Illustrated lectures on ambulance work / by R. Lawton Roberts.

  • Roberts, R. Lawton.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Illustrated lectures on ambulance work / by R. Lawton Roberts. Source: Wellcome Collection.

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    external injury, A fragment of bone may be driven inwards on to the brain, or a blood-vessel may be ruptured inside the head, as frequently happens in fractures of the floor of the skull, or, as they are termed, “ fractures of the base.” In such cases, usually spoken of as compression of the brain, the brain is pressed upon by the piece of bone, or by the accumu- lation of blood from the injured blood-vessel; and the patient lies insensible, more or less completely paralysed, with, it may be, occasional convulsive movements, snoring loudly, the eyes being insensible to the touch, the pupils insensible to light, and one or both of them dilated ; and with all this there maybe bleeding either from the ear, mouth, or nose, or, more rarely, a copious watery discharge from the ear. Fracture of the spine is easily recognised on account of the accompanying injury to the spinal cord, and the paralysis of the parts of the body below the seat of the fracture. Many of you, unfortunately, have seen accidents of this de- scription, and well remember the heavy fall of coal or dirt on your comrade’s back, the tenderness and pain caused by the blow, and worst of all the loss of feeling in the sufferer’s legs and his inability to move them—sure signs, you know as well as I do, of serious injury to the spine. Fractures of the pelvis are the result of great violence— such as a squeeze between the buffers of two railway trucks. The patient is unable to stand, and any movement or at- tempt to get up causes great pain and a feeling as if the body was giving way. Sometimes you may be able to feel crepitus. The great danger in these cases is that the bladder or other vital parts may be torn. Now, in all these serious cases of fracture you should endeavour to convey the sufferer as steadily and as gently as you can to the nearest hospital or to his home, and you must be particularly careful when lifting him on and off the stretcher that you disturb the injured part as little as possff ble. Medical aid should be sought for at once ; but in the meantime the patient should be placed in the lying-down position with the head slightly raised, In fractures of the skull, you can, before the doctor arrives, apply cold to the injured part, especially if there is any bleeding from the ears, nose, or mouth. Ice may be used for this purpose broken into small pieces and tied up in a bladder ; or you can apply sponges, cloths, or folded handkerchiefs steeped in cold water. You should be careful also to remove anything tight about