December 22, 1941 DRUG TOPICS 17 First Aid badly he is hurt. Be sure nothing is done that will cause further injury to the patient. Dressings And Bandages As proper care of wounds to prevent infection is of prime importance, one should have definite knowledge of materials that may safely be used next to the wound, have skill in applying bandages to hold these in place, and have the ability to handle properly the materials used. Dressings or Compresses. Dressing or compress is the name given to material applied directly over a wound or burn. Do not use absorbent cotton directly over a wound or burn, as it sticks and is very hard to remove. A compress must not only be clean in the ordinary sense, but must also contain no germs, that is, it must be sterile. Never use adhesive tape, electrician's tape, court-plaster, collodion or similar preparations directly on a wound. Bandages. Any gauze or cloth material is called a bandage if it is used: To hold dressings or compresses in place. To keep splints in place. To control bleeding by pressure. As a sling. General Directions for Bandaging. Bondages are not applied directly over wounds; the wound must always first be covered with a-dressing. Do not cover the ends of the fingers or The photographs and cut captions published with this course in "War Time First Aid" are fully copyrighted by Life magazine. They are reproduced here by special permission. toes, unless this is necessary to cover the injury. Never apply a wet bandage. Cotton cloth or bandage applied wet tends to shrink and becomes too tight as it dries. Do not apply a bandage too loose, as it may slip and expose the wound. Wounds A wound is a break in the skin or in the mucous membrane lining one of the body cavities. Kinds. Wounds may be divided into four kinds: 1. Abrasions. Wounds made by rubbing or scraping off the skin or mucous membrane. These are very easily infected. 2. Incised Wounds. These are made by any sliarp cutting instrument. They tend to bleed freely as the blood vessels are cleanly cut across. Very little tissue around the cut is destroyed, and they are not so liable to infection as other kinds of wounds. 3. Lacerated or Torn. Injuries by blunt instruments, machinery, a piece of exploding shell, or by falls against angular surfaces produce this type wound. Hemorrhage is as a rule, not so severe as the blood vessels are torn across irregularly instead of cleanly cv'.. The danger of infection is greater, however, due to dirt frequently being ground into the tissues, to lack of bleeding, and to destruction of body tissues forming the edges of the wound. 4. Punctured Wounds and Stabs. These may be caused by any penetrating instrument, as nails, ends of wire, bullets, etc. These wounds do not bleed freely unless a sizable blood ves-sell is injured. They are very difficult to clean out and often become infected. Wounds are subject to two dangers, infection and serious bleeding or hemorrhage. Remember, no matter how small the wound may be, it is always large enough for thousands of germs to enter. Since it is impossible to know the number of germs in the wound the vitality or ability of the germ to grow, or the body's own resistance when the wound is made, the only safe thing to do is to take proper care of each wound, no matter how small, as soon as it occurs. First Aid Treatment Of Wounds First aid treatment of wounds varies, depending upon whether or not the wound is bleeding seriously. 1. Wounds in which Bleeding is Not Severe. The chief duties of the first aider are to prevent more germs from getting in and to use an antiseptic or germicide to destroy as many of the germs in the wound as possible. A physician should always be consulted if the wound is of any seriousness. Do not touch the wound with the hand, mouth, clothing or any unclean material. Only sterile gauze should be used. Do not zvash with soap and water. It is impossible for the first aider to do this without carrying in large numbers of germs from the surrounding skin and from the water itself. In cases where a physician's services are soon available, it is probably better to leave all cleaning of a wound to him. (Continued on Next Page) Wartime Look for hemorrhage, stoppage of breathing, wounds, burns, fractures, dislocations, poisons, etc. Be sure all the injuries are found. Keep cool; a life may depend on your ability to keep calm and not get excited. Examine the patient gently, being careful to avoid touching a wound with anything unclean, such as dirty fingers, dirty clothes, or dirty water. Check hemorrhage quickly either by compression or tourniquet. Use the cleanest materials available to avoid unnecessary future infection. Send for a doctor or ambulance if necessary. Keep the crowd back, enlisting the aid of a willing assistant to do this while you render first aid. Loosen clothing and keep patient warm. Splint fracture cases where they lie, using the nearest satisfactory means of splinting that are available. If the fracture is compound, bandage with sterile material