RED CROSS. U.S. AMER. NAT'L. RED CROSS. FIRST AID INSTRUCTION. ARC 301 Supersedes A R C 110 December 5, 1917 THE AMERICAN RED CROSS DEPARTMENT OF MILITARY RELIEF Bureau of Medical Service First Aid Division WASHINGTON, D. C. First Aid Instruction INTRODUCTORY The purpose of the instruction in First Aid to the Injured, offered by the American Red Cross is to train men and women to administer First Aid treatment promptly and intelligently when emergencies demand such assistance. First Aid treat- ment by no means takes the place of the physician's services, which at all times are desirable as a precautionary measure. The question of the value of a study of First Aid to the Injured very naturally presents itself. The answer to this question is most emphatic: The training is of the most prac- tical value not only to the individual when accidents and sud- den illnesses occur in his own home, but through him, to the community in which he lives, and to the public at large in great disasters. Every man who takes it becomes thereby a more helpful member of society. There is perhaps no way of ascertaining the number and variety of accidents which occur in the home, or the number of deaths or serious disablements which result from the lack of proper safeguards or prompt emergency treatment. It is safe to assert, however, that they number thousands daily, and also that the application of First Aid methods to each case, would immeasurably lighten the country's toll of suffering and death. The dissemination of First Aid training and information has produced a far-reaching and beneficial influence in the prevention of accidents. This statement has been confirmed par- ticularly by railroads, mining companies, and great industrial 2 FIRST AID INSTRUCTION concerns, whose employees are especially liable to acci- dents. It is also abundantly proven that First Aid instruc- tion not only makes the expert and older employee more careful, but also more considerate of his less experienced fellow workmen. The benefit of a widespread knowledge of First Aid in the event of a great disaster, such as a train wreck, an explosion, an earthquake, etc., is obvious. In such an emergency the physicians available cannot meet the demand for their services. This condition is accentuated at the present time, when the demands of war are withdrawing large numbers of doctors and nurses from civil life, and the tax upon the services of those who remain is proportionately increased. The assistance of the layman who has had First Aid training, is therefore now of unusual value in rendering emergency treatment. The life of an injured person often depends upon the care he receives from the first individual to aid him. Convincing proof of the necessity for the work of the Red Cross in First Aid instruction, will be found in a study of the following facts: It has been conservatively estimated that between 90,000 and 100,000 fatal accidents occur annually in the United States, and that five times that number of accidents occur which so disable individuals that they can no longer earn their own living. Computing the earning capacity of each of this latter group at the low rate of $500 per annum, gives an aggre- gate loss of wages of $250,000,000 annually. These figures, of course, take no account of the suffering and sadness brought into thousands of homes, which cannot be measured in terms of dollars and cents, the charges for medical care, the expenses incurred by legal claims and damage suits, or the loss to employers. According to the Interstate Commerce Commission, there were 206,723 casualties on the steam railways of the United States for the year ended December 31, 1916. Of these 10,001 FACTS IN REGARD TO ACCIDENTS IN THE UNITED STATES FIRST AID INSTRUCTION 3 were deaths. These figures show an increase over the year ended December 31, 1915, of 1,371 in the number of persons killed, and 34,835 in the number injured. The United States Bureau of Mines reports for 1916 show that out of a total of 720,971 men employed in the coal mines of the United States, 2,226 were killed, or, to put it more graphically, one life was sacrificed for every 265,000 short tons of coal produced. There are no statistics of the number of non-fatal injuries in the coal mines of the United States, but a table compiled by the United States Bureau of Mines from official reports of Great Britain shows that 150 out of every 1,000 men employed in and about the coal mines of Great Britain in the year 1914, were injured in accidents resulting in disability of seven days or more per person, and that there were 1,107,518 non-fatal injuries in the coal mines of the United Kingdom in a period of seven years. As the fatality rate is higher in American coal mines than in those of Great Britain, there is reason to believe that the non-fatal injury rate is higher also. Indeed, statistics com- piled from the reports of 280 companies in 1915, show that the non-fatal injury rate at metal mines in the United States in that year (excluding surface, shop, and yard employees) was 362 per 1,000. These