect answer to each. The questions are rather haphazard in their sequence and are not based on any definite scheme or official textbook. They are, however, essentially practical and deal with accidents which might happen or have happened. Students of first aid will find the book very interesting and instructive and will appreciate its serviceable index. NURSING IN TIME OF WAR. By P. H. Mitchiner, C.B.E., M.D., F.R.C.S., and E. E. Macl\1anus, O.B.E., S.R.N. London :- J. & A. Churchill, Ltd. Price IS. 6d. This excellent manual has been written for the benefit of members of the Civil Nursing Reserve and others who may be called upon to tend sick and injured in any grave emergency. It is written in simple, non-technical language; and for this reason it will be invaluable to those who have had no previous experience of this kind. Its first chapter provides a general introduction to Air ~aid Wor~, while. the ?e~t three deal with nursing in first ald \?osts, 111 .certa1l1 .bUlldll1gs converted to casualty hospital service and 111 hospltal huts and tents under improvised conditions. The remaining five chapters set out fully and yet concisely the war-time treatment of burns and gas, wounds, fractures, medical casualties, transfusion and administration of anesthetics. There are four useful appendices, the first of which gives a list of the equipment which will be required in first aid posts and dressing stations and the second of the lotions in common use with practical hints as to their strength and methods of diluti?? .The th.ird touches on the operating thea.tre and s~enhsatlOn, while the fourth supplies a most servlceable senes of 25 domestic and surgical improvisations.

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F. SUTHERLAND'S FIRST AID. Edited by Halliday Sutherland, M. D. Edinburgh: E. and S. Livingstone. P1'ice 6d., by post 7d.

A book which is in its 41 st edition and of which 120,000 copies have been published, requires no words of praise. This one is as old as the Brigade and almost as useful as th e Brig-ade to the community at large. It is so compacL that it fits into a waistcoat pocket, and it covers carefully and concisely the whole range of first aid, together with a section dealing with air raid gases. Further, the usefulness of the book is enhanced by an index which will serve for ready reference in times of emergency and of preparation for examinn.tion-though not, a s we hope and as a quoted criticism on the back cover states •• in the examination room." At least, we find no fault with the book although the description of the Schafer and Silvester methods of artificial respiration differ in certain essential s from those usually taught and although the latter name is misspelt.

A Joint Appeal of the Red Cross and St. John Emel'lgency Comlnittee, 1939 TilE Duke of Gloucester, as Grand Prior of the Order of St· John and Chairman of the Council of the British Red Cross Society, heads the signatories to an appeal to the public for funds to enable joint work of the two bodies for the relief of the sick and wounded to be organised and maintained on any scale that the needs of war may require. Sir Arthur Stanley, Chairman of the Executive Council of the Society, and Lord Scarbrough, Sub-Prior of the Order, supports the appeal, which is issued through the Red Cross and St. John Emergency Committee, 1939, with the address of 12, Grosvenor-crescent, London, S. W. 1. Lord Cromer has consented to be the chairman of the Com mittee, with Major-General Sir John Kennedy as vicechairman. A fund is being opened in the name of the joint bodies, and donations should be sent to the Hon. Sir William H. Goschen, K. B. E., Hon. Treasurer, Red Cross and St. John Fund, at Messrs. Coutts & Co., 1, Park-lane, London, VV.1. It is announced that the King has sent a donation of £5,000 and the Queen £2,000, whilst other Royal donations are Queen Mary £1,800, the Duke and Duchess of Gloucester £1,000, the Duke and Duchess of Kent £750, the Princess Royal and the Earl of Harewood £500, the Duke of Connaught £500. On September 11 th, Sir Frank Bowater, Lord Mayor of London, made an Empire-wide appeal fe>r funds. lIe recalled that during the last war more than £20,000,000 was raised and £17,000,000 spf:nt on the humanitarian work of the organisation. But immense though the task was then, the joint body may now have to face an immeasurably bigger one. County Ambulallce Officer (Dr. W. A. L. Marriott) for Norfolk Branch, B. R.C. S., reports that during 1938 9,000 miles were covered by the Norfolk ambulances and more than 30,000 cases carried.

AID

First Aid in Fractures. *

INVALUABLE TO

By J. W. LITCHFIELD, B.M., B.Ch., M.R.C.P.

FI~ST =AIDE~S

ONE of the commonest injuries which require first aid treatment is injury to bones, particularly fractures. The actual causes of fractures are: (1) Direct violence, the bone being broken at the si te receiving the injuring force, as when a leg is " run over." (2) Indirect violence, by means of which a fracture occurs at some distance from the spot receiving the injury, e.g., the clavicle may be fractured by a fall upon the outstretched hand. In this case, the muscles being stiffened the force is transmitted up the arm and jerks up the shoulder so violently that the clavicle breaks. (3) Muscular contraction, a bone being broken by a sudden and violent contraction of muscles which are attached to it. The commonest example is fracture of the patella by a kick which misses its objective, as sometimes occurs in football, or by inadvertently stepping off a kerb and suddenly contracti~g the muscles of the thigh in order to prevent falling.

VARIETIES OF FRACTURE.

Fractures may be classified as follows:According to the bony injury: (1) complete; (2) incomplete; (a) greenstick, (b) fissured; .(3) comminuted. According to the extent of the Injury to other tissues: (1) simple; (2) compound; (3) complicated. Simple; fracture. The bone is broken in one place only and no further injury, except mod~rate bruising, occurs. Such frac~ures may b~ descnbed as oblique, transverse or spIral, accordIng to the direction of the break. Compound fracture. There IS a ,,,ound through skin or mucous m.em?rane, forming a direct or indirect communicatlOn between the broken bone and the external air. Comminured fracture. The bone is splintered into several fragments in the same region. Impacted fracture. The broken ends of the bone are wedged into each other. Com pI icated fracture. I n addition to t~e fracture, there is injury to important structures In the surrounding tissues, e.g., all artery, nerve or vein is torn, a joint cavity is opened, or the broken bone injures an internal organ, such as the lung by a fractured rib, or the bladder by one of the pelvic rami. Incomplete fracture. (a) Greenstick, where a long bone is so bent that the con~ex s.urface breal~s while the concave portion remaIns Intact. ThiS type occurs only in children whose .bones .are not completely ossified; (b) Fissured, In which the

* Extracts of a lecture given at the College of Nursing.

In spite of its name" The Family Physician" is a book which will be found invaluable by all connected with First Aid or Ambulance work. The Editor, Douglas Hay Scott, M.B., Ch.B., is a lecturer in First-Aid, Hygiene, Home Nursing, Anatomy and advanced Physiology at Morley College, LO '1don, and First-Aid Commandant, Surrey Cadet Brigade. Formerly he was County Director, British Red Cross Society, City of Dundee, and Lecturer and Examiner in First Aid and Home Nursing, St. Andrews Ambulance Association. He has taken great care in compiling this work and has been assisted by other wellknown medical men to ensure that the information given is absolutely authoritative.

SOME

THE

SUBJECTS.

First Aid- Home Nursing-Hygiene-Drugs -The Giving of Medicines-Electricity and l\Iedicine-Anatomy and Physiology-Physical Culture --General Diseases- Infectious Diseases-Diseases of the Heart, Blood, Digestive System, Urinary System, Respiratory System, Eye and Ear, Skin, Nervous System, Ductless Glands-Vitamin-Deficiency Diseases - Diseases due to Impaired Metabolism-Diseases of the Bone-Diseases of the Joints, etc., etc.

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The section on First Aid constitutes a complete man ual of "First Aid" work. The chapters on " Fractures" "Dislocations and Sprai ns," and " Bandaain'a and Slings," have been written by one of the bforemost medical authorities on the subject, and are profusely illustrated with X-Ray and other photographs and diagrams.

A. R. P. Included in the First-Aid Section is a chapter on Air Raid Precautions. This contains all the latest information on protecting the home and family from air attack. It tells how to admi~ister First-Aid, and describes all types of weapon lIkely to be used in hostile bombardment.

SEND FOR PARTICULARS. To The Caxton Publishing Co. Ltd., 46 Clun House, Surrey Street, London, W.C.2 Please send me, free of charge, full particulars of "The Family Physician." Nanle .. . ... . ........................... . ........ ... ... ............ . ......... . Send this form in unsealed envelope (!d. sta mp) or a postcard. Address ......... . ........ . ... . ........... .. ' ... . U.7 ..... ................ · ........................... .........

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bone is merely cracked. This may occ ur in a long bone or in the skull. Fractures are said to be " pathological " when they occur almost spontanously as a resu lt of very slight injury. In these cases the bones are unusually brittle or they are the site of active disease. DIAG NOSIS OF FRACTURES . The sig ns and sy m ptoms of a frac tu re are as follows: 1. History of an injury . 2. Pain (especiall y if remote from the site of violence) and tenderness. 3. Loss of function. 4. Deformity from muscular action or as the result of violence or gravity. 5. Unnatural mobility of the part. 6. Crepitus, or a sensation of grating, felt when the broken ends of the bone move over each other. (A first aid worker should never attempt to elicit this sy mptom.) In all probability only a few of these signs will be present, but if a fracture is suspected time s hould not be lost in trying to confirm the fact. The g olden rule is to treat the patien t as though a fracture had occurred until it is proved that the bones are intact. Do not remove clothing (unless this is necessary in order to treat hcemorrhage or a se rious wound) for the incidence of shock is reduced by keepi ng the patient as warm as possible, and further injury that might accrue from the displacement of frag ments is avoided. If the accident occurs in a private house and the fracture is in the lower extremity do not move the patient until the surgeon has seen him, unless he cannot be made comfortable where he is with pillows and rugs. General lines of treatment Include: (1) The control of hce morrhage, if present. (2) The treatment of primary shock, sending to the nearest dw elling for hot drinks, blankets and a hot water bottle. (3) Immobilisation of the fractured bone, in the natural position if possible, utilising the assistance of any available person in the vicinity. To MOVE A FRACTURED LIMB. Place one hand above and the other below the seat of injury , grasp firmly and, while maintaining gentle extension, place the limb in the position in which it can be immobilised by fixing some form of temporary splints in place. For this purpose pieces of board, umbrellas, walking sticks, broomhandles, cardboard, or even folded newspapers around a branch of a tree could be used, and these could be secured by handkerchiefs, scarves, neckties, straps, braces or towels. The opposite lim b or the body itself may act as a splint. it may be possible to obtain equipment from the nearest first aid station or hospital. A splint must, in all cases, incl ude and extend beyond the two joints of the fractured bone, and in

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a ll cases of fracture of the upper extremity the lim b m ust be supported by a sling. When the limb has been immob ilised it must be ascertained that the circulation is not impeded in any way.

B. R.C.S. Blood Transfusion Service. MR. P ERCY L. OLIVER, the hon. secretary of the above Service, has sent a printed communication to all members pointing out that the past work of the Service in selecting individual donors an d despatching them to hospitals to give thei r blood to definite patients will cease on the outbreak of war, and the Service, as such, will cease to exist until peace is restored. Present members of the service should keep a careful note of any transfusion given, and submit same to the hon. secretary after hostilities have ceased, when seals and badges will be awarded as if the transfusions had been carried out unde r peace conditions. Only those whose names were on the official roll of the Service at the outbreak of the war will be eligible for these awards.

Colliery Ambulance News. On S a turday, Au g us t 19 th, the Kent Colliery Owner s' Ambulance Shield competition wa s h eld at Deal Ce ntral School. Chi slet Colliery gained Rrst place , Bettesh a n ge r (h old er s) being second, Snowdown third a nd Tilman s ton e fourth. A Junior Com petition was inau g ura ted thi s year an d a g ain Chislet lead the way followed ' by Snowdown, Betteshanger and Tilmanstone. Mr. J. Reed, manag er of Betteshange r Colliery, pres ented the trophi es and medals. Major H. C. Owen org anis ed the fun ction a ssis ted by a representative Committee. Presenting the" St. John Ambula nce " cup, award ed by the South Derbyshire Miners' W elfare Committee to th e Cadley Hill Colliery team, Major G. D. Mayh e w, manag in g director of Hall Collieries, Ltd., Swadlincote, said that 133 employees of the firm held first aid ce rtificates . Cadley Hill had 56, Swadlincote Old Colliery 42 and Bretby Colliery 35. Supt. D. T . Aldridge trained the Cadle)' Hill t ea m consisting of Messrs. J. Garland, V. Cross , J. Anslow, G. Dennis and J. Tildersley who were presented with medals . The South Elmsall Pretoria W. M .e. team won th e ambulance competition promoted by the sports committ ee of the Mexborough Montague Hospital at Mexborou g h on Saturday, August 12th. Houghton Main were the runnersup and were awa rded the Hospital Challen g e Cup. ;,

Toy manufacturers have been warned by the Board of Trade that they must not make toys or children's nurse outfits bearing the Red Cross. Under the Geneva Convenvention Acts of 1911 and 1937, any imitation of the British Red Cross is illegal, and the sign mus t not be used without special permission from the Board of Trade or from the Army Council.

pracliti o ~ er

il y become an ex!")ert of Swedis h l\1 assage and enjoy the stat us, remuneraof th e professlO nal work er If yo u are pre pared to s tud y for a n h ou r or so each day. Y O U,t iontoo,a ndcacon mfeasorts Yo ur knowl ed ge of Fir s t Aid will be co ns idera bl y e nha nce d. if yo u. ~ea r . t h e . ba~ ge of ~he S1\L\E In s titute , whic h is r ecog ni sed as a n embl em of so und a nd effiCIe nt t rall11 ng 111 sCIentI fic s u bjects. ~be holder is th ereby known to h ave satisfied a Boa rd of E xa miners th at h e or s?e possesses a most . comp r ~henslve kno wled g e of hum a n a nato m y a nd phYSIOlogy and ca n satlsfactonl y treat a ll th e hundreds of co nditi ons that a re amenable to Massage and m a ni pul at ive Th era py. Tre m end ous op port u nities li e before you in th is u ncrowded field which is no\v ope n to yo u w it ho u t h ay in g to leave your present work u ntil you q u a li fy as a n expert a nd can command a n expert's pay. If yo u a re in ter es ted in First Ai d yo u will at once arpreciale t he \alue of IVI ass a ge, rea lisin g th at w hi lst exercise is t h e fi nest mea n s of r~taining hea lthy m uscles in g ood to n e, that it does produ ce combustlOn and fa ti g u e produ('ts in th e t iss ues.

l\l assage will b uild up th e musc ul a r a nd n ervou s systems in exactly t he sa m e way as exe rcise; but does not incu r a ny waste prod ucts and eve n re m oves th e m .vhe n th ey a re present. I t is then t h e most va luable asset a nd a w ond e rful treat m e nt fo r injured and sick. FILL IN AND POST THIS COUPON

------------------

C0 U P 0 N

To The Secretary, The SMAE Institute. Leatherhead. Surrey . Pl ease send me w ithout obliga; tion . a copy of your free Booklet "Manipulative Therapy as a Profession. "

N a nle . .. . .. . ........... . .. . . . ... . Address . . .... . .......... . .. ... .. .

.. F.A." Sep t.. 1939 .

The proper study of mankind is man . S tudy th e most absorbing subject in the world in g ood com pan y under the guidance of the S.M.A.E. Turn y our interest in Fi rs t Aid work and your hobby into channels that mean mone y for you-health for others. Get this Free Book" Manipulative Fill in Therapy as a Profession" and the Coupon learn how you can en ter the for this profession with a future. Fill Free in the Coupon and post withBook out delay.

FIRST

A.R.P. Topics. INSTRUCTIONAL DIAGRAMS.

For those who are engaged in lecturing on Incendiary Bombs and protection against same, the Stationery Office has published two diagrams, which measure 30 in. X 40 in. each. No.1 deals with a Typical Kilo Magnesium (Electron) Incendiary Bomb, showing the outer appearance and the interior construction. No. 2 depicts a Typical Roof Construction, showing how it should be reinforced and protected against possible bombs. The net cost of each diagram is 2/- post free.

PROTECTION OF BABIES A TD YOUNG CHILDREN.

A memorandum on the protection of the above against gas has recently been issued (1 ~d. post free). The appliance to be used is decided according to the individual child, but the general rule is: From Birth to 2 years of age, the Protective Helmet; from 2 to 4t or 5 years of age, the small child's Respirator; above 4t or 5 years of age, the Civilian Respirator (small size). The small child's Respirator has been made in colours and is light in weight. The container is also lighter than that of a civilian respirator, and it has been proved by testing that the face-piece is non-irritant to the skin. Full instructions for fitting are given. The Protective Helmet is described, also the application of same.

AIR RAID SHELTERS.

Three publications have recently been issued on this subject. A. R. P. Handbook No. 5 .\ " Born b Resisting Shelters" (7d. post free), which may be regarded as a supplementary to A.R.P. Handbook No. 5 "Structural Defence." Whilst the latter was in course of preparation, the technical data contained therein was communicated to a Design Panel, set up at the req uest of the Home Office by the I nstitute of Civil Engineers, for the purpose of framing specific recommendations as to the design of bombresisting structures. The present handbook contains the recommendations of the Panel. "Air Raid Shelters for Persons Working in Factories, Mines and Commercial Buildings," Revised Code (6~d. post free), and a Memorandum on the same subject (4id. post free), are the other two publications under this heading.

AID

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OTHER PUBLICATIONS.

Circular No. 1841 "Government Evacuation Schemes" (3~ post free), and Memo. Ev.5 (3~d . ) on the same subject (an enclosure with the former) ; Circular No. 15~ / 1939 "Civil Defence Act, 1939, " (4td.), which calls the attention of local authorities to certain provisions of the Act and gives guidance for its administration. "Fire Fighting in Peace and War)J is th e title of a new publication by Jordan Bros. Ltd., of 116, Chancery-lane, London, W. C. 2 (1 / 2 post free). This book can be taken as a practical man ual not only for the training of A.F.S., Ai r \Vardens, but also for the Office and Factory Fire Squads as required under the Civil Defence Act. I t is also a useful hand book for householders. There are chapters, covering Fire Extin guishers, the Working and Maintenance of Fire Pumps, Drill, Useful Knots, First Aid, Incendiary Bombs, Every-day Fire Accidents and how to deal with them, etc. " GAS-A SYNOPSIS OF DEFENCE AGAINST."

Yet another edition of this excellent " best seller" has been found necessary. The latestthe fourth-contains the new respirator drill, an d also reference to the Helmet for Babies and Gases have been placed in their "respective value )J positions, whilst mention is now made of the Mobil e Aid Posts. Complimentary letters on its value and contents are frequently being received, therefore we recommend this book on the recommendatio n not only of the student but also on that of th e lecturer. The price is 1/ 1 post free, obtainable from Dale, Reynolds & Co. Ltd., 46, Cannon street, London, -E.C.4.

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TRAINING OF FIRST AID PARTIES.

The first edition of A.R.P. Handbook No. 10 (" The Training and Work of First Aid Parties" ) has just been issued. Chapter 1 deals with First Aid Parties: responsibility for enrolment, initial instruction, alloca tion of selected personnel, practical training. Chapter 2 deals with general description of the work and arrangements for practical training. General principles of training in the treatment and handling of cases is dealt with in Chapter 3, which also includes types of injury to be expected ; wound shock, primary and secondary; hcemorrhage; initial disposal; individual and team practice, together with team tests and competitions. There are numerous appendixes which deal with bandaging, arrest of hcemorrhage, abdominal wounds, burns and scalds, fractures and other Su bjects. The cost of the book is 7d. post free.

Apart from Cups and Medals, Alexander Clark always have an enormou.s range of utility Prizes and Gifts sUlt~ble for Ambulance Competition Prizes.

Catalogues and Wholesale Terms allowed bona-fide First Aid Societies, gladly sent upon request.

London Showroo'Jns: E C 3 38 LEADENHALL ST., · · 125-6 FENCHURCH ST., E.C.3. , BIRMINGHAM , Manufactories:

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Queries and Ansvvers to Correspondents. Queries will he dealt with under the following rules : 1.-Letters containing Queries must be marked on the top leEt-hand corner of the envelope" Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C. 4. 2.-All Queries must be written on one side of paper only.

3. - AII 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.

AID bandage roun.d ankles and feet in spite of the fact that the fr:;tcture . IS compound. Surely this must result in extension being apphed to the fractured leg. whi ch is contrary to the black type instru ction at end of Rule 4 on p. 67 of the Textbook. I do not like to question the deta iled marking sh.eets used in competitions; but I feel that I cannot let thIS p~ss unchallenged. So I await your ruling with much lI1terest. The fig-ure-of-eight bandage is used to tie foot to foot and if properly ~pplied it will not cause any true extens ion. Cons~qu e ntly, It does not come within the scope of the warnIng not t~ pull on the lower fragment of a compound fracture; and It sho uld be applied in s uch cases just to hold foot to. foot and to prevent mo vements. If there is also shorteOlng. present you should tie the feet together \.vith figur.e-of-elght bandage as best you may but without any tractIOn on the foot of the injured Iimb. -N.C. F.

4. -The Textbook to which reference may be made in this column is the 39th (1937) Edition ot the S.l.A.A. Manual of First Aid to the Injured.

FRACTURES OF FEIIIUR, LEG AND PATELLA .

J. W. .(Bromley). -Yo ur advice will be greatly appreciated SCHAFER'S ARTIFICIAL RESPIR ATION. W.S. (Berne, Switzerland}.-At the recent International Congress of First Aid held in Zurich the various methods of arti~~ial respiration. were discussed, even though in ~ny OplOIO~, far too briefly. As a Swiss Surgeon much Intereste.d 10 fir~t aid,. I would ask you why Schafer's Method IS descnbed differently in the textbooks of the St. ] ohn Am bulance Association and tIle British Red Cross ~oc.iety. Personally, I favo ur the Schafer though t~e maJonty of surgeons on the Continent prefer the Stlvest~r method. Your kind reply will be much apprecIated. The t~uth of the matter is that, judging from the several books whIch I have read, I find that no two manuals of surg~ry,. let alone textbooks of first a id, give identical desc.nptlOns of Schafer's Method, each varying in certain parttculars. For example. the B. R. C. S. textbook tells stu?ents to .I oos~n the patient's clothing- before commencingactlOn and Its dIagram shows the uniformed operator pe;for-ning pressure with bent elbows. . In t.hese ci~cumsta.nces it is fortunate that the Royal LIfe Saving SOCiety (wh Ich has a l ways specialised in methods of resusc~tation, especially of drowning cases) kept in close touch With Professor Schafer and in 19:51 obtaineJ his approva.1 of ce~tain modifications of his original (1903) su.ggestLO n. It IS equally fortun ate that the Revision Committe: ~f the St. John Textbook (which was published in 1937)JolOed hands with the Royal Life Savi ng Society with the result t~lat the~e two g-reat teaching organisations now present ll1structions which are identical in alI particulars.N. CORBET FLETCHER.

WIth ref~rence to the correct treatment of the follo wing case which was set at a recent Divis ional practice :_ As the result of a motor accident a man was found to be surrerin~ from (1) a compound fracture of the right femur co mplicated by protrusion of the fragment s on the outer side of the limb; (2) a compound fracture of the left leg with wound on the shin, and (3) a si mple fra cture of the left patella. My suggestion is that, having dressed the wou nds, on~ bearer should steady and support the right foot whl~e the other bearers fix the left patella with a fig ureof-~Ight bandage and the left leg in the usual ~ ay. ThIS done, the fractured femur should be steadied with an inside splint extending from crutch to foot and the two lower I~mbs should be secured together by band ages. You wIll no te that I propose to substitute an inner for the outer splint for the fractured thio-h and to omit the back splint for the fractured patella. 10> Please te11 1l1e if I am right. Your suggested treatment is perfectly sound. There is however, the probability that with such combination of in~ juries sh?ck may be so severe that yo u will have to concentrate on ItS treatment rather than on that of the indivi dual injuries , and that you may ha ve to be content to omit spl ints and to tie limb to Iimb. - N.C. F.

sen.d t~le story along 111 the hope that it may cause a smde 10 these unhappy days. Good! Next, please! !-N.C.F.

TRANSPORT BY HAND SEAT. H.J, (St. Albans). - The 38th Edition of the Textbook taught us that, for transport of patient by two-handed seat, the bearers should march with broken-step. The current Edition, however, states that the bearers must march with cross-over step. Please tell me if you consider the method of usi ng the cross-over step an improvement over the prev ious method and if you consider it suitable for the rap id transport of a patient on the football field and for instance, on street duty in London. Personally I fa'vour the old method and advocate its perfomance at half speed.

TREATMENT OF COMPOUND FRACTURE. P. S. (Ho.rnsey).-On p. 9 of the] uly issue of FIRST AID you publtsh t.he detailed marking sheet used for Bearer Nos. t :;tnd 2 In the Inter-Railway Final. I note with Surpnse that marks are given for applying a figure-of-eight

On both points I agree with you. The cross-over step may be satisfactory if patient has to be carried a distance of three ~r four yards, but the broken-step at half speed is, in my opI~lOn, more eff~ctive and dignified if the patient h as to be carned the full dIstance of fifty yards which is usu ally regard.ed as the maximum distance for transport by hand seat WIthout rest. - N.C.F.

EXAMINATION HOWLER.

M. D. (Cardiff). -In a recent examination I asked a candidate to describe the skeleton. I confess that 1 was ~omewhat amused when she answered :-' ( 7 he skeleton zs a man with his insi~e out and lzis outside off I" So I

FIRST

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HIGH GERMICIDAL EFFICI ENCY 'Dettol' can be used at really effective strengths without danger, discomfort or

without danger

staining - a marked superiority over carbolic and cresylic antiseptics. It maintains high bactericidal efficiency in the presence of blood, pus and other organic matter, and is the antiseptic now widely used for all obstetrical purposes. 'Dettol' is a clean, clear fluid, nonpOl')onous and non-staining, with a distinctly pleasant smell.

'D E T T 0 L

Sold by Chemises al1d Medical Supplier. bOllle., I -, I 9,1 -, 5 - and 7.6, alld 11/ larger sl~es for Medical and H ospital lise. Sample, alld fu/lll/Jormarioll 011 re:zuest.

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By E. M. CO\VELL, C.B.E., D.S.O., M.D., F.R.C.S. " The text is written in plain straightforward English . . . . Good use is made of simple illustrations . . . . A useful Thumb Index is provided. "-British IVedz'cal Jou1'lzal. This is the ideal book for the "Man in the Street."

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TRANSPORT BY TIIREE-BEARER SQUAD . R. B. (Adelaide, Australia).-With reference to the transport of a patient by the Three-Bearer Stretcher Squad as set out on p. 218 of the Textbook, will you please indicate which bearer is leader and gives commands? The previous Edition gave Bearer No.2 as the leader but the revised Edition is silent on the point. Neither in the 38th nor in the 39th Editions of the Textbook can I find any statement as to which of the three bearers is the leader. On the analogy of the Four-Be£1rer Squad, however, I take it that No. 3 now replaces No.2 who was leader under the old regulations for the ThreeBearer Squad. At any rate it is common sense that No.3 should now give orders to Nos. 2 and 1 who face him.N.C.F. TREATMENT OF BURNS. W. B. (Stockport).-In the treatment of burns the Textbook on p. 179 tells us to apply strips of lint soaked in solution of baking soda or warm strong tea allow£ng them to dry. Do I take it that the first aider has to wait an hour or two before applying the cotton wool and bandage? Your usual helpful reply will be appreciated. In your query you convict yourself of errors on two points. First, when you use a solution of baking soda in the treatment of burns, you must" keep the dressing moist until medical aid is obtained." Secondly, when you use solutions of baking soda or warm tea for this purpose, you must leave the dressings exposed to the air. In other words, the Textbook names three p0ssible dressings for burns-(1) lint soaked in solution of baking soda; (2) lint soaked in solution of tea, and (3) cotton wool and handage.-N.C. F. TREATMENT OF WOUND WITH VENOUS BLEEDING. W. B. (Stockport).-Please tell me if Rule 4 on p. 128 of the Textbook means that, when we apply digital presSure in the treatment of a wound accompanied by venous h::emorrhage, the thumb is to be placed in direct contact with the wound. I ask because no mention is made about a dressing over the wound first. If you take an instruction out of its context, you can often make any textbook look silly! In this instance, you have forgotten the "Objects of Treatment of Wounds" which are set out very fully and carefully on pp. 106-108 of the Textbook. In other words, you must apply the General Rules on p. 128 in accordance with the Objects of Treatment. It follows, therefore, that if you follow the instructions of the Textbook, you will not clap your thumb on any wound unless (or until) you have rendered your hands surgically c1ean.-N.C. F.

FI RS T

AID his blood pressure was above normal, was suffering from a transient fainting attack and was unduly scared about the possi ble effects of a cu p of tea. - N . C. F.

TREATMENT OF FRACTURED JAW. E.H. (Barnet).-In the treatment of fracture of lower jaw the Textbook (p. 71) tells us that, if the patient is about to vomit, we should remove the bandages immediately. Please tell me if this means that we are to undo the knots or just slip the bandages off the patient's head. The interval between" any indication of being abou t to vomit" and the act of vomiting may be so short th at it would be foolish to waste time in loosening the knots of the bandages. In other words, when I saw any such indication , I would at once slip the bandages off the patient's head and then untie the knots.-N.C.F.

Your advice and suggested treatment were perfectly sound. Evidently your patient, who happened to know that

b u.:t

C. P. (Bath).-Having learned much from your answers to correspondents, I think that it is my turn to put a qu ery to you. \Vill you, therefore, please tell me if the foreand-aft method of transport may be used in place of the now discarded human stretcher? Personally, I m uch regret that the latter has been cast out of the Textbook, because it was most useful method of transport by two bearers, especially for an unconscious patient whose face is pale. There is no reason why in your practice of first aid you should not continue to use the human stretcher if in any particular case it seems to you to be the most suitable method of transport. Its omission from the Textbook simply means that it is not acceptable in examination s or competitions conducted under the authority of the Associa tion and Brigade. Truth to tell, experience proved that the human stretcher is only useful when the patient is a light-weight and that it is useless when he (or she) is a heavy. weight. As a substitute the Revision Committee deemed that the t wohanded seat could be modified and would be more suitable even when patient's face is pale. The fore-and-aft meth od is not a satisfactory substitute because it occupies more ti me and is specially indicated for the removal of patients from narrow and confined spaces. -N. C. F.

CARRIAGE OF STRETCHERS.

The condition of the limbs controls the situation, and t he colour of thp patient's face in such circunlstances is of lesser importance.-N.C.F.

QUESTIONS AND ANSWERS, atc.,

IN FIRST AID.

Sixth Edition. Thirty-fourth Thousand. Revised in accordance with 39th Edition of Sl. John Text Book.

QUESTIONS AND ANSWERS, etc., IN HOME NURSINC. ~econd Edition.

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O. H. (Port Dinowic).- Please tell us how you would ad apt Rules (a) and (b) on p. 224 of the Textbook wh en carrying a stretcher uphill and downhill supposing- th at in Rule (a) the patient's face is pale or in Rule (b) it is flushed?

e ffi.cac iou.s .

he first application of Sphagnol Peat Ointment soothes pain and allays heat. It causes neither smar~ no~ burn. In cases of blepharitis, for instance, the apphc~~lOn of Sphagnol is excellently borne even by the most senslt.lve and . Aal~ed eyelids. Sphagnol's two-fold action-so~thll1g a.nd ~nntiseptic-comes from the peat distillates which l~ conta1l1s in concentrated form. Sphagnol Ointment and ~edlcal. S~aps are prescribed by m~~y doct.ors .in cases of sinn afflictIOns

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TREATMENT OF BLOOD PRESSURE ATTACK. F .J. (Monks Orchard).-I received a request the other day for advice regarding treatment for what was termed a "blood pressure attack." The patient apparently nearly fainted and the face was pale, but he refused a cup of tea saying that as a stimulant it would cause greater blood pressure. I advised immediate medical attention, and suggested that the attack was probably not caused by blood pressure, and that the ordinary rules of first aid applied to the condition. Can you please confirm my advice, and also give me details of the symptoms of a "blood pressure attack? "

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INFLAMMATION

~ORRHAGB WOUNDS FRACTURES

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ANAESTHETICS PHARMACY AND DISPENSING

AsPHYXIA INSENSIBILITY

CooKING FOR THE SICK

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FI~.sT AID is published on the 20th of each month. The Annual Subscription is 3S. 6d. 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 12th of each month, and must be accompanied (not necessarily jor 1JUblication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Comm~nications connected with FIRST AID should be forwarded to the Publishers. DALE, REYNOLDS & Co., LTD., 46, CANNON STREET, LONDON, E.C.4·

CONTENTS

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Carrying On The Healing of Wounds-The Reason Why Notice to Readf'rs S.]. A. B. Headquarters and District Reports Appointment of Home Nursing- Examin~rs St. ] ohn Am bulance Association .. St. Andrew's Ambulance Association Priory for Wales Stretcher Drill Railway Ambulance News Ambulance Trains The Lady Hospitallers' Club A. R. P. Topics . .. ... . .. Red Cross and St. ] ohn Emergency Committee Our Nurses' Pages Ward Administration Ambulance News Cuttings from the Press Random Notes from a First Aid Post A New Self~Adhesive Bandage ... An ABC for Srecial Constables and Police '\Var R eserves QUEIHES AND ANSWERS

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OCTOBER, 1939.

