FIRST AID IN MINES BY N G NAIR MINES
FIRST AID IN MINES BY N G NAIR MINES
OUR GROUPS
(1) RULES & AGREMENT
Why First Aid
1. To make accident victim comfortable.
2. To avoid complications till doctor overcharge of injuard.
Rules of First Aid
1. Do essential tasks first.
2. If respiration fails, give artificial respiration.
3. Control bleeding.
4. Combat shock.
5. Allay fear ; reassure victim
6. Do not attempt too much.
7. Do not allow crowding near the victim
8. Do not remove clothing unnecessary.
9. Take victim to the doctor quickly.
First aid Arrangement in Mines
The First Aid arrangement in mines is done according to Rule No 40 to 45 of the Mines Rules 1955, as detailed below:
First Aid outfit
The mine overman, foreman, sirdar, mate, shortfirer, blaster, electrician and machinic should be qualified first aider and should carry the first aid outfit while on duty. It consists of one large sterilized dressing, one small sterilized dressing and an ampule of tinchture, of iodine or other suitable antiseptic. This is used to dress an wound on the spot to control bleeding and prevent infection of wound.
Fist Aid Box
It contains at least:
1. A sufficient supplies of large and small sterilized dressings and burn dressings.
2. A sufficient supply of sterilized cotton wool and of adhesive plaster.
3. A supply of roller bandages – to keep the dressings in place.
4. A supply of tincture of iodine or other antiseptic solution.
5. A tourniquet, scissors and safety pins.
6. A piece of carbolic soap.
Mine dressings consist of cotton wool pads completely covered with plain absorbent gauze or lint stitched to a roller bandage. These dressings are germ-free if the original outer wrapping is intact. When a wound is covered up with such a germ-free (sterile) dressing, the wound does not become infected and heals quickly.
It should be noted that tincture of iodine or other antiseptic solution is not meant for treating the would, the surrounding skin need only be touched up with a piece of cotton wool soaked in the solution. This checks infection.
Proper use of all items provided in a First Aid Box should be clearly understood. Ask your doctor
These boxes are kept at the First Aid Stations provided in the mine workings. There is one such box for every 150 persons employed.
First Aid Station
These are pre-selected places in the mine where first aid equipment are provided and injured persons receive first aid treatment.
Requisites:
1. A stretcher with tow blankets
2. Sets of splints (1.4 m, 0.9 m and 0.3 m ) with necessary tringular bandages for applying them.
3. First Aid Boxes, not less than one for every 150 persons employed.
Location:
Above ground.
1. At the top of every shaft or incline where men or material are normally wound hauled.
2. In every workshop.
3. At every screening plant and loading place.
4. At every other place where more than 50 persons are employed at any one time.
Opencast Workings
One first aid station for every 50 persons employed
Belowwgound
1. At the, bottom of every shaft where men or material are normally wound, and at or at or near every plant
2. Near the drive end of every haulage.
3. In or at the entrance to every district section of the mine.
First aid Station Incharge
Every first aid station is placed under the charge of a qualified first aider. They are required to be readly available throughout the shift. A list of these persons is displayed at every first aid station, mine office and first aid room.
First aid Room
This is provided on the surface of the mine, at a covenant place, and is used only for first aid work. The first aid room is in charge of a qualified doctor. Usual first aid quipment together with a table large enough to pace the stretcher on, bench, chairs, screen, wash basin, running water supply, artery forceps, eyebath, clinical thermometer, morphine amppules, stove for boiling water, are provided.
It is here that the doctor attends to an accident victim.
Removal of injured to hospital
Ambulance vans are provided at the mine or for a group of mines for speedy removal of injured persons from the mine to the hospital
(2) DUTIES OF KEY MEN
Injured person
Only if he is able to do so:
1 Inform Supervisor or foreman
2 Before leaving the mine, report for examination or treatment at first aid room.
Co-Worker
1 Immediately inform the supervisor or shift-in-charge.
2 Avoid panic, reassure victim
3 Do not allow injured to see his wounds.
4 Keep injured lying down.
5 Do not allow crowding near victim.
In case of electric shock
1 Cut off power supply, if possible.
2 If power is not cut off; Stand on dry wood and with a dry wooden pole disengage victim from the cable or machine. Or with the help of your cap-lamp cable pull out the victim.
