CIRCULAR

           OF THE


 State Board of Health,

       CALIFORNIA.




     RESUSCITATION

           OF THE







      METHODS


 TO BE  ADOPTED ON THE  SPOT.



Please Preserve this Circular,  or place
 it in the hands of some one by whom
    it may be likely to be used. 
« 
Ijcsuotitatttm  of %  Urouwei
    The season for DEEP-WATER, especially SEA
BATHING, being at hand, the State Board  of
Health  issue the  following  advice and directions,
which may be profitably adopted in case of accident by
drowning.   They are  simple, always  available, require
no delay, and can be effectually practiced by any intel-
ligent person, until medical aid can be  obtained.  Many
lives are annually lost by drowning through  ignorance
on the part of bystanders of  the proper method of
restoration, and many sacrificed by the use of inefficient
and improper means.  The plan of treatment proposed
is the " Direct Method " suggested  by  Dr. Howard, and
adopted by the New York Life Saving Institution.
                     Rules.

       I.   INSTANTLY  turn  the patient  downward,
   with a large firm roll of clothing under his stomach and
   chest.   Place one of his wrists or arms under his fore-
   head, so as to keep  his mouth off the ground.  Press
   with all your weight, or with a force proportioned to
i   the age of the patient, TWO OR THREE  TIMES,
   FOR FOUR OR FIYE SECONDS  EACH TIME,
j   upon the patient's back, below the shoulder-blades, so
   that the water may  be pressed out  of  the lungs  and 
4           'Resuscitation of the (Draw-itcd.
stomach,  and drained  freely  out of  the  mouth ;  as
represented .in the following cut.   (Fig. No.  I.)
     2.  QUICKLY turn the patient, face upward, with
the  roll  of clothing  under  his  back,  just  below  the
shoulder-blades, so as to make the head hang back as low
as possible.   Place  the patient's  hands above his head,
where they may be  secured by a handkerchief or cord.
Kneel with the patient's  hips  between your  knees, and
fix your elbows firmly against your hips.   Now—grasp- 
Resuscitation of the (Drowned.           5
ing the lower part of the patient's naked chest—squeeze
his two sides together, pressing GRADUALLY FOR-
WARD  with all  your weight, for  ABOUT THREE
SECONDS, until your  face is nearly over  the face of
the patient, as shown in  the following.  (Fig. No. 2.)
    Then, with  a push, SUDDENLY jerk  yourself
back.   (Fig. No.  3.) 
6           (Resuscitation of the Or owned.
    Rest  about  THREE  SECONDS;  then, begin
again (Figure No. 2), repeating these  bellows-blowing
movements about EIGHT OR TEN TIMES A MIN-
UTE,  FOR,  AT LEAST, ONE HOUR, or until the
patient breathes naturally.  By these  alternate move-
ments, foul air is pressed out of the lungs  and pure air
drawn in. 
(Resuscitation of the  (Drowned.
7
     Note.—The above directions  must be  used ON
 THE SPOT,  THE FIRST  INSTANT  THE PA-
 TIENT IS  TAKEN FROM THE WATER.  Lose
 no time.  A  moment's  delay—and  success  may be
 hopeless.  Observe  that neither APPARENT death, nor
 much delay in  the appearance of the signs of life, afford
 just ground for despair.   Perseverance is often rewarded
 by success, even after an apparently hopeless prolonga-
 tion of insensibility.
     Act  promptly and  steadily, following closely
 the rules given.
     Prevent crowding  around the  patient.  Fresh  air
 is essential.
     Should the patient commence to breathe, be careful
 not to interrupt the  first short natural breaths.   If they
 be long apart, carefully  continue  between them the
 bellows-blowing movements as before.  (Figs. 2 and 3.)
     After  breathing is regular, let the patient be rubbed
 dry and wrapped in  warm blankets.
     As soon as the patient can CERTAINLY SWAL-
 LOW, a little  warm spirit and water may be  given.
 This should be done cautiously, lest  the patient may be
 choked.
     After restoration, let the patient  be KEPT QUIET
 and sleep encouraged.

     The above rules are  intended for  adoption in the
 case of adults.   For younger persons the force applied,
 as shown in  Figure  No. 2, should be modified  to suit
 the age, " the operator feeling  his way as to how little
or much he is  doing, or  may do,  and  regulating his
course accordingly."