figures include all injuries occurring inside the mine resulting in a disability of one day, or more, and are therefore not directly comparable with the coal mine figures. During the year 1916, among 90,797 men employed in the quarries of the United States, 173 were killed outright and 13,427 were injured, the total of killed and injured being fifteen per cent, of the number employed. In the State of Washington, in the first five months of 1914, 63,350 men were employed in the lumber industry. Among these men, in that short period of time, there was a total of 4,928 accidents. There are said to be more than 800,000 men employed in the lumber camps and mills of the United States, but no accurate statistics of accidents are obtainable for the country-at-large. FIRST AID INSTRUCTION 4 The reports of the Bureau of Census (which now comprise a registration area of sixty-five per cent, of the total population of the United States) state that in 1913 there were approxi- mately 15,000 deaths caused by street car, automobile, and other vehicle accidents, by lightning and electric shock, and by drowning. The percentage of death, for example, from typhoid fever does not approach that from accidents. The typhoid death rate is continually decreasing, while that from accidents is increasing. If the increase continues, at the present rate, it will soon exceed the annual death rate from tuberculosis. METHODS FOR PREVENTION OF ACCIDENTS AND FOR RELIEF The Red Cross aims to remedy existing conditions by chang- ing the attitude of the public toward this subject. The meth- ods for prevention of accidents and for relief when they occur fall naturally under the following three heads: 1. Education of the public. 2. Installation of safety devices. 3. Instruction in First Aid to the injured and in accident prevention. 1. Education of the public should begin with the employer. He may be appealed to in two ways: First, from the humani- tarian side; second, from a purely business standpoint. It is easy to demonstrate to an employer that prevention of acci- dents will lessen the number of cripples to be cared for, dimin- ish the death-rate among employees, and minimize the loss from damage suits, with the legal expenses they entail. This demonstration appeals not only to the heart but also to the economic sense. The influence of this training will quickly reach the employee and extend from him to the general public. 2. Safety appliances, in many instances, prove very valuable in preventing accidents, and their use should be persistently encouraged as a part of the general "Safety First" propaganda. 3. Full realization, however, of the special danger of his or her employment can be brought to the individual only by instruction in First Aid to the injured and accident preven- tion. Instruction in the latter alone has not proved effective. FIRST AID INSTRUCTION 5 On the other hand, when a man or woman once sees the results of accidents, an interest in accident prevention naturally fol- lows. It has been shown too, that efficient First Aid treat- ment shortens the time lost by disabled workmen. Hospital records prove that patients who have had prompt treatment are in much better condition on entering than those to whom no First Aid has been given. In the State of Pennsylvania the disbursements of benefit associations have been actually cut in half as a result of efficient First Aid instruction. The extensive experience of the Red Cross has demon- strated that the accident rate among men who have been in- structed in First Aid and accident prevention is seventy-five per cent, less than among the uninstructed. WHAT RED CROSS FIRST AID WORK INCLUDES Red Cross First Aid work includes the following activities: I. The formation and conduct, through Red Cross Chapters, of classes for instruction in Accident Prevention and First Aid to the Injured among men and women in all communities and in every industry. 2. The creation of a volunteer reserve force of men, trained in First Aid to the Injured, who will be qualified for duty with any Red Cross organizations formed for service with the armed forces of the United States in time of war. 3. The creation of a sanitary reserve for the Army and Navy, through the formation of Sanitary Training Detachments and instruction in the duties pertaining to the sanitary services of the Army and Navy. See ARC 302. 4. The stimulation of interest in and encouragement of pro- ficiency in First Aid methods through the promotion of First Aid contests. 5. The preparation of up-to-date books and other literature on First Aid and the designing and standardization of First Aid materials. 6. Cooperation with other organizations in the dissemina- tion of information on Accident Prevention and First Aid methods. 