TEXTBOOK OF NURSING PROCEDURES 
BELLEVUE SCHOOL OF NURSING THE MACMILLAN COMPANY 
NEW YORK • BOSTON • CHICAGO • DALLAS 
ATLANTA • SAN FRANCISCO 
MACMILLAN & CO., Limited 
LONDON • BOMBAY • CALCUTTA 
MELBOURNE 
THS MACMILLAN CO. OF CANADA, Lm 
TORONTO CARRIE J. BRINK, R.N., 
1864-1920. 
Superintendent of Bellevue School of Nursing. 
1907-1920.. TEXTBOOK 
OF 
NURSING PROCEDURES 
Bellevue School of Nursing1 
COMPILED BY 
DOROTHY DIX HILL, R.N. 
Graduate of Bellevue School of Nursing, 1921; Instructor of Nursing Pro- 
cedures, Bellevue School of Nursing, New York City 
jfteto gocft 
THE MACMILLAN COMPANY 
1923 
All rights reserved PRINTED IN THE UNITED STATES OS’ AMERICA 
Copyright, 1923, 
By THE MACMILLAN COMPANY. 
Set up and electrotyped. Published September, 1923. 
Press of 
FERRIS PRINTING COMPANY 
, NEW YORK CITY To The Memory 
of 
CARRIE J. BRINK, R.N., 
loyal friend, faithful and devoted nurse, un- 
tiring and courageous worker for the cause of 
suffering humanity; inspiring teacher and skill- 
ful exponent of the principles and practice of 
nursing PREFACE 
For many years Miss Brink taught the prin- 
ciples and practice of nursing to the students of 
the Bellevue Training School for Nurses. During 
those years a technique of procedure was evolved 
which gradually became known and described as 
the “Bellevue method.” 
Notes of these procedures have been handed 
down from class to class, and some additions and 
revisions have been made from time to time. In 
order to preserve them, as well as make them 
more easily available to a constantly increasing 
number of students, they have now been brought 
together and arranged for publication. 
Following the accepted method of instruction, 
these procedures are first demonstrated in one 
classroom and practiced under the supervision of 
the instructor. The underlying principles are 
explained and emphasized. With each demon- 
stration or class the student is given references 
for study in the various nursing texts, which not 
only further emphasize the principles evolved, 
but which also give a method of procedure which 
may differ in some particulars from that which 
has been taught and demonstrated, but which will 
produce equally successful results either of ther- PREFACE 
apy or of bringing ease and comfort to the 
patient. 
These procedures cover the elementary nursing 
measures as well as the more advanced nursing 
procedures usually included in the nursing care 
and treatment of medical and surgical patients, 
and those used in the diseases of the eye, ear, 
nose, and throat. 
Grateful acknowledgment is made to Miss 
Maude C. Kelley, R.N., Mrs. Ruth Burkett, R.N., 
Miss Sadie Sweeney, R.N., and Miss Mae Knowl- 
ton, R.N., for assistance in the compilation of 
these notes. 
Dorothy Dix Hill, R.N. 
New York City. TEXTBOOK OF NURSING PROCEDURES 
BELLEVUE SCHOOL OF NURSING TEXTBOOK OF NURSING PROCEDURES 
ADMISSION OF PATIENTS 
i. Method of admission. 
1. Through gate office. 
2. In admitting office. 
1. History of patient taken. 
2. Admission slip given containing: 
1. Patient’s name. 
2. Date. 
3. Hour of entry. 
4. Number of ward to which as- 
signed. 
5. Division to which assigned. 
3. In admitting baths. 
1. Non-urgent cases. 
1. Searched for money and val- 
uables. 
2. List of patient’s clothing taken, 
and entered in admission book. 
Patient signs book to verify list 
and it is witnessed by two 
nurses. 
3. List of patient’s property taken 
and entered in admission book 
—signed as before. 
1 2 
ADMISSION OF PATIENTS 
4. Temperature, pulse, and respira- 
tion taken by nurse. 
5. Clothing removed. 
6. Bath given (tub or sponge as con- 
dition permits). 
7. Hair is washed (treated for pedi- 
culi if necessary). 
8. Gown, bath robe, and slippers 
given patient. 
2. Urgent cases. 
1. Entered in separate book. 
2. Taken directly to ward by mes- 
senger, and accompanied by 
nurse in charge. 
3. List of clothing obtained on ward 
and entered in admission book 
(signed as before). 
4. List of property obtained and en- 
tered in admission book. 
5. Duties of ward nurse if patient is 
serious. 
1. Notify priest or chaplain (if 
religion is unknown she 
must send for both of 
them). 
2. Have bedside card signed by 
priest or chaplain. 
4. Taken to ward by messenger. 
1. On stretcher. 
2. In wheel-chair. 
5. Put to bed and temperature, pulse, 
and respiration taken by the ward 
nurse. ADMISSION OF PATIENTS 
3 
2. Care of clothing. 
1. Placed in clothes bag and marked. 
1. Yellow tag—Infectious cases—clothes 
fumigated. 
2. Red tag—Vermin present. 
1. All leather goods as shoes, belts, 
hats, etc., are fumigated in sep- 
arate bag. 
2. All other clothing are steam 
sterilized. 
3. White tag—Clean clothing. 
2. Clothes bags sent to clerk of clothes room 
once a day. 
1. Tags numbered. Numbers are sent to 
admitting baths and entered on 
admission book. 
3. Care of property. 
1. Placed in large envelope. Articles listed 
on outside. 
2. Envelopes given to property clerk. 
1. Articles examined and property slips 
made out. 
3. Property slip filed in admission baths with 
number of clothes tag on back. DISCHARGE OF PATIENTS 
1. Bedside card signed by ward doctor. 
2. Bedside card taken to and signed by assistant 
superintendent. 
3. Property slip and clothes number obtained 
from admission baths. 
4. Clothes obtained from clothes house and signed 
for by nurse. 
5. Nurse dresses patient in ward. 
6. Nurse takes patient and property slip to prop- 
erty office. 
7. Property received, examined, and signed for 
by patient and nurse. 
8. Taken to gate office. 
1. Bedside card is left. 
2. Patient dismissed. 
Note. If patient leaves against physician’s ad- 
vice: 
1. Nurse obtains an A. 0. R. (at own risk) 
slip from supervisor’s office. 
2. Patient signs slip. 
4 TRANSFER OF PATIENT 
1. From one department to another. 
1. Bedside card signed by ward doctor, and 
assistant superintendent. 
2. Gate office changes number of ward on 
bedside card. 
3. Messenger and stretcher are sent from ad- 
mitting office to the ward if called for. 
4. Nurse must accompany every woman, al- 
coholic, insane, and prison patient. 
5. If from pavilion A and B to main building 
or surgical pavilion. 
1. Transfer property slip and clothes 
number from A and B to main ad- 
mitting baths by transfer book. 
6. If from main building or surgical pavilion 
to pavilion A and B transfer property 
slip and clothes number without transfer 
book. 
2. Method of transfering patients from Bellevue 
to the hospitals of the Department of Public 
Charities on Blackwell’s Island. 
1. Bedside card and form of request for noti- 
fication of relatives of patient, concern- 
ing transfer sent to registrar’s office 
before 4 p.m., any day except Sunday. 
2. Patient must be held forty-eight hours 
after notice to relatives is sent out. 
5 6 
TRANSFER OF PATIENT 
3. On day of transfer. 
1. Obtain permission to have transfer 
from assistant medical superin- 
tendent between 8.30 and 10.30 
A.M. 
2. Bedside card signed as for discharge 
of patient. 
3. Duplicate transfer slips made out and 
signed by the senior house officer. 
4. Assistant medical superintendent 
calls at the ward and signs bedside 
card and transfer slip (if transfer 
is given). 
4. Bedside card, transfer slips, copy of his- 
tory, and physical examination sheets 
are sent to registrar’s office by 11.30 on 
day of transfer. BED-MAKING 
To strip a used bed. 
1. Place chair at foot of bed. 
2. Place pillows neatly on chair, open end of 
case down with soft pillow next to back 
of chair. 
3. Loosen all bed clothing at foot and sides 
of bed. 
4. Fold spread over from top to foot of mat- 
tress. Grasp in center, folding in four. 
Place folded edge over back of chair. 
5. Remove each blanket separately in same 
manner and place over chair. 
6. Remove top sheet in the same manner. 
7. Fold cotton draw sheet from side to side 
and place folded edge over the chair. 
8. Fold rubber draw sheet in two and place 
over chair. 
9. Remove bottom sheet, fold in same manner 
and place over chair. 
10. Turn mattress from head to foot. 
11. If bed is to stand before being made up' 
place pillows and folded bedding on 
springs at head of bed. Replace chair. 
7 MAKING A STANDING BED 
Articles necessary. 
1. Two large sheets. 
2. Rubber draw sheet. 
3. Cotton draw sheet. 
4. Two bed blankets. 
5. Spread. 
6. Two pillow cases. 
7. Bedside chair. 
Procedure. 
1. Turn mattress toward foot of bed. 
2. Place first sheet on mattress. Tuck ten or 
twelve inches securely under head. 
Bring down tightly over mattress and 
tuck surplus under foot. Make square, 
tight corners, and tuck smoothly under 
side of mattress. 
3. Place rubber draw sheet, upper edge 
thirteen inches from top of mattress. 
4. Place cotton draw sheet eleven inches from 
top of mattress. Let it extend two 
inches below rubber sheet. Tuck secure- 
ly under side of mattress. 
5. Go to other side of bed. Follow the same 
procedure. 
8 MAKING A STANDING BED 
9 
6. Place upper sheet at top of mattress. 
Right side of hem down. Draw down 
over foot. 
7. Place blanket nine inches from top of mat- 
tress. Make two two-inch tucks in sheet 
and blanket at foot, five inches from 
each side of center rod. Tuck under 
foot of mattress. Make a square comer. 
8. Place second blanket nine inches from top 
of mattress. Fold under itself at foot, 
tuck under mattress at side. 
9. Turn upper sheet nine inches over blankets 
at top. Tuck under at side. 
10. Go to the other side and follow same pro- 
cedure. 
11. Place spread with upper hem even with 
top of mattress. Tuck surplus in at 
foot. Make square comers. 
12. Place soft pillow on bed. Open end away 
from door. Stand hard pillow upright 
on soft pillow. 
13. Straighten bedside table, replace chair, 
and line bed with the preceding one. 
Refekence Readings: 
Harmer, pages 34-36. 
Hampton-Robb, pages 104-105. 
Maxwell* and Pope, pages 48-56. TO OPEN A BED 
Articles necessary. 
1. Two safety pins. 
Procedure. 
1. Eemove pillows to bedside chair. 
2. Turn spread under blankets at top. 
Turn top sheet nine inches over blankets 
and spread. 
Pin with a safety pin at edge of mattress. 
3. Lay hard pillow on mattress w7ith open end 
away from door. 
4. Lay soft pillow on top of hard pillow. 
5. Straighten bedside table, replace chair, 
and line bed with preceding one. 
10 EMERGENCY BED 
Articles necessary. 
1. Rubber pillow case. 
2. Long rubber sheet. 
3. Cotton sheet. 
4. Bath blanket. 
5. Night gown. 
6. Extension light for night service. 
7. Two safety pins. 
Procedure. 
1. Select a bed which has a long rubber next 
to the mattress. 
2. Remove pillows and place on bedside chair. 
3. Turn edge of spread under blankets. Fold 
top sheet nine inches over spread. Fan 
covers twice, fold over once, and place 
fold neatly on rod at foot. 
4. Cover soft pillow with rubber case. Place 
on bed. 
5. Over entire bed and pillow place long rub- 
ber sheet. Lower edge even with mat- 
tress. 
6. Place a cotton sheet over rubber sheet. 
Fold its edges under the rubber sheet 
at top and bottom. Tuck under mattress 
at sides. 
11 12 
EMERGENCY BED 
7. Place fanned bath blanket at foot of bed. 
8. Place night gown in stand. 
9. Place extension light beside head of bed. 
10. Place bed in most accessible location from 
main entrance of ward so as not to dis- 
turb other patients and may be readily 
observed. 
Procedure after patient is admitted. 
1. Screen with two screens. 
2. Cover with bath blanket and undress. 
3. Care for property and clothing according 
to regulations. 
4. Give patient a cleansing sponge bath and 
put on night gown. 
5. Give any necessary treatment. 
6. Turn patient toward you, go to other side, 
loosen cotton and rubber sheet, roll to 
center of bed. Turn patient toward you. 
7. Go to first side and remove cotton and rub- 
ber sheets from under the patient. 
8. Draw upper clothes over patient. Eemove 
blanket. Arrange bedding neatly. 
9. If no scalp or face wounds, or vomiting, 
remove rubber pillow case. 
10. See that necessary articles are in bedside 
table in place. ETHER BED 
Articles necessary. 
1. Ether rubber. 
2. Cotton draw sheet. 
3. Isolation blanket. 
4 Towel and two safety pins. 
5. Night gown. 
6. Two hot water bottles and covers. 
7. Rubber pillow case. 
8. Gauze bandage. 
9. Isolation blanket (to be placed in table). 
Bedside table articles. 
1. Emesis basin. 
2. Tooth cup with three ounces boric acid 
solution, 2%. 
3. Paper bag. 
4. Two narrow strips of adhesive. 
5. Gauze mouth wipes. 
6. Artery clamp. 
7. Two tongue depressors. 
8. Towel. 
Procedure. 
1. Put on long rubber if case requires it. 
2. Make up foundation of bed as usual. 
13 14 
ETHER BED 
3. Place the ether rubber at the head of the 
mattress, over it place draw sheet, fold- 
ing lower edge of sheet under edge of 
rubber and tuck surplus under head of 
mattress, make square corners and tuck 
under mattress at sides. 
4. Place an isolation blanket nine inches from 
head of mattress and turn up at foot. 
On side farthest from door turn under 
itself even with mattress. 
5. Place cotton sheet on as usual, but do not 
tuck in at foot or make box plaits. 
6. Over this place blankets. Do not tuck in at 
foot. 
7. Turn top sheet over blankets at head. 
Fold blankets and sheet under them- 
selves at foot even with foot of mattress. 
8. Put on spread, turning upper edge un- 
der itself for nine inches and lower 
edge under itself, even with other bed- 
ding. 
9. Place folded towel as a protection for 
upper bed clothing and pin securely at 
each end with a safety pin. 
10. Tuck all of top covers, excepting spread, 
under side of mattress farthest from 
door. 
11. On side nearer door fold top covers, includ- 
ing isolation blanket, under in eight inch 
folds to edge of mattress. 
12. Place hot water bottles in bed—one in 
folds of gown where patient’s shoulders 
would come, the other at foot of bed. ETHER BED 
15 
13. Place hard pillow, protected with rubber 
pillow case, upright at head of bed and 
tie in position to rods of bed with two 
pieces of three inch gauze bandage. 
14. Place isolation blanket in lower part of 
bedside table. 
15. Place towel wrong side up—half over top 
of table, the other half hanging loosely 
at back. 
16. Turn down edges of paper bag. Fasten to 
front of table with adhesive. 
17. On towel place tongue depressors, mouth 
wipes, emesis basin, artery clamp, and 
tooth cup with three ounces boric acid 
solution, 2%. 
.18. Place free end of towel over these articles 
while not in use. 
Notes. 
1. When patient returns from operating room 
fan bedding neatly in two folds toward 
side of bed away from door. 
2. Remove hot water bottles and place in 
bedside table. 
3. Remove blankets, which are wrapped 
around patient, under the bed covers. 
4. Wrap isolation blanket around patient. 
5. Laparotomy jacket and leggings are 
not removed until patient is out of 
ether. 
6. When patient is in shock, he is placed upon 
warm blankets. 
7. Put extra blanket from bedside table over 
patient. 16 
ETHER BED 
8. All of bedding except spread may be 
tucked in at sides to restrain patient. 
Side boards may be used. 
Reference Readings: 
Harmer, pages 136-138. 
Hampton-Robb, pages 108-109. 
Maxwell and Pope, pages 56-62. BALCONY BED 
Articles necessary. 
1. Three single dark blankets. 
2. Hot water bottle and cover. 
3. Two isolation blankets. 
4. Long rubber sheet. 
5. Three safety pins. 
6. Gauze folded 4x8 
7. Ordinary bedding except spread. 
8. Underwear for patient. 
9. Stockings and bed slippers. 
10. Night gown and bath robe. 
11. Nightingale with hood. 
Procedure. 
1. Place blanket on springs, turning back 
upper corners for additional warmth. 
2. Place rubber sheet on blanket turning un- 
der itself to fit springs. (On very cold 
weather three rubber sheets may be 
used). 
3. Make foundation of bed in usual way. 
4. Place isolation blanket eleven Inches from 
top of bed, tucking it under mattress at 
foot and sides. 
5. Dress patient with required clothing and 
and have her lie on blanket. 
17 18 
BALCONY BED 
6. Place another isolation blanket over pa- 
tient, and tuck in around shoulders, sides 
of body, and feet. 
7. Place hot water bottle at feet, having 
blanket between hot water bottle and 
patient’s feet. 
8. Put on upper sheet and two blankets in 
usual way. 
9. Bring up foot and sides of under brown 
blanket and make square corners at 
foot. 
10. Put on upper dark blanket, fold under 
twelve inches at top, and turn sheet nine 
inches over it. 
11. Tuck in at bottom, make square corners, 
and tuck in at sides under mattress. 
To arrange the wind shield. 
1. Place blanket lengthwise evenly over head 
of bed. 
2. Fold back front edge about two inches and 
fit about face and head to form hood. 
Pin under chin. 
3. Bring corners out on bed to edge of mat- 
tress. 
4. Bring other edge of blanket neatly and 
tightly about head of bed and pin to 
mattress on each side. 
5. Arrange surplus blanket in three folds on 
each side, one fold toward head, two to- 
ward foot, making first fold twelve 
inches from head of bed. BALCONY BED 
19 
6. Place gauze under patient’s chin to protect 
face and chin from blankets. 
Reference Reading: 
Harmer, page 499. “L” BED 
Articles necessary. 
1. “L.” 
2. Eight safety pins, eight common pins. 
3. Nightingale (in cold weather). 
Procedure. 
1. Make np foundation of bed in usual way. 
2. Place “L” in position at foot. 
3. Place top sheet and first blanket on in 
usual way at head of mattress. Bring 
down over the “L” and pin tightly 
around “L” at foot. 
4. Draw ends of sheet and blanket across 
themselves and tuck under mattress at 
foot and sides. 
Pin blanket with safety pin. 
5. Place second blanket over “L” and foot of 
bed, tuck under springs at sides. Tuck 
in surplus even with foot of bed. 
6. Place on spread in same way, only pin to 
springs at sides. 
Pin with four common pins on each side 
of “L.” 
7. Make two two-inch, tucks, ten inches apart 
in spread at head of bed. Fold down 
20 “L” BED 
21 
cuff of sheet and pin through tucks, pin 
at edge of mattress. 
8. Place nightingale around patient’s 
shoulders. CRADLE BED 
Articles necessary. 
1. Cradle. 
2. Six safety pins, four common pins. 
3. Nightingale. (In cold weather) 
Procedure. 
1. Make up foundation of bed in usual way. 
2. Place cradle even with foot of mattress and 
pin securely at four corners. 
3. Place top clothing, except spread, over 
cradle, tucking all in under mattress at 
foot. Make square corners and tuck in 
at sides. 
4. Place on spread. Tuck under at foot. 
Make square corners and pin to foot of 
cradle with two pins at each side. 
5. Turn back cuff at head and pin in usual 
way. 
6. Place nightingale around patient’s should- 
ers. 
22 BALKAN FRAME BED 
Articles necessary. 
1. Extra draw sheet. 
Procedure. 
1. Make up foundation of bed in usual way. 
2. Place extra draw sheet on lower half of 
bed with nine inch cuff at the top. 
Pull well up under suspended thigh. 
Tuck under mattress at foot, and make 
square corners. 
3. Place one blanket folded on foot of bed. 
Tuck surplus under foot of mattress. 
Make square corners. Turn cuff of draw 
sheet over blanket at top. 
4. Place spread on separately. Fold to fit 
space at foot. 
5. Place large sheet even with head of mat- 
tress. 
6. Place blanket nine inches from head of 
mattress. 
7. Fold blanket and sheet over themselves so 
as to meet the covering on lower half of 
the bed. Pin upper and lower coverings 
together with four safety pins. 
8. Turn down cuff of sheet nine inches over 
covers and pin with two safety pins. 
23 CARE OF BED AFTER PATIENT HAS 
BEEN DISCHARGED 
To carbolize a bed. 
