13. Medical

See also: Handbook of First Aid Treatment for Survivors of Disasters at Sea

Be sure you include medical supplies in your abandon-ship package. All seamen, and everyone who may have to abandon ship, should carry at all times a waterproof packet containing at least two ounces of sulfanilamide powder.

SULFANILAMIDE. -- R.H. Pilcher, the radio operator of the torpedoed Anglo-Saxon, had his left foot mangled by shrapnel. His foot turned green and black from gangrene, which is dead tissue. It swelled to twice in natural size. The stench from it made his lifeboat mates sick. On the seventh day the foot went dead, and on the eleventh day the remains of Pilcher were dropped over the side.

Sulfanilamide, the miracle drug, even administered by unskillful hands, undoubtedly would have saved Pilcher's life.

In the first World War 80% of the men suffering from abdominal wounds were killed by infection. After Pearl Harbor, thanks to sulfanilamide, no service man died from infection. Less than 4% of the compound fractures became


infected, and infection did not cost any man an arm or a leg.

FIRST-AID KIT. -- An adequate first-aid kit in a watertight container for a lifeboat should contain:

ARTERIAL BLEEDING. -- While someone is preparing a tourniquet, use whichever of the six following pressure points is needed to stop


bleeding. If you can prevent it, never allow bleeding to continue longer than four or five minutes.

Illustration of first aid techniques
A. Point of compression for carotid artery. B. For brachial artery. C. Femoral artery.
D. Windlass tourniquet. E. Strapping an ankle with adhesive, first step. F. Strapping completed.
G. Strapping broken ribs, first step. H. Strapping completed.

Press your fingers on the point indicated. Fingers may also be pressed directly on the wound, since


saving life is the primary consideration, while avoiding infection is secondary.

1. Bleeding from scalp and forehead: Press in front of the opening of the ear.

2. Bleeding from face below eyebrow: Press the side of the jaw just in front of the angle of the jawbone.

3. Bleeding from neck or throat: Put your thumb behind the neck, and the fingertips at the side of the neck beside the windpipe and press backward.

4. Bleeding from the shoulder and armpit: Press your thumb downward against the side of the neck behind the collar bone.

5. Bleeding from the arm: Press the inner side of the arm below the armpit.

6. Bleeding from the leg: Stretch the injured person out. Press the heel of your hand into the middle of the groin.

To make a tourniquet: Use a handkerchief, belt, strip of canvas, or any piece of cloth at least two inches wide. Never use a wire or a rope.

Apply the tourniquet about four inches below the armpit or groin. Take two round turns around the arm or leg and tie with a square knot. Insert a stick and twist to tighten the tourniquet. Then secure the ends of the stick.

Be sure the tourniquet is tight. You have to constrict the arteries, which are further below the surface than the veins. Loosen the


tourniquet every 15 minutes by untwisting the stick. If the bleeding starts again, tighten the tourniquet.

GUNSHOT, SHRAPNEL WOUNDS. -- Clean the wound -- with sea water, if no other antiseptic wash is available, and you are far enough out to be certain that the water is clean. Debride the wound. That is, you must cut away all the dead and dying flesh, on which germs can feed. Your knife must be sterile -- free from germs.

To sterilize the knife, either thrust the blade in the flame of a lantern or match, or dip it in the compass alcohol. The black carbon that collects on the knife from the flame will not do any harm. After sterilizing, do not touch the blade with your hands.

When you have cleaned the wound, dust it with two ounces of sulfanilamide power. To be effective, the sulfanilamide powder must be put directly onto the wound.

Place sterile gauze or layers of bandage over the wound, and bandage so that the wound will drain freely. Dressings may be sterilized by scorching. Use a heavy dressing for a chest or abdominal wound. The wound must be dressed daily.

If sulfathiazole tablets are available, they may be given by mouth to the wounded person in dosages of two 7½-grain tablets every four


hours. This treatment may be continued as long as the infection shows evidence of advancing.

A nmild toxic -- poisonous -- condition may result from the sulfathiazole treatment. This toxic condition may cause nausea, vomiting, headache, rash, and reduced kidney function. If the toxic manifestatoins become pronounced, discontinue the sulfathiazole.