No. 544.-VOL. XLVI. . NOTICE

GEORGE

92 q2 ()2

92 92

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9494 9+ 9+

past month has seen great activities among members of the voluntary ambulance movement, but members are beginning to settle down to war time conditions. In spite of A.R.P. duties at First Aid Posts and the like, it is necessary that the voluntary movement should be carried on. Divisional meetings should be held as and when possible, and practices held at convenient times. Even though only a small percentage of members may be able to attend such meetings, it will help to keep together that esprit de corps which is so apparent among the personnel of the voluntary first aid THE

CARRYING ON.

army. One sphere of the work that will suffer most is that of competitions. It is accepted that the National events, such as the" Pim" Trophy, the Inter-Railway Shield, the Brigade and the Red Cross finals, will not be held during the war period; but this should not discourage the holding of local even ts. The trained com petition man or woman is usually of more use in a crisis than one who has taken no part in such training. Theyare used to all kinds of conditions being put before them in an abrupt manner, which brings out prompt diagnosis and correct treatment. Therefore, endeavour should be made to carryon with competitions, even if only in a small way, as an essential part of training. Cfwing to paper rationing, the pages of this Journal will be less than before, but, by using a uniform type for all articles readers will find that, as the reports are less numerous, the inst ructio n given will be increased. It would greatly facilitate matters if readers would place a standing order for FIRST AID, thus avoiding possible disappointment and enable US to conserve our supply of paper.

FIRST

The Healing of Wounds-The Reason

Why. By CAPT. A. C. WH ITE KNOX, M.C., M.B. Ch.B. ,\iVHEN any tissues of the .body have been divided or injured the repairing activities of the body quickly get to work in order to make good the defect, unless they are slowed up for a time by the necessity of overcoming an invasion of germs, and even then the means employed by nature to conquer the infection are useful in the early stages of repair. The repair process is the same in whatever tissue the injury has occurred, and in most cases the ultimate result is the production of a scar which serves as a bond of union between the divided structures. In a few tissues such as muscle, bone, tendon, nerves and some gland structures, there is a further stage of "Regeneration" of the injured parts, following the initial formation of granulation tissue. " Regeneration" depends on accurate approximation of the injured parts and complete asepsis. The tissues round the margins of a wound are always in a state of lowered vitality. The divided vessels are filled with clot back to the next open branches, which are dilated as a result of the obstruction. The surface of the wound is generally covered with blood clot and blood clot occurs amongst the injured tissues also. From the dilated blood vessels small white cells called leucocytes exude into the damaged tissues and their ultimate object is to absorb and remove the damaged tissues and later the blood clot. The exudation of the leucocytes is quickly followed by the appearance of large cells called Fibroblasts which come from the tissues themselves and form a cellular layer between the lips of the wound, gradually replacing the leucocytes. The next object is to get a blood supply into this cellular layer. From the nearest capillaries little buds begin to grow and continue as small solid rods of protoplasmic substance. They grow quite quickly and bend and form loops with one another or with other capillaries. The rods gradually become hollow and ultimately a110w blood to pass along them from the mother vessel. They thus become small capillary vessels amongst the new-formed fibroblast cells and this new tissue is called granulation tissue, the granular appearance being due to the separate origins from the various capillary loops. The granulation tissue now has to be transformed into something firmer. The cells become

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longer and thinner and the whole structure is grad ually transformed into the fibrous tissue of the scar. This fi brous tissue contracts, the vessel s become constricted and, ultimately, the scar becomes firmer, denser, and almost completely without blood supply, giving the pale appearance of the old scar. While the last stage is in progress, the surface of the wound is covered over with cuticle, which spreads inwards from the healthy skin in the neighbourhood of the wound. This process of healing is modified in two principal ways. " Healing by First Intention" or "Primary Union" occurs in clean-cut aseptic wounds where the two sides of the wound are brought close together so that there is no great collection of blood or discharge between them, and there is ultimatel y only a thin microscopic line of scar tissue joining them. " Healing by Granulation" or" Second Inten tion " occurs in cases where there has been definite loss of substance so thatthe lips of thewound cannot be brought together; when the surface of the wound is so damaged that portions of tissue have to separate by sloughing; and when infection has prevented the occurrence of Primary Union. Healing by Granulation naturally takes much longer than healing by Primary Union, and the ultimate scar contracts in all directions. The moral is, that wounds should be as clean as possible, and nothing should be done which is likely to bruise or irritate the tissues round the edges, and so delay the commencement of the growth of the new tissue. This is the reason why irritant types of antiseptic should never be used in wounds, nor should rough handling ever be allowed. The healing process is a very delicate one and needs gentle encouragement.

Notice to Readers. IN order to avoid disappointment readers should now place a firm order with their usual newsagent, or with the publishers, for the regular delivery of FIRST AID. This will assist in avoiding wastage of paper, which is restricted to a certain degree. FIRST AID was first published in 1894, and for 45 years it has served first aiders at home and abroad and we are convinced that there is a bond of friendship between our readers and ourselves. We have received innumerable expressions of appreciation and gratitude from members of voluntary first aid organisations for the assistance they have gained from instructions given each month. It is our firm intention to carry Ofl such work.

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St. John Ambulance Brigade Headquarters and District Reports. Brigade Headquarters

No. m District.

A special Brigade Order was issued by the Chief Commissioner (Sir John Duncan) dated September 27th, 1939. This reads as follows :To Commissioners and Offi cers in Charge Ambulance and Nursing Units. BRIGADE EFFICIENCY DURING THE PERIOD OF WAR. All m embers of the St. John Ambulance Brigade who, with the knowledge of the Chief Commissioner, accept service with H. M. Forces o r with Hospitals or other Institutions recognised by the Admiralty, War Office, Air Ministry or A. R. P. Authorities, for the care if Ilze sick and wounded, will be excused drills and practices, annual re-examination and inspection, and granted their efficiency in the Brigade for the period of their services in connection with the present war, provided such services are carried out to the satisfaction of the Authorities concerned.

R UGBY.-The war-time organisation of the Rugby Division has now been completed. l\1r. W. A. Jenning, Lay-Comm andant of the A. R. P. Casualty Organisation, under Dr. C. R. Hoskyn, Area First Aid Commandant, is also the Brigade's A. R. P. Staff Officer. Supt. L. F. Hazel and Lady Su pt. 1\1 iss Syl vester are the officers in charge of t he ambulance and nursing personnel. Thirty-three of the uniformed members and auxiliaries are manning the first aid post in Lower Hillmorton-road, which is in charge of Dr. C. H. Gregory, with Dr. P. Tyson Davidson as second in command. Eleven members are each doin g three eight-hour shifts, and they report for duty at the first air raid \,·arning. The Division is also stRffing two mobile first aid units, whose bases are at the Clinic, Temple-street, and in Biltonroad. Several members are also going out as ambulance attendants. A new Division which has been formed at Hillmorton, now numbers about twenty, and is co-operating with the Rugby Division.

The Conference of Commissioners and Assistant Commissioners proposed to be held on October 29th at the Great Central Hotel, has now been cancelled .

No. I (Prince of Wales'S) District DEPUTY COMMISSIONER.-The Chief Commissioner has sanctioned t he appointment of Brigadier General Sir Joseph Byrne, G. C.l\1. G., K. B. E., C. B., as Deputy Commissioner for No. 1 (Prince of Wales's) District, Sir Joseph is a Knight of the Order and was at one time Governor of Kenya.

Noll District On October 7th County Commissioner A. Barrett Cardew inspected members of the Brockworth Division. Dr. Barrett Cardew said that the members were well up to if not even a bit beyond. the average standard in the different divisions he had inspected this year. He paid tribute to the work of the officers in training the men and to that done by Div. Surgeon K. G. Salmon. Not a single member failed in the examinations. Demonstrations of stretcher drill, etc., were given. Mr. F. A. McKenna presented awards and congratulated the men on their very fine turn-out. They were fortunate in having such excellent leaders with Supt. Clutterbuck at the head. Amb. Officer Harding had also worked very hard, and it must be gratifying to them to have been able to obtain such excellent results. Those present included Lady Div. Supt. Miss E. Chambers, Supt. ]. Palmer (Wagon 'Works Division), and others interested in the work.

SILEBY.-Service Medals were presented at the Sileby Division headquarters to Amb. Officer J. W. l\1arston and Sergt. Edward HFlrriman. The" Marston" Cup has this year been won by Corpl. C. Whittington, the runner-up being Pte. Ron. Newton.

No. V District KEIGHLEY.-On September 25th members of the Keighley Division presented to Lieut-Col. VV. Scatterty and 1\1rs. Scattert)' a pair of inscribed gold serviette rings to mark the fiftieth anniversary of their wedding and to express the appreciation of the Di vision for the.ir \~· ork. Thanking the members for their klOdness, Dr. Scatterty, who is Assistant Commissioner, Northern Area, No. 5 District, and who was formerly Corps Surgeon ?f the Kei~hley Corps, said that he ?ad been connected WIth t~e Association for 53 years and 10 the aggreg-ate he and I11S wife had done between 80 to 100 years' work for that body. Irs . Scatterty is Lady Corps Superintendent of the Keighley Corps. HARTSHILL. -A course of lectures commenced on WednE'sday, October 11 th, in the Church Hall Institute, \oyith Dr. D. Wainwright as lecturer. A new Division of the Brigade for men and anoth~r for women will be formed in the near future and those deSirous of joining are asked to apply at the Institute any Wednesday evening.

No. VI District As the result of a flagday, held on September 16th, the sum of £813 iSs. 1d. was collected on behalf of the Bristol S.J.A. B. The result was a record.

J ARROW. - Service Medals, on the complet ion of 15 years' work, have been presented to the following members of Jarrow Division : -

FIRST

Messrs. G. W . Wilson, ]. Thompso n, J. Nicol, W. A. Atkinson, ]. Cane and A. McCallum. l\1essrs. A. Tweedy, A. H enderson, J. Forrest and G. Cheg-win have heen presented with Silver Bars on completion of 20 years' service.

No. IX District SWANAGE.-On Saturday, September 23rd, Swanage had its first St. J ohn flag day in aid of funds for the newlyformed Brigade Division. A good response was re ceived from the townsfolk and visitors. Memb3rs of the Metropolitan Police Force will be interested to learn that ex-Sergt. A Green, "L" Division, who retired in Jun e last and who nOw resid es in Swanage, is taking- a great interest in the work and has done mu ch good work in the formatiol'l of the Division.

Eire District. CORK.-On October 7th Sir John Lumsden (Commissioner) carried out the annua l inspection of the Cork Division. Previous to the inspection a dinner was given in honour of Sir John Lumsden, who was accompanied by Asst. Commissioner A. J. Connor and District Officer R. L. Downes. Sir J ol1n said that, although Eire was a neutral country, members of the Brigade in Cork, as elsew here, shou ld be ready to render assistance. He recalled the excellent work of the Cork Division a nd complimen ted the Division. The Lord Mayor, ]. Hickey, T.D., welcomed Sir J ohn to Cork, recalling- that it was he who founded the Brigade in Ireland 3S years ago, and that the constant attention he had al ways devoted to every detail since then was worthy of the greatest appreciation. Mr. Hugh Finn, T. D., Parliamentary Secretary to the Minister of Finance, also expressed appreciatio n of the Brigade's work. Mr. John J. Horgan, solicitor, President of the Cork Division, presided at the dinner.

AppOintment of Home Nursing Exarniners. ~HE St. John

Ambulance Association has decided lo recognise the following members of the Nursin cr Profession as Examiners in its Home Nursing Course, nal;;ely, thuse who hold or have held within three years prior to the date of an examination in Home Nursing posts as Matron, Ass ista nt M~tr~n or Sis~er Tutor of a General Hospital. County or DIstrict Superintendents of the Queen's Institute of District Nursing will also be recognised as Examiners in Home Nursing. General Trained State Registered urses who hold or have held within three years prior to the date of examination in Home Nursing a post of Sister in charge of a Ward of a General Hospital will, on the recommendat ion of th e Matron of the Hospital and with the approva l of the Matron-in-Chief of the Order of St. J oh n, also be r ecog-ni sed as E xam iners. General Trained urses, who have g ive n four courses of lect ures based on the cu rrent (4th) edition of t he H ome Nursing Textbook of the St. John Ambulance Association may also be appointed to the Associations' panel of Examiner~ in Home Nursing. Those desirous of appointment to the Associa tion' s pa?el of Exami ners in Home Nursing, s hould apply to the Chlet Secretary, St. John Ambulance Association Willey Park, Broseley, Shropshire, for the necessary forms ~f enrolment.

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St. John Ambulance Association Further to the notice In our September issu e regarding the address of the various departments of the Order of St. John, we have now been informed that the St. John Ambulance Association , which deals with the information of first aid an d home nursing classes, arrangement for examinations, sale of stores, and payment of accounts, has removed to Willey Park, Broseley, Shropshire (Telephone: I ron bridge 237, 238 and 239). Willey Hall was offered by Lord and Lad y Forester, and already thousands of textbooks an d tons of bandages, in addition to stretchers, first ai d outfits, pouches, haversacks, etc., are now in the new home. The library, drawing room, main hall an d gallery have been put at the Association's di sposal; whilst some members of the staff are billeted In one of the wings and others in the village. Captain A. N. Cahusac, M.C., Chief Secretary of the Association, is in charge. The Headquarters of the Order of St. Joh n and the Headquarters of the St. John Ambulance Brigade will, until further notice, remain at St. John's Gate, Clerkenwell, London, E.C.1.

St. Andrew's Ambulance Association. The Association 's activities have increased greatly owing to the International situation and at the headquarters in Glasgow four classes are bein g held every Sunday and, in addition, twice nightl y classes throughout the week. In other districts further classes are in full swing. In A.R.P. the Association has 150 traine d instructors who in turn have trained and recruited thousands of men and women in the work. The Civil Nursing Reserve, the Military Hospital Reserve and other departments are bein g maintained. During last year over 27 ,000 certificates were issued for first aid, home nursing and A.R.P. ; and the present classes at headquarters are being attended by 3,000 men and women. The Association, which is appealing for funds, has 90 ambulances for use throughout Scotland attending to calls, which average 70 to 80 daily. IVIr. W. Sutcliffe Rhodes has been elected chairman of the Management Committee of the Liverpool branch of the British Red Cross Society in the place of the late Alderman F. C. Wilson. H e is chairman of the Merseyside Hospital s Council, and vice-chairman of the Royal Liverpool United Hospital.

FIRST

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Priory for Wales. H EADQUARTER NOTES. The Priory and its local Units are co-operati ng in the ioint efforts being undertaken in response to the appeal to the Empire by II. R. H. the Duke of Gloucester on behalf of the British R ed Cross Society and Order of St. John Joint War Fund. In Cardiff, where the annual" St. J ohn Amb ulance Day" appeal was du e to be organised by the Priory on Saturday, O ctober 28th, it has been decided to run a Joint Flag Day under the presidency of the Lord Mayor of Cardiff j and on the above date the uni fo rm of both bodies will be much in evidence among the large number of helpers who are offering their se rvices to the Joint Secretaries. For the guidance of Centres and U nits of the Brigade in Wales, the Principal Secretary (the Hon. J. H. Bruce) has issued a circular giving the following extracts from a statement cir culated by the Secretary-General of the Order : "You will have seen in the Press accounts of a meeting held at the Mansion House on September 20th called to elect a General Council and appoi nt an Executive Committee for the Lord Mayor's Appeal in s upport of the R ed Cross and Order of St. J ohn Fund inaugurated by H. R. H. the Duke of Gloucester. " I am directed to say that the position and needs of centres of the Association and U nits of the Brigade in regard to this appeal have received carefu l consideration, and it is now felt that they will desire to raise funds to enable local work to be carried on, and, in ad diti on, as was done in the last war, to assist in raising money for the main fund, the call s on which cannol be foreseen. "Accordingly, I am to say that in asking the Association and Bri~ade to co-operate to the fullest extent possible with local ;\1ayors in raising funds to augment the Lord Mayor's Appea l for the National ] oint Fund, it is appreciated that they may, at the same time, require to appeal locally for funds to meet the cost uf their local work " I am to say further that if local funds fall short of lo cal needs, the Joint Committee will end eavour to s u pplement them as far as possible out of the funds received in response to the National Appeal. "The Sub-Prior, the Earl of Scarbrough, desires me to say , therefore, that he hopes yo u and all the members of t he Association an d Brigade will do everything in yo ur and their power to assist in the raising of funds for the atio nal Appeal, a nd at the same time he desires me to offer his best wishes for the success of any local appeal you may a lso und ertake." The circular recommended the running of Flag D ays in co-operation with the sister. Organisation wh~r~. the British Red Cross Society f un ctIOns j a nd urged DiVISions to bear in mind the need fo r peace-time maintenance when making plans for the wider Nation a l issue .. In this connectioo, the followin g extract from the COl11mUOlcation from Lord Ebbisham, Directo r of Appeals, R ed Cross and St. John Joint Executive Committee, have been received with g ratification:I •

" It is desirable that the Red Cross Society and the Order of St. John should co-operate to the utmost of their power with their 0wn local Civic Authority.

The gross results should be paid into the local Civic Authority Fund for the ultimate benefit of the National Fund organised by the Lord Mayor of London. OJ the net total collected by means oj the Flag Day, 25 per cent. should be passed to the Joint Organisation oj the Red Cross and St. John jor equal distribution to both County Organ/sations, proV1'ded both organisations are jimct ioning. " Another item of news in connection with war actiVItIes is the decision that the joint body formed to co-ordinate all activities in connection with the sick and wounded should have representatives of each body in each region, who would be avai lable for His Majesty's Regional Commissioner to consult on any matter affecting the activities of the Order a nd the Society in the respective region. The Hon. John H . Bruce, Principal Secretary, Priory for Wales, Order of St. J oho, has been appointed to serve in this capacity in the No. 8 Region. V.A. D. MOBII .ISATION. An interesting letter has been receivE'd from 1\1r. E. Charles Ingram, a member of the St. John Voluntary Aid Detachment at Bridgend, who, with eleven of his colleagues, was mobilised on the outbreak of war : "We were ordered orig-inally to West Drayton, Middlesex, where we were medically examined; and, un fortunately, some were unfit and returned home. From vVest Drayton we went on to Uxbridge for attestation and equipping. We were then sworn into the l\ledical Section of the Royal Air Force. From thence we proceeded to-- --, and, following a test in General Knowledge, those found proficient, were posted to various hospitals, two being retained at - - - for further training. This was the last time we were all together, which is our only regret so far. The two retained at - - - were Ptes. A. Backwayand . \V. C. Leysholl. Our Assistant Commandant, Mr. C. H. Bennett, was posted to another hospital; and you will be interested to know he has since attainE'd the rank of Leading Air Craftsman. My brother, E. George Ingram, and myself were posted together to - -- ; Ir. W. Thomas had none ot his V.A.D. colleagues with him when, on Saturday last, he proceeded overseas." AMBULANCE COMPETITIONS. For the durationofwar ithas been decided to discontinue the h olding of Welsh National .Ambulance Compe~itlOns. This decis ion will have the immedIate effect of cancelling the 1939 Welsh Cadet Finals and the Welsh Inter-Railway Contests due to have been held next month. Falling earlier in the year, the R oyal Welsh Agricultural Show presented the usual opportunity for. ambulance enthusiasts to try their skill; and the followJI1g . are the results of the three competitions which the Pnory for Wales was again entrus ted to organise at the request of the Show a uthorities . Class. i.-Silver Challeng-e Shield for l\len in Wales and Monmouthshire: 1st, Hafod Colliery; 2nd, Conway Division, S.J.A. B.

FIRST Cl a ss 2. - Silver Challenge Shield for Women in Wales and Monmouthshire : 1st, Denbigh o. 10, B. R. C. S. ; 2nd, Flint o. 6, B. R. C. S. Cl ass 3.- " Arnallt Jon es" Shi eld for St. John Boy Ca dets in W a les and Monmou t hs hire : 1st, Lla ndudno ; 2 nd, Conway. Co ntinuou s ra in throu g hout the period of the Show a dd ed to the strenuous nat ure of th e ambulance dut ies un dert a k en by t he Ambula nce a nd Nursing Members of th e Brigade in Caernar von shire, in co-operation with B. R. C. S Pe r~onn e l. T wo well-equipped First Aid T ents were maintained , w hile men patrolled the g round, a St. J ohn Medi cal Officer being on du ty at all times. Vis ito rs to the First Aid T ents included th e L ord Penrh yn (Caernar vonshire Centre Pres ident), S ir Mi chael R . V. D. Ass heton-Smith, Ba rt. (Com miss ioner), Assista nt Commission er Edwa rd William s, Inspector R oberts (Centre Treasurer), Mrs. R. I. William sE lli s, J. P. (Coun ty Director, B. R. C. S. ), a nd ot hers. Th e Principal Secrela ry of t he Priory thanked th e Society for continu ing to includ e the Ambulance Compe litions, a nd ac kno wledged t he helpful co-operation of th e H on . Director of th e S ho w, l\I aj or W. Lloyd-Gri ffi ths, O. B. E . T hanks were a ccorded by Sir Mich ael Ass h etonSmith to tbe Jud ges, Dr. S. B. Turner (Ass istan t Commissioner, Caerphilly County Area), Dr. G. P a ri Huws (County Officer, W est De nbig hshire) , a nd Dr. W. G. E va ns (Di visiona l Surgeo n, Wrexham ). The trophi es were presented by Pri ncess Ka ra m of Ka purthala and Mrs. Cyril Vivian (Ang lesey B. R. C. S. Commanda nt).

Stretcher Drill. OWING to the introduction of the rigid pattern s tretcher it has been found necessary to Instruct bearers somewhat differently to that which is laid dow n in the R.A. M.C. Drill Manual. A.R.P. First Aid personnel who are trained in the R.A.M.C. method, as taught by the St. John Ambulance and British Red Cross, can still continue to use that method. It must, however, be appreciated that a proportion of the first aid personnel have received no previous training in this important part of their work, and therefore A . R . P. Handbook No. 10 contains general instructions suitable for such persons. Incidentally, we noted that In "Collect Wounded" a slight error crept in. This we submitted to an authority, who informed us that the ori g inal script had to be referred to a large number of persons, and that unfortunately a typist's error had occurred. The following are the instructions for the use of the stretcher contained in A. R. P. Handbook Handbook No. 10, and an officially issued correction of the first error in the "Collect Wounded." Further copies of the Handbook will have this page corrected.

S tand to St1'etcher.- The four men of approximately the san:e height will be numbered 1, 2, 3 and 4. No.1 IS the leader and stands at the front right handle. All orderswill be given by No.1. No. 2 places himself at the left of the stretcher opposite

.AID No. 1. No.3 is at the rear handle behind No.1 , and No.4 behind No.2. Lijt Stretclter. - AII stoop, grasp handles of the poles with the inner hand, rise together, holding the stretcher at the full extent of the arm. Collect Wounded.- The squad will advance and place thc stretcher on the ground in line with the patient, either at the head or foot, as may be convenient. No. 1 attends to the casualty, assisted by Nos. 2 and 3, unless they are attending to othe r casualties. No. 4 prepares the blankets on th e stretcher and helps as required. When the patien t is ready for removal, Nos. 2, 3 and 4 will kneel on one knee at one side and lift him from the ground , assisted by No. 1 from the opposite side. On e man takes the weight at the shoulders (No.4), the two bearers on the opposite sides at the centre (Nos. 1 and 3) lift the hips, and in lifting they may find it easier to join hands beneath him , w hile the fourth (No. 2) raises the legs. Th e patient is rested on the knees of Nos. 2, 3 and 4, while No. 1 slips the stretcher under him an d arranges blankets as he is lowered on to it. An y convenient anicle may be used as a pillow, though a pillow is not necessary for most cases. Advancing .- The bearers step off togethe r with the inner foot, usin g short, sh uffiing steps . The party is therefore out of step, which is more comfortable for the patient. If only two men can be spared to carry the stretcher, the front ma n should step off with the left foot and the rear man should step off with the right, thus being out of step. It does not matter whether the patient is carried head first or feet first, but his he~d should be uphill un less th ere is some reason to the contrary.

Shoulder Carry .- The party should halt, turn inwards, grasp stretcher with both hands, and lift it gently on to the shoulders, turning to the right or left, according to the direction they are going. When a stretcher is being carried on the shoulders, both hands are required to support and steady it, and some padding on the shoulders is desirable. Then follow instructions regarding loading a stretcher with only two men, loading an ambulance, and general instructions in connection with stretcher work, including the preparation of a stretcher with blankets, stretcher carriage over irregular ground, and notes on the position of the casualty on the stretcher, as indicated by specific types of injury.

On October 9th, Mr. Willia m Sm yth e, Chairman of the Whitehead Urban Council, presented certifi cates, medallions and labels to candidates success ful at the r ecent S.J.A.A. examination.

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Railway Ambulance News. Great Western. The report of am bulance work on the Great vVestern Railway for the year endin~ June 30th last discloses the fact that another record has been achie\'ed in the number of successful students. No fewer than 9,075 members of the staff passed their first aid examination, an increase of 1,096 over the fi~ure for the previous year, and a particularly gratifying feature is the number of certificate membe~s, 1 075 which was more thall double the number of recruIts iain~d to the movement in the previous session. The international situation and the consequent appeals for National Service, has no doubt resulted in a quickening of interest in first aid work, and this appeal was supported by a special folder campaign urging the staff to join the Company's classes. The recruitment has been general throughout the line, and the" Athlone" Bowl, awarded ~o' the ambulance division gaining the hig-hest number of recruits in proportion to its adult staff, was won by the Bristol B Division, with the excellent percentage of 4 '28. The Exeter Division "vere runners-up for the trophy with a percentage of 3 '72. The examination results of the G. W. R. Centre for the past decade were as follows : Year

Certificates

1929-30 1930-31 1931-32 1932-33 1933-34 1934-35 1935-36 1936-37 1937 -38 1938-39

1,069 1,113 788 +82 515 657 747 808 797 1,605

Vouchers 851 767 657 492 379 40+ 515 553 564 660

~Iedal1ions

805 764 589 565 4+3 341 350 427 476 5+3

Labels +,958 +,983 5,582 5,568 5,869 5,989 5,908 5,995 6,142 6,267

Total 7,683 7,627 7,616 7,107 7,206 7,391 7,520 7,783 7,979 9,075

The divisional ambulance competitions attracted an entry of 279 teams, 119 in Class 1 (ad\'ance~) and 160 in Class 2 (beginners). The contests ,,,ere hel~ m each of .the seventeen ambulance divisions, and troplues and prizes awarded in each class in all divisions. The final compelition was held al Paddington Station on April 28th, when the eight teams selected by the semi-fin~1 roun~ contested possession of the Directors' challenge shIeld, wInch was won by the Barry Loco team. The Pontypool-road team, as runnersup, were awarded the" Carvell "C~p.. TI:e" Butt ': ~o\\:l, awarded to the beginners' team attammg hIghest positIOn m the competitions, was won by the Kington team. The second annual competition for 'women employees \vas held at Padd inO'ton on March 29th, when the Paddington ladies' team w~n the "Florence M. Lean JJ challenge cup, and the Shrewsbury ladies' team, runners-up, ~he ." lY~abe l A. Potter" cup. An innovation this year was the 1.nstitutlOn of a separ~te competition for ambulance workers. In the G, vV. R . Poltce Department. This was held at Bristol on February 9th, when five teams competed, and the Cardiff and Northern teams obtai ned 1st and 2nd places respecti\'ely. Three new trophies have been generously given to the Centre durin CT the year. In addition to the "l\1abel A. Potter" cup, ~he gift of, l\lr. F. R. Potter, Superintende!1t of t h e L ine, a silver cup was presented by l\lr. J ..G. \V. W~Ight, Area Superintendent of Road Transport, Bn.s~o~, for Interdepartmenta l competit ion in the Exeter DIVIS Ion, and a fur the r silver challenge cup was given by the [ayor of

Weston-super-l\1are, Alderman H enry Butt, the donor of sever al previous trophies, for competition among members of the Weston-super-Mare class. Gold, silver and bronze medals and a number of framed certificates were awarded for the most meritorious cases of actual first aid rendered, and in presenting these the Chairman of the Company, the Rt. Hon. Viscount Horne, G .C.V.O., commented on the outstanding character of the services rendered. During the year 363 gold efficiency medals for 15 years were awarded, in addition to 1iO bars for 20 years, 90 Q uarter Century medals, 37 bars for 30 years' and 13 bars for 35 years' efficiency. The total number of efficiency awards issued since their institution is 5,716, made up as follows: 15 year gold medals, 3,335; 20 year gold bars, 1,460 ; 25 "ear gold medals, 683; 30 year gold bars, 194 ; 35 year gold bars, 44. The annual gathering of gold medallists took place at Gloucester on l\1ay 20th, when the guests, numbering upwards of 500, were accorded a civic receptio~ .. The continued progress of the movement IS 111 no small measure due to the devoted services of divisional secretaries, class secretaries, instructors and others, and it is pleasing to record that the Order of St. John has recogrJised their good work during the year by the admission of fourteen members of the staff as Serving Brothers of the Order, one as Officer (Brother), and ill another case has awarded the Vellum Vote of Thanks of the Order.

Lon don and North Eastern. NORTH EASTERN AREA.- The Centre Secretary (!\Ir. S. Cooper) has presented his report for the year ended June 30th, 1939. Once again a record year was experienced, : 93 classes being formed and 4,162 awards gained. ThIS was an increase of 19 classes and 564 a wards. There were 923 first year men as against 704, 659 voucher, 463 medallion and 2 117 label mem bers. Since the formation of the Centre the a~\'ards O'ained are: Certificates, 18,238; vouchers, 11,167; medalli~1s, 8,554 ; labels, 23,645. Making a grand total of 61,604. . ' . Cases treated were: Darl1l1gton District 27,590 ; Hull Dislrict 12,308 ; Leeds District 2,7i4 ; l\1iddle~br?ugh !?istrict5 111 ' Ne\\'castleDistrict10,956; York Dlstnct 11,/09. l\laki~g a ~rand total of 1,942,759 since Jan uary 189~. ~ District Com petitions attracted 50 teams as aga1l1st 4:>. T\'ne Dock were successful in .vinning t~1~ "vV.harton JJ Si1ield, took first place in the Group Competlt~on, thIrd .place in the Inter-Railway Competition and also thIrd place 111 the Scotland v. EnO'land International. . DurinO' the;:, year 46 gold medals for 1 5years ' ser\'lce, ten 20 years b:rs, nine 25 years bars, three 30 years bars! and one 35 years bars were gained by members. The N ortl~ Eastern Area has now been awarded 49~ medals and 328 bars, including 9 for 35 years cllicient service. It is with great pleasure that the Centre Secr~tary a nn ou nces that l r. C. 1\1. Jenkin j ones (the Centr~ Prf'sident and Divisional General Manager) has been admItted as an Officer (Brother) of the Order of St. John. ' . In concl ud ing his report l\lr. S. Cooper orlers S1l1cere

FIRST tha nks to the Centre President, District Officers, Centre Chairman, District and Class Secretaries, instructors and members of committees for their great effort on behalf of the movement. As a further effort to obtain new members 1\lr. C. M. Jenkin Jones has addressed a letter to all members of the . E. Area Staff pointing out the great need for training in first aid. SOUTHERN AREA.-The annual meeting of the March class was held on September 24th. 1\1r. W. F. R. "Vebb presided, supported by Drs. A. C. S. Waters, J. A. Hislop and W. D. Cairns, and 1\1r. S. W. Atkinson (Hon. Secretary). Presenting his annual report 1\1r. Atkinson reported that the number of railway employees who had obtained first aid certificates has increased. During the year 58 members passed their re-examination. Over 500 cases of injury or sudden illness were dealt with at the Company's first aid boxes j none being of a serious character. In the Company's competitions the March team s had equitted themselves honorably. The Cambs. and District Officers' Shield was again won by "A" team, cc B " team being third. " A" team gained seventh place in the G. E. cup final. 1\lr. \V. C. Crow (hon. treasurer) had been admitted as a Serving Brother of the Order, and in addition he and 1\1r. ReIton had acquired the Bar for 30 years' ambulance service.

