Cdt Hand Book Common Subject SD 06 May 13 PDF

214 INDEX HEALTH & HYGIENE Ser Lesson Subject Cat Page No No Code Structure & Functioning Of The Human 1. H1...

214 INDEX HEALTH & HYGIENE Ser Lesson Subject Cat Page No No Code Structure & Functioning Of The Human 1. H1 SD/SW 215 Body Hygiene & Sanitation (Personal & Food 2. H2 SD/SW 218 Hygiene) 3. H3 Physical & Mental Health SD/SW 225 Infectious & Contagious Diseases & Its 4. H4 SD/SW 228 Prevention First Aid In Common Medical 5. H5 SD/SW 233 Emergencies 6. H5 Basics Of Home Nursing (III Term) SD/SW 241 7. H6 Treatment and Care of Wounds SD/SW 247 Treatment and Care of Fractures 8. H6 SD/SW 250 (III Term) 9. H7 Introduction To Yoga Exercises SD/SW 255  215 LESSON PLAN : H 1 STRUCTURE AND FUNCTION OF THE HUMAN BODY Period - One Type - Lec Code - H1 Term - I (SD/SW) ______________________________________________________________________________ Training Aids 1. Computer Slides, Pointer, Charts, Black Board and Chalk. Time Plan 2. (a) Introduction - 05 Min (b) Skeletal and Muscular System - 10 Min (c) Organ Systems - 20 Min (d) Conclusion - 05 Min INTRODUCTION 3. The human body is the greatest of all complex machineries. In order to carryout first aid, a first aider should have basic idea of structure and function of every part of the human body. Many lives can be saved if proper and timely first aid can be rendered. AIM 4. To teach the NCC cadets about the Structure and Functioning of the Human Body. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Skeletal and Muscular System. (b) Part II - Organ Systems. PART I : SKELETAL AND MUSCULAR SYSTEM Skeletal System 6. Structures of Bones. The human body has 206 bones of various shapes and sizes. The bones give shape and firmness to the body, as also it protects the vital organs like brain, heart, lungs spinal cord. Bones can either be ‗loosely arranged‘ or ‗densely arranged‘. The loosely arranged bone is called ‗spongy bone‘ and densely arranged bone is called ‗compact bone‘. Some bones are hollow from inside and filled with bone marrow. 7. Classification of Bones. Bones can be classified according to their shape as under:- (a) Long Bones. These bones are long and tubular and are confirmed to upper / lower limbs. (b) Short Bones. This bones are short and tubular and are found in the ankle / wrists.  216 (c) Flat Bones. These bones are flat like plates, e.g. bones of cranium (Skull), shoulder or hips. (d) Irregular Bones. Irregular or mixed shape, eg. vertebral column. (e) Sesamoid Bones. They develop in the tendons of the muscles around the joint. eg. patella. Muscular System 8. The muscle forms about half of the total weight of the body and are responsible for body movement. The muscles form the ‗flesh‘ of the body are under the control of nervous system. 9. Classification. The muscles of the body are classified into the following types:- (a) Voluntary/Skeletal Muscles. Voluntary muscles or skeletal muscles are attached to the surface of bones. These muscles form about 47% of the body weight and are either fiber type or striated type. Most of the skeletal muscles pan from one bone to another across a joint and by contracting, they act upon the joints and produce movements. (b) Involuntary Muscles. These are called involuntary muscles, because they are controlled by the autonomic nervous system. (c) Cardiac Muscles. Though cardiac muscles are striated structurally, they form the main part of heart wall. PART II : ORGAN SYSTEMS 10. Circulatory System. The circulatory system consists of the Heart, Blood Vessels and Blood. Each time the heart contracts, blood is pumped along the blood vessels. It is therefore kept in a state of continuous motion. By blood circulation, oxygen, nutrients and other substances are brought to the tissues and the waste products and carbon dioxide formed by the tissue are constantly removed. (a) Heart. The Heart is the most important organ of blood circulation. It is situated in thorax between the lungs and on to the left side of the body. The size of heart in equal to a cloned fist and the average wt of heart in a male is about 300 gms, and in a female about 250 gm. It is divided into two compartments, the right and the left. The right side contains impure blood while left side contains pure blood. Each side is again divided into AURICLEs and VENTRICLEs. Auricles are the receiving chambers. (b) Blood. The blood is also known as the ‗transport system‘ of the body, and plays an important role in maintenance of life. The total volume of blood contains – hemoglobin, RBC, WBC & platelets. (c) Blood Vessels. Blood vessels are tube like structures which carry blood all over the body for circulation. These are of three types:- (i) Arteries. These are the blood vessels which carry pure blood from the heart to all parts of the body. (ii) Capillaries. These are tiny blood vessels which connect the small arteries & veins. The exchange of oxygen and nutrition with carbon di oxide by the tissue takes place in the capillaries. (iii) Veins. These blood vessels carry impure blood to the heart. The main veins are called ‗superior‘ and ‗inferior‘ vena cava. 11. Respiratory System. Respiration or breathing is a process by which, oxygen, obtained from fresh air, is absorbed in to the blood stream and carbon dioxide, formed by the tissue action,  217 is removed from the blood and expelled into the air, that is then expired. It is a process essential to life. It involves the taking in of oxygen and giving out of carbon dioxide. The main organs of respiratory system are Nose, Pharynx, Larynx, Trachea, Bronchi, and the Lungs. 12. Digestive System. Digestion is a mechanical and chemical process by which, complex food substances are converted into simple substances so that they can be easily absorbed by blood and utilized by the various tissues of the body according to their requirements. The main organs of digestive system are mouth, salivary glands, pharynx, esophagus, stomach, pancreas, liver, small intestine and the large intestine 13. Excretory System. Excretion is a process by which waste products are removed out of the body. Among the organs that contribute towards the elimination of waste products are the skin, lungs, kidneys and the gastro-intestinal tract. (a) Skin. The skin covers the external surface of the body. Waste matter in the form of sweat is removed through perspiration by the skin. (b) Urinary System. The main organs of the urinary system are:- (i) Kidneys. There are two bean shaped organs situated on the posterior abdominal wall in the lumbar region. They act as filters in the body, to filter the waste. (ii) Ureters. Ureters are two tubes, which carry the urine from kidney to Urinary bladder. (iii) Urinary Bladders. It is a hallow muscular organ situated in the pelvic cavity. It is a freely movable organ. Its size and shape varies according to the amount of urine it contains. It stores the urine. (iv) Urethra. It is a tube leading from the floor of the urinary bladder to the exterior. It is used for excretion of the urine from the body. 14. Nervous System. Internal Balance of the human body is maintained within normal limits by the nervous system and the endocrine system. The nervous system may be sub divided into three main portions:- (a) The Central Nervous System. This consists of brain and spinal cord. (b) The Peripheral Nervous System. This forms the connections between the central nervous system and the various organs and muscles. (c) The Autonomic Nervous System. It is an offshoot of the central nervous system and controls the involuntary functions of the various internal organs such as the stomach, intestine bladder and also the tiny muscles of the blood vessels and also controls the secretions of the Liver and Kidneys. A person is neither conscious for the normal activities of the autonomic system nor is he able to control them. CONCLUSION 15. Basic knowledge of our body systems allows us to understand the field of health and hygiene with ease. This knowledge provides us the basic framework on which subsequent knowledge and skills dealing with medical science can be gained in a progressive manner.  218 LESSON PLAN : H 2 HYGIENE AND SANITATION Periods - Two Type - Lec Code - H2 Year - I / III (SD/SW) ______________________________________________________________________________ Training Aids 1. Computer Slides, Pointer, Charts, Black Board and Chalk. Time Plan 2. (a) Introduction - 03 Min (b) Hygiene - 40 Min (c) Sanitation - 35 Min (d) Conclusion - 02 Min INTRODUCTION 3. Hygiene and Sanitation are fields of medical science which aim to preserve and improve the health of the Individual and of the community as a whole. Its study is aimed at making the cadets aware of the many preventable health hazards and to enable them to look after themselves and their community most efficiently. It seeks to develop in them the concepts of healthy living. This field has nothing to do with religion or social customs but it is simply based on scientific requirements. Personal hygiene involves all aspects of the health of an individual. Responsibility for the maintenance of personal health therefore lies with the individual. Every person must remain in perfect physical, mental and social health, only then can he serve the community and the country well. AIM 4. To teach the NCC cadets about Hygiene and Sanitation. