American Red Cross Text-Book on Home Hygiene and Care of the Sick by Isabel McIsaac (best large ereader TXT) 📖
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SPECIAL POINTS IN THE CARE OF CHILDREN, CONVALESCENTS, CHRONICS, AND THE AGED
In many cases of sickness institutional care has marked advantages. It may be the only solution when adequate provision for the sick is impossible at home; and it is often a necessity when a patient requires special equipment or apparatus, expert nursing, and medical attention within reach both day and night.
On the other hand, it would not be desirable even if it were possible for all sick persons to be cared for in institutions. Care at home when it is adequate may be more successful than equally skillful care given elsewhere, since the sick quite as much as the well are injured by long separation from normal family life. Most children, because they need the attention of their own mothers, most convalescent and chronic patients, and most aged persons are cared for at home; and in the great majority of cases no better place for them could be found. Since patients of these four groups have needs peculiar to themselves, some special points in caring for them are considered in this chapter.
CHILDRENAbility to observe quickly and accurately is seldom more needed than it is by a woman who cares for children. No one expects babies to explain their troubles, but people forget that small children are unable to describe their physical sensations with any degree of accuracy, although discomfort or sickness may show itself in all degrees of ill temper and bad conduct. For these exhibitions many a suffering child has been punished, where an older and more articulate person would have received considerate attention.
Children, like babies, have a low resistance to disease. Moreover, they react quickly both to favorable and to unfavorable surroundings. Hence slight causes sometimes produce pronounced or even violent symptoms in children without giving cause for great anxiety, although the same symptoms if exhibited by adults, might indicate critical illness. On the other hand the recuperative power of children is high, and their recoveries are sometimes surprisingly rapid. It is a mistake, when a child has completely recovered from an acute but brief illness, to coddle him for weeks afterward merely because a grown person in similar circumstances would have failed to regain his strength.
When a child is sick in bed, especial efforts should be made to insure adequate ventilation without chilling him. Children always lose heat rapidly because the body surface is proportionately large; when they are ill, therefore, it is especially necessary to keep them well covered, to see that their hands and feet are warm, and to avoid chilling them during their baths. But overheating must also be avoided, since all children, sick or well, who are too warmly dressed or who stay in rooms that are too warm, become weak and irritable and more susceptible than others to colds and other respiratory disorders. The child's skin should be kept clean and dry, but he should not be disturbed nor handled unnecessarily.
Sick children require very simple food at short intervals. Variety is not so necessary for a child as for an adult, unless the child has been allowed to form bad habits of eating. Sick children should not be indulged unnecessarily, either in regard to their food or in other ways. However, attempts made during an illness to change the habits of a badly trained child are unwise because usually unsuccessful; parents who sow the wind by neglecting to train their children when they are in good health may as well make up their minds to reap a veritable whirlwind when the children are ill. Even when children are well trained it is difficult and sometimes impossible to prevent them from forming bad habits during sickness. Yet the labor of training a child reaps perhaps at no other time a richer reward than it does when the child is ill, and his recovery might be seriously impeded by unwillingness to accept necessary food, medicine, or treatment.
are faults in the structure of the body; adenoid growths, imperfect eyes, abnormally curved spines, and defective teeth are examples. Most physical defects can be cured in childhood by treatment or by slight operations. If untreated they frequently lead to sickness or to serious impairment of the body, and if neglected until adult life their injurious consequences are generally beyond remedy, even when the defects themselves can be repaired.
Some indications of common physical defects are given below; they ought to be more generally known than they are. If a child exhibits one or more of the symptoms mentioned, he ought to be given a complete physical examination by a competent physician, and treatment, if needed, should begin without delay. The idea that children will outgrow these defects without treatment is erroneous. Better, however, than waiting until symptoms appear is the modern way of giving every child a physical examination at stated intervals, a practice already common in public schools where effective health work is carried on.
frequently comes from imperfections in the shape of the eye; these imperfections can almost always be corrected by glasses. When a child is suffering from eyestrain, the eyes themselves may show indications of trouble; they may be blood-shot, the lids may itch or be crusted or inflamed, or styes may appear. In other cases the symptoms of eyestrain have no apparent connection with the eyes; such symptoms are headache, nausea, vomiting, indigestion, fatigue, irritability, poor scholarship, and nervous exhaustion. If a child shows any of these symptoms, or if he rubs his eyes, frowns, squints, wrinkles his forehead, sits bent over his book, or develops round shoulders, there is sufficient reason for having his eyes examined by an oculist. Examination by an optician should not be considered sufficient.
