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Attention after patient

as she passes from one thing to another in her attention to the various details of service.

When the patient has been placed in bed and is placed in warmly covered with blankets, the hot applications

being placed around her, a towel should be placed under her chin, a light basin under the head of the bed to be on hand should she vomit, and a towel wrung out of cold water may be placed upon

her forehead. The blinds or screens should be so arranged that the light in the room may be modified. A chair for the surgeon may be placed at the head of the bed, and, as he or his assistant

takes his place there, the nurse may attend to from room speedily removing the things used during the operused during ation, as tables, protectives, etc., from the room. operation. These may be placed temporarily in an adjoining

room, until the nurse or some one who volunteers to assist her may see the different articles taken back to their respective places in the house.

Sheets, etc., soiled with blood, should be placed clothing. in a tub to soak. This will render the washing of

a them quite easy, as the blood being well-rinsed out of them, they may then be placed in the ordinary wash, unless it is preferred to do them separately.

Screens being placed around the bed to prevent the patient's feeling the draught, the windows should be raised and doors opened to thoroughly change the air in the apartment. This may more

of

Care of soiled

Ventilation of room,

watch over

effectually be done by “pumping the door,” as it is called, that is rapidly opening and closing it, without latching, so as to use it as a fan as it swings upon its hinges.

When the surgeon has to leave the patient, the The nurse's nurse must take up her station by the bed. Like patient's a sentinel on duty, she should be vigilant in her watch, noting every symptom promptly and meeting its demands. Until the patient is well out of ether the nurse should not entrust her care, even for a moment, to any inexperienced person.

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CHAPTER XI.

THE NURSE'S DUTIES AFTER OPERATION AND

DURING CONVALESCENCE.

Treatment of shock.

The immediate duties of the nurse after operation will depend much upon the condition in which the patient has been put to bed.

If the condition of shock be profound, vigorous measures may be necessary to produce a reaction. The application of dry heat, by means of blankets heated in an oven and tucked closely around the patient, and of pieces of flannel heated and placed over the chest immediately next the skin, serves to stimulate the circulation. The extremities may be rubbed with whisky or brandy, the nurse's hands being carried under the blankets to avoid exposure to air. The head should be kept low, even lower than the feet, in order to keep up the circulation of blood in the brain The foot of the bed may be elevated for this purpose, being raised by means of bricks or stools, or a high chair upon

which a stool has been placed may be slipped under the foot-board.

The patient may be fanned, and hartshorn sprinkled on a handkerchief or towel held near the

a

mic use of

in shock.

nostrils. Should further measures be necessary the nurse may, with the sanction of the surgeon, give hypodermic injections of some stimulant. Brandy or whisky may be thus given, or solutions of caffeine, strychnia, or digitalis. These are intended to strengthen the heart's action, and, if doing their work properly, the effect should be soon noted in the pulse. It should grow stronger and slower. The frequency with which these injections Hypodershould be given and the amount given at one time, stimulants will in every case need to be regulated by the surgeon. Careful instructions must be obtained from him. The full 30 minims of brandy or whisky may be given, filling the barrel of the syringe full. Ten to fifteen minims of tincture of digitalis generally constitutes a dose. It may be diluted in sufficient water to fill the barrel of the syringe. One to two grains of caffeine in solution, or b gr. of strychnia in solution, may be given by computing the dose according to the strength of the solution compounded. The hypodermic syringe is a delicate instrument Care o hy

podermic and should be carefully managed and kept in good syringe. order, so that it may be ready for use at any time. The barrel may be of metal, glass, or rubber; the nozzle or needle of gold, silver, or steel. The latter should be very sharp, hence the point should be kept well protected. If dulled its introduction

will cause pain. After use, a fine gold wire should be run through it, from the point of the needle upward, to keep out dust, etc. The barrel should be kept filled 73 full of water to keep the packing of the piston soft.* Should the packing become loose, draw out the piston and slip the finger-nail around the upper part of the packing, and spread it a little and soak in a little warm water for a time. A screw-piece attached to the piston enables a more

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accurate regulation of the dose, when it has to be Method of estimated in minims. In administering the injechypodermic injec- tion take hold of a portion of the upper part of the

arm or thigh and hold it firmly for a little time to benumb sensation; then insert the needle quickly,

tion

* Some surgeons prefer anointing the packing with a little gray mercurial ointment to prevent its drying, and not using the water, which, unless it consists of some antiseptic solution, does not keep the syringe in an aseptic state.

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