NEW BEDFORD.-The annual meeting of this class took place on September 10th, when Dr. D. Fraser presented awards as follows :-Seven certificates, seven "oucllers, and ten labels. The chair was taken by Mr. Burton, stationmaster, who commended the class on its 100 per cent. pass, which was the first class to gain that distinction at which he h a d been privileged to preside over. On behalf of the class, he presented a fountain pen to the doctor. GRI~lSBY

DOCKS. -The Chief of Police, :'Ilr. R. R. Pettit, on a recent visit to Grimsby Docks, presented 27 :\.mbulance awards as a result of refresher courses taken early in the year. ~Ir. Pettit, addressing the parade, expressed his appreciation of the men voluntarily taking- the refresher courses in Ambulance \Vor],:, parlicularly at the present time. Among those who received awards was Superintendent G. H. Peck, who also received a surprise presentation in the form of an eng-raved cigarette case, subscribed for by the members of the Ambulance Class as a souvenir of his thirtieth year of ambulance work, and also as a mark of their appreciation of his assistance to them durinO' the time that he has been in Grimsby. ::-

London, Mid land and Scottish. Every effort is being made to continue with the first aid According to DJstnct reports, there 1S IJkclthood of a !:>CYreat influx of new • • members 111 \'lew of the present national state of emerg-ency. The question of competitions is in abeyance for th-e time being, but many loral events are expected to be held as us ual. in~tr~ction among em~lo):ees. of the L.M .S.

Does your colleague rea d FIR.ST AID, if n ot, send us his address and w e will post him a copy

FIRST

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Southern. BARNSTAPLE. - A meeting was held recently by the Barnstaple class at which members from Torringlon and Bideford attended. The presentation of awards was made by Dr. KillardLeavey (Hon. Class Lecturer, Barnstaple), who, before the distribution, gave an interesting talk on "War Gases and their effects." Hon. Secretary H. Stevens, after the presentation of awards, cordially thanked Dr. Killard-Leavey for his past services to the. class and for making the presentations, adding that all members of the ambulance class deeply appreciated what he had done on their behalf and the way in which he had materially assisted them to gain their a wards.

OKEHAi\IPTON.-The presentation of awards to members of the railway staff at Okebampton took place on Saturday, September 30th, at St. John headquarters. The Mayor (1\Ir. W. B. Chamings) presided, supported by the president. of the Town Brigade, 1\1r. C. Sprague, J. P. , Dr. E. D. Allen Price, M. O. H. (Brigade divisional surgeon and hon. lecturer to the class). The awards were presented by tbe Vicar of Okehampton (the Rev. F. L. Compton), who referred to the splendid work being done by the Brigade. Messrs. S. Sims and A. Parker were tbe recipients of the Association's 2nd class certificate of merit for services rendered at Meldon Quarry last June. In addition to labels, medallions, etc., the following awards were also made :- Seven years' bron ze medal: Messrs. A. Parker, \\'. Pedri ck and H . S. Ta) lor.

Anlbulance Trains. IN a Railway Executiye Committee statement, issued through the l\linistry of Information, it ",-as announcE'd that casualty evacuation trains for immediate use in distributing civilians in air raids to hospitals throughout the country have JlOW been built. .\ number of ambulance trains are also in course of being built to be used both at home and overseas. To enable more such trains to be placed into sef\'ice rapidly, work upon different sections ha s been entrusted to seven different workshops t.hroug-hout Lhe country. Each train is fully equipped with cars for travelling staffs of nurses and docLors, kitchens, and wards for stretcher cases , sitting-up and mental ca<;es. Cars are also provided for infecLious cases and as travelling- pharmacies.

The Lady Hospitallers' Club. TlIE Committee of the Lady Hospitallers' Club has decided to suspend all meetings until further notice owillg- to \var duties. The President, Miss Howes, e.' tends her good wishes to all mem hers, and t rusts that a "Though t for absent members" will be in the minds of all on the 6rst Saturday in each month. The Secretary adds her hopes for a speedy reunion in happier days. All enquiries, etc., wilh reg-ard to the Club should be addressed to the Secretary, Mrs. E. V . ""oolfold, 15, Tyrone-road, E. u.

A.R.P. Topics. At the moment it seems as though A. R. P. is definitely taking the major portion of the first aider's time; therefore we feel that readers will welcome the "Random Notes from a First Aid Post," which Dr. M. M. Scott contributes in this issue. Readers may welcome an opportunity of giving particulars of their own individual experiences or even to ask for guidance in their work at first aid posts. Dr. Scott, having had great experience of the organisation of such posts, ,vould be pleased to assist in this matter.

DECONTAMINATION OF CLOTHING.

A new A.R.P. Handbook, No. 4A, " Decontamination of Clothing, including Oilskin AntiGas Clothing and Equipment, from Blister Gases " (31d. post free), gives the procedure to be followed for the decontamination produced by 1\Iustard and Lewisite. The first process, generally recommended, is Boiling in Water; other processes being Stearn Treatment in high-pressure steam disinfector, Immersion in Warm 'Vater (50-55 degs. C.), and Weathering. For all civil ian clothing including oily and greasy clothing, rubber articles, etc. (but not leather), oilskin anti-gas clothing (modified process), the first process is recommended. For Dry \Voollen clothi ng the second process; articles made wholly or partly of leather, the third; and clothing, etc., contaminated with vapour only the fourth process. The tim€' and actual process needed for the different classes of clothing, sllch as woollens, cottons, linens, etc., is given together with general procedure in all cases. This handbook may be regarded as supplementary to A. R. P. Handbook No. -t, "Decontamination of Materials," in which it will, ·we understand, be eventually incorporated.

"A. B.C. OF A.R.P." The second (revised and enlarged) edition of this very useful picture guide contains information on Air Raid \Varning, Black-outs, Steel and other shelters, High Explosives and Incendiary Bombs, Gas, Respirators-including the Baby Helmet. In many instances the reading matter is profusely acco~lpanied by diagrams which are clear and correct. Then~ is the full page illustration on " How to Gas-Proof a Room"; How to Use a C ivil ian Respirator"; "Official Protective Helmet for Rabies"; "Cleaning Facilities for A.R.t>.

A ID

Services," in addition to interesting data on inn umerable featu res appertaining to A. R . P. Cop ies of the guide can be obtained from Messrs. Jordan & Sons Ltd., 117, Chancery-lane, London, \V.C.2, price 8d. each post free. We can, and do, recommend this guide to our readers. OTHER PUBLICATIONS.

For the benefit of those who wish to be kept informed of the various Government publications referring to A. R. P., the following have recently been issued : Circular 1849 " Emergency Hospital Scheme" (3}d. post free), which deals with Equipment of Hospitals; Circular 1850 "Civil Defence Act, 1939" (2!d. post free), which explains certain parts of the Act; Circular 1848 "Repair of War Damage" (1!d. post free); and Circular 1474 "Schooling in an Emergency" (6id. post free), which is issued by the Board of Education and sets out suggestions for the education of children transferred to the reception areas. TRAILER A~IBULANCE.

A new type of trailer ambulance, speci;t1ly adapted for A. R. P. Service, has been designed by two well-known ~Iidland engineers, 1\1r. G. A. Phillips and Mr. C. R. Dawtray, and produced by a Coventry firm. Low loading, which only requires two persons for the work, instead of the usual four, is a feature. The interior has accommodation for four stretchers and three sitting patients, together with an attendant.

Red Cross and St. John Elnel~gency Committee. The Committee has announced that their first responsibility in the adminis tration of funds subscribed by the public must be on behalf of war casualties- that is, sick and wounded and prisoners of war interned in enemy or neutral countries. The follo""ing principles will go,-ern the distribution of supplies, pending further experience, in accordance with the Duke of Gloucester's Appeal as broadcast by the Lord l\layor of London on September 11th. In yiew of the heavy calls on the Joint Committee, supplies are no t available at present for evacuees, or for patients 10 civilian hospitals. It is intended to make supplies available for the relief and assistance of war casualties, whether military or civilian, at home or overseas, so far as the resources of the joint bodies admit. The Lord ;\Ja"or's fund no\\' exceeds £,375,000 and, in addition, a quantity of jewellery, includ!ng a diamond necklace insured for 1,20,000, has been recel,-ed .. AmonD' the numerous donations is one of 100 dollars which the Rotary Club of AUfusta, Georgia, U.~.A .• sent. to the \Volverhampton Rotary Club. The donntl0n was ln~ tended originall , for chlb festivities.

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FIRST

Our Nurses' Pages. :J'

COMPILED

WAR UNIFORMS FOR TRAINED NURSES.

The uniform to be worn by trained nurses working under the British Red Cross and Order of St. J oh11 was on view on September 26th at 7, Belgrave-square, which was lent by Lord Clifden to be the headquarters of the Committee for Trained Nurses. There was no regulation dress for nurses working under similar conditions in the last war. The one-piece dress shown now was designed by the Matron-in-Chief of the British Red Cross Society and Order of St. ] ohn, Dame Joanna Cruickshank. It is made of navy blue ging-ham, fadeless and shrunk, 60 ins. round the hem and 12 ins. from the ground. There are detachable collar and cuffs of white cambric. A shoulder cape of the blue gingham gives a smart appearance to the uniform. The apron has no cross pieces at the back; instead the bib clips into slots in the front of the dress. Light grey stockings will be worn with black laced shoes which have leather Cuban heels. A navy blue felt sailor hat with a ribbon band of red and black with a touch of white is for out-of-doors, when a double-breasted overcoat in navy serge with an all-round belt will also be worn. The cap to be worn in the wards is of organdie and is somewhat smaller than the previous cap. Dame Joanna Cruickshank has been experimenting with a design which can be worn with a gas mask. Enrolment of trained nurses has already begun. Their work will be mostly in auxiliary hospitals which supplement the military hospitals. The staff for the auxiliary hospitals will be selected by the matron-in-chief and be under the direct control of the committee. A classified register is being formed, and nurses enrolled ..viII be appointed according to their qualifications as matrons or sislers. Trained nurses between the ages of 25 and 60 are eligible for these posts. 'W omen are coming from all walks of life and offering their services. Many are middle-aged women who had valuable experience in the last war. The register also includes masseuses and dispensers. Nurses under 45 may enrol for transfer to the Army and Air Force Nursing Services, the pay and conditions corresponding to the branch of the Service in which they are appoinied. Besides these full-time services trained nurses are needed as examiners and lecturers. The training of members of Voluntary Aid Detachments, Nursing Auxiliaries, and the public in home nursing is a most valuable form of national service, and those who undertake it are helping to build up an efficient Auxiliary Tursing- Service ready for emergency work. This work may be undertaken on a paid or voluntary basis, the fees payable (based on those laid down by the ~1inistry of Health) being 12/6 per examination or lecture. Those wishing to enrol for service under the Emergency Committee or who are willing- to serv~ as examiners or lecturers should apply in writing to the Matron-in-Chief, British Red Cross Society and Order of St. John, 7, Bel gra ve-sq uare, S. W. 1. SUSSEX DIVISION, B.R.C.S. . When the Mayoress of St. Leonarcls (Mrs. E. M. Ford) ln SpC'ctC'c\ 1he su I'p1)' depot of tlw St. Leonards branch of this

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AMBULANCE SISTER.

Division on Monday, September 25th, she found members :n white caps and overalls busily engaged in rolling, sizing and packing bandages and other necessary articles required for hospital work. They were working under the supervision of Mrs. Holmes, Organing Secretary for the depot. From there the Royal East Sussex, the Buchanan and the Municipal Hospitals will receive supplies for use. The Mayoress was received by Mrs. G. M. Jefferson, Deputy President of the British Red Cross Society, Sussex Division, and was conduded over the place accompanied by Mrs. Robbins and Miss Sharp, Commandants of Sussex -j. and 6, and Miss Macdonald, Acting Commandant, Sussex H. DUTIES. Most members of the St. John Ambulance Brigade an the British Red Cross Society undertake hospital duties for a certain number of hours each vvt'ek, and take great pleasure in their work. It is to them part of their hobby, and is a means of gaining actual experience and of helping others, if only in a small way. Now that war is once again upon us, more will be expected of us, and we shall all give as much help as possible to the hospitals. There are some among us, doubtless, who will be undertaking' these duties for the first time, and to whom these notes may not come amiss. The first thing that seems to strike the voluntary nurse when taking up this work is the rigid discipline among the hospital staff. The majurity of women first aiders probably work for their living, and are used to obeying those over them and rules laid down to maintain order. But in business or other spheres of labour there is a certain amount of laxity, but not so in hospital. Man), little rules and acts of courtesy, long displaced elsewhere, are often irksome to the voluntary nurse, but they must be obeyed, and soon come as a matter of course. Hospital duties may be undertaken in either a general hospital or a clinic where special diseases are treated. In both cases there may be certain tasks to do which do no t come under the heading of nursing, but which are, nevertheless, very important. Such as, for instance, reception of patients, filing case reports, scubbing mackintoshes, turning out lockers and cupboards, or perhaps a certain amount of actual cleaning and dusting. Each is a necessary part of the hospital routine and must be done well. Much can often be learned by the intelligent nurse from what at first appears to be a menial task; while she who performs a simple job cheerfully and efficiently is more likely to be the one selected for work of greater responsibility. Before taking up hospital duties the voluntary nurse would do well to learn the names of the different instruments in general lise. Th is knowledge will prove very useful. A nurse may be sent for an instrument required for immediate use, and to waste time in bringing the wrong one, or in asking for a desuiption of the one required, is, to say the least of it, exasperating to the senior nurse or surgeon, if it does not have more serious results. Work in the wards is usually given to the voluntary nurse who attends hospital for the first tiln('. IIere she HOSPITAL

FIRST must be prepared to rank below the junior probationer. Routine is the order of the day, and it is advisable to change the hours of duty from time to time if lhis can possibly be none. For instance a nurse who attends only in the evenings in a general way can only assist with washing patients, serving suppers, and preparations for the night's sleep. Temperalures, pulses and respirations have probably been taken before she arrives, and only occasionally will she see or be able to assist with dressings. Morning- duties are more interesting when dressings have to be done and treatments given, and perhaps pal:ients prepared for and escorted to the operating theatre. The Sister and her staff are al ways willing to help the learner by allowing her to watch the practical work, and by answering intelligent questions put at the right time. Patients, too, welcome the voluntary nurse who comes at regular intervals from the outside world. To them it means a fresh face in the ward, probably a few cheery words as she attends to their needs, besides addilional help for the staff which means extra attention for the sick. At many of the hospitals to-day there are various departments where specialised treatment is given, and where the voluntary nurse may be sent to work. Here she will find it very interesting to watch the progress of the patients between her visits. In the X-ray department she will see much to assist her in her studies. She will see what actually happens in the case of a fracture, and the care that must be taken before moving the sufferer, and in transport. While those plates showing stages of various diseases, if explained to her, help her to underst<'lnd in part why a specified treatment is given, and, if the task is given her, to apply surh treatment intelligently. In a civilian hospital it is not often the privilege of a voluntary nurse to enter the operating theatre while operations are being performed, at least, not until she has had a fair amoun~ of experience. But should she be allowed to do so, she may learn a great deal if only as an onlooker. The preparations beforehand of surgeons, nurses, instruments, and everything to be used during the operation that all is sterile makes her realise the meaning of the word aseptic as she probably never did before. In the hospital wards the voluntary nurse may be allowed to assist with the dressings. She learns how to prepare her trolley with everything neces~ary for a dress~ng or re-dressing, and how to prepare the patient before makmg her hands st~rile. By wa tching the skilled nurse she sees how a patient can be made comfortable with speed, dexterity and gentleness. Perhaps in the casualty ward the first-aid nurse feels more at home, although she will not be called upon to make her own diao'nosis <'IS she has to do when rendering first aid, but carries ~~t the instructions of the doctor or sister. She may have to wash dirt y wounds, or apply dressings. She certainly learns that the treatment of shock b!, warmth a.nd rest is a most important factor after an aCCident, a poml inclined to be overlooked in giving first a id to a sufferer in less ideal surroundings than a hospital ward. Duties are also O'iven to the voluntary nurse in the outpatients' departmenf's of some hospitals: C?n the medical side patients have to be prepared for eXamlI1atlOn, and pulses, temperatures and respirations taken. A cheerful a!ld sympathetic manner, especially with young people, will of.ten allay that dread which some sick people feel before a medical examination. On the surgical side there may be treatments to be given, dressings to do, or stitches to be removed after minor injuries or minor operations. With depleted hospital staffs help will now be needed i.n both civilian and auxiliary hospitals. But \vhether she IS working among civilians ' or w~r casualt!es, the voluntary nllrse will be doing valuable natIOnal serVIce.

A course of lectures on Home Nursing for WOI1lC'O will

AID commence on October 24th, at 181, Marylebone-road, N. W.1. Lectures will be held on Tuesdays, Thursdays and Fridays, the lecturer being- 1\1rs. Cove-Smith. Fee 5/-. Full particulars from Supt. V\l . V. 1\1. Allen, at 181, ~Iaryle bone-road, N. VV.1.

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Ward Administration. * To maintain a ward in an efficient state, the following require constant attention : (a) Cleanliness. (b) Ventilation. (c) Temperature. (d) Routine. (e) Descipline. (/) Equipment. It should be noted that although these principles refer chiefly to the administration of wards, they apply equally well, with modifications, to the administration of Sick Bays.

(a) Cleanhness. This is the first principle in the care of wards. Every person, patient and nurse, and every article in a ward must be kept scrupulously clean. Dirt is the soil in which organisms grow and flourish, and it increases the risk of infection. The nurse should be most careful of his personal cleanliness-a clean, smart nurse means a clean and efficient ward. Dirty hands, a soiled gown, an unshaven chin, a dirty collar, unbrushed hair, grease stained tronsers, or undarned socks showing over torn ward slippers, are the hallmarks of inefficiency. The floors should be wiped with a damp cloth every morning and evening to collect the dust, and afterwards polished. The Iighter articles of furniture should be moved before the floor is dusted and also the bedsteads, when the condition of the patient perm its. Every article of furniture in the ward must be wiperi over \\ i[h a damp duster daily, and washed and polished regularly. The insides of drawers should have special attention, and no food should be allowed in the lockers. The windows must be kept clean. Sunlight brightens the ward and cheers up the patients. The walls should be cleaned periodically. Bed and body-Ii nen should be changed w.he.n soiled j in the case of patients allowed up thiS IS usually done weekly. No clothing must be kept in the ward excert that belonging to the patients allowed up. Boots

* Extract from the l\Ianual of Instru ction for the Rl':ai Naval Sick Berth StarT, reprinted by permission of the Controller of H. M. Stationery Office. C()pies of the Manual can be had of H. M. Stationery Onice. l\dastral House, KingsV\"ay, London. \V.C.2, or any hrallch, price -15d. post free.

FIRST

should be kept clean. All ward patients must be properly dressed. Brasswork, when well polished, gives an appearance of brightness and cleanliness which is well worth the time spent on it. Flowers brighten a ward, but should be removed at night and before they fade. The ward annexes require special attention. These consist of the pantry, hathroom, lavatory and water closet. They should be scrubbed out daily; the pantry should be tidy, and its contents clean and in order. The pan of the water closet is liable to become soiled unless cleaned daily with the brush provided. Feeders should be cleaned by washinoin hot . . b water Immediately after use. The lip requires special attention. Spit Pots should be cleaned after the Medical Officer's visit daily, more often if necessary. The under side of the lid must not be overlooked. Remember to give the patient another spit pot whilst cleaning the one last used. A little ~arbolic lotion should be kept in the spit pot while In use. Never throwaway sputum until the Medical Officer has seen it. Bed Pans are cleansed, after emptying their ~ontents, ?y inverting over an upright jet of \vater, In a slop slOk. They must be emptied and cleansed immediately after use, except when the contents are required for inspection by the ~VIedical Officer. The ~\lderside of the half lid requires special attentIOn. Bed pans, when being carried throuo-h a ward, should be covered with a cloth. b Urinals or "Goosenecks" must be emptied and washed out immediately after use, except when the urine is required for examination. When not in use they should be kept filled with water. Wash bowls, basins and receivers must be cleaned immediately after use. Table utensils, especially cutlery, must be kept bright and ready for use. . J u~s and cans used for storing milk must ImmedIately be cleansed, and then scalded with boiling water. They must never be taken into the ward, and should be kept covered with clean white gauze.

(b) Ventilation. . Is of the utmost importance in treating disease. Neglect of this duty lowers the health of the pati~nts ~nd favours the development and spread of lllfectlOn. . Remember that each patient in the ward is takIng up the oxygen of the air and breathino- out carbon dioxide, and that the air is also beinob contaminated by emanations from sweat excreta etc. ' , To test the freshness of air in a ward 0-0 into the open air for several minutes, and on r~t~rning any stuffiness can he at once detected. '

AID The opening of windows to admit fresh air, and the closing of windows to prevent draughts, require the nurses' constant attention. The ventilation of an nexes should not be overlooked.

(c) TemjJe1'atza-e. Open stoves and hot water pipes are used in wards as a means of warming. Open stoves, as well as heating, ventilate the wards by drawinothe used air up the chimney. h They tend to dirty the ward with smoke and particles of soot. I n some cases the stove is in thc centre of the ward, and the chimney runs under the floor and up the walls outside the huilding. Every ward should possess a thermometer and the nurse should endeavour to keep the temperature as near 60 degs. Fahr. as possible. A ward should never be warmed by closi n (T the windows. h The coldest time of the day is from 2 a. m. to sunrise, and the temperature of the ward 'will then require special attention. The ventilation and warming of a ward are very closely associated. (d) Routine. Routine is the first essential to good ward administration. Everything done in the ward should have its correct time and be done in its correct order. Fuss should be avoided. The ward will then be quietly and efficiently run, giving the patients the maximum of rest and comfort which is so very important to good nursing. The nurse in charge of the ward should see that his routine is efficient and that it is properly and punctually carried out.

(e) Dz"sczplz"ne. . The nurse is responsible for the discipline of hIS ward. He should see that all orders he gives are promptly and properly carried out. Tact should be used, especially when dealing with patients, whose illness may make them unreason · able. ()) Eqztz"pment. The nurse must know exactly what furniture and appliances are supplied to the ward, and should see that they are in place and in a serviceable cond.it~on. This can only be done by cultivating tidiness. Each article should be kept in its proper place, so that it can be found readily when wanted. If anything is missing or broken, or otherwise unserviceable, the fact must be reported at once. See that there is a sufficient su pply of all consumable stores. These will include dressings, pins, pJ.per,

:FIRST pens and ink, requISItIOn and other forms, methylated spirit, etc. The various fittings must also be frequently examined and any defect reported. As examples, broken windows and window catches, defective electric lights, an escape of gas, broken locks, leaking flush tanks, and stopped up drains may be mentioned. The breakage of glass and crockery must be fully reported on the proper form.

Ambulance News Cuttings from the Press. Tl,c EJllor invites Readels to send newspaper cUltings on matter uf general interest for inclusion in this column.

DEATH AFTER IAT ASP ST1NG. lrena Smith, 32-year-old caravan dweller, living in Feltha11l, was stung- ill the mouth by a wasp yesterday while eating breau and butter. She died before a doctor could be brought to her. Sunday Disj>atc1t.

CAT OVERTURNS KETTLE .

A boy, aged 10 months, was sitting on his grandmother's lap in a house in Fulham. A. cat in the room jumped on the stove (on which were two kettles full of hot water) and overturned one kettle. The child was scalded to death. The grandmother, who also was scalded, was too ill to attend the inquest at Padcling ton to-day. Verdict: Accidental death. - Eveninc lVe7fJs. SHOT l\lAN WALKS INTO SURGERY.

After walking a distance of 250 yards into a Whitl.::y Bay doctor's surgery with a bullet wound in his body, a man (lied in Tynemouth Hospital last night. When the doctor saw him he was in a state of collapse, but managed to hand over a revoh er. After treatment, he was rushed to hospital. Foul play is not suspected.Dai~)' kIail. l\li\N's BODY AS

SmELl) FOR BABY.

Using his O"VI1 body as a shield Herbert Mitchell, a Hull lahourer, saved the life of a baby and is now in the Royal Infirmary with fractured ribs. 1\1rs. Watkins, of Bean-street, was pushing a perambulator across Porter-street when it was overturned by a horse, and her child was thrown into the road. Seeing that the wheels of the trolley drawn by the horse would pass over the child, Mitchell thre,,' himself across it. Two wheels of the trolley passed over his back The baby was unhurL-Daily Telegraplt ARTIFICIAL RESPIRATION PROLONGS LIFE.

Four policemen successfully used artificial respiration to restore to life an elderly woman whose heart and breathing stopped when her skull was fractured in a street accident in Southend. They began their work of restoration in the amb ul ance which picked, the victim up, and on reaching hospital continued under the direction of a surgeon. After more than two hours of continuous work she began to breathe again, but a few hours later she died. - S7I1lda), Express.

AI»

Random Notes from a First Aid Post. By M. M. SCOTT, :\I.R.C.S., L.R.C.P. (l\ledical Officer in charge Mobile U nit and Decontamination Centre, Southwark.) HERE we are at last, prepared for active duty under the Home Office A. R. P. Scheme, after many months of inten.sive anticipation and training. All members of first aid posts are now under the supervision of the local Medical Officer of Health; one cannot, however, regret that no matter how well the scheme may work there is not more intimate contact between the members and the officers of the organised first aid bodies. N cvertheless, it is extremely gratifying to note how l\ledical Officers of Health depend so implicitly upon the members of the S.J.A.B. and the B. R.C.S. all working together under their control. In my own particular case the Medical Officer of Health has proudly told me that so efficient were his first aid preparations that there was at least one St. John man on duty at each post every hour of the day. The personnel of a first aid post must necessarily be untried and, to a great extent, untrained, because notwithstanding the great efforts made by the St. John Ambulance Association and the British Red Cross Society it has been impossible to obtain the necessary numbers of skilled first aiders, especially now that many members of the Brigade and Red Cross have been called up for service as reservists with H. M. Forces. The l\ledical Officer of Health realises that with one fully trained St. John man to take charge of person nel it will not be long before the newcomers will have their efficiency considerably increased. Credit must be given to mem bers of the St. John Ambulance Brigade and British Red Cross Society, ,'v ho are quietly teaching beginners at their respective posts the essential principles of practical first aid and instilling in them that sense of confidence which will prove so necessary in the event of an actual emergency. An important part of the training at first aid posts consists of a rehearsal of procedure under actual air raid conditions. I have personally attended several of them and I am now more convinced than ever of the necessity of holding first aid competitions in time of peace and feel tempted to say even in time of war. The trained competitor man (or woman) invariably stands out on every occasion. He instinctively kno,,,,s what to do and where to go. He overlooks nothing and sees that every member of his squad is usefully and actively utilised; and, above all, he radiates an air of assurance to all around him.

FIRST It may very well be suggested that the various relays or shifts of personnel in first aid posts organise themselves into working competition teams, and thereby participate in competitive first aid either with teams from other shifts or even other posts. The value of competition work in first aid training has been awarded official recognition inasmuch as A.R.P. Handbook No. 10 actually contains detailed competition marking sheets. I would therefore suggest to Medical Officers in charge of first aid posts that their personnel be encouraged to interest themselves in this important sphere of first aid work. Marking sheets can always be obtained from back numbers of FIRST Am and modified to suit individual cases. SCOPE OF FIRST AID. One important matter which has been worrying both Brigade Surgeons and mem bers is the official scope of first aid in time of war. Official instructions to Medical Officers indicate that their first aid personnel should be conversant with the uses and application of the Thomas Splint and the roller bandage, both of which are to be found described in the appendix of the St. John Ambulance Textbook, and therefore not within the scope of examinations or competition work. It is interesting to note that one of the principal items on the agenda of the now postponed conference of S.J .A. B. surgeons was a demonstration and application of the Thomas Splint. I should imagine that orily a very small proportion of certificated first aiders have ever seen, let alone used, this extremely valuable appliance. Perhaps when peace reigns again the examining bodies may consider the advisability of insisting upon a knowledge of the Thomas Splint and the roller bandage, at least for their more advanced certificates of efficiency in first aid. Another thought which strikes me under these emergency conditions is the close affinity that exists between first aid and home nursing. Under actual working conditions it is impossible to delineate a clear line of demarcation between them. Moreover, notwithstand ing the fact that the St. John man is trained to appreciate the limitation of first aid, he often finds himself in a position where a knowledge of home nursing is necessary and, to further complicate matters, the public expect of him the required dexterity and ability. Consequently one often hears of first aiders going beyond their legitimate sphere merely because they find themselves in an embarrassing position. The solution, of course, is for every first aider to take his certificate in home nu rsing. Incidentally, it would seem that home nursing as taught in times of peace is not sufficien tly w ide in its scope in times of war and that the person ne I of first aid posts are expected, under the supervis ion of the Medical Officer, to admin ister hypode r m ic

All)

FIRST

injection s and perfo rm other nursing operations of a n advanced deg ree. This again offers scope for a wider sy ll a bus for the mo re advanced nursing certificate. F urther c'Random Notes ,. will appear from tim e to time.

AID

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WE have received a sample and particulars of a new selfadhesive bandage, which is known under the name of " Stanlast." It is manufactured under a special patent process and adheres only to itself. It does not stick to skin or hair and can be painlessly removed without leaving behind any adhesive substance. No undue pressure is necessary to keep it in position and it will remain in position as long as desired without being affected by moisture or body heat. Being porous and washable it can remain in use on the affected part for a conSIderable time. Sam pIes, free of charge, will be su ppl ied to read ers of FIRST AID. Applications should be made to Stanning- Proprietaries, Stanbrook House, 2-5, Old Bond-street, London, W.1, mentioning this Jouma!.

An AB C for Special Constables and Poli ce War Reserves. Tms is a guide to Police action in criminal cases alphabetically arranged and, as many of our readers are mem bers of the Regular and other Police Forces, we have pleasure in bringing this book to their notice. It is of a handy pocket size, and covers the Special Constables Acts and Order5, 1831 to 1923, also first aid hints and notes on treatment of war-gas victims. I n the space of 100 pages the com pilers have collected much useful information and we have no hesitation in recommending the book. At the popular price of 1/- it should command a ready sale. The publishers are The Poli ce Review Publishing Co. Ltd . , 5/6, Red Lion-square, London, W.C .1.

Fo r more t han 50 years Alexander Cla r k have sup pl ied Presentation G ifts an d Competition Pr izes to Firs t Aid Societi es throughout the enti r e World . . . . . surely conv incing test imony to the ir val ues and service . Write , ' phone or call for illustrated C atalogues . \ \

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Councillor E. M. Mail (Chairman of tbe IIarrogale A. R. P. Committee) has accepted, on behalf of the COIllmittee, an offer made by Mr. and Mrs. J. E. A. Title)' to present to the Town a new type of mobile trailer ambulance. ,

•

As members of the Committee of the West Lancashire Branch of the British Red Cross Society, the Mayor of Lancaster (Mrs. H. L. Musgrave-Hoyle) and Mayoress (M iss H. M. Foster) are reforming the Lancaster Divisional Branch and opening a hospital supply depot and work centre in the city. 3

•

The Hertfordshire Branch of the British Reel Cross Society has divided the County into six areas, each with an Assistant Count y Control1pr. There are now 44 detachments with 1,476 members. Of the mob ile V.A.D.'s 39 have been called u p fo r active service.

THE NEW "PORTLAND" GEAR This new patent Ambulance Gear offers man y unique advantages whethe r the Ambulance is carrying two stretcher cases o r only a sin g le case. A self-contained unit, it can be placed in a lmost any vehicle , and it makes the loading of either top or bottom the simplest possible matter. The "PORTLAND" Gear should be specified f or an y new Ambulance and it 125, 121, 129, provides an ideal Great Portland Street, method of modLondon, V/.I. ernising vehicles al read yin use. T elephone-Lang ham 1040. fcl egra ms-"Ba th cha ir, Wesd o, L ond on. '

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FIRST

Queries and Ansvvers to Correspondents. Queries will be dealt with under the following rules : i.-Letters containing Queries must be marked on the top ldt-hand corner of the envelope" Query," and ad dressed to FIRST AID, 46, 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 39th (1937) Edition of the S.].A.A. Manual of First Aid to the Injured.