6 FIRST AID INSTRUCTION SOME OF THE THINGS ALREADY ACCOMPLISHED The work already accomplished can only be stated briefly and incompletely. In the latter part of 1909 authority for the establishment and organization of First Aid work was granted by the governing body of The American Red Cross. Its actual organization dates from January 2, 1910. By the provision of an Act of Congress, the First Aid work is in charge of an officer detailed from the Medical Corps of the United States Army, and is a part of the Department of Mili- tary Relief of the Red Cross. A large committee, known as the National First Aid Committee, acts in an advisory capacity concerning this activity. The committee is composed of the following members: Lieutenant Colonel C. H. Connor, Medical Corps, United States Army, Chairman Miss Mabel T. Boardman, The American Red Cross Dr. Edward R. Hunter, The American Red Cross Captain M. J. Shields, M. O. R. C., United States Army Mrs. E. H. Harriman, New York Mr. John Hays Hammond, Mining Engineer Surgeon R. C. Holcomb, United States Navy Mr. Van H. Manning, Director United States Bureau of Mines Professor H. H. Stock, Mining Department, University of Illinois Mr. John Mitchell, former President United Mine Workers Rev. A. R. Mansfield, Superintendent Seaman's Church Institute, New York Mr. W. G. Lee, President Brotherhood of Trainmen Assistant Surgeon General W. C. Rucker, U. S. P. H. S. Captain W. A. May, President Pennsylvania Coal Company Mr. S. B. Thorne, President Thorne, Neele & Co., New York City Mr. Carl Scholz, President Rock Island Mining Company Dr. W. H. Tolman, Director American Museum of Safety, New York City Mr. Julius Kruttschnitt, Chairman Executive Committee, Southern Pacific R. R., New York Mr. J. E. Rhodes, Secretary National Lumber Manufacturers' Association Major E. G. Griggs, President St. Paul & Tacoma Lumber Company Captain John B. White, Kansas City, Mo. Dr. Charles H. Mayo, Rochester, Minn. Colonel Frank P. Williams, Surgeon General, Massachusetts Volunteer Militia Mr. Howard Elliott, Chairman Board of Directors, New York, New Haven, and Hartford Railroad, New York City FIRST AID INSTRUCTION 7 Mr. S. W. Eccles, American Smelting and Refining Company, New York City Mr. C. I. Close, Bureau of Safety, United States Steel Corporation Mr. A. L. Salt, Vice-president Western Electric Co., New York City Mr. G. C. Allen, General Superintendent of Plant, New York Telephone Company, New York City Mr. James E. West, Chief Executive Boy Scouts of America, New York City Mr. William H. Ball, Physical Department International Committee, Y. M. C. A., New York City Mr. E. W. Rice, Jr., President General Electric Company, Schenectady, N. Y. Mr. F. D. Underwood, President Erie Railroad Company, New York City Mr. C. H. Markham, President Illinois Central Railroad, Chicago, Ill. Mr. A. H. Mohler, Former President Union Pacific Railroad, New York City Dr. Henry S. Graves, Chief Bureau of Forestry During the past eight years First Aid representatives of the Red Cross have been over almost all of the territory of the United States, the total distance traveled amounting to more than 300,000 miles. During this time 500,000 persons have received instruction in First Aid to the Injured among rail- road employees alone. A car in charge of a Red Cross physi- cian, specially fitted up with a lecture room, is kept in constant operation over the railroads of the country. Additional physi- cians are available for work in special districts or with certain industrial concerns. Frequently the physicians of the staff are loaned, under mutually agreeable conditions, to telephone companies, manufactories, mines, lumber mills, quarries, and other industries for the purpose of instructing their employees. An organization devoted to life-saving in the cities on the coast, Great Lakes, and rivers of the country, was inaugurated on February I, 1914. This branch of the work, which is really "Water First Aid," is known as "The American Red Cross Life- Saving Corps." An expert life-saver is on the staff of the Red Cross and acts as instructor and organizer of life-saving corps. Since its inception, local life-saving corps have been started in various sections of the country and the membership is steadily increasing. Information regarding the organization of local life-saving corps, the granting of charters, and other data, will be found in pamphlet ARC 121, which will be mailed upon application. 8 FIRST AID INSTRUCTION In June, 1915, First Aid instruction was begun among men working in the lumber industry in the State of Washington. Since that date this work has been extended to the States of Oregon, Idaho, Montana, and California, and eventually it is hoped to extend it among lumbermen in all sections of the country. During 1916, two physicians on the staff of the Red Cross who confined their efforts largely to this field, ac- complished the following results: Towns visited in connection with the instruction ... 