CRAMPS, HOW TO SAVE LIFE, RESUSCITATION - SWIMMING

CRAMPS

To be suddenly seized with cramps is a thing liable to happen to most expert swimmers; it is caused by various reasons—staying too long in the water and getting chilled, going in after a heavy meal, stiffening the legs too much, and varicose veins. Preventive: Never remain in the water after feeling chilled; always swim around and exercise yourself; twenty minutes is long enough for any one to remain in the water; always turn over on the back when getting a cramp, and float, at the same time working toward the shore with the hands, and don't lose your presence of mind.
Don't attempt to rescue a person from drowning unless you are a good swimmer yourself; remember that a drowning person is generally insane for the time, and is liable to drag you to your death unless you are capable of swimming with a heavy load.

HOW TO SAVE LIFE

To the person who accidentally falls overboard, or who is compelled to leap into deep water, as was the case with many victims of the General Slocum, the first essential is to keep one's presence of mind. Do not feel alarmed if your head should sink below the surface once or twice—you are bound to come to the surface, and will be able to sustain yourself for a considerable time, even if you are not a swimmer, if you will but keep your hands under water. The reason so many people drown is because directly they come to the surface they raise their hands above their head and shout for help. This is fatal. The moment the hands are raised out of the water the body will sink below the surface.
Another thing to remember is to keep the mouth closed until the body attains the floating position; then try and breathe naturally through the mouth and help propel yourself with your hands. Should you be able to swim, try and take off your outer clothing, as the latter, when water-soaked, tends to drag the body down, besides retarding the movements of the drowning person.
To risk one's life in order to save a fellow being from drowning is one of the most heroic acts that one may be called upon to perform, yet how many of us have the presence of mind and courage to act in such an emergency? To rescue a person from drowning is no child's play, even for the best swimmers; it requires pluck, nerve and stamina. Of course, I allude to rescues which take place some distance from shore. Many a daring swimmer has been clutched and dragged down to death simply because he did not know the safest way to approach a drowning person.
Of the many different ways of saving life, the safest and best method is to swim as near the person as possible, then dive under and come up behind him; otherwise he is liable to grab you around the neck with a death clutch, from which it is extremely difficult to escape. When swimming up behind the person, grab his biceps and force him on his back; the more he struggles the more he helps himself to keep afloat.
To prevent being clutched by a drowning person the following rules should be carefully studied. Every action, however, must be prompt and decisive, otherwise this method will be of no avail.

THE BEST METHOD OF SAVING LIFE

1. If grasped by the wrists, turn both arms simultaneously against the drowning person, thumbs outward, and attempt to bring your right arms at right angles to your own body. This will dislocate the thumbs of the drowning person and he must let go his hold.
2. If clutched around the neck, immediately take a deep breath, lean well over your opponent, place the left hand in the small part of his back and draw your right arm in an upward direction until in line with his shoulder, and pass it at once over his arm. Then with the thumb and forefinger catch his nose and pinch the nostrils close, at the same time place the palm of your hand on his chin and push firmly outward. This will cause him to open his mouth for breathing purposes, and he, being under you, will swallow water. Choking ensues, and not only is the rescuer let go, but the other is left so helpless as to be completely under control.
3. If clutched around the body and arms, take a deep breath, lean well over your opponent and throw the right arm in an upward direction at right angles to the body, or draw it up between your body and that of your opponent. Then with the thumb and forefinger catch the nose and pinch the nostrils close, and at the same time place the palm of the hand on the chin and bring the right knee as high as possible up between the two bodies, placing it, if possible, against the lower part of your opponent's chest; then, by means of a strong and somewhat sudden push, stretch your arms and legs out straight, at the same time throwing the whole weight of the body backward. The sudden motion will press the air out of the other's lungs, as well as push him off, no matter how tightly he may be holding.
Should the drowning person act sensibly and not try to grab his rescuer, he can be brought in by placing his hands on his rescuer's shoulders and kicking out his legs behind him while the rescuer swims in toward shore. Another method is to pull the person on his back by holding him under the right arm-pit with your right hand and using the left hand and legs to swim with. Should the rescue be close to shore, swim behind the person and help by pushing him in toward shallow water. Should the drowning person have sunk for the third time watch when the air-bubbles rise to the surface. At once dive down perpendicular to the bottom when the air-bubbles show, seize the drowning person and bring him to the surface by pushing off from the bottom and using your legs to send you upward to the surface. Before trying to rescue any one get rid of as much clothing as possible, if time will permit.

RESUSCITATION AFTER RESCUE

After bringing a drowning person ashore your work is only half done; the main thing is to bring him back to life should he be unconscious. There are several methods for resuscitating the apparently drowned. The method adopted by the Royal Humane Society of England is, to my knowledge, the simplest of all. It is as follows:
Begin treatment in the open air as soon as you have brought the unfortunate ashore. Meanwhile send for medical assistance, blankets and dry clothing. Expose the patient's throat and chest to the wind, except in very severe weather. Remove all tight clothing from neck and chest. Take off suspenders.
The points to be aimed at are: First and immediately the restoration of breathing, and, secondly, after breathing is restored, the promotion of warmth and circulation. The efforts to restore breathing must be commenced immediately and energetically, and persevered in for one or two hours, or until a medical man has pronounced that life is extinct.
Efforts to promote warmth and circulation beyond removing the wet clothes and drying the skin must not be made until the first appearance of natural breathing, for if circulation of the blood be induced before breathing has recommenced the restoration of life will be endangered.

