How to Act In Cases of Drowning
IN " Abstract of an Investigation into Asphyxia," just published and presented to the Royal Humane Society .by Dr. MAE- SHALL HALL, opens quite a new view of the way in which suffocation from drowning or other causes should be treated—a way, as experiments show, likely to become inva- luable in the saving of life. He states that asphyxia is not so much caused by depriva- tion of oxygen, as by the retention of car- bonic acid in the blood; and that, as re- spiration is the only mode by which this deadly acid can be eliminated, all other means of reanimation are secondary to that which renews the act of breathing. How often does it happen that a drowned person cannot be resuscitated, owing to the failure of the .means adopted for inducing respira- ;ion ! The reason why, as Dr. M. HALL shows, is to be found in mistaken treatment.
The patient is laid on his back, in which position it is impossible that he should breathe at all, as " the tongue falls back- wards, carries with it the epiglottis, and closes the glottis or entrance into the wind- pipe and air-passages." Fluids and mucus also remain lodged in the throat. The remedy is, to reverse the position—prone instead of supine—or on the belly instead of on the back. " In this position "—we quote the doctor's words—" the tongue falls for- wards, draws with it the epiglottis, and leaves the glottis open. The tongue may even be drawn forwards. All fluids will flow from the fauces and mouth. In order that the face may not come into contact with the ground, the patient's hands and arms are to be carried upwards and placed under the forehead. It will now be per- ceived that the thorax and abdomen will be pressed by a force equal to the weight of the body. This pressure will induce ex- piration. And, if necessary, additional pressure may be made on the posterior part of the thorax and abdomen. This will in- duce slight additional expiration. This lat- ter pressure may then be removed. Its re- moval will be followed by a slight /respira- tion. The weight of the body is then to be raised from the thorax and abdomen. This may be done in various ways: First, the body may be gently turned on its side by an assistant placing one hand under the shoulder, and the other under the hip of the opposite side. This will remove in great part the weight of the body from the thorax and abdomen, and allow all but one side of the thorax to expand. In this manner, a fair degree of inspiration is induced. And thus, without instruments of any kind, and with the bands alone, if not too late, we ac- complish that respiration which is the sole effective means of the elimination of the blood-poison." It appears that a really dead body may be made to breathe, by placing it in the prone position; and that turning it on the left side, not beyond the quarter- circle, induces violent inspiration. Prona- tion and partial rotation are, therefore, the means to be borne in mind. To attempt to restore warmth, especially by the warm- bath, before breathing is restored, is con- demned as highly prejudicial. It has been forbidden in France. Dr. HAT.T, is well known for his discoveries and researches in the phenomena of the nervous system ; and he treats the present question in connexion with those phenomena, and publishes the results as the first portion of an investigation of the whole subject.—( Chambers's Journal.) The following are now the methods of treatment recommended by the Royal Hu- mane Society, whose judicious instructions have, we have been informed, been the means of restoring, during the last 80 years, between 30,000 and 40,000 persons, appa- rently dead:— Cautions.
1. Lose no time.
2. Avoid all rough usage.
3. Never hold the body up by the feet.
4. Nor roll the body on casks.
5. Nor rub the body with salt or spirits.
6. Nor inject tobacco-smoke or its infu- sion.
Restorative Means.
If apparently drowned, send quickly for medical assistance; but do not delay the following means:— I. Convey the body carefully on its face, with the head and shoulders supported in a raised position, to the nearest house.
II. Strip the body, and rub it dry; then wrap it in hot blankets, and place it in a warm bed in a warm chamber, free from smoke.
III. Wipe and cleanse the mouth and nostrils.
IV. In order to restore the natural warmth of the body— 1. Move a heated covered warming-pan over the back and spine.
2. Put bladders or bottles of hot water, or heated bricks, to the pit of the stomach, the arm-pits, be- tween the thighs, and to the soles of the feet.
3. Foment the body with hot flannels.
4. Rub the body briskly with the hand; do not, however, suspend the use of the other means at the same time; but, if possible, 5. Immerse the body in a warm-bath at blood-heat, or 100° of the thermometer, as this is preferable to the other means for restoring warmth.
V. Volatile salts or hartshorn to be passed occasionally to and fro under the nostrils.
VI. No more persons to be admitted into the room than are absolutely necessary.
If apparently dead from intense cold, rub the body with snow, ice, or cold water. Re- store warmth by slow degrees ; and after some time, if necessary, employ the means recom- mended for the apparently drowned. In these accidents it is HIGHLY DANGEROUS to apply heat too early.
General Observations.
On restoration to life, a teaspoonful of warm water should be given; and then, if the power of swallowing be returned, small quantities of warm wine, or weak brandy and water, warm: the patient should be kept in bed, and a disposition to sleep en- couraged.
The treatment recommended by the So- ciety is to be persevered in for three or four hours. It is an erroneous opinion, that per- sons are irrecoverable because life does not soon make its appearance—cases having come under the notice of the Society of suc- cessful results even after five hours—and it is absurd to suppose that a body must not be meddled with or removed without the permission of a Coroner.
The above instructions are kept in each of the Life-boat houses of the Royal National Life-boat Institution.