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Hygiene. (b) Part II - Sanitation. PART I : HYGIENE Personal Hygiene 6. Maintenance of personal hygiene is very important in preventing disease. It deals with the practices that help in the maintenance and promotion of a person‘s health. Personal Hygiene helps in the following:- (a) To maintain a good and clean physique.  219 (b) To maintain good muscle strength. (c) To maintain clean mouth and teeth. (d) To maintain resistance to prevent information. 7. Main Components. The main components of personal hygiene are:- (a) Sleep. Sleep means the periodical rest of both body and mind and it is extremely essential for a healthy body. The amount of sleep one requires varies with individual age. The average requirement of sleep is about 7 to 8 hours a day. (b) Bathing. Keeping the skin clean and in healthy condition is essential for good health. A bath with a mild soap with warm water in winters and cool water in summers are essential for body cleaning. While bathing, all parts of the body including folds in the skin must be cleaned well. After the bath, the body must be dried properly including the folds in the skin as wetness or dampness will lead to cuts /fungal infection. (c) Eating and Drinking. Properly cooked food with its full nutrient value is beneficial for health. Eat slowly and chew well. Do not swallow hastily. Drink plenty of water between meals and avoid strenuous exercise after a heavy meal. (d) Care and Cleanliness of Skin, Hair and Teeth. Our skin keeps on secreting sweat and hence it is necessary to keep it clean through bathing and by removing dust and dirt.. Regular changing and cleaning of clothing is essential to keep the body fit. Digestive and other disorders take place when decayed teeth and unhealthy gums bleed giving foul smell in the mouth. Teeth should be regularly brushed after the last meal at night and early in the morning. In – sufficient vitamins C & D are the cause of dental decay. (e) Exercise. Organized games and physical exercise are necessary for proper development of the body and mind. 8. Water Supply and Its Purification. (a) Sources of Water Supply. The main sources of water supply are:- (i) Rain Water. Most of the fresh water on earth comes from rains. However, most of this water is not fit for consumption due to impurities of the atmosphere. (ii) Surface Water. Surface water is found mainly in rivers and streams or lakes. This water is unfit for human consumption without treatment due to discharge of various types of wastes into it. (iii) Underground Streams. Bore Wells are a good source of potable water supply. However, even these need to be protected from contamination. (b) Purification of Water. Safe drinking water comes only from an authorized source. Purification provides good and safe water by eliminating the suspended matter, harmful salts in solution, bad taste/smell, undesirable colors and germs. The following methods are used for water purification:- (i) Boiling and Filtering Water. Untreated or treated potable water from any unreliable source must be boiled at 100 degrees for 30 min, cooled and then filtered. Only then will it be fit for consumption. (ii) Clarification. This is the removal of suspended matter through filtration, by passing it though filter beds of gravel and sand or through properly sterilized filters. (iii) Sterilization. This is done by using chlorine gas or bleaching powder. (iv) Pinking. During cholera epidemic potassium permanganate should be used for pinking of wells.  220 (v) Precipitation. This is done by adding alum or some similar chemical to water, which makes all impurities accumulate at the bottom and leaves pure water. This water is then passed through a filter. Food Hygiene 9. Food is a potential source of infection and is liable to contamination by microorganisms at any point during its journey from the producer to the consumer. Prevention of contamination of food has to be observed from production to handling, distribution and serving. The following are the important components of food hygiene:- (a) Milk Hygiene. Milk is an efficient vehicle for many disease organisms. Contamination of milk may be due to infected animal, human handler or environmental factors. Following aspects should be ensured to obtain clean and safe milk:- (i) The animal and its surroundings should be healthy and clean. The animal should be properly washed before mulching. (ii) Milk handler should be free from any communicable disease. (iii) Milk vessels should be totally clean, sanitized and kept covered. (iv) Water supply must be safe. (v) Pasteurization. It is the heating of milk to such temperature and for such periods of time, as are required to destroy any pathogens without destruction of nutritive value. It does not alter taste. (Temperature 130 C and time 1 to 2 seconds). (b). Meat Hygiene. The word meat includes various tissues of animal origin. The diseases which may be transmitted through meat are ‗Tapeworm Infestation‘ and ‗Bacterial Infections‖ like anthrax, tuberculosis or food poisoning. The animal intended for slaughter, must be subjected to proper ante mortem and post mortem inspection. Good meat should neither be pale pink nor deep purple nor should it be should not be slimy. Good meat should be elastic to touch and should have agreeable color. (c) Fish Hygiene. Fish for human consumption should be fresh. In fresh fish, the gills are bright red and the eyes are clear and prominent. Consumption of contaminated fish may give rise to fish poisoning. (d) Egg Hygiene. Though the majority of freshly laid eggs are sterile inside, the eggshell may become contaminated by fecal matter from the hen. The egg must be properly washed before cooking. (e) Fruits and Vegetables Hygiene. Fruits and vegetables are an important source for the spread of pathogenic organisms, protozoan and helminthes. Fruits and vegetables consumed raw must be washed well before eating. (f) Hygiene of Eating Places. (i) Eating places should not be located near filthy places, open drains, animal sheds, manure /soakage pits and other such places. (ii) Floors should be easy to clean, and should be preferably tiled. (iii) Rooms for storage of food should be well ventilated, insect and rat proof and should have adequate lighting. (iv) Perishable and non perishable items should be kept separately. (v) Furniture should be strong and easy to clean.  221 (vi) Refuse should be collected in covered bins and removed regularly. (vii) Water supply should be independent, adequate and safe. (viii) Proper place for cleaning of utensils should be provided. (g) Hygiene of Food Handlers. (i) Complete medical examination of food handlers must be done at the time of employment. (ii) Regular health checkups should be done. (iii) Education of food handlers should be regularly educated on health and hygiene aspects. (iv) They should be constantly reminded about hand washing, trimming of nails, covering of hair, wearing of overalls and covering mouth while coughing and sneezing during cooking. PART II : SANITATION 10. Definition. Sanitation means keeping the living area and its surroundings neat and clean. This involves removal of waste products and refuse. Waste Products / Refuse 11. Types. Some types of the waste products are :- (a) Human excreta - faeces & urine. (b) Stable litter - horses & cow dung. (c) Dry refuse & garbage - household, municipality, industrial & agricultural. (d) Liquid wastes: household sullage, municipal & industrial effluent. (e) Offensive trade wastes. (f) Dead animals, carcasses & offal of slaughtered animals. 12. Sources of Refuse. (a) Street Refuse. Refuse that is collected by street cleansing service or scavenging is called street refuse e.g. leaves straw paper etc. (b) Market Refuse. Refuse that is collected from markets is called market refuse. e.g. spoiled vegetable and animals matter. (c) Stable Litter. It contains mainly animal dropping and left over animal feeds. (d) Industrial Refuse. Industrial refuse comprises of a wide variety of waste ranging from (e) Domestic Refuse. The domestic refuse consist of ash, rubbish and garbage. Disposal of Waste Products / Refuse. 