Follow the same procedure as for caring for 
bed after patient has been discharged. In addi- 
tion wash bed with 1% cresol solution. Dip whisk 
broom in carbolic solution, 40% before brushing 
springs and mattress. 
Articles necessary. 
1. Basin of warm water. 
2. Two cleaning cloths. 
3. Soap and scouring soap in soap dish. 
4. Old toothbrush. 
5. Whisk broom. 
6. Floor rubber. 
7. Clean bed linen. 
8. Two bedside chairs. 
Procedure. 
1. Place two chairs on balcony back to back. 
2. Bring foot tub to bedside. Place in it bed 
linen and rubber draw sheet. 
3. Place pillows and blankets on bedside 
chair. 
4. Fold mattress from each end toward cen- 
ter. Place over chairs on balcony. 
24 CARE OF BED AFTER DISCHARGE 
25 
5. Place blankets over mattress. Pin pillows 
to each side of mattress through hem. 
6. Remove foot tub. Disinfect rubber sheet 
with 1% cresol solution. Wash off with 
warm water and soap. 
7. Bring to bedside cleaning articles. Place 
floor rubber under head of bed. 
8. Brush springs with whisk broom. 
9. Wash head of bed with brown soap and 
warm water. Dry. 
10. Place floor rubber under foot of bed. 
11. Wash foot and sides. (Use scouring soap 
for marks and stains.) 
12. Remove articles from bedside table and 
wash table inside and out. 
13. Clean articles belonging to table and re- 
place. 
14. Remove cleaning utensils. Bring in 
fresh linen and rubber draw sheet. 
15. Brush blankets and pillows, and place on 
bedside chair. 
16. Brush mattress. Place on bed. 
17. Make up bed in usual way. 
Reference Readings : 
Harmer, pages 35-36. 
Maxwell and Pope, pages 49-50. MORNING TOILET 
Articles necessary. 
1. Basin half full of water at temperature 
105° F. 
2. Necessary bed linen. 
3. Bath tray containing: 
1. Alcohol, 50%. 
2. Boric acid solution, 2%. 
3. Talcum powder. 
4. White mineral oil. 
5. Large enamel jar or paper bag for 
waste. 
6. Small jar containing mouth com- 
presses. 
7. Tongue depressors and applicators. 
8. Whisk broom. 
9. Small tray containing one pint 1% 
.cresol solution. 
1. Hair brush, comb, fine tooth 
, comb. 
2. Hand brush, orange wood stick. 
Procedure. 
1. Screen patient with two screens. 
2. Bring equipment to bedside. 
3. Place bedside chair at foot of bed. 
26 MORNING TOILET 
27 
4. Place towel under chin. If patient is able 
have him brush his teeth before re- 
moving pillows. If helpless remove 
pillows to bedside chair. Turn head to- 
ward you. Place towel under chin, brush 
the teeth, clean the mouth, and lubricate 
the lips of the patient. 
5. Loosen upper bed clothing at foot and 
sides. 
6. Fold spread and one blanket and place 
over pillows on chair. 
7. Remove gown. 
8. Protect chest with towel. Before soap is 
placed on the wash cloth wash about 
eyes. 
9. Place soap on wash cloth and wash face, 
neck, and ears. Rinse cloth and go over 
surface. Dry thoroughly. 
10. Place towel on bed at patient’s side, rest 
basin on it, and have patient place his 
hands in it. Wash hands thoroughly, 
using hand brush. Dry carefully. Cut 
and trim nails. Leave them short, even, 
and clean. 
11. Protect bed with towel and comb patient’s 
hair. 
12. Place gown on patient. Nurse puts her 
hand through lower end of sleeve, grasps 
patient’s hand, and draws the arm 
through. 
13. Turn patient toward you, rub back with 
alcohol (circular motion, using small 
amount of alcohol on palm of hand), and 28 
MORNING TOILET 
lightly powder. Examine prominences 
for redness. If they do not disappear 
upon massage, report to head nurse. If 
back is in unclean condition, wash with 
soap and water before rubbing with 
alcohol. 
14. Take draw sheet, large sheet, and whisk 
broom to other side of bed, loosen foun- 
dation sheets, whisk crumbs from be- 
neath sheets, replace with fresh sheets. 
Make square corners and tighten. Bring 
gown toward middle of back. Turn 
patient toward you. 
15. Go to first side of bed. Remove soiled 
sheets and place in hamper. Draw 
fresh sheets into place and tighten. 
16. Draw gown down over back and fasten. 
17. Fold blanket and place on chair. 
18. Put on fresh top sheet, remove soiled sheet, 
and make up bed in usual way. 
Reference Readings : 
Harmer, pages 77-78. 
Hampton-Robb, pages 105-108. 
Maxwell and Pope, pages 62-73. EVENING TOILET 
Articles necessary. 
1. Complete bath tray except cresol solution. 
2. Necessary bed linen. 
Procedure. 
1. Pass basins at four o’clock and wash 
patient’s face and hands. 
2. Screen patient with two screens. 
3. Bring articles to bedside. 
4. Remove pillows, brush patient’s teeth, and 
clean the mouth. 
5. Turn back top covers in form of triangle. 
6. Turn patient toward you, rub back with 
alcohol, and lightly powder. Examine 
prominences on back for red spots. If 
redness does not disappear upon mas- 
sage report condition to charge nurse. 
7. Take whisk broom and necessary linen to 
other side. Loosen cotton and rubber 
sheets. Brush out crumbs, using hand 
near the patient. If necessary, change 
linen; if not, tighten under sheet and 
draw sheet. Turn patient toward you. 
8. Go to first side of bed. Loosen draw sheets 
and follow same procedure. 
9. Replace pillows. 
29 30 
EVENING TOILET 
10. Straighten upper bed clothing over patient. 
11. Leave patient comfortable and everything 
in perfect order. 
Reference Readings: 
Harmer, pages 75-76. 
Maxwell and Pope, pages 152-153. HOW TO GIVE AND REMOVE A BED PAN 
Articles Necessary. 
1. Bedpan. 
2. Bedpan cover. 
3. Toilet paper. 
Procedure. 
1. Screen patient with two screens. 
2. Warm bedpan by holding under hot water. 
Dry sides and bottom. Cover with bed- 
pan cover and take to patient. 
3. Flex patient’s knees. 
4. Pass one hand under and raise hips. 
5. Place pan in position. 
6. To remove, raise hips in same manner. Do 
not allow pan to scrape against patient. 
7. Cleanse patient with toilet paper. 
8. Cover pan and remove at once. 
9. Examine contents. 
31 CARE OF TEETH, MOUTH, NOSTRILS, 
AND NAILS 
i. Care of teeth. 
Articles necessary. 
1. Tooth cup with solution. 
2. Toothbrush. 
3. Emesis basin or sputum cup. 
4. Towel. 
Procedure. 
1. Have patient brush teeth, if able, pro- 
tecting bed with towel; if unable, 
remove one pillow, place towel 
under side of head and chin. 
2. Turn head toward you. 
3. Pour some mouth wash on brush or 
place paste on brush. 
4. Ask patient to open mouth and brush 
both surfaces of teeth from gums to- 
ward edge. (Never brush teeth 
across, or allow patient to do so.) 
5. Cleanse crevices of teeth with tooth- 
picks wrapped with cotton. 
6. Have patient rinse mouth with solu- 
tion, then with water, and expec- 
torate into emesis basin or sputum 
cup. 
32 CARE OF TEETH, MOUTH, NOSTRILS 
33 
7. Rinse brush with clean water, and 
put in place in bedside stand. 
8. Fold towel and put in place. 
2. Care of sensitive gums. 
Articles necessary. 
Tray containing: 
1. Mouth wash in tooth cup. 
2. Artery clamp or tongue blade. 
3. Mouth wipes. 
4. Emesis basin or sputum cup. 
5. Paper bag. 
6. Glass or cup of drinking water. 
7. Lubricant—albolene or mineral oil 
Procedure. 
1. Split tongue blade lengthwise in two, 
wrap about one end one or two 
thicknesses of gauze, or if clamp is 
used, clamp gauze securely. 
2. Pour small amount of solution over 
gauze and wash mouth thoroughly— 
roof, sides, about and under tongue, 
inner and outer surfaces of teeth. 
3. Place waste gauze in paper bag. 
4. Rinse mouth with solution, then with 
water. 
5. Have patient expectorate into sputum 
cup or emesis basin. 
6. Wipe lipsvand, if they are dry, place 
a few drops of albolene or mineral 
oil on gauze and wipe off lips. 34 
CARE OF TEETH, MOUTH, NOSTRILS 
3. Care of mouth of unconscious patients. 
Articles necessary. 
1. Tooth cup with solution. 
2. One dozen mouth wipes. 
3. Two tongue depressors. 
4. Artery clamp. 
5. Paper bag with two strips of ad- 
hesive. 
6. Mineral oil or albolene. 
7. Towel. 
Procedure. 
1. Place one end of towel on bedside 
table and arrange necessary articles 
on towel. 
2. Attach paper bag to back of stand 
with adhesive. 
3. Split tongue depressor lengthwise; 
wrap with two or three thicknesses 
of gauze; if clamp is used, clamp 
gauze securely. 
4. Pour small amount of solution over 
gauze and cleanse mouth carefully— 
roof, sides, about and under tongue, 
and inner and outer surfaces of 
teeth. 
5. Place waste gauze in paper bag and 
continue No. 4 until thoroughly 
cleansed. 
6. When mouth is clean, place loose end 
of towel over articles. CARE OF TEETH, MOUTH, NOSTRILS 
35 
Reference Readings : 
Harmer, pages 168-174. 
Hampton-Robb, page 127. 
Maxwell and Pope, pages 144-150. 
4. Care of the nostrils. 
Articles necessary. 
1. Applicator. 
2. Small bowl containing warm water. 
3. Olive oil. 
Procedure. 
1. Dip applicator in warm water and 
cleanse each nostril. 
2. Use olive oil instead of water if secre- 
tions have become hardened. 
5. Care of nails. 
Articles necessary. 
1. Scissors. 
2. Orange wood stick. 
3. Towel. 
Procedure. 
1. Arrange towel on bed and place 
patient’s hands or feet on towel. 
2. Trim nails short. Clean with orange 
wood stipk. FEEDING PATIENTS 
1. Articles necessary. 
1. Feeding cnp on plate or saucer. 
2. Or glass drinking tube and drinking glass 
on plate; or ideal drinking glass on 
plate or saucer; or cup on saucer or 
plate and spoon. 
Procedure. 
1. Have cuffs on sleeves, hands, and nails 
perfectly clean. 
2. If drinking glass and tube, or ideal drink- 
ing glass is used, bring to bedside on 
plate, not more than three-fourths full. 
3. Support patient’s head by placing hand 
and forearm under pillow. 
4. Grasp glass at bottom and allow patient to 
drink. 
2. To provide constant supply of water: essential 
for force fluids 
Articles necessary. 
1. Pitcher containing ice water. 
2. Drinking tube. 
3. Large piece of gauze and narrow 
gauze bandage. 
36 FEEDING PATIENTS 
37 
Procedure. 
1. Fill pitcher with ice water, cover with 
gauze, and tie neatly in place with 
bandage. 
2. Insert short end of drinking tube 
through mesh in gauze. 
3. Encourage patient to drink water 
freely, six ounces per hour. 
4. Fresh water must be given to patient 
at 
9 A.M. 
3 P.M. 
6 P.M. 
9 P.M. 
6 A.M. 
5. Drinking tubes should be washed with 
soap and water and boiled once a 
day. 
3. Feeding solids. 
Articles necessary. 
1. Serving tray. 
2. Necessary dishes and silver. 
3. Napkin. 
Procedure. 
1. If condition permits, prop patient up 
in bed ten minutes before serving 
tray. 
2. Prepare tray and bring to bedside. 
3. Arrange napkin in place- 38 
FEEDING PATIENTS 
4. Place tray before patient on bed and 
arrange articles in position most 
convenient for patient. 
5. If helpless patient, place tray on bed- 
side table—feed in small quantities 
and give patient time to masticate. 
Reference Readings: 
Harmer, pages 86-93. 
Hampton-Robb, pages 238-252. LIFTING AND TURNING PATIENTS 
1. To lift a patient up in bed. 
1. Remove pillows. 
2. Instruct the patient to flex her knees and 
press heels against mattress. 
3. The nurse places one arm under patient’s 
shoulders and the other under knees. 
Brace knees or thighs against side of 
bed. Take a deep inspiration, hold ab- 
dominal muscles taut, and in lifting al- 
low the weight to come on the muscles 
of the chest and shoulders. 
4. Instruct patient to lift her hips and help 
move up in bed. At the same moment 
nurse lifts her. 
2. To lift a helpless patient. 
Two nurses required. 
1. Both nurses stand on same side of bed. 
2. One nurse places one arm under patient’s 
shoulder and the other arm under 
patient’s hips. The second nurse places 
one arm under patient’s back and the 
other under patient’s knees. 
3. Lift simultaneously. 
39 40 
LIFTING AND TURNING PATIENTS 
3. To arrange a patient on side in bed. 
Articles necessary. 
1. Two soft pillows. 
2. Small pillow with rubber pillow case. 
3. Rubber pillow case, if necessary. 
Procedure. 
1. Flatten on edge of a feather pillow 
and place close to patient’s body. 
2. Turn patient on pillow by grasping 
shoulder with one hand and hips 
with the other. 
3. Flex the knees, the upper more than 
lower. 
4. Place small pillow covered with rub- 
ber pillow case between the knees, 
as this helps to relax abdominal 
muscles. 
5. Place soft pillow (covered with rub- 
ber pillow case, if patient is incon- 
tinent) at patient’s back. Arrange 
one edge well under the patient and 
fold other edge underneath for 
additional support. 
4. To place patient in a steamer chair or wheel 
chair. 
Articles necessary. 
1. Underwear, stockings, slippers, wrap- 
per, and bath robe. 
2. Double gray blanket. LIFTING AND TURNING PATIENTS 
41 
3. Single gray blanket. 
4. Footstool. 
5. Eight safety pins. 
Procedure. 
1. Dress patient with underwear, stock- 
ings, slippers, wrapper, and bath 
robe. 
2. Place steamer chair at foot of bed and 
arrange double blanket crosswise 
over seat of chair. 
3. Raise patient to a sitting position, 
support back with one arm, place 
other arm under knees, and draw 
the patient’s limbs over the edge of 
bed. 
4. Stand in front of patient, place hands 
under each axilla, and assist patient 
on to a footstool. Have patient take 
one step and place comfortably in 
the steamer chair. 
5. Fold blanket snugly about patient’s 
body. Tuck upper edge of blanket 
under feet and bring up lower edge, 
pin in form of semicircle, using 
three safety pins at foot and two up 
side of blanket. 
6. Fold single blanket lengthwise, place 
about patient’s shoulders, fold back 
edge to form collar and pin. 
7. Arrange blanket about wrists, kimono 
fashion, and pin. 42 
LIFTING AND TURNING PATIENTS 
5. To draw mattress up with patient in bed. 
1. Remove pillows. 
2. Nurse stands at head of bed and grasps 
mattress at each side. 
3. Instruct patient to grasp rod at head of 
bed with both hands and pull. At same 
time nurse pulls mattress to head of bed. 
Reference Readings : 
Harmer, pages 56-64. 
Hampton-Robb, pages 116-119. 
Maxwell and Pope, pages 78-90, 707. CLEANSING SPONGE BATH 
Articles necessary. 
1. Complete bath tray. 
2. Two bath blankets. 
3. Necessary bed linen. 
4. Two towels and wash cloth. 
5. Basin half full water, at temperature of 
105° F. 
6. Foot tub half full of water, temperature 
115°-118° F. 
Procedure. 
1. Screen patient and offer bedpan. 
2. Prepare articles and bring to bedside. 
3. Arrange basin and tray on top of bedside 
table and place foot tub on lower shelf 
of bedside table. 
4. Remove bedpan. 
5. Place chair at side of bed, near foot. 
6. Remove one pillow and place with open 
end downward on chair. 
7. Protect bed clothing with towel and brush 
teeth. 
8. Loosen upper bed clothing at foot and 
sides, remove spread and blankets— 
folding each separately and place on 
chair. 
43 44 
CLEANSING SPONGE BATH 
9. Place tanned bath blanket across patient’s 
chest, tuck upper edge securely under 
the shoulders, and, by grasping lower 
edge of blanket and top end of upper 
sheet, bring blanket to foot of bed, at 
same time removing the upper sheet. 
10. Turn patient toward you, take second bath 
blanket to other side of bed. 
11. Place one-half lengthwise smoothly over 
bed close to patient’s back. 
12. Turn patient toward you, go to other side 
of bed; and draw blanket under 
patient. 
13. Turn patient on his back and remove gown. 
14. Note condition of feet, and if necessary 
prepare and apply a soap poultice—pro- 
tecting bed with dressing rubber—allow 
poultices to remain on feet until feet 
are bathed. 
15. Protect patient’s chest with towel and 
bathe face, neck, and ears. Dry thor- 
oughly. 
16. Uncover arm on farther side and bathe 
arm and axilla and lightly powder. 
17. Wrap arm in under bath blanket. 
18. Uncover other arm and bathe in same 
manner. 
19. Always support a limb while bathing any 
part. 
20. Place towel on side of bed, rest basin on it, 
• and put patient’s hands in basin. 
21. Wash thoroughly—scrub nails with nail 
brush. CLEANSING SPONGE BATH 
45 
22. Rest hands on towel and place basin on 
top shelf of bedside table. 
23. Dry hands carefully, paying special at- 
tention to space between fingers. 
24. Place foot tub on top of bedside table and 
use for rest of bath. 
25. Bathe chest and abdomen, under cover of 
upper bath blanket. Expose, if neces- 
sary, by lifting blanket from side as 
required. 
26. Turn patient toward you, bathe back from 
neck to end of spine. 
27. Dry carefully and examine for red spots. 
28. Rub with alcohol, if redness does not dis- 
appear upon massage, report matter to 
head nurse. 
29. Powder lightly. 
30. Turn patient on his back and drape thighs 
with blanket. 
31. Bathe the farther side from hip to below 
knee. 
32. Bathe other limb in same manner. 
33. Place towel under upper bath blanket at 
foot of bed. 
34. Place foot tub lengthwise on towel, 
flex patient’s knees and place feet in 
tub. 
35. Wash feet and legs to knees thoroughly. 
36. Lift feet from tub with left hand, by grasp- 
ing under knees, withdraw tub with right 
hand, allowing feet to rest on towel. 
37. Place foot tub on bedside table. 
38. Dry feet thoroughly. 46 
CLEANSING SPONGE BATH 
39. Put soap on wash cloth and give to patient 
with instructions to complete bath. 
40. Place towel under patient’s head and comb 
the hair. 
41. Remove pillow. 
42. Turn patient toward you, take fresh sheet, 
draw sheet, whisk broom, and go to 
other side of bed. 
43. Fold under bath blanket close to patient’s 
back. 
44. Loosen cotton and rubber sheets and whisk 
crumbs from beneath. 
45. Change bed linen, if necessary. 
46. Turn patient toward you, go to other side 
of bed, remove bath blanket, follow same 
procedure as to whisking of crumbs, 
changing or tightening sheets. 
47. Put on night gown. 
48. Place upper sheet over patient at same 
time removing bath blanket. 
49. Fold bath blanket properly and place on 
lower shelf of bedside table. 
50. Proceed with making of bed in usual way. 
51. Put soiled linen in hamper immediately 
and remove bath blanket, foot tub, basin, 
and tray. 
52. Place chair in position and leave bedside 
table in order. 
Reference Readings: 
Harmer, pages 78-94. 
Hampton-Robb, pages 138-143. 
Maxwell and Pope, pages 125-132. MECHANICAL APPLIANCES 
1. “L” (see “L” bed, page 20). 
2. Cradle (see cradle bed, page 22). 
3. Elevator and shock blocks. 
1. Articles necessary. 
1. Elevator or shock blocks. 
2. Muslin bandage. 
2. Procedure. 
1. Remove castors from end of bed that 
is not to be elevated. 
2. Kemove castors from end of bed to be 
elevated and place elevator in place. 
3. Tie castors together and tie to head of 
bed. 
4. Cranes. 
1. Place at head of bed and tie in place with 
muslin bandage. 
5. Fracture boards. 
1. Place under springs on side rounds of bed. 
6. Side boards. 
1. Articles necessary. 
1. Two side boards. 
47 48 
MECHANICAL APPLIANCES 
2. Muslin bandage. 
3. Two safety pins, four common pins. 
2. Procedure. 
1. Remove spread. 
2. Tuck blankets and top sheets under 
mattress at sides. 
3. Place side board along side of mat- 
tress, fitting into rod at head of bed. 
4. Tie to head and foot with muslin 
bandage. 