Thanks to the Doctor. Once again it is our pleasing duty to extend to Dr. N. Corbet Fletcher our heartiest thanks, and also those of our readers, for the service which during the past twelve months he has rendered to FIRST AID, and to the ambulance world as Honorary Medical Correspondent to this J ourna!. It was during the Great War that the initials "N.C.F." first appeared in FlRST AID. At that time Dr. Corbet Fletcher w.~s not well known; but thanks to his rcady unde~standlOg of the layman and his ability to elucidate q~estlOns .he soon became an authority on first aid. To-day hIS word IS accepted all over the world and queries arrive from Australia, India, South Africa and Canada, in addition to those from home readers. We are proud of the fact that his name has reached such a high standing mainly through the pages of this Journal. Since October, 1915, Dr. Corbet Fletcher has ~n.dertak~n the arduous duty of answering queries; and it IS .Imposslble to calculate how much time he has given to thIS extremely valuable contribution to first aid traininO'. Once again-" Thank you, Doctor; and may it b~ our pleasure to have your assistance for many years to come. " THE EDITOR. TREATMENT OF CARBOLIC ACll) POISONINl;.

E. W. (Volksvust, South Africa).-On page 173 of the Text?ook we are told to give half-a-pint of medicinal paraffin 10 t~e

treatment of Carbolic Acid Poisoning-if readily available .. When, however, our members gave this tr~at~ent tn. a recent examination the doctor disagreed WIth It. WIll you please tell me if there is any special reason why he does not consider givin rr medicinal paraffin satisfactory treatment ? ~ Your ruling will be greatly appreciated. Medicinal paraffin will soothe the burned parts of the m~uth, gU.l1et ~nd stomach in cases of poisoning by Carbolic ACId, and IS WIdely recommended for this purpose. Consequently, I ~an offer no explanation of the objection raised by your examll1er.-N. CORBET FLETCHER.

AID

Good!

Next, please! !-N.C.F.

ASPHYXIA WIT I-I BOWEL PROTRUSION. R.S .. (Ramsgate).-At a recent competition, a test was given 10 which a ~an was injured by a boat's propeller, had the abdommal org-ans protruding, and was also apparently drowned. Will you please inform me, as to what is the proper procedure? Should the first aider at once attend to the pr~tru.ding o.rga.ns or should he immediately apply artIfiCIal respIration, and leave the injuries while performing this? Your ruling upon this point will be much appreciated by the members of our Division. This test belongs to the group usually known as " dead or dying," which lead competitors nowhere and give rise to great diversity of opinion as to the correct treatment. Clearly in the circumstances named, you would protect the ab~ominal wound an.d protruding bowel as best you may ~nd qUlc~ly.com~e~ce SIlv~ster's Method of artificial respiratIOn, as lt IS qUite ImpOSSIble to turn patient on his face because Schafer's Method would force more bowel throuO'h the abdominal wound.-N. C. F. l5 TREATMENT OF DIABETIC COMA. A.B. (Knowle).-Being myself both a diabetic and a first ~ider, I was particularly interested in your reply publIshed under the above title in the August issue of FIRST AID. Whilst agreeing with you in principle, that treatment should merely be (a) for the unconscious state and (b) sending for medical aid, I do feel that the Revision Committee-or some other competent body- could usefully take up this matter with the Diabetic Association with the idea of introducing some regular instruction o~ the point. I am sure that a good deal of confusion exists in the minds of the average first aider about the treatment of diabetic coma-some having received instructions to administer sugar and some not. I myself carry a card issued by the Diabetic Association (12-1-, Baker-street, W.1), sayin!5: "The bearer is a diabetic and takes insulin. In the event of sudden faintness or unconsciousness please give two tablespoonsful of sugar in water and communicate with the nearest doctor." Surely first aiders could be instruct~d to look for such cards in the pockets of the unconscIOus and to do as the card requests if such a card be found? Incidentally, as an Air Raid Precaution for Diabetics I feel they should all be thus labelled, and in the unfortunate event of them becoming casualties their additional injuries could be also entered on the same label that any an~sthetist may have the information at the right time. Meanwhile I thank you in anticipation of your further consideration of this matter. Thanks for your letter which is both interestinO' and informative. Nevertheless, I have nothing further to ~dd to o;y previous reply except to remind you that when first alders have occasion to give a stimulant by mouth (p. 25) or to treat a patient for Shock (p. 45) the Textbook tells them to give " plenty of sugar." Incidentally, the instructions quoted by you require modification since no efficient first aider would administer fluid to an' unconscious patient ! -

N.C.F. EXAMINATION HOWLER. D. S. (East London). - In a recent examination the doctor asked a member of our A. R. P. class in first aid what were the chief varieties of hremorrhage. He was much amused when the candidate replied :-" Ete1'nal and External! "

FIRST

COMPOUND, COMPLICATED FRACTURE OF HUMERUS. ""V. R. (Warrington).-Can you please let me know the cor rect first aid treatment for a compound complicated fracture of the humerus involving the brachial artery? No two people whom I have asked have given the same treatment. May I have an answer before Tuesday next?

•

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FIRST

Your query is too vague for a concise reply. Consequently I am not surprised that those whom you consulted differed in their suggestions! So, pending more precise details of your problem, I sug-~est that you keep the patient recumbent with his upper limb extended alongside his body and that you maintain digital pressure (by relays of assistants if necessary) on the subclavian artery until medical aid is obtained, treating the wound and associated shock as best you may in the supposed (though unstated) circumstances of the case. It is regretted that answers by post are outside our contract. - N. C. F. FRACTURED ELBOW WITH WOUND OF FOREARM. M. K. (Brisbane, AU5tralia).-In a supposed case of a fracture (simple) involving the elbow joint, with a wound a few inches below (and clear of the same elbow), accompanied by anerial h<£morrhage, would a small ann sling (as indicated by Rule 4 on p. 84 of the Textbook) be correct, or should a large arm sling be used? It is contended that, in view of the combination of the injuries, the latter would give greater support and comfort. Meanwhile best thanks. With this combination of injuries I con~ider that Rule 4 controls the situa tion and that the small arm sling should be used. Further, this sling (which normally extends from middle of forearm to base of little finger) can, if necessary, be spread a little in order to take within its fold a dressed wound which, as you vaguely state, is situated "a few inches below the elbow." Of coursE', with an uncomplicated wound anywhere in the upper limb, the large arm sling should be used for the reason stated by you. - N.C.F. SITES OF SPLINTS WITI-! FRACTURED ARM. M. K. (Brisbane, Australia). - vVith simple fracture of arm, the Textbook in Rule 3 (p. 83) says: .. Apply splints . . . on the front, back and outer sides of the arm in its present position." Assuming that the right arm is fractured and that the patient is facing directly North, I contend that the splints should be applied on the North, East and South sides of the limb. My friend contends that the splints should be applied on the North, East and West sides basing such contention on the footnote on the frontis~ piece, and concluding that the" front" of the arm is that portion indicated when the palm of the hand is facing the front. Kindly excuse the unorthodox reference to the cardinal points which the Textbook lays down in the treatment of this fracture. Your North, East and South description gives the correct sites of the splints which are to be used in controlling a fractured arm. Your friend has gone wrong because h'e has overlooked Rule 1 (p. 83) and also the words "arm in its present position" in Rule 3. The fact that the forearm is first placed across the chest in the sling (Rules 1 and 2) results in a modification of the anatomical position of the upper limb as stated on the frontispi.e~e. It fur~her represents the clever way in which lhe RevIsion Committee corrected its error on this point in the 38th Edition. - N. C. F.

FIRST

AID bandaging both lower limbs together, I obtained the assistance of other members of the Division and I-emoved the patient in the position found on a stretcher to the ambulance room where we awaited the doctor. The doctor, on arrival, told us that patient was suffering from fracture of femur and dislocation of the hip, this diagnosis being subsequently confirmed on X-ray examination. He then an<£thetised the patient and told me to pull on the left ankle. Apparently I wa s too gentle because he left the patient's head and repeatedly flexed the injured limb, turning it toward s the trunk. After all my careful treatment I was surpri~ed at his action; and I wondered if it is worth while to have the sole teaching of the Black Book drummed into us first aiders. On your statement of facts both the doctor and you did your duty by the patient. You ptevented further aggravation of the injuries and the doctor did his best to reduce the dislocated hip on the spot. What appeared to you to be rough movements were in reality skilful manipulations. So what is your worry ?-N.C.F. TRE A Tl\l~:NT

OF QUICK-LIME IN EYE. O. H . (Port Dinowic).-When we have to treat a patient with quick-lime in the eye as laid down in the Textbook (p. 185), are we to understand th a t it is not necessary to brush a way as mu ch quick-lime as possible and is the omission of this instruction intentional in the Revised Textbook? I a'vvait your ruling with interest. The omiss ion seems to me to be intentional, because, quite frankly, the instruction to first aiders to brush the eyeball to remove quick-lime never appealed to me and would only be justifiable if no water was at hand. It is easier fo r first aiders to cause further injury by su ch action than by washing the eyeball freely with cold water when vinegar is not available.-N.C. F.

first touch of Sphagnol Peat Ointment soothes inflamed T hetissues. The penetrating, antiseptic peat distillates which Sphagnol contains neutralise the poisons and promote the growth of new, healthy skin. Even the most obstinate of skin diseases-Prurigo Senilis, for instance, which frequently resists the most drastiC'treatment- yield readily to Sphagnol. In all Crises of skin disease or external septic conditions, use Sphagnol Soaps and Ointment. They are a perfectly natural remedy of wonderful healing- power.

Spha9nol In case you have no personal experience of Sphagnol. we will send you a free sample if you will write to PEAT PRODUCTS (SPHAGNOL) LTD., Dept. F.A.19, 21, Bush Lane, London, E.C.4.

Become a ~~~~/s y~~~ ~rit~or~

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JOHN

DALTON

MANCHESTER,

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E. R. (~ig Bell, Australia). -Recently I was called to a patient who had been crushed between an eltctric train and a wall. On examination I found that he was suffering from a fracture of the left l-iip. So, after

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"Yperite" or " Yellow Cross" are two nam es given to liquid gas known in this country as Mustard Gas. The correct name is Dichlorodiethylsulphide and the chemical formula (CH, Cl CH 2 ) 2S, Injuries can be caused by the liquid and by the vapour given off. Treatment must be given as soon as possible after attack.-EDITOR.

For septic wounds, insect bites, blisters.

TREATMENT OF "YPERITE" GAS. P.J . C. (Wanstead).-Could you give me details of the properties and treatment of "Yperite" (Yellow Cross) gas which is reported to have been dropped in toy balloons among the Polish lines.

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THIS

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Settling Down First Aid Treatment of Fraclure of the Lower la,,",,. Some Causes of Asphyxia S.] .A. B. Headquarters and DistnCL Repurts Priory for \Vales Reviews Letters to the Ed i LOr Making Modern Splints Railway Ambulance News B. R. C. S. Blood Transfusion Service Red Cross and St. John \lVar Organisatidl1 Sending Copies Abroad ... Our Nurses' Pag-es Preparation of Surgical Trays Hospitallers' Club Police Ambulance News A. R. P. Topics

r._______

97 ll X SI <)

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110

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FI R5T AID is published on the 20th of each month The Annual Subscription is 3S. 6d. 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 Lhe Movement and also welcomes suggestions for Practical Papers. All Reports, &c., should be addressed to the Editor at Lhe address below, and should reach him before the 12th of each month, and must be accompanied (not necessarily jor tub/ication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Comm~nicl.tions connected with FIRST AID should be forwarded to the Publishers. DALE, REYNOLDS & Co., LTD.,

CONTENTS

BOVE are the three septics. This is apprereasons whyGermo- ciated most in dealing lene Ointment has been with children. universally accepted as Man y medical authorithe finest skin healer ties use and recommend obtainable. Its unique Germolene Ointment, Aseptic' action offers countless homes have you the undoubted adbenefited by its effecvantage of PAIN-FREE tiveness. A trial tin healing - doing will convince away with the FREE you. Take adThe manufacturers smarting associ· will vantage of our be de,ig-hted to ated with Anti- send a trial sample, offer NaVy! tree ot charge, to

NOVEMBER, 1939.

No. 545.-VoL. XLVI. NOTICE

GEORGE

46, CANNON STREET, LONDON, E. (04Telegraphic Address-" Twentv·jour, London." Telephone- City 37 IO.

30urnal for

rl)e Ambulance nub ~Ulsi1l9 ~~

Printing Spaces- 16 in. x 141n. at 9 in. x 8 in.

A local printer can fill i'n the blank space with any required matter.

FIRS

112 112 112 112 112 1 12 112 114

11-1 11-1

1H 114 114 11i

IN our last two issues we have emphasised the importance of carrying on our usual activities as far as circumstances would permit; therefore, we are particularly pleased to note that during the past few weeks first aid fun ctions have been far more numerous than was th e case but a month previous. With the withdrawal of restrictions on places of amusement, the re-starting of football and other sports, means that public duties will again begin to take a place in the volun ta ry am bulance workers' arrangements. In other spheres, too, the work IS settlin g down to war-time conditions. Competition s , dedications of am bu lances, socials and the like are once agaIn to be found In the forthcomin g SETTLING

DOWN.

arrangements. At recent functions the large gatherin g of person nel and friends is a sure sign that they a re just as necessary now as tbey were last winter. I n fact we are tempted to say that to-day such events are of greater service and of greater i rn portance than ever. In the rush of war-time emergency the public are apt to forget that there is still a voluntary first aid army functioning in their midst; that funds are still required to carryon the good work; that members are still willing to assist in teaching the unitiated the art of first aid. The quicker we settle down to present-clay conditions and the quicker we can adjust ollf"seh'es to present arrangements. will mean the overcoming of at least one obstacle caused hy the war. Then we shall be able to carryon the work which is of the greatest importance to our fellow men and women.

FIRST

First Aid Treatment of Fracture of the Lower Jaw. By CAPT. A. C. WHITE KNOX, M.C., M.B., CH.B. RECENTLY there has been some criticism of the St. John method of treatment of Fracture of the Lower Jaw, and it is well to discuss the variations of treatment so that the best one shall be evolved. It is probably a fact that in most fractures of the lower jaw, the main displacement of the anterior fragment is downwards and backwards, owing to the action of the Depressor muscles attached to the front part of the jaw, while the

AID

FIRST

that the fracture should be treated by the Barrel Bandage method. Let us take the St. John method first: The jaw is supported in position by one hand whi le the centre of a narrow bandage is placed under the chin and tied above the forehead. If this bandage is securely fastened the lower jaw should be securely splinted to the upper jaw and no displacement should take place. The centre should be placed well back under the chin and tied well forward on the head. The second bandage is placed with its centre in front of the jaw and is tied at the back of the neck while the respective ends of the bandages are tied on either side of the head, so anchoring the front bandage which by its forward position would otherwise tend to slip off the forehead. The criticism is that the posterior bandage

also similar to the St. John method without th e second bandage. A 10nO" triangular bandage folded narrow, or about six f~et of strong two-inch bandage is used. The centre is placed well back under the chin, taken up over the angles of the jaw and tied in a single knot on top of the head, Fig. 1. Holding the bandage securely the knot is opened out into a loop. The front part is passed forward over the forehead and the back part down over the back of the head below the occiput, Fig. 2. This makes two run ning hitches in front and above the ears. The bandage is now tied off firmly on top of the head. Note that the anterior loop is smaller than the posterior loop to ensure a forward pull on the jaw, Fig. 3. . I t will thus be seen that thiS corresponds to

FIG.

2. FIG.

posterior fragment is drawn upwards owing to the action of the Elevator muscles attached to the posterior part of the jaw. With different types of fracture there may be tilting either to one side or the other. In all cases it is agreed that there is no satisfactory method of Tern porary or First Aid treatment, and that the only satisfactory treatment is replacement of the fragments and wiring- the teeth in their correct position. This is obviously beyond the scope of the first aider, so we must compare the two suggested methods in the light of the Home Office suggestion

tends to dislocate the fragment backwards and may tend to choke the patient. In fairness to this method, it is obvious, that if the first bandage is applied well back under the chin and tied firmly well forward on the head, it gives as good a temporary support as one can hope for with the suggested forward pull to the jaw. The second bandage should certainly not be applied tightly and need not be, as it is only meant to be an anchor for the forward bandage. The four-tailed bandage method is similar to the St. John but, in my opinion, not so secure. The Barrel Bandage method of treatment is

.3.

the tirst bandage of the St. John method with a different method of anchoring the bandage. I ncidentally the Barrel H itch gets its na~e from the fact that it is used by brewers when lifting barrels of beer. . So the A. R. P. worker has his chOice of method. In my humble opinion if they are each done correctly, there is little to choose betwe.en them ; but if, in the St. John method, the. postenor bandage is applied too tightly then,.I th1l1k, there may be some possibility of causing backward displacement.

AID

For those who fear th is possibility the Barrel Bandage will relieve their fear. (Illustrations are by courtesy of the " , ursing Times. ")

Some Causes of Asphyxia. THE terms " asphyxia " and "suffocatio?" are often ~nd incorrectly used to express the same meanmg, ?ut there IS a difference. Asphyxia means" pulseless " and IS the general term used to signify the condition that supervene~ on the interruption of the respiration and tl:at may ~esult In death, viz. suffocation, hanging, strangulatIOn, chokm~: and s.o on. Suffocation, pure and simple, from .th~ medical pomt of view means the condition in which air IS prevented f:om penetrating into the lungs, not by constrict.ion of the wmdpipe, but by some mechanical cause operatI~n or: the mout.h and nostrils externally, or on the throat, :vmdplpe and air passa~es internally, Thi~ includes drownmg and smothering and poisoning by noxIOus gases, . In Hanging, as a result of suicid~, the eyelids. are open and bluish, eyes are staring and burstIng, f:om their sockets, pupils dilated tongue swollen and hVld and probably protruding thr~ugh the mouth, lips swollen, blood or bl~o,dy froth about the moutll or nostrils, hands clenched and hVld, and the face swollen and congested, Afte,r death the face becomes pale, In cases of Judicial I-Ia;tgmg the cause of death is fracture-dislocation of the cerVical vertebrre of the spin e. k t f It must not be presumed that every person ta en ou () the water in an insensible condition is suffocat;d by water. He may be unconscious from fright, shock, disease of t,he heart concussion, etc. A person insensible from DrO'lVII1.1Z/? has a' pale face, a placid expression, half open eyes, eye~ds up' ls dilated mouth either closed or half open, to.nt- ue I"IV1 d , P I, '1 d th a swollen and congested, lips and nostn s c?dvere WI. mucouS froth, the skin is cold and palh, sometImes contracted (" CToose-skin " effect). In Smotlze:ing of healthy adults, where pressure i: made either on the chest or mouth, th~n: ,are Signs of VIOlence resent and usually a pinkne~s or liVidity of the face. If the pperson .IS w ak e helpless are often , . or mhrm the symptoms .d nil, the patient's face being pale and placl,. . ' .U' bv Carhonic Acid Gas, whIch IS a yery ' P,Olsonzn~ ./ d f . 'n from . as takes place in a perio 0 tIme varYI to>CT pOflsono~s ~es' upwards according to the concentratio? with a ew mmu sensatIOn of the atmosphere air. The sym ptoms are a . I t the head a sense of pressure on great welg 1 o n . . ' tthe h temple, se ~ . "'in in the ears with a pungent sensation 10 e. no " ~~~~~ i! also a strong tendency to sleep accompamed lb y 'dd' Further there is a great loss of muscu ar 0'1 mess" t . t' on he falls ~ctivity that if the patient is in an .erec. pOS1; d' ffi It d The breathIng IS at lIrst I cu I instantly to t le groun . . 0' The action of the heart and stertorous, later ceaSIOr-' 'bTt ' is lost and ,1' h 's at first violent soon ceases, sensl 1 1 ) '.\. lie I f d ma In cases 0 the patient goes in to a state of pro oun cOco"I' O'as etc the l .. b th sessuchassmo{e, '" 1 - > ' ., pOIsonIng y 0 er ;~he same except that insensibility comes symptoms are muc. .d ils are of a bluish tint

f;c:~~~a~~ii~:~e ~~tSish~~~: o~~en ;~Ie, and the pupils fixed

I . many ways The Sufjocat/on itself may ta 1{e p ace fin c'lden' teo, . b t ped by orce or ac " h' mouth and nostnls m.ay e s ~p d bein cr suffocated by a helpless person fallIng on hiS face an 1 be mechanical 1 arth There may a so water or oose e . f 11 f earth or pressure with pressure on the chest by a a l Obe closure of the glottis homicid a l int.ent. !her~fmf~: s:r other substances, thus (throat). by .1mpactI.on tl I CTS Similar results are seen prevcntlOg air entenng le ukn o ' d noxious O'ases. in suffocation by vapour, smo e an b

FIRST

roo

AID

FIRST Although only formed i,l May last several ambulance m embers have A. R. P. qualifications in addition to hom e nursing- awa rd s. Numerous public duties are being cove red.

St. John Ambulance Brigade

No. VII District

Headquarters and District Reports. Brigade Headquarters As we go to press a conference of Commissioners and . \ssistant Commissioners is being held at the Great Central H~tel, London, to discuss many items appertaining to the BrJg'ade. In our next issue we hope to publish a repo rt of the proceedings.

No. I (Prince of Wales's) District The ~o. 1 District, and the Central Area in particular, has sustall1ed a great loss with the passing of Assistant Commissioner Captain H. A. Fenton, L.l\l. S.S.A., whose death took place on October 22nd, following an operation . Capt. Fenton, who served in the R.A. M.C. during the G~e~t Wa~, .,,:as appointed Divisional Surgeon of No. 85 (Ealtng) DIVISIon on 1\la)' 22nd, 1928. On December 1st 1930, he was promoted to County Surgeon for the WesterI~ f\rea a.nd: on August 1st, 1936, he was appo inted Assistant ~ommlssloner, Central Area. He was a Serving Brother of I he Order, Lecturer and Hon. Life 1\1em ber of the St. J ohn Ambulance Association. . Ilis great keenness and interest in the work of the ~nga~~ brought him rapid promotion; and his cheedul diSposItIOn and kindly good nature and the encouragement he ah,yays gave endeared him to all with whom he came in contact. ., In cO.J1lpetitio.n work h~ was known as a competent and excel~ent Judge, hiS tests be1l1g straightforward and always practIcable. , Tl:e .Bri?"ade will mourn the loss of a beloved Assistant Co.mmlss.lOner; deepest sympathy is with his w ife and cilddren 111 their bereavement. The fUlleral was private \"ith no Iloral tributes, by l"I.' lluc <, t.

.\f embers of the No.1 District will have learned with ~'g- ret . of. the d('ath ot l\frs. Lund, the wife of Assistant

CommIssIoner Dr. K. F. Lund. !)r. Lund was f~r some tillle the Orficer in charge of II,JC Centr~l ~rea and IS now Assistant Commissioner in the ~o. 10 DIstrICt.

A. course of six lectures on ~irst Aid to the I njured will be held on Wednesdays and Fndays, commenc in g \Vednesdar. November 22nd. Lecturer Dr R Cove Sn 'll F S/6d" ' " - 11 1. ee I . , 1l:clud1l1g textbook a nd exam i nat ion. Full particulars ~~~.~IV. Supt. W. V. 1\1. Allen, 181, Ma ryJebo ne-road,

No. ill District. . ~AR.BOROUGII. 1\1r. A. H. Lord presided at the annual cltstfl.butlOn of awards, Supported by 1ajor and l\lrs C H ;\1 a rt1l1 , Mr. and Mrs. Heaton, Dr. and Mrs A '1 . Brown the R d l\1 . . un op, e~. an rs. A. Turner. and others. Irs. Mart1l1 presentrd 20 cert ificates , seven vouchers numerous labels and A . R - I~ ; ce rtlJJ 'c. inel " cates. Special award s• uded the Rona ld Tree! trophy which, for the fourth

year in. s ~ ccession, had been won by Pte. F. Simpson; Sergt. 'vV. Milltngton was 2nd; \IV. Carter, Jrd , and Pte. L. i\100 re, 4th . !he President's C up was won by Cadet G_ Elliott, with D . SImpson as r unn er-up. A special prize, g iven by the President, was awarded to Pte. L. Moore, whilst Pte. R. Smith gained t h e prize given by Dr. Brown. A large number of residents attended the function.

No. IV District CIIESflIRE. BIRKENHEAD.-First aid in struction at Birkenhead is proceeding apa~e and the .classes are now 500 per cent. stronger, numencally, than III ordinary times. The classes meet ':It the Devonshire Place, Claughton, headquarters of the Blrkenhead Co rps, wh ich are in use every day trom early afternoon until late at night. The classes have g r ow n to such proporLions as to present a problem to the Ambu lance and Nursing Divisions of the Corps, who are responsible for the instruction. 1\1 an)' memb~rs uf first aid parties at the town depots are now attachIng lhemseh-C's tu the Brigade for practice purposes. 1.. \1\'l· . \~dlIf{E.

) BLACKI>O?L. Despite the b lack-oul, the members of the Blackpool BrIgade held the first socia l of the winter sess ion o~ Satu~~a?' evening, October 14th, the proceed s being in a Id of dIVISIonal funds. The soc ial look the form of a whist drive, followed by a dance. The ~o.mmjttee are working hard for funds, and it was \-ery 5ratlfytng to see a good number presC'nt on t he IJI- ~t C'\·elllng-.

No. VI District ORMESBY.-At a wh ist drive, organised by the Orl11e~by Ambulan~e a nd Nursing Divisions, held on NovC'mber 1st, presentatIOn of awards were made by Mrs_ ]. B. \\'. Pennyman, of. Ormesby Hall, who was p,-es('nted with h er badge as presIdent of the Nursing Division by Lady Supt Wears. In the unavoidable absence of Lieut.-Col. ]. B. Pennyman through illness. his badge as president of the Ambulance Division was handed to Mrs. Pennym&n by Supt. J. S. Adkin. Mr. A.. vVood presided in the absence of the president rtnd the Vicar (Rev. Lloyd J acobs) moved a vote of thanks: . Th e results of the examinations were ve ry gratifying to Dtv. Sur£;eon E. W. P. Davies and Supt. Adkin. The members had r espo nd ed to the nat ional ca ll a nd were read . to help those in di str ess . ) The Divi sio ns were ~e ry g-r.ateful. to Col. Pen~yman f~r all he ha d done and In placlllg hIS premises at their ?ls~osal as. headquar t('rs. In addition an eq uipped hos pita l IS 111. se r v ~ c~. at Ormesby Hall, where m e mbe rs of the Nurslllg DIVISion gain much practical ex:perit:'nc~. Col. ~ennyman has also permitted his lorry to be converted Into an amb ulan ce, whilst Mrs. Penn)'lllan has vo lunt eered to drive same.

During- an in terva l at a whist drive, in aid of the Pontril as Division fu nd ", held on October 27th, County Offic('r G. N. Bullock presented awards to numerous members. He spoke of the remarkable growth of the Brigade in the County, and expressed his appreciation of the wo rk done by the local Division_ He also stressed the need fo r funds to provide the necessary equipment to carryon the work in that district. The M.C. was I\1r. D. Cole, and the arrangements were carried out by Div. Supt. A. [1. Badham.

No. VIII (Duke of Connaught's) District AOO ISCOM13E.-During the past month all members of the Addiscombe Division have attended and passed their re-examination in A. R. P. Dr. Wilkinson is now lecturing- to the members, together with railwaymen of the Southern Railway Centre. Over 100 a re attending the classes. Six members of the Division have joined the Home Hospital Service. On the occasion of the flag day on behalf of the British R ed Cross Society and Order of St. John War Organisation, members assisted in the collection and ve ry satisfactory results were obtcined in the Croydon area. The Motor Ambu lance Service has experienced a busy period removing patients to nursing homes, hospitals and also travelling on long journeys. CAMBERLEY.-The Cadet Division held a social last month, those present including Lieut.-Col. L. W. Lucas (Chairman of tlw Urban District Council), Lady Supt. Miss Mack, Amb. Officer G. Pain and Mr. T. Howard (treasurer). Refreshments were provided by Mr. J. Bevi n. and a number of musical items were given.

No. IX District On Sunday, October 22nd, some 500 men and women, St. John and Red Cross workers. from all parts of Cornwall, participated in an imposing parade at Truro . County Commissioner Col. W. Blackwood was in charge of the St. J ohn personnel assisted by Asst. County COJ::missioner W. VV. Johnston, County Officers S. M. Landrey, T. E. Tresidder and E. O. Samuels. The Red Cross Detachments were under Acting Co unty Director Mrs. I vens Knowles and County President 1\1rs. E. H_ W. Bolitho. Th e Lord Lieutenant, Colonel E. H. W. Bolitho, a nd Lady Vivian, head of the Co un ty Women's Voluntary Service, a lso attended. A procession to Truro Cathedra l was h eaded by the Truro City Band. und er Bandmaster E. W. Cuttance, the St. John Standard being borne by Am b.' Officer Eddy. The Bishop of Truro gave an inspiri ng se rm on. After the ser vice the Lord Lieutenant addressed the parade. Th e service in the Cathedral was attended by the Mayor of Truro (Mr. John D elbridge) accompa ni ed by the Mayoress (Mrs. F. J. Sawl e). also representing I\1rs. W. J. Ru ssell , secretary of Truro Wor,nen's Voluntary Service; the Mayor of St. Ives (Mr. C. W. Curnow), and the chairman of N e wquay Urba n Council (Mr. ]. Carwardine). BUDE.-The Bude Statton Division was formed in 'lay

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of this year with 21 members and a further 21 anxious to qualify as members. Since its inc('ption the Division has been of service to the community in many ways. Recently the Division joined forces with the B.R.C.S. Ladies' Detachment, also recently formed, in an effort to raise funds. A treasure hunt, sand castle competition, children's fancy dress parade, Caledonian market, a parade of deoorated cars led by King Neptune, who obligingly rose from the sea and, finally, a dance resulted in each Unit receiving ,£74 towards funds. HAYLE.-On October 26th the new ambulance of the Hayle Division was dedicated by the Bishop of Truro (Dr. Hunkin). Mr. Kenneth Uren (president) said it was a great day in the history of the Hayle Division. They had never had a new ambulance before; they were proud of their new car and wished to thank those who had subscribed towards it. They particularly wanted to thank Mr. S. S. Spray and Capt. E. H_ Hawden, who had done much towards procuring the car. 1\1r. C. C. Rosewarne presented the car to Asst. County Commissioner W. W. Johnston, and said that two years ago the need was felt for a new building- for the ambulance and also for a new ambulance itself. Last August they opened their new headquarters. To-day, under clouded skit,>s in more ways than one, they were dedicating their new ambulance. Following- an appeal the residents in the town subscribed ,£227 and the Cornwall Voluntary Aid advanced another ,£100, which would be repaid over a period of years. He wished to make an appeal to all residents to give as much financial aid as possible. vVben all the bills were paid the ambulance would cost approximately ,£310 ; and they should remember that they still had to pay back the ,£100 and also the debt on the new building. l\1r. Johnston said that the Hayle Division was worthy of a good ambulance car. He knew that the work they were doing was being done well. They had a good leader in Supt. J. R. Bond. He congratulated the Division on such an energetic cummittee, and on having such a fine building and ambulance. 1n handing over the new ambulance to Hayle, he did so with the knowledge that it would be well looked after. Supt. Bond said he accepted the car with a sense of responsibility. Looking back over the past seven years they had removed over 700 people, and if they had ~een responsible in saving only one life, they would con~lder their work well done. He .vished to thank the commIttee for what they had done. Besides the Hayle Division, the IlIogan Division was also present. The Hayle Nursing Di,-ision, under Lady Supt. H. W. Turner; the Hayle Nursin~ Cadets. under 1\1iss V. Love; and the Camborne V.A.D.'s, under I\1rs. C. L. Rosewarne, also attended.

No. X District CLACTO:\,. -The experiences of the Clacton ambulance when called to fetch a case from Birmingham last month were anything but pleasant in the flooded 1\1 idlands, though their experience proved to Supt. C. Cheeld the real w.ort~ of the new ambulance, which went through a severe tnal JI1 a most satisfactory manner. As th ey passed through the nooded areas. the water was frequently up to the axles and sometimes over. Three times they had to make a detour because the water was too deep on the main road for them to e\,pn attempt to get through. . Returning at night, the ambulance got JI1to a very Ion?" stretch of flood near Northampton, and, bad as theIr experience was in the daytime, it was ever so much worse duri ng th~ black-o\.lt <It night.