13. Collection and Removal of Refuse. (a) House Hold Refuse. Covered galvanized irons bins are placed on brick / cement platforms at convenient distances from the house. These should be used for dumping  222 house hold refuse. This refuse is then collected in covered wheel barrows or municipal vans to prevent blowing out by air. (b) Special Refuse. This is from stables and cowsheds. It is collected in carts and taken to disposal grand at frequent intervals. (c) Street Refuse. Covered dustbins should be placed at suitable intervals along the street and all the sweeping should be dumped in it. It is then collected early morning in covered vans. 14. Disposal of Refuse. Various methods for disposal of refuse are:- (a) Filling. In this method the refuse is generally utilized in filling up pits, unsanitary tanks or in reclaiming low land. The area selected should be at least 100-150 feet away from any habitation. No refuse should be left uncovered for more than 72 hrs. (b) Controlled Tipping. Controlled tipping or sanitary landfill is the most satisfactory method of refuse disposal where suitable land is available. Chemical, bacteriological and physical charges occur in buried refuse. (c) Incineration. Hospital refuse, which is particularly dangerous, is best disposed off by incineration. (d) Composting. It is a method of combined disposal of refuse and night soil or sludge. (e) Manure Pits. The garbage, cattle dung, straw and leaves should be dumped into the manure pits and covered with earth, after each days dumping. (f) Burial. This method is suitable for small camps. A trench 1-5m wide and 2m deep is excavated. When the level in the trench is 40 cm from ground level, the trench is filled with earth and comported. (g) Sorting. This method consists of storing refuses in three separate parts for easy disposal:- (i) Breeze. Cinders and pieces of coal are used for making bricks. (ii) Soft Core. Animal and vegetable organic matter, which is used as manure. (iii) Hard Core. Broken bottles and crockery is used for metaling of roads. 15. Disposal of Human Waste. Proper disposal of human night soil / excreta are very essential for prevention of various communicable diseases and also to prevent pollution / contamination of soil, water or food (through flies). Various methods are available for disposal of human waste / excreta as per the type of area ie, area with a proper sewage system (sewered areas) and areas without proper sewage system (unsewered areas). (a) Sewered Areas. The latrines used in such areas are mainly the Flush Latrines. It implies that ample supply of water is available to flush the night soil away. It is simple and hygienic. (b) Unsewered Areas. There are of various types latrines for such areas:- (i) Domestic Latrines. These are those latrines which are used in houses in areas not having a sewage system. These are of following types:- (aa) Bore Hole Latrine. The latrine consists of a circular hole 30-40 cm in diameter dug vertically in the ground to a depth of 4 to 8 mtr. In loose  223 sandy soil the hole is lined with bamboo matting or earthenware lining. (ab) Dug Well Latrine. A circular pit about 75 cm in diameter and 3 to.5 cm deep is dug into the ground for the reception of the night soil. In sandy soil the depth of the pit may be reduced to 1.5 to 2 mtr. (ac) Water Seal Latrine. The water seal performs two important functions e.g. it prevents access to flies and it prevents escape of foul odour. Out of many designs of water seal latrines, the RCA type is widely adopted. (ii) Camp Latrines. These are of following types:- (aa) Deep Trench Latrines. A pit three feet wide, at least eight feet deep and of a length suitable to the requirement is constructed and wooden seats placed over it with proper partitions and curtains. Soil may necessitate reverting of sides with sand bags, bamboos or wire netting. On vacation of camp, these are filled up with soil to assist in disintegration and prevent breeding of flies. (ab) Shallow Trench Latrines.. For camps of less than a week‘s duration, dig a row of trenches in parallel, each trench being 3 feet long, 1 foot wide and 2 feet deep. Each trench should be 2 feet apart. The ratio is 5 trenches for the first hundred users and three for each subsequent hundred. After defecation, the excreta is covered with loose earth with a shovel or a scoop. These trenches are filled up after 24 hours and new trenches are dug up. (ac) Urinals. The most common urinal used for camps is the Funnel Urinals which are constructed over a simple soakage pit. (c) Soakage Pits. These are essential for the disposal of liquid refuse like greasy water from kitchen and waste water from bathrooms. Dig a pit 4 feet by 4 feet and 5 feet to 6 feet deep. Fill with small stones and broken bricks. Cover the top with oiled sacking and put earth or sand 6 inches above. In the centre keep a perforated empty tin of kerosene oil. Fill this tin with layers of gravel or sand and gravel. In this fit remove the strainer daily and replace with fresh one. (d) Disposal of Garbage. Disposal of solid refuse like kitchen garbage, bones etc, be done by burial or burning. The household refuse should be deposited in a covered bin placed outside. Improvised kerosene/oil tins are not advisable. Further disposal should be done under municipal arrangements. 16. Disposal of Sewage. Proper disposal and treatment of sewage has assumed great importance today. The disposal of sewage involves treatment and disposal as under :- (a) Treatment of Sewage. Treatment of sewage is brought about by the action of anaerobic and aerobic bacteria. The different steps involved in this process are:- (i) Screening. (ii) Chambering. (iii) Primary Sedimentation. (iv) Trickling Filter. (v) Activated Sludge Process.  224 (vi) Sludge Digestion. (vii) Disposal of Effluent. (b) Disposal of Sewage. The sewage is collected by the water carriage system and where no treatment facility is available can be disposed off by:- (i) Sea Out Fall. The sewage is drained into the sea. This is applicable mostly for coastal cities / towns. (ii) River Out Fall. The sewage is drained into the river. This is applicable mostly for cities / towns situated along the rivers or connected by drains. (iii) Land Treatment. Here the sewage is allowed to drain out on the earmarked land / pits. This is mostly applicable to small villages. (iv) Oxidation Pond. CONCLUSION 17. Hygiene and Sanitation are two sides of a coin, which must be ensured together for best results. These are simple steps which, if taken regularly and correctly can be beneficial to both individuals and community as investing of time and effort in them can lead to saving of lives.  225 LESSON PLAN : H 3 PHYSICAL AND MENTAL HEALTH Period - One Type - Lec Code - H3 Year - III (SD/SW) Training Aids 1. Computer Slides, Pointer, Charts, Black Board and Chalk. Time Plan 2. (a) Introduction - 03 Min (b) Physical Health - 15 Min (c) Mental Health - 20 Min (d) Conclusion - 02 Min INTRODUCTION 3. Earlier doctors defined health simply as ‗an absence of disease or illness‘. However, after the formation of World Health Organization (WHO) in 1948, health is defined as ‗a complete state of physical, mental and social well being‘ and not merely the absence of disease or infirmity‘. The mind and body are single system. AIM 4. To teach the NCC Cadets about the importance of Physical and Mental Health. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Physical Health. (b) Part II - Mental Health.. PART I : PHYSICAL HEALTH 6. Physical health is the absence of disease and infirmity and it is assessed by taking health state measurements of the body. 7. Elements of Good Health. Good health is an essential condition for a purposeful existence. The main elements good health are:- (a) Absence of disease. (b) Ability to work hard with efficiency and enthusiasm. (c) Ability to endure stress and strain.  226 (d) Cheerfulness. (e) Courage. (f) Freedom from anxiety. (g) Self control and self confidence. (h) Sense of well being. (j) Wholesome mental attitude. PART II : MENTAL HEALTH 8. Importance of Mental Health. Mental health refers to the successful performance of mental functions, resulting in productive activities, fulfilling relationship with other people, ability to adopt to change and cope up with adversities. It is of paramount importance, to lay due emphasis on the development of mental health of children. Any disregard to this may lead to mental disorder and conflicts, which ultimately may bring frustration, misery and unhappiness. Parents and teachers play a major role in providing an environment in which children develop healthy mental attitude. 9. Characteristics of a Healthy Mind. These are:- (a) Normal appetite. (b) Calmness. (c) Cheerful outlook. (d) Good temper. (e) Socially acceptable habits. (f) Well regulated instincts. (g) Normal physical vitality. (h) Receptivity to new ideas. (j) Sex consciousness. 10. Mental Disorders. Following are some of the indicators of mental disorders:- (a) Undue anxiety. (b) Embarrassment in presence of others. (c) Lack of courage. (d) Undeveloped habits and will. (e) Low intelligence. (f) Depressed and pessimistic outlook. (g) Moodiness.  227 (h) Bad temper. (j) Full of prejudice. 