5. Place spread over all, pinning bottom 
to springs at sides. Fold surplus 
under and pin with two common 
pins at each side. 
Note. When finished using, clean all appliances 
and return to splint room. CARE OF HAIR AND TREATMENT FOR 
PEDICULOSIS 
i. Articles necessary for the daily care. 
1. Bath tray. 
2. Towel. 
Procedure. 
(In Bellevue the hair must be combed each 
day during the morning toilet. Twice a 
day is advisable. For men and children 
twice a day.) 
1. Remove pillows and place towel under 
patient’s head. 
2. Part the hair evenly in the center and ex- 
amine for pediculi, courteously and 
without the patient’s knowledge, if 
possible. 
3. Separate the hair into small strands. 
4. Twist the hair near scalp around the fin- 
gers. Begin at the end and brush and 
comb each strand. (If the hair is 
tangled badly use vaselin, olive oil, or 
alcohol 50% to dissolve the substance 
which causes the tangle.) 
5. Comb hair well up back of the ears, braid 
in two braids, and tie with gauze band- 
age. 
49 50 
CARE OF HAIR 
In order to cut tangled hair we must obtain: 
1. Written consent of patient or written 
permission of nearest relative or 
friend. 
2. Permission from the superintendent 
of the hospital. 
3. Permission from the superintendent 
of nurses. 
2. Articles necessary for the treatment of 
pediculosis. 
Tray containing: 
1. Comb, brush, and fine tooth comb in 
1% ere sol solution. 
2. Small bowl containing four or five 
ounces of Tincture of Delphinium. 
3. Small pieces of gauze. 
4. Small squares of paper on which to 
wipe the fine tooth comb. 
5. Paper bag for waste. 
6. Towel. 
7. Rubber and cotton draw sheets. 
8. Rubber pillow case. 
9. Triangle. 
Procedure. 
1. Screen patient with two screens. Bring 
tray to bedside. 
2. Cover soft pillow with rubber pillow case. 
3. Apply Tincture of Delphinium to scalp and 
hair. Put on triangle bandage. Leave 
for two hours. CARE OF HAIR 
51 
4. Place bedside chair at foot of bed and 
remove pillows. 
5. Fold covers back in form of triangle and 
protect with towel. 
6. Unfasten patient’s gown and put down 
over shoulders. 
7. Place rubber and cotton draw sheet under 
patient’s head and roll the edges of cot- 
ton draw sheet at head and sides to fit 
the mattress. 
8. Remove triangle. » Separate hair into 
strands. Comb until free from tangles. 
9. Dip the fine tooth comb in the Tincture of 
Delphinium, begin at scalp and comb 
each strand. 
10. Wipe the comb on a small square of 
paper. Redip in Tincture of Delphinium 
and repeat until hair is combed. 
11. Apply Tincture of Delphinium to scalp 
with piece of gauze. 
12. Apply hot vinegar for nits. 
13. Braid hair in two braids. 
14. Fold the cotton draw sheet from each side 
toward center. Let the head rest on a 
fresh portion, and apply triangle band- 
age. 
15. Roll rubber draw sheet over the cotton 
sheet. Remove. 
16. Place the pillow protected with rubber 
pillow case under the patient’s head. 
17. Shampoo the hair after two or three 
hours. 
18. Disinfect rubber sheet with 1% cresol 52 
CARE OF HAIR 
solution. Boil cotton draw sheet and 
towel. 
3. Articles for treatment of body pediculi. 
1. Articles same as for complete bath. 
2. Cresol solution 1:100 in foot tub, or 
bichlorid 1:2000. 
3. Mercurial ointment. 
Procedure. 
1. Proceed as for bed bath. Using first the 
cresol solution 1:100, then soap and 
water. 
2. Apply mercurial Ung. to pubic and axillary 
hairs. 
Reference Readings: 
Harmer, page 42. 
Hampton-Robb, pages 126-127. 
Maxwell and Pope, pages 142-144. * BED SHAMPOO 
Articles necessary. 
1. Foot tub and stool. 
2. Tray containing: 
1. Small pitcher to pour. 
2. Large pitcher of water, temperature 
110° F. 
3. Small pitcher of cold water. 
4. Small paper bag. 
5. Liquid castile soap. 
6. Two small cotton pledgets. 
7. Comb and brush. 
8. Two safety pins. 
9. Wash cloth and face towel. 
10. Dressing rubber. 
11. Bath towel. 
12. Cotton draw sheet. 
13. Rubber pillow case. 
Procedure. 
1. Screen the patient and guard against pos- 
sibility of draughts. 
2. Arrange articles on tray in order in which 
they are to be used. 
3. Bring articles to bedside, placing tray on 
bedside table, and foot tub on stool at 
side of bed near the head. 
53 54 
BED SHAMPOO 
4. Place chair at side of bed near foot. 
5. Remove soft pillow, put on rubber pillow 
case, cover with cotton pillow case, and 
place under patient’s head at same time 
removing hair pillow which is placed on 
chair. 
6. Unfasten gown at neck and bring it well 
under the patient’s shoulders. 
7. Place cotton draw sheet smoothly over the 
pillow. 
8. Fold bath towel lengthwise and turn back 
upper edge three inches. Place about 
patient’s neck snugly, and pin it at the 
front. 
9. Spread rubber sheet over pillow and pin 
around the patient’s neck. Roll edges 
to form trough, through which water 
will flow into tub. 
10. Place face towel over shoulders, tucking 
lower edge under edge of upper sheet. 
11. Place small piece of cotton in each ear. 
12. Unbraid the hair, separate it into strands, 
and brush each strand. 
13. Dampen wash cloth and wrap around fin- 
gers. Pour on some liquid soap and 
apply to scalp. 
14. Shampoo one side of scalp, then the other. 
Pour the water from small pitcher by 
holding pitcher close to head, at same 
time massaging the scalp with the other 
hand. 
15. Place small amount of soap on end of hair 
and wash thoroughly. BED SHAMPOO 
55 
16. Rinse with warm water, gradually adding 
cold water to water in pitcher. 
17. Continue to add the cold water and to 
spray until scalp and hair have been 
thoroughly rinsed. 
18. Squeeze hair to remove as much water as 
possible. 
19. Unpin rubber and drop it into foot tub. 
20. Unpin bath towel and spread it over the 
sheet. 
21. Replace the foot tub and stool under side 
of bed and remove cotton from patient’s 
ears. 
22. Dry hair with bath towel, rubbing scalp 
until hair is dry. Support head with one 
hand while massaging it with the other. 
23. When partly dry, brush hair, taking small 
strands at a time. 
24. Spread the hair over draw sheet until dry. 
25. Brush, comb, and braid it. 
26. Remove draw sheet and rubber pillow case 
and leave bed in order. 
27. Remove foot tub, stool, tray, and screens. 
Cleansing of scalp of very weak patient. 
Articles necessary. 
Tray containing: 
1. Small bowl with two ounces alcohol, 
50%. 
2. Squares of gauze or old muslin. 
3. Paper bag. 
4. Brush, comb, and fine comb. 
5. Draw sheet. 56 
CLEANSING WEAK PATIENT’S SCALP 
Procedure. 
1. Prepare tray, screen patient, and 
bring articles to bedside. 
2. Remove hard pillow and place folded 
draw sheet over feather pillow. 
3. Separate hair into strands and brush 
each strand. 
4. Wrap gauze about fingers, dip into 
alcohol, and apply lightly to scalp. 
5. Fine comb hair to remove dandruff. 
6. Brush and comb hair and arrange in 
usual way. 
Reference Readings: 
Harmer, pages 84-85. 
Hampton-Robb, pages 126-127. 
Maxwell and Pope, pages 136-141. RUBBER GOODS 
1. To fill hot water bottle. 
Articles necessary. 
1. Hot water bottle and cover. 
2. Pitcher. 
3. Bath thermometer. 
Procedure. 
1. Take chill off bag by pouring a little 
hot water into it from pitcher and 
empty. 
2. Test water in pitcher having temper- 
ature of 125° F., never higher. 
3. Fill bottle half full, expel air, and put 
on cap. 
4. Turn upside down and test for leaks. 
5. Cover with hot water bottle cover and 
place between blankets. 
6. Put away dry and containing small 
amount of air. 
2. To fill ice cap and collar. 
Articles necessary. 
1. Canvas bag and mallet. 
2. Spoon. 
3. Ice bag and cover. 
4. Small piece of nonabsorbent cotton. 
57 58 
RUBBER GOODS 
Procedure. 
1. Place ice in canvas bag and crush fine 
with mallet. 
2. Fill ice cap half full of ice with a 
spoon. 
3. Expel air, place nonabsorbent cotton 
on top, and put on cap. 
4. Cover before applying. 
5. Put away dry and containing small 
amount of air. 
3. Ice coil. 
Articles necessary. 
1. Ice coil and cover. 
2. Funnel covered with gauze. 
3. Pail or large basin for ice and water. 
4. Pail or foot tub for drainage. 
5. Carrier for tubing. 
6. Abdominal binder. 
Procedure. 
1. Place abdominal binder under patient. 
2. Elevate basin containing ice and 
water on stand above patient’s head. 
3. Connect inner tube of coil to funnel 
and let out tube drain into foot tub 
on floor. 
4. Cover coil and place in position. 
5. Start water flowing by filling funnel 
and tipping it quickly into basin. 
6. Place carrier over edge of basin and 
see that there are no kinks in tubing. RUBBER GOODS 
59 
7. Water must be kept ice cold and suffi- 
cient to cover funnel. 
8. Fasten binder in place. 
9. Put away dry. 
4. Rubber sheets. 
1. Rubber sheets are always laced to mattress 
with muslin bandage. 
2. After using, disinfect, wash, dry, and roll. 
5. Rubber cushions. 
1. Always cover before giving to patient. 
2. Put away containing small amount of air. 
6. Rubber rings. 
1. Fill half full of air. 
2. Cover with gauze bandage. 
3. After using, disinfect and put away con- 
taining small amount of air. 
7. Air and water beds. 
1. Place over bed mattress and always cover 
with rubber sheet. Have valve at foot of 
bed. 
2. Protect bed with side boards. 
3. Put away containing small amount of air. 
8. Catheters and rectal tubes. 
1. Boil before using. 
2. After using wash in warm soapy water, 
boil and hang up to dry. 60 
RUBBER GOODS 
9. Stomach pumps. 
1. Place in ice water ten minutes before 
using. 
2. After using, wash in warm soapy water, 
disinfect, and hang up to dry. 
10. Rubber gloves. 
1. Before using, gloves must be sterile. 
2. After using, disinfect, wash in warm water 
and soap, and dry. 
3. Powder and put in cases, having cuff 
turned down at top and both thumbs 
toward center of case. 
4. Send to surgical supply for sterilization. 
Reference Readings: 
Harmer, pages 34-36, 63, 115-116, 119-200, 219- 
220, 258-284, 383-384, 411, 535-538. 
Hampton-Robb, pages 192, 193, 202, 203. 
Maxwell and Pope, pages 42-47, 508-509. RESTRAINTS 
Varieties. 
1. Cribs. 
2. Side boards. 
3. Sheets. 
4. Jacket restraint for children. 
5. Wrist or ankle restraint. 
6. Elbow restraints. 
7. Body restraints. 
i. Wrist restraint. 
Articles necessary. 
1. Two wrist restraints. 
Procedure. 
1. Roll each end of wrist restraint to 
within 18 inches of padded portion 
and pin securely. 
2. Fold back covers in form of triangle, 
place arm in comfortable position, 
extended and not too near edge of 
bed. 
3. Make clove hitch knot in padded por- 
tion and slip it over patient ’s hand. 
4. Tie a single knot on outer side of 
wrist. 
61 62 
RESTRAINTS 
5. Test by slipping two fingers under 
restraint to see that it is not too 
tight. 
6. Twist ends tightly, make a single 
knot, and tie around rod at side of 
bed with double knot. 
7. Unpin ends, fasten short end to head 
of bed and long end to foot of bed. 
Tuck surplus under mattress. 
2. Ankle restraints. 
Articles necessary. 
1. Ankle restraint. 
2. Four safety pins and four common 
pins. 
Procedure. 
1. Turn back covers neatly at foot of 
bed. 
2. Straighten lower limbs. 
3. Place center of the restraint over 
ankles, cross ends underneath, draw 
up between ankles, and tie in a 
double knot. 
4. Twist the ends, make a single knot, 
tie to upper rod at foot of bed and 
twist the ends down the upright 
rod. 
5. Tie to center of horizontal rod with 
double knot and tuck surplus under 
mattress. RESTRAINTS 
63 
6. Place covers over foot of bed and pin 
to springs at sides with safety pins. 
Fold over surplus and pin in place 
with common pins. 
3. Shoulder restraint. 
Article necessary. 
1. Large cotton sheet. 
Procedure. 
1. Fold large sheet diagonally into folds 
five inches wide, and fold ends 
toward center. 
2. Turn top covers back in form of tri- 
angle, remove pillows and place 
restraint under shoulders. 
3. Bring each end under axilla, up over 
shoulder, cross ends underneath 
restraint at back, and tie securely 
to upright rods where they join the 
horizontal rod at head of bed. 
4. Place soft pillow under head to pre- 
vent head from resting on restraint. 
4. Body restraints. 
Articles necessary. 
1. Large cotton sheet. 
2. Basin with water. 
3. Whisk broom. 
Procedure. 
1. Fold large sheet lengthwise in three. 
2. Place folded sheet over patient’s 64 
RESTRAINTS 
body, extending from axilla to below 
hips. 
3. Dip whisk broom in basin of water 
and dampen ends of sheet. 
4. Roll ends of sheet around rods at 
sides of bed and be sure they are 
secure. 
Note. If applying to women with large pendu- 
lous breasts, place soft rings around each breast. 
5. Jacket restraint for children. 
Article necessary. 
Restraining jacket. 
Procedure. 
1. Slip arms through jacket and button 
jacket in back. 
2. Tie shoulder straps to head of bed. 
3. Pass side straps under bed, cross 
them, and tie to rod on each side of 
bed. 
6. To restrain child for examination of ears, nose 
or throat. 
Article necessary. 
1. Draw sheet. 
Procedure. 
1. Fold draw sheet diagonally. 
2. Place under child’s body with double 
edge close to neck. RESTRAINTS 
65 
3. Bring point up over child’s feet, place 
arms at side, and bring sides of 
sheet around body, thus holding 
arms securely. 
4. The nurse then places child’s feet 
between her knees, place left arm 
around body and use right hand for 
holding head. 
7. Elbow restraints. 
Articles necessary. 
1. Two elbow restraints. 
Procedure. 
1. Fold surplus muslin under upper 
edge, extend child’s arm and tie 
around elbow, thus preventing child 
from bending arms and scratching 
face or removing dressing. 
Reference Readings : 
Maxwell and Pope, pages 156-164, 330. FOWLER’S POSITION 
Articles necessary. 
1. Back rest. 
2. Knee roll. 
3. Four soft pillows. 
4. One small pillow. 
5. Sheet folded on bias. 
6. Narrow gauze bandage. 
7. Muslin bandage. 
8. Rubber ring. 
9. Side boards. 
10. Shock blocks. 
11. Nightingale. 
12. Five safety pins. 
13. Rubber pillow case. 
Procedure. 
1. Place hard and soft pillow on back rest 
with gauze bandage, hard pillow at top, 
soft at bottom. 
2. Fold large sheet on bias. 
3. Bring articles to bedside and screen 
patient, remove spread. 
4. Raise patient to sitting position and pin 
nightingale around shoulders. 
5. Place back rest in position and tie securely 
66 FOWLER’S POSITION 
67 
to rod at head of bed with muslin band- 
age. 
6. Place soft pillow, covered with rubber and 
cotton pillow cases, well down under 
small of back, another soft pillow un- 
der shoulders and small pillow under 
patient’s head. 
7. Place rubber ring in position, flex knees 
and place roll under knees, fastening with 
tapes to head of bed. 
8. Place folded sheet around soles of feet 
and pin to sides of spring. 
9. Place a soft pillow under each elbow. 
10. Put side boards on and arrange spread. 
11. Elevate head of bed on shock blocks. 
12. Tie castors to head of bed with muslin 
bandage. 
Reference Readings: 
Harmer, pages 574-577. 
Maxwell and Pope, pages 91-94. COLLECTION OF SPECIMENS 
1. Urine specimen. 
Articles required. 
1. Urine glass or bottle. 
2. Label. 
3. Bedpan and cover, or urinal. 
Procedure. 
1. Obtain early morning specimen, if 
possible. 
2. Have bedpan, or urinal and urinal 
glass or bottle perfectly clean. 
3. Examine vulvae of female patient and, 
if necessary, wash to prevent epithe- 
lium and hair from getting into 
specimen. 
4. Pour urine into bottle or glass care- 
fully. 
5. Write plainly on label— 
1. Patient’s name. 
2. Ward. 
3. Date. 
4. What it is to be examined for. 
6. Attach label securely and take to 
laboratory. 
2. Twenty-four hour specimen of urine. 
Articles necessary. 
1. Large glass bottle (containing five 
pints, if possible.) 
68 COLLECTION OF SPECIMENS 
69 
2. Funnel. 
3. Label and adhesive. 
4. Bedpan or urinal and cover. 
Procedure. 
1. Bottle, funnel, bedpans or urinals 
must be perfectly clean. 
2. Always start specimen at 7 a.m. 
3. Have patient void at 7 a.m. and de- 
stroy this specimen. 
4. Save all other voidings until 7 a.m. 
next morning. 
5. Write plainly on label— 
1. Name. 
2. Ward. 
3. Hour started and date. 
4. Hour finished and date. 
5. Amount and time of each voiding. 
6. Total amount. 
6. Attach label to bottle with adhesive 
and take to laboratory immediately. 
Note. Twenty-four hour specimens must be 
kept in cool place. 
3, Specimens of feces. 
Articles necessary. 
1. Wide-necked bottle and cork. 
2. Tongue depressor. 
3. Label. 
4. Bedpan and cover. 
Procedure. 
1. Specimen bottle and bedpan must be 
perfectly clean. 70 
COLLECTION OF SPECIMENS 
2. Obtain specimen and half fill bottle 
with feces by using tongue de- 
pressor. 
3. Label specimen, writing— 
1. Name. 
2. Ward. 
3. Date. 
4. What specimen is to be examined 
for. 
4. Take to laboratory immediately. 
4. Specimen of sputum. 
Articles necessary. 
1. Sputum specimen bottle and cover. 
2. Label. 
Procedure. 
1. Obtain specimen early in morning. 
2. Patient’s mouth and teeth must be 
carefully cleaned. 
3. Give patient specimen bottle and in- 
struct patient to expectoraite into 
bottle, filling only half full, no more. 
4. Label bottle plainly with— 
1. Patient’s name. 
2. Date. 
3. Ward. 
Reference Readings : 
Harmer, pages 107-108. 
Hampton-Robb, page 277. 
Maxwell and Pope, pages 357-363. COLLECTION OF SPECIMENS 
71 
5. Mosenthal test—collecting of specimens. 
Articles necessary. 
1. Bedpan or urinal and cover. 
2. Seven bottles. 
3. Seven labels. 
Procedure. 
1. Urine is to be collected for twenty- 
four hours as follows. 
2. Start test at 8 a.m. Throw away 
8 a.m. voiding. 
3. Collect specimens every two hours 
until 8 p.m., i.e., 10 a.m., 12 noon, 
2 p.m., 4 p.m., 6 p.m., and 8 p.m. 
Put each specimen in separate bot- 
tle. 
4. Collect from 8 p.m. to 8 a.m., in one 
specimen. 
5. Put label containing, on each bottle— 
1. Mosenthal test. 
2. Patient’s name. 
3. Hour and date. 
4. Ward numbers. 
6. Send to laboratory when all collected. 
6. Phenolsulphonephthalein or “Red Test”—col- 
lecting of specimens. 
Articles necessary. 
1. Hypodermic syringe with intramus- 
cular needle. 
2. One ampule (1 c.c.) of phenolsulphone- 
phthalein. 72 
COLLECTION OF SPECIMENS 
3. Two bottles. 
4. Two labels. 
5. Two glasses of water. 
Procedure. 
1. Have patient void before giving test. 
2. Doctor then gives 15 minims of phe- 
nolsulphonephthalein. Nurse notes 
exact time. 
3. Encourage patient to drink two 
glasses of water. 
4. Collect first specimen one hour and 
ten minutes after phthalein injec- 
tion. Send entire amount to labora- 
tory, marked “first specimen and 
time of collecting. ’ ’ 
5. Collect second specimen one hour 
after first specimen has been ob- 
tained. Send entire amount to 
laboratory marked “second speci- 
men and time of collecting. ’ ’ 
6. Write on each label in addition: 
1. Phenolsulphonephthalein test. 
2. Patient’s name. 
3. Ward number. 
4. Date. 
Reference Reading: 
Harmer, page 449. ENEMATA 
Soapsuds enema. 
