CHAPTER XI
EMERGENCIES
Suggestions for demonstrations. 1. Describe the bath thermometer and illustrate its use with water at different temperatures. 2. Demonstrate the preparation of an enema and show the correct position of the body when taking one. 3. Show how to protect the baby from infection when the mother has a cold.
Babies should be protected from excessive excitement. The brain grows as much during the first year as it does during the entire remainder of life. As the baby’s nervous system is easily upset, he should be kept free from disturbing influences.
Convulsions. Anything which upsets the baby’s nervous system may interfere with the process of digestion. This, as well as improper food, constipation, or some acute illness may be the cause of convulsions. When in a convulsion, the baby loses consciousness, the legs and arms stiffen, and the facial muscles begin to twitch. Send for a doctor at once. Meanwhile the baby should be placed in a tub of warm water. If a thermometer is not at hand, some adult should always test the temperature by placing her arm, up to the elbow, in the water. Great care should be taken that the water is not too hot, as many babies have been seriously burned in this way. The temperature of the water should be slowly raised to 108° F. by adding hot water. A cold compress should be placed on the child’s head and frequently changed. When the convulsion ceases the child should be removed from the bath and wrapped in a warm blanket, and his face should be bathed with cold water. If necessary, he may be kept in the bath about twenty minutes. If a child has convulsions and a tub is not available, he should be wrapped in a large bath towel which has been dipped in water at a temperature of 104° F., wrapped in a soft blanket, and the face and hands should be bathed in cold water.
BATH THERMOMETER
Colic. Colic, or a pain in the bowels, is indicated by a sharp, spasmodic cry, a drawing up of the legs, and a contraction of the muscles of the face and abdomen. The sufferer should be given a little warm water to drink and should have a soft, hot flannel placed over the abdomen and around the feet, or he should be laid on his stomach across a hot-water bag which is protected by a cloth covering.
Constipation. It is important that the mother who is nursing a baby should have a free movement of the bowels each day; if her bowels are kept open and her digestion is good, the baby will not, as a rule, be constipated. A little water given to the baby between feedings will help to prevent constipation. Fruit juices, such as prune and orange juice, should also be given. The most effective way of overcoming or preventing constipation is to develop the habit of having the bowels move at the same time each day. The baby should not be allowed to go more than twenty-four hours without a movement. Except in emergency, however, do not give the baby an enema or suppository or any medicine unless ordered to do so by a physician.
Enema. An enema of two to four ounces of warm water, to which has been added a little soapsuds and one or two tablespoonfuls of warm olive oil, will usually cause a movement of the bowels.
Directions for giving an enema. Place the baby on his back with a folded towel under his buttocks. A soft rubber catheter is safer to use than the hard rubber nozzle provided for this purpose. Allow the water to run freely through the catheter before inserting, so as to prevent injecting cold water and air into the rectum. Lift the baby’s feet with the left hand and with the right insert the oiled catheter gently into the rectum for two or three inches.
Diarrhea. A well baby usually has one or two movements a day. Frequent movements, or diarrhea, may be the beginning of a severe illness, and a physician should be consulted at once. This condition occurs more frequently with bottle-fed babies. If it occurs in a breast-fed baby, it is usually because the mother has not been careful about her diet or because the baby has been given improper food. To relieve this condition, if a physician is not at hand, give one teaspoonful of castor oil and omit the feeding in order to let the baby’s stomach rest.
Prevention of chafing. The skin of the baby is sensitive and may be easily irritated. For this reason the baby’s diaper should be removed as soon as soiled and the skin cleansed with warm water. The folds of the skin should be thoroughly dried and dusted with a little talcum powder, or olive oil may be applied, before the clean diaper is put on.
Colds. Common colds are contagious and in infants often lead to serious illness. A mother with a cold, when nursing her baby, should tie a handkerchief loosely over her nose and mouth in order to protect the child from infection if she should cough or sneeze. Many children’s diseases, such as whooping cough, measles, etc., are transmitted through the secretions of the nose and mouth. Any member of the family who has a cold should keep away from the children, and particularly from the baby.
PROTECTING THE BABY FROM HIS MOTHER’S COLD
Vaccination. Before the discovery of vaccine, smallpox was the most dreaded disease in the world and more prevalent than measles is to-day. A hundred years ago it was considered a disease of the children; to-day, by the simple and safe process of vaccination, it has been almost entirely eliminated, except in those localities where through prejudice or ignorance the children are not vaccinated. Therefore every baby should be vaccinated before he is six months old; this should be repeated at about six years of age, and later if there is a smallpox epidemic.
The best place for vaccination is on the left arm. If the leg be selected, as it is occasionally (especially with girls), the child should stay in bed during the reaction following vaccination.
The aftercare of a vaccinated child is important. A dressing of clean, sterile gauze should be placed over the point of vaccination and held in place with strips of adhesive plaster. The dressing should be changed only by the physician or under his orders. If it sticks to the scab, it should not be pulled off; the cloth should be cut away around it and a small piece left adhering to the arm and a fresh dressing placed over this. Do not apply vaseline or any kind of ointment to the point of inoculation. Nothing must touch it but clean boiled water and sterile dressing handled by clean hands.
A vaccinated child should have a bath and a change of underwear daily, but it is important that the dressing over the vaccination should be kept clean and dry. The child should not be permitted to play in gardens, stables, or dusty streets until the arm has completely healed.