11. Measures to Improve Mental Health. Following measures will help in improving mental health:- (a) Favorable and stress free home and school environment. (b) Regular medical examination. (c) Provision of educational and vocational guidance / counseling. (d) Provision of co-curricular activities. CONCLUSION 12. Health is very important aspect for all living beings. Human have a tendency to get into bad life styles due to facilities available to them which results in their poor health.The subject of health must be understood by all of us to remain in good health.  228 LESSON PLAN : H 4 INFECTIOUS & CONTAGIOUS DISEASES AND ITS PREVENTION Period - Two Type - Lec Code - H4 Year - I (SD/SW) Training Aids 1. Computer Slides, Pointer, Charts, Black Board and Chalk. Time Plan 2. (a) Introduction - 03 Min (b) Classification of Diseases - 35 Min (c) Preventive Measures - 40 Min (d) Conclusion - 02 Min INTRODUCTION 3. Many of the deadly diseases can be prevented from spreading to healthy persons if proper precautions are taken by checking infection and contagion of several diseases and by killing carriers of several other diseases. AIM 4. To teach the NCC cadets about the different types of Infectious and Contagious Diseases and their Prevention. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Classification of Diseases. (b) Part II - Preventive Measures. PART I : CLASSIFICATION OF DISEASES 6 Communicable diseases can be classified as follows:- (a) Excremental Diseases. These are those diseases which are communicated or transferred through human excreta (urine and faeces). The excreta can contaminate food, water or hands of cooks and thus pass on the infection. Typhus fever, dysentery, diaorreah, jaundice and intestinal worms are some of the important diseases belonging to this group. (b) Droplet Infection. These are those diseases which are communicated or transferred through germs which are sprayed out from the nose, throat or lungs in the air, in small droplets of saliva during coughing, sneezing or even while talking. These germs are inhaled by a healthy man if he happens to be near the sick. Common cold, influenza,  229 diphtheria, meningitis, (inflammation of the brain) and tuberculosis are the common diseases in this group. (c) Contact Diseases. These are those diseases which are communicated or transferred when the germs pass from a sick person to a healthy person by actual body contact. Venereal diseases i.e. syphilis, gonorrhea and skin infection are some common examples. (d) Insect Borne Diseases. These are those diseases which are communicated or transferred when the germs move from a sick person to a healthy person through Blood sucking insects known as ‗Carriers‘. These insects first bite a sick person and then bite a healthy person, transferring the germs of the diseases in the blood of the healthy person. These germs then multiply in the blood of the healthy person during the period of incubation, and at the end of which he starts showing symptoms of the disease carried by the insect. Some of the carrier insects and their disease are:- (i) Mosquito - Malaria, Dengue and Filaria. (ii) Sand fly - Sand fly fever, Kala Zar, Oriental Sore. (iii) Lice - Typhus, Relapsing Fever. (iv) Flies - Diaorreah, Dysentery, Cholera, Typhoid. (v) Fleas - Plague, Typhus. (vi) Ticks - Relapsing Fever, Typhus. (f) Water Borne Diseases. Certain diseases spread due to infection carried through water. These are cholera, dysentery, diaorreah, jaundice etc. These spread as water gets contaminated through vomits or faeces passing into it. Epidemics are likely to spread if immediate steps are not taken to disinfect water and to properly dispose off the excreta through efficient conservancy arrangements. All sources of the diseases ought to be eliminated. (g) Animal Borne Diseases. The germs are transmitted through the agency of animals by drinking milk or through the agency of insects. Rabies, plague, anthrax and tuberculosis are some of the common diseases. PART II : PREVENTIVE MEASURES 7. Specific measures to prevent diseases are as under:- (a) Prevention of Excremental & Water Born Disease. (i) Control of water route is easy by disinfecting water or providing safe water in place. (ii) Control of the milk route is easy by subjecting the milk to boiling or pasteurization. (iii) Food born infection may be controlled by standards of food hygiene, exclusion of sick persons from food handlings, strict attention to personnel hygiene, promotion of hand washing, protection of foods against flies and rodents and providing facilities for refrigeration. (iv) Safe disposal of excreta will block the transmission of disease by the faecal –oral route. (b) Prevention of Droplet Infection. This can be achieved by :- (i) Use of mask.  230 (ii) Bed spacing. (iii) Screening. (iv) Dust Control. (v) Avoid over-crowding. (vi) Proper ventilation. (vii) Avoid spiting in public places. (viii) Proper sunlight. (ix) Proper disinfection of air. (c) Prevention of Contact Disease. (i) Complete segregation of patient. (ii) No direct personal contact between patient and the staff. (iii) The early diagnosis will help in preventing the spread in the patient. (iv) Proper disposal of all the excreta and disinfection of all articles of the patient. (d) Prevention of Insect Born Disease. (i) Filling, leveling and drainage of breeding places and water management will help in eliminating larvae. Adequate collection, removal and disposal of sewage and waste water are important in preventing culex. (ii) Use kerosene oil, fuel oil, or special oil to prevent larvae. (iii) Use of residual sprays like malathion. (iv) Use of mosquito nets, screening of doors and windows, mosquito repellant and sun down sleeves. (v) Control the presence of rodents and fleas in and around the home. (vi) Avoid contact with any species of wild rodents, especially sick or dead rodents. (vii) Not to handle sick or dead animals or animal waste. 8. The following preventive measures are necessary to ward off these diseases;- (a) Segregation of the Patient. Important points are as under:- (i) Preferably shift patient to an isolated room. (ii) Ensure room confirms to hygiene and sanitation standards ie adequate ventilation, sunlight and cleanliness. (iii) Nominate one healthy person to undertake nursing and care of the patient. (iv) Nominated person to take preventive measures like use of mask, gown, and gloves and avoid direct contact and hand washing before and after every visit. (v) Clothing and utensils used by patient to be cleaned / washed separately.  231 (vi) Safe disposal of patients excreta – Urine, Stool, Sputum, Refuse eg discarded dressings, garbage etc by burning. (b) Destroy Agents (Germs) Causing Infection in the Surrounding Area or Premises. Immediately on detection of a communicable disease, the source of agents / germs causing infection should be destroyed by following actions :- (i) Removal / destruction of garbage. (ii) Cleaning the drains & keep them covered. (iii) Remove/ dry out waste water. (iv) Spray malathion mixed in water (ratio: malathion - 1 ml, water 1000 ml) in and around premises. (Caution - malathion is highly poisonous direct breathing / touch should be avoided). Wash hands after use. (v) Keep premises free of rodents (rats), stray dogs. (vi) Use mosquito nets, long sleeves, screening of doors & windows. (c) Disinfection. All articles in contact with the patient should be disinfected by following means:- (i) Natural. Sunlight and air can be used to disinfect articles like blanket, mattresses, pillows and also the rooms. The microorganisms thrive in darkness and need moisture for their survival, on being exposed to sunlight and air they die. (ii) Physical. Physical agents like heat, cold radiation etc. can also be used for disinfection and sterilization. (aa) Heat. Heat can be used in two ways for sterilizing. (i) Moist Heat. Moist Heat in the form of ‗boiling‘ kills germs very rapidly. In addition, ‗autoclaving or Steam under Pressure‘ is the most effective method used to disinfect all hospital equipment which can be boiled like linen, bandage, dressing material, gloves and instruments. (ii) Dry Heat. Dry heat like flaming or use of hot air oven. Sterilization by steam under pressure (autoclaving) is the commonest method for sterilization which is being used in the army. (ab) Cold. Freezing or freeze-drying can inactivate bacteria. Some of them can however survive even at 0° C. (ac) Radiation. It includes ionizing radiations like X rays, gamma beta and ultraviolet radiation. These are expensive methods and are not suitable for small-scale procedures. (ad) Other Methods. Disinfection and sterilization can also be done by using other methods like of infrared rays, filtration etc. (iii) Chemical Agents. Chemical agents like phenol, savlon, potassium permanganate, Hydrogen peroxide etc are commonly used for disinfection and sterilization. The strength of agent depends upon its used concentration being. (iv) Control of Food & Drink. Salient points to be observed while feeding the patient:- (aa) Clean water preferably boiled must be served to the patient Water container must be kept covered.  