183 Companies whose men received instruction 248 Meetings held 322 Number of men attending 25,501 In the latter part of 1916, a campaign of First Aid instruc- tion was inaugurated among men in the limestone, sandstone, slate, marble, and granite quarries of the country. In the effort to reach individuals not directly connected with industrial concerns, hundreds of classes have been organized all over the country. During the first eight months of the year 1917 there were 57,814 certificates issued to students complet- ing First Aid Courses, as against 8,950 for the year 1916. The recent transfer from National Headquarters to the local chap- ters, of the woik of organizing and conducting classes, should further promote the general interest in instruction classes through which, perhaps, the First Aid work of the Red Cross is most widely known. A First Aid supply division is conducted from which First Aid books and equipment can be procured at a reasonable cost. The equipment necessary for instruction in First Aid and Accident Prevention has been installed, and a complete First Aid service organized in a large number of industrial plants. So many industrial concerns have requested the Red Cross to advise them about First Aid supplies that a number of kits have been standardized to meet the particular needs of vari- ous industries, as well as those of every-day life. At the present time there are two household kits (large and small), an industrial kit, and school, street, telephone, railroad, auto- mobile kits, a pocket emergency outfit, and two other kits for FIRST AID INSTRUCTION 9 general use, known as General Use A and B. Special kits have been furnished to the Bureau of Forestry of the United States Department of Agriculture, and to the United States Coast Guard. The Red Cross is always ready to give advice regarding First Aid equipment, and to design and supply special boxes and dressings to meet the needs of manufacturing and indus- trial companies. All supplies are listed in a catalogue available upon application. FIRST AID INSTRUCTION CLASSES The primary First Aid course consists of ten lectures and demonstrations of one and one-half hours each; a total of fifteen hours instruction. Shorter lectures may be given at the discretion of the instructor and for the convenience of the members of the class, provided the fifteen hours are made up by increasing the number of lectures. Classes may be formed of individual members of commu- nities, in social or other organizations, and in every industry. Arrangements for organizing the class should be made with the nearest Red Cross Chapter, whose First Aid Committee will gladly furnish any information about the course, in addi- tion to that which is given in this pamphlet, and assist in every way possible. Class Members. It is desirable that a class be small rather than large, as individual instruction in practical work must be given each student. A class should have not less than four, nor more than twenty-five members. A class of ten or fifteen is considered a desirable size. The minimum age limit is six- teen years. Membership in the Red Cross, while desirable, is not obligatory. Class Secretary. The class should elect a Secretary to handle the funds of the class, and represent it in all business with the Chapter. Class Instructor. Class instructors must be physicians in active practice who are graduates of recognized medical schools and who have received the degree of Doctor of Medi- 10 FIRST AID INSTRUCTION cine. All instructors and examiners should be in good standing with their local or state medical society. The class may nomi- nate its instructor, subject to the approval of the Chapter, or the Chapter will assign the instructor if the class so desires. When sending in the name of a physician for instructor, it is necessary to furnish the physician's full name and address, the name of the medical college from which he graduated, and the year of graduation. If the physician's credentials are found to be satisfactory, an appointment card will be sent to him, unifess he is already a First Aid instructor, and the class Secretary will be notified of his assignment to the class. Class Roll. A blank Class Roll will be sent to the Secretary at the time the Secretary is notified of the instructor's assign- ment. The Class Roll should be filled out by the Secretary in accordance with the directions on the form, and must be forwarded to the Chapter (together with the class fees) before the third lecture is given. Class Fees. Any charge that may be made by the class in- structor is a matter to be arranged between him and the class. The Red Cross approves of instructors donating such time as they may be able to give to First Aid work, or of making a rea- sonable charge for instructing the classes, but it prefers not to give advice relative to the amount of such fees. In ad- dition to a charge for instruction, if any, a regular fee of fifty cents ($0.50) is charged each student. This fee covers the expense to the Red Cross for stationery and postage, and general supervision of the work. A check or post office money- order, made payable to The American Red Cross, in a sum sufficient to cover the charge of fifty cents ($0.50) for each student, must be forwarded to the Chapter (together with the Class Roll) before the third lecture is given. In the larger Chapters, where general classrooms may be maintained, it may be necessary to make a charge greater than fifty cents ($0.50) in order