I02

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Priory for EMERGENCY MEASURES ADOPTED. vVHEN the Ambulance Committee sat under the chairmanship of Professor George Knox, M. 1. M. E., F. G. S., at Priory House on October 31st, the first meeting- since the outbreak of war, emergency measures were adopted to cope with the increasing demand for ambulance instruction. For the war period mixed classes in Home Nursing (as in First Aid) will be permitted j and examinations in the same subiect may be held at intervals of 4 months up to and including the issue of the first label. In consideration of the restriction of travelling facilities in war-time and consequent difficulty in securing examiners, the rule whereby examiners must be selected from outside the vicinity of the class will be relaxed. Recognition as Examiners in Home Nursing is now accorded to General Trained State Registered Nurses who hold or have held appointment as Matron, Assistant Matron, Sister Tutur, and Sister in Charge of a Ward of a General Hospital, and County Superintendents of the Queen's Institutes of District Nursing. Brigade Officers have been invited to submit suitable nominations; to form a Panel. Since the beginning of the year 1,179 class examinations have been arranged, and this figure does not take into account the courses in elementary first aid taken by large numbers of A. R. P. volunteers not qualifying for the certificate of the Association. The following new appointments by the Sub-Prior (the Earl of Plymouth, P.C.) acting on behalf of the Prior (the Duke of Kent) were announced :_ Dr. G. Pari Huws, as Commissioner for West Denbighshire Centre j Mr. E. C. Marshall-Hughes, as Assistant Commissioner for West Denbighshire Centre; Dr. Ernest Llewellyn Davies, as Assistant Commissioner, Cardiganshire Centre. An application for the transfer of the Barry and District Corps from the Cardiff Centre to Glamorgan, supported in person by Assistant Commissioner F. R. Hortop, was acceded to; and at the subsequent meeting of Council, over which Dr. D. Rocyn Jones presided, it was decided to create, subject to the approval of the Glamorgan County Centre, a new Barry County Area, a development which it was felt was justified by the recent incorporation of Barry as a municipal borough. A. R. P. MATTERS. Brigade Officers in Wales have been notified that (1) All courses and examinatiions for Grade 1 and Grade 2 Instructor Certificates have been suspended for the duration of the War. An exception is made in Wales in case of Units deficient of Instructors in Anti-Gas measures. The Chief Commissioner at Home will consider applications which can be justified on the ground that Grade 1 Instructorship is lacking within the locality of a Unit. (2) The Chief Commissioner has ruled that in the case of unpaid duty Brigade uniform should always be worn. In the case of paid duty our members should wear uniform until a Government uniform has been provided, subject to cons~nt of the. Mcdic~l Officer of Health. Although the wea~mg . of un.lform IS a token of voluntary service, the publt~ wtll denve. mo~e confidence by being treated by an expenenced first alder 10 uniform. Great. credit is due to the following Instructors who have qualtfied by attendance at their own expense Courses at the Home Office A. R. P. Schools at Falfield or Easingwold this year as Brigade Officers :_

r 1 n .s T

AID

Wales. SPECIAL INSTRUCTOR, A. R. P S. Private W. L. Cottrell, Porthca wI Division. 1ST CLASS INSTRUCTORS, A. R. P. S.

A. R. P. Officer Robert Stephen, Trevethin County Area; Corps Officer A. E. Williams, Barry and District Corps; Div. Surgeon B. Siddons, Pontypool; Div. Supt. J. W. Barnes, Dowlais Cardiff Works Division; Div. Supt. E. W. Irons, Fernhill Division; Div. Supt. A. Williams, LIandudno Division; Lady Div. Supt. Mrs. F. M. Duke, Pontnewynydd Nursing Division; Amb. Officer W. McTiffin, Llwynypia Division; Amb. Officer O. Morgan, Pontygwaith Division; Corporal G. Lloyd, Ponlypool Division; Div. Sec. ]. A. Davies, Glanamman Division. 2ND CLASS INSTUCTORS A.R.P.S. Amb. Officer T. H. Davies, Penrikyber Colliery Division iAmb Officer 1. C. Jones (Dyfan), Barry Division; Sergeant T. S. Rogers, Dowlais Division. AMBULANCE TRANSPORT FACILITIES. The purchase of a new ambulance to supplement the fleet of cars operated and maintained by the Priory for Wales was authorised at a meeting of the Ambulance Transport Committee, held at Priory House, on October 30th, when a comparative table of figures representing the services carried out by the 23 cars showed that during the September quarter 5,280 cases were removed involving a total mileage of 87,083. A considerable number of new contracts were reported to the Colliery Companies, who are thus recognised by the Mines Department as complying with their statutory obligations regarding ambulance transport. The result of a questionnaire to Colliery Companies on the extent to which the Priory ambulances might cooperate in meeting A. R. P. requirements, notwithstanding the need for maintaining colliery ambulance services, indicated a general desire to leave the matter to the discretion of the Priory, which is acting in consultation with the Mines Department and H. M. Commissioner for the No.8 Region. PRIORY CHRISTMAS CARDS. An attractive card has been produced for purchase by Priory and Brigade membership at actual cost of production. The card forms a unique and pleasing greeting. The front cover shows the Priory badge and a figure representing a St. John Knight, the colouring corresponding to the red ribbon with which the card is tied; and on an inset of art paper appears a reproduction of a charming new portrait of H. R. H. the Duchess of Kent, the memory of whose inspection as Lady Superintendent-in-Chief for Wales is still fresh in the minds of Brigade personnel who took part in the 1939 Royal Review. By committing itself to an order for 2,000, the Priory is able to sell the cards at the very reasonable figure of 3~d. each or 3/3d. per dozen for any quantity over 11. These prices include envelopes, postage extra. Members of the Priory Committee, Centre and Brigade personnel are invited to send in their orders as early as possible to the Principal Secretary, Priory House, 4, Cathedral-road, Cardiff. CIVIL NURSING RESERVE The Chief Commissioner has approved the Civil Nursing Reserve Badge being worn by members of Nursing Divi-

sions fully enrolled in that Reserve. The badge will be worn on the right hand side of bib of the apron. . . Nursing Units have been informed as to tl~e conditions o-overnin0'" payment of the grant of 5/- sanctIOned by the Ministry ~f Health to Brigade personnel fully enrolled in the C. N. R. in lieu of the free issue of overalls and caps m~de to nursing auxiliaries who are not members of the Bngade. The o-rant is payable only to those who have completed the appr~ved course of 50 hours' h?spital training (in addition to First Aid and Home Nurs1l1g) and whose names are recorded by the Local Emergency Organisation. GRANTS TO GLAMORGAN EX-SERVICE MEN. At a time when every effort is being made to s,:"ell the Red Cross Fund, which is to be used for the SIck and wounded in war, it i.s of interest to learn I~ow the Gl~morgan Emergency Help Committee of the JOInt Councl! of the Order ot St. Job n and British Red Cro~s SocIety h.as assisted necessitous rases among the ex-servIce co~mll?llY during the past year from the balance of a fund raised 111 a smilar manner in the last war. Grants were made in over 500 new and many recurrent cases in the twelve months ended October 31st, involvin~ a total expenditure of £1,067 11s. 9d., in additi~n. to whIch o-rants amounting to £80 13s. 2d. were adm1l1lste;ed on behalf of other or~anisati.ons. The type of assistance rendered varies according to the need. ~~art from monetary o-rants assistance in th" form of prOVISion .of dental ~nd ~onvalescent treatment, spectacles,. clo~hln~, surgical units for Il1valId tflcycles, andI lanc es , bedd'lng ' motor. ' app 1', arrangemenls for special dIets, busll1ess grants and rem ova

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Letters to the Editor. We are in no way responsible for the opinions expressed, or the statements made, by Correspondents.-EDITOR. STATE lENT OF ACCOUNTS. DEAR SJR,It is gratifying that the flag-day collection on July 22nd, in the No. 1 Distric-t, reached the record sum of £8,415 iSs. 11d. . As this sum (after deduction of the percentage paId to the District Headquarters) is at the disposal of the local Corps or Divisions, I suggest it might ?~ ~atisfactor'y to tl:e public contributors if the Corps or DIVISIOns publtshed 10 their local press the" Statement of Account" (B. F .j12) for the previous year as " certified by two auditors." . I would also urge that Regulation No. 90, SectIOn V, should be strictly enforced. -Yours faithfully, " AMBULANCE OFFICER."

EQUIPMENT FOR PERSONNEL.

Reviews.

DEAR SIR, Many members of the Brigade are doing part tir:ne duty tAR P First Aid PostS and also Public Duties at ClO e mas, :katin~ rinks, etc. vVe ~re noe allowed, ho;vever, ~o take home ~uch equipment as steel helmets or service re~plrators. · I1 t I suo-gest that such equipment be avaIlable for M Ig ~ . , ? members doing bona fide dutIes as abo\:. . A St. John man inspires confidence 111 the gene.ral pubhc and should a raid develop, or damage he done, pantc may. be caused. Our present headgear will aff~rd no protect.lOn against flyin~ debris wbilst we are attendl~g to casualties, and should gas be used, our civilian res~lrators would not enable us to work very long in the ~ontamlnated a:ea. Members pay for their own uniforms but I thmk a concession should be made in this instance. It would be greatly appreciated by the personnel. . . lT FIRST AID every success in these trying tlmes. W I'shin ,.., - Yours faithfully, J. P. DOR:'IADY.

ILLUSTRATIONS OF BANDAGING & FIRST AID.

- - - . _ . - - --

expenses. fj- d' r f Since the inception of this scheme for a or Ir: g re Ie to those suffering trom illness or disablement, attnbutable to or aggravated by war servi~e, a total amount of over £23 000 ' has been administered 111 grants by the G lamorgan Eme'ro-ency Help Committee, which operates under the Chair~lanship of Mr. John Grimes, M. B . E., at the He~d quarters of the Priory tor Wales , -+, Cathedral-road, CardIff.

Com piled by Lois Oakes, S. R. N., D. N.

Making Modern Splints.

Edinburgh: E. & S. Livingstone.

Pn'ce 6s. net. This is the most complete and be~t illust.rate2d9g0ui~e to . which we have read; and It contalOs p 10tObandlagl?g. 250 pages The photographS are excellent grap 1S In I t S ' '1 . tl t ~nd easily accomplish the purpose of the compl er'.111 la clear to the last detail and are true. PlCtuff;S. ~~;th:~e they are accompanied by letlerpr.ess wl~l~h, by I~~ urac' and conciseness, increases their use u ne:s :~~dent: of first aid, especially when the demonstrator IS not available to assist. I 'tl tl e Divided into four Sections, the book ~ea s W,I 1 ~ triangular and the roller bandage, and also WIth the first aid reatment of haemorrhage and fractures. Erro~s are cant icuous by their absence; and the o.nly ?nes .whlch we"fi;d sp 12 where the St. John sltng IS misnamed t. aJ~~n~~ "P~n p. 35 where a bandage apP.lied todthe l~;verdend , I lied" wnst ban ao-e an on of the forearm is incurrect y ca • r 0p. 45 where ~ narrow banda?"e fi~ur~s as ~ Sl:l~ :~~hse I~~'_ and, contrary to usual pr~ct.lce, ItS l"nol~ I~ t~~oIT and one .. d .d Truly tb IS IS an exce en ... , 1I1J ~rle WIs.lllel·JrOVe inv~luable to all who setk help from its WllCl 1 letterpress and photographs.

11'

, h lar idea that splints are invariably made EXPLODING t e popu. . f " splinters" 1\1r. from wood and denve theIr. name rom .. firm of S W Veale managing director of a Ll\erpool · I 1 addressing the L IverpoO orthopaedic mechal11clans, w len I tl ' said . . t CI b at their ~ eekly I unc leon recen ), Soroptlmls u r which calls for extremely skilled that the modern sp 1I1t, . f the very simple workmanship, is (with the exceptIOn 0 ones) seldom made of wood. f "Modern splints," he said, "are mainl~ ma:eeY~fv:d d . nd those used in X-ray wor { ar . steel an Iron! a I which is extensively used In from duralul11l11-a fine me~a " The primary 0bject in the manufactu.re of aerop ani es · 1\1 Veale that the splint . d I n was remar {e d r., I . uSIng ura uml '. h'l an X-ra)' photograp 1 IS a'n on the patIent w I e . ca? rem I 't does not distort the photograph 111 any way. bell1g ta l{en as 1 " . d I'll Veale "Liverpool has the proud distinction, fsal 1 r .. rnt i~ . ' I ho ne of the most amouS sp I "of being the ongll1a TI I l"nt which was designed the world-the Owen lomas sp I _' Ie of the late Sir H 11 Owen Thoma:>, unc by the late 1r. ug I d' 70rk is known the world Robert Jones, whose ort lOpae IC ~ over. " . '

. '

FIRST

[04

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FIRST

Railway Ambulance News. london and North Eastern. NORTH EASTERN AREA.- The followino- members of the staff have qualified for Gold Medals and B"'ars for the halfyear ended September 30lh, 1939 : -

Mr. Bridge, the Instructor, thanked 1\1r. Corner for taking so much interest locally. . A vote of thanks to the surgeon lecturer, Dr. P. Goldsmith, the Governors of the Technical College, Dr. Bowen, Messrs. Harrison, Bridge and Tuckwood, moved by Mr. Whomsley, was carried with acclamation.

old as many recruits as they possibly could, at the same time hopin~ the next time they met would be under more agreeable conditions. Mr. F. J . Hancock, District Secretary, emphasised the necessity for every qua l i fled Ei rst aider to wear his badge, so that in the event of an emergency, he might be recognised and assistance secured as soon as possible. Among the awards presented, were three gold medals for passing 21 years, the recipients being: A. Greenway, clerk, Exmouth Junction; S. Gregory, guard, Exeter; H. Forder, porter, Exeter. Thanks were expressed by IVIr. S. Gregory, Mr. H. C. Walter (Assistant to Div. Supr.), l'vlr. W. E. Fox (A.ssistant Div. Engineer) and Mr. L. Steer.

MEDALS. Adkin, A., coach body maker, York; Atkinson, A., sub g-ang-er, Grosmont; Atkinson J. clerk Leeds' Atki~son, W. fireman, Starbeck '; Be~kton, fitter: Carlisle; Bennison, ]. H., yard inspector, Skinnino-rove' ~Iackburn, H~, district inspector, Darlington; Boudl, R.: slgna!m~n, ~underland; C:raggs, W. L., signalman, Aycld1e.; Davison, A., crossmg keeper, (Jsworth; Dixon, H., dflver, Newport; Filer, \V. A., coal porter, York; Forster, ]., ganger, Manors, Newcastle' Gibson W fitter, Galeshead; Griffin, F., station fo~eman, Chur.:·h Fenton; Hall, J. H., fireman, Carlisle; Hansell, J. G., goods porter, Leeds 1\larsh Lane; Harness, H. A., constable, Hull; HeneghalJ, J., teamer, Tyne Dock; Hod~~on, T. T., porter sl~nalman, I ng-leby ; Howson, W., goods guard, Leeds; Irving, C., constable, Darlington' Kent, A . . J., fitter, Darlington; Kent, F. G., constable' H~I1; Klrkus, J. R . , shipwrig'ht, Hull; Macklam, H.: dnver, Su~d~rland ~ Mansfield, G. W., checker, Drypool; Oldfield, H., JOiner, York; .Punto.n, T. A., dist. relief porter, Alnmouth ; Tate, ]., eng-me drl\'er, Gateshead ; Ward, P., stalion lampman, Leeds; Williams, S., guard, Garsdale' Yates, ]. E., labourer, Malton; Young, G. H., pas~ shumer, Neville Hill, Leeds.

T.,

20 YEARS BAR. . Davidson, A. N., fi~ter, Walker Ga.te ; Dent, ]., station JOspector, Selby; Hutchmson, A., brake repairers assistant York; Jarrett, W., fitter, Darlington; Lillico, F., wood turner, Wal~er Gate; Longstaff, C. H., police sergeant, York; .\1 artm, N., plater, Gateshead; Maughan, ]., plater, S~uth Dock; Pearson, R., signalman, Eaglescliffe' Richardson, R., goods guard, South Dock' S~aife W' sergeant, Darlington; Skelton, C. J., stat{on jns;ecto~' York; Stapylton, T., driver, Percy Main' Toreveil R' foreman ticket collector, York; Ward, R. H., ~ergeant, Huli: 25 YEARS BAR. Braithwaite, F., driver, Starbeck', R T Percy Main. ae, .

guard,

30 YEARS BAR. Gibson, A., foreman, York; Ritzema, W h' Darlington. ., mac mist,

NEWARK.-Mr. J. T. Corner, stationmaster distributed awards at the recent presentation ceremony. ' The awards i~cluded cert.ificates, medal ions and labels. Mr.. Corner, who IS the President, apologised for the un aVOidable absence of the two vice-Presidents Coun 0Essame , J . P ., and .M r. H . H . N . P almer, and cungratulated '" the successful candidates on passing their recent e . . He co d h f xamlllatlOn mmente. on t e act that the Railway Ambulance had ~l~ays been In the vanguard of renderino- first aid to the IOJured, and he was proud to think he had ~ rna b on his staff proficient to render first aid. ny mem ers

RE CAR.-On the invitation of the Commandant, Dr. II.

l:'.a~lows, SO members of the Redcar ambulance class paid a

VISit to the local A. R. P. first aid station. They were shown round in two I?arties by Dr. Fallows and Mr. S. Blakey, and after watch1l1g a demonstration by part-time workers at the post, t.lley expressed appreciation of the efficiency, both of the equipment and organisation. . . ~OLCHESTER. -The annual meeting of the Colchester !?Ivision was held on October 19th. 1\1r. G. Adams preSided, supported by the officers Rnd memhers. The chairman referred to the war, and said that some of the I~emhers were absent, as they were called up for National Service. He wished them a speedy and safe return. . The secretary (.\ 1r. Felgate) reported on the financial posltl~n: . The examir>ation of members reJlected credit on ~he DJ\TJslOn. The n:ajo.rity of the Division had also passed 111 the ~. R.~. ~xammatlOns. They were again winners of the G. E. Dlstnct Officers Shield, and over 400 cases had been treated b~' ~his Division during the past year. l\lr. ~. Wdliams, First Olllcer, gme a pleasin~' leporl as to the. lnter~st taken by the members and the excellent manner 10 which they carried out their part in the various comp~tltl~ns. As ~ Division. they were ready to deal with any aIr-raid casualtieS that might arise. . . Presentations were made during the evenin<y b), the Chairman. t> It was agreed that practice be held every Tuesday, in the Railway Company's Laundry. .LEITH.-The following members of the Leith L.N.E.R. sectIOn the St. Andrew's Ambulance Corps have been presented With the Voluntary Medical Service Medal, which is ~ranted on the. completion of 15 years' efficiel.t service: Sergt. John ~Vnght, First Corporal John Paterson, Second Corporal Colin C. Anderson, and Peter Robertson. Of the 26 .members who are in possession of the medal, 21 are still active mem bers of the section.

PORTORELLO .. - The Portobello and District L. N. E. R. Am?~lance SectlOn now meet in the Portobello Station WaltlOg-roo,m. on Sunday afternoons, when Dr. K. N. A Herdman, Edmburgh, gives lectures on first a id. .

Southern. . EXETER.-The importance of ambulance work in these times, was stressed by Mr. C. F . De. Pury, Western Div. Supt., who made.the annual presentation of awards to members of the first ald.class at Exeter on Friday, October 21st. In congratulatll1g the recipients of the awards, he expressed the hope that ambulance men at Exeter and throuo'hout the Western d istrict wou ld carryon, and attract to tl~ ir

REf)HILL.-The value of first aid training in these days of emen:;ency was stressed by railway officials, on the uccasion of the preser.tation of awards won by members of the Redhill and Jistrict ambulance class, which took place at Redhill station. Mr. P. Harlow (Station Master, Redhill) presided, and was supported ,by Dr. C. F. Cope (Chss Lecturer), Mr. C. ]. C. Latham (Central Div. Supt.), Mr. L. Sears (Asst. Central Div. Supt.), Mr. F. Hamilton (District Inspector, Engineers' Dept.), Ir. W. Crew (Loco . Foreman, Redhill) and ['dr. H. Hunneybell (Hon. Secretary, Redhill Ambulance Class). The most notable award of the evening was a special cert ihcate presented to Signalman D. Hatt for passing 30 annual examinations in succession-a splendid feat. Mr. Hunneybell's annual report on the activities of the class revealed a position almost comparable with the previous year. Numerically the class had stood still. On the other hand 14 loco. members of the class had attended an intensi','e two-day course of A. R. P. training, having successfully passed and since received A. R. P. badges for their duties. Mr. Hunneybell reviewed other activities of the year and expressed the hope that many new members would join the class, which was about to commence with Dr. Cope as lecturer. The chairman endorsed this hope, and wished that a large number of traffic men would join the class in future. The awards were distributed by Mr. Latham, who reviewed the crisis and events that had crowded upon them since he last attended one of these gatherings, and congratulated the men who h~d equipped themselves to meet any emergency that may arise. Mr. Chrimes said there could surely be nothin~ better or higher than efforts to serve one's fellow men, and ambulance and first aid work were in the very forefront of such efforts. He hoped the class, which had done so well, would go on from strength to strength. , Dr. Cope made a brief appeal for large attendances at the next course of lectures . The meetin cT closed with a vote of thanks to the chairman and speak~-;'s, proposed by Mr. Hunneybell, who said the presence of departmental heads should stimulate. th~m to make an extra effort to get all the men they could InSide th e Movement.

B.R.C. S.

BLOOD

TRANSFUSION

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105

Red Cross and St. John War Organisation. A " SUi\lMARY OF WORK" is being published at fortnightly intervals to supply those actively engaged in the War Services of the Society and the Order with current information. The first issue (October 21st) set out the aims and objects of the War Organisation; and emphasises the fact that it is the duty of us all, no maLter to which of the two bodies we belong, to give of our best to the Joint War Organisation. BrieRy the activities of the Organisation are set out. A list of gifts for the sick and wounded can be ohtRined from 54, Victoria-street, London, S. W.1. Region Officers have been appointed in each Civil Defence Region; gifts of garments and of made-up supplies should be sent to the Victoria Club for Ladies, 9, Halkin-street, London, S . \N.i, whilst a department, with the Earl of Clarendon at its head, has been opened for prisoners of war, wounded and missing. The second issue (. ovember 4th) draws attention to the fact that the J oint War Organisatien is an independant body which has been entrusted with the expenditure of money voluntarily subscribed by the public. The admini,.,tration and control of this expendit1lre can only be exercised by (he responsible officers of the Joint Organisation. To each R. A. F. prisoner of war the Department dispatched a parcel of food and a parcel of comforts. Lord Stonehaven has undertaken to supervise the arrangements for tracing missing and wounded at base hospitals in France, and Lord Fairhaven has agreed to keep in touch with branch officers established in this country. The office of the V. A.. D. Council has now moved to 3, Belo-rave-square, London, S. 'N.t. t- The Lord l\Iayor's Fund is steadily rising and is now on the way to £700,000. Contributions have been received from many places overseas.

Sending Copies Abroad. iv!E:\1BERS of the general public are not now allowed to send papers, periodicals, etc., to foreign countries without a special permit. . ' The countries affected by the censorship regulatlOn are :-Italy, Ruthenia, Holland, Belgium, ~uxemburg, Denmark, Switzerland, Hungary, Jugo-Slavla, Sweden, Japan, China, Norway, San l\Iari.no, Un~on o.f Sov!et Socialist Republics, Finland, Estol11a! Latv~a, LJthuan~a, Spain, Bulgaria, Thailand (Siam), Vatican City: Rumania. Turkey, Greece, Portugal, l\lonaco, Liechtenstein, Andorra, or any dependencies thereof.. . FIRST AID will post copies of thiS Journal to any person in the censorable countries, and to the Briti h Troops in the field at the usual rate of 3/6 per year, post free. Instruction~ should be seot to The Publisher, FIRST AID, 46, Cannon-street, London, E. C. 4.

SER V ICE.

REFERRING to the notice which appeared in our September issue we are now informed that the Service is 5till carryingon it~ activities and will not cease during the period of hosti lities as was first announced. Call s on members have not been so numerous as in the past, owing to the evacuation of patients from numerous hospitals but, neverthe less, the Service is still a very essential national one.

" The Lecture Pocket Book," by Kenneth Black, 1\1. B., etc. The publishers of this pocket book have asked us tc draw readers' attention to an error which appears in the diacrram of the heart. Unfortunately, the numbers were trR~sposed-"141eft auricle," should read "1~ left auri~le ",; whilst ''is ri~ht ventricle," should read" 14 fight ventncle. Future copies will be altered.

FIRST

106

AID

Our Nurses' Pages. COMPILED

BY AN AMB ULANCE SI ST ER.

o. 1 DISTRICT, S.J.A.B. Following on the death of its Assistant Commissioner, the Central Area I as suffered another loss by the death of Lady District Officer Miss M. M. Masson, who passed away on November 1st, after a long and distressing illness. Miss Masson was a founder member of the No. 28 (Civil Service) Nursing Division, on its formation in June, 1914, and worked wholeheartedly thereafter in its service. She ""as appointed Lady Ambulance Officer of the Savings Bank Section and became Lady Superintendent in 1925, a position she filled with much success for 10 years. In 193j, she was promoted to the rank of Lady District Officer for Central Area. in which capacity she endeared herself to the ofncers and members of the Nursing Divisions under her control. The funeral service was held at the Old Church, Willesden. Lady District Supt. Miss Walker, Lady District Officers Mrs. Morrish and Mrs. Tapley and a number of other officers and members attended. No.3 DISTRICT (EASTERN) S.].A.B. ROYAL VISIT TO DAVENTRY.- Wearing the uniform of Deputy Commandant-in-Chief of the Nursing Corps and Divisions of the St. John Ambulance Brigade, H. R. H. the Duchess of Gloucester inspected Daventry's First Aid Post on Saturday, October 14th. This was Her Royal Highness's second visit to Daventry in a week, and the townspeople showed their appreciation of this honour by giving her a great reception. She was welcomed by the Mayor (Councillor R. J. Willoughby) and walked into the post accompanied by the Marchioness of Exeter (President for Northamptonshire, S.lA. B.), Mr. G. E. Foster (Town Clerk) and other officials. After signing the visitors' book, the Duchess inspected a guard of honour formed by officers and am bulance sisters of the St. J oh n Am bulance Bri£;ade. She showed a keen interest in the well-appointed post which is situated in the Abbey Buildings, and expressed her pleasure at the efficiency of those on duty. She then impected the Daventry ambulance and the mobile first aid post which has been equipped in a horse box. Those presented to the Duchess included Mrs. R. J. Willoughby (the Mayoress), Lady District Supt. Mrs. Harvey Reeves, County Officer Miss Mawby, Dr. 'YV. A. Clements (M. O. in charge of the first aid post), Lady Div. Supt. Mrs. E. Townsend, Lady Cadet Supt. Mrs. E. Arguile, Supt. C. E. Meacock (Ambulance Division) and Councillor F. W. Cowley. No.5 DISTRICT, S.J.A.B. WETHERBY NURSING DIVISIoN.-Lady District Officer Mrs. E. H. Lodge is making an appe::tl for support for the fortnightly whist drives held on a Tuesday, the proceeds of which go towards the Lord Mayor of London's Fund for St. John and Red Cross work. She points out that various public functions, such as shows, race meetings, garden fetes, etc., have had in the past the services of St. John Ambulance Brigade, and now the public have an opportunity

of showing their appreciation for the services rendered voluntarily, b>' supporting the whist drives. Mrs. \Vebb, Mrs. Ryan and Mrs. Grime are acting as collectors, and will be glad to receive donations, however small, from any who cannot or do not wish to attend the drives. FIRST AID DISPLAY AT HAREWOOD.-H. R. H. the Princess Royal took a keen interest in a practical demoIlstration of first aid at Harewood, on Tuesday, October 17th. Attended by 1\1rs. Nigel Fitzroy, who is in chuge of the Harewood First Aid Party, and Lady District Officer Mrs. E. H. Lodge. Wetherby Nursing Division, the Princess Royal examined the various methods of bandaging and expressed her satisfaction at the efficiency shown. She also congratulated the members of the party on their skill. Her Royal Highness was enthusiastically welcomed when she arrived at the school to present vouchers and certificates for first aid. She handed nearly 40 members a certificate and greeted each one with a handshake. Following the presentations, demonstrations were given in the methods of bandaging for various injuries, and the precision with which they were carried out must have given Harewood people a feeling of security. If they were called upon to function, it is evident that the First Aid Party could give the necessary treatment. The Princess Royal was particularly interested in a display of stretcher work, and expressed her approval of the way in which the teams acted. She was loudly applauded after wishing the assembly good night before leaving. Among the guests present were Mr. Nigel Fitzroy, Mr. Gordon and the Rev. H. H. Griffiths. The First Aid Party were trained in anti-gas and first aid by Mrs. Lodgf', and in stretcher work by PoliceConstable Tanner. These instructors are at present giving lectures in home nursing to the Hare"w ood Red Cross Hospital Detachment, of which Mrs. Fitzroy is Commandant. NORTHERN IRELAND DISTRICT, S.J.A.B. BANBRIDGE NURSING DIVIsION.-Mrs. Kelly, County Officer, inspected the Banbridge Nursing Division and the Banbridge Cadet Nursing Division at the local A. R.P. headq uarters <=I nd, at the close, expressed satisfaction at their efficiency and strength. She was accompanied by County Officer Miss Gaftkin, County Surgeon Mrs. E. M. Gibson and Asst. Commissioner J. Harris Rea. Lady Div. Supt. Mrs. M'Cormick, Lady Ambulance Officer Mrs. Larmour and Nursing Officer Mrs. M'Elroy were in charge of the Nursing Division, while the Cadets were under Lady Cadet Supt. Miss M. M'Keown and Lady Cadet Officer Miss M'Masters. The Asst. Commissioner congratulated Dr. Eileen Gibson on her promotion to the rank of County Surgeon.

FIRS T T he members of the Nursing Division were in uniform, and with them were a number of probationers who are in t raining under Div. Surgeon H. J. Ritc.hie, J. P. The whole compal~y was drilled by M~ss ~ardy: . . . Lady District Supt. MISS Sll1clalr lIlsrect~d the ~Ivlslon, and complimented those in charge on the effi.clency displayed. The Nursing Division, under Lady Dlv. Supt.. M~s. ~. Agnew and Lady Ambulance Officer Mrs. H. J. !Z-Itchle, IS in' a very flourishing condition. Over 20 of their number have joined the Civil Nursing Reser.ve, .and some of ~h.ese are finishin a their training. Dr. RItchie has been glVll1g lectures to ~Ia.;;ses for the past two years in p.o~aghadee. Mr. Justice Brown congratulated the !?lvlslonal Surgeon and the Division on the good work done Sll1ce the last. meeting, and said that 100 per cent. had passed the fir~t aId and home nursing examinations. He handed the certtficates to Lady District Supt. Miss Sinclair, who then presented them to the members. ST. ANDREW's AMBULANCE ASSOCIATION. At a meeting of the Waverley Station (Edinburgh) ambulance class and section hE'ld on October 22nd, the Voluntary lVledical Service l\ledal was presented by lh~ honorary surgeon to Miss Alice T. Cleary for 15 .ye~rs efficient service in the St. Andrew's Ambulan ce As"o~latlOn. This is the first medal of i's kind to have been gall1ed by a women member of the section. In m.aking the presenta1" Dr Deuchars mentioned that 1\1 ISS Cleary had capt~~~~d th'e ladies' team which had won. t.he ~1ary ~'Dougall Shield on two occasions. This competitIOn IS considered the ladies' championship of Scotland. CROYDON DETACHMENT, B. R . C. S. On Saturday afternoon,. O~t~ber 7th, Sir Herbert Williams, M.P., paid a surpnse VISit to the headquarters at Coombe Road, Croydon. He was received by Mrs. Chiles, Commandant o~ ?~rre)' V A D 124 who introduced l\1r. Croucher, DIVIsIOnal S~c;et~ry, a~d also the officers on duty. Sir Herbert then entered the lecture room where 1\lrs. Sweetten!lam, Asst. Commandant Surrey V.A. D. 124, was lectunng to the mem bers. .. f II tl: t Sir Herbert expressed his appreCiatIOn 0 a .a was b ' d b the Red Cross and wished the members elI1g s on~e :as interested to hear that ;\1rs. Chiles had ~ucces '. d her long service medal and bar for twenty-five Just receive . years' service with the Society. . I The visit gave great pleasure to all connected With t 1e detachment. PENZANCE DETACIlMENT, B. R. C. S. At St. John'S HaIl, Penzance, on Friday, ~ctober 13th, V A D 46 was inspected by the Asst. County Director, Mrs. I~e~s i"nowles. She expresse~ to the Commandant, Mrs. A. Bolitho, her great satisfactIOn at the. smartness of the members both in their appearance and their work. . In the course of her speech, Mrs. Ivens Kno:".les said she would never forget the work done by the Bntlsh Red S . t . the last war and she was sure that the Cross oCle y tl~on would ably' carryon the traditions of the present genera I

Soci~y~ote of thanks was expressed to 1\1 rs: I vens I~nowles I 0 F Chown Medical Officer, for so ktndly taktng the ?y lI1specr·t ·10 n' , especi~lly in "iew of the fact that at the present time she is so extremely busy. . The detachment is re-starttng classes in first aid and home nursing at once.

r07

AI D

On the LONDO NCOUNTVCOUNCll

AM BU LANCE TRAI NS

is the selected Antiseptic -and

here are

A sing-Ie-decker 'bus has been convertE'd into an ambulance by' its owners, J Bullock & Sons (1928) Ltd ... of Wal{efield, and presented to the Wakefield A. R. P. Services.

reasons.