232 (ab) Balanced diet, well cooked, hygienically prepared food using less oil and condiments, should be served hot. Stale, cold and food exposed to flies & insects should not be served. (ac) Food items sourced from restaurants / dhabas must not be served. (v) Inoculation and Vaccinations. Important inoculations & vaccinations are provided free of cost under various Government programmers. These are administered at Primary Health Centers/Hospitals. It not available the same should be administered/ taken from market. Important inoculations and vaccination are as under:- Name of Vaccine Disease Prevented Inj Rabipur Rabies Inj TAB Typhoid Inj Hepatitis ‗B‘ Hepatitis ‗B‘ Inj T T Tetanus Oral Polio Polio CONCLUSION 9. Communicable diseases as the name suggests are most easy to prevent if timely measures are taken as recommended above. As these diseases are communicated through some carrier or agent, their spread on occurrence is difficult to control. It is advisable to always follow the prevention measures to save precious human and animal lives national resources and effort.  233 LESSON PLAN : H 5 FIRST AID IN COMMON MEDICAL EMERGENCIES Period - Two Type - Lec/Demo/Prac Code - H5 Year - II (SD/SW) Training Aids 1. Computer Slides, Pointer, Charts, Black Board and Chalk. Time Plan 2. (a) Introduction - 03 Min (b) Injuries to Internal Organs - 07 Min (c) Burns and Scalds I - 05 Min (d) Snake Bite, Scorpion Bite & Rabid Dog Bite - 15 Min (e) Foreign Bodies in Eye, Ear and Nose - 10 Min (f) Asphyxia - 15 Min (g) Insensibility or Unconsciousness - 10 Min (h) Artificial Respiration - 10 Min (i) Conclusion - 05 Min INTRODUCTION 3 There will be number of occasions on which we may be faced with a situation where, we may be required to provide First Aid to the injured, because of an accident or due to any calamity. Therefore it is very important for all cadets to have knowledge of providing basic First Aid in common medical emergencies. In the succeeding paragraphs we will deal with certain medical emergencies and discuss about the methods First Aid to be provided. PREVIEW 4. The class will be conducted in the following parts:- (a) Part I - Injuries to Internal Organs. (b) Part II - Burns and Scalds. (c) Part III - Snake Bite, Scorpion Bite & Rabid Dog Bite. (d) Part IV - Foreign Bodies in Eye, Ear and Nose. (e) Part V - Asphyxia.  234 (f) Part VI - Insensibility or Unconsciousness. (g) Part VII - Artificial Respiration. PART I : INJURIES TO INTERNAL ORGANS 5. These injuries cannot be seen but can only be suspected, where bleeding instead of coming to the surface occurs into the cavity of chest or abdomen wherein, important organs like heart, lungs, liver or spleen might get ruptured. The following symptoms are observed in case of internal injuries:- (a) Cold clammy skin. (b) Weak and rapid pulse. (c) Shallow sighing and breathing. (d) Face pinched and pale. (e) Eyes deeply sunken with dark rings around them. (f) Patient usually restless and anxious and may lose consciousness. 6. First Aid Treatment. (a) Keep the patient warm and lying down with feet raised up and head kept low. (b) Apply cold application on the suspected injured region. (c) Cheer up the patient. (d) Arrange medical attention as soon as possible. PART II : BURNS AND SCALDS 7. Burns may be caused by heat either, dry by contact with fire or flame, or wet, as caused by moist heat such as hot water, hot fluids and steam, which is called scalding. Chemical burns may be caused by strong acids or alkalis.. 8. First aid Treatment. (a) If the burn is chemical, let water from a pipe or hose flow freely on the burn so that the chemical flows off. (b) Protect the burnt area by applying bandage or cover exposed part with clean towel or cloth. (c) Give complete rest and plenty of fluids to the patient. (d) Re-assure the patient. (e) Give him morphia, if required. (f) Evacuate patient to the nearest hospital or dispensary.  235 PART III : SNAKE, SCORPION AND DOG BITE Snake Bite 9. In Snake bite, the poison is injected by the snake through a pair of hollow and deeply grooved biting fangs. The majority of bites occur on parts of limbs which are exposed like hands, feet and lower legs. 10. First Aid Treatment. All cases of snake bite should be treated as being bitten by poisonous snakes. The First Aid treatment will be as follows:- (a) Make the victim lie down comfortably. (b) Give convincing reassurance against fear of death. (c) Apply a light constricting tourniquet with hand kerchief, bandage or shoe lace above the knee for a bite on the leg and above elbow for a bite on the arm. So that the poison does not flows to all parts of the body. (d) Wash with soap and water. Use water freely. (e) Incise into the skin 2‖X ½‖ across the fang mark with a blade. (f) Suck the blood either with mouth or with a suction pump. Be careful that there is no cut out or ulcer in the mouth. (g) Evacuate the patient quickly to the nearest dispensary or hospital. (h) If breathing fails, start artificial respiration. Scorpion Bite 11. Bite by scorpions should be treated like snake bite. 12. First Aid Treatment. If blood has been drawn, the wound should be cleaned well with antiseptic lotion. Rabid Dog Bite 13. Rabies is a very dangerous disease transmitted by a rabid dog. The disease is preventable by giving anti-rabies vaccine. 14. First Aid Treatment. (a) Immediately wash the bite area with lots of water and soap. (b) Wound should be cleaned with available antiseptic. (c) Patient should be sent to hospital for an anti-rabies injection course. (d) Dog and the patient should be kept under observation for at least 10 days. PART IV : FOREIGN BODIES IN EYE, EAR AND NOSE Foreign Body in Eye 15. Particles of coal or dust may lodge on the eye-ball or inside the eye lid causing discomfort and damage to the tender structure.  236 16. First Aid Treatment. (a) Ask the patient not to rub the eyes. (b) Wash the eye with water repeatedly for a minute or two. (c) Search for the foreign body by lifting the upper eyelid and parting the lower eyelid down. The patient should face the light. If the foreign body is seen, it can be wiped off with the moistened corner of hand kerchief, cloth or cotton swab. (d) If foreign body is fixed to the eye-ball, patient should be sent to the hospital with a light eye bandage. Foreign Body in Ear 17. This is common with children. They often put beads, peas, nuts and other objects into the ear or an insect may get into the ear. 18. First Aid Treatment. Do not try to remove the foreign body with the help of a pin or forceps as this may push the foreign body further in, causing damage to the ear drum. The patient should be sent to the hospital. Foreign Body in Nose 19. This is a common occurrence among children. They might put peas, beads etc in the nostril. 20. First Aid Treatment. (a) Blowing the nose and sneezing may expel the foreign body. (b) Make the casualty breathe through the mouth. (c) Do not try to remove the foreign body. (d) Send the patient to the nearest hospital. PART V : ASPHYXIA 21. The tissue and organs of the body are supplied with oxygen through respiration, essential for the functioning of body. Respiration consists of inspiration, expiration and a pause. During inspiration air is drawn inside causing the lungs to expand. During expiration the lungs contract and air is pushed out. The respiratory system consists of the air passage known as respiratory tract and lungs. The actions of muscles concerned with respiration are controlled and regulated by the respiratory centre of the brain. Asphyxia 22. Causes. Anything which interferes with respiration producing irregularities in breathing, produces a condition known as Asphyxia. The main causes of Asphyxia are :- (a) Drowning – due to water entering the air passage. (b) Hanging and Strangulation – due to obstruction to entry of air. (c) Suffocation. (i) Due to obstruction to entry of air through the air passage.  237 (ii) Foreign body obstruction in air passage. (iii) Inhalation of poisonous gases e.g. carbon monoxide. (d) Over dosage of drugs such as sleeping pills, morphine, pethedine. (e) Electric Shock. (f) Diseases e.g. tetanus, epilepsy, rabies. 23. Signs and Symptoms of Asphyxia. (a) Dizziness and weakness. (b) Shortness of breath rate or breathing increase. (c) Rapid pulse. (d) Partial loss of consciousness. (e) Swelling of the veins of the neck. (f) Face, lips, nails, fingers and toes turn blue. ‗ 24. General Rules for Treatment of Asphyxia. (a) Remove the cause if possible or the casualty from the cause. (b) Ensure that there is a free passage for air. (c) Lay the individual on his back. Press the head back-wards supporting the neck on your palm. Lift the tongue clear of the airway. Give mouth to mouth breathing. 25. First Aid for Special Cases - Drowning. (a) Wet cloths should be loosened. (b) Mouth, throat and nostril should be cleaned of mucus and any foreign body. (c) Patient should be made to lie down over his belly, face down, head turned to one side, arms stretched beyond the head, tongue pulled out. (d) Artificial respiration should be given till he starts breathing. (e) Cover the patient with a blanket. 