In an emergency of this type remember that you should try to do your best for the largest number. Do not be rushed into
careless attitudes or negligence because of the urgency of the situation. Give the best first aid that you possibly can under
the circumstances. Always remember that bleeding, shock and fractures require early attention. The possibility of infection
also is important. These require attention in the order in which we have listed them. Any informed person can give faithful
attention to these problems. If you have cases which are very difficult and that you do not know how to handle, you should
always try to obtain help and advice from better trained and more experienced persons. Sometimes you may be able to obtain advice from a physician at a first-aid station or have him see a seriously injured casualty.
       The injuries that result from atomic explosions are in most cases very similar to those which result fr om ordinary high
explosive bombs. They may be classified as follows : 1. Injuries due to the force of the explosion. These would be indirect blast
injuries-the force of the wave will topple buildings, shatter glass, etc., causing injuties. There will be direct blast injuries
due to the pressute changes. These are extremely rare among survivors. 2. Bum injuries. These would be flash burns-caused by radiant heat waves coming from the bomb and other heat burns-caused by flame or contact with hot objects. 3.
Radiation sickness. The general instructions as given under the section of first aid would apply in cases of radiation
burns and the effects of blast and explosion.        Wounds caused by Explosions and extensive  bruises which are inflicted  by great force or compression we be sustained by many. Cuts from flying glass will usually be only surface injuries but they may also be deep.Such wounds may effect any
part of the body and may cause severe bleeding as well as shock. There are also deep puncture wounds, and foreign bodies -such as pieces of glass or mortar or sticks-may be imbedded in the flesh.often there we be many wounds on the body.Very frequently at explosion accident so the casualties have numerous tiny glass particles imbedded in or just under the skin.Frequently these particles are so small that the clothing gives little protection. Flying objects may break bones as well as cause such cuts as we have just mentioned. The size of the wound also may
be deceptive. A small wound might extend through the abdominal wall, or a penetrating object may enter the chest cavity and cause very serious injury.
 There may be little direct evidence of internal injury involving the abdominal organs or urinary tract or the chest.
but such damage can be suspected from external evidence, such as penetrating wounds, bruises, and crushing ; as well as from the story of what happened to the victim. Also you should always suspect internal injury if the patient complains of
internal pain and shows signs of prostration, even though there
may be no superficial wounds that you can discover. The nature and seriousness of such injury can be determined only by medical examination.
      Blast injury is caused by exposure to greatly increased air pressure. The symptoms of blast injury will vary with the
degree of severity of the injury. The injured person may have pain in the chest. He may be nauseated. There may be vomiting. He may have abdominal pain and shortness of breath. Sometimes a little blood is coughed up. Sometimes the person is unconscious. Serious shock may develop. Ear-drums may be ruptured or damaged. Perforation of the ear-drum causes pain and some interference with hearing. Such a perforation usually heals soon, though the deafness may last for several days and in
some cases may even be permanent.
     Another type of injury that is frequently found resulting from blast is caused by crushing. This would include fractures and multiple internal injuries. Persons who have been pinned down by debris with heavy weight resting On an extremity may
have damaged muscles. When the pressure has been exerted for  several hours, harmful substances from the muscles injure the kidneys, although the victim may seem in fair condition immediately after being extricated from the position in which he
had been pinned. In such a case heat should not be applied to the injured part.
      Asphyxia and other breathing difficulties may result from a variety of causes in an area which has been subjected to high explosive bombs or a violent explosion of any sort. Drowning is
possible, of course, under a number of circumstances. Electrocution may occur, and if one is doing rescue work around damaged buildings, he should be very careful if power lines still carry
current. Harmful chemicals may present a problem in some industrial areas. Gas poisoning caused by broken gas mains or
containets is not so likely, but the possibility must be considered, especially where air traps, such as in an isolated basement area,
may exist. However, the most frequent causes of asphyxia following explosion are compression of the chest by weights such
as beams or debris which prevents breathing movement, and wounds which interfere with breathing. Death occurs quickly when chest movements are completely stopped. Therefore rescue
of compression cases must be made in
a matter of minutes, and only those who are already near the victim can accomplish the
task in time. Wounds on the face, neck and chest may cause breathing difticulties and sometimes even asphyxia. Respiration
difficulties may become greater as time goes on if obstructive swelling occurs, for example, in the region of the throat.
      Injury to the eye should receive high priority. Attention should be given first to the eyeball itself, and injuries to the
surrounding tissue may be cared for later. If the victim complains of marked dimness of vision in one eye or states that the
field of vision in one eye is restricted, he should have urgent treatment. In the case of eyeball injury, transport the casualty
lying flat on his back, cover both eyes with a loose cloth and be sure that he is seen by a physician soon.
         Much is made in propaganda of the dangers of radiation sickness. Although radiation sickness does occur in some atomic bomb casualties, it rarely constitutes a special problem for the person who is doing first aid work or who is a layman doing what he can in an emergency.
     Radiation sickness will not occur when the explosion has been caused by an ordinary high explosive or even by an
incendiary type of bomb, nor will it be likely to occur from ordinary industrial blasts.
       According to the most thorough investigation that was conducted, it is believed that no very important radiation injury occurred among those who were a mile or more from the explosion of the Hiroshima bomb, although they may have been completely unshielded. There were a few instances in which some blood changes were reported later in those at this distance from the point of explosion .
       Neither the victim nor the one treating him can know what the degree of exposure was, whether any damage will show up
later, nor what its extent will be, because radiation as received is not perceptible. It is true that gamma waves are very penetrating, though dense material between the subject and the bomb offers some protection. Ordinary clothing gives no protection against gamma rays.
       It seems that in Japan there were many recoveries among those who had nausea and vomiting the first day, even though
there was inadequate care and lack of simple directions. Radiation in large doses causes nausea and vomiting, and also causes fear and anxiety ; but fear and anxiety also may produce nausea.
[next] Lack of appetite, tiredness, diarrhoea, thirst and fever may appear as a result of radiation injury within a few days or weeks and is not necessarily preceded by nausea or vomiting. Loss of hair occurs among some at a later period, perhaps a week or
several weeks later, but the hair will grow in again.
       At the time of the bombing ot the explosion there is little that the average person can do about radiation injury. That is something that will have to be taken care of later and should be handled by properly qualified medical personnel. But it is well to remember that those who have been exposed to radiation should be careful not to expose themselves to undue fatigue and chilling.
They should get sufficient sleep, food and water. They should wear adequate clothing and protect insignificant wounds against
contamination. They should seek medical attention for any pallor, undue fatigue, or any wound infection that may be
present or develop later. But remember : radiation illness will not be the major cause of disability in an atomic attack.
       The only information on the actual eftects of atomic explosions on human beings comes from the results of those in
Hiroshima and Nagasaki. Compared to the hydrogen bomb, those were not very large. Should atomic warfare break out today with bombs of 50 or more megatons, the eftects would be correspondingly greater. But the principles learned from the
experience with lesser bombs would hold for the larger ones too .




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