Accidents are fourth in the list of causes of death in the United States. Motor-car accidents constitute one fourth of all that occur. Under such circumstances, people ought to be aware of the immediate steps that need to be taken whenever anyone is involved in an accident, far-removed from any contact with a doctor or a hospital. People who frequently drive the country roads will be well-advised to provide their : cars with a first-aid kit containing at least some adhesive tape, bandages, cotton, tourniquets, and the other essentials that are helpful in stopping hemorrhage and thus saving a life. Remember, however, that the immediate services of a competent doctor are better than any amount of first aid by those not specially trained in care of wounds and injuries.

First Aid

In attending an injured person:

1. Keep the injured person lying down in a comfortable position, his head level with his body, until you know whether the injury is serious.

2. Look for hemorrhage, stoppage of breathing, poisoning, wounds, burns, fractures, and dislocations. Be sure you locate every injury. Remove enough clothing to determine the extent of the injury. Rip the seams if necessary. Attempts to remove the clothes in the usual manner may cause unnecessary suffering or may aggravate injury. Serious bleeding, stoppage of breathing, and poisoning must be treated immediately before anything else is done.

3. Send someone to call a physician or an ambulance.

4. Keep calm and do not be hurried into moving an injured person I unless absolutely necessary.

5. Never give water or other liquid to an unconscious person.

6. Keep onlookers away from the injured.

7. Make the patient comfortable and keep him cheerful, if possible.

8. Don't let the patient see his own injury.

Shock

Any person severely injured may develop shock, and treatment must be started immediately to prevent shock, if possible. This involves:

1.Prevention of hemorrhage by application of pressure.

2. Maintaining body temperature by covering the patient with a blanket but not applying heat.

3. Increasing the flow of blood to vital organs by tilting the body so that the blood tends to flow to the upper portions, raising the foot of the stretcher or bed from twelve to eighteen inches.

4. Except when there is abdominal injury, giving fluids in small amounts and frequently, preferably as hot as can be taken comfortably.

5. Administering artificial respiration as described later, if necessary, to restore breathing.

Dressing And Bandages

Do not use absorbent cotton directly over a wound or bum because it sticks and is hard to remove. Do not use adhesive tape, electrician's tape, collodion, or similar materials directly on a wound. Apply sterilized gauze squares or bandage compresses to wounds. Bandages are not applied directly over wounds, which should always be covered first with a dressing.

Wounds

Do not touch any wound with the hand, mouth, clothing, or any unclean material. Apply a sterile dressing or compress and bandage snugly in place. When bleeding is present, apply a dressing as soon as available; press firmly. Make sure that bleeding is stopped before moving the patient. Tourniquets are dangerous, and should not be used if bleeding can be checked readily otherwise. Whenever there is serious bleeding get a physician as soon as possible to take responsibility for care of the patient.

Puncturing Wounds

Always secure a physician, who will not only treat the wound itself but may give tetanus antitoxin for prevention of lockjaw.

Powder Burns

Explosion of gunpowder usually carries burned powder and dirt into the skin. Make sure that the patient is seen by a physician. The value of tetanus antitoxin in such cases cannot be over-emphasized.

Infected Wounds

Apply wet dressings, consisting of three heaping tablespoonfuls of ordinary salt, or twice this amount of Epsom salts, in each quart of water. Change wet dressing often enough to keep hot, and apply continuously for an hour. Repeat every three to four hours until the patient is turned over to a physician.

Wounds Of Abdomen

Keep the patient lying quietly on his back. Move patients with wounds of the abdomen carefully. When intestines protrude from wound, keep patient on back with a coat or pillow under the knees. Don't try to push the intestine back in. Cover with a sterile dressing and keep moist.

Animal Bites

Wash the wound thoroughly to remove saliva. Use a gauze compress and a thick solution of soap and water to scrub the wound. Rinse it with clean running water and apply a sterile dressing. Consult a physician at once. Do not kill the biting animal except to protect others from danger. Have biting animals examined by competent veterinarians to determine whether or not they have rabies.

Snake Bites

Make the victim lie down and keep quiet. Tie a constricting band firmly around the limb just above the bite, to restrict the spread of the poison. Sterilize a sharp knife or razor blade with a match flame, iodine, or alcohol. Make a cross-cut incision about one-quarter-inch long through each fang mark. Apply suction with a suction cup or syringe; apply suction by mouth if a mechanical device is not available. Call a doctor as promptly as possible. Antivenin serum should be given by someone experienced, if it is available.

Foreign Bodies In Wounds

If a foreign body like a splinter, a piece of glass or metal is near the surface, apply an antiseptic to the skin. Sterilize a knife, needle, or tweezers by passing through a flame; use this to remove foreign body. Encourage a little bleeding by gentle pressure on the wound. After bleeding has stopped apply a sterile compress.

Foreign Body In The Eye

Never rub the eye. Never touch it until you have washed your hands thoroughly. Never be rough with the eye. Never try to remove a foreign body from the eye with a toothpick, match, knife blade, or any instrument.

Pull down the lower eyelid and see if the foreign substance is on the surface of the lower lid. If visible, it can be removed by touching it with a comer of a clean hand kerchief. Grasp the eyelashes of the upper lid gently between the thumb and forefinger. Have the patient look upward, and pull the upper eyelid upward and downward over the lower eyelid. This may dislodge a foreign body, so that it will be washed away by the tears. Wash the eye with a solution of boric acid (a half teaspoonful to a drinking glass of boiled water). If foreign bodies are still present, make sure that the patient has attention from a physician.

Nosebleed

Have patient sit up with head thrown slightly back, breathing through mouth. Apply cold wet compresses over the nose. Tell person with nosebleed not to blow nose for a few hours. Press the nostril on the bleeding side firmly against the middle portion for four or five minutes. If these measures do not stop the bleeding in a few minutes, call a physician. Try putting sterile gauze pack back in the nostril, leaving the end out so it can be easily removed.

Internal Bleeding

Keep the patient lying on his back as flat as possible. Turn the head to one side for vomiting or coughing. Keep the patient warm. Get a physician at the earliest possible moment.