to cover the additional overhead expense to the Chapter, but where this is done the class should benefit by the improved classroom facilities provided. FIRST AID INSTRUCTION 11 Classrooms and Equipment. Where the Chapter cannot pro- vide a general classroom, it will assist the class in every way possible to secure a suitable meeting place. W'hile not obli- gatory, it is recommended that each student of a class obtain a copy of the Red Cross textbook on First Aid. This book is published in several editions, as described on page 14 of this pamphlet. Each class should have an Instruction Outfit, a set of Anatomical Charts, and a set of First Aid Charts. These supplies are described in detail on pages 14-16 of this pamphlet. Examination. The class instructor may examine the class. At least two weeks before the date set for the examination the class Secretary should advise the Chapter of the time when the lectures will be completed and request that a blank Examina- tion Record form be sent to^ the instructor. The names of the students will be entered on the Examination Record as they appear on the Class Roll. Only those students who have at- tended at least eighty per cent, of the lectures will be eligible for examination, and it will be the duty of the class Secretary to keep a record of attendance in order to determine this. No student who has failed to pass an examination shall be eligible for further examination until another full course of instruction shall have been taken. Students1 Certificates. Certificates will be issued to students who have attended at least eighty per cent, of the lectures and have attained an average of seventy-five per cent, or more in the examination. Certificates will be written from the names as they appear on the Class Roll. Therefore it is important that the names be typed or printed on the latter exactly as it is desired to have them appear on the certificates. ADVANCED COURSE AND MEDAL Students who have satisfactorily completed the primary course in First Aid, and desire to continue the study of the sub- ject, may take an advanced coursewhich consistsof five lectures and demonstrations, or as many more as the instructor may deem necessary, each session to continue one and one-half hours. 12 FIRST AID INSTRUCTION Students in advanced courses are expected to become pro- ficient in First Aid treatment of fractures, dislocations, burns, wounds, hemorrhages, and in performing artificial respiration. The general edition of the First Aid textbook is used in this course. Instructors will require students to study the chapters of the book covering the foregoing subjects and will limit their class instruction to actual practical demonstrations, requiring each student to repeat the work demonstrated. Examinations in the advanced course are limited to practical demonstrations of the methods of treatment studied. The instructor who officiated for the primary course may be obtained to conduct the advanced course without further authorization by the Chapter. If this is not practicable, a new instructor must be authorized. The fee charged each student in this course is one dollar ($1.00) which covers the cost of the examination and medal award. This fee is in addition to any charge which may be made by the instructor, and these fees must be forwarded with the Class Roll to the Chapter in the manner described for the primary course. The procedure as to securing and forwarding Class Rolls and Examination Recordswill be thesame as for the primary course. Students who pass the advanced course examination will be awarded a Red Cross bronze medal, to which metal bars, with the year of passing engraved on them, may be added for sub- sequent study and examination. The number of bars that may be added to the medal is limited to three. The charge for the bars and engraving will be fifty cents ($0.50) each. When a student has acquired a medal and three bars, he should be competent to cope with almost any ordinary injury. PRIZES AND AWARDS The Red Cross offers the following prizes for the best First Aid work performed during each calendar year: First $50.00 Second 25.00 Third 15.00 Fourth 10.00 FIRST AID INSTRUCTION 13 Competition for these prizes is open to all holders of Red Cross First Aid certificates, and, in special cases, to others who have been instructed in First Aid under the auspices of the Red Cross and yet may not hold certificates. These prizes are not, however, open to railroad men, for whom special prizes in like amounts are provided from a fund known as "The William Howard Taft Fund." Prizes are also offered to the Life-Saving Corps. For full information on this subject see pamphlet A R C 121. Physicians who serve as instructors, or any other person who gives his or her unremunerated services in any of the First Aid activities for a period of three years, in a manner satisfactory to the Red Cross, will receive a certificate from the Red Cross in recognition of such services. In appropriate cases assistance and help in this humane work will be acknowledged by a vote of thanks of the Red