Due to its drying effect, suflanilamide powder checks the healing of the wound after three or four days' treatment. However, under lifeboat conditions, it is advisable to continue the treatment, rather than run the risk of gangrene.

FRACTURES. -- Unless a simple fracture is kept immobile, it is liable to become a compund fracture, with danger of infection which may prove fatal. Do not try to set a bone. Merely use traction, that is, exert a slow, steady pull to straighten the limb, turning the hand or foot to a normal position as you pull. Then have an assistant apply splints, while you maintain traction. Except in an extreme emregency, do not move the paitent until splints are applied.

Once you have started the traction, do not release it until the splints are in place. Thereafter, fixed traction should be used until a doctor is reached. Fixed tracton is a constant light strain on the end of an arm or leg.

In a compound fracture put a tourniquet


loosely around the arm or leg, ready to be tightened in case of arterial bleeding. Paint the compound fracture wound with iodine, cover it with a sterile dressing and bandage. If the bone is

CITY OF NEW YORK survivors
Within a few days after this photograph of City of New York survivors was taken, three of these men were dead. General Djoukanovitch, a passenger, with a handkerchief over his head, succumbed on his fourth day in the open boat. Armando Ferreira, quartermaster, wearing a cork jacket, and William Hannegan, electrician, his back to the camera, died on the twelfth day. Ten persons passed away in this lifeboat, either from exposure, in which the entire body was refrigerated, causing the heart to wear itself out trying to keep up circulation, or from shock (see page 94). The warmth that a life suit provides quite likely could have prevented these casualties. (Acme)


sticking out, apply iodine to the bone as well as to the rest of the wound. No harm is done if the protruding bone disappears when traction is applied.

A man with a head injury should be kept lying down. The head should be slightly raised if the face is red, but level if the face is pale. Apply cold cloths to the head. Avoid any pressure on the head wound. Avoid giving stimulants. Keep the person warm. Move him only in a prone position, and avoid unnecessary handling.

SHOCK. -- Shock, which may be caused by an injury, exposure, or a severe emotional disturbance,m is a condition in which the fluid of the blood spreads out into the tissues. Because of this, the blood concentrates, and this concentration impedes the circulation.

The abdominal vessels dilate, thus increasing the volume of the containers of the blood. When there is more space than blood, the circulation collapses, and the victim of shock actually bleeds to death in his own circulation.

A shock victim often has a fear of impending disaster. His skin becomes clammy. He breaks out in cold perspiration, and his pulse is rapid and feeble.

In treating shock, heat applied to the abdomen or to the sides of the body is the most


important. For this purpose it is advisable to purchase a chemical bag which gives off heat when water is added.

The victim should be placed on his back with his head low, so that blood will flow to the heart and brain. A teaspoonful of aromatic spirits of ammonia in half a glass of water may be given every thirty minutes. Black coffee is helpful. The patient must be kept warm and quiet.

DROWING. -- If you are swimming, never take hold of a drowning person while he is struggling. Wait until he becomes quiet. Approach him from behind. Grab his hair and pull him onto his back. Turn on your back, holding onto his hair or neck, and swim.

In the lifeboat place four oars in a row on the thwarts. Spread the life preservers on top of them, and stretch the person belly down on the preservers. You can also use the bottom of the boat by moving the bread tanks and the water breaker, but this is not advisable in a heavy sea.

Do not take time trying to get the water out of the stomach and lungs. Restore spontaneous breathing by using the simple prone-pressure method of artificial respiration. Keep it up until the person is breathing. People have regained consciousness after four hours of artificial respiration.

To restore breathing: [NOTE: These instructions are obsolete, having been replaced by the modern technique of cardio-pulmonary resuscitation (CPR). The are included here only for historical purposes. They should not be relied upon in an actual emergency. -- Hyperwar] Stretch the person, face


down, full length, right arm stretched forward past the head, left arm bent. Rest the person's cheek on the bent arm.

Straddle the patient's thighs. Put your palms on each side of his back, so that pressure will work the chest like a bellows. Hold your arms straight and bear down. Squeeze all the breath out of his lungs. Hold the pressure, which should be 35 to 40 pounds and never more than 60, while you count three. Swing back, removing the pressure completely.