I. It is really SAFE. T. C. P. is com pletely free from poisonous or irritating properties. It is non-inAammable. It does not stain. It can be applied a t full strength straight from the bottle.

2. It is doubly effective in preventing SEPSIS. T. c. P. has a double antiseptic action when applied to any injury : (a) It acts as a powerful penetratin~ germicid e - and effectively sterili ses the affected tissues. (b) It actually stimulates th e activity of the leucocyte blood cells in the ar~a, and thus increases the resistance of the tissues themselves to infection.

3. It relieves PAIN. Applied to any painful injury:-a cu~, burn .or . T C P has an almost Immediate palObrUlse- . . . . f" h k" relieving action-invaluable 10 cases 0 s oc .

4. It promotes faster and cleaner HEALING. T. c. P. promotes particularly clean and rapid healing, because it ~ctu~IIy stimulates the formatIOn of healthy granulatIOn tissue.

Does the Antiseptic which you are at present usin o - offer you these 4 big advantages? If not, writ~' to-day for a trial sam ple and copy .of ~he T.C. P. First Aid Book, sent FREE on appltcatlOn to :BR ITISH

DONAGHADEE NURSING DIVISION. - The inspection of the newly-formed Nursing Division took p lace on Thursday evening, October 26th. The President of the Ambulance Division, M r. Justice Brown, D. L., presided,

the

ALKALOIDS

LTD.,

D ashwood H o use, Old Broad St., London, E.C.2.

IO~

FIRST

Preparation of Surgical Trays. So many nursing members are now doing duty at hospitals, fi rst aid posts, etc., that a few directions on the preparation of surgical trays will not he amiss. Three trays are necessary-Dressing, Stitchin~ and Hypodermic. We will take each in its turn. DRESSING TRAY.-Choose a suitably large tray, which cleanse first with soap and water, and then carbolise with 1-20 carbolic. Requisiles. --Three bowls, one receiver, sterile towels and sterile dressings. In addition, there is required one pair of dissecting forceps, one pair sinus forceps, one probe and one pair surgical scissors. Bowls and instruments are sterilised by boiling for 20 minutes, except the scissors and sharp-edged instruments, which are immersed in an antiseptic, such as surgical spirit, for 30 minutes. STITCHING TRAY. - The tray shou ld be prepared in the same way as above, but, in addition, a pair of stitch scissors, some horsehair or silk gut, and some needles are required. HYPODERMIC TRAY.--Prepare small tray with the following requisites: One bottle of picric acid, iodine or spirit, one hypodermic syringe needle immersed in spirit, spirit lamp and box of matches, one dissecting forceps and spoon in a receiver, small bowl with a few swabs, drug to be administered, small gallipot of sterile water. Appl£catz'on 0./ Injedion.--First well scrub hands and arms and dry with sterile or clean towel. Remove syringe fro~ spirit, using the dissecting forceps. Rinse through with stenle water, then take up about 10 minims of water. Place the drug tablet in spoon, have same checked, then add the water from the syringe. Heat for a few seconds over the spirit I~mp and carefully take up into the syringe. Having partly Immersed a swab in spirit, place round needle and then in the receiver. The syring-e is then conveyed, covered, t? the .patient; the patient's arm is swabbed and the injecttOn gIven.

------ .--.-------

The Hospitallers' Club. MR. G. C. GREEN, the president, has fowarded the following- letter to members :-" Many of our members are on Active Service or engaged in A. R. P. work and, in addition, the I black out' would make it difficult for us to meet even if we were able to arrange for speakers to address us. Your Com mittee feels, therefore, that it will be better for the activities of the Club to be suspended for the present. . " Until such time as it is my privilege to meet once agatn at our meetings, my thoughts will be with you in whatever you are called upon to undertake, knowing full well that we shall all have constantly in mind the motto of the Order' Pro Utilitate Hominm12.' "

The Scottish Branch of the British Red Cross Society has decided to hold a flag day throughout Scotland on Saturday, December ?nd. Mr. E. Hugh Hudson, Asst. County Director for Surrey, B. R. C. S., addressed the Guildford Rotary Club and outlined the general work and local activities of the Society.

AID

FIRST

Police Ambulance News. CITY

LONDON

SPECIAL

CONSTABULARY.

Owing to Emergency Duties it has not been found possible to hold an examination course, but on every Wednesday evening a practice is held at Headquarters. New members attending the practices are instructed in the essential treatments, and short talks are Riven by Capt. A. C. White Knox, the Chief Medical Officer. On two occasions Capt. White Knox has demonstrated the application of the" Thomas" splint and members are becoming quite expert in the use of same.

------ .--.------The present headquarters of the "Help Yourself Society" is at 36, Ship-street, Brighton. The Society is including as a beneficiary the Duke of Gloucester's Fund for the British Red Cross and Order of St. John. At the annnal meeting of the Hebden Bridge Centre, S.J.A.A., it was announced that 7 first aid certificates 34 home nursing certificates, 3 vouchers, 1 medallion and 3 home nursing pendants had heen gained during the year.

10 9

r-----------------_________________________________________________________________________________ .

Confidence in An tisepsis

The high germicidal efficiency of' Dettol,' combined with its special propertjes of safety and convenience, have won for it a leading position in hospitals and private practice.

, DettoJ ' maintains its efficiency in the presence of blood and other organic matter, and can be used in high con-

METROPOLITAN. On Sunday, November 5th, the first war · time competition in the Metropolitan district was held by I, M " Division, when 23 teams competed for the new ., Clean Sweep " trophy. The arduous task of judg-ing was undertaken by Dr. M. M. Scott, who set a ten minutes' test. The setting was that of a road accident in whirh a man knocked down sustained a wound on the left forearm, with arterial hremorrhag-e, simple fracture of rig-ht leg and severe shock. The teams were mostly of the novice class and were composed of regulars, war reserves and special constables; not more than two regulars being allowed in anyone team. Nevertheless, the standard of work was good, especially as but 10 days were allowed for training. Supt. BriRgs is to be congratulated on his boldness in staging a competition in these hectic days but, as he himself said, "First aid is to-day of the greatest importance in the work of the Police." The competition made history in the fact that for the first time women police team s competed and did remarkably well. The result was 1st, Southwark "A," ; 2nd, Deptford" B " ; 3rd, South wark " C" ; 4th, Tower Bridge" B." Mrs. Briggs presented the trophy (a new short broom decorated with the St. John colours and an inscribed silver plate), together with individual prizes for the first four teams. In additi0n a memento was given to members of the women's teams. Supt. Briggs expressed sincere thanks to Dr. Scott for undertaking the noble task of judging 23 teams; and extended thanks also to those who assisted in training the men. . Dr. Scott, in reply, said that he had enjoyed the task of Judging; and then outlined in length the case and how the work should have been carried out. He stressed the importance of treatment of severe h;:emorrhage first, and of speed in treatment. The work had left him with the impression that" M " Division had the nucleus of many good teams. Those present who witnessed the tests included Chief Constable Sprooles, and many Divisional Officers, COl11mandant Matthews and Mrs. Matthews, Div. Supts. Webb and Olstead (S.].A.B.),

AID

centration thus giving a wider margin of safety. It is absolutely non-poisonous and non-staining, and possesses a distinctly pleasant smell. Sold by Chemists and Medical Suppliers in bottles, 1/-, 1/9,3/-, 5/- and 7/6, and in larger sizes for Medical and Hospital use. Sample , and full information on request.

'DEIIOt: TRADE

RBCKITT

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SONS,

HULL

AND

LONDON .

THE MODERN ANTISEPTIC

MARK

( PHARMACEUTICAL DBPARTMBNT ,

HULL

DO YOU KNOW HOW TO BANDAGE? IF NOT, THIS BOOK WILL SHOW YOU

ILLUSTRATIONS of BANDAGING AND

FIR S T

AID.

By LOIS OAKES, S.R.N., D.N., Nursing Editor, NURSING ILLUSTRATED. This book provides a vivid description by means of text and. illustr~tions .of the methf'ds ~dPloye~ in applying all forms of triangular and roller bandages SUItable for various types 0 accl ent ~n injury. The photographs are all original and are remarkably clear to follow, and thf bcc?mp;nYlng text-matter provides a full description of the .me~hods illustrated. Th,s book wll e oun most useful by all first aid workers and A.R.P. organIsations .

NEW BOOK

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FIRST

I 10

A.R.P. Topics. THE DETECTION GASES.

AND

IDENTIFICATION

OF WAR

These subjects are fully discussed in a booklet recently issued by the Ministry of Home Security, Air Raids Precautions Department (1 / 1d. post free). Primarily for the use of gas identification officers the book is divided into five chapters, with three tables and two appendixes. Chapter 1 deals with The \Var Gases: Introductory, which incorporates General Considerations, Classification, General Properties ~nd Physiological Effects. Although the foregoing is dealt with in Home Office publications there is additional data regarding vapour pressure, volatility and persistency. In Chapter 2 the Physical and Chemical Properties of War Gases are describeu. This again differs from A. R. P. Handbook No.1, in so far as that other gases are mentioned. Under Lung Irritants, in addition to Chlorine and Phosgene, we find Dzplzosg-en (trichloromcthyl chloroformate) and Chloropzcr£n (trichloronitromethane). The former deri ves its name from the circumstance that it is decomposed into two molecules of phosgene by heat, detonation, etc., and, further, reacts with water and amines as if consisting of two molecules of phosgene. Under Lachrymators numerous gases are discussed in addition to the three usual ones. Xylyl Brom£de, a persistant gas, with a smell of lilacs; Benzyl B1'omide, very similar to xylyl bromide but with a very aromatic odour resembling water cress j Bromacetone (B.A.) the liquid in contact with the skin will produce painful blisters which, however, heal quickly; Bromo-methyl ethyl ketones, introduced as war gases by the Germans, and Ethyl Bromacefate which resem bles K.S.K., but is considerably less effective as a lachrymator. Under Vesicants Etlzyl D£chlorarsine and Methyl compound are mentioned. Both are nonpersistant liquids, have a marked lung irritant and cause a blistering action on the skin. Phenyl compound is a similar but less volatile liquid. Having fully discussed the gases, Chapter 3 is devoted to Principles and Methods of Gas Detection. It is emphasised that whilst none of the available methods is entirely satisfactory per se, taken all together they usually afford a reliable indication of the nature of the gas present. Discussing the detection of gases by smell the following hints are given : (1) Don't inhale deeply: only the nose can smell: sniff ! (2) Only smell once: repeated smelling dulls the perception.

AID

FIRST

(3) First smell, then reflect: ability to recollect smells can be acquired with practice. Learn smells by heart. (4) After smelling, breathe out strongly through the nose several times. Don't make a new smell test until the effects of the last have disappeared. (5) Don't smell while smoking: smoking dulls the perception. (6) Name each odour perception. A thing is only odourless when no perception is sensed. Under (5) there is one exception. Even slight traces of phosgene affect the taste nerves that tobacco smoke acquires a flat, metallic taste and becomes disagreeable and repugnant. Thi s characteristic, known as the "tobacco reaction," is also present, to a lesser degree, in the presence of hydrocyanic acid and hydrogen sulphide. Other methods discussed are sight, other senses, physiological effects, physical and physicochemical methods, detector paint, chemical methods, field testing and sampling. Chapter 4 deals with Duties and Responsibilities of Gas Identification Officers, and Chapte r 5, Chemical Identification of War Gases. Table 1 sets out the Physical Properties of the War Gases; Table 2, the Odour and Irritant Effects of the YVar Gases j Table 3, the Chemical Properties of the War Gases. Appendix 1 deals with the G.I.O.'s Samplin g and Testing Equipment; whilst the second appendix sets out a Report Form for use of Gas Identification Officers.

I •

AID

I I T

AID

FIRST

IGLODINE

GET A

SPARKLET RESUSCITATOR

FOR ALL CUTS, BURNS, SCALDS, ETC. HEALS HURTS-WITHOUT HURTING Used by the prominent Workshops in their Ambulance Departments

Write for free Booklet From all Chemists : 9d., 1/6d., 2/6d. (SPecial Prices for Bulk) THE IGLOOINE CO. L TO., NEWCASTLE-ON-TYNE TELEPHONE-MUSEUM 2703.

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18, Fitzroy St., Tottenham Court Rd .• London, W.l. Human Articulated & Disarticulated Skeletons & Skulls. Half-Skeletons, Pelves & Fcetal Skulls, Innumerable Icases· "ofj death [from GAS POISONING ,'lSHOCK. DROWNING. etc. , could have been prevented by prompt use of the SPARKLET RESUSCITATOR. SPECIAL

WORKS

AMBULANCE

OUTFIT

Upper & Lower Extremities, Feet, Hands & Loose Bones of every description.

as/-

Anatomical Models & Wall Charts,etc.

Write for leaflet on the "Prompt First Aid Treat~,ent of Asphkiia a d Other Respiratory Failure Emergencies and boo e~ d~scribing this and other resuscitation outfits to Sole Makers .

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When cons idering Trophies, remember it is only by dealing direct with the Actual Manufacturers that intermediat e profits are eliminated and lowest prices obtained . It is this service that has made Alexander Clark Official Silversmiths to leading Fi rst Aid Societies th roughout the World. for more than half a century.

GAS DETECTION AND IDENTIFICATION.

A.R.P. Memorandum No. 11 (3 t d. post free) deals with the organisation and duties of those engaged in the detection, exami nation and iden tification of war gases. Part 1 includes Organisation, including questions of Recruitment and Training j Part 2, the Duties of Respective Services j Part 3, Detector Paint. Appendix A is an application form for the selection as a Gas Identification Officer j whilst Appendix B sets out a Report Form for use of Gas Identification Officers. HIGH EXPLOSIVE INSTRUCTIONAL

Apart from Cups and Medals. Alexander Clark always have an enormous range of utility Prizes and Gifts, suit~ble for Ambulance Competition Prizes .

Catalogues and W holesale Terms allowed bona-fide First Aid Societies, gladly sent upon request.

DIAGRAM.

The Home Office A. R. P. Department has published' an H, E . Diagram specially suited for instructional purposes. The diagram, which measures 36 ins. by 30 ins., illustrates a 112 lb. bomb. Clearly marked and easily read it should prove of great assistance to the enthusiastic lecturer. The price is 1/ 6d. post free. Owing to pressure on space many items of interest have had to be omitted from this issue.

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I 12

FIRST

AID

FIRST

AID

PULSE TAKING WITH TIIUl\lB.

Queries and Ansvvers to Correspondents.

S. W. (Old Trafford). -What is the real reason why the thumb is not used in taking the pulse? Has it to do with the anatomy of the hand as pointed out on p. 40 of your admirable book, Common Errors, or is there a deeper meaning-? r have never been able to find out the reason for this insignificant question.

Queries will be dealt with under the following rules ;_

You refer to my statement about the hand being preem inently suitable for compressing pressure points of th e lil1lbs, the thumb "pressing" the point and the finger s "clutching-" the limb; but this does not answer your present query. I f, however, you !Jlace your halld Rat on the table, you will find that the thumb is tilted towards the fingers at an angle of 45 degs. This peculiar relationship, therefore, ca uses you to feel the pulse in your own thumb if you attempt to take a patient's pulse with your thumb and so spoils the result of your investigation. - N. C. F.

1.-Letters containing Queries must be marked on the top left-hand corner of the en velope " Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C.4. 2.-AII Queries must be written on one side of paper only. 3.-AII Queries must be accompanied by a " Query Coupon" cut from the current issue of the Joumal, 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 39th (1937) Edition of the S.J.A.A. ;\'1anual of First Aid to the Injured.

CAPELINE

BANDAGE FOR HEAl).

S. W. (Old Trafford).-In the Nursing Textbook p. 26 we are taught to apply the joined ends of the two roller bandages to the middle of the forehead, heads of the bandage z'nwal'ds. Does tllis mean the heads of the bandages should be directed towards the operator who is standing behind the patient? This would mean the inside of the bandage is placed on the forehead . I have always applied the outer side of the joined bandag-es to the patient's forehead \-"hich places the heads of the bandages further from the operator. It is dinlcult to ullderstand the instructions to which \'ou direct attention, unless it be that the heads of the bandage are to be inwards in relation to the middle line of the forehead, more especially as Fig, :1 (p.27) definitely shows the heads turned outwards. The method of application which you say that you u<;e is that usuallyadopted.-.

N. CORnET FLETCHER.

E'A~IINATION

HO\\· I.EH.

U.S. (Eastbourne). -- ln a recent examination the doctor asked a candidate how she would commence her treatIllent of a patient in an Epilertic Fit. He was much amused when she replied : " I wuuld lell the pahenf 10 lie down and not to 'won')l .I " . We thought that this would be worthy of a place 111 your long list of " Examination Howlers" and send it in appreciation of the many lau ghs ",hich this item of your column has given us. Good!

Next, please! !-N.C. F.

API'LlCATlON OF COLl) COMPRESS.

S. W. (Old Trafford).-Please tell me if we are to take the notE on p. 47 of the Textbook as to cotton wool bein(Y applied to all dressings, except the cold compress, and kept in place by a bandage to exclude the use of a bandage with a cold comp ress ? I note under par. 2 (a), p. 47. that the cold compress must be changed trequer.!1.J~ in order to keep it cold and wet, and presume that thiS IS the reason for the non-inclusion of a bandage to secure the dressing-.

Yes .

f':.C. re.

TREATMENT OF BURN BLISTERS.

R.M . (Dcal).-I am a Brigade man. at present employed a:, a member of an A. R. P. Stretcher Party. My kit contain:, a tube of tannic acid. This has led me to study this subject of burns more fully, and r am I erplexed at the seeming contradiction of instructions in the Textbook. On p. 178 it states: "Do not break blisters"; but on p. 247, in Appendix II describing the use of tannic acid jelly, it instructs us to "Carefully remove blisters with sterile forceps and scissors." I should be glad of further enlightenment from you on this matter. The explanation of your perplextity is that difTerelll remedies call for different methods in their applications. The Textbook requires the blisters to be unbroken because a raw burned <;urface, if exposed, is very liable to become septic. On the other hand, the tannic acid ielly recommended in Appendix II is most effective if brought into contact with the said raw surface. - N.C. F.

.\ PUZZLING

7J,ere w;11 he a National demand for Trained Mlltteurs is your opportunity of becoming- trained .for the great .wo:k which lies . ahead in field of N owTherapeutics. Every man and woman skilled In the art of SCIentific massage wlll be a NatIOnal asset. ~he

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holder is thereby known to have satisfied a Board of Exarntners that he or she possesses a most.compr~hen::;)\ l: knowledge of human anatomy and physiology and can sattsfactonly treat all the hundreds of conditions that are amenable to Massage and manipulative Therapy. Tremendous opportunities lie before yo u in this uncrowded ~leld ~vhich is now open to you without having to leave y~ur present work until you qualify as an expert and can command an expert spay.

PICTUHE.

]. P. (Birmingham).-Once again I am asking your valued opinion on the following ; As you see, the enclosed picture is the front page of Prepared, which is the oFficial monthly magazine of the Birmingham A. R. P. Department. I was asked what the injuries were, and I said that they appeared to me to be fractured ribs (simple) and fractured lower jaw. Imagine my surprise when I was told that the patient was suffering from multiple in juries to the head, and nothing else. J asked why the bandages were round the body, and 1 was to ld to prevent the patient breathing deeply so that he would not increase the bleeding- in the head. In my opinion, if a person is prevented frolll breathing normally, that would most likely cause him to ~ouRh. I would be pleased if you would tell me whether my opinion is correct, and also give your opinion on what the injuries appear to you and the treatment afford ed to the actua l injury shown in the picture. Like you, I am puzzled and I hazard no opinion. Incidentally, I cannot accept the picture as portraying the treatIllent of fractured jaw and fractured ribs. If yo u treated these fractures in your annua l re-examination in s u ch fashion, you would fail! !- N.C.F.

DANGEROUS DRUGS

If you are interested in First Aid you will at once appreciate.the value of :.'IIassage, it will build up the muscular and nervous systems In exactly the same way as exercise; but does not incur any waste products and even removes them when they are present. It ~s then the most \'aluable asset and a wonderful treatment for injured and Sick.

The proper study of mankind is man. Study the most absorbing subject in the world in CTood company under the ----------------- ~ CTuidance of the S . 1\1 . A .E,. T urn )'~ur interest in First Aid b work and your hobby Into To The Secrelary. The SMAE channels that mean money for Institute. Leatherhead. Surrey. you-health fo~, othe~s. ~et Please send me without obligathis Free Book Manlpulatl ve tion. a copy of your free Booklet Fill in Therapy as a Profession II and " Mani!:'ulatlve Therapy as a the Coupon Profess ion ... learn how you can enter the for this profession with a future. Fill Nanle ............ ............... . Free in the Coupon and post withBook out delay. FILL IN AND POST THIS COUPON

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ACT.

M . R. (Chelsea).-I have heard from various sourc~s of several temporary amendments in the provision of Dangerolls Drug-s,

" F.A." Nov., 1939.

FIRST

IT 4

Cou you tell me whether this information is correct, and, if so, the scope of these amendments, stating particularly whether they refer to the storage or administration of Opiates? I have not heard of any amendments, temporary or otherwise, of the Dangerous Drugs Act.-N. C. F.

BARREL BANDAGE FOR

FRACTURED JAW.

1..s. (Blackpool) and Others.-Reading in "The Emergency l\ledical Services Memorandum, No.4," I was rather surprised to see the following words on p. 10:-" The ordinary triangular bandage should not be used for a lower jaw fracture, as it is likely to increase the displacement of the fragments by its backward pull. The , ~arrel ' type of bandage is suitable, is easily applied, gIves an upward and forward pressure well back from the chin, and relieves pain." I should be much obliged if yo u would tell us how to apply this particular kind of bandage and how it applies to us who follow the standard Textbook without question.

Elsewhere in this issue, Dr. \Vhite Knox descri bes this curiously named bandage. This, I am told, takes origin from the method of tying the rope when a barrel is lowered end up, into a ships' hold.-N.C. F. '

TRANSPORT OF PATlENT3 \-\lITH SPRAINED ANKLES.

C. P. (Bath).-If we treat patients with sprained ankles in the ~anner now laid down in the Textbook (p. 97), 1 conSIder that transport by human crutch would be useless. I n these circumstances, I ask if you would approve of our continuing to treat such patients as was taught in the 38th Edition of the Ttxtbook and if yo u agree that the human crutch method is usel ess . Your kind answers on these points will be greatly appreciated. . Here again i~ !s up to you in any given case (examinatIOns and competttIOns excepted) to uecide what is best for your patient. Further, I cannot see how the chanae in treatment of the sprained ankle affects the method ~f removal, because the patient with a sprained ankle will take good care to tread lightly. Most positively I do not agree that the human c rutch method of transport is useless. N.C.F.

FRA CTURE INVOLV ING ELBOW JOINT.

C.M. (South. Shields). -I "v~uld be greatly obliged if you would gl:'e me your rul1l1g on a little di~pute that has occurred 111 a A. R. P. class to which I am instructor. I have been telling the men that in the treatment of a fracture ~nvolving the elbow joint they should apply the figure-of-elght bandage over the hand and wrist in such a \.va)' that the thumb is left outside. Another instructor has been telling them that it does not matter whether they keep the thumb out of the figure-of-eight bandage or not. I have been a mem ber of the Brigade for three yea.r'3, and that was the way I was always taught to dOlt. ' . While I agree t~at the method of applying the figureof-eight bandage, With fracture involving elbow joint as taught by Y0U is regarded as correct, I confess that' the Textbook (Rule 3, p. 84) i~ nO.t very definite on the point. The nearest we get to a rulmg IS that with fracture of fore~rm .the instructions with reference to this handage are Identical as far as hand anJ wrist .are concerned (Rule 3, p. 85) and ar~ supplemented by a dIagram which shows the thumb outSide the handage.-N.C.F.

AID

FIRST TRANSPORT II \.

HAND

Personally, J consider that the former method will prO\ e more satisfactory and proviJC' "safe, steady and speed y transport" as required by the T ext book (Rule C p. 194 ) --=N.e.F. ' .

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G.C. (Surbi~on).-In the September issue of FIHST AlD, when answenng a query under the above heading, you re fer to the cross over and to the broken step. When usi na a hand seat we have been instructed to walk cross ove~ in broken step-that is, outside leg of each bearer and then inside leg . Do yo u r eco mmend this or that bearers should walk in unison? Your assistance will oblige.

IN WOUNDS.

M.e. (Kentish Town ). -If during an air raid a casualty is c~t ?y ~lass ~nd has Iar~e pieces. (even a foot lon g) stlckmg- mto hi S body and limbs or If he has a carving knife sticking in his body, ought we to leave these in the wounds or ought we, as I think, to remove all those t~at are easily removable? Your ruling will be appreCIated by myself and the other men,hers of our A. R. P. Stretcher Party. Rule ? o n p. :Og"of the T extbook answers your query. If the foreIgn bodl.es can be seen lying loose in the wound ," remove them but If they are imbedded, do not attempt to remove them, lest you ca use sudden and profuse bleeding. N.e. F.

Am. A. H. (Thornton).-A doctor when le cturing last year to a class turned to one man (a first-year man) and asked " Are you sure you know the difference between sign s a.nd symptoms?" "No Sir," was the reply. "\V'eIJ , slg'ns a re what you act ua ll y see, such as the sign on th e , Dog and Gun.'" Another man in the class quickl y remarked: And the symptoms are what you feel after an hour or two's stay." H UMOUR IN FIRST

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Death of Dr. A. T. Lakin Treating Burns with Aniline Dye Railway Ambulance Ne\ovs Am bulance Trains Suffocation- Sudden and Slow

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QUERIES AND ANSWERS TO CORRESPONDENTS : -

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FIRST AID is published on the 20th. of eac~ month. The Annual Subscription is 38. 6d. post free ; ~mgle copies 3d. Its aim and object being the advancement of Ambulan~e Work in all its branches, the Editor invites Readers to send Arucles 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 12th.of ~ach month, and must be accompanied (not necessarily jor tJublzcatwn) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Comm~nications connected with FIRST AID should be forwarded to the PublIshers. DALE, REYNOLDS & Co., LTD., 46 , CANNON STREET, LONDON, E. C.4·

CONTENTS

DECEMBER, 1959.

No. 546.-VoL. XLVI.

Printing Spaces-16 in. x 141n. & 9 in. x 8 in.

GEORGE

132

132 132 132 132

132

134 134 1.14

134 134 134 134

THE first report received conANNUAL nected with the Order of St. REPORT OF John is that of the Priory for THE PRIORY Wales. On another page will be FOR WAL E S. found a graph giving particulars of the Priory's activities over a number of years. This clearly shows the importance of the work carried out in the Principality. The Medical Comforts Depots from which 9,439 comforts were issued, the ambulance cases carried (18,241) and the mileage (302,240), are but three of the Priory'S activities; but each is of the greatest importance to the community. In the training of A.R.P. over 6,000 awards (instructors' certificates, rank and file and also G. P. certificates, etc.) have been issued. During 1938 the Brigade members attended 56,954 reported cases, 4,581 being removed to hospital or home, while t ,816 represent road accidents. Roadside first aid huts and aid posts were maintained by Brigade personnel. Nursing personnel gave voluntary assistance at homes and institutions on 582 occasions; the demand for such service is increasing yearly. During 1938, 91 service medals, 35 first bars, 24 second bars, 9 third bars and one each fourth and fifth bars were issued. The recipient of the fifth bar was Commissioner S. T. Beard, O.B.E., who has, we are proud to state, been a regular reader of FIRST AID since its first issue. Sixty-one divisions are the proud possessors of ambulance halls, at forty of which a Medical Comforts Depot is accommodated. The report also contains references to other activities such as camps, inspections, competitions, whilst Centre Reports are also incorporated. VI e congratulate the Priory for Wales ?n its splendid contribution for the benefit of mankInd.

FIRST

Hints on Stretcher Practice. By CAPT. A. C. WIIITE KNOX, M.C., M.B., CH.B. THESE Hints are intended to be a guide to those who have not had the opportunity of practising the moclern stretcher drill, or who are confronted with the difficulties of the Rigid Slretcher. The sug-gestions regarding the Rigid Stretchers are not meant to be binding, but offer a way out of some of the difficulties. There are four Bearers in a Stretcher Squad; and their ., Permanent Positions" are as follows : No.2 on the left of the Stretcher with his toes in line with the front ends of the Poles; ~o. 4 behind No.2 with his heels in line with the rear end of the poles; No.1 on the Right of the Stretcher in line with No.2, and No.3 behind No.1 in line with No.4. All orders are given by No. 1. In order to form a Company into Stretcher Squads it is well to practise the following drill. The use of the Rigid Stretcher, which is ordinarily carried by four bearers, complicates the early part of the drill, and its use is not recommended for til is type of practice. From the prepal-ed Stretcher Section, however, it coincides with the ordinary folding stretcher drill. STRETCIIER DRILL. Si::,ing tlte Bearers. (a) Tallest on the Right, shortest on the Left, in single Rank-Size. (b) Number. (c) Odd numbers one pace forward, Even numbers one pace step back-March. (d) Number one stand fast, Ranks, Right and LeftTurn. (e) Form Company, Quick-March. (No.3 goes behind No.1). Or, alternatively, (a) Tallest on the Ranks, shortcst in the centre, in two Ranks-Size.

i'orming tlze Squads. (1) From the Rig-ht, at half a pace interval, RightDress. (File on right stand fast. Every other man of the front rank rlaces his right hand on his hip and eases off until his elbow is just clear of the man on his right. He turns his head and eyes to the Right and corrects his alignment. The Rear rank confirm with the movements of the front rank, without placing the hand on the hip.) With Rig-id Stretchers it will be necessary to give the order-From the Right, at one pace interval, Right-Dress, when with the exception of the Ri~ht File each man of the Front Rank will extend his Right arm, palm downwards and finger tips touching the Shoulder of the man on his right. He turns his head and eyes to the right and corrects his alignment. (2) Eyes Front. (3) Company-Number. Proving the Bearers. (+) Front Rank-odd numbers, Number one Bearers, Stand at-Ease. (5) Even numbers-Number two Bearers, Stand atEase. (G) Rear Rank-Odd numbers, Number three Bearers Stand at-Ease. ' (7) Even numbers, Number four Bearers, Stand atl~ase.

(8) Company-atlention.