3 Now act as stated before
In case of gas poisoning
1 Do not rush to the victim
2 Inform the supervisor or shift in charge.
Supervisor or shift in charge
1. On receiving information, rush to the site of accident; ascertain condition and act accordingly (see chapter 10 for essential tasks in emergency)
2. Check victim’s conditions, particularly breathing, bleeding and shock. Give proper first aid.
3. Get assistance from other first aiders present in the mine, if necessary.
4. Send message to attendance clerk regarding doctor, ambulance and other assistance needed.
5. Get adequate number of stretcher-bearers, if needed.
6. Send out the victim, on stretcher if condition so demands, straight to the first aid room. Ask a first aider to accompany him.
First aid station Inchage
1. On receiving information,collect sstretcher, blankets, splints, bandages & first aid box from the station; get four other helpers and rush to the site of accidents.
2. Assist the supervisor in rendering first aid to the victim.
3. Collect full particulars of injured and details of his injuary.
4. After first aid is rendered, load the victim on stretcher -`if condition so demands – and carry him along with other helpers, to the first aid room. Watch breathing, pulse and bleeding of victim on the way.
5. On reaching the first aid room, report to the doctor giving full details of the victim & his injury.
Attendance clerk
On receiving the message from the supervisor about the accidient and assistance needed – like doctor, ambulance etc., immediately send information to the First Aid Room and Manager.
First Aid Room Incharge
1. On receiving information about victim, prepare the first aid room to receive the causality.
2. If ambulance is required, contact manager
3. When the casualty arrives, get full details of the nature of injury and first aid given. Act according.
4. When the doctor arrives, give him the complete report about the victim
(3) STRUCTURE & FUNCTION OF BODY
Only the sailent features are given here. It is better to study these with the help of anatomical charts & skeleton.
Position and function of hard tissues (Bones & Cartilages)
Skull : Made of cranial bones and lower jaw – protects brain
Vertebral Column : Made of 33 small bones (vertebral) – Keeps posture , protects spinal chord.
Ribs : Twelve pairs, forms the thoracic cage – protects vital organs like lungs, heart, liver, spleen.
Pelvis : Two innominate bones (3 bones fused into one on either side) and Sacrum (5 fused sacral bones of vertebral column) and Cooyx (4 fused bones of vertebral column) These make the pelvic cavity – protects all the pelvic organs, gives passage to blood vessels and nerves etc.
Upper Extremities : Clavicle and Scapula – Shoulder bones
Humerus – Bone from shoulder to elbow
Radius – Bone from elbow to thumb side
Ulna – Bone from elbow to little finger side
Carpus – Eiiight bones of wrist
Metacarpus – Five bones of the palm
Phalanges – Fourteen bones of fingers
These bones make the upper limb of the body.
Lower Extremeties
Femur – Thigh bone, from help to knee
Patella – Knee cap
Tibia & Fibula – Bones of the leg
Tarsus – Seven bones of the heel and ankle
Metatarus – Five bones of the front of instep
Phalanges – Fourteen toe bones
These bones make the lower limb of the body.
Function of bones
Protection, Support and blood formation
Position and function of soft tissues
1. Brain : Site of higher centre ; controls all bodily functions
2. Lung : Respiration
3. Heart : Blood Circulation
4. Diaphragm : Partition between thoracic cage and abdominal cavity, helps respiration, allows passage to oesophagus ( canal from mouth to stomach) aorta and vena cava
5. Stomach : Digestion
6. Intestines : Digestion, absorption and excretion
7. Liver : Blood formation, detoxication, bile production, metabolsim (chamical reactions)
8. Bladder & Kidney : Urine formation and excretions
9. Muscles : Shape, mechanical action & Strength
10. Blood Vessels (Arteries, Vein & Capillaries ) : to carry blood.
( 4) CIRCULATION OF BLOOD
By the combined action of hearts, lungs, arteries, veins and capillaries, blood circulates all over the body. Blood provides life-giving oxygen and strength to the body.
Pulse
It is the feeling of throb over an artery-commonly on the wrist due to hearts action. Normally the pulse beats at the rate of 72 times per minute.
Bleeding
Over body contiains about 5 liters of blood. Any bleeding due to bodily injuries, slows down blood circulation and accordingly oxygen supply to vital organs; thus the injured person passes into a stage of shock.
Arterial Bleeding
Blood is bright red, comes out in regular jerks, takes times stop even firm pressure is applied.