26. First Aid in Case of Strangulation or Hanging. (a) Cut the constriction. (b) Clear the air passage. (c) Start artificial respiration. (d) Give inhalations if possible. (e) Make the patient warm and comfortable.  238 27 First Aid in Case of Choking. Bend the casualty‘s head and shoulders forward, to dislodge the obstructions. In case of small child hold him upside down and thump his back hard between the shoulder blades or encourage vomiting by passing two fingers to the back of the throat. 28. First Aid in Case of Suffocation by Poisonous Gas. Protect yourself and remove the casualty from the gas as early as possible. 29. First Aid in Case of Electric Shocks. (a) Switch off or break the current, if possible. (b) Remove the casualty from contact with the current, if possible. Stand on some insulating material such as rubber soled shoes or boots or piles of news papers. (c) Give artificial respiration. (d) Treat for shock and burns. PART VI : INSENSIBILITY OR UNCONSCIOUSNESS 30. Insensibility or unconsciousness is caused due to interruption of the action of the brain, through some interference with the functions of the central nervous system. 31. Stages of Unconsciousness. (a) 1st Stage - Delirium – When the restlessness of body and mind are present. (b) 2nd Stage - Patient responds to loud commands, gives maximum response to minimum stimulus. (c) 3rd Stage - Semi- Coma- Patient responds to painful stimuli only (minimum response to maximum stimulus). (d) 4th Stage - When the patient makes no response to any Stimulus. 32. Causes of Unconsciousness or Coma. (a) Head injury. (b) Hemorrhage from brain. (c) Heart failure. (d) Diabetic coma, Hepatic coma, Uremic coma. (e) Excessive narcotics e.g. sleeping pills, morphine. (f) Intracranial or brain infections like meningitis, encephalitis. (g) Physical agents such as heat strokes, electric socks. (h) Epilepsy. (i) Hysteria.  239 33. General Rules of First Aid in Casualties of Unconsciousness. (a) Make the patient lie down with head turned to one side. Pull out his tongue. (b) Loosen the clothing, ensure fresh air. (c) If breathing has stopped or is irregular, start artificial respiration. (d) Keep the air passage clear. (e) Nothing should be given by mouth. Remove false teeth, if any. PART VII : ARTIFICIAL RESPIRATION 34. If there is any irregularity in breathing or a cardiac arrest, artificial respiration is given. If it is given correctly and in time, the patient‘s life can be saved. 35. Types of Artificial Respiration. (a) Holger-Nielson Method. Keep the casualty in prone position. (i) Movement 1. Go down on the left opposite the casualty‘s head, placing the right foot on the ground. Place the casualty‘s arm carefully above his head and keep them there during the turn. Grasp his right upper arm and turn his face to one side. The mouth and nose must be unobstructed. The operator should be 6‖to 12‖from the top of his head. Place the hands on casualties back with the heel of the hand on the lower part of the shoulder blade, the thumb on spine and fingers pointing to casualty‘s feet. Keeping the arms straight rock gently forward until the arms are almost vertical, depending on the build of the casualty using no special force. The movement takes 2 seconds counting one, two. This pressure causes expiration. This is called movement 1. (ii) Movement 2. The operator now rocks back counting 3 for one second and slides his hand and grips the upper arms near the elbow. He raises and pulls on the arms for 2 seconds counting 4, 5. He should take care not to raise the chest from the ground. This movement causes inspiration. Counting 6 the operator lowers the casualty‘s arm. The movements should be rhythmic in character and continued until breathing recommences. When the casualty begins to show signs of breathing the operator should continue with movement 2 only. For children the pressure on the shoulder blade should be considerably reduced or applied with fingers. The ratio should be 12 times in a minute. (b) Schaefer‘s Method. (j) Position of the Casualty. Lay the casualty in prone position with hand one over other under his head, the head turned to one side, mouth and nose unobstructed. (ii) Position of the Operator. Face the casualty‘s head; kneel on both knees at the side of casualty just below his hip joint. Sit back on your heels, place your hands on the loins of the casualty, one on each side of back bone with wrists almost touching, and thumbs as far forward as possible without strain, and fingers together. (iii) Movement 1. Without bending your elbows swing slowly forward by unbending the knees until the thighs are in almost upright position, allowing the weight from your body to be communicated to the casualty‘s loins. This causes  240 abdominal organ compression against the ground and up against the diaphragm. Air is forced out of the lungs, thus expiration takes places. (iv) Movement 2. Swing back slowly on to your heels, thus relaxing the pressure. This causes the abdominal organs to fall back and the diaphragm to come down thus inducing inspiration. These 2 movements must be carried out smoothly and rhythmically and should take 5 seconds (i.e. 12 times per minutes). Artificial respiration must be continued until natural breathing is restored, or unless a doctor decides that further efforts will be of no use. (c) Mouth to Mouth Respiration. (i) Casualty should be in supine position. (ii) Clean the mouth and throat to maintain clear air passage. (iii) Extend the neck to straighten the air passage. (iv) Cover the patient‘s mouth with clean gauze and blow directly and slowly into it. (10 – 12 times per minutes). CONCLUSION 36. First aid is a very simple and effective method which if known to an NCC cadet can save precious lives under various life threatening situations. The crucial aspects are promptness and correctness in administering first aid. A NCC cadet who reaches the victim must first quickly investigate the cause and type of injury before attempting to administer first aid.  241 LESSON PLAN : H 5 BASICS OF HOME NURSING Period - Three Type - Lec/Demo/Prac Code - H5 Year - III (SD/SW) Training Aids 1. Computer Slides, Pointer, Charts, Black Board and Chalk. Time Plan 2. (a) Introduction - 05 Min (b) Qualities of a Nurse - 15 Min (c) Bandage & its Application - 15 Min (d) The Sick Room Preparation - 20 Min (e) Recording of Temperature and Pulse - 20 Min (f) Feeding a Helpless Patient - 20 Min (g) Medicines and their Administration - 20 Min (h) Conclusion - 05 Min INTRODUCTION 3. Nursing plays a very important role in the recovery of a patient. While the doctors prescribe a course of treatment, it is the nurse who actually translates it into action. It is on the efficient nursing of the case that the whole success of the treatment depends. A large number of people have to be nursed at home either because their sickness is not severe or because on being discharged from hospital they recover at home. It is here that skill in home nursing comes in. A cadet trained in home nursing can be a great asset to a family AIM 4. To make all the NCC cadets aware about the basics of Home Nursing. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Qualities of a Nurse. (b) Part II - Bandage & its Application. (c) Part III - The Sick Room Preparation.  242 (d) Part IV - Recording of Temperature and Pulse. (e) Part V - Feeding a Helpless Patient. (f) Part VI - Medicines and their Administration. PART I : QUALITIES OF A NURSE 6. Definition. Home nursing can be defined as functioning of a nurse, in one‘s own home, taking care of the establishment and reducing the intensity and the frequency of sickness to the barest minimum. The meaning of the word-Nurse is:- N - NOBILITY, KNOWLEDGE U - USEFULNESS, UNDERSTANDING R - RIGHTEOUSNESS, RESPONSIBILITY S - SIMPLICITY, SYMPATHY E - EFFICIENCY, EQUANIMITY 7. Qualities of a Nurse. A good nurse must possess the following qualities:- (a) Honesty and Truthfulness. A nurse should be honest to her profession. She should confess her mistake whenever she makes any, and not risk the life of the patient by hiding it. (b) Sympathy and Understanding. A good nurse should deal with the patient with understanding and sympathy. She should sympathetically appreciate the pain and suffering of the patient. (c) Cheerfulness, Gentleness and Willingness. A cheerful nurse reduces the sufferings of the patients to half. Her gentleness reduces their pain and discomfort. Her willingness and eagerness to help is instrumental in making them bear their troubles with a smiling face.