be given therapeutically and the amounts that produce death.
6. Morphine causes considerable mental confusion and interferes with the proper exercise of judgment and therefore should not be given to ambulatory patients.
7. Morphine is a dangerously habituating drug. It should not be given trivially and must be rigidly accounted for. Under no circumstances should the corpsman administer morphine except in an emergency.
Morphine administration to patients in shock or with extensive burns should be rigidly controlled. Morphine administration by subcutaneous or intramuscular routes may not be absorbed into the bloodstream because of the reduced peripheral circulation, and pain may persist. When this happens, the uninformed often give additional doses, hoping to bring about relief. Then when resuscitation occurs and the peripheral circulation improves, the stored quantities of morphine are released into the system, and an extremely serious condition (morphine poisoning) ensues. When other pain-relieving drugs are not available, and the patient in shock or with burns is in severe pain, 16 mg of morphine may be given intramuscularly (followed by massage of the injection site), but the temptation to give more must be resisted. Doses should not be repeated more than twice and then at least 4 hours apart, unless otherwise ordered by a medical officer.
If the pain from the wound is agonizingly severe, morphine may be given if examination of the patient reveals no:
1. Head injury.
2. Chest injury, including sucking and nonsucking wounds.
3. Wounds of the throat, nasal passages, oral cavity, or jaws wherein blood might obstruct the airway.
4. Massive hemorrhage.
5. Respiratory impairment, including chemical burns of the respiratory tract. Any casualty having fewer than 16 respirations per minute should not be given morphine.
6. Evidence of severe or deepening shock.
7. Loss of consciousness.
Overdose is an ever-present danger. For this reason, every casualty who has received morphine should be plainly identified. Write the letter M and the hour of injection on the patients forehead, e.g., M0830. A skin pencil, colored antiseptic, or ink maybe used for this purpose. The empty morphine syrette or tubex should be attached to the shirt collar or other conspicuous area of the clothing by a safety pin or other means to alert others that the drug has been administered.
Many kinds of accidents cause injuries to bones, joints, or muscles. In giving first aid to an injured person, you must always look for signs of fractures (broken bones), dislocations, sprains, strains, and contusions.
An essential part of the first aid treatment for fractures consists of immobilizing the injured part with splints so that the sharp ends of broken bones will not move around and cause further damage to nerves, blood vessels, or vital organs. Splints are also used to immobilize severely injured joints or muscles and to prevent the enlargement of extensive wounds. You must have a general understanding of the use of splints before going on to learn the detailed first aid treatment for injuries to bones, joints, and muscles.
In an emergency, almost any firm object or material will serve as a splint. Thus, umbrellas, canes, rifles, tent pegs, sticks, oars, wire mesh, boards, corrugated cardboard, and folded newspapers can be used as splints. A fractured leg may sometimes be splinted by fastening it securely to the uninjured leg. Whenever available, use manufactured spirits such as the pneumatic splints or the traction splints.
Splints, whether manufactured or improvised, must fulfill certain requirements. They should be lightweight, strong, fairly rigid, and long enough to reach past the joints above and below the fracture. They should be wide enough so that the bandages used to hold them in place will not pinch the injured part. Splints must be well padded on the sides touching the body; if they are not properly padded, they will not fit well and will not adequately immobilize the injured part. If you have to improvise the padding for a splint, you may use clothing, bandages, cotton, blankets, or any other soft material. If the victim is wearing heavy clothes, you may be able to apply the splint on the outside, allowing the clothing to serve as at least part of the required padding. Fasten splints in place with bandages, strips of adhesive