before splinting. Do not give anything by mouth if there is injury to the abdomen. Alcoholic stimulants are not advocated without exceptional reasons, as it may incriminate the injured if the accident is investigated by military or civil authorities. In most cases the use of water, hot coffee, or similar liquids is beneficial. Relieve pain wherever possible. Put the patient in the most comfortable position and, if his condition will permit, remove him carefully to a clean quiet area away from curious spectators. Serious bleeding, stoppage of breathing, and poisoning take precedence in this order over everything else and demand immediate treatment. Keep the patient warm. This is essential 'in preventing serious shock. If the patient is unconscious or semi-conscious following an accident of violence, an injury to the head is usually the cause. Send some one to call a physician or ambulance. In all cases, in calling be prepared to give the following information: 1. Location of injured person. 2. Nature, cause and probable extent of injury and the supplies available at the scene of the accident. 3. What first aid is being given. Never give an unconscious person water or other liquid, as it may enter the windpipe and strangle him. Avoid letting the patient see his own injury, and in severe cases, do not let him know how Prompt Pressure At Key Points In Body Controls Arterial Bleeding pomplete Course In Principles And Methods I Of First Aid Definition. First Aid is the immediate, temporary treatment given in case of accident or sudden illness before the services of a physician can be secured. Purpose Of First Aid Training 1. To prevent accidents. Impressing the results of failure to have small injuries immediately cared for is one of the best methods of getting people to have all minor injuries treated without delay. 2. To equip the individual with sufficient knowledge to determine the nature and extent of an injury. This does not mean that the first aider is expected to make a complete and accurate diagnosis such as the physician makes, but he should be able to come to some decision as to the nature and possible extent of the injury. 3. To train the first aider to do the proper thing at the proper time, and to know what not to do. General Directions When a person is injured, the trained man possesses the ability to render first aid and he should tactfully assume charge of the situation. Keep the patient lying down in a comfortable position with the head level, at least until it is determined that the injury is not serious. This prevents fainting, quite frequent otherwise, and helps prevent shock. In the lower arm, arterial bleeding can be stopped by pressure on artery on inside of arm, a handsbreadth below armpit. Other hand is feeling pulse. Tourniquet should be at least 1 inch wide, and is best applied at point where hand pressure would be applied. Tourniquet must be loosened every 15 minutes. Shoulder-wound arterial bleeding is controlled by pressing artery located behind collarbone against the upper edge of the first rib. Artery in leg is shut off by pressing heel of hand on pressure point in groin. For bleeding in lower leg, pressure point is behind knee. g Drug Topics Presents First Concise Text The carotid artery—in the neck—from which bleeding is swiftest, can be shut off by pressing the artery against the vertebrae, taking care to avoid the windpipe. Above temple, arterial bleeding is controlled by pressing artery just in front of ear. For f?cial bleeding, pressure point is under jaw Drug Topics is privileged to present the first concise course in "War Time First Aid" that has been made available to the drug field. It is different, in many respects, from the first aid previously taught here in that it is based on the new techniques found necessary in war-torn England. The course was prepared by Prof. Leonard J. Piccoli, head of the department of pharmacology and physiology at Ford-ham University College of Pharmacy. Prof. Piccoli is considered the outstanding authority in Dr. L. J. Piccoli American pharmacy circles on the subject of first aid. Chairman of the First Aid Committee of the New York Pharmaceutical Association, he holds two medals: (1) from the American Red Cross—for service (2) from the Royal Life Saving Society of Great Britain—for service. He has taught first aid for 16 years and, at present, is directing the work of first aid instruction in New York State. As war experiences developed new techniques in Great Britain, Prof. Piccoli incorporated them in his course. Last week, a representative of the National Office of Civilian Defense studied his course and gave it wholehearted approval, urging that it be adopted immediately by every pharmacy college in the country. The remarkable photographs shown with this course appeared in the September 29 issue of Life magazine. They are copyrighted pictures, and Drug Topics is grateful to Life for permitting us to reproduce them here—as a vital, immediate service to the pharmacists of the nation.