Articles required. 
1. Isolation blanket. 
2. Irrigating standard. 
3. Bedpan and cover. 
4. Toilet paper. 
5. Tray containing: 
1. Irrigating can with tubing, clamp 
and glass connecting tube. 
2. Basin containing rectal tube. 
3. Pus basin. 
4. Sterile lubricant. 
5. Rubber sheet. 
6. Cotton draw sheet. 
Procedure. 
1. Boil rectal tube two minutes, remove 
and place in basin on tray. 
2. Prepare two quarts' of solution in 
pitcher, with castile soap and water 
at temperature of 105° F., and 
remove froth. 
3. Pour solution into can and carry 
equipment to bedside. 
4. Screen patient with two screens. 
73 74 
ENEMATA 
5. Cover patient with isolation blanket 
and fan down covers to foot of bed. 
6. Place rubber sheet covered with draw 
sheet under patient. 
7. Remove one pillow and have patient 
on left side near edge of bed with 
knees flexed. 
8. Hang irrigating can on standard, not 
more than one and a half feet above 
patient’s hips. 
9. Connect rectal tube to tubing, lubri- 
cate, and expel air and cold water. 
10. Separate buttocks and gently insert 
tube from 6 inches to 8 inches fol- 
lowing natural curve of rectum, 
backward, upward, and slightly to 
left side. 
11. Unclamp tubing and let water run 
very easily at first by pressing tube 
between fingers. 
12. Shut off flow for short time if patient 
complains of pain. 
13. Shut off flow before can is empty. 
14. Remove rectal tube and place in pus 
basin. 
15. Encourage patient to retain enema 
ten to fifteen minutes after removal 
of rectal tube. 
16. Take tray to utility room, rinse 
rectal tube in cold water, wash in 
hot soapy water and boil two min- 
utes. Clean other articles and place 
on tray. ENEMATA 
75 
17. Remove rubber and cotton sheet from 
under patient, after enema has been 
expelled. Clean rubber and fold in 
clean draw sheet and put on tray. 
18. Remove isolation blanket and leave 
patient comfortable. 
19. Note result of enema and chart. 
Reference Readings: 
Harmer, pages 108-116. 
Hampton-Robb, pages 156-160. 
Maxwell and Pope, pages 370-386. ENEMATA OF SMALL AMOUNT 
Articles necessary. 
Tray containing: 
1. Rectal tube in basin. 
2. Funnel. 
3. Graduate containing solution. 
4. Pus basin. 
5. Lubricant and toilet paper. 
6. Towel. 
Procedure. 
1. Boil rectal tube two minutes. 
2. Prepare solution. 
3. Carry articles to bedside and screen 
patient with two screens. 
4. Have patient on left side. 
5. Fold back covers in form of triangle. 
6. Protect bed with towel. 
7. Attach and lubricate tube, expel air and 
insert about eight inches. 
8. Allow solution to run very slowly, holding 
funnel eight inches above hips. 
9. Shut off flow before funnel empties, re- 
move tube. 
10. Pinch tube when removing to prevent 
drops falling on bed, place in pus basin. 
11. Tidy bed and make patient comfortable. 
76 ENEMATA OF SMALL AMOUNT 
77 
12. Remove screens and carry tray to utility 
room. 
13. Boil rectal tube and leave tray in perfect 
order. 
14. Chart solution and amount given. 
Refekence Readings: 
Harmer, pages 110-112, 528-531. 
Hampton-Robb, pages 160-164. 
Maxwell and Pope, pages 376-381. ENTEROCLYSIS OR HIGH HOT COLON 
Articles necessary. 
1. Isolation blanket. 
2. Kelly pad. 
3. Irrigating standard. 
4. Floor rubber. 
5. Foot tub. 
6. Tray containing: 
1. Irrigating can, tubing, clamp, and 
glass connecting tube. 
2. Two pitchers—normal saline, temper- 
ature 115° to 120° F. 
3. Two rectal tubes in basin. 
4. Pus basin. 
5. Lubricant. 
6. Toilet paper. 
Procedure. 
1. Boil rectal tube two minutes. 
2. Prepare solution—usually two gallons. 
3. Bring articles to bedside and screen pa- 
tient. 
4. Place chair at foot of bed and remove one 
pillow. 
5. Cover patient with blanket and fan covers 
to foot of bed. 
78 ENTEROCLYSIS OR HIGH HOT COLON 
79 
6. Place Kelly pad under patient, have her on 
left side with buttocks well over to side 
of bed—knees flexed. 
7. Protect floor with floor rubber and place 
foot tub on rubber. 
8. Hang irrigating can on standard, connect 
rectal tube, lubricate both tubes at once 
and expel air and cold water from con- 
nected tube. 
9. Insert both tubes at once, having inflow in- 
serted 6 to 7 inches and outflow 3 inches. 
10. Unclamp tubing and let water run, having 
outflow tube drain into foot tub. 
11. Shut off flow before can is empty. 
12. Remove rectal tubes and place in pus 
basin. 
13. Remove Kelly pad and straighten out bed. 
Remove articles and cleanse, leaving 
everything in perfect condition. 
15. Note return flow and chart. 
Reference Readings : 
Harmer, pages 519-525. 
Maxwell and Pope, pages 366-370, 380-388. MURPHY DRIP 
Articles necessary. 
1. Murphy drip with complete tubing and 
clamp. 
2. Small rubber catheter. 
3. Graduated glass connecting tube. 
4. Lubricant on toilet paper. 
5. Pitcher. 
6. Bath thermometer. 
7. Gray basin. 
8. Floor rubber. 
9. Irrigating standard. 
10. Safety pin. 
Procedure. 
1. Fill pitcher with water of temperature 
125° to 130° F. 
2. Pour small amount in thermos bottle to 
warm it. Empty out. 
3. Fill thermos bottle with water temperature 
125° to 130° F. 
4. Carry to bedside with other articles. 
5. Place floor rubber on floor beside bed. 
6. Place standard on floor rubber. 
7. Hang thermos bottle on top of standard 
and arrange gray basin to catch any 
drops. 
80 MURPHY DRIP 
81 
8. Connect catheter to tubing and lubricate. 
9. Open clamp gradually and regulate drops 
thirty-five to forty per minute. 
10. Insert catheter six to eight inches. 
11. Fasten tubing in place on side of bed with 
safety pin. 
Reference Readings: 
Harmer, pages 525-528. 
Maxwell and Pope, pages 523-524. DOUCHE—VAGINAL 
Articles necessary. 
1. Irrigating standard. 
2. Douche pan and cover. 
3. Isolation blanket. 
4. Rubber and cotton draw sheet. 
5. Large sheet. 
6. Tray containing: 
1. Irrigating can with tubing and clamp. 
2. Douche point in boiling basin. 
3. Pus basin. 
4. Small bowl with y2% cresol solution 
and six cotton pledgets. 
5. Towel. 
Procedure. 
1. Boil douche point wrapped in gauze for 
three minutes. 
2. Prepare solution ordered in pitcher and 
pour into irrigating can (temperature 
110° to 120° F. as ordered.) 
3. Place articles on tray, cover with towel. 
4. Carry tray and other articles to bedside. 
5. Screen patient. 
6. Cover patient with isolation blanket and 
fan covers to foot of bed. 
82 DOUCHE—VAGINAL 
83 
7. Place rubber and cotton draw sheet under 
patient. 
8. Drape lower limbs with sheet. Have knees 
flexed with the patient in dorsal position. 
9. Remove pillows and place warm douche 
pan under patient. 
10. Hang can on standard one foot above 
patient’s hips. 
11. Go to utility room and wash hands thor- 
oughly. 
12. Separate labia and cleanse by wiping 
downward—first on one side, then other 
side, and then in center using separate 
pledget for each movement. 
13. Connect douche point to tubing and expel 
air. 
14. Insert nozzle downward and backward, al- 
lowing it to follow the curve of vagina. 
15. Unclamp tubing and let solution flow. 
16. Clamp tubing before can is empty. 
17. Remove douche point and place in pus 
basin. 
18. Place irrigating can on tray. 
19. Remove douche pan and note return. 
20. Remove large sheet, rubber and cotton 
draw sheets, and isolation blanket. 
21. Straighten the bed covers and leave in 
order. 
22. Remove screens and carry tray and other 
articles from bedside—clean and put 
away dry. 
23. Rinse douche point in cold water and boil. 
24. Chart result of treatment. 84 
DOUCHE—VAGINAL 
Reference Readings: 
Harmer, pages 238-243. 
Hampton-Robb, pages 165-167. 
Maxwell and Pope, pages 392-398. IRRIGATIONS 
i. Ear irrigation. 
Articles necessary. 
Tray containing: 
1. Sterile basin with irrigating solution. 
2. Syringe in disinfecting solution. 
3. Sterile cotton applicators. 
4. Kidney basin. 
5. Towel. 
6. Waste cup. 
Procedure. 
1. Have patient sitting up, if possible. 
2. Protect shoulder with towel and have 
patient hold kidney basin close to 
ear. If a discharge is present wipe 
out with sterile applicator. 
3. Draw the fluid into the syringe, hold 
upright and expel the air. 
4. For adult draw tip of ear upward and 
backward to straighten out canal. 
For children draw tip downward 
and backward. 
5. Inject fluid slowly into auditory 
canal, being careful not to place 
point of syringe too far into ear. 
85 86 
IRRIGATIONS 
6. Wipe out carefully with sterile ap- 
plicator. 
7. Leave the tray in order. 
Note. If irrigating can is used it should he 
placed not more than three or four inches above 
the level of the patient’s ear. A glass connecting 
point is attached to rubber tubing and used for 
injection of fluid into the ear. 
If patient is unable to sit up, remove pillow, 
protect the bed with dressing rubber and towel 
and follow same procedure. 
Reference Readings: 
Harmer, pages 658-663. 
Hampton-Robb, page 527. 
Maxwell and Pope, pages 407-411. 
2. Nasal irrigation. 
Articles necessary. 
1. Irrigating standard. 
2. Tray containing: 
1. Irrigating can with tubing, clamp and 
solution. 
2. Nasal douche point. 
3. Emesis basin. 
4. Dressing rubber and towel. 
Procedure. 
1. Have patient sitting up, if possible. 
2. Cover dressing rubber with towel and 
place across the patient’s chest. 
3. Hang irrigating can on standard IRRIGATIONS 
87 
three or four inches above patient’s 
head. 
4. Keep patient’s head tilted forward so 
that Eustachian tubes are higher 
than the nose. 
5. Have patient hold the emesis basin in 
position. 
6. Instruct patient to breathe through 
mouth. 
7. Irrigate one nostril then the other, 
using two or three ounces at a time. 
One pint is sufficient for irrigation. 
8. Leave tray in order. 
Note. If one nostril is obstructed, solution 
should be injected into that nostril first. 
Reference Readings: 
Harmer, pages 669-670. 
Maxwell and Pope, 402-405. 
3. Throat irrigation. 
Articles necessary. 
1. Irrigating standard. 
2. Tray containing: 
1. Irrigating can, with tubing, clamp 
and solution. 
2. Drinking tube. 
3. Dressing rubber and towel. 
4. Basin. 
Procedure. 
1. Patient can be either sitting or in re- 
cumbent position, head bent for- 
ward. 88 
IRRIGATIONS 
2. Place dressing rubber covered with 
towel in such a way that it will pro- 
tect the patient and bed. 
3. Place irrigating can on standard two 
feet above patient’s head. 
4. Put basin in place to catch solution. 
5. Connect glass drinking tube to rubber 
tubing. 
6. Move glass tube from side to side so 
that the solution will reach all 
parts of the pharynx. 
7. Remove articles, boil tube. 
Reference Readings: 
Harmer, pages 666-668. 
Maxwell and Pope, pages 406-407. 
3. Eye irrigation. 
Articles necessary. 
1. Bowl or bottle of solution for irriga- 
tion. 
2. Sterile eye dropper fitted with rubber 
bulb. 
3. Jar sterile cotton pledgets. 
4. Sterile thumb forceps. 
5. Kidney basin or cellulose cotton. 
6. Waste cup or paper bag. 
7. Towel. 
8. Dressing rubber, if necessary. 
Procedure. 
1. Have patient sitting up in chair with 
head bent back, if possible. IRRIGATIONS 
89 
2. Wipe eye carefully with cotton 
pledget, from inner to outer can- 
thus. 
3. Have patient hold the kidney basin 
close against cheek. 
4. Hold lids open with left hand and ir- 
rigate with right hand. 
5. Dry the eye with cotton pledget. 
6. Leave tray in order. 
Note: If patient is too ill to sit up, remove 
pillows, cover dressing rubber with towel and 
place so as to protect patient’s chest and bed. 
Place kidney basin under side of head and pro- 
ceed in the same way. 
Reference Readings : 
Harmer, pages 651-653. 
Maxwell and Pope, pages 411-415. INSTILLATION OF DROPS 
Articles necessary. 
1. Eye dropper. 
2. Sterile cotton pledgets. 
3. Waste cup. 
Procedure. 
1. Have patient tilt his head backward. 
2. Draw down the lower lid with thumb of 
left hand. 
3. Instruct patient to look up. 
4. Hold dropper in right hand at least an 
inch from patient’s eye and let drop 
fall in pocket formed by lower lid. 
5. Press cotton pledget at inner canthus for 
a moment. 
Reference Readings: 
Harmer, pages 647-648. 
Maxwell and Pope, pages 477-478. 
90 PREPARATION FOR OPERATION. 
Articles necessary. 
1. Tray containing: 
1. Basin antiseptic solution. 
2. Basin green soap. 
3. Basin sterile water. 
4. Sterile gauze wipes. 
5. Kidney basin. 
6. Dressing rubber and cover. 
7. Razor and small squares of toilet 
paper. 
8. Towel. 
9. Binder or bandage. 
10. Clinic blanket and draping sheet. 
11. Sterile 4x8 for dressing. 
Procedure. 
1. Place dressing rubber and cover under 
part to be prepared. 
2. Protect shoulders with clinic blanket and 
fold down covers. (Drape lower limbs 
with sheet if necessary.) Protect with 
towel. Expose part to be prepared. 
3. Soap area well with green soap. 
4. Hold the razor flat against the surface and 
draw it while held in that position. 
Shave clean. 
91 92 
PREPARATION FOR OPERATION 
5. Scrub thoroughly with green soap and 
water. 
6. Wash off with disinfecting solution. 
7. Apply sterile dressing. Hold in place 
with bandage or binder. 
Rules for general preparation. 
1. Cleansing sponge bath day before. 
2. Cathartic the night before. S. S. Enema 
in eight hours. 
3. No breakfast. No fluids for at least three 
hours before. 
4. Have hospital patient sign “Permission 
for Operation Book.” Have patient at- 
tended by Priest or Minister. 
5. Put on fresh laparotomy suit. Put tri- 
angle on head. 
6. See that patient voids. Chart amount. 
7. Remove false teeth or any foreign object 
in mouth. Also wedding ring. 
8. Place folded draw sheet on stretcher under 
patient’s buttocks. Cover well with 
blankets. 
9. Send chart with patient completely filled 
out with Medication and notes. 
10. Destroy all Medication Tickets and treat- 
ments. 
Reference Readings: 
Harmer, pages 501-518 
Maxwell and Pope, pages 641-648. TEMPERATURE 
Thermometer tray. 
1. Thermometers in jar with 1-40 carbolic 
solution. 
2. Jar clear water to rinse thermometers. 
3. Small enamel bowl with paper wipes. 
4. "Waste cup or small paper bag. 
5. Rectal thermometer in small tray with 1-40 
carbolic solution. 
6. Tube sterile lubricant. 
Procedure by mouth. 
1. Rinse thermometer in clear water and 
wipe dry. 
2. Shake mercury down to 95° F. 
3. See that patient has not had anything hot 
or cold in his mouth just before. 
4. Have patient moisten lips. 
5. Place thermometer under tongue. 
6. Keep lips closed for three minutes. 
7. Remove thermometer, wipe off, read and 
record temperature. 
Procedure by rectum. 
1. Turn patient on side, if possible. 
2. Shake mercury down to 95° F. 
93 94 
TEMPERATURE 
3. Oil bulb, and insert in rectum inches. 
4. Let it remain three minutes. 
5. Remove, wipe end of thermometer with 
toilet paper, read and record tempera- 
ture. 
Procedure by axilla. 
1. Wipe the axilla dry. 
2. Shake mercury down to 95° F. 
3. Place bulb in hollow of armpit. 
4. Have patient place arm across chest with 
hand on opposite shoulder. 
5. Leave thermometer in 8-10 minutes. 
6. Remove, record. PULSE 
Article necessary. 
1. Watch with second hand. 
Procedure. 
1. Have patient lying down, arm at rest. 
2. Nurse places index and middle finger over 
artery, making slight pressure. 
3. Count for one minute, dividing the minute 
into halves or quarters and record. 
Locations where pulse may be felt. 
1. Radial artery—wrist. 
2. Temporal artery—temple. 
3. Facial artery—jaw. 
4. Femoral artery—pelvic bone. 
5. Dorsalis pedis—foot. 
6. Carotid artery—throat. 
95 RESPIRATION 
Article necessary. 
1. Watch with second hand. 
Procedure. 
1. Take immediately after the pulse is count- 
ed and while fingers are still on wrist 
so the patient will not know you are 
counting the respirations. 
2. Watch rise and fall of chest wall. 
3. Count for one minute and record. 
Reference Readings: 
Harmer, Chapters XIII, XIV, XV. 
Hampton-Robb, Chapter IX. 
Maxwell and Pope, Chapter VII. 
96 MEDICATIONS 
Articles necessary. 
Tray containing: 
1. Medicine glasses. 
2. Drinking glass. 
3. Pitcher of water. 
4. Minim glass. 
5. Measuring cup. 
6. Medicine dropper. 
7. Stirring rod. 
8. Teaspoon. 
9. Bowl for medication tickets. 
10. Gauze for wiping bottles. 
Procedure. 
1. Read medication ticket. 
2. Take required medicine from cabinet. 
3. Read medication ticket and label on bottle. 
4. Calculate dose. 
5. Remove cork, holding it in little finger of 
right hand. 
6. Pour required dose into medicine glass, 
holding glass on level with eye. 
7. Wipe bottle with gauze. 
8. Replace cork. 
9. Read medication ticket and label on bottle. 
10. Place ticket in glass and put on tray. 
97 98 
MEDICATIONS 
11. Replace bottle in cabinet. 
12. Dilute medication, if necessary. 
13. Give to patient. 
14. Wash medicine glasses, place ticket in 
bowl and leave tray in order. 
Preparation of dose of castor oil. 
1. Pour one dram lemon and orange juice in 
glass and wet sides of glass with juice. 
2. Pour required dose of oil in glass and add 
another dram of lemon juice. 
3. Place medicine glass on plate, and arrange 
a few pieces of lemon or orange on plate. 
4. Take to patient, instruct patient to open 
mouth wide and take in one swallow. 
5. Wipe lips immediately and give patient 
piece of lemon or orange. 
Medicine tickets. 
q. 3. h. Pink. q. 1. h. 
1 corner off. 
q. 4. h. Red. q. 2. h. 
1 corner off. 
A. C. T. I. D. Blue. q. 6. h. 
1 corner off. 
P. C. T. I. D. Yellow. B. I. D. 
1 corner off. 
0. D. White. 0. N. 
1 corner off. 
Green. 
Irregular Orders. MEDICATIONS 
99 
Reference Readings: 
Harmer, pages 419-430. 
Hampton-Robb, pages 218-225. 
Maxwell and Pope, pages 451-454. HYPODERMIC INJECTION 
Articles necessary. 
1. Glass jar with gauze in bottom containing 
needles and wires. 
2. Enamel jar containing small sterile cotton 
pledgets. 
3. Enamel jar with gauze in bottom contain- 
ing syringe and forceps in 95% alcohol. 
4. Enamel cup for waste. 
5. Bottle alcohol. 
6. Bottle of water for boiling needle. 
7. Alcohol lamp and box of matches. 
8. Spoon. 
Procedure. Preparing medication. 
1. Remove wire from needle and place needle 
in spoon containing water. 
2. Light alcohol lamp and boil needle for one 
minute. 
3. Support handle of spoon on box of 
matches. 
4. Figure out dose to be given, remove cork 
from bottle, take a cotton pledget on the 
forceps, pour on it a few drops of alco- 
hol and clean mouth of bottle. 
