□ TEPID SPONGING
Sponging is the process in which the patient’s body is cleaned with soap and wet cloth while the patient remains in bed. Ordinary sponging is never required by the first aider, but tepid sponging may be required. It is done so as to reduce the body temperature in cases of high fever. The method is as follows.
1. Check the body temperature.
2. Soak sponges with water, squeeze them and place two of them in the patient axillae, two in the groins, and one on the abdomen. Place an ice-bag on the head. Change the sponges periodically.
3. Wipe the patient’s body with sponges soaked in the water. Do not dry the body entirely.
4. Complete the procedure in 18-20 minutes.
5. Check the body temperature \ hour later.
□ COLD PACK
This procedure is done to lower body temperature in cases of high fever. The method is as follows.
1. Place a mackintosh and a bath-blanket under the patient.
2. Remove the patient’s clothes.
3. Soak two bed sheets in water at 1 8°C and squeeze them moderately.
4. Turn the patient on one side and place one bed sheet under the patient. Then place the patient on this bedsheet and place the other bed sheet over him from neck to toes.
5. Place cold compresses or ice bag on his head.
6. Soak the bed sheet in water after it becomes less cool, squeeze and place it over the patient again. Do this for 10 to 15 minutes.
7. Check the patient’s temperature after 30 minutes.
□ ICE BAG
It is a rubber bag in which pieces of ice are kept. It is used to reduce body temperature in cases of high fever, to reduce hemorrhage into a hematoma, and toe relieve pain after blunt trauma. The procedure for its use is as follows.
1. Break ice into pieces of desired size. Place them in a bowl of water so as to remove sharp edges which could tear the rubber bag.
2. Put them in the bag with a spoon. Add some salt to it so as to lower the freezing point further. Do not fill the bag more than 2/3.
3. Place the bag on a flat surface, remove air from it and dry it.
4. Place a mackintosh below the part to be cooled with the ice-bag.
5. Place the ice bag over the part to be cooled.
6. Check periodically to see that the part does not become numb.
7. Do not leave very old or very young patients alone while the ice bag is being applied.
8. Check the patient’s temperature periodically. Avoid overcooling.
9. After use empty the bag. Dry it well from inside as well as outside. Let some air into it and place in a cool, dry place.
□ HOT WATER BAG
A hot water bag is used for varied problems such as :
1. To relieve pain.
2. To help resorption of a hematoma.
3. To help a patient with urinary retention to pass urine.
4. To keep a patient of hypothermia warm.
5. To keep a newborn baby warm in conditions like prematurity, birth asphyxia, hypothermia etc.
The procedure for the use of a hot water bag is as follows :
1. Fill the bag about 2/3 with water at 55-60°C.
2. Place the bag on a flat surface and remove all air from the bag.
3. Close the mouth of the bag.
4. Invert the bag to confirm that it does not leak. Dry the outer side of the bag.
5. Cover the bag with cloth or a cover.
6. Place it over the area to be warmed covered by a towel.
7. Change the water inside when it cools.
8. Empty the bag after use, dry it well from inside and outside, let some air in, and keep it in a cool, dry place.
9. Do not use water at a temperature more than 49°C when to be used for small children and patients with heart disease.
10. Do not place the bag under the body at any time.
11. Do not use a hot water bag if the patient is unconscious or paralytic with loss of sensation, as accidental burns can occur.
12. Change the position of the bag after 5 minutes. 1 3. Remove the bag if the site of application of the bag becomes red. Apply talcum powder locally.
Eye wash or eye irrigation is the procedure of washing the eye under aseptic precautions. It is done to remove a foreign body from the eye, to remove inflammatory discharge from the eye, and before an eye operation. The procedure of giving an eye wash is as follows.
1. Make the patient lie down or sit up as convenient. Tilt the head backward in sitting position. Put a mackintosh under the head in a lying down position and wrap a towel around his neck.
2. Ask the patient or an assistant to hold a kidney tray below the eye to be washed. Wash your hands thoroughly well with soap and water. Open the patient’s eyelids.
3. Soak a swab of cotton in sterile normal saline and squeeze it into the patient’s eye, first under the upper eyelid and then under the lower eyelid.
4. Repeat the procedure till the eye becomes clean.
5. Dry the eyelids from outside using dry cotton swabs.