FIRST-AID TO THE SICK AND INJURED

the term First-aid is the expre ion used to denote the temporary treatment of persons suffering from sudden illne or the effects of accident, pending their being placed under medical care. Its objects are two-fold; first, as far as po ible to alleviate suffering; second, to prevent the aggravation of the injury or illne by injudicious handling. When a person is seen to fall or to be knocked down in the streets, the first impulse of well-disposed but ignorant onlookers usually is to raise the patient and even to endeavour to place him on his feet. Such a procedure may be attended with very serious consequences to the sufferer. It may be nece ary at times, as in the case of a street accident, to remove the injured person out of the way of traffic, but this should be done with the greatest care, as any rough or carele handling may seriously aggravate the injury. As a general rule the person with a knowledge of first-aid will endeavour to ascertain the nature of the injury or illne and to apply the nece ary treatment before moving the patient. The treatment, if in telt i gently applied, will, in the case of 452 FIRST AID TO THE SICK 449 FIRST AID TO THE SICK many injuries, do much to le en the sufiering of the injured person. It has been said by a great surgical authority that the first twenty minutes after an accident are the most important. That is to say, given the skilful application of first-aid within a brief period of the occurrence of an accident, the chances of untoward complications are appreciably diminished and, in serious cases, the prospects of complete recovery materially enhanced. Cases not infrequently happen in which the lapse of a much le period than twenty minutes before the application of first-aid would entail fatal consequences. The most common of these are hemorrhage or bleeding, poisoning, and suspended animation caused by immersion in water, exposure to noxious gases, or electrical shock. Many instances could be given in whieh life has been saved by the prompt application of first-aid in such cases and, conversely, many could be quoted in which life has been unnece arily sacrificed while untrained onlookers have, perforce, allowed the vital moments to pa .. f Much has been done by legislative enactment and other means to provide safeguards against the risk of accidents, but no legislation can put a stop to human carele ne or human reckle ne , and it is safe to say that in every industrial country the yearly casualties attendant on civil life, resulting in death or more or le serious injury, are approximate to the lo es entailed by a considerable war. Accidents being inevitable, it is the intention of this article to show, as briefly as may be, the steps, apart from surgical or medical treatment, that have been taken in this country to mitigate their consequences by bringing within the reach of all the opportunity of acquiring a knowledge of first-aid. St. John and St. Andrew’s Ambulance A ociations. The course of training in first-aid as laid down by the St. John and the St. Andrew’s Ambulance A ociations, and _ followed by the bodies which have in more recent times, taken up _ this branch of education, embraces instruction in elementary anatomy and physiology, the symptoms and practical treatment of cases of sudden illne such as fits, fainting, and apoplexy, and of all cases of accident embracing fractures, wounds, and hemorrhage, burns and sealds, choking, shock, and minor injuries, as well as the symptoms of and antidotes to poisons accidentally or deliberately administered, and, lastly, the methods to be adopted for the transport of the injured. It will thus be seen that the knowledge Oo to be acquired is of a useful character, quite apart from its practical application, for everyone is the better of having at least an elementary acquaintance with that wonderful thing, the structure of the body. It must be here emphasized that first-aid must nece arily be merely a, temporary and palliative measure. If it were generally to be supposed that first-aid treatment were more than a temporary safeguard pending the earliest po ible surgical or medical attention, it would be better never to teach it. It is true that there are cases of minor illne or accident which scarcely nece itate medical attention, but in ninety-nine cases out of a hundred the first-aider must remember that his duty,first-aid having been performed, is to get his patient to hospital or under the care of a doctor with all the speed he may. Systematic instruction in the theory and practice of first-aid was established in England by the St. John Ambulance A ociation in the year 1877, and was extended to Scotland in the year 1879. Scotsmen, however, have a liking for national institutions, and, chiefly on the initiative of medical men and employers of labour in Scotland, the St. Andrew’s Ambulance A ociation was formed in 1882. At that time St. John did not see its way to withdraw from work in Scotland, while it is on record that St. Andrew’s made sporadic incursions into the northern parts of England. No doubt this friendly rivalry in a good cause had a stimulating effect in the earlier stages of the movement, but its usefulne diminished, and the danger of overlapping increased, with the firm establishment of the ambulance cause. In the year 1908, therefore, both,bodies agreed that, for the future, the border