5. Put syringe together with forceps, rinse 
out barrel with sterile water, place end 
100 HYPODERMIC INJECTION 
101 
of barrel in mouth of bottle. Turn bottle 
upside down and draw up two or three 
minims more than required dose. 
6. Cork bottle. 
7. Adjust needle on syringe with forceps, 
turn syringe upwards and expel air, and 
see that quantity of dose is correct. 
8. Pour few drops of alcohol on cotton 
pledget, wrap around needle, and take 
to bedside. 
Procedure when nurse reaches patient. 
9. Take up flesh between finger and thumb of 
left hand and rub surface with cotton 
pledget, which is around needle. 
10. Insert needle quickly, deeply and with an 
upward slant. 
11. Draw out needle a little, loosen fingers of 
left hand and press piston, injecting 
fluid slowly. 
12. Press same cotton pledget where needle is 
inserted, withdraw needle quickly and 
rub upward to prevent losing any of the 
medication. 
13. Rinse syringe, replace in jar containing 
alcohol. 
14. Boil and wire needle. 
15. Leave tray in good order and replenish 
supplies. 
Reference Readings: 
Harmer, pages 431-433. 
Maxwell and Pope, pages 454-463. CATHETERIZATION 
Articles necessary. 
1. Isolation blanket. 
2. Large sheet. 
3. Towel. 
4. Tray containing: 
1. Unsterile kidney basin, for soiled 
catheters. 
2. Paper bag. 
3. Sterile kidney basin for urine. 
4. Two rubber catheters in small bowl, 
wrapped in gauze in small amount 
sterile water. 
5. Bowl containing cresol 1% for nurses’ 
hands. 
6. Bowl containing cresol %% and s^x 
sterile cotton pledgets. 
7. Sterile thumb forceps in basin with 
cotton pledgets. 
8. Sterile towel. 
Preparation of tray. 
1. Place the three bowls, thumb forceps, kid- 
ney basin and two catheters wrapped in 
gauze, in sterilizer and boil for five 
minutes. 
102 CATHETERIZATION 
103 
2. Cover one end of tray with sterile towel, 
and on it by means of sterile forceps, 
place small bowl containing catheters in 
sterile water, kidney basin, thumb for- 
ceps, and two bowls. 
3. In one bowl pour one half pint of cresol 
1 °/o, in the other, pour one half pint 
cresol y2% and in it place six sterile 
cotton pledgets. 
4. Cover with the other half of sterile towel. 
5. Place unsterile kidney basin and paper 
bag on uncovered portion of tray. 
Preliminary preparation of patient. 
1. Screen patient with two screens. 
2. Carry tray, isolation blanket, large sheet 
and towel to bedside. 
3. Mention to patient just what you intend 
to do and reassure her mind. 
4. Place isolation blanket over patient’s 
shoulders and fold down covers to foot 
of bed. 
5. Drape lower limbs with sheet, fold sheet 
over abdomen and protect pubic region 
with towel. 
6. Remove bedside table to lower third of 
bed. 
Preparation of nurse. 
1. Return to lavatory, roll sleeves to elbow. 
2. Scrub hands and arms to elbows, with 
green soap under running water. 104 
CATHETERIZATION 
3. Use orange-wood stick for cleaning nails 
and scrub with hand brush for five 
minutes. 
4. Return to bedside, being careful not to 
contaminate the hands by touching any- 
thing. 
Further preparation of patient and procedure. 
1. Uncover tray, immerse hands in hand 
solution for one minute. 
2. Remove gauze from catheters. 
3. Remove folded towel from pubic region 
with elbow, allowing towel to fall on bed. 
4. Wrap thumb and first finger of left hand 
with cotton pledget from the sponging 
solution. 
5. Separate labia, with the right hand, take 
sterile forceps from bowl, catch in same 
a sterile pledget; squeeze surplus fluid 
against side of bowl. 
6. Cleanse folds of vulva, from above down- 
ward, discard pledget into paper bag. 
7. Take another on forceps, cleanse other 
side, and use a third for meatus uri- 
narius. 
8. Place sterile cotton pledget in vaginal 
opening to prevent catheter from slip- 
ping into same. 
9. Place sterile kidney basin in position 
under pubes to catch the flow of urine. 
10. Hold labia separated with wrapped thumb 
and finger of left hand. CATHETERIZATION 
105 
11. With right hand take catheter—3 inches 
away from eye—insert into meatus 
downward, very gently—2y2 to 3 inches. 
12. Hold catheter in position and direct flow of 
urine into kidney basin. 
13. When flow appears to be diminishing, 
pinch catheter and remove slowly and 
gently, allow fluid to run into kidney 
basin and place catheter in unsterile kid- 
ney basin. 
14. Take sterile pledget on forceps and 
cleanse parts, discard pledget and wipe 
parts dry with towel. 
15. Remove towel, bring blanket down, at same 
time removing the drape sheet. 
16. Replace upper bed clothing and remove 
blanket. 
17. Replace bedside table and remove articles. 
18. Put tray away with all basins on it. Not 
sterile. 
19. Measure and chart the amount of urine 
obtained. 
Note: If sterile specimen of urine is desired 
place about 15 c. c. in sterile test tube and label 
with name, date and ward. 
Reference Readings: 
Harmer, pages 531-542. 
Hampton-Robb, pages 167-169. 
Maxwell and Pope, pages 432-438. BLADDER IRRIGATION 
Articles necessary. 
1. Same as for catheterization. 
2. Sterile funnel. 
3. Sterile pitcher of sterile solution 100° F. 
Procedure. 
1. Catheterize patient first. 
2. With catheter still inserted connect funnel 
and pour in three or four ounces (or as 
much as patient can take) of solution. 
3. Drain off in pus basin. 
4. Repeat three times. 
5. Remove catheter as in catheterization and 
cleanse parts. 
6. Clean tray and put away as in catheteriza- 
tion. 
Reference Readings: 
Harmer, pages 539-541. 
Hampton-Robb, pages 169-170. 
Maxwell and Pope, pages 439-442. 
106 CHARTING 
On every patient’s bed are— 
1. Admission card in holder: 
(blue for women, white for men). 
2. Chart, consisting of the following sheets: 
1. Standing orders, on which the phy- 
sician’s orders for diet, medication 
and treatment are kept. 
2. Plain card board for the purpose of 
1. Keeping the chart clean. 
2. Keeping the edges from curling. 
3. Temperature sheet. 
4. Treatment and nurse’s notes, on 
which are recorded 
1. Diet, medication, and treatment 
given. 
2. Remarks concerning patient’s 
condition, dressings, wound and 
any unusual or important ob- 
servations made by nurse. 
5. History sheet on which the physician 
records the patient’s history. 
6. Continuation history sheet. 
7. Physical examination record. 
8. Pathological sheet. 
9. Progress record. 
107 108 
CHARTING 
Rules for charting. 
1. All nurse’s charting must be printed not 
written. 
2. The temperature chart starts with the 
patient’s admission to the hospital, and 
the words “on admission” are printed 
in the spaces above and at right angles 
to the temperature and pulse. 
3. The temperature is taken and re- 
corded 8-12-4 (depending upon the divi- 
sion). 
4. The hours are charted in black during the 
day and in red during the night. 
5. At 12 M., a red line is drawn perpendicu- 
larly to separate the days on a q. 4 h. or 
q. 2 h. chart. 
6. The temperature is recorded in black dots, 
light lines connecting. 
7. The pulse is recorded in red dots, light 
lines connecting. 
8. The respiration is recorded in figures and 
in spaces, except when a curve is speci- 
fied in special cases. 
9. Urine which is not measured is recorded 
“L” (lost). 
10. Defecation is recorded by Roman Nu- 
merals (I, II, etc.) 
11. Urine and feces are recorded in black dur- 
ing the day, in red ink during the 
night. 
12. The stool resulting from a simple enema 
is marked S. S. E. CHARTING 
Record on nurse’s sheets. 
1. Date and hour of admission. 
2. Manner of admission, walked, wheel chair, 
stretcher. 
3. Condition of body—Pediculi observed. 
4. T.P.R. 
5. Patient’s complaints. 
6. Nurse’s observation on admission. 
1. Bed sores, location, size, character, 
whether superficial or sloughing. 
2. Peculiarities of speech or gait. 
3. Any indication of mental disturbance. 
7. By whom seen (physician’s name). 
Nurses’ daily observations for charting. 
Digestive System. 
1. Nausea. 
1. Time and severity—slight, or ex- 
treme with retching, etc. 
2. Cause of nausea if it can be ascer- 
tained. 
2. Vomiting. 
1. Time. 
2. Amount. 
3. Color. 
4. Consistency. 
5. Constituents—food remains, bile, 
fluid, blood, etc. 
6. Odor. 
7. Reaction to Congo paper. 
8. Cause of vomiting, if known, viz., 
after medicine, after eating 
109 110 
CHARTING 
fruit, etc. Reasons patient 
may give for it. 
3. Stools. 
1. Preserve all stools containing 
blood or anything unusual or 
suspicious. 
2. Note any change of color. 
3. In jaundiced patients state 
whether or not stools are clay 
colored. 
4. Distention of the Abdomen. 
1. Time and degree of distention, 
slight, much, marked, etc., dis- 
comfort, pain, etc. 
2. Measures applied for relief and 
results. 
Respiratory System 
1. Breathing—note any change, such as 
1. Dyspnoea. 
2. Orthopncea. 
3. Cheyne-Stokes. 
2. Cough. 
1. Time—morning, afternoon, all 
day. 
2. Severity. 
3. Expectoration. 
1. Color—rusty, etc. 
2. Constituents—blood, etc. 
3. Consistency—froth, heavy, tena- 
cious, etc. 
4. Odor. CHARTING 
111 
5. Quantity (estimate fairly ac- 
curately). 
Nervous System. 
1. Restlessness. 
2. Irrational. 
3. Delirium. 
1. Coma vigil. 
2. Picking at bed clothes, busy, oc- 
cupational, etc. 
3. Subsultus tendinum. 
4. Active—noisy. Patient trying to 
get out of bed. 
5. Measures taken to relieve, re- 
straint, etc., and effects. 
4. Stupor. 
5. Coma. 
6. Convulsions. 
1. Onset, bow, where, aura. 
2. General, or only partial, and 
parts involved. 
3. Duration. 
4. Clonic or tonic. 
7. Hiccough. 
8. Eyes. 
1. Unequal pupils. 
2. Markedly contracted or dilated 
pupils. 
General Symptoms. 
1. Pain. 
1. Location. 
2. Time. 112 
CHARTING 
3. Duration. 
4. Character—sharp, dull, darting, 
shooting, knife-like, etc. 
5. Measures applied for relief and 
results. 
2. Chills. 
1. Duration. 
2. Severity. 
3. Skin. 
1. Eash—character, etc. 
2. Marked sweating or dryness. 
3. Jaundice. 
4. Bed sores. 
Chart any red areas on back or 
over body prominences. 
Chart if getting larger. 
4. Medication. 
1. Result, for example, if codein is 
given for cough, chart if it re- 
lieves it. 
2. Refusal to take medicine pre- 
scribed. 
The following symptoms are to be reported to 
the House Physician as well as charted: 
1. Any sudden rise in temperature, or a very 
high temperature. 
2. Any marked change in the rate and char- 
acter of the pulse, weakness, irregu- 
larity or difficulty in counting. 
3. Any marked change in rate or character 
of respiration. CHARTING 
113 
4. Vomiting of blood. 
5. Hemorrhage of the bowels. 
6. Abdominal distention. 
7. Retention or suppression of urine. 
8. Unusual or severe pain. 
9. Twitchings and convulsions. 
10. Drowsiness and coma. CARE OF BODY AFTER DEATH 
Articles necessary. 
1. Absorbent cotton. 
2. Non-absorbent cotton. 
3. Gauze bandage, 3 inches. 
4. Packer (nozzle, glass rod, tongue de- 
pressors). 
5. Comb. 
6. Shroud, morgue pad, and morgue tag. 
7. Foot tub warm water. 
8. Soap. 
9. Towel and wash cloth. 
Procedure. 
1. See that patient is screened with two 
screens. 
2. Notify the doctor that the patient has ap- 
parently ceased breathing. (Doctor 
must pronounce the patient dead.) 
3. Straighten the limbs, close the eyes, and 
mouth, put in false teeth if patient has 
them, while waiting for the doctor. Be- 
move wedding ring. 
4. After the doctor pronounces patient dead, 
1. Place few shreds of cotton or tissue 
paper under eye lids. 
114 CARE OF BODY AFTER DEATH 
115 
2. Pack nose, ears, and mouth with ab- 
sorbent cotton. 
3. Pack rectum and vagina with non- 
absorbent cotton. 
4. Bathe body thoroughly with soap and 
water. 
5. Apply clean dressing to bed sores and 
wounds. 
6. Cover external genitals and rectum 
with morgue pad. Pin with safety 
pin. 
7. Comb hair and braid in two braids. 
8. Close mouth and apply chin support. 
Place the tip of chin in opening. 
Bring the two lower ends up and 
tie on top of head. Bring upper 
ends back and tie back of head. Tie 
together. 
9. Put on shroud and fasten in back. 
The hood of the shroud covers the 
face and head. Lap shroud in back, 
bring ends around and tie (if the 
patient is very large two shrouds 
should be used). 
10. Cross hands on breast and tie to- 
gether. 
11. Attach morgue tag and cover body 
with sheet. 
Reference Readings: 
Harmer, pages 302-304. 
Hampton-Robb, page 136. 
Maxwell and Pope, pages 164-167. COUNTERIRRITANTS 
i. Abdominal turpentine stupes. 
Articles required 
1. Two pieces of flannel. 
2. Towel and protector. 
3. Basin of hot water. 
4. Turpentine and oil (1 in 4). 
5. Swab for applying turpentine and oil. 
6. Stupe wringer. 
7. Electric stove (if possible). 
8. Alcohol and powder. 
9. Clinic blanket. 
Procedure. 
1. Collect articles and bring to bedside. 
2. Protect chest and abdomen with blan- 
ket, turning down covers to edge of 
blanket. 
3. Protect bed covers with towel. 
4. Apply turpentine and oil to abdomen 
with swab. 
5. Wring flannel out of hot water in 
stupe wringer. 
6. Shake flannel quickly to incorporate 
air, arrange in loose folds and cover 
with stupe protector. 
116 COUNTERIRRITANTS 
117 
7. Have fresh stupe ready before remov- 
ing old one, and never allow stupe 
to become cold. 
8. Change every 2-4 minutes. 
9. Apply turpentine and oil every third 
or fourth time. 
To discontinue stupes 
1. Remove oil and turpentine with alco- 
hol. 
2. Powder lightly and cover part with 
flannel. 
Reference Readings: 
Harmer, pages 203-207. 
Hampton Robb, pages 198-201. 
Maxwell and Pope, pages 495-499. 
2. Flaxseed poultice. 
Articles necessary. 
1. Flaxseed meal. 
2. Saucepan and boiling water. 
3. Large spoon. 
4. Poultice board. 
5. Old muslin and piece of thin flannel. 
6. Bandage or binder. 
7. Towel and protector. 
Procedure. 
1. To one and one half cups of boiling 
water gradually add one cup of flax- 
seed meal. 118 
COUNTERIRRITANTS 
2. Stir mixture thoroughly. 
3. Boil two minutes, or until mixture 
drops readily from the spoon. 
4. Beat well to incorporate air. 
5. Spread half inch thick on old muslin 
and fold envelope fashion. 
6. Carry to bedside wrapped in poultice 
cover and towel. 
7. Place binder under patient. 
8. Cover area to which poultice is to be 
applied with a thin flannel. 
9. Test temperature on arm and apply 
poultice slowly. 
10. Cover with protector and hold all in 
place with bandage or binder. 
11. Change every 1-2 hours. 
Note. Add dissolved mustard (1-6) to poultice 
for mustard poultice. 
To discontinue poultice. 
1. Remove poultice, and dry part. 
2. Powder lightly and cover part with 
flannel for two or three hours. 
Reference Readings: 
Harmer, pages 207-211. 
Hampton-Robb, pages 195-198. 
Maxwell and Pope, pages 489-491. 
3. Mustard paste. 
Articles necessary. 
1. Mustard and flour. 
2. Small bowl and spoon. COUNTERIRRITANTS 
119 
3. Poultice board. 
4. Old muslin. 
5. Towel and stupe cover. 
6. Olive oil and swab. 
7. Bandage or binder. 
8. Powder. 
Procedure. 
1. Spread towel on poultice board, then 
stupe cover, and muslin of desired 
size. 
2. Measure mustard and flour and thor- 
oughly mix, using one part mustard 
to four parts flour (for children use 
1-6). 
3. Add water sufficient to make paste 
(white of egg may be added to pre- 
vent blistering). 
4. Spread paste about half an inch thick 
on muslin and fold envelope fashion. 
5. Roll in towel and carry it to bedside. 
6. Oil the skin with olive oil, apply paste 
and cover with stupe cover. 
7. Hold in place with binder. 
8. Remove when skin is sufficiently red- 
dened. 
9. Dry moisture on skin by patting. 
10. Powder lightly and cover with piece 
of soft muslin. 
Reference Readings: 
Harmer, pages 338-341. 
Hampton-Robb, pages 206-207. 
Maxwell and Pope, page 494. 120 
COUNTERIRRITANTS 
4. Cupping. 
Articles necessary. 
Tray containing: 
1. Alcohol lamp. 
2. Steel rod and cotton. 
3. Five or six cupping glasses. 
4. Small dish for alcohol. 
5. Glass of water. 
6. Waste cup. 
7. Box of matches. 
8. Blanket. 
Procedure. 
1. Place folded blanket under patient’s 
shoulders open end at top. 
2. Turn half of it down over head and 
shoulders to protect hair. 
3. Turn down spread and sheet leaving 
patient completely surrounded by 
blankets. 
4. Remove gown. 
5. Arrange tray—alcohol at far end, 
cups in center and lamp nearest 
bed. 
6. Ignite swab—place in glass and hold 
open end of glass down. 
7. Place quickly on surface and leave cup 
until skin becomes red or until cup 
drops off. 
8. Insert fingers under rim to remove 
cup. COUNTERIRRITANTS 
121 
Reference Readings: 
Harmer, pages 334-336, 341-345. 
Hampton-Robb, page 210. 
Maxwell and Pope, pages 510-515. 
Typhoid screen. 
Articles necessary. 
1. Typhoid frame. 
2. Mosquito netting. 
3. Gauze bandage. 
4. Pins. 
5. Needle and thread. 
Procedure. 
1. Place frame around bed and secure to 
bed posts, above castors, with band- 
age. 
2. Place unhemmed netting on top and 
tighten around frame. 
3. Place side netting on sides, tucking in 
fulness (one inch tucks, one inch 
apart). The shorter piece around 
the head overlaps the longer piece 
around the foot for six inches, 
twenty-five inches from head of bed. 
4. Sew netting securely in place. 
Reference Readings : 
Harmer, pages 488-497. 
Hampton-Robb, pages 437-443. 
Maxwell and Pope, pages 743-751. 122 
COUNTERIRRITANTS 
Croup tent. 
Articles necessary. 
1. Wooden frame. 
2. Croup tent blanket (obtain from of- 
fice). 
3. Linen covering (obtain from office). 
4. Electric plate. 
5. Croup kettle. 
Procedure. 
1. Place wooden frame around head of 
bed. 
2. Cover with croup tent cover. Leave 
side near bedside table open. 
3. Place linen covering on in same man- 
ner. 
4. Connect electric plate to socket. 
5. Put water and medication in croup 
kettle and place on plate. Have 
spout of kettle extend into opening 
at side. 
6. Leave in position, as ordered. 
Reference Readings: 
Harmer, pages 668-669. 
Hampton-Robb, page 228. 
Maxwell and Pope, pages 472-476. 
Burn tent. 
Articles necessary. 
1. Wooden frame. 
2. Burn tent blanket (obtain from of- 
fice). COUNTERIRRITANTS 
123 
3. Linen covering (obtain from office). 
4. Carbon light. 
5. Muslin bandage. 
Procedure. 
1. Place frame in position around bed 
and secure to bed posts above cas- 
tors with muslin bandage. 
2. Place carbon light in position and 
secure with muslin bandage. 
3. Cover with burn tent blanket, leaving 
side near bedside table open. 
4. Place linen covering on in same man- 
ner. 
Reference Readings: 
Harmer, pages 617-618. 
Hampton-Robb, pages 367-369. 
Maxwell and Pope, pages 710-713. 
INSTRUMENTS, CARE OF 
Needles: 
1. Draw water through them immediately 
after use. 
2. Wash in cold water, then hot soapy 
water. 
3. Dry on inside by running wire through 
them. Wipe wire off each time. 
4. Put away containing wire that has been 
dipped in white mineral oil. 