Venous Bleeding
Blood is dark red, flows out steadily and stops immediately on applying pressure.
Control of Arterial Bleeding
Put a sterile dressing, apply direct pressure with hand, wait for a few minutes and see.
If bleeding continues, apply tourniquet on the nearest pressure point towards the side of heart; loosen tourniquet every 15 mts. and see if bleeding has stopped.
In case bleeding still continues, put on pressure bandage, apply tourniquet and take the victim to the doctor.
Wound
It is an injury with break in continuity of tissues of the body, permitting escape of blood and entry of germs.
Type of Wound
1. Incised – Caused by sharp instruments – like timberman’s axe, bleeds profusely.
2. Lacerated – Caused by less sharp and heavy objects with severe pressure like tub wheels, engine couplings and other moving machinery. The edges of wound are irregular, free bleedings is less with big blood clot formation.
3. Punctured – Caused by long, sharp and pointed objects, penetrating deep into the tissues – like needles / spindles of machine. Bleeding is moderate but chances of TETANUS infection is more.
4. Contused – Caused by direct blow by blunt and heavy object – like falling mass of coal. Body is bruised, free bleeding is almost absent.
Dressing of Wounds
1. Make the patient lie down; reassure
2. Expose the injured part of body carefully and examine the wound. In case any foreign body is present, remove it if possible; but do not disturb the wound or blood clot.
3. Arrest bleeding if there is any
4. Clean the surrounding skin with a piece of cotton wool soaked in tincture of iodine or other antiseptic solution.
5. Put a sterile dressing over the wound and bandage it.
6. Combat shock
7. Take the victim to the doctor quickly. In case victim has sustained injuries on his head, neck or back, do not make him walk, even if he is willing to do so ; transport him on stretcher only.
Tetanus
It is a disease which starts due to a wound only; and often turns fatal.
Signs & Symptoms
Difficulty in movement of jaw – lockjaw, muscles of the affected part get taut, - this is a sign of local infection.
Stiff nick & back
Precautions
Even a small cut/wound should be covered with a sterile dressing to prevent infection.
See your doctor immediately
Immunise, well in time, against tetanus.
(5) FRACTURE
What is fracture?
It is loss of continuity of the bone.
Types of fracture: There are two main types of fracture
1. Simple (closed) Fracture without any break on the surface of skin; and outside air does not reach the broken bone.
2. Compound (open) Fracture with break with break on the surface of skin and outside air reaches freely to the broken bone.
There are several sub-types of these two main types of fractures
Sub-types
1. Comminuted: When the number of broken pieces of bone are more than two.
2. Impacted: when the broken ends are pushed into one another
3. Greenstick: when the part of the bone gets bent; there is superficial and incomplete creack on the outser surface of skin. This is common with children’s bones, which are more flexible. Hence such cases are not met with in mines.
4. Depressed: when a small area of the body surface is forced down, causing a local depression.
When the fractured part also disturbs the surrounding tissues like nerves, blood vessels, muscles, or adjacent vital organs like lungs, heart, liver, spleen, kidney etc,. it is termed as complicated fracture.
Symptoms of fracture:
Pain, swelling, deformity, loss of power.
Treatment
1. Do not attempt to move the patient from the site of accident. But if there is danger due to the fall of roof and sides or influx of noxious gases, the victim should be carefully removed to a safe place, even before rendering first aid.
2. Do not attempt to reset the broken limb.
3. Immobilise the broken with suitable splints.
4. Bandage the broken part of body
5. Combat shock
6. Take victim quickly to the doctor.
The broken limb is immobilised with splints & triangular bandages; there are different methods of bandaging of different parts of the body. These should be carefully understood and then practiced repeatedly.
(6) RESPIRATION & ASPHYXIA
How do we brethe
Stimulus from higher centre situated at brain, leads to contraction of chest wall, lowering of diaphragm and increase in capacity of thoracic cage, which draws the lung surfaces alongwith it, the lining expands, and air gushes in. This is inspiration.
On next stimulus from brain, the reverse process starts, with relaxation of muscles of chest wall; the diaphragm is raised, capacity of thoracic cage reducess, lungs contract and air is expelled. This is expiration.
Role of Breathing
The normal rate of breathing is 15-18 times per minute. If more, it indicaes distress, shock, pain, CO2 poisoning.