HALL'S METHOD IN RESUSCITATION

To clear the throat, place the patient on the floor or the ground with the face downward and one of the arms under the forehead, in which position all fluids will more readily escape by the mouth, and the tongue itself will fall forward, leaving the entrance into the windpipe free. Assist this operation by wiping and cleansing the mouth.
If satisfactory breathing begins, use the treatment described below to promote warmth. If there be only slight breathing, or no breathing, or if the breathing fail, then, to excite breathing, turn the patient well and instantly on the side, supporting the head, and excite the nostrils with snuff, hartshorn, and smelling-salts, or tickle the throat with a feather, etc., if they are at hand. Rub the chest and face warm, and dash cold water, or cold and hot water alternately, on them.
If there be no success, lose not a moment, but instantly, to imitate breathing, replace the patient on the face, raising and supporting the chest well on a folded coat or other article of dress. Turn the patient very gently on the side and a little beyond, and then briskly on the face, back again; repeating these measures cautiously, efficiently and perseveringly about fifteen times in the minute, or once every four or five seconds, occasionally varying the side. (By placing the patient on the chest, the weight of the body forces the air out; when turned on the side this pressure is removed, and air enters the chest.)
On each occasion that the body is replaced on the face make uniform but efficient pressure, with brisk movement, on the back between and below the shoulder-blades or bones on each side, removing the pressure immediately before turning the body on the side. During the whole of the operations let one person attend solely to the movements of the head, and of the arm placed under it.
The result is respiration, or natural breathing, and, if not too late, life.
While the above operations are being proceeded with, dry the hands and feet, and as soon as dry clothing or blankets can be procured, strip the body and cover, or gradually reclothe it, but take care not to interfere with the efforts to restore breathing.

SYLVESTER'S METHOD

Rule 1. To Adjust the Patient's Position.—Place the patient on his back on a flat surface, inclined a little from the feet upward; raise and support the head and shoulders on a small, firm cushion or folded article of dress, placed under the shoulder-blades. Remove all tight clothing from about the neck and chest.

SYLVESTER'S METHOD—FIGURE 1

Rule 2. To Maintain a Free Entrance of Air Into the Windpipe.—Cleanse the mouth and nostrils; open the mouth; draw forward the patient's tongue, and keep it forward; an elastic band over the tongue and under the chin will answer this purpose. (Fig. 1.)
Rule 3. To Imitate the Movements of Breathing.—First, Induce inspiration. Place yourself at the head of the patient, grasp his arms (at the elbow-joints), raise them upward by the sides of his head, stretch them steadily but gently upward, for two seconds. By this means fresh air is drawn into the lungs by raising the ribs. (Fig. 2.)

SYLVESTER'S METHOD—FIGURE 2

Secondly, Induce Expiration.—Immediately turn down the patient's arms, and press the elbows firmly but gently downward against the sides of the chest, for two seconds. By this means foul air is expelled from the lungs by depressing the ribs. (Fig. 3.)
Thirdly, Continue These Movements.—Repeat these measures alternately, deliberately, and perseveringly fifteen times a minute, until a spontaneous effort to respire be perceived. By these means an exchange of air is produced in the lungs similar to that effected by natural respiration.

SYLVESTER'S METHOD—FIGURE 3

When a spontaneous effort to respire is perceived, cease to imitate the movements of breathing, and proceed to induce circulation and warmth, as described on following page.
Rule 4. To Excite Respiration.—During the employment of the above method, excite the nostrils with snuff or smelling-salts, or tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them. Friction of the limbs and body with dry flannel or cloths should be had recourse to. When there is proof of returning respiration, the individual may be placed in a warm bath, the movements of the arms above described being continued until respiration is fully restored. Raise the body in twenty seconds to a sitting position, dash cold water against the chest and face, and pass ammonia under the nose. Should a galvanic apparatus be at hand, apply the sponges to the region of the diaphragm and the heart.
To Induce Circulation and Warmth.—Wrap the patient in dry blankets, and rub the limbs upward energetically. Promote the warmth of the body with hot flannels, bottles or bladders of hot water; heated bricks to the pit of the stomach, the arm-pits, and to the soles of the feet.
On the restoration of life, when the power of swallowing has returned, a teaspoonful of warm water, small quantities of wine, warm brandy and water, or coffee should be given. The patient should be kept in bed, and a disposition to sleep encouraged. During reaction, large mustard-plasters to the chest and below the shoulders will greatly relieve the distrest breathing.
Note.—In all cases of prolonged immersion in cold water, when the breathing continues, a warm bath should be employed to restore the temperature.

Pan-American Republics and the United States, August 11, 1910