5. Boil before using. 124 
COUNTERIRRITANTS 
Syringes: 
1. Rinse out with cold water immediately 
after use. Remove piston. 
2. Wash in warm soapy water. 
3. Put away dry with piston removed. 
4. Boil before using. 
Scissors, probes, applicators, clamps, and forceps: 
1. Wash in cold water, then hot soapy water. 
2. Scour with scouring soap if necessary. 
3. Boil for ten minutes. 
4. Dry with sterile towel. 
5. Wrap in sterile towel and place in sterile 
basin. 
Scalpels: 
1. Wash in cold water. Then hot soapy 
water. 
2. Wrap blade in absorbent cotton and put 
away dry. 
3. Soak in 95% alcohol twenty minutes before 
using. 
Reference Reading: 
Maxwell and Pope, pages 537-590. 
Clean-up tray for skin. 
Articles necessary. 
1. Alcohol and iodin. 
2. Sterile applicators or gauze wipes. 
3. Sterile towel and dressing rubber. 
4. Sterile gloves. COUNTERIRRITANTS 
125 
5. Sterile gauze dressing with adhesive, 
or collodion. 
6. "Waste cup or paper hag. 
Procedure. 
1. Pour iodin over applicator holding 
mouth of bottle one inch or more 
from applicator. 
2. Begin in center of area and work to 
outer edges cleaning skin. 
3. Wash off with alcohol in same man- 
ner. 
4. Drape with sterile towel. 
1. Wassermann’s test. 
Articles necessary (tray kept set up on wards). 
1. Clean-up tray. 
2. Sterile test tubes in holder. 
3. Tourniquet. 
Procedure. 
1. Doctor takes the Wassermann test. 
2. Nurse cleans and replenishes tray. 
Reference Readings: 
Maxwell and Pope, page 245. 
2. Lumbar puncture. 
Articles necessary. 
1. Clean-up tray. 
2. Sterile hypodermic syringe with co- 
cain or ethyl chlorid. 126 
COUNTERIRRITANTS 
3. Sterile test tube in holder. 
4. Sterile lumbar puncture needles 
(two). 
Procedure. 
1. Have patient on side near edge of bed 
with knees drawn up and head bent 
forward. 
2. Fan covers back in form of triangle. 
3. Clean skin and drape with towel. 
4. Assist the doctor as he may desire. 
5. Clean tray and needles as soon as pro- 
cedure is finished. 
Reference Readings: 
Harmer, pages 346-351. 
Maxwell and Pope, pages 554-560. 
3. Intravenous infusion. 
Articles necessary. 
1. Clean-up tray. 
2. Sterile hypodermic syringe with co- 
cain. 
3. Sterile infusion set. 
4. Flask sterile saline in basin hot water. 
5. Tourniquet. 
6. Irrigating standard. 
7. Extra bedside table. 
Procedure. 
1. Have patient lie on back near one side 
of bed with arm resting on bedside 
table. COUNTERIRRITANTS 
127 
2. Fold covers back in form of triangle. 
3. The arm and forearm several inches 
from the bend of the elbow must be 
cleansed and disinfected. 
4. Pass a dressing rubber with a sterile 
towel under the arm. 
5. Cover the hand and part of the fore- 
arm not disinfected with a sterile 
towel. 
6. Place tourniquet around upper part of 
arm. Be sure that the ends do not 
touch sterile field. 
7. After needles are inserted remove 
tourniquet. 
8. When finished clean, and equip in- 
fusion set. 
Reference Readings: 
Harmer, pages 560-561. 
Hampton-Robb, pages 225-226. 
Maxwell and Pope, pages 529-538. 
4. Phlebotomy or venesection. 
Articles necessary. 
1. Clean-up tray. 
2. Sterile phlebotomy set. 
3. Sterile hypodermic syringe with co- 
cain. 
4. Tourniquet. 
5. Glass graduate (one quart if pos- 
sible). 
6. Extra bedside table. 
7. Floor rubber. 
8. Rubber apron for doctor. 128 
COUNTERIRRITANTS 
Procedure. 
1. Follow same procedure as for intra- 
venous infusion. 
2. Assist the doctor as he may desire. 
3. Clean up tray and set. Return set 
completely replenished. 
Reference Readings: 
Harmer, page 359. 
Hampton-Robb, page 315. 
Maxwell and Pope, pages 563-565. 
5. Hypodermoclysis. 
Articles necessary. 
1. Sterile hypodermoclysis set. 
2. Clean-up tray. 
3. Flask of sterile saline in basin hot 
water. 
4. Sterile hypodermic syringe with co- 
cain. 
5. Irrigating standard. 
Procedure. 
1. Place patient comfortably on back. 
2. Fan bedclothes below breasts—draw 
up night gown to expose both 
breasts. 
3. Cleanse and disinfect lower portion of 
each breast. 
4. Place sterile towel in place. 
5. Place flask of sterile saline in basin 
hot water on irrigating standard. COUNTERIRRITANTS 
129 
6. Assist the doctor as he may desire. 
7. When procedure is finished clean and 
replenish hypodermoclysis set. Re- 
turn to office. 
Reference Readings: 
Harmer, pages 560-561. 
Hampton-Robb, pages 225-226. 
Maxwell and Pope, pages 525-529. 
6. Paracentesis. 
Articles necessary. 
1. Clean-up tray. 
2. Sterile paracentesis set. 
3. Sterile hypodermic syringe with co- 
cain or ethyl chlorid. 
4. Foot tub and floor rubber. 
5. Isolation blanket to protect patient’s 
shoulders. 
6. Stimulants as ordered. 
Procedure. 
1. If necessary shave abdomen where 
puncture is to be made. 
2. See that patient voids just before the 
operation. 
3. Put laparotomy stockings on patient. 
4. Have patient sit on edge of bed near 
the head with feet resting on a chair 
or stool. 
5. Cover shoulders with blanket. 
6. Support the back well with pillows or 
back rest. 130 
COUNTERIRRITANTS 
7. Paint skin of abdomen with iodin. 
8. After operation is finished, dress 
wound with sterile dressing. 
9. Return patient to lying position. 
10. Apply binder tightly. 
11. Clean and replenish paracentesis set. 
Reference Readings: 
Harmer, pages 356-358. 
Hampton-Robb, page 314. 
Maxwell and Pope, pages 554-558. 
7. Chest aspiration or thoracentesis. 
Articles necessary. 
1. Clean-up tray. 
2. Sterile aspirating set. 
3. Hypodermic syringe with cocain or 
ethyl chlorid. 
4. Sterile water to test apparatus. 
Procedure. 
1. Have patient lie on sound side in a 
semi-recumbent position, arm of af- 
fected side raised above his head. 
2. Fold back covers in form of triangle. 
3. Prepare skin with iodin and alcohol. 
4. Drape part below with sterile towel. 
5. When finished wash apparatus, under 
cold running water. 
Reference Readings: 
Harmer, pages 351-354. 
Hampton-Robb, page 314. 
Maxwell and Pope, pages 558-563. PACKS 
i. Cold chest pack. 
Articles necessary. 
1. Two isolation blankets. 
2. Cotton draw sheet. 
3. Rubber pillow case. 
4. Small rubber sheet. 
5. Ice cap and cover. 
6. Towel. 
7. Foot tub. 
8. Alcohol and powder. 
Procedure. 
1. Fold an isolation blanket crosswise in 
three, place a rubber draw sheet be- 
tween the folds and fan each end 
toward the center. 
2. Fold the cotton draw sheet, length- 
wise in quarters and fan each end 
toward center. 
3. Wring draw sheet out of water at tem- 
perature of 65° or 70° F. Open 
blanket at center and place wet 
sheet in center of blanket. 
4. Carry equipment to bedside. Place 
chair at foot of bed. 
131 132 
PACKS 
5. Put rubber pillow case on soft pillow, 
place under patient’s head and re- 
move hard pillow. 
6. Place a folded isolation blanket across 
patient’s chest and fold back bed 
clothing to waist line. 
7. Remove gown, turn patient toward 
you and place folded blanket and 
sheet under patient. 
8. Place ice cap on head. 
9. Bring each end of wet sheet under the 
arms and across to opposite shoul- 
der. 
10. Bring ends of upper isolation blanket 
underneath the arms and wrap 
around each arm. 
11. Draw up bed clothing and leave in 
pack for twenty minutes. 
To remove from pack. 
1. Fold covers down to waist line. 
2. Unwrap the arms. 
3. Loosen wet sheet and remove sheet 
lower blanket. 
4. Dry patient with towel. 
5. Rub back and chest with alcohol and 
lightly powder. 
6. Put on gown. 
7. Remove isolation blanket and rubber 
pillow case. 
8. Take temperature, pulse and respira- 
tion and record. PACKS 
133 
Reference Reading: 
Maxwell and Pope, pages 374-388. 
2. Cold pack. 
Articles necessary. 
1. Two bath blankets. 
2. One long rubber sheet. 
3. Three cotton sheets. 
4. One bath towel. 
5. Ice cap and cover. 
6. Hot water bottle and cover. 
7. Bath thermometer. 
8. Hot fluids and feeding cup. 
9. Foot tub containing water tempera- 
ture 70° to 80° F. 
10. Alcohol and powder. 
Procedure. 
1. Roll rubber sheet between cotton 
sheet and bath blanket. 
2. Fan bath blanket crosswise. 
3. Fan one cotton sheet lengthwise and 
one crosswise and place in foot tub. 
4. Carry equipment to bedside. 
5. Place bath blanket over chest. Tuck 
well in around shoulders and fan 
clothing to foot of bed. 
6. Adjust bath towel over loins, and re- 
move gown. 
7. Place roll made of blanket, rubber 
sheet and cotton sheet under patient 
with blanket next to bed. 134 
PACKS 
8. Wring out sheets from water of re- 
quired temperature. 
9. Place the sheet, folded, lengthwise 
under patient, bring up and tuck 
well around patient. 
10. Wring out second sheet, place across 
chest, make secure at neck and 
shoulders, bring down over patient 
and tuck well around patient. 
11. Bring up top covers and leave in pack 
from 20 minutes to one hour. 
To remove from pack. 
1. Fold down covers to foot of bed. 
2. Remove blanket and upper sheet, then 
under wet sheet and rubber. 
3. Dry patient with towel, wrap lower 
blanket around patient. 
4. Bring up bed clothing and leave for 
twenty minutes. 
5. Give hot milk or broth and friction if 
patient is chilly. 
6. At the end of 20 minutes, remove 
blankets, rub with alcohol and put 
on gown. 
7. Take T. P. R., and record. 
Reference Readings: 
Harmer, pages 276-282. 
Hampton-Robb, pages 147-201. 
Maxwell and Pope, pages 388-393. PACKS 
135 
Hot pack. 
Articles necessary. 
1. Seven isolation blankets. 
2. Two long rubber sheets. 
3. Ice cap and cover. 
4. Rubber pillow case. 
5. Towel. 
6. Stupe wringer and two stupe sticks. 
7. Feeding cup and fluids. 
8. Alcohol and powder. 
9. Foot tub. 
Procedure. 
1. Roll together lengthwise rubber sheet 
between three blankets (thin blan- 
ket on top to wrap around patient). 
2. Fan one isolation blanket crosswise. 
3. Fan rubber sheet and blanket cross- 
wise. 
4. Fan two isolation blankets lengthwise, 
separately. 
5. Carry articles to bedside. Screen 
patient. 
6. Cover patient with blanket at same 
time fanning down covers to foot of 
bed. 
7. Remove gown. 
8. Turn patient on side, place roll of 
blankets and rubber sheet under 
patient. 136 
PACKS 
9. Tuck sides of under blanket under 
sides of mattress. 
10. Bring up sides of thin blanket which 
is under patient and tuck well in 
around arms and legs, so that no 
skin surfaces touch. 
11. Fan blanket which covers patient to 
foot of bed. 
12. Apply ice cap to head. 
13. Wring dry blankets in sterilizer, bring 
to bedside in stupe wringer in foot 
tub. 
14. Turn patient on side and after shak- 
ing blanket quickly place under 
patient and tuck well around arms 
and legs. 
15. Shake second blanket and place 
over patient, tuck well around 
body. 
16. Bring up dry blanket at foot of bed 
and tuck in around patient. 
17. Bring up blanket and rubber sheet on 
each side. 
18. Place second rubber sheet and blanket 
over all and tuck in at sides. 
19. Place folded towel over blankets 
where they come in contact with 
patient’s face. 
20. Draw up upper bed clothing and 
leave in pack 20 to 30 minutes as 
ordered. 
21. Give fluids while in pack. 
22. Avoid drafts and watch pulse. PACKS 
137 
To remove from pack. 
1. Fold outer clothing to foot of bed. 
2. Remove top rubber sheet and wet 
blankets. 
3. Remove under wet blankets and rub- 
ber sheet, leaving patient between 
blankets for one hour. 
4. At end of one hour rub patient with 
hot towels, give a hot alcohol rub 
and put on gown. 
5. Remove blankets. 
Refebence Readings: 
Harmer, pages 369-371. 
Maxwell and Pope, pages 291-295. 
Cold sponge bath. 
Articles necessary. 
1. Two basins (one with ice water, one 
with tepid water). 
2. Bath blanket. 
3. Long rubber sheet. 
4. Two cotton sheets. 
5. Two wash cloths. 
6. Ice cap and cover. 
7. Hot water bottle and cover. 
Procedure. 
1. Make a roll of blanket, rubber sheet 
and cotton sheet. Bring to bedside 
all articles. 138 
COLD SPONGE BATH 
2. Cover patient with sheet and fold 
down clothing to foot of bed. 
3. Place roll of blanket, rubber sheet and 
cotton sheet under patient with 
blanket next to bed. 
4. Remove gown and pillows. 
5. Place hot water bottle at feet. 
6. Bathe face and apply ice cap. 
7. Sponge first with tepid water, then 
with ice water, beginning with arm 
farthest away, then near arm, chest, 
back, and lower limbs. 
8. Apply friction to each part while 
sponging and sponge each part from 
three to five minutes. 
When finished. 
1. Remove rubber and cotton sheet from 
under patient. 
2. Draw up top covers and remove sheet 
which has been covering patient. 
3. If patient is very ill, the bed may be 
protected by placing bath towel or 
draw sheet under each part while 
sponging. 
4. Take temperature, pulse, respiration, 
one hour after bath and record. 
Alcohol sponge. 
1. Proceed as for cold sponge. 
2. Use alcohol and water, equal parts, 
instead of ice water. Evaporation ALCOHOL SPONGE 
139 
of alcohol and water, cools the sur- 
face of the skin, thus reducing tem- 
perature. 
Reference Readings: 
Harmer, pages 396-397. 
Hampton-Robb, pages 148-150. 
Maxwell and Pope, pages 264-269. 
Hot air bath. 
Articles necessary. 
1. Five isolation blankets. 
2. Two long rubber sheets. 
3. One short rubber sheet. 
4. One rubber pillow case. 
5. Two bed cradles (tied together). 
6. One electric heater. 
7. One bath thermometer. 
8. One ankle restraint. 
9. Six safety pins. 
10. Two towels. 
11. Ice cap and cover. 
12. Feeding cup and fluids. 
13. Alcohol and powder. 
Procedure. 
1. Fold long rubber fan shape. 
2. Fold two blankets fan shape. 
3. Roll long rubber between two blankets 
lengthwise. 
4. Fan single blanket and carry equip- 
ment to bedside. 140 
HOT AIR BATH 
5. Cover soft pillow with rubber pillow 
case and place under patient’s 
head at same time removing hard 
pillow. 
6. Loosen bed clothes at foot and sides 
of bed. 
7. Place single blanket across patient’s 
chest, tuck upper edge well under 
patient’s shoulders, grasp lower 
edge and draw down over patient at 
same time folding down covers to 
foot of bed. 
8. Remove covers and place on chair. 
9. Remove gown—turn patient on side 
and place rolled rubber, sheet and 
blankets under patient, tucking 
lower blanket under mattress at 
sides. 
10. Tuck the blanket covering patient well 
around arms and legs so that no 
skin surfaces touch. 
11. Place towel under patient’s head and 
place ice cap on head. 
12. Place restraint lightly around ankles 
and tuck ends under mattress. 
13. Place cradle in position and attach 
electric heater. 
14. Suspend bath thermometer from 
cradle by long tape. 
15. Bring up blanket and rubber sheet 
and pin to bars of cradle at each 
side with three safety pins. 
16. Place folded blankets on cradle, tuck HOT AIR BATH 
141 
in around neck and shoulders and 
under cradle at sides. 
17. Place rubber over the blankets and 
tuck in under shoulders and under 
sides of cradle. 
18. Place short rubber at the foot and tuck 
in under mattress. 
19. Put the regular bed covers in place, 
tuck in under the mattress at the 
foot. 
20. Put a folded towel under patient’s 
chin and tuck ends under patient’s 
shoulders. 
21. Give fluids while in bath, and watch 
color of patient’s face. 
22. Take pulse frequently. 
23. Leave in bath from one half to one 
hour as ordered. 
To discontinue. 
1. Fold down top covers, remove and 
place on chair. 
2. Loosen rubber sheets and blankets at 
foot and sides of bed—remove top 
rubbers. 
3. Disconnect electric heater and remove 
heater and bath thermometer. 
4. Remove cradle from the side allowing 
the warm blankets on top to cover 
the patient. 
5. Turn patient on side, remove blanket 
and rubber sheet, leaving the pa- 
tient between blankets. 142 
HOT AIR BATH 
6. Place top covers in position. 
7. At the end of one hour rub patient 
with hot towels and give hot alcohol 
rub. 
8. Put on night gown and remove blan- 
kets. 
Reference Readings: 
Harmer, pages 363-369. 
Hampton-Robb, pages 144,192-193. 
Maxwell and Pope, pages 289-303. 
Modified tub or slush bath. 
Purpose—to reduce body temperature. 
Articles required. 
1. Two double blankets. 
2. One single blanket. 
3. Long rubber sheet. 
4. Short rubber sheet. 
5. Rubber pillow case. 
6. Two bath blankets. 
7. Two cotton draw sheets. 
8. Two towels and a wash cloth. 
9. Ice cap and cover. 
10. Hot water bottle and cover. 
11. Large pail or foot tub of water. 
12. Long piece of rubber tubing with fun- 
nel and bath spray attached. 
13. Pitcher. 
14. Carrier. 
15. Ice coil standard. 
16. Bath thermometer. SLUSH BATH 
143 
17. Foot tub. 
18. Two floor rubbers. 
19. Shock blocks. 
20. Fluid and feeding cup. 
21. Alcohol and powder. 
Procedure. 
1. Roll single blanket and two double, 
blankets crosswise and tie at each 
end and in the center with bandage. 
Fold cotton draw sheet lengthwise 
in thirds and roll together with a 
bath blanket and long rubber sheet. 
Carry equipment to the bedside. 
Screen patient. Place large pail or 
foot tub of water, required tempera- 
ture, on top of ice coil standard. 
Fill tube and funnel with water to 
remove air and establish siphonage 
from pail or pitcher held at level of 
patient. Put carrier over edge of 
pail to prevent kinking of tubing. 
Loosen top covers at sides and foot 
of bed. Place folded bath blanket 
across patient’s chest, tucking up- 
per edge under shoulders. Fold 
top covers to foot of bed, replacing 
them with the blanket. Place top 
covers on chair. Protect hard 
pillow with rubber pillow case. Re- 
place soft pillow by hard one. Place 
bath blanket, rubber sheet and draw 144 
SLUSH BATH 
sheet under patient. Remove gown. 
Place the rolled double blankets un- 
der the rubber sheet on either side, 
and the rolled single blanket under 
the rubber at the foot of the bed. 
Place the short rubber under the 
long rubber at the foot of the bed. 
Roll the sides to form a trough and 
let it drain into the foot tub. Pro- 
tect the floor under the tub with a 
floor rubber. Apply ice cap to the 
head and hot water bottle to the 
feet. Protect patient’s loins with 
a towel. Remove top blanket. 
Bathe patient’s face with clear 
water. Spray body with one hand, 
giving friction with the other hand. 
Pass the hand under the patient’s 
back occasionally and rub it. The 
usual duration of the bath is 10 to 
20 minutes. 
To remove from bath. 
1. Remove the single rolled blanket from 
the foot of the bed. Raise the head 
of the bed on shock blocks. Allow 
the water to drain into the foot tub. 
Cover the patient with a draw sheet 
and remove loin cloth. Remove the 
rolled blankets from under the rub- 
ber at the sides of the bed. Dry the 
patient with the draw sheet over SLUSH BATH 
145 
her, turn her on her side, dry her 
back, roll the rubber sheet and draw 
sheet to the center of the bed, roll 
patient to other side over these, dry 
other side and remove rubber sheet 
and draw sheet. Place bath blanket 
over patient and remove draw sheet. 