Cross. Boys and girls of sixteen years of age and over, having studied under an authorized First Aid instructor may compete for merit badges. Girl and Boy Scouts obtain these badges through their respective organiza- tions, after passing tests recommended by The American Red Cross. Information regarding these tests can be obtained from the Girl Scouts' Headquarters, Washington, D. C., and the Boy Scouts' Headquarters, 200 Fifth Avenue, New York City. FIRST AID CONTESTS The American Red Cross is prepared to assist in promoting First Aid contests anywhere in the country. At such contests or "meets," four or five problems are presented for the solution of the competing teams. Judges mark all the teams, and prize medals and prize certificates are awarded to the winners. Whenever Red Cross prizes are awarded, the Red Cross must be represented among the judges, and all judges must be physicians. If timely request is made, the Red Cross can supply most of the judges for these occasions. This has been the custom for years in certain localities. Rules for conducting First Aid contests, and problems for the practice of teams, from which selections may be made at First Aid contests, may be obtained upon application to The American Red Cross, Depart- ment of Military Relief, First Aid Division, Washington, D. C. (Con- sult ARC 300, First Aid Contests.) 14 FIRST AID INSTRUCTION AMERICAN RED CROSS FIRST AID INSTRUCTION OUTFIT This outfit has been prepared for the use of teachers of First Aid and is intended for instruction purposes only. With it and the Red Cross Charts, which follow, any teacher will be in possession of all the mate- rials required to give a practical course of instruction in First Aid to the Injured. The outfit consists of: 12 Triangular Bandages, 12 Roller Bandages of assorted sizes, 4 Wooden Splints, 2 U. S. Army Tourniquets, 6 First Aid Outfits, 2 Dozen Large Safety Pins. The outfit is packed in a substantial cardboard case. Size i8J^X6X 3X inches. The price is $5.00 each (subject to change without notice), f. o. b. Washington, D. C., or $5.15 postpaid, if ordered from Divi- sion Headquarters. FIRST AID TEXTBOOKS The American Red Cross Textbooks on First Aid, by Colonel Charles Lynch, Medical Corps, United States Army, are published in several editions, as follows: The American Red Cross Textbook on First Aid and Relief Columns. Complete edition. This is a very comprehensive work and adapted especially to the use of instructors. Price, $1.00, postage prepaid. FIRST AID INSTRUCTION 15 The American Red Cross Textbook on First Aid. Abridged editions as follows: General edition in English or Spanish; Women's edition; Police and Firemen's edition Railroad edition; Miners' edition; Industrial edition, in English, Italian, Lithuanian, Slovak, or Polish. Price each, $0.33, postage prepaid. AMERICAN RED CROSS ANATOMICAL CHARTS FOR SCHOOL ROOMS, FIRST AID CLASSES, ETC. This series consists of 5 hand- somely lithographed wall charts, mounted on linen and heavy rollers: size of each, 20 X28 inches. These charts can be used with the instruction outfit, in teaching classes of First Aid, when it is not desired to spend the amount necessary to purchase the set of 16 charts. Charts are numbered and are illustrative of the following: Chart I: The Skeleton Chart II: The Muscles Chart III: Scheme of System- atic Circulation, in 3 colors Chart IV: Fracture and Dislo- cation Chart V: Arteries and Points of Pressure for Controlling Hemorrhages, in 2 colors Price, $2.75 per set (subject to change without notice), postpaid from any point. American National Red Cross Chart V Artener and Points of Preswre for Contrallmg Hemorrhages NEW AMERICAN RED CROSS FIRST AID CHARTS For school rooms, first aid classes, etc. Size of each, 14X22 inches. This series consists of 16 handsomely lithographed charts on card-board. Charts are numbered and are illustrative of the following: Charts I and II: Fractures ; Charts III, IV, and V; 16 FIRST AID INSTRUCTION Bandaging; Charts VI and VII: Wounds; Charts VIII and IX: Bleeding; Charts X and XI: Drown- ing ; Charts XII and XIII: Electrical Shocks; Charts XIV and XV: Carrying; Chart XVI: Poisoning and its treatment. The new American Red Cross First Aid Charts were specially designed for this Society. These charts depict so graphically how to treat the commoner in- juries, that by studying them, even without pre- vious knowledge of First Aid to the Injured, one should experience little difficulty in rendering such aid. It is believed the charts should find a place in every school and college, mine, mill, and factory. They should be of undoubted utility if kept at all wharves, boat-houses, etc. The charts on rescue and treatment of the apparently drowned are particularly good. Furthermore, our police and firemen, many of whom have already developed into competent first-aiders, should have the charts made available to them. Price, per set of 16 charts, $4.00 (subject to change without notice), f. o. b. Washington, D. C., or $4.15 postpaid from Division Head- quarters. DOUGLAS C. MCMURTRIE NEW YORK