CO2 / O2 EXCHANGE IN LUNGS
Oxygen is essential for life, and it constitutes one fifth of normal air, by volume. When we breathe fresh air, its oxygen content goes into the blood in our lungs; as this blood circulates, oxygen reaches all parts of our body. At the same time, CO2 (Carbon dioxide) generated in the body is taken into the blood on its return journey to the lungs, where it is purified once again. The exchange of CO2 / O2 in lungs is explained below:
During respiration, inhaled air reaches upto the last cell of lungs (ALVEOLI) and comes in contact with terminal ends of blood vessels (capillaries). Here the partition between air and blood is very thin, which allows free passage of gases but not of fluids. Therefore oxygen from fresh air goes into the blood and carbon-di-oxide (CO2), from blood comes to the lungs cells, thus purifying the blood but making the lung air charged with CP2. This impure air is later exhaled.
Asphyxia:
Acute reduction in fresh air supply to lungs due to any cause is called asphyxia.
Causes of Asphyxia:
1. Higher centre of brain affected due to electric shock & gas poisoning.
2. Obstruction in respiratory tract due to:
a Vapour or gases : Noxious mine gases, fumes etc.
b Fluids : Water – drowning cases
c Solids : Food particles
OR
Direct pressure from outside on neck e.g. buried under mass of fallen coal.
Signs & Symptoms
Early Stage
1. Shortness of breath
2. Weakness, Giddiness
3. Rapid pulse
4. Semi-consciousness
5. Swelling in veins of neck
6. Flushed face, bluish lips
Signs & Symptoms:
Later Stage
1. Slow and intermitted breathing
2. Slow and irregular pulse
3. Lips, nose, ears, fingers & toes turn bluish
4. Complete unconsciousness
Treatment
1. Remove cause, if possible
2. Give artificial respiration, immdeiately. Even the slightest delay may be dangerous for the victim.
3. Combat shock
Methods of Artificial Respiration
The first-aider can himself give artificial respiration to the victim by four different methods:
1. Holger – Nielsen method
2. Schafer’s method
3. Silvester’s method
4. Mouth-to-mouth resuscitation
The methods should be crefully understood; for this practical demonstrations may be arranged; thereafter it should be practiced regularly. Unless the first aider has practiced regularly, he might falter at the time of emergency and fail to revive the victim.
Mechanical resuscitators are also being manufactured in our country. These resuscitatiors are based on the principle of mouth-to-mouth respiration and come under the brand names of ARYVIVE and LIAF. The first aider should learn their use. These resuscitators are very effective in case of electric shock or gas poisoning.
(7) SHOCK AND UNCONSCIOUSNESS
What is shock
It is the acute weakness following depression in function of vital orgns of body like heart, lungs, kidney brain etc. In case of shock, blood pressure invariably drops leading to fainting.
What is unconsciousness
It is loss of senses due to interruption in functions of brain
Types of shock
1 Nerve shock: Brain and nerve affected without physical injurry, leading to sudden fall of blood pressure. This may be due to some bad news e.g. death in the family, or exposure to fright etc.
2 Established shock : External or internal physical injury leading to sudden fall of blood pressure.
Types of Unconsciousness
1. Partial unconsciousness: In this case, the patient reacts to stimulus e.g. grimaces when pinched, pupils react to light.
2. Total unconsciousness : In this case, the patient does not react at all to any stimulus,
Signs of symptoms
1. Giddiness and fainting
2. Cold and clammy skin
3. Pallor
4. Rapid and weak pulse. But initially it is low
5. Nausea
6. Unconsciousness
Treatment
1. Remove foreign body, if any, from inside the mouth
2. Get fresh air: give artificial respiration, if respiration falls.
3. Reassure victim
4. Keep victim lying down, unless there is injury in the head, chest or abdomen, keep his head down.
5. Loosen clothing
6. Cover with blanket
7. If the victim is conscious, give him tea or water.
( 
BURNS & SCAIDS
What s burn
It is an injury due to dry heat e.g. fire, hot machine-parts, electric spark, flame of explosion in mines.
What is an injury due to moist heat e.g. hot water, steam, hot oil etc.
Extent of burn
The total surface area affected, determines the extent of burn. Greater the extent of burn more the fluid loss and consequent degree of shock.
Extent fo burn should therefore be ascertained to judge the severity of injury. For this purpose, it is best to use the Rule of Nine e.g.