—The tonsils are masses of spongy tissue situated at the back of the mouth, on either side of the opening into the throat. If enlarged they may seriously interfere with breathing, and if diseased they frequently harbor the germs causing many acute infections, as well as germs of rheumatism and most of the heart disease originating in early life. Therefore the tonsils ought to be removed if they are diseased or greatly enlarged, but there is ordinarily no good reason for removing normal tonsils.
Adenoids are situated at the back of the nose, and like the tonsils are composed of spongy tissue. Adenoids sometimes become so enlarged that they interfere with the passage of air through the nose, thus predisposing to catarrh, colds, and other respiratory diseases, to high palate with irregular teeth, to inflammation of the middle ear leading to deafness, to diminished mental activity, and to general poor health.
If a child breathes through his mouth, if he snores at night, keeps his mouth open and has a dull, apathetic expression, his nose and throat should be examined, and if advisable his tonsils and adenoids should be removed.
—Permanent deafness among children in the great majority of cases comes from trouble in the throat or nose; hence the most effective measure to prevent deafness is to make sure that every child's nose, throat, and mouth are in a normal condition. Sensitive or timid children try to hide infirmities of any kind, but deaf children seem peculiarly unable to explain their difficulties. "No one," says Cornell, "has ever recorded that a small child complained of inability to hear." A child's ears should be examined if he breathes through his mouth, if he stoops habitually, if he is persistently inattentive, or if he is vague or stupid in carrying out directions. A child who appears normal at times and inattentive or stupid at other times should also be examined, since he may be deaf in one ear.
Temporary deafness may come from accumulated wax in the ear. The wax should be removed by a doctor; inexpert attempts are likely to cause serious injury to the ear drum. Intermittent deafness may be caused by enlarged tonsils and adenoids. Children thus affected are not infrequently punished for seeming disobedience. Such children are especially liable to street accidents.
have been considered on page 44.
—In childhood the bones are soft and yield with comparative ease to continued strains; hence they often become deformed by bad positions assumed in sitting, standing, or in using the body in other ways. The postures habitually assumed by a child should be noticed and good postures should be insisted upon. But it is not enough to admonish him. The various causes tending to encourage bad positions should be corrected; among them are insufficient illumination of books and work, defective eyesight or hearing, obstructions in breathing, muscular weakness, and low general vitality. Children should have their chairs and tables suited to their size for their work both at home and in school.
(From Cornell, "Health and Medical Inspection of School Children." F. A. Davis Co., Philadelphia.)
Fig. 29.—Incorrect Sitting Postures.
(From Cornell, "Health and Medical Inspection of School Children." F. A. Davis Co., Philadelphia.)
Fig. 30.—Incorrect Sitting Postures.
(From Cornell, "Health and Medical Inspection of School Children." F. A. Davis Co., Philadelphia.)
Fig. 31.—Incorrect and Correct Standing Postures.
(From Cornell, "Health and Medical Inspection of School Children," F. A. Davis Co., Philadelphia.)
The adjustable chairs and desks now used in schools are a marked improvement upon the school furniture which has caused so many deformities in the past.
One of the serious deformities caused by habitual faulty posture is curvature of the spine. A curvature not only injures a child's appearance and thus handicaps him in later life, but it brings strains and pressure upon the organs of the chest and abdomen which may seriously impair his health. As curvatures often pass unnoticed in their early stages, every child should be inspected occasionally when all his clothing has been removed, to see whether the weight is borne evenly on both feet, whether the development of the two sides is uniform, and whether the head and shoulders are properly carried. It should be noticed when the child stands, whether one shoulder is higher than the other, whether one shoulder blade projects more than the other, whether one hip is higher than the other, and whether one hand is lower than the other when the arms are hanging at the sides. The child should walk both toward and away from the observer, who should notice whether the child uses the two sides of his body in the same way, and whether he drags or shuffles his feet or has other abnormalities of gait.
If abnormalities are found, a physician should be consulted. Often corrective exercises
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