The patient's lungs will expand, drawing in air. Count three, and apply the pressure again. This acton of pressure and release, pressure and release, should be repeated from 12 to 15 times a minute. Each complete movement -- bearing down, then swinging back -- should occupy 4 or 5 seconds.

BURNS. -- Remove clothing over the burned area. If clothing sticks to the skin, cut around it, but do not attempt to remove the part that is stuck.

Apply several layers of sterile gauze soaked in a sodium bicarbonate solution, ort moisten picric acid gauze and apply several layers to the burn.

Sterile gauze moistened with a 5% solution of tannic acid proves an excellent treatment. A 5% solution may be made by half-filling a


sterile jar with tannic acid powder and adding fresh after until the jar is filled.

Do not apply iodine to a burn.

A few drops of clean olive oil, mineral, or castor oil may be put into the eyes.

SUNBURN. -- A lifeboat is not the place to acquire a suntan. To conserve your body's water supply, as well as to avoid sunburn, keep well covered up, especially on clear days in the tropics. Keep your clothes and hat on, and stay under the boat-cover awning as much as possible.

If you are a blond or redhead, you are far more sensitive to the sun's ultraviolet rays than if you are dark-haired. Give special consideration and protection to the heliophobe -- the person who reddens and blisters, but who does not tan.

In a lifeboat your tolerance to sunshine -- or the time you may safely expose yourself to the sun -- is no more than 30 minutes.

The sun's reflection on the water will burn you just as severely as will the direct rays.

Even on a misty, cloudy day, it is possible to receive a painful burn.

Because of the salt on your face and body, lotions are apt to prove ineffective. If you do


use a lotion, remember that many of them -- and probably the one your are using -- permit a 50% transmission of the sun's rays to your skin. Therefore, the lotion's value as a protective film will reach the limit of safety after one hour.

Olive oil, cocoanut oil, vinegar, carron oil -- equal parts lime water and raw linseed oil -- are not effective in the treatment of burns. Linseed oil and lanolin increase the possibility of infection.

Apply talcum to east first degree burns -- identified by bright redness.

For third degree burns, use tannic acid.

Pain may be eased with a 2 to 5% solution of aluminum subacetate. Apply with a compress.

SUNSTROKE. -- In the doldrums, beware of sunstroke. It is caused by exposure to the sun's infra-red or heat rays, with humidity and the lack of a breeze as contributing factors. Sunstroke signifies that the heat-regulating mechanism of your body has been thrown out of gear.

Your body's normal temperature is 98.6 degrees Fahrenheit. Sunstroke can run this temperature up to 113 degrees F., which is, of course, fatal.

You are not immune to sunstroke. If exposed to the sun when the air is still, African monkeys, which are used to the heat of the tropics, will soon die.


Fortunately sunstroke is almost always preceded by warning. Headache, dizziness, spots before the eyes and swimming vision, nausea, vomiting, diarrhea, and abdominal pains indicate that you should get under cover immediately.

Loosen your clothing. Have some one fan you. Bathe your face and head. Put your wrists in sea water. Drink water in sips. Rub the skin with water to increase the circulation. Cold tea or coffee will stimulate circulation.

In case of actual sunstroke, the person should be stretched out under the awning on a bed made of the oars placed on the thwarts. Use the life preservers for cushions. Loosen the clothing. Fan him. Administer aromatic spirits of ammonia, if it is available. Have some one stand at the opposite end of the boat and dash sea water over him. Keep the patient quiet for at least forty-eight hours.

Sunstroke is dangerous. It can permanently injure the heart and brain, and it can kill.

TOOTACHE. -- If your teeth have cavities or if the nerves have given any warning of impending toothache, do not fail to take along a toothache remedy.

From the steward obtain a piece of paraffin or candle wax. Filling the cavity with paraffin will keep out salt, sugar, food, liquids, and extremes


of temperature, all of which contribute to toothache.

Flooding the cavity with whiskey often will deaden the nerve, though this remedy is not always reliable.

A thick paste, consisting of zinc oxide powder mixed with a few drops of oil of cloves -- both likely obtainable from the ship's medical stores -- will deaden the nerve when put into the cavity.

MINOR INJURIES. -- The importance of avoiding minor injuries in a lifeboat cannot be overstressed, as they will simply refuse to heal under lifeboat conditions.


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