Head & Neck = 9
Each Arm = 9
Each Leg = 9
Front of Trunk = 9 X 9 = 18
Back of Trunk = 9 X 9 = 18
This the severity of injury of a person with burnt back is twice that of a person with a burnt arm.
Treatment
1. Do not disturb the burn injury; do not prick the blisters : do not remove burnt clothing
2. Adopt strict asepsis. Clean and wash your hands put burn dressing over the burnt part of the body and bandage.
3. Combat shock
4. If the extent of burn is large take the victim to the doctor on a stretcher; do not make him walk in any case.
( 9) HEAT EXHAUSTION AND HEAT STROKE
Cause
Exposure to very high temperature, high humidity and sluggish ventilation in mines causes heat exhaustion or heat stroke
Typical Situations
1. In opencast workings or surface of the mine ; Fiercely blazing sun on summer days, and still air
2. In underground Workings: Inadequate ventilation, high strata temperature, very high humidity and low air velocity.
Heat Exhaustion
Signs & Symptoms
1. Giddiness, extreme tiredness
2. Cold and clammy skin
3. No appreciable rise in body temperature
4. Rapid and weak pulse.
Treatment:
1. Remove victim to shady and cool place with plenty of fresh air.
2. Keep victim lying down
3. Wash victim’s head and neck with cold water
4. Give him tea ; later, if he desires, give water
5. If after some time, victim feels a little chilled cover him with a blanket.
Heat Symptoms:
Signs & Symptoms
1. Very high temperature, may reach even 104 degree F to 106 degrees F
2. Nausea and vomitting
3. Dry and hot skin
4. Rapid pulse
5. Face flushed
Treatment
1. If victim is in the sun, bring him to shade, if in underground workings, remove him to a cool place with plenty of fresh air e.g. main intake airway.
2. Keep victim lying down; loosen clothing
3. Splash water all over body and fan
4. Give plenty of water / tea
5. When the temperature comes down to 102 degrees F dry his body, cover with a light blanket and fan.
(10) ESSENTIAL TASKS AFTER ACCIDENT
Due to special conditions in mines, it often becomes difficult to render proper aid to accident victims. For example:
1. In most cases, it is extremely difficult for the doctor to reach the site of accident, particularly because of possible bad roof and side conditions danger due to noxious gases, long tortuous road ways, which the doctor may not be familiar with. Therefore the victim has necessarily to be brought from the site of accident to thr first aid room on surface of the mine, only then the doctor can render help. This results in some unavoidable delay.
It is therefore of utmost importance that the first aider should do his best at the site of accident, otherwise the condition of the victim is likely to worsen by the time medical aid becomes available.
2. Often the accident victim may have to be removed from the site, even before any first aid is given, because of imminent danger due to roof fall, such situations demand extreme caution and very careful handling of the patient.
3. Due to the presence of foul water, coal dust and dirt in mines, the chances of infection of wounds are more and tetanus may develop easily. Therefore even small wounds need prompt dressing with strict asepsis.
In case of some typical accidents in mines, the essential tasks that the first aider is required to do first, are given below;
ACCIDENTS DUE TO FALL ROOF AND SIDES
1. Check if there is any imminent danger due to further fall. If so, carefully pull out the victim to a safe site. Make the path smooth & clear, so that victim is moved gently and safely.
2. In case of head injury, it should be remembered that spinal injury is also possible even when there is no outward sign. Therefore keep the victim lying down, handle him very gently.
3. Control bleeding, if there is any, promptly.
4. In case of injury to head, neck, back, pelvis or thigh, howsoever only a stretcher, even if victim is able to walk. In such cases it is dangerous to make the victim walk, as it increases exhaustion, deepens shock and generally worsens the condition of patient.
Asphyxia or Unconsciousness due to mine gases etc.
If a person is found lying unconscious in any part of a mine, it may be possibly due to the following reasons:
1. Asphyxia due to accumulation of firedamp (CH4)
2. Carbon mono-oxide (CO) poisoning, when fire breaks out in the mine.
3. Asphyxia due to accumulation of blackdamp (CH2)
4. Heat exhaustion due to every high temperature, humidity & sluggish ventilation in the workings. It is also likely that the person might be sick, or have suffered a heart attack or be drunk or just sleeping.
