OCR Text |
Show For this reason both the American Red Cross and the National Ski Patrol system specifically exclude such procedures from their training programs. On the other hand, both the National Academy of Sciences ( Reference No. 7) and the American Heart Association ( Reference No. 3) have recommended that rescue workers be taught the techniques of closed- chest heart massage. Individual rescue organizations will have to reach their own decisions about seeking such training. We can only point out here that there is indisputable medical advantage to a cardiac arrest victim in properly applied cardiopulmonary resuscitation. The alternative to restored heartbeat is death. 3.3 Post- Resuscitation Care After the rescue, the accident victim is positioned flat, if possible, with the upper part of his body slightly lowered. The blood circulation can be stimulated by massaging the arms and legs from the periphery toward the heart. Any further chilling has to be avoided. The victim's reaction to fight the cold consumes large amounts of energy. Existing heat not only has to be conserved, but external heat has to be supplied to counteract the body cooling. A warm sleeping bag is essential. This may be heated by chemical hot pads or hot water bottles, or by preliminary occupation by a healthy person. A large sleeping bag is preferred, for then it is possible for one of the rescuers to get in with the victim to help warm him. When external heat sources are used, especially hot pads, care must be exercised to avoid local overheating. Wet cloths should be removed from the victim, his body dried, and dry clothing ( blankets, down garments) provided. Shelter from wind and snow is an obvious essential for such care of the victim. A small, light- weight tent which can be quickly erected at the accident scene is very useful, as well as a small, portable stove ( butane, gasoline) to heat it. As long as the victim remains unconscious, full attention has to be paid to keeping the breathing passages open and to the possible need of administering further artificial respiration. The unconscious person is positioned on the rescue sled and on the stretcher in a horizontal prone position with neck slightly extended and tied above the hip with belts or cloth; the head and upper part of the trunk lie flat or are even inclined slightly downward. According to his condition, the rescued person is transported to the hospital or to his home in the company of an attendant who observes him continually. In either place, medical supervision must be continued. The rescuers should be alert for head, neck and back injuries. If the latter are suspected, particular care should be used in moving and positioning the victim. In the case of mechanical injuries in general, the conscious victim should be positioned for transport in the most comfortable pos it ion. 60 |