‖ A warm smile may be more therapeutic than a dose of medicine‖. (d) Obedience and Discipline. A nurse should have self discipline and should obey the orders of the doctor and carry them out without argument. (e) Observant. A Nurse should observe the minutest details of the patient‘s condition. If there is the slightest change in the patient‘s condition, she should immediately report it to the Doctor. She should also observe also observe whether the hospital equipment is functioning properly or not. (f) Tact and Sense of Humor. A tactful nurse can deal easily with the patient who becomes irritable due to disease. Her sense of humor also helps her in bearing the hardships of her profession cheerfully. (g) Courage. To be brave or not to be afraid. He should not be afraid of any situation in professional practice. (h) Team Spirit. Spirit of team work is very essential for a nursing assistant as he is a vital link in the great chain of health work.  243 PART II : THE BANDAGE AND ITS APPLICATION 8. General. Bandages are made of various materials and are of various lengths and width according to the part on which they are to be applied. These are:- (a) Bandage for Finger - 1‖ wide (b) Bandage for Head and Arm - 2½― (c) Bandage for Trunk - 6‖ (d) Bandage for Leg - 3½― 9. General Rules for Application. The rules for application of bandage are:- (a) Face the causality. (b) Hold the head of the bandage in the right hand. (c) Apply the outer side of the free end to the part and where possible lock it in position by a superimposed turn. (d) Bandage firmly from below upwards and from within outwards over the front of the limb. (e) Apply the layer of the bandage so that it covers neither too tight nor too loose. (f) When completed secure the bandage by a safety pin. 10. Method of Application. There are three methods of applying the roller bandages :- (a) The Simple Spiral. This is only used when the part is of uniform thickness, for example, finger or wrist. The bandage is carried out in a spiral direction. (b) The Reverse Spiral. This is used in bandaging those parts of the limbs where there is varying thickness. This is made by a number of spiral turns in which the bandage is reversed downward upon itself at each circuit of the limb. (c) The Figure of 8. It is used for bandaging in the neighborhood of a joint such as knee or elbow. This is applied by passing the bandage obliquely round the limb alternately upward and downwards. PART III : THE SICK ROOM PREPARATION, CLEANING AND VENTILATION 11. General. The sick room should be that room of the house, which is away from all noise and through which there is no passage. However, it should have a bathroom and lavatory close by. It should face South or South-West. 12. Preparation. A sick room should not have too many things. However, it should be comfortably furnished. There should be a comfortable bed, a bed side table, two chairs and one easy chair. A cupboard for keeping equipment should also be there. A wash basin with jug of water, soap, nail brush and towel must be arranged on a stool or a small table. If possible, a curtain stand may be arranged. A waste paper basket should be kept at a convenient place.  244 13. Cleaning. Dirt and dust are depressing to a sick person and retard his recovery. Moreover, these are the biggest source of illness as they harbor germs of various diseases. Hence, due importance should be given to the daily cleaning of the room. The following points should be kept in view :- (a) All cleaning work should be done without disturbing the patient after the toilet is over and the bed remade. (b) Light furniture should be removed before the room is swept and dusted. After dusting, each piece should be wiped with a weak solution of disinfectant and then polished with dry cloth. (c) Dusting should be done with damp cloth. The floor should be cleaned after scattering damp tea leaves so that dust does not rise. (d) At night, flowers should be removed from the vases and fresh flowers arranged in the morning. 14. Lighting. The light should not fall direct on the face of the patient. It should come from behind or the sides. There should be a shaded lamp on the side of the patient. There should be another shaded light for the nurse, so placed, that she can do her job without disturbing the patient. A well protected light can quite serve the purpose. 15. Ventilation. Ventilation means the availability of pure, fresh air in abundant quantity. It also means bringing inside a house or a place of work, plenty of sunlight. This is done through doors, windows and open spaces. Fresh air is essential for human existence. One of the important processes of living is, inhalation and exhalation. The dirty air exhaled by the breathing process is replaced by clean, fresh air inhaled by nostrils. The foul breath breathed out gets mixed up with fresh air and is to be separated so that air is available for the breathing process to continue. PART IV : TAKING / RECORDING OF PULSE AND TEMPERATURE Pulse 16. The patient‘s quick recovery depends very much on the efficient routine care by the nurse. Daily routine should be planned according to the patient‘s habits and followed regularly unless some sudden change in the patient‘s condition requires some adjustment. The pulse is the heart beat and is most commonly felt at the radial on the point of the wrist. The average pulse rate is 72 beats per minute. In case of infants, it is 100 to 140 beats per minute and in case of children it is 90 to 100 beats per minute. 17. Taking Pulse. The rate or the pulse changes with the change in emotions and while doing exercise. To count pulse, the patient should be made to sit down in bad. The arm must be relaxed and in a prone position. To take pulse, the tips of the first three fingers should be laid down on the radial artery at the base of the palm. The index finger should be nearest to the palm of the patient‘s hand. The thumb should be placed at the second‘s hand in your watch. The result should be immediately entered in the pulse column of the TPR Chart. Temperature 18. The normal temperature of a man is between 97 and 99 degrees F. There are slight ½ F variations between the daily temperature in the morning and evening. The lowest temperature is between 2AM and 4AM. 19. Measuring Temperature. It is important to know how to measure temperature. The body temperature is taken by the clinical thermometer which is a device consisting mercury band. The  245 range of the thermometer is 95 F to 110 F. The degrees are indicated by black lines. A figure is written after every 5. An arrow indicates the normal level of level of temperature i.e.98.4 F. (a) Normal temperature by mouth is 98.4 F or 37 C. (b) By axilla or groin it is 1 F lower than by mouth. (c) By rectum, it is 1 F higher than by mouth. (d) Fahrenheit is changed to centigrade by the formula. F-32 x 5/9 = C. 20. Method. Keep the bulb of the thermometer pressed under the armpit or beneath the tongue or in the groin for 2 minutes. Take the reading and record in the Temperature column of the TPR Chart. 21. Recording of TPR Chart. The TPR Chart is a morning and evening record of the patient‘s temperature, pulse and respiration with some other details such as the number of times the patient had motions and the amount of urine passed. This helps the doctor in learning about the latest condition of the patient at one glance. 22. Fever. Whenever there is an inroad of disease germs in the body, due to some infection, it raises its temperature to put up a fight against the invasion. The state of more than normal temperature is called ‗Fever.‘ 23. The normal temperature of the body is 970 F to 990 F. The temperature above 990 causes pain, restlessness, headache and body ache. Moderate temperature from 990 F to 1030 F is called PYearexia. High temperature from 1030 F to 1050 F is called High PYearexia. Very high temperature over 1050 F is called Hyper-PYearexia. Fever may be :- (a) Constant. In this the temperature remains the same all the 24 hours as in pneumonia and scarlet fever. (b) Intermittent. The temperature rises very high and falls very low. It appears when there is severe infection. PART V : FEEDING A HELPLESS PATIENT 24. While feeding a helpless patient, the bed and the table should be properly and neatly arranged. The nurse should give full attention to the patient so that patient does not feel that he/she is being hurried through a meal. (a) Feeding a Patient on Fluid Diet. The mouth of the patient should be washed and wiped. If the patient can sit up, the fluid can be given in a cup or in a glass. If the patient wants to take fruit juice with a straw he/she should be given that. But it should be ensured that the straw is absolutely clean. If the patient cannot sit up, he/she should be fed with a feeding cup or a feeder. The bed clothes should be protected by placing a clean napkin beneath the patient‘s mouth. The nurse should place her left arm, under the first pillow to raise the patient‘s head slightly. The flow of the fluid should be regulated so that too much of it does not flow into the patient‘s mouth. One mouthful should be done with a tea spoon also. In case of jaw injuries, a small rubber tube is attached to the spout of the feeding cup and then put between the teeth. The patient should be given small quantity to swallow at one time. After feeding the patient, lips should be wiped with a clean towel. (b) Feeding with Solid Food. Food should be served in an attractive manner arranged attractively on a side table. One dish should be brought at one time. The food should be served hot. It should be put in a plate in the kitchen before bringing to the  246 patient. Patient should be fed with a spoon. As soon as food is finished the plate should be removed. PART VI : MEDICINES AND THEIR ADMINISTRATION 25. A Nurse has to take great care with medicines. She should fully understand the doctor‘s prescription and keep the medicines well labeled and properly stored. There should be three separate shelves of a cupboard, one for lotion, one for medicines and the third one for poisons. 