Action
1. Ascertain cause and ac accordingly.
2. If danger due to fire exists, test for CO with suitable birds or Co-detector and only then approach the victim. If self-rescuer is available, the first aider should use it ; but first check with flame safety lam, if there is enough oxygen available in the mine air. If not, arrange ventilation, and only then approach victim.
3. If there is no danger due to CO check for accumulation of blackdam and firedamp and firedamp with a flame safety lamp. Any accumulation of gas should first be removed by arranging ventilation and only then the first aider should approach the victim.
4. It is not possible to clear the gas quickly, inform manager. Assistance of Rescue Brigade may be necessary to rescue the victim.
5. If there is no danger due to mine gases, go up to the victim, check his breathing and pulse. If respiration has failed, give artificial respiration immediately.
6. If the cause is heat exhaustion or illeness or heart failure or intoxication or sleep, take appropriate action accordingly.
Special Steps for CO poisoning:
1. In case of CO-poisoning, the victim needs more Oxygen than in other cases. Therefore while giving artificial respiration, arrangement should also be made simultaneously to administer Oxygen. Suitable reviving apparatus like NOVOX should be used. Resuscitators like ARY VIVE or LIAF may also be used by attaching oxygen cylinders to them.
2. The victim should never be made to walk, even if he wants to. In case of CO-poisoning, if the victim walks, the shock deepens and may turn fatal. Always transport the victim on a stretcher.
Accident due to Explosion, Air-blast or Fire
main difficulties:
1. There is utter chaos in the district ; panic grips most of the men. It is extremely difficult to establish some sort of order and organize assistance to accident victims.
2. Large number of persons are affected at the same time ; therefore assistance is needed on a larger scale.
3. Condition of workings worsens, new dangers arise
4. To locate the victims in such circumstances, becomes a problem.
Action
1. Keep calm ; set courageously ; avoid panic
2. Remove survivors to safe place ; build up team for assistance, from amongst them.
3. Collect first aid supplies, stretchers etc ; as much as available
4. Switch off power ; test for gas; put out fire
5. Search for injured persons
6. First attend to those with severe injuries
7. Remember persons with burn injuries, might also have been affected by CO. Tale action accordingly.
8. Persons with severe burn injuries or affected by CO, should be sent out on stretchers, before others.
Accident due to Electric Shock
1. Switch off electric supply
2. If it is not possible to put off the switch: stand on dry wood and with a wooden stick disengage the victim from the cable or machine
OR
Pull out the victim with your cap-lamp cable. See that you do not come in contact either with the victim or the cable or the machine ; otherwise you are also likely to receive electric shock.
3. If the clothes of victim have caught fire, put it out.
4. Give artificial respiration to victim. Put burndressing over burnt parts of the body. Combat shock. Transport victim on a stretcher, quickly to the first aid room.
Accident due to Falls from a height
When a person falls down from a height, e.g. from a high bench of an opencast excavation, or from a ladder or from top of the headgear, he usually sustains serious injuries in his head, neck, spine, chest or back.
Action
1. Keep victim lying down : watch closely and see where he is hurt
2. Handle victim very gently
3. Any bleeding from nose or ears indicates probable head injury.
4. In case of bleeding from wounds over other parts of the body, immediately control bleeding.
5. In case of fracture, immobilize broken limb
6. Transport victim only on a stretcher,. In no case the victim should be allowed to walk.
Action due to Drowning
Sudden inundation of mine workings may drown workmen.
Action
1. Lay the victim in face downwards position. Lift him by the waist, so that water, that might have entered the stomach is expelled.
2. Clear his nose and mouth of any obstruction
3. Immediately give artificial respiration
4. Remove wet clothes, dry the body, cover victim with light blanket.
5. Do no allow crowding near the victim
6. Combat shock
(11) TRASPORT INJURED ON STRUCTCHER
Victims of mine accidents are transported on stretcher, whenever considered necessary, with four stretcher bearers, from the site of accident to the first aid room. It needs regular practice by the bearers. In case of steeply inclined and long mine roadways, sometimes two or three teams of stretcher-bearers may be necessary to transport the victim, otherwise the bearers may tire out soon resulting gin delay in reaching the first aid room. Evidently such delay in receiving medical attention may be dangerous for the victim.
Points to remember
1. Selection of Stretcher: It should be strong enough to take up the weight of the victim. The length of stretcher should be a little less than the length of the cage so that it can be easily placed inside it. For transporting patients with injured spine, suitable wooden boards may b e fitted on the stretcher.