AID SupPl.ying SLrelclzns. (9) Supply Stretchers, Quick-M arch . Numbers 2 and 4 hearers lead out in file from the Right followed by the Number 2 and 4 bearers of the remaining squads in succession. Kumber 2 bearer takes the front handles of the Stretcher and Number 4 bearer the rear handles. With Rigid Stretchers allow the stretcher to hang down, runners away from the body. Bearers rejoin their squads in succession, moving in from the rear. Number 3 bearers then take a pace to the rear in line with Number 4. (10) Lower-Stretcher. With Rigid Stretchers let the top of the stretcher come down on the Right, the bearers leaning across the stretcher as they stoop. (11) By Squads-Number. Pilmg" Stretchers. (12) Lift-Stretchers. With Rigid Stretchers lcan over and take the Right hand handles. (13) Pile Stretchers, Quick-March, (as before, in quick time). (14) Rear Rank, one pace forwarJ-l\larch. (15) Company Right Dress. J-!-'xtendz'ng and Closz'ng. From No.-Squad to four paces-Extend. The Squad named remains steady. The remaining squads make a full turn away from the named squad and march in quick time to their positions, turn to their front and pick up their dressing by the named squad. Moving squads will ceunt silently 1,2,3,+, 1,2,3,+, &c., the number of times that they are removed from the named sq uad, before halting and turning to their front. For example, if No.1 is the named squad, No. 2 squad is once remov'ed from No.1, and counts 1,2,3,4, once, before halting and turning to the front. No. 3 sq uad is twice removed from No.1 and counts 1,2,3,4, twice before haltir.g and turning, and so on. On No.-Squad-Close. Extended sq uads will make a full turn towards the named squad, march in quick time to their positions and turn to their front. Preparing and Closing Stretchers. Prepare-Stretchers. Nos. 1 and 3 take a side pace to the Right. Close-Stretchers Nos. 1 and 3 take a side pace to the Left at the finish of the movement. Loading Stretchers. Collect wounded. Halt three paces from, and in line with, head of patient. Lower Stretcher. Order given by No. 1. Prepare Stretcher. Order given by No. 1. In folding Stretchers No. 1 goes to the right of the patient and No.3 to the left of the patient, whilst Nos. 2 and + prepare Stretcher. With the Rigid Stretcher Nos. 1, 2 and 3 go to the patient, whilst No. 4 covers the Stretcher with blankets. Ultimately, Nos. 2, 3 and 4 take up their positioll on the left of the patient with No.1 on the right opposite No.3. Lift. Lower.

FIRST Carriage oj Stretchers. Hand Ca1'1'iage. For two bearer Hand Carriage Lift-Stretcher. Nos. 2 and 4 take a side pace between the handles. The Rear carrying bearer steps off with Right foot, all others with Left. For four bearer Hand Carriage Lift-Stretcher. All bearers stoop, grasp the handles of the poles with the inner hand and rise together. The bearers step orf together with the inner foot. Shoulder Carriage. On Shoulders lift-Stretchers. The bearers turn inwards together, stoop and grasp the stretcher, hands wide apart, palms uppermost, lift it slowly and evenly to the level of the shoulders. They then turn to the front end of the stretcher, supporting the handle of the pole on the inner shoulder, steadying the stretcher with the other hand. All bearers step off with the inner foot. In Shoulder Carriage the patient is carried Head foremost. R etiring with Shoulder Ca1'rz'age. Squads-Halt. Squads will retire, about-Turn. The bearers grasp the handle with both hands, lift the stretcher and turn about, placing the handle on the inner shoulder. Retire.

Conference of Commissioners and Assistant Commissioners of the St. John Ambulance Brigade. As the outrome of the suggestion made by an officer in the south Sir John Duncan (Chief Commissioner) decided to hold ~ conference of Commissioners and Assistant Commissioners on September 29th last. Unfortunately, war activities caused a postponement, but it was later decided that the conference should be held on Sunday, November 19th, at the Great Central Hotel, London. The conference duly took place, and Sir John and I~is staff must feel very satisfied at the successful outcome of thiS, the first of such conferences ever to be held. On Saturday, November 18th, a d~nner was held, at which Sir John presided. Some fifty ofhcers ","ere present, including Sir John Lumsden (Eire) and the Hon. J. H. Bru.ce (Wales). The function was an informal o~e. The ~hlef Commissioner welcomed those present and said how satisfied he was that it had been found possible to hold the confer:nce. He referred to the Brigade's activities prior to, ~nd. S1l1ce, the war em phasising the fact that officers should 1I1SlSt that Brigad~ members worked tog-ether with their own officers as laid down by the Home Office. He welcomed the opportunity of meeting so many Commissioners. On Sunday, November 19th, Sir John presided at the Conference, supported by Brigadier vV. G .. 0. Barn 7 (Secretaryof the Order) ; Col. G. A. Moore (ASSistant C.hlef ~om missioner); Dr. N. Corbet Fletcher (Surgeon-1I1-Chlef); Major P. G. Darvil-Smith (Brigade Secretary), and Mr. H. J. Wrigglesworth (Assistant Brigade Secretary)... . Many items were discussed and th.e follow1l1~ IS a bnef resume of the proceedings dealing With the BrIgade as a whole. EFFICIENCY OF MEMBERs.-After a g-eneral discussion it was decided that durin CT the ""ar reriod members on fulltime A. R. P. duty sho~ld be granteJ their ~fficiency and tal~e a re-e~arnina.tion if possible. Part tIme member:;

AID

T 19

should attend at least six drii!s during the year and take a re-examination. WEARING OF BRIGADE UNIFORilI ON i\. R. P. DUTIES.Cost of uniforms worn on A. R. P. duties, the I-lome Office utility uniform and other uniforms were discussed, and it was decided to leave the matter in the hands of the Chief Commissioner to deal with it in co-oreration with the British Red Cross Society. REVISED STRETCHER DRILL. -In view of the fact that the instructions in the present Official Drill Handbook are different to the drill given in the revisecl first aid texthook, which is in accordance with the R. A. M. C., and that with the rigid A. R. P. stretcher a modification is necessary, a discussion ensued re~ardin!5 new instructions to Brig-ade personnel. Capt. 'White Knox (Asst. Commissioner, ~ o. 1 District) put forward a copy of a revision compiled by himself, and it was decided that Dr. N. Corbet Fletcher (Surgeon in Chief) should go through the suggested ne\v drill and that later the instructions should be published for the benefit of Brigade members whilst awaiting the issue of a revi~ed drill handbook. In this issue of FIRST AID will be found a copy of the suggested drill. OFFICERS' TUNIC.-It was decided to omit the brace and to wear a belt only. It was prorosed that in future new tunics should haye a built-in belt with white metal bucl<le in front. OTIIER SUBjECTs.-These included the Joint vVar Organisation ; difficulties experienced by the Brigade undcr the A. R. P. scheme; retrol supply for administrative officers of the Brigade; assessment of credit for public duties; Brigade finance' maintenance of divisions during the war period. Ea~h subject was debated in length and many minor points were made clear. The Surgeon-in-Chief addressed the conference on the trials of doctors, and drew attention to nu merous details which too-ether makes for efficiency. At t;e close of the business Col. Sir Bertram Ford ~ ~ o. 3 (W) District) expressed, on behalf of al.l present, sincere thanks to Sir John Duncan for the great 1I1terest taken and the sympathetic hearing given to all speakers. The Chief Commissioner, in reply, said that the longer he was in the work the greater became his interest. The Brio-ade was a wonderful voluntary movement and he was pro~d to be a mem ber of it. The .conference had provcd a valuable opportulJity to exchang'e news and he prorosed to make the function an annual event. Every District and nearly e,"ery County was. represented at the conference, the number of representatl,'es present numbering about sixty. " A most successful conference," was the remark heard voiced by many of those present.

The following dates have been arrangecl for the 1940 competitions, held under the auspices of the Durham, Cleveland and \Vestmorland Ambulance Le~gue :-Donald Bain (Senior) Divisional Competitions, February 3rd; Elizabeth Bain (Junior) Di\'isional Comretitions, February 17th; finals at Durham, on Saturday, ;\larch 2. Entr~es close January 13th. All men engaged in mines anJ. q~arnes in Durham, Cleveland and \Ves(morlancl are eligible to compete.

Owing to pressure on space many reports have had to be held over. Will readers plea e forward news items as early as possible.

FIRST

120

A First Aid Post-Somewhere in London. J N the centre of London, on the banks of the Thames, and within reach of two large railway stations, there is a major First Aid Post, hidden below ground in what was once a large modern garage. In their spacious and comfortable air-conJitioned quarters, the St. John Ambulance Brigade members work in shifts of 7 hours per day and 10 hours at night. Attached to each shift are 2 Trained Nurses, some of whom come from Overseas, and are waiting to be called up for service at the front. There are several members of the A. R. P. Brigade reserves, Council volunteers and orderlies. One of the members is an authority on eyes, and has had much experience of such treatment in Palestine and Syria. In the same Post there are also the Demolition Squads, Rescue Parties, First Aid and Stretcher Parties, Ambulance Drivers-in all about 400 workers, and a large canteen.

FIRST

AID Many distinguished visitors have paid the Post a VISit, the first of whom was H. M. the Queen, who took a great interest in all the arrangements, and was most surprised and plea~ed to hear that the Post had been ready for action since 3 p. m. on September 1st. Some very interesting lectures are given by a doc lor on First Aid work, and the members are able to practice bandaging and stretcher drill. There are also lectures on Gas and A. R. P. Every Sunday afternoon a short service is taken by the Chaplain attached to the Post, and on Armistice Day a service was held. followed by the Two Minutes Silence. On Sunday, NovembEr 12th, all the Poppies from the Post were made into a wreath, and representatives from each group in the Post drove to the Cenotaph, where they lined up while one of the nurses from Overseas, accompanied by a~St. John Sister, placed the wreath on the Cenotaph. For the entertainment of the whole Post, there are weekly concerls in the canleen, given either by visiting Concert Parties or organised by local talent. One of the

121

AID

Priory for Wales. AMilULANCE COMMITTEE MEETING.

TI-JE allcnclancc at the meeting of the Ambulance Committee over which Professor George Knox, M.l.M.E., F.G.S., presided at Priory House, Cardiff, on November 28th, was indicativt! of the keenness of those responsible for the development of Priory activities in the various counties of \Vales. Despite the difficulties and inconveniences of travellin~, members attended from considerable d~stances only four of the twenty-six representatives present being residents of Cardiff. Sanction was given to the formation of two new Corps in the Caernarvonshire Centre where the President, Lord Penrhyn, and Commissioner, Sif Michael D. Assheton-Smith, Bart., have each fostered first aid classes in connection with the respective quarries. They are to comprise the following units : Arfon Corps.-Conway, L1andudno, Llandudno J unction, Llysfaen, Penmaenmawr and Talybont and District Ambulance Divisions; and Conway Cadet and Llandudno Cadet Ambulance Divisions. Eryri Corps.-Bangor, Caernarvon, Cynfi, L1anfairfeehan, Penrhyn Quarry and Vaynol Amhulance Divisions; and L1anberis Nursing Division. The new Assistant Commissioner, Mr. T. J. Pritchard, Chief Constable, is ably assisted in the work of the Centre by the Honorary Secretary, Mr. W. T. Davies, who has maintained an active connection with ambulance work for the past 30 years, and the Hon. Treasurer, Inspector G. 'yV. Roberts. ... 6~ Following the decision of the SL John Ambulilnce Association to recognise State registered nurses holding-

quali6cations as examiners in home nursing-, a number of nominations were considered, and Dr. D. Rocyn Jones, Surgeon-in-Chief for Wales, undertook to submit to the next meeting nominations for the appointment of a distinguished representative of the nursing profession to act in an advisory capacity. The Committee was pleased to learn that the draft revision of the textbook on First Aid in :'.1ines, compiled by a Committee of mining and medical experts set up by the Priory, had been submitted to the St. John Ambulance Association for early publication, a reviSEd textbook on this important branch of first aid having been regarded as longoverdue. In recognition of long periods of gratuitous services a" lecturers Dr. J. Dunlop and Dr. R. M. Carmichael, Divisional Surgeons of the Abercarn and New Tredegar Divisions respectively, were elected Honorary Life Members of the Priory, no fewer than 153 members of the medical profession in Wales having had their names added to this Roll, and without whose services ambulance work could not have achieved the present state of development in Wales. BRIGADE SERVICE AWARDS.

The Sub-Prior, Major-General the Earl of Scarbrough, KG., G.B.E., KC.B., T.D., actim; on behalf of His Royal HiO'hness the Grand Prior, has approved the award of the folk,wing thirty-seven Service l\ledals and sixteen Service Medal Bars :Glamorgan County Centre. - County Officer W. J. Skyrme, Corps Supt, A. Bate, Corps Sec. T. D. John, Corps Treas. E. J. B. Trott, Corps Treas. L. Owen, Diy.

Priory for Wales. Twenty Years' Achievement. ASSOCIATION AWARDS (THOUSANDS)

TRANSPORT

BRIGADE PERSO~NEL

M I LES (1000 ' S)

(THOUSANDS)

245

St. John Personnel at a First Aid Post" Somewhere in London."

16,368 AWARDS

1937

The~e provide the First Aid

Post with minor casualties in the form of cuts, bruises, burns, fractures, eye injuries, etc., whilst not a few outside casualties caused by the "Blackout" have come in to be treated. . When an air raid warning is given, there are many dutIes that have to be done, such as dressing ambulance drivers i.n p~otective. clothing, also one of the 6rst aid personnel, !Jght1l1~ hurncane lamps, etc. After this the entire personnel proceed to the Air Raid Shelter. where they await the "All Clear," or the order "Action Stations." Should Lhis. order be rec.eived, everyone goes to their appointed statl.on, and, wllll~t awaiting casualties, time is spent in ge~t1l1g. ready dress1l1.gs and lotions, preparing for gas casualttes, 111 ~act, makll1g preparations for all eventualities. The Supenntendent sends out a "chit" giving the nature of the raid-whether gas has been used or not and whether H:E ..or in~endiary bombs, or bOlb, have been'dropped. By thiS time It has generally become known whether it has been a real raid or only a "mock" one and whether the casualties which will be brought in are 'to be the genuine thing, or only imagillary ones.

Bri.g-ade members arranges a monthly Whist and Bridge Dnve, and plans are well ahead for a Christmas Dinner and Cabaret Show.

1936 1935 1934

1933 1932

The ambulance cause in- Bristol has lost, by death, a member who had devoted his life to first aid. County Officer A. Cotton, who passed away on November 12th, at the age of 77, had served the St. John Ambulance Brigade fOf 40 years. 3

"The pu blic are realising that there is a St. John ambulance in Tunbridge \\Tells and tbat it is doing a great service for the public," was the final comment of the Mayor (Ald. C. E. Westbrook) when on Sunday, November 5th, a 25-h. p. Sun beam am bu lance was accepted from M iss Ada Carr and dedicated by the Rural Dean, the Rev:' Canon T. G. Gilling-Lax. ..

1931 1930

192.9 1928 1927 1926 1925

1924 1923 \

1922 1921 1920

1919

12,794 STRENGTH

9439 I'SSUES

280

315

FIRST

I22

Supts. T. J. Jones, P. H. Richards, G. H. Pilliner, Ambulance Officers T.]. Morgan, J. L. Jones, C. H. Keen, S. Edwards, Sergeants C. H. Davies, W. H. Murphy, Cpls. O. Price, C. Beavan, W. Matthews and 1. 1. Lewis. Monmouthshire Centre.-Corps Secretary W. Osborne, Corps Inspector of Stores V. Smith, Div. Supts. C. H. Muschamp, H. C. Evans, F. J . Whitcombe, Sergeant G. E. Fryer, Corporals W. Rogers, W. J. Belch, E. Protheroe, Privates T. H. Edwards, E. W. Jones, F. J. Parslow, W. Williams, A. Ball and Ambulance Sister E. A. Mogford. Denbighshire Centre.-Div. Surgeon T. Hampson, M.C., M.B., Ch.B., Div. Supt. J. E. Harris, Sergeant C. H. Davies. Cardiff Centre.-Ambulance Officers L. W. Parker and T. L. Dayment.

Service Medal Bars (First). Glamorgan Centre. - Div. Supts. J. Ings and G. Barnett. Monmouthshire Centre.-Corps Treasurer C. Bassett, Amb. 0t?cer A. Williams, Sergeant W. D. Jenkins, Corporal W . LewIs. Cardiff Centre.-Private E. H. S. Jos ty.

Service Medal Bars (Second). Cardiff Centre. -Dr. Edgar Llewellyn, Commissioner. Monmouthshire Centre.-Corps Secretary W. Price, Corps Treasurer W. J. Little, Corps Inspector of Stores C. R. Lee and Private A. Roberts. Servzce Medal Bars (Third). Monmouthshire Centre.-Corps Sec. W. H. Jones and Div. Supt. H . Dennis. Borough of Merthyr Tydfil Centre. - Corps Treas. J. Wooding.

Sen.'ice Medal Bar (Fourth). Borough of Merthyr Tydfil Centre.-Amb. Officer E. Withers. In referring to the cherished awards for efficient service it is well to remind Secretaries of Units at this time of year: ~hen annual retur.ns add to their onerous duties, of the Importance of theIr responsibility to record all details accur~tely. and clearly, so many members having been pe~ahsed I~ the p~st for delinquencies on the part of officers. ThIS year.' I? partIcular, too mudl stress cannot be laid upon the SUb~ISSIO~ of returns and it is very important that members servmg WIth His Majesty's Forces, should be so recorded as Headquarters have decided to adopt the same regulation~ as :vere in. for ce during thE' Great War, whereby members enlIsted, wIll be g ranted Brigade efficiency.

------ .--. ------

AID WARWICK AND TUNSTALL'S FIRST AID TO THE INJURED AND SICK Edited by F. C. Nicholls, M.C., M.B., L.D.S. Bristol: John Wright & Sons, Ltd. P1'ice as. 6d. net. This is the 17th edition of a deservedly popular book which, as an advanced ambulance manual, has served two gE'nerations of first aiders. Its chief features are a more complete account of gas poisoning in warfare and the addition of a new section on the civilian respirator which gives full details of the apparatus and how to fit 'use and take care of it. ' As in previous editions the manual is divided into two main. sections. In the first the essentials of anatomy and phYSIOlogy are. set for~h exte~sively. and occupy 81 pages. I~ the sE'cond InstructLOn begms wlth a description of the trIangular, roller, four and many tailed bandages. Next follows detailed instruc~ion i~ the treatment of bleeding, wo~nds, fractures and dIslocatIOns, and in many instances a ch~\ce of methods .of treatment. Incidentally, Fig. 209 whIch shows the axIllary pad for fractured clavicle outside the coat, will not appeal to those who have been trained on the St. John Syllabus and who realise the need to place the pad within the axilla. After t?is. comes an admirable chapter on asphyxia with a full deSCrIptIOn of three methods of artificial rE'spirationSchafer, Silvester and Laborde. We note however that the description of Silvester (at long la~t correctl~ spelled !) differs from that taught by the St. John Textbook. N ext there is a useful chapter on poisons, of which an ~Ipha~etical l~st (covering six pages of small type and 1Oclud1Og speCIal symptoms and treatment) is a noteworthy feature. . The~ , .~fter careful instr~ction in the handling of cases of msenslbllIty and of the various local injuries, there comes an excellent chapter on transport, in which the subject is treated from all angles-on land, by rail, sea and air. Next follows an augmented chapter on gas poisoning in warfare. . The. manual c.loses with a chapter on competition work, which w~ll be serVIceable ~o th~se commencing this branch of first aId, a glossary whIch will be of assistance to junior students and a comprehensive index. We again commend the manual to all students of first aid and especially to those who are seeking an advanced ambulance handbook. ARTIFICIAL RESIRATION IN A.R ,P. London: The Royal Life Saving Society, 8, Bayley-street, Bedford-square, w.e. Price 6d. net.

Reviews. This pamphlet has been prepared to indicate the value ANATOMICAL

MODELS OF THROAT AND FEMALE BODY. London : Messrs. Allmans & Son. P1'ices: Throat, as. " Female Body, as. 6d.

. These are two useful anatomical models which measure 7. Inches by 5 inches and in movable manikin form resent dIfferent and organs of the body , e ac 11 b' . d b parts d " ' emg Paccompanle y escnptlve letterpress key. The first deals with the throat a~d the second with the female human bod . . B~th wIll be of service to students of anatom y wh Wlt~l .tlle models before them, will be able to apprecfate tl~~ positIOns and relationshi,rs of the internal organs more full than they can from readmg- descriptions thereof in te;\.tbook!.

~f artificial respiratio~ in w~r-time.. It has just been pubIIs~ed by the Royal LIfe Savtng SOCIety which seeks to rally

sWImmers already trained in life saving and to place their expert knowledge at the service of the A. R. P. authorities. Ar~jficial respiratio.n is often a long, drawn-out process; and so It follows that 10 an emergency such trained personnel could release the first aid personnel for the treatment of other types of cases in urgent need of assistance. The pamphlet is divided into three parts. In the first the value of artificial respiration is made evident and also th~ ways in which the need for it might arise during an airraid. In the second paft the method of performing the necessary movements are described precisely as Shafer taught and approvE'd i~ 1931, together with some very usefl-ll notes on the phYSIOlogy of the circulation, respiration

FIRST and resus~itation. I n the third part are some further valuable notes on practical points in artificial respiration, on insensibility and shock and also on the history of the subject. Without hesitation we commend the pamphlet to a ll readers of FIRST ATrJ ; and we thank the compilers tor their most useful and instructive contribution to an essential item in the practice of first aid.

Emergency Medical Services. MEi\IORANDUM No.4, issued by the Ministry of Health , for the Guidance of Medical Officers anJ other Personnel at First Aid Posts (3 t d. post free), contains some very interesting data. First aid posts, we read, have been set up with the intention of protecting casualty hospitals from a rush of minor and ambulant cases and providing early treatment in those districts wherE' the hospital is some distan ce away. The function of the first aid post is : 1. To treat and send to their homes the slightly injured and those suffering from nervouS shock. 2. To arrest hccmorrhage, relieve pain, and so prepare those casualties who may be found to need institutional treatment that they can be transferred to the casualty (receiving) hospital with the least poss ible harm, i.e., by having taken steps to prevent any immediate deterioration. Qualified and unqualified personnel staff both fixed and mobile posts; and it is for the doctor in charge of the post to determine and give instructions, durin g the collective training of his personnel, as to the extent of which treatme nt will be undertaken and in how far the personnel may act independently of his assistance and advice. A word of warning is given to the first aid worker. The duty of such a person is not to try and accomplish too much as this may only be done at the expense of the patient. We have often come across the first aider who, after but six lectures, is of the opinion the he (or she) has learnt all that there is to kn o w. First aiders should ::Ilways keep in mind Principle 13 in the St. John textbook-" The first aider must on no account take upon himself the duties and responsibilities of a doctor." Under" General" we find that the aseptic condition of dressings is stressed and that dressings applied should ~ot be removed unless it is thought that with a clean dreSSIng the patient might be sent home or unless some other cause warrants it. Then follows notes on small skin wounds, the result of explosives which may inAict serious injury to underlying parts; severe injuries to soft tissues when it is suggested that the part should be splinted; multiple wounds; hccmorrhage, drawing attention to the correct application of a tourniquet; partially detached limbs whIch should .be removed at an aid post. It i:> seldom necessary to give general anresthetic in such cases-morph!a, which w~uld have been administered, u!'lually suffiClOg; abdomInal wounds; ear injuries; burns, which should be covered wit.h a burn dressing (picric acid) ; morphia; and A. T. S. ThIS latter, tetanus antitoxin, should be given to all casualties with open wounds, the routine dose being 2 C.c. of standard serum (2,600 international units). ORTHOPAWIC INJURIES Here, again, it is sug-gested that in the treatment ~)f those cases, accompanied with op~n ,:ou?ds, tl~e'y WI\I require an injection of tetanus antltoxlO 111 addItIOn to temporary treatment of/shock and ha~ mo~rhage. . . Under I I Wou nds of Joi nts" are InstructIOns to Immobilise with splints after the appropriate dressing h::-s been applied; whilst with I I Compound Fra.ctures" morphIa gr. ! for an adul t is suggested if wound IS severe or very painful.

AID

12 3

Numerous suggestions are then given as rough guides to the best methods of temporary fixation for compound fractures of va rious bones, the following being some uf them. Shoulde1' region including uppe1' part of hUlIlerus.-Put forearm in sling and bind arm to trunk with circular turns of roller bandage over sling. Shaft of humenls.-Bandage straight wooden splints or pieces of gooching to outer and posterior aspects of humerus. Put wrist in sling with elbow at right angle and bind arm to trunk. R egion of elbow joint and upper t'loo-thirds of forea1'l1l.Fix elbow at right angles on Jone's arm splint or one made of Cramer splinting, if available, extending from shoulder to knuckles, apply sli ng to elbow and forearm. Lower tlth'd oj /0 rea 1'711 and 'lvn·st.-Apply straight splint to front of forearm and palm extending from just below elbow to creases in palm. Apply a sling. Buttock and uppe1' end of fe11lur.-Apply a long Liston splint. Femur.-Apply a Thomas splint with the ring on the large side, and with three or four double strips of bandage, to act as cross slings between the side bars for the support of the limb. Extension should be obtained by supplying a bandage about the ankle as follows : Take about nine feet of bandage and with it form a clove hitch r ound the ankle in such a way that of the two free ends, both lying on the outside of the ankle, one is roughl y twice the length of the other. The long end, which should be ne xt the anl.de, is passed under the instep and up through both loops of the bandage on the inner side of the ankle. Th e two ends of the bandage are now ready to be tied to the foot of the splint to maintain extension of the limb. The boot or shoe need not be removed. Applya supporting splint or piece of Cramer splinting to back of thigh. Adjust the cross slings to support the splinting and the calf. Stead y the knee in the spli nt by inserting a padding of tow or wool on either side and applying a bandage around the splint and knee. .. . Ma ke sure the leg is supported so that the knee Jomt IS not quite extended, or it may be strained. Sling the foot of the Thom as splint to a suspension bar fixed to the stretcher. Fractures of Tibia and Fibula. C'Pper two-thirds.Apply Thomas splint with extensio? as for femur with splinting fitted to calf instead of thIgh. Both knee and ankle should be stabilised by padding and bandages. Lower tlti1d and a1ikle.-Apply back splint with footpiece or Cramer splinting bent to fit calf and foot, holding ankle at 90 de grees. Readers will note how the instructions differ somewhat from the tea ching of the recognised associations. HEAD INJURIES. General treatment for shock and against tetanus should be given but doses of morphia should not be more than k grain. . on-penetrating wounds should be treated \0 the manner of \,vounds in other places. Open head wounds, such as those wl1f're the skull has been penetrate.d, should not be taken to an aid post, but such cases that. arnye should be treated with speciaJ antiseptics that wIll not cause damag-e to brain tissue. . The id eal procedure in cases of open head wounds IS set out, but it is emphasised that it is generally beyond the capacity of first ::lid posts and that such cases ~hou.ld be evacuated as soon as possible to the casualty hospItal 10 the vicinity. CHEST INJURIES. After general preliminary treatment for shock, hremorrhage and prpvention of tetanus, twO! gramme tablets of

124

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M. & B. 693 (one of the Sulphanilamide group) can be given. After carrying out such treatment and as soon as the condition of shock will allow, the patient should be sent to the nearest casualty (receiving) hospital. Those patients found to be suffering from injuries due to crushing, which is usually accompanied by fractures, should, if dyspn cea (difficult breathing) be considerable, be placed in a slightly raised position. Adhesive strapping from below upwards extending over the middle line in front and behind, should be applied, care being taken not to cause perforation of a rib through the skin or into the lung. Small penetra(ing wounds should be dealt with as necessity demands. MAxILLa-FAcIAL INJURIES. Prevention of suffocation and the arrest of h;:emorrhage is the chief early treatment. After general treatment for shock and against tetanus those cases requiring further treatment !>hould be sent by the Medical Officer to the nearest casualty hospital. It is emphasised that a nurse or orderly mus( remain with the patient during transit by ambulance to the hospital. The danger of suffocation, it is pointed out, is commonly due to loss of control of the tongue. It is, therefore, suggested that a wounded person should be placed face down wards with his head hanging over the end of the stretcher and any foreign body present removed from the throat. If patient is able to walk we note he should do so in a stooping forward position. If, in spite of positioning, the patient still shows signs of becoming suffocated personnel are instructed to seize the ton~ue with a pair of forceps or put a suture through the tongue and pull forward. For the treatment of a fracture of the lower jaw instructions state, "The ordinary triangular bandage should not be used as it is likely to increase the displacement of the fragments by its backward pull. The' barrel' type of bandage is suitable and easily applied and gives an upward and forward pressure well back from the chin and relieves pain." After reading the foregoing instructions we made enquiries as to exactly what was a " barrel" bandage. The result of such enquiries w::\s published in this JournaL For feeding purposes a feeding cup with about 3 in. of free rubber tubing is suggested. Other sections of this Memorandum deal with neurosis; warning labels; records to be kept at aid posts, and gas casualties. There is also an appendix giving the opium dosage for cleaning burns and scalds. Readers will find that the scope of first aid has been extended far beyond that usually accepted. The giving of hypodermic injections, even undt:r the direction of a medical officer, is but one great advance.

Red Cross and St. John War Organisation. " SUMMARY of vVork" No.3 gives further particulars of the work of the Organisation. At an Executive Committee meeting held last month the following appointees were received: Field Marshal Sir Philip Chetwode, as representing the Society; Major General Sir John Duncan, as representing the Order; Lord I1iffe, as representing the Lord Mayor's Executive Committee; Sir Walter Citrine, Mr. William Holmes and Miss Florence Hancock, as representing the Trades Union Congress. Sir Philip Chetwode and Mr. William Holmes were appointed members of the Finance Sub-Committee. Survey of B. E. F. needs, local finances, flag day receipts, comforts and Red Cross, and addresses where to send comforts are among the items given publicity. "The Red Cross Fund" is the title of an article by Lord I1iffe, whilst departmental activities are discussed.

FIRST

AID "Summary of Work" No.4 refers to the Queen'<; book of the Red Cross. Her Majesty bas personally sponsored the book and has contributed a messag~ \Vritten by her own hand. Fifty famous authors and artists have collaborated to make the book a really wonderful production. We earnestly ask all readers to purchase as many copies as possible. Get your friends to give copies as Christmas presents. At 5/- it is an inexpensive gift and one which will give pleasure to the recipients and, at the same time, it will help to swell the Red Cross fund to which all profits will go. Copies of " Summary of Work" can be obtained from the War Organisation Headquarters, 14, Grosvenor-crescent, London, S. W.1, at the following rates: 12 copies, 1/6 ; 25, 3/- ; 50, 5/ 6; 100, 10/-, all post free. The secretary of the Lord Mayor's Fund has informed us that pre{:arations have reached an advanced stage for the organised mass-collection of tin foil. This embraces all classes of metal foil including that from cigarettes, tobacco, tea, chocolates, cheese, etc., metal caps from milk bottles, empty tubes of dentifrice; face cream, shaving- cream and other similar types of containers. Discarded aluminium cooking utensils. aluminium boxes and tubes, such ::\s those used for medicinal and beauty preparations, are also included. Readers are asked to assist in the collf'ction of such items which will not only add an appreciable amount of money to the Lord Mayor's Fund, but will maimain in circulation a valuable metal which has been allowed to go to waste. The Central Receiving Depot for all foil collected is Canterbury Works, 53, Canterbury-place, London, S. E.11.

Death of 01--. A. T. Lakin. WE regret to announce the death of Dr. Arthur Thomas Lakin, which took place on November 11th. Dr. Lakin, who qualified 42 years ago, was a g-reat advocate of First Aid, and was associated with the British Red Cross Society, being the author of the Society'S Elementary Manual of First Aid. It is, however, his work for the Order of St. John for which he will be most affer.tionately remembered and sadly missed. Over 30 years ago he began instruction to railwaymen of the former L. & Y. Railway Company, and his interest grew throug-hout the years with that Company, and later with the L.M.S. He made a special study of the subject of First Aid, and his knowledge and advice, recognised throughout the country, was sought by the Order of St. John on a number of occasions, and particularly during the past few years in regard to the revision of the St. John Textbook, in which connection he was one of a committee appointed by The Order. Dr. Lakin was also prominent in First Aid circles amongst miners and police, and as a competition judge his name was prominent throughout England and Wales, having frequently judged national' competitions of the Police and Railway Organisations. In recognition of his services, he was recently created a Commander of the Venerable Order of St. John of Jerusalem in England, and was the proud possessor of the Service Medal of The Order, an almost unique distinction. Dr. Lakin's death is a sad occasion for the first aid movement. At competitions he was always ready to help competitors, Riving credit where credit was due. On the other hand, if the work had been badly done, he did not hesitate to say so. At the Police National Final but a year or so ago, he prefaced his remarks with "I am a tired and disappointed man," and then told the competitors their mistakes. To Mrs. Lakin we extend our deepest sympathy.

A.ID

12 5

Ask these Questions about your First Aid

ANTISEPTIC The importance of havin?; the right Antiseptic for First Aid use is now greater than ever. Modern research has shown that many antiseptics, when used on the tissues, do more harm than good. So when selecting your antiseptic, ask thesequestions:-

Is it REALLY Safe?

Lady Ambulanre Officer Miss D. E. Kindon of No. 34 (Barking) Nursing Division, No.1 District, S.J.A.B., with trophies won in local competitions. Miss Kindon completed 15 years service in December, 1938.