Place covers on the bed and leave 
patient between the blankets for 
one hour. At end of one hour take 
temperature and record. Rub pa- 
tient with alcohol, put on gown and 
and remove blankets. 
Lavage for baby. 
Definition—Lavage is the washing out of the 
stomach. 
Purpose— 
1. To remove poison. 
2. To cleanse stomach of remnants of 
former feeding which have not been 
digested. 
3. To cleanse lining of stomach of irri- 
tating substances. 
Articles required. 
1. Rubber catheter, size 16 French. 
2. Basin of ice water. 
3. 18 inches of rubber tubing. 
4. Glass funnel. 
5. Glass graduate of solution. 
6. Rubber bib. 146 
LAVAGE FOR BABY 
7. Sheet for restraining. 
8. Solution basin. 
9. Emesis basin. 
10. Floor rubber. 
Procedure. 
Measure catheter and mark off a dis- 
tance equal to that from the bridge 
of the baby’s nose to a point three 
fourths of the distance from the 
baby’s nipples to the umbilicus. 
Wash your hands. Turn down the 
baby’s clothing around the neck. 
Restrain and apply bib. Expel air 
from the tube. Insert the tube until 
the marker is at the lips. Keep 
tube pinched and wait to see if baby 
can breathe naturally. Raise fun- 
nel five or six inches above the 
child’s mouth. Pour in the required 
amount of fluid. Do not let the fun- 
nel become empty. When it is still 
half full invert quickly into a basin 
which is as far below the level 
of the child’s stomach as the length 
of the tubing will allow. 
When the fluid begins to come back 
slowly, raise the funnel and again 
pour in the required amount. Re- 
peat this process until the return is 
clear. The amount of fluid given 
each time should be a little less than LAVAGE FOR BABY 
the child’s stomach capacity. The 
child’s feeding usually approxi- 
mates his stomach capacity. 
Chart the amount of fluid used be- 
fore the return was clear and the 
character of the return. 
Gavage. 
Definition.—Gavage is the introduction 
of fluid food or medication into the 
stomach through a stomach tube. 
Articles necessary. 
1. Stomach tube with funnel. 
2. Dressing rubber or bib. 
3. Prepared food in glass graduate. 
4. Basin of ice water. 
5. Sheet for restraining. 
Procedure. 
1. Introduce tube as for lavage. 
2. Pinch the tube and wait a few sec- 
onds, pour the liquid slowly into the 
funnel and do not hold the funnel 
more than two or three inches above 
the patient’s mouth. 
3. Pinch the tube before it empties and 
remove gently and quickly. 
Mustard bath for a baby. 
Articles required. 
1. Foot tub or stationary tub. 
2. Bath thermometers. 
147 148 
MUSTARD BATH FOR BABY 
3. Pitcher. 
4. Ice cap and cover. 
5. Hot water bottle and cover. 
6. Basin of ice water. 
7. Compresses for head. 
8. Mustard in bags of gauze (one ounce 
in each bag). 
9. Warm blanket. 
10. Alcohol and powder. 
Procedure. 
Test water in tub, temperature 105 de- 
grees. Put in one ounce of mustard 
to each gallon of water. Amount of 
water used must be sufficient to 
cover the child. Place the child in 
the bath entirely submerged, except 
the head. Place fingers of left hand 
in child’s further axilla and sup- 
port head and back with your left 
hand and arm. Bub the body 
briskly. Allow the child to remain 
in the bath 10 minutes, or until the 
skin is well reddened. Apply cold 
compresses to the head while in the 
bath. When removing the child 
from the bath, roll in a warm blan- 
ket. Do not dry his body except 
partially by patting through the 
blanket. 
Put in bed with an ice cap to his 
head and hot-water bottle at his MUSTARD BATH FOR BABY 
149 
feet. Leave for one hour. At end 
of hour, remove ice cap and water 
bottle, rub body with alcohol and 
powder, remove blankets and put on 
usual clothing. 
Mustard pack for child. 
Articles required. 
1. Pitcher. 
2. Foot tub. 
3. Bath thermometer. 
4. Mustard in gauze (one ounce in each 
bag). 
5. Two thin blankets. 
6. Two pack blankets. 
7. One heavy blanket. 
8. Bath thermometer. 
9. Ice cap and cover. 
10. Hot water bottle and cover. 
Procedure. 
Take water temperature 105 degrees to 
saturate the pack blankets, add mus- 
tard balls sufficient to give one half 
ounce of mustard to a quart of 
water. Wrap the child in the thin 
dry blanket, tucking it in around 
the limbs. Saturate and wring out 
of the mustard water the pack 
blankets. Wrap around the child 
tucking in between arms and body 
and between legs so that it comes in 150 
MUSTARD PACK FOR CHILD 
contact with all parts of the body. 
Roll in the thick dry blanket and al- 
low to remain in this until the skin is 
pink which will usually be 15 to 20 
minutes. Watch the skin closely. 
While in the pack apply ice cap to 
the head and hot-water bottle to the 
feet. When you remove from the 
pack roll in a warm blanket and 
leave for one hour. 
Ear irrigations for babies. 
Articles required. 
1. Irrigating can and tubing. 
2. Clamp. 
3. Emesis basin. 
4. Restraining sheet. 
5. Kelly pad. 
6. Rubber bib. 
7. Dressing pail. 
8. Return-flow ear tip (Luca’s). 
9. Solution. 
10. Cotton wipes and swabs. 
11. Irrigating pole. 
Procedure. 
Place can with fluid not more than 12 
inches above child’s head. Tem- 
perature of fluid, if for cleansing, 
100 to 105 degrees, if to relieve in- 
flammation 110 degrees. Turn 
down clothing around neck, restrain, EAR IRRIGATION FOR BABIES 
151 
adjust bib, wipe out any discharge 
of outer ear. Lay baby with head 
on covered rim of the Kelly pad, 
place pus basin so as to receive re- 
turn flow. Allow a little fluid to 
run through tip until warm. Insert 
snugly in the ear. Pull downwards 
and backwards on the lobe of the 
ear to straighten out the canal if 
the child is under two years of age. 
For children over two years of 
age pull upwards and backwards. 
Syringe until the return flow is 
clear. 
Nasal irrigations for babies. 
Articles required. 
1. Same as above except that a small 
hard rubber tip is used instead of 
an ear tip. 
Procedure. 
Place the irrigating can of fluid not more 
than two inches above the child’s 
head. Restrain the child as above. 
Place child with his head on the cov- 
ered rim of the Kelly pad. Allow a 
little fluid to run until warm. Have 
the nostril to be irrigated upper- 
most. Insert tip in upper nostril. 
Return flow should come back 
through the lower nostril. If neces- 152 
NASAL IRRIGATION FOR BABIES 
sary turn the child over and irrigate 
the other nostril. 
Throat irrigations for babies. 
Articles required. 
Same as for nasal irrigation except that 
a long hard rubber tip is placed in 
the upper angle of the mouth, well 
back but not touching the back of 
the throat. The fluid should flow 
across the throat and out the lower 
angle of the mouth. 
If the child is inclined to swallow 
the fluid, hold with his chin pressed 
down on his chest while irrigating, 
or, sometimes, turning on his stom- 
ach and holding his head over the 
edge of the basin or the Kelly pad 
will prevent his swallowing the fluid. TEST-MEAL, EWALD. 
Articles necessary. 
1. Bread 50 gm. (one slice). 
2. Water 400 c.c. (two glasses). 
Procedure. 
1. Give test-meal in a.m. on an empty 
stomach. 
2. Prepare following articles to remove con- 
tent one hour later. 
1. Duodenal tube with politzer bag or 
20 c.c. syringe. 
2. Basin for content. 
3. Dressing rubber and towel. 
3. When finished wash articles thoroughly, 
boil and put away dry. 
Reference Readings : 
Harmer, page 417. 
Maxwell and Pope, pages 390-391. 
153 BANDAGING 
1. Definition. 
A bandage is a strip of muslin or other fabric 
rolled in the form of a cylinder, making 
a compact roll, so as to be in a convenient 
shape. 
2. Names of various bandages. 
Bandages are named according to (1) form, 
(2) method of applying, (3) construc- 
tion, and (4) purpose. 
1. Roller. 
2. Triangular. 
3. Four tailed. 
4. Many tailed. 
5. T. Bandage. 
6. Circular. 
7. Oblique. 
8. Pressure. 
9. Recurrent. 
10. Spiral. 
11. Spica. 
12. Plaster of Paris. 
13. Chalk. 
14. Starch, silica. 
15. Bartin. 
16. Martin. 
17. Velpeau. 
Note. Special care in use of Martin or rubber 
bandage. 
1. Do not apply turns with too much pressure. 
2. Stretch hut slightly. 
3. Remove each night, clean and dry thor- 
oughly. 
154 BANDAGING 
155 
4. Reapply each morning. 
5. Do not apply over oily surface. 
6. To put away after use. 
1. Disinfect, then wash with soap and 
water. 
2. Dry and powder lightly. 
3. Reroll, and put in cool place. 
3. To apply a bandage. 
1. Select a bandage of suitable width and 
material. 
2. Stand in front of part to be bandaged. 
3. Place external surface of the initial ex- 
tremity to the part to be bandaged. 
4. Anchor bandage by one or two circular 
turns around the point of least diameter. 
4. Rules to observe in bandaging. 
1. Have your bandage tightly rolled before 
applying. Never attempt to reapply a 
bandage without first rerolling it. 
2. The bandage should be moulded to the 
part, never unroll more than three or 
four inches of the bandage while you 
bandage. 
3. A bandage should exert even pressure 
everywhere. There should be no tight 
bands. 
4. Skin surfaces should never lie in con- 
tact. At the fold of the groin, at the 
bend of the elbow and knee, between the 
fingers or between the arm and the side, 156 
BANDAGING 
padding should be placed to keep skin 
surfaces apart. 
5. An arm or leg when a bandage includes 
one or more of its joints should always 
be bandaged in the position it is to re- 
main in afterwards. 
6. A bandage should cover the entire dress- 
ing and extend a short distance beyond 
it on every side. 
7. Fingers and toes, particularly the former 
should always be left free in applying 
bandages to a limb, unless, of course, 
they are, themselves the injured mem- 
bers. Especially in a fracture of the 
arm the fingers become stiff if they are 
included. 
8. Bandage from below upward. 
9. Apply the bandage smoothly and firmly, 
but never too tightly or too loosely. If 
a bandage is applied too tightly there 
is danger of the circulation being inter- 
fered with. One should always note the 
character of the circulation after apply- 
ing a bandage to an extremity. If the 
tips of the fingers or toes are cyanotic, 
cold or painful the bandage should be 
removed or reapplied. 
10. Do not end a bandage over an injured 
part. If the terminal should come at 
that point turn the end under to shorten 
it. Neither should you end it over a 
prominence. 
11. To secure a bandage—the terminal ex- BANDAGING 
157 
tremity should be secured by a pin or 
safety pin, applied transversely to the 
bandage, and if the pin is used its point 
should be buried in the folds of the ban- 
dage. The end of the bandage may be 
split in two parts and the tails secured 
round the part by tying—adhesive strips 
may be used. 
12. In removing a bandage the folds should 
be carefully gathered up in a loose mass 
as the bandage is unwound, the mass 
transferred rapidly from one hand to the 
other. This prevents entanglements of 
the bandage. 
13. Never drop bandage when applying. 
Reference Readings: 
Harmer, pages 257-270. 
Hampton-Robb, pages 340-355. 
Maxwell and Pope, pages 569-575. 
Ascending spica of thumb. 
1. Place the initial extremity at the wrist. 
2. Anchor by two circular turns, bandaging 
from ulnar to radial side. 
3. Carry bandage across the back of the hand 
to the base of the thumb. 
4. Make rapid spiral turns to the base of the 
thumb nail. 
5. Make one circular turn and two spiral 
turns around thumb. 
6. Carry bandage to the wrist and make one 
circular turn. 158 
BANDAGING 
7. Alternate thumb and wrist turns, ascend- 
ing to the base of the thumb, each turn 
overlapping one-half the width of the 
preceding turn. 
8. Terminate bandage by a circular turn, cut 
bandage into two ends and tie on dorsum 
side of wrist. 
Note: See that spica is made over dorsum of 
the' thumb. 
Descending spica of the thumb. 
1. Anchor the bandage with two circular 
turns around the wrist, going from ulnar 
to radial side. 
2. Carry the bandage to the metacarpal pha- 
langeal joint of the thumb and make a 
circular turn. 
3. Return to the wrist. 
4. Alternate thumb and wrist turns over- 
lapping two-thirds width of the bandage 
descending toward tip of thumb. 
Note: See that spica is made over dorsum of 
thumb. 
5. Terminate by cutting bandage into two 
ends and tie on dorsum side of the wrist. 
Demi-gauntlet. 
1. Anchor the bandage by two circular turns 
around the wrist bandaging from ulnar 
to radial side. BANDAGING 
159 
2. Carry bandage across dorsum of the hand 
and loop around the base of the thumb. 
3. Carry back to wrist and across palmar 
side to dorsum side. 
4. Carry across dorsum side of hand and loop 
around the base of index finger. 
5. Carry back to the wrist. 
6. Continue with similar turns around each 
successive finger until dorsum of the 
hand is covered. 
7. Terminate same as in spica of the thumb. 
Gauntlet bandage. 
1. Anchor by two circular turns around the 
wrist, bandaging from ulnar to radial 
side. 
2. Carry bandage obliquely across dorsum of 
hand to the base of fingers to be band- 
aged. 
3. Make oblique turns to the matrix of the 
nail. 
4. Make one circular turn around the fin- 
ger. 
5. Make ascending spiral turns until web of 
finger is reached. 
6. Carry bandage obliquely across the dor- 
sum of the hand to the radial side. 
7. Terminate by two circular turns around 
the wrist, split into two ends and tie on 
dorsum side of the wrist. 
When each finger is bandaged it is called 
a gauntlet. 160 
BANDAGING 
Mitt or recurrent bandage of the hand. 
1. Anchor the bandage by two circular turns 
around the wrist, bandaging from the 
ulnar to the radial side. 
2. Miter the bandage at the dorsum side of 
the wrist. 
3. Take recurrent turns back and forth 
across the tips of the fingers. 
4. Make the center and first recurrent over- 
lap itself. 
5. Make the next recurrent turn overlap the 
center turn by one-half its width. 
6. Make the next recurrent so that the two 
on either side meet. 
7. Make one more recurrent turn on either 
side, overlapping one-half its width. 
8. Hold the recurrent turns in place with the 
thumb and first finger of the left hand. 
9. Miter the bandage at the wrist after 
the sixth recurrent turn. 
10. Anchor the recurrent turns by two circular 
turns around the wrist, bandaging from 
ulnar to radial side. 
11. Carry the bandage across the dorsum of 
the hand to the tip of index finger. 
12. Make a complete circular turn bandaging 
from ulnar to radial side. 
13. Carry to ulnar side. 
14. Carry bandage obliquely downward to the 
metacarpal phalangeal joint of the 
thumb. 
15. Carry across the palm to the ulnar side. BANDAGING 
161 
16. Carry obliquely across the dorsum of the 
hand to the circular turn around the tips 
of the fingers intersecting the other ob- 
lique at the center of the circular turn. 
17. Repeat these figure-of-eight turns to the 
wrist, split the bandage into twm ends 
and tie on dorsum side of the wrist. 
Figure-of-eight of elbow. 
Note: Bandage from within outward. 
1. Anchor by two circular turns over joint of 
elbow. 
2. Carry the bandage upward so that the 
turn overlaps the anchor turns by two- 
thirds its width ascending. 
3. Carry the bandage downward and over- 
lap the anchor turn by two-thirds its 
width descending. 
4. Alternate with above and below turns that 
overlap in front of the joint until four 
complete figure-of-eight turns have been 
made. 
5. Terminate the same as in spica of the 
thumb. 
Figure-of-eight of arm. 
1. Anchor the initial extremity by placing 
obliquely on the wrist and making two 
circular turns, bandaging from ulnar to 
radial side. 
2. Carry bandage obliquely across dorsum of 162 
BANDAGING 
the hand to the web of thumb and index 
finger. 
3. Carry to the outer side of the little finger, 
the lower edge of the bandage cross- 
ing the hand at the base of the little 
finger. 
4. Make a circular turn. 
5. Carry bandage obliquely upward across 
the dorsum of the hand to the metacar- 
pophalangeal joint of the thumb. 
6. Carry across the palmar side to the ulnar 
side. 
7. Carry bandage obliquely across the dor- 
sum of the hand to the base of index 
finger. 
8. Carry bandage across palmar to ulnar 
side. 
9. Make two figure-of-eight turns around the 
hand and below the thumb each overlap- 
ping the preceding turn one-half its 
width. 
Note. Points of crossing should be near the 
middle of the hand and kept in a straight 
line. 
10. Carry the bandage up the wrist by one or 
two spiral turns. 
11. Make figure-of-eight turns to elbow. 
12. Make one circular turn just below the 
elbow. 
13. Slightly flex elbow and make two circular 
turns carrying the bandage with its cen- 
ter over joint. 
14. Make figure-of-eight turns of elbow. BANDAGING 
163 
15. Carry bandage above elbow and make one 
circular turn. 
16. Make one spiral turn. 
17. Make figure-of-eight turns to the axilla. 
18. Terminate by one circular turn, split the 
ends and tie on the ulnar side. 
Ascending spica of the shoulder. 
1. Anchor the initial extremity around the 
upper arm, from ulnar to radial side, 
with the upper border of bandage reach- 
ing axilla. 
2. Carry bandage obliquely upward across 
the prominence of the shoulder around 
the chest, to the opposite axilla. 
3. Carry bandage across the back to the 
shoulder crossing the previous turn over 
the shoulder at a point midway between 
chest and back. 
4. Repeat figure-of-eight turns making four 
in number, each overlapping the preced- 
ing turn one-half the width ascending; 
but exactly covering the preceding turns 
under opposite axilla. 
Note. Pad should be placed under axilla where 
bandage overlaps. 
5. Terminate bandage at front of chest by 
safety pin or adhesive. 
Descending spica of the shoulder. 
1. Anchor the initial extremity of bandage 
under the axilla of the uninjured side. 164 
BANDAGING 
2. Carry bandage obliquely across the back 
near the neck on the opposite shoulder. 
3. Carry downward under the axilla of in- 
jured side. 
4. Carry bandage up and across at the neck. 
5. Carry bandage obliquely across front of 
chest to the axilla of uninjured side, ex- 
actly overlapping the initial extremity. 
6. Repeat figure-of-eight turns, overlapping 
the preceding turns one-half width de- 
scending until the shoulder is covered. 
7. Terminate as in ascending spica of the 
shoulder. 
Figure-of-eight of head and neck. 
1. Place the initial extremity behind the right 
ear. 
2. Anchor by two circular turns around the 
head bandaging from right to left. 
3. Carry to left ear. 
4. Carry down to base of neck. 
5. Make one circular turn around the neck. 
6. Make one spiral turn to behind the left ear. 
7. Carry bandage obliquely to the right ear. 
8. Carry bandage behind left ear, exactly 
overlapping the preceding turns around 
the forehead. 
9. Carry obliquely downward crossing oppo- 
site bandage at the median line touch- 
ing semi-circular around the neck. 
10. Carry bandage around the neck to the left 
ear. BANDAGING 
165 
11. Pass bandage obliquely upward to the 
right ear, and around forehead, over- 
lapping preceding turns to the left 
ear. 
12. Carry bandage obliquely to the oblique of 
right side crossing same at median line 
overlapping previous turn two-thirds. 
13. Carry bandage around the neck. 
14. Alternate turns around the neck and 
across forehead until circular turns are 
reached. 
15. Make two circular turns around head. 
16. Terminate in back of right ear and secure 
with adhesive. 
Figure-of-eight of neck and axilla. 
1. Place the initial extremity on left side of 
the neck. 
2. Anchor by two circular turns, bandaging 
from left to right. 
3. Carry bandage from the neck to the axilla 
on left side. 
Note. Behind-forward. 
4. Carry bandage to the neck. 
5. Alternate turns around neck and axilla 
overlapping each turn three-fourths 
width of the preceding turn. 
6. Repeat until dressing is covered. 
7. Terminate bandage by circular turn 
around the neck and secure with ad- 
hesive. 166 
BANDAGING 
The front scalp bandage. 
1. Place the initial extremity behind the 
right ear. 
2. Anchor by two circular turns around the 
head from right to left. 
3. Carry bandage to left ear. 
4. Carry downward around occiput overlap- 
ping one-half the circular turn at the 
median line. 
5. Carry forward over right ear and cross 
the circular turn. 