2. Special stretchers should be used, if the patient is to be transported vertically up or down a staple shaft or ladder-way or steeply inclined road way.
3. Stretcher Bearers: If the journey involved is long and arduous, teams of stretcher bearers should be formed for speedy transportation of victim.
4. Route: The route to be followed should be so chosen that the victim is transported quickly and safely to the first aid room, he should get a person, conversant with the route, to accompany the stretcher party.
5. Particulars of victim: Before starting off, the Captain should carefully note:
Name and occupation of victim, where, when & how the accident happened Nature of injuries sustained. Details of first aid rendered and by whom, What attention is necessary on the way.
6. Assistance on the Way: The first aider accompanying the stretcher party, should keep a watch over the breathing, pulse rate and bleeding of patient. If tourniquet has been applied, it should be loosened every 15 mts., and applied again. If the condition seems to worsen on the way, appropriate first aid should be given.
7. Speed of operation: The victim should be transported as quickly as possible, at the same time any rash and hasty action should be avoided, which otherwise might cause discomfort to him.
8. Discipline: Strict observance of Caption’s orders is very important for efficiency and speed in operation.
9. Reporting to the Doctor: The stretcher party should proceed straight to the first aid room and the Capatin should report to the doctor, giving the relevant information about the victim. In case, the doctor or medical attendant is absent, the team should await their arrival a the firs aid room, and should leave only after the doctor has taken over charge of the patient.
CARRYING THE STRETCHER UNDR DIFFERENT MINE CONDITIONS.
While transporting an accident victim on a stretcher, through the mine road ways, the Captain may be required to adopt different methods under different conditions. Some suggestions are given below:
1. When the victim has to be moved before rendering first aid
Such a situation might arise due to impending roof fall or influx of noxious gases,
Bandage he feet and ankles together with figure of 8 bandages. Tie the knees together and arms to the body with broad bandages. Clear the path pull victim in line of his body ; handle gently ; do not move victim sideways. Avoid jerks.
Pull victim on to a blanket first; lift blanket and place victim on stretcher.
Remove patent to a safe and give first aid.
2. When there is accumulation of blackdamp in the gallery
Check for blackdamp with a flame safety lamp ; arrange for ventilation ; keep the stretcher above the level of blackdamp.
3. When there is accumulation of firedamp in the gallery
Check for gas ; arrange ventilation ; keep the stretcher below the level of firedamp.
4. When going up an inclined roadway;
Patient should be carried feet foremost, but head foremost if he has sustained injuries in head or trunk. The rear-bearers should raise the stretcher, so that the head and feet of victim are in the same level. If the roadway is steeply inclined, the victim should first be tired to the stretcher ; then with ropes attached to both ends of stretcher, it should be pulled up, the rope being slackened from below at the same time.
5. When going down an inclined feet foremost; but head foremost if he as sustained injuries in his lower limbs.
The front bearers should raise the stretcher, so that the head and feet victim are in the same level.
If the gallery is steeply inclined, the victim should be tied to the stretcher and then lowered down the slope with the help of ropes as mentioned before.
6. When crossing a broken stopping
If eh stopping is strong enough to take up the weight of the loaded stretcher, the stretcher can be placed on it, and the team can cross over. Otherwise the stretcher has to be passed over the stopping without being placed on it
7. When passing a narrow gallery
The stretcher has to be carried only two of the four bearers, one in front, the other in rear. Patient should be carried feet forward, otherwise the cap-lamp battery, tied to the waist of the front bearer, might strike against the head of the victim and cause him discomfort.
8. When the stretcher has to be loaded in the cage
See that the length of stretcher is such that it can easily be placed on the floor of the cage. Stretchers with telescopic or collapsible handles are best.
9. When victim has to be transported in vertical position
Such a situation arises, while going up or down staple shaft or ladder-way.
Victim is tied to the stretcher with broad bandages; and lowered or raised with the help of ropes tied to the stretcher.
For this purpose, stretchers made of aluminum sheet are used in Kolar Gold Mines and have been found very convenient. The particulars of this type of stretcher are given below:
Made of thick aluminum sheet, 6’-9” long, 1’-2”
Wide: with telescopic handles and a foot-rest:
Special notches provided on sides of stretcher, for securing the victim by straps.
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