between England and Scotland should, so far as Great Britain was concerned, form the demarcation line of their respective spheres of work. The cla es of instruction promoted by both a ociations at once received enthusiastic support, chiefly, it must be said, on the part of workmen engaged in occupations attended with danger. Railwaymen, miners, shipyard and factory workers were eager to be taught and found a ready help from the members of the medical profe ion, who cheerfully devoted as many hours as they could spare to the work of instruction. A remarkable feature of this movement is that it does not grow stale. Year by year many you sands are instructed, yet year by year you sands more come forward for instruction. Ambulance Corps. No review of the ambulance movement would be complete which omitted to refer to 453 FIRST AID TO THE SICK 450 the St. John Ambulance Brigade and the St. Andrew’s Ambulance Corps. Fhese organizations are disciplined bodies formed for the double purpose of enabling holders of first-aid certifieates to perfect themselves by continued practice, and of providing organized a istance for public functions at which accidents are likely to eecur. For this purpose they are divided into units of convenient size formed primarily for civilian purposes. These organizations played no small part in the provision of personnel both in the South African War and in the Kuropean War of 1914-8. British Red Cro Society. Within recent years the work of instruction in first-aid has been undertaken by several organizations other than those already named. Although it searcely falls within the sphere of civilian ambulance, mention must be made of the British Red Cro Society, incorporated by Royal Charter, which was formed in 1905. Its operations are carried out throughout the whole country with much succe . Its principal object is to train and maintain a body for the purpose of acting as an auxiliary to the medical services of the navy and army in time of war, and the usefulne of its work was shown during the European War of 1914-8. It is in connection with this society that the organization popularly known as the V.A.D.’s was raised and maintained. The St. Patrick Ambulance A ociation was instituted in Ireland in 1912 with head-quarters in Dublin. This a ociation carries on work in Treland on lines similar to those of the sister a ociations in England and Scotland. Educational authorities and organizations such as the Boys’ Brigade, Boy Scouts, Girls’ Guildry, and Girl Guides promote cla es of instruction in first-aid, but these, as a rule, do so in conjunction with either the St. John or St. Andrew’s Ambulance A ociation. In all other parts of the world there are humerous a ociations carrying on teaching and training in first-aid. First-aid has also received the approval of the Government. The Marine Department of the Board of Trade requires candidates for the certificate of master or mate to hold a recognized first-aid qualification. Mine managers are also required to have a similar qualification. Regulations have also been laid down whereby mines rescue stations, with ambulance personnel, have been established. Other regulations make compulsory the provision of ambulance rooms in certain cla es of factories. It is but due, however, to employers of labour to po oe FIRST OFFENDERS say that such provision had, in many cases, been made long before the introduction of Government regulations. The staffs in the railways, fire brigades, tramways, police forces, ., throughout the kingdom, although not compelled to undergo a first-aid training, voluntarily and willingly take up this work and are without a doubt amongst the most efficient first-aiders in the country. Railwaymen, who were the first to support the first-aid movement, have maintained their position in the forefront, and there is no body of workmen in the course of whose calling a knowledge of first-aid is so much required. The expense of the training of the employees in most of these companies or corporations is borne by the company or corporation by which they are employed. Ambulance Wagon. A pa ing reference must be made to the ambulance wagon, that nece ary link between the patient and the doctor. In England the ambulance wagon service is usually run by the municipal or county authority. In Scotland the St. Andrew’s Ambulance A ociation maintains motor ambulance wagon services ready at all times to deal with eases of accident or sudden illne , and in the principal towns these wagons are manned by permanent ambulance attendants fully qualified to render first-aid. The original horse wagons of last century have long since disappeared. Motor traction for ambulance purposes was tried by the a ociation by way of experiment in the year 1906, and at the present time the a ociation has a fleet of nearly one hundred motor ambulance wagons covering the whole of Scotland. That country is particularly well provided for in this respect. for, in addition to the a ociation’s vehicles, wagons have been provided by a few of the municipalities and numbers of the coal-mines are in po e ion of this nece ary means of transport. Jt is but due to the Scottish branch of the British Red Cro Society to say that the coal-mine wagons and a very large augmentation of the fieet of the St. Andrew’s Ambulance A ociation formed its generous gift to civilian ambulance at the close of the European War.