Cautions in Applying External Heat
Always in giving external heat to a patient it is important to avoid a too high degree. Often the patient’s sensation is dulled, sometimes completely lost; and often the condition of the skin, circulation and other tissues and functions are decidedly defective or the patient may be unconscious. In these cases the patient cannot determine what is a suitable temperature and sometimes a seemingly suitable one causes some degree of disturbance. Blistering of the patient is inexcusable and may lead to more or less serious consequences.
A fomentation wringer is good to have at hand in case fomentations are required. One may be made by taking a piece of coarse toweling about eighteen inches long, making a two-inch hem at each end, then running a thin round stick somewhat longer than the towel is wide through each hem. The fomentation is placed on the toweling and wrung by twisting the sticks in opposite directions. Another excellent wringer may be made by tacking circularly around the end of a round stick a piece of heavy ticking or duck, then similarly attaching the other end to another stick, having the duck or ticking between the sticks at least a foot long. The fomenta¬tion cloths are placed in the opening in the wringer cloth and the sticks turned in opposite directions. If nothing better is available, a towel may be used as a wringer, without the sticks.
Many people believe in the efficacy of the turpentine stupe as a counterirritant. The turpentine itself has no medicinal effect when used in this way, but it does increase the effect of a fomentation upon the skin. If its use is desired, apply as follows: Have the fomentation material ready, also a tea-spoonful of turpentine mixed with two teaspoonfuls of olive oil. Stir this mixture and apply with gauze or cotton to the part to be treated, then apply the fomentation in the ordinary manner.
BEDSORES.—When a patient is confined to bed for a con¬siderable time, especially if helpless or poorly nourished, sores are likely to develop upon those parts exposed to pressure.
These pressure sores are usually called bedsores. Paralytics, if confined to bed, are almost certain to develop them. The usual locations are the lower end of the spine, shoulder-blades, elbows, inner surfaces of the knees, ankles, heels, toes and the back of the neck. Bedsores are difficult to heal, because of the continuation of the conditions that bring them on. Hence in caring for the bedfast patient efforts should be made to prevent these developments if possible—and it usually is.