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The essential feature in all these conditions is the cessation of breathing. In hanging, it is true, when properly done, the vertebrae in the neck are dislocated. This injury is beyond all relief.
So long, however, as no other feature is present in the case than the stopping of respiration, there is always a chance for recovery within a certain time after the breathing has ceased.
If the respiration has been arrested by constriction of the throat, such as occurs in hanging and strangling, the first thing to be done is, of course, to cut the object which causes the constriction. Even though consciousness be completely lost, an effort should be made to revive*the patient.
Treatment.-In case of choking from the presence of food or other matters in the throat, the body should be inverted so that the head is lower than the shoulders. The body may then be violently shaken; if relief be not at once obtained, the finger should be introduced into the throat and an effort be made to extract the foreign body. In case of drowning, the body should be so placed that the head is lower than the chest ; this can be arranged by placing the body over the knee of another person, or any object of sufficient height. In this way some of the water will probably escape from the lungs and air passages.
Artificial respiration is then to be performed in one of the following ways :
The patient is placed upon his back, the head hanging over some projection, such as the end of a bench, upon which he may lie. The operator stands above the patient's head, grasps the arms below the elbows and draws them upward above the head, inclining them away from the body at the same time. After holding them in this position for a second, the arms are returned again to the sides of the body so that the elbows rest against the chest and the forearms on the abdomen. The operator should press the patient's arms firmly against the chest and abdomen so as to force all the air out of the lungs.
By raising the arms in this position the chest is expanded and the air enters the lungs ; by pressing the arms upon the body, the air is forced out of the chest again. In this way the respiration is artificially induced.
This series of movements should be executed at first about ten times in the minute ; in ten or fifteen minutes the rapidity of the movement may be increased to fifteen or eighteen respirations per minute.
If an assistant be present, he should see that the tongue does not fall back into the throat; the end may be grasped by means of a soft cloth or towel, and should be pulled forward out of the mouth.
This process should be continued ten or fifteen minutes, whether the patient show signs of life or not. At the end of this time, the ear may be applied to the patient's chest to observe whether or not the heart beats. Any movement of the heart, however slight, is an indication that life can be saved by further respiration ; even though no movement be felt, the respirations should be continued for at least half an hour.
CONTENTS OF SMOTHERING :
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