6. Carry over forehead, overlapping one-half 
of the circular turn, to left ear. 
7. Cross circular turn at left ear. 
8. Carry bandage below the occiput, over- 
lapping one-half width of the preceding 
turn. 
9. Cross circular turns at right ear. 
10. Carry bandage upward across the head 
overlapping one-half width of the 
preceding turn, building toward ver- 
tex. 
11. Carry down to left ear crossing the circu- 
lar turn. 
12. Reverse and make two circular turns. 
13. Terminate over right ear, and secure with 
adhesive. 
Recurrent of the head with a double roller. 
Note. The left hand roller is called the Wan- 
derer. The right hand roller is called the 
Traveler. BANDAGING 
167 
1. Place portion of the bandage between the 
two bodies of the roller upon the fore- 
head. 
2. Carry bandage around the head to the occi- 
put. 
3. Pass Wanderer under Traveler and re- 
verse it. 
4. Carry Wanderer over vertex along the 
median line to the root of the nose. 
5. Carry Traveler around the head passing 
over Wanderer at the fixation joint on 
forehead. 
6. Reverse the Wanderer and carry it 
directly over previous turn in median 
line to occiput. 
7. Continue Traveler on around head passing 
over Wanderer at occiput and again at 
forehead, each time around. 
8. Reverse Wanderer each time at occiput 
and forehead and make recurrent turns, 
alternately on each side of the scalp, 
overlapping two-thirds width of band- 
age until whole scalp is covered. 
9. Cut Wanderer at the occiput. 
10. Terminate Traveler by two circular turns. 
Secure over right ear with safety pin or 
adhesive. 
The monocle bandage. 
1. Place the initial extremity behind right 
ear. 
2. Anchor two circular turns about the head, 
bandaging from right to left. 168 
BANDAGING 
3. Carry bandage to the left ear. 
4. Carry to occiput. 
5. Pass bandage below right ear. 
6. Carry obliquely up over right eye to 
tuberosity of the parietal bone on left 
side. 
Note. Keep the lower border of the bandage at 
bridge of the nose. 
7. Carry bandage down to the occiput. 
8. Repeat these turns, overlapping the pre- 
ceding turn one-half the width crossing 
at the bridge of the nose. 
9. Terminate by one circular turn and secure 
behind the right ear with adhesive. 
Binocle bandage. 
1. Place the portion of the bandage between 
the rolls on the forehead. 
2. Carry the rolls back to the occiput just 
over the ears. 
3. Cross at the occiput. 
4. Carry forward under ears. 
5. Carry up over angle of jaw to summit of 
nose. 
6. Cross at summit of nose. 
7. Carry over tuberosity of parietal bone to 
occiput. 
8. Cross at occiput. 
9. Carry forward below ears covering one- 
half preceding turn. 
10. Cross again at summit of the nose. BANDAGING 
169 
11. Carry over parietal protuberance one-half 
width of preceding turn to occiput. 
12. Repeat previous turns covering one-half 
width of preceding turn. 
13. Make sufficient turns to cover dressing and 
cut one bandage at occiput. 
14. Complete bandage with two circular turns 
of other roll. 
15. Secure bandage with adhesive over right 
ear. 
Single oblique of the jaw. 
1. Place initial extremity behind right ear. 
2. Anchor bandage by two circular turns, 
bandaging from right to left. 
3. Carry bandage to occiput. 
4. Pass beneath right ear, under the chin to 
angle of mouth on opposite side. 
5. Ascend to vertex. 
6. Descend behind ear on the sound side to 
neck. 
7. Carry up to vertex, overlapping preceding 
turn three-fourths width. 
8. Carry behind ear and overlap exactly pre- 
ceding turn. 
9. Repeat turns until angle of injured jaw is 
covered. 
10. Make right angle reverse over temple on 
right side. 
11. Make circular turn around head. 
12. Terminate bandage over right ear and 
secure with adhesive. 170 
BANDAGING 
Double oblique of jaw. 
1. Place the middle of bandage, between rolls 
on forehead. 
2. Carry rolls to nape of neck. 
3. Cross bandage at this point. 
4. Bring forward under chin. 
5. Cross and proceed up sides of the face. 
Note. Anterior side of bandage coming as far 
forward as the external angle of the eye. 
6. Cross bandage on the vertex of the head 
in the median line. 
7. Bring to nape of neck. 
8. Repeat the previous turns with each suc- 
ceeding turn on the vertex of the head 
slightly behind the one in front. 
9. Carry bandage to the ears. 
10. Rever'se bandage behind right ear and 
make one circular turn over bandage on 
left side. 
11. Cut bandage behind left ear one inch below 
circular turn. 
12. Turn back terminal end of cut bandage. 
13. Make a circular turn about head securing 
terminal end of cut bandage. 
14. Secure bandage with adhesive over right 
ear. 
Single mastoid (left ear). 
Dressing required. 
1. Absorbent cotton six inches square 
and one inch thick. BANDAGING 
171 
2. Two pieces of shaken gauze, eighteen 
inches square. 
3. A semi-circnlar patch of folded gauze 
to place behind ear over wound. 
Note. Place dressing well over ear. The for- 
ward edge just back of the angle of the eye 
and extending below angle of jaw. 
Mastoid bandage. 
1. Place initial extremity behind right ear. 
2. Anchor by two circular turns, bandaging 
from right to left. 
3. Carry the bandage to the left side. 
4. Descend obliquely across dressing below 
occipital protuberance. 
5. Ascend to circular bandage over right ear. 
6. Carry bandage over vertex then down- 
ward, outlining dressing to angle of jaw. 
7. Follow lower border of dressing under 
occipital protuberance. 
8. Carry bandage to circular turn over right 
ear. 
9. Carry bandage over head overlapping two- 
thirds width the preceding turn at 
median line. 
10. Carry to crossing over left ear. 
11. Carry bandage around dressing, overlap- 
ping two-thirds width of outlining turn 
to crossing at right ear. 
12. Eepeat these turns until bandage which 
passes over forehead comes directly 
over circular around head. 172 
BANDAGING 
13. Make two circular turns around head. 
14. Terminate bandage behind right ear and 
secure with adhesive. 
Double mastoid bandage. 
Mastoid dressing required—two single dress- 
ings. 
Mastoid bandage. 
1. Place initial extremity behind right ear. 
2. Anchor by two circular turns around head 
from right to left. 
3. Carry bandage to left side. 
4. Descend obliquely across dressing below 
occipital protuberance. 
5. Ascend obliquely over dressing on right 
side to circular turns. 
6. Carry bandage over vertex as in single 
mastoid bandage. 
7. Carry down under occiput, outlining 
dressing over left ear. 
8. Carry upward, outlining dressing over 
right ear. 
9. Cross circular turn over right ear. 
10. Carry over vertex and cross circular turn 
over left ear. 
11. Carry the bandage around dressing over- 
lapping two-thirds width of bandage 
which is outlining dressing. 
12. Carry bandage up to the circular turns on 
right side. BANDAGING 
173 
13. Carry bandage over bead, overlapping two- 
thirds width the preceding turn at 
median line. 
14. Carry bandage over to the crossing at left 
ear. 
15. Repeat these turns over the top of head 
anteriorly. 
16. Make two circular turns around head when 
dressing has been covered. 
17. Terminate bandage behind right ear and 
secure with adhesive. 
Velpeau bandage. 
1. Place hand of affected side on opposite 
shoulder with elbow in median line, thus 
pushing the shoulder upward, outward, 
and backward. 
Note. Place small pad under axilla, elbow and 
palm of hand. 
2. Place initial extremity of bandage in axilla 
of sound side. 
3. Carry bandage obliquely upward across 
back, over shoulder of affected side close 
to the neck. 
4. Pass down across middle of the upper arm 
at the insertion of the deltoid muscle, 
behind point of elbow to point of start- 
ing on unaffected side. 
5. Repeat this turn. 
6. Carry bandage transversely across back. 
7. Pass over flexed elbow of affected arm to 
under axilla of unaffected side. 174 
BANDAGING 
Note. Cover previous turns under axilla ex- 
actly. 
8. Carry bandage obliquely across back, over 
shoulders on affected side, overlapping 
two-thirds of previous turn. 
9. Pass down outer and posterior surface of 
arm, behind elbow, and across chest to 
axilla of sound side. 
10. Carry bandage transversely across back, 
overlapping one-half preceding trans- 
verse turn. 
11. Pass over point of the flexed elbow and to 
axilla of unaffected side. 
12. Alternate oblique and transverse turns un- 
til arm and forearm are bound firmly to 
side and chest. 
Note. Four or five oblique turns are made over 
the shoulder each turn overlapping two-thirds 
of preceding turn. 
Transverse turns ascend toward shoulder until 
wrist of affected arm is covered, each turn 
overlapping one-half preceding turn. 
13. Terminate at back by safety pin or strip of 
adhesive. 
Barton bandage. 
1. Place initial extremity behind the ear on 
sound side. 
2. Carry bandage beneath occipital protuber- 
ance, to corresponding point behind ear 
on affected side. BANDAGING 
175 
3. Carry it to vertex and down unaffected 
side of face to chin. 
4. Pass up affected side to vertex intersecting 
previous turn at median line. 
5. Carry back to starting point. 
6. Repeat these turns to anchor bandage. 
7. Carry bandage to occiput. 
8. Carry it along injured side of jaw to chin 
and back to occiput. 
9. Pass up to vertex. 
10. Make three complete turns covering each 
preceding one exactly. 
11. Terminate bandage at vertex with small 
safety pin. 
12. Insert safety pin at the crossing on each 
side of jaw. 
Single suspensory of the breast (left breast). 
1. Place initial extremity under axilla on 
right side. 
2. Anchor by two circular turns around waist 
just below breast from right to left. 
3. Carry bandage beneath left breast. 
4. Incline bandage upward and carry it across 
lower portion of breast, to under left 
axilla. 
5. Carry it up across back to right shoulder. 
6. Descend between breasts and cross pre- 
vious turn under most dependent por- 
tion of breast. 
7. Continue bandage on around body. 
8. Make alternate turns over opposite 
shoulder and around body, overlapping 176 
BANDAGING 
each preceding turn two-thirds its width 
until four or five are made. 
Note. The turns as they pass over the shoulder 
overlap more than when they cross under 
breast. The points of crossing under breast 
should be in same vertical line. 
9. Terminate by safety pins or adhesive on 
right side. 
Suspensory for both breasts. 
1. Place initial extremity on right side of 
chest. 
2. Anchor by two circular turns from right to 
left. 
3. Carry bandage beneath left breast. 
4. Incline bandage upward and carry it 
across lower portion of breast under left 
axilla. 
5. Carry it up across hack to right shoulder. 
6. Descend between breasts crossing previous 
turn as in single suspensory. 
7. Continue bandage around back to under 
right arm. 
8. Incline bandage upward and carry it 
across lower portion of right breast, 
across chest to left shoulder crossing the 
bandage which goes to left breast from 
right shoulder in median line. 
9. Carry the bandage downward across back, 
crossing bandage which goes over right 
shoulder in median fine. BANDAGING 
177 
10. Pass under right arm and cross (under 
most dependent portion of breast), the 
bandage which ascended under right 
breast to left shoulder. 
11. Carry bandage across chest to left breast. 
12. Incline bandage upward and pass under 
left axilla. 
13. Pass obliquely upward across back to the 
right shoulder. 
14. Descend between breasts, crossing the pre- 
vious turn under left breast. 
15. Carry the bandage to left axilla and pass 
across back to under right axilla. 
16. Alternate turns under left and right 
breasts until four or five turns are made. 
17. Terminate bandage under right arm. 
Spica of foot bandage. 
1. Place the initial extremity across ankle 
joint. 
2. Make one circular turn from fibula to 
tibia side. 
3. Carry bandage obliquely downward under 
sole of foot. 
4. Carry across dorsum of foot to root of 
toes. 
5. Anchor by two circular turns around root 
of toes. 
6. Carry bandage to outer side of foot. 
7. Carry upward across instep. 
8. Carry directly around point of heel to 
outer side of foot. 178 
BANDAGING 
9. Carry across instep to root of large toe. 
10. Carry around foot, overlapping two-thirds 
width of preceding turn. 
11. Carry across instep. 
12. Carry around heel so the lower edge of 
bandage just reaches border of heel. 
13. Repeat these turns until five have been 
made around foot and back of heel. 
Figure-of-eight of the heel. 
1. Place initial extremity on outer side of 
heel. 
2. Anchor by two circular turns around heel, 
having the point of heel in center of 
bandage, pass from fibula to tibia side. 
3. Carry bandage upward around ankle, from 
point of heel to outer side of ankle. 
4. Carry obliquely over dorsum of foot to 
heel. 
5. Carry directly under heel overlapping one- 
third the width of circular turn. 
6. Carry obliquely over dorsum of foot. 
7. Repeat figure-of-eight turns overlapping 
two-thirds each preceding turn until 
three turns are made on each side of cir- 
cular turn. 
Figure-of-eight of the knee. 
1. Place initial extremity on outer side of 
patella. 
2. Anchor by two circular turns bandaging 
from fibula to tibia. BANDAGING 
179 
3. Carry to the popliteal space. 
4. Carry bandage upwards so that turns over- 
lap the circular turns two thirds ascend- 
ing. 
5. Carry to popliteal space. 
6. Carry bandage downward so that turn 
overlaps the circular turn two-thirds 
descending. 
7. Alternate these turns above and below 
joint diverging from patella but exactly 
overlapping at the popliteal space. 
Note. Make four figure-of-eight turns. 
8. Terminate bandage by splitting end and 
tying on the tibia side of leg just below 
knee. 
Figure-of-eight of leg. 
Bandage of the foot the same as for foot 
bandage. 
1. Make as many spiral turns as diameter of 
ankle will permit. 
2. Carry bandage obliquely upward above 
the greatest diameter of calf of leg. 
3. Make a circular turn around leg just be- 
low knee and above the calf. 
4. Descend to spiral turns at ankle, crossing 
ascending turn just outside crest of 
tibia. 
5. Pass across dorsum of leg to fibula side. 
6. Repeat these turns until six or eight are 
made. 180 
BANDAGING 
7. Terminate by a circular turn above calf of 
leg, just below knee. Split ends of band- 
age and tie. 
Note: If entire limb is to be bandaged proceed 
as follows: 
8. From circular turn, carry bandage up and 
make two complete circular turns over 
knee. 
9. Make figure-of-eight bandage of knee. 
1CL Make a circular turn above knee. 
11. Make as many spiral turns as diameter of 
leg will permit above the knee. 
12. Carry bandage obliquely upward above 
greatest diameter of thigh. 
13. Make a circular turn directly around thigh 
near the groin. 
14. Descend to spirals above knee crossing 
ascending turn just outside middle of 
thigh. 
15. Pass across dorsum of the leg to fibula 
side. 
16. Repeat these turns, overlapping one-half 
width of preceding turn, until area is 
covered. 
17. Terminate by a circular turn below the 
groin. Split ends and tie. 
Ascending spica of the groin. 
1. Place initial extremity about upper part of 
thigh. 
2. Anchor by two circular turns, bandaging 
from outer to inner side. BANDAGING 
181 
3. Carry bandage across the pubis to the 
crest of ilium on opposite side. 
4. Carry around waist. 
5. Return to circular turn. 
6. Encircle thigh, overlapping two-thirds 
width, ascending. 
Note. The lower border of bandage determines 
position of the spica. It should intersect directly 
in front of the thigh. 
7. Cross pubis and overlap exactly preceding 
turn over the crest of ilium. 
8. Repeat these turns until the dressing is 
covered. 
9. Terminate at back and secure with ad- 
hesive or safety pin. 
Descending spica of the groin. 
1. Place initial extremity at the uppermost 
portion of thigh. 
2. Anchor by two circular turns. 
3. Carry bandage across highest part of ab- 
domen which is to be covered. 
4. Carry across back. 
5. Carry around groin, overlapping circular 
turns two-thirds width, descending. 
6. Carry bandage across abdomen, making it 
converge toward preceding turn so that 
it will overlap exactly turn at crest of 
ilium. 
7. Carry across back to groin. 
8. Carry around groin overlapping preceding 
turn two-thirds, descending. 182 
BANDAGING 
9. Repeat these turns until dressing is cov- 
ered. 
10. Terminate in back and secure with ad- 
hesive or safety pin. 
Double spica of the groin. 
1. Place initial extremity upon right thigh 
well up to groin. 
2. Anchor by two circular turns bandaging 
from right to left. 
3. Carry bandage from thigh obliquely across 
pubes to a point low on the opposite side 
of waist. 
4. Carry across back to same place on right 
side. 
5. Carry downward obliquely to outer part of 
left thigh crossing previous turn in me- 
dian line just below umbilicus. 
6. Make a circular turn around left thigh well 
up to groin. 
7. Carry to inner side of thigh. 
8. Pass obliquely upward over the crest of 
ilium. 
9. Carry around waist. 
10. Carry down to right thigh, overlapping 
the previous turn one-half width and 
crossing in front of thigh at median 
line. 
11. Carry across abdomen one-half width of 
preceding turn. 
12. Carry around waist. 
13. Carry down to right hip. BANDAGING 
183 
14. Carry bandage obliquely down over right 
groin. 
15. Terminate over right side and secure with 
adhesive or safety pin. INDEX 
A 
Admission of patients, 1 
B 
Bandaging, 154 
Bed-making, 8 
1. Balcony bed, 17 
2. Balkan frame bed, 23 
3. Carbolize a bed, 24 
4. Care of bed after pa- 
tient has been dis- 
charged, 24 
5. Cradle bed, 22 
6. Emergency bed, 11 
7. Ether bed, 13 
8. “L” bed, 20 
9. Open bed, 10 
10. Standing bed, 8 
11. To strip a used bed, 7 
Bladder irrigation, 106 
Burn tent, 122 
C 
Care of teeth, mouth, nos- 
trils, and nails, 32 
Catheterization, 102 
Charting, 107 
Cleansing sponge bath, 43 
Clean-up tray for skin, 124 
Croup tent, 122 
Cupping, 120 
D 
Death—care of body, 114 
Discharge of patients, 4 
E 
Ear irrigation 
For adults, 35 
For infants, 150 
Enemata, 73 
1. Enema of small amount, 
76 
2. Soapsuds enema, 73 
Evening toilet, 29 
Eye drops, 90 
Eye irrigation, 88 
F 
Feeding patients, 36 
Flaxseed poultice, 117 
Force fluids, 36 
Fowler’s position, 66 
G 
Gavage, 147 
H 
Hair 
1. Bed shampoo, 53 
2. Daily care of, 49 
185 186 
INDEX 
High hot colon irrigation or 
enteroelysis, 78 
Hot air bath, 139 
Hot water bottle, 57 
Hypodermic injection, 100 
Hypodermoclysis, 128 
I 
Ice cap, 57 
lee collar, 57 
Ice coil, 58 
Infusion, 126 
Instruments—care of, 123 
L 
Lavage, 145 
Lifting and turning patients, 
39 
Lumbar puncture, 125 
M 
Mechanical appliances, 47 
Medication, 97 
Medication tickets, 98 
Modified tub or slush bath, 142 
Morning toilet, 26 
Mosenthal test, 71 
Murphy drip, 80 
Mustard bath, 147 
Mustard pack, 149 
Mustard paste, 118 
Mustard poultice, 118 
N 
Nasal irrigation 
For adults, 86 
For infants, 151 
0 
Operation—preparation for, 
90 
P 
Pack—cold, 133 
Pack—cold chest, 131 
Pack—hot, 135 
Paracentesis—abdominal, 129 
Pediculi—treatment of, 50 
Phenolphthalein test, 71 
Pulse, 95 
R 
Respiration, 96 
Restraints, 61 
Rubber goods, 57 
1. Air and water mat- 
tress, 59 
2. Catheters and rectal 
tubes, 59 
3. Hot water bottle, 57 
4. Ice cap and collar, 57 
5. Ice coil, 58 
6. Rubber rings and cush- 
ions, 59 
7. Rubber gloves, 60 
8. Stomach pump, 60 
S 
Scheme for nurse’s notes in 
charting, 109 
Specimens—collection of, 68 INDEX 
187 
Sponge—alcohol, 138 
Sponge—cold, 137 
Stupes—turpentine, 116 
T 
Temperature, 93 
Test meal, 153 
Thoracentesis, 130 
Throat irrigation 
For adults, 87 
For infants, 152 
Transfer of patients, 5 
1. From Bellevue to the 
hospitals of the De~ 
partment of Public 
Charities, 5 
2. From one department 
to another, 5 
Typhoid screen, 121 
Y 
Vaginal douche, 82 
Venesection, 127 
W 
Wassermann test, 125 
Wheel chair—preparing a 
patient for, 40