Treating Burns with Aniline Dyes. THIS treatment was originally based on. the the.ory. that t~e heat causintY a burn broke down the skll1 protell1s 1I1tO tOXIC agents, whi~h, in turn, ca~sed the toxemia. se~n in burned patients. A later theory IS that the ~oxemla .IS du.e to the invasion of the burn by streptococcI. Gentian ViOlet has been successfully used as an antiseptic against these streptococci and investic.ration has shown, it is claimed, that even better :esults can b~ obtained if use is made of a combination of the three aniline dyes-gentian violet, brilliant green and neutral acriOavine. After the patient has been treated for shock the. burned area is exposed to air under a cradle. All loose pleces of skin are excised, but no attempt is made to do complete ~e bridement. If the burn has been previously treated With any oil or salve this must be. removed, ~l1e method of removal being to pat the areas 1I1volved With a sponge .well soaked in ether. The burned areas are then sprayed With a 2 per cent. of the solution of the mixture of the three. dyes. The spraying converts the upper layer of the burn II1t~ a flex.ible crust, which protects the burned nerve ends .whtl~, at the same time, the burn is sterilised by the antlse~tlc action of the dyes. All the w,ay thr?ugh. constant atten.tlOn must be given to this crust; If any 1I1fec~lOn gets under It at any point that area becomes soft and mOist. The treatmen.t continues until healing is complete under the crus~, or untt! the underlying structures have healed ~o th~ pomt where they will accept skin grafts.-Sajety Engmeenng.

-------.--.------FouND. -Medallion No. 251694. Owner can have same returned on application to Mr. F. H. Deeley, 6, Audleyroad, South Yardley, Birmingham, 25.

To be really SAFE, an antiseptic should be absolutely jree from irritating or caustic action, and also non-poisonous. It should be non-inflammable too, and capahle of being used, in emergency, undiluted-sttaight from the bottle. It should be unaffected by keeping, or exposure to air. T. c.P. has all these properties.

Is it effective in preventing Sepsis? The fact that an antiseptic destroys germs in a test tube of water- is no guarantee that it will kill germs in the tissues. Blood, pus and se;um rend.er many antiseptics ineffective i.n. preven.tll1g sepsl~, because they destroy its germlC1dal actIOn before It can reach the germs. T. C. P. has been pro7.'ed ejfecHve in destro)'~ng sepsis g-erllls even in deep!.)' iJ~rested suppuraizng wound~. Blood, pus and serum does not a.tfect its germicidal j07.fJer. These are some of the reasons why T. C. P. has been so widely adopted for First Aid ~se. Bu.t th~re are other reasons too. T. C. P. reheves pa1l1 (111 valuable in cases of shock). And actual tests show that it actually speeds up heal.ing;-and ,Prevents the forming of scars. Safe, SWift In actIOn, alw,:ys ready for instant use-T.e. P .. has all the properties of the ideal First Aid Antiseptic. If you have not tried T.C.P., send to-day fora sample and the T.C.P. First Aid Book. Post free, on application to BRITISH ALKALOIDS LTD., 69, Old Broad Street, London, E. C. 2.

.~.

eRe1d.

THE IDEAL FIRST-AID ANTISEPTIC EXACTLY OF THE

FULFILS THE REQUIREMENTS S. J. A. A. TEXTBOOK NEW

FIRST

126

AID

FIRST ~EQUIP

YOURSELF

Railway Ambulance News. Great Western. The present el11er~ency leaves no doubt in the m inds of any of the value of a first aid t ra ining, and in spite of the fact that a record year was achieved by the Great Western Railway Centre last year, when no fewer than 9,07 5 members passed a successful examination, there wo uld appear to be a prospect of another successful year. New classes, and re-examination of old classes, are being held all over the system. Although in present conditions neither the InterRailway competition of the St. J ohn Amb ul ance Association nor that of the Priory for Wales will be held, there is no lack of enthusiasm among G reat \Vestern Railway ambulance men who are maintaining, and using to advantage, their training. LISKEARo.-The Mayor of Liskeard, Councillor J. H. Pitts, who is himself a rail wayman, presided over t he annual presentation of ambulance awards at the station on November 8th, and said at Liskeard there were always 30 tra in ed ambulance men to deal with any emergency. He was particularly proud of the fact that 12 of these members held the Company's gold medal for 15 years' efficiency. His Worship was himself a member of the class. The presentations were made by Mr. S. Pearson, Assistant Traffic Manager, and included a 20 year gold efficiency bar to Mr. James Moon . Tribute was paid to the medical lecturer, Dr. J . G. Morgan, and to the class secretary, Mr. P. D. L. Moss, and an appeal was made for young recruits to the movement. Reference was made by Mr. J. H. Tippett, Divisional Ambulance SecrE.tary, to the record of 9,075 men who had passed a successful examinat ion u nder the Great \\'estern Railway Centre last year, to which record the Plymouth Division had contributed no fewer than 538 members. WESTON-SUPER-MARE. - The Mayor of Weston-superMare, Alderman Henry Butt, was present at the annual distribution of awards to members of the Great Western Railway ambulance class on November 6th, when Mr. R. G. Pole, Divisional Superintendent, presided and .made the presentations. A report of the class's progress was made by the secretary, Mr. A. C. Napper, who refer red to the absence of their lecturer, Dr. Kerrigan, with the Forces . Mr. Pole spoke of the generos ity of the Mayor, who had already given five cu ps for ambulance work on the rai l way, and who had now promised, in addition to his trophy for lo.-:al competition at Weston, to present gold medals to any team achieving distinction in the Company's final contest at Paddington. Among other speakers, who paid tribute to the class secretary and instructor, M r. Napper, we re Mr. Burgoyne, station master, and Mr. W. E. Wills, d iv isional ambulance secretary. The presentatio ns included 62 examirJation awards and a number of ~ol d efficiency a wards, among them being the 20 year bar for Mr. Nappe r, a nd t h e 2S year medal to Mr. J ames Palmer.

London, Mid land and Scottish. The ann u al report for the year end ed Ju ne 30th , 1939, has been recently issued. O nce again we a r e pleased to

note a s u bstant ia l in crease in st uden ts as co mpared wit h the previous year. The actual figures are 1, 790 fi rst year, 943 second year, 594 t hi rd year, 6,067 fo urth a nd s u bseq uent yea rs, m a kin g a grand total of 9,394 as agai n st 8,499 ; a n in crease of 895. M r. G . S. Hill, Ge nera l Amb ul a nce Sec retar y, stresses the importance of co ntin uin g th e existin g classes a nd of orga nising new ones w herever th ere a re prospects of fres h interest. COMPETITIONs.-D uring t he year un der rev iew 489 teams entered in the D istr ict Competitions, th is bein g t he highest n u m ber since 1930. I n the nna l competitions Crewe Machine Sh op were placed first , after a t ie w ith Cam de n Goods A. Crewe a lso took nrst place in the I nte rn at ional com peti tio n. For the second year in succession a team of the L. M. S. gained first place in the Inter-Railway Competition. Camden Goods A, fi rst appearance in the fi na l, now holds the J nter-Railway Shield. Twenty-two women's teams entered the prelim ina ry round, the final being won by London C team . SERVICE A WAHDS. -Since the formation of the Centre the following long service medals and bars have been awarded to members in England an d Wales: m ed a ls, 3,464; 20 year bars, 1,517; 25 year bars . 763; 30 year bars, 303 ; 3S year bars, 80 ; 40 year bars, 12. In add ition 2,036 medals and bars have been awarded to members in Scotland, including 3 bars for ..J-5 years' service. HONouRs. -During the year twenty-three membe rs of the L.lYl. S. Centre, including doctors, received recognition from the Order of St. John. GENERAL. -The award of the Meritoriou s First Aid Certificate had been made to Herbert Hockey, clerk, Goods Dept., Manchester, for ass istance gi\'en at an acc ident on May 6th, 1938. Mr. Hill, in h is closing par agraphs, pays t rib ute to t h e invalu able help received from members of the medica l profession , district secretaries a nd committee members, class secretaries, instructors and divisional welfa re s u pervisors; also to officials of the St. John Ambulance Association and the Priory for Wales.

Southern. The "Walker" Chall e nge Tro phy, prese nted by Si r Herbert Walker, awarded ann ua lly to the D istrict showi ng the greatest increase in first aid members hi p in pr opor tion to the number of staff e m ployed in t hat di strict, h as t hi s yea r been wo n by No.1 B District (Lo nd on Subu rban Area). The presentation was made at Wate rl oo. o n Monday, November 6th, by 1\1r. W . Geo . Pape, Cha irma n of t he Southern R a il way Centr e, in t he un avoid ab le abse nce of M r. E. ]. M issenden, Genera l Manager. M r. E. Uzze ll (Welfa re Officer), M iss Grind ley a nd n umerou s C lass Sec reta ri es we re present. In ha nd ing over the much coveted t roph y, lYl r. P ape gave a n inspiring message fro m t he Ge nera l Ma nal2"er, wh o m uch r egretted his inabi li ty to do S0 perso na ll y, a nl said t he winners had done remarkably well to obta in so m a ny recr u its. He stressed t he fact t ha t it was 111 0r e than e ve r necessary that the w hole of the staff sh ould have a k no wled ge of first a id at t he presen t t im e. . Mr. E. ] . P rew, in thankin g Mr. Pape fo r presenting the sh ield , a lso t h anked his Class Secretaries for t h e s uccess-

AID

FOR WAR Essential

EMERGENCIES~

knowledge to treat successfu ll y, ALL possible injuries,

THE

HOUSEHOLD PHYSICIAN Describes in SI MPLE LANGUAGE such necessary inform ation with helpful plates and diagrams.

AND FOR MORE PEACEFUL TIMES The COMPLAINTS OF ME N, WOMEN AND CHILDREN , Their Cause, Treat me nt and Cure with

complete

instru c t ions

on First Aid.

The 500 illustrations and full- p a g e Plates and the Anatomical Model showing the Organs of the Human Body exactly as they ov erlay each other makes the reading matter mor e easily understood.

ACCIDENTS A few of the Subjects t ..eated:

WAR EMERCENCIES :Gas Warfare First Aid Bandages Splints Burns Scalds Hcemorrhage Fainting

PEACE TIME SUBJECTS:-Influenza,Colds,etc. Measles, Mumps Catarrh Corns and Warts Physical Culture What to Do in Emergencies Treatment for all Skin Diseases The Lungs, Pleurisy Hygiene, Anatomy, Pharmacy The Principles of Nursing The Eye, the Ear The Throat, the Nose The Chest, the Heart The Stomach, the Liver The Teeth, the Muscles I nfant Welfare Homrepathy, Neurasthenia 375 Prescriptions, etc., etc.

vrhat

case

of:

Bodily Injury, Burns a nd Sc al ds , Clothing Alight. Foreign Bodies in Eyes, E ars, Nose, Throat. Machinery Accidents , E l e c t ri c ity Accidents. Drown i ng, Suffocatio n, B l ee ding, Poison, Broken Bones, Fractures, Dis l oc a t ions, Sprains, Fainting, Concussion, Etc .

THE YOUNG WIFE wil l find just the information she rf'quires. MOTHERS who wish their daughters to develop naturally will find exactly the teaching they need. WOMEN OVER 40 will find their difficulties regarding health frank ly discussed. BEAUTY CULTURE-Complexion Diets, Wrinkle Cures, Care of the Hands, Mouth, Eyes, Hair, Recipes, etc. PRESCRIPTIONS -375 proved remedies. There are hundreds of s u bjects. The muscles, teeth, digestion, hair, food values, Jujitsu, Phrenology. How to diagnose diseases !ro~ appearance of head, face, neck, tongue, throat, chest, perspiratIOn, etc.

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MESSRS. VIRTUE & CO., LTD. , F.A. Dept., 19, 20, 21, THAVIES I NN, LOND ON, E.C.l. Please send me FREE Booklet on " THE HOUSEHOLD PHYSICIAN," stating cash price, also monthly terms of payment without any obligation to purchase. NAl\1E . .

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FIRST

AID

FIRST --

ful fruition of their work, and expressed determination to further the work of the Centre. Mr. Pape then handed over a replica of the shield to last year's winners (No. 1 A District) w!1ich Mr. E. Boo~man, representing 1\1 r. W. Hag-ell, DIstrict Secretary, sUitably acknowledged. RAMSGATE.-Owing to the national emergency, the concert which was arranged for the presentation of awards in connection with the Ramsgate class, had to be cancelled. The awards were presented at the opening class night by Dr. N. Gordon and Dr. R. ]. Archibald. In opening the meeting-, Mr. Sinden. who presided, welcomed the doctors and also new members. Dr. Gordon said how pleased he was to see that the small service which he was able to render, had been a big help to the members. It g-ave him g-reat pleasure to lecture to railwaymen, and he was pleased to see new members whom he hoped would have a successful session.

Ambulance Trains. THE British Railways have completed a number of ambulance trains for use both at home and overseas, the work upon different types of vehicles having- been entrusted to the various companies' works at Derby, WolverhaOlpton, Swindon, Doncaster, York, Eastleigh and Lancing. Each train is fully equipped with cars for the accommodation of travelling staffs of doctors, nurses and R. A. M. C. order! ies; wards for lying, sitting and mental cases, and travelling pharmacies, while kitchens and cars for infectious cases and stores are also provided. The details of design had been previously completed by the L. M. S. on behalf of all the com panies, and at the outbreak of hostilities the companies had already agreed to the types of vehicles they would convert. The general difference in this procedure from that adopted during the War of 1914-1918 was that instead of

AID

12 9

-----

In the p esence

of blood

it is a marked property of' Dettol' that it maintains

high germicidal efficiency when blood or pus is present- even in considerable quantity.

The value in emergency of this

modern antiseptic- which can be user] rapidly without danger, discomfort or staining---is now everywhere acknowledged.

, TRADE MARK

Sold by Chemists and Medical Suppliers in bottles, 1(-, 1/9, 3(-, 5/- and 7(6, and in larger sizes for Medical and Hospital use. These prices do not apply in Eire or Overseas. Sample, and full information on request.

The Modern Antiseptic RECKITT

SONS,

HULL

LONDON.

( PHARMACEUTICAL

DEPT ..

H U L L)

C a ~te ~ S~I I I I I I I I I I I ,I I I I lI I I I I I I I:11111II

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1 ...... vALID

Interior of Ward Car, Beds Down. Dr. Archibald expressed his pleasure at being with the members once again, as he thou~l1t it was his 34th year that he had been with the class. He thanked all the members for givin~ up their valuable time in training for such a national service. The Secretary (Mr. G. Pointer) reported that seven members had been called to the colours. Twenty-two new members hid joined the class and he was expecting- more to enrol. He also said that No.1 team were successful in winning the cup in the competition this year. Mr. Sinden was thanked for presiding and in reply said he was more than pleased to see so many new members.

At the annual g-eneral meeting of the Yorkshire Collieries Ambulance Leage, it was announced that the Executive Committee had decided that the objects of the League were of vital importance and that the competitions should be maintained.

Whatever the Chassis use Carters ' Am bu Ian ce Fittings.

FVR.N ITU R.E

Sectional Catalogue 7A, which is free for the asklng, describes this .Patent. Stretcher Elevating Gear, which is a triumph ID compactness and scientific design, and the whole r~nge of Ambulance Furniture and FlttlDgS.

By Appointment.

WRITE FOR IT.

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The most up-to-date and scientific in the world.

each company converting complete trains of eacl1 type of veh icle, they specialised in particulu types, which were subsequently sent to a central point to be mar.c:halled into trains. This procedure minimised the variation and quantity of materials and fittings to be provided by each factory, and thus permitted complete trains to be formed within the shortest possible time. The L.M.S. Company had also been responsible for the purchase and manufacture of material, which was forwarded to each factory within a few hours. Further, the vvhole of the vehicles converted were selected from L. M. S. coaching stock, and were located and forwarded to each company immediately, to enable the work to be put in hand. In addition to fittings already on hand, each company manufactured a larg-e amount of others, including- furniture, this work proceeding concurrently with the stripping and reconstruction of the cars, many of which had to have new side sections, embodying double doors, new partitions and interior casing-. Each home train is composed of nine vehicles of seven

THE NEW "PORTLAND" GEAR (Pat. No. ?80963).

This new patent Ambulance Gear offers many unique advantages whether the Ambulance is carrying two stretcher cases or only a single case. A self-contained unit, it can be placed in almost any vehicle, and it makes the loading of either top or bottom the simplest possible matter. The "PORTLAND" Gear should be specified for an y new "9 Ambulance and it 1 125, 127, r-, 'd I prOVl' d es an 1 ea Great Portland Street, method of mod-

London, W.I. Telephone-Langham 1040. fe!egrams-"Bathchair, Wesdo, London.'

ernising. vehicles already 1 n use.

This illustration shows the clear gangway for load.ing the lower stretcher when only one case Is being cawed.

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FIRST

13 0

lypes, while there are sixteen vehicles of nine different types in each overseas train. All vehicles are 57 ft. long, mounted on four-wheeled bogies, and have side buffers, screw couplings and communicating gangway connections, the couplings and drawgear of the overseas vehicles being of Continental pattern with special type steam coupling-s for usp. with French locomotives. They are steam-heated- each heater being under separate control, while, in addition, independent heating is fitted in cars for the staff and personnel who may be required to live on the train at periods when no steam is available. The staff cars are provided with bedrooms, dining-rooms and bathrooms for the medical officers and nursing sisters. The organisation of each train is from an administrative car (o~ in the case of overseas trains, a pharmacy car), which comprIses a treatment room, offi ce for the l\ledical Officer in ch~rRe, and stores for medical supplies, and or. the home trains a compartment for silk officers together with a kit store. The "Ward Cars are fitted with cots supported on the body Side in tiers of three, with a central aisle for the passage s.tretchers and attendants, while ashtrays, paper rack~, splttrng ~ups and brackets to support fans are provided at the Side of each patient. At the end of each car ~s a sn:~ll compartment equipped with a sink and cupboard In additIOn to lavatory accommodation. . Adeq.uate c~oking an~ water-heating facilities are 10stalled 10 the kitchens which supply meals for both staff and patients, and there is ample accommodation for linen ~ood and domestic .sto res. Two such vehicles are provided 10 th.e ~vers~as trams, one of which embodies a compartment for slttmg ~Ick offi cers. There is a large capacity storage for water m each car, while drinking water is available throughout the trains. . A special. car is set aside for sitting up cases on the hnes of a CorrIdor Coach, but having washable upholstery while in the same car are two padded compartments fo~ mental cases. Lighting is by electricity, and arranged in such a manne~ that various ~ombinations of lamps may be switched off ~r. dimmed as deSired, and fans are fixed in all cars, in additIOn to portablE· fans in each Ward Car. The noors and whole of the interior are finished in such a way.that the train can be kept quite clean, and with the :xceptlOn of the .staff! sitti.ng-up, kitchen and guards' l-ol11partm~n.ts, the InterIor finish is chiefly in white enamel, thus provldtng- for the service being- administered under Jl1~st hygienic conditions. Large Red Geneva Crosses are painted on each side of the khaki-painted exterior and in the centre of the roof. TI~e trains, which are r~plete with every necessary con~enlenc~ and. may be .descnbed as hospitals on wheels, ~re In keeping WIth t.h~ hll;h ~radition of carriage construc~Ion of whIch the B~ttlsh Railways are justly proud, and it IS an undoubted achievement that six trains-comprisinG" a total of 82 vehicles of various types- were completed, m~r shalled and handed over to the Military Authorities in less than th:ee w:eks from the outbreak of war, while work was proceeding Simultaneously on a number of further trains.

- - -- .-. _ - -~n increase in the works was announced at the annual meetIng of the Oxfordshire County Centre of the S J A A held on November 21st. Classes number 128 and ca~d'id~t~~ 3,868. On Sunday, November 12th, 120 members the Ipswich Corps, S .]. A. B., attended the annual Armistice Service at S1. Michael's Church. A wreath was laid at the Memorial on beha~f of the Brigade by Corps .C;upt. F. E. Goddard and Lady Dlv. Supt. M. L Bines.

FIRST

AID

Suffocation-Sudden and Slow. entirely different and distInct acts of signs and symptoms. SUDDEN SUFFOCATION.

In this condition the signs are the sudden onset the dark bluish colour of face and extremities, the staring ~yes, the swollen and perhaps protruding tongue, t he distress or terror expression of the face and the unconsciousness of the patie~t during his violent efforts to breathe. These particular slg-ns are caused by some interference with the venous circulation of the blood. 1n hangz"ng and sb-angulaHon there is constriction round the throat, causing pressure on the great veins of the neck, and in chokzng the patient has pressure on the blood vessels f~om the. insi.de by the substance that is impacted or by the VIOlent 1I1splratory efforts which cause intense venous congestion. It is this pressure which causes the bluish colour in the :ace, and the eyes to be staring-. The efforts made to get air lOtO the lungs increase the congestion.

GET A

SPARKLET RESUSCITATOR

Keep this remedy for EMERGENCIES For quick and effective first-aid treatment of burns, scalds, cuts or wounds, no remedy surpasses 0.0.0. Brand Prescription. It is a powerful yet so~thing antiseptic liqUid which destroys harmful germs and promotes normal healthy healing. Cuts or wounds will not turn septic and the skin heals rapidly. If applied at once to burns or scalds the pain is eased, the skin will not blister and no scars will be left.

SLOW SUFFOCATION.

In this condition there is no pressure on the venous trunks. The symptoms are produced by the slow admixture of the poisonous vapour with the blood or by the deprivation of oxygen, whereby result increased drowsiness with no struggling and a placid face until at last insensibility ends very quietly in death. The death of a patient is caused by the fact that the oxygen which the .blood requires to keep the heart and grpat nerve centres actIve becomes g-radually diminished. The carbonic acid gas cannot be eliminated. Indeed more is taken in, and, in consequence, tile venous blood coming from ~he heart cannot get properly purified (or oxygenated) In the lung-s; thus the arterial blood gradually becomes venous. !h~ effect of this on the brain is to cause insensibility, and In hme the nerve centre for respiration becomes increasingly paralysed, and the chest movements become slower u.ntil they and respiration ceases altogether. At the sam~ time the heart becomes more and more paralysed until complete paralysis takes place and death ensues.

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TREATMENT.

The treatment is practically the same for both varieties. In all cases, however, the first thing to do is to remove the cause in ea~h particul-:r case. In choking, the foreign body must be dlslodg-ed; In hanging, the constriction must be removed; and so on. Next, artificial respiration must be started at the earliest mom:nt, and must be followed by the loosening" of all tight clothIng about the neck, che~t and waist to ensure that there is no restr~c[ion on the parts covered. If ha~ morrhag-e is present, thiS must have attention and medical help obtained at the earliest possible moment. Shock is treated by wrapping the patient in blankets and by applying. ~ot bricks or hot water bottles to his upper and low extr.emltles and body. On recovery of consciousness, the patient should be given hot stimulants (tea, coffee, m:~t extracts, etc.), in sips, care being taken first to test his ablhty to swal.low. While all attempts at physical exercise, such as walkIng, are best avoided until sanctioned by the doctor.

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13 1

BU RNS, SCALDS, CUTS, WOUNDS

•

TII~RE ar~ two kinds o~ s~ffocation which are recog-nised by

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Queries and Ansvvers to Correspondents. Queries will be dealt with under the following rules : 1.-Letters containing Queries must be marked on the top left-hand corner of the envelope" Query," and addressed to FIRST AID, 46, Cannon-street, London, E. C. 4. 2. - .-\,11 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 39th (1937) Edition of the S.].A.A. Manual of First Aid to the Injured. CAPELINE BANDA GE FOR HEAD. l.S. (Wetherby).-Fllrther to your reply to query, published under the above heading in the November issue of FIRST AlD, may I say that we of the Wetherby Nursing Division find no difficulty in following the instructions in the Nursing Textbook for this bandag-e, namelv to stand behind the patient and have the heads of the bandages directed towards the operator? Although this is contrary to the general teaching that a bandage is al ways commenced with the head fa cing outwards, in this parti c ular instance it adjusts itself when the bandages a re interlocked in the first turn at the back of the patient' s head. The bandage in the operator's left hand (horizontal ~andage ) then continues to be in the correct position (L.e. head of bandage outward) until the bandage is completed. The bandag-e in the operator's rio-ht hand (vertical bandage) is in the incorrect positi~n (bead inwards) whilst being carried from back to front of patient's head, but assumes the correct position (head outward) on the return journey, i.e., from front to back. May I also take this opportunity of thanking you for your very helpful suggestions and replies to queries through the colums of FIRST Am. VVe are most grateful. We thank you for your letter and comments.-N. CORBET FLETCHER.

its

interestin g

EXAMINATION HOWLER. S. L. (Whitwell). - In a recent examination the doctor asked one candidate how she would distinguish arterial hcemorrhage. She replied that it is scarlet in colour and comes from the side of the wound nearest the heart. The doct~r then said that there was yet one more point, and to hiS amusement the candidate added : -" Olz, yes I A rterial blood spits I " Good!

Next, please! !- N.C. F.

SLING W[TH FRACTURED HUMERUS. .\.S. (Heaton Park).-l should appreciate it if you could give me the reason why the Textbook (pp. 82 and 83) tells us to apply the armsling last with fracture of humerus close to the shoulder and first with fracture near middle of shaft of humerus. In the treatment of fractures the golden rule is " first control the fracture, then the splint (or splints) and lastly

FIRST

AID the limb." This rule is broken with fracture of humerus near middle of shaH because with the arm in its anatomical position, the front splint would rest directly on the biceps muscle. Consequently, the limb is first supported in an artnsling so that the splints may be placed" on front, back and outer side of the arm In /Is present posihon (my italics)."N.C.F. END OF DESCENDING AORTA . T. R. (Durham).-At what point does the descending aorta end? The Textbook, on p. 113, states that it divides into the two iliac arteries just below the second vertebra. The Frontispiece, however, shows the division at the fourth vertebra. In my perplexity I ask you kindly La tell me which is correct, The usual point of division of the descen rling aorta is said to be halfway down the fourth lumbar vertebra. Other surface markings of this point are half-an-inch below and a Iirtle to the left of the umbilicus, and also a line drawn across the front of the abdomen from tile hio-hest point of one iliac crest to the liighest point of the othe:i1iac crest.-N.C.F. TREATMEN T OF COMPOUND FRACTURE. the Textbook we are told not to extend the limb if a compound fracture is present; and an N.C.O. in charge of an Ambulance Station says that, if in such circumstances the limb is Hexed all attempts at extension should be avoided. I, how~ver, suggest that the limb can be straightened by gentle traction without extension. Please say who is right.

A. D.

(Leic~ster).-In

The Textbook (Rule -+, p. 66) tells you to place the limb in as natural a position as possible - (1) with great care, (2) without using force (or a pplying extension), and (3) without letting go till the limb is secured in position with splint s . If, therefore, you can manipulate the limb inlo a natural rosition when it is nexed at the fracture, and if you do not break .any of the restrictions just quoted, then y ou are right. Expenence, however, makes me doubt if you could clo it. N.C.F. SOME GAS ASPIIYXIA PROBLEM S.

J. S. (Swindon). - The present emergency has set us all talking and thinking around possibilities that might be expected to happen. Having a few knotty points some of my colleagues and myself would appreciate your expert advice on the following :(1) A modern air attack on civilian population might be expected to produce several cases of syncope from mental shock and perhaps from heart weaknesses. Would ~uch unconscious patients manage to breath sufficiently while wearing a gas mask, if this was necessary owing to the presence of gas? (2) While it was still necessary for a patipnt to wear a gas mask owing to the presence of a war gas, would it be effective to perform artificial respiration with the patient's ga'> mask still in position, if resuscitation was necessary owing to asphyxia from, say, C. O. or extreme shock? (3) In the event of severe head injuries, would a patient receive sufficient protection by simply placing the gas mask over the face and not setting the straps in position over the injured head? Before closing my letter I should like to say what valuable help we derive from reading and discussingyour monthly answers to difficult questions. (1) You have a choice of evils. So 1 answer your query by asking another Cjuery- " What is the good of restoring a

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FIRST

134

patient from syncope if he is to be alluwed to die from the effects of war gases?" In other words, in the presence of war gases, first aiders and patients must wear their respirators. (2) The problem here is the same as that with which we ha ve just dealt, although its form is somewhat different. So its solution is the same. (3) The face piece of the respirator, to be efficient, must be in close contact with the face. This is hardly practicable in the circumstances, owing to the intervention of dressings and bandages. Some protection, however, would Le given to the patient: and this might be increased by allowing the face piece and head harness to hold the dressings in position. The problem is discussed in Section 17 of A. R. P. Handbook No.2, where we find th e comment-" This is nothing more than a desperate remedy to meet a desrerate case ." -N. C. F. TREATMEN T OF ARTERIAL BLEEDING.

M.C. (Kentish Town).-During a discussion among members of our Stretcher Party it was stated that, if a casualty is suffering from arterial bleeding and shock, we should treat shock first. With this instruction 1 agree pro vided that the Aow of blood is not so fast at first while Bearers Nos. 2 or 4 (who should carry the blankets) come up; and I consider that Bearer No.1 (who examines the patient) should at once cover the inj uries and then compress the pressure point in case the bleeding is not arrested. You seem to be meddling cause and effect. The g reatest and commonest cause of shock is h remorrhage. So I wonder who told you that you must treat shock first when the patient is suffering- from arterial bleeding and shock. On the contrary if you refer to p. 44 of the Textbook, you will find that the first (and immediate) step in the treatment of shock is to " arres t severe h re morrhage if present!"N.C.F. PATIENT IMPALED ON R A ILING.

1\1. C. (Ke nt ish Town). - During a recent discussion among my A. R. P. comrades it was sugg ested that, if during an air raid, a person is impaled on a railing the Demolition Squad should cut down the railing and remove the patient to hospital with railing embedded in him. I contended, however, that as there were 14 men at least present, all necessary preparation should first be made and that this done, the patient should be lifted off the railing; and I based my arg ument on the fact that you cannot remove a patient with railings attached especially during transport in an ambulance. While thanking you for answering my queries, I would ask you to recommend a good hair tonic, because I am losing all mine owing to the arguments which spring up among our party every minute of the day and because to refuse to argue with my comrades means defeat. As the Textbook tells you that you must not remove a foreign body embedded in a wound, I suggest that the Demolition Squad should not remove the whole railing but that it should cut off the top just clear of the wound. In th.is way th.e difficulties of transport, to which you refer, wlll be aVOided and the embedded portion can be left in position until the surgeon is ready to deal with it. If your loss of hair is really serious, I assume that ~omethi~g is wrong with your methods of debating problems In first aId, and I hold out no prospects of its restoration by means of hair tonics. On the c;ontrary, I believe that the proper use of " the qualifications of a first aider" will prove beyond doubt the more useful remedy in the prev~ntion of further deterioration of your pristine beauty! I n other words, always "keep your hair on II Curing arguments! ! - N.C.F. .. .. , .

AID

AID ApPLI CATION OF BORACIC LINT.

O. R. (Redditch). - "Would you kindly inform me which side of boracic lint should be placed next to the wound. We have differences of opinions. Some say the plain side, owing to the fluffy dressing- adhering to the wound; but, if this is so, why do the makers roll it with this side in. Personally, I think that the fluffy side is specially prepared and should be placed Ilext to wound. I seem to have some recollection of you answering this query some time ago, but I cannot place my hand on the issue containing your answer. Doctors differ on this point. My practice is to place the fluffy side on the skin when I am applying ::l. hot fomentation and the plain side when I am dressing a \yound. Frankly, however, I do not think th a t it reall y matters which side of the lint is applied to the broken or unbroken skin. - N.C.F. EXTEN S ION OF COMPOUND FRA CT U RES.

O. R. (Redditch).-Am I correct in assuming that , with a compound fracture with wound leading down to seat of injury, we apply extension; and that it is only, as the Texthook states, when the bone protrudes that we do not apply extension. O therwise I take it that th e Textbook would state: " In all cases of compound fr acture do not apply extension." Thanking you for the many excellent tips that I have had from you, in your an s wers to our queries.

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conditions militating against cure. In these circumstances Sphag- nol Peat Ointment frequently proves successful. We ha ve on record a cas e in which a patient, in addition to the V.D. for which he was attendin g the clinic, had a long ~ t a ndin g ecze ma of th e arm. Sphag nol Ointment ClI red the cc::;e lll a i n a wtlek.

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Frankly, I consider that th e de cision on this point should be made by the doctor who tak es charge of th e case. After all, first aid exists not for treatment but mainl y for prevention of aggr2.vation of injury or condition. - N. C. F.

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135

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