26. Administering Medicines. Proper administration of medicines is most important, as on it depends, the very life of the patient. Hence, if there be any doubt the doctor should be asked to clear it. The following points should be kept in mind while giving medicines:- (a) While Giving Liquid Medicines. (i) Check the label with the prescription. If handling a new medicine read the instructions carefully. Shake the medicine well. (ii) Put your thumb near the correct marking of dosage on the medicine glass. Hold the glass in level with the medicine bottle. Pour away from the label so that it does not become illegible. Replace the cork immediately. (iii) Read the instructions once again before actually giving the medicine to the patient. (iv) Take the medicine on a tray with a glass of water and spoon in case the medicine requires stiffing. If the medicine has a bitter taste, give the patient some sweet drink. (v) Never pour back any unused medicine, throw it away. (b) Other Medicines. (i) In case of pills, tablets, capsules and powder, remember that a pill has a sugar coating and a capsule has a gelatin coating and hence can be easily swallowed with water. Tablets if not swallowed by the patient may by crushed and put on the back of the tongue for swallowing. Powder must be poured at the back of the patient‘s tongue and water poured in his mouth. (ii) Iron mixture should be given with straws so that the teeth are not stained. If the patient is not too weak, he/she should be asked to clean his/her teeth. CONCLUSION 27. Home nursing is a common household practice prevalent in the society. NCC cadets can be of tremendous assistance at their homes or neighborhood whenever such the need arises for extending assistance to our relations and friends during sickness or injury. Knowledge of this subject is essential for cadets to be of assistance to other cadets during camps and adventure activities as also to victims during disaster management.  247 LESSON PLAN : H 6 TREATMENT AND CARE OF WOUNDS Period - One Type - L/P Code - H6 Year - II (SD/SW) Training Aids 1. Computer Slides, Charts, Pointer, Black Board and Chalk. Time Plan 2. (a) Introduction - 03 Min (b) Classification of Wounds - 10 Min (c) First Aid for Wounds - 10 Min (d) Dressing of Wounds - 15 Min (d) Conclusion - 02 Min INTRODUCTION 3. In our daily life, we do suffer from various types of wounds. Proper treatment and care of wounds is extremely important for a healthy life, especially in children because, if some wounds are not treated properly, they may cause serious diseases like gangrene or tetanus. AIM 4. To teach the NCC cadets about the Treatment and Care of Wounds. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Classification of Wounds. (b) Part II - First Aid for Wounds. (c) Part III - Dressing of Wounds. PART I : CLASSIFICATION OF WOUNDS 6. Definition. Wounds can be defined as a brake in continuity of the skin or muscles membrane. It is caused by violence. 7. Classification. Wounds can be classified as under:- (a) Inside Wound. It is wound caused by a sharp instrument like knife, razor and so on. Its edges are clean. (b) Lacerated Wound. It is caused by blunt instrument. The edges are torn or uneven.  248 (c) Punctured Wound. It is a deep narrow wound caused by a pointed instrument like knife, bayonet. The wound is small on the surface but may be very deep causing injuries to internal organs. (f) Contusion. A contusion is an injury or a bruise in which some of the tissues or a part is irregularly torn or ruptured but, the skin may not be broken. It is caused by a blow or blunt instrument. PART II : FIRST AID FOR WOUNDS 8. The method for giving first aid for different types of wounds are:- (a) Place the patient in a comfortable position. (b) Stop the bleeding, if any. (c) Remove any foreign body, if it is easily visible and can be easily removed. (d) Prevent the entry of germs by applying sterilized dressing like first field or shell dressing. (e) Give rest to the injured part by sling. (f) Immobilize the part, if wound is large or complicated by fracture. (g) Treat the patient for shock. (h) Send the patient to nearest hospital. PART III : DRESSING OF WOUNDS 9. A wound is to be cleaned with antiseptic lotion and covered with cotton or gauze piece with medication, before applying the bandage. 10. Aim. The aim of dressing a wound is as under:- (a) To protect the wound from infection. (b) To reduce swelling and early healing. (c) To support the effected part. (d) To enable the individual to carry out his day to day routine. (e) To stop the bleeding. 11. Articles Required for Dressing of Wounds. (a) Anti septic (A/S) lotion. (b) Cotton / Gauze piece. (c) Scissors. (d) Bandages of different size and band aid. (e) A/S ointment or powder. 12. Procedure for Dressing of Wounds. The following procedure is to be adopted while dressing of wounds:- (a) Reassure the patient and place him in comfortable position. (b) Stop the bleeding, remove foreign body and clean the wound with A/S lotion and cotton.  249 (c) Apply A/S ointment or powder and cover it with gauze. Select suitable bandage, Start bandaging clock wise from outer aspect to inner aspect by covering 1/3 of previous lining. (d) Put the knot away from the wound. (e) Bandaging should not be either too tight or loose. CONCLUSION 13. Wounds are a common feature among humans who are outdoor oriented. If cared properly during early stage the wounds heal quickly. Resultantly the wounded person suffers less and is available to the society as a healthy and fit person to resume work. NCC cadets by virtue of their routine are prone to injuries and hence must possess this basic knowledge to help fellow cadets or friends in school or at home.  250 LESSON PLAN : H 6 TREATMENT AND CARE OF FRACTURES Period - One Type - L/P Code - H6 Year - III (SD/SW) Training Aids 1. Computer Slides, Charts, Pointer, Black Board and Chalk. Time Plan 2. (a) Introduction - 03 Min (b) Causes, Classifications and Symptoms of Fractures - 10 Min (c) First Aid for Different Fractures - 15 Min (d) Dislocation, Sprain and Strain - 10 Min (e) Conclusion - 02 Min INTRODUCTION 3. In our daily life, we do suffer from various types of fractures. Proper treatment and care of fractures is extremely important for a healthy life, especially in children because, if some fractures are not treated properly, they may cause serious deformity or diseases like gangrene leading to amputation of the affected limb. AIM 4. To teach the NCC cadets about the Treatment and Care of various types of Fractures. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Fractures – Causes, Classifications and Symptoms. (b) Part II - First Aid for Different Fractures. (c) Part III - Dislocation, Sprain and Strain. PART I : FRACTURES AND THEIR CAUSES 6. Definition. A Fracture is defined as a discontinuity or break in a bone, resulting in the dissolution of the supporting frame work of the body. 7. Causes of Fracture. Fractures can be caused due to the following:- (a) Through Direct Violence. The bone breaks on the spot where direct violence is applied by a kick, bullet, blow etc.  251 (b) Through Indirect Violence. The bone breaks at some distant place from the spot of violence i.e. fracture of clavicle, base of skull etc, when the force is on out stretched hands or other extremities. (c) Through Forcible Muscular Contraction. Fracture of patella (knee cap) by contraction of thigh muscle. Fracture of ribs may be caused by violent coughing. (d) Diseases of Bones. Certain diseases of bones make them weak and easily breakable. 6. Classifications of Fractures. A fracture can be classified into the following three types:- (a) Simple or Closed. In this type, the broken bones are covered with skin and there is no open wound. (b) Compound or Open. In this type, the skin covering the fracture is broken or ruptured and sometimes the broken piece may protrude through it. (c) Complicated. The broken bone damages the under lying structure like blood vessels nerves, lungs, brain etc. 7. Symptoms & Signs of Fractures. The visible signs and symptoms of fracture are:- (a) Pain, swelling and tenderness over the fractured part and around it. (b) Loss of power. (c) Abnormal mobility. (d) Deformity and irregularity of bones. (e) Grating sound due to broken bones. PART II : FIRST AID FOR DIFFERENT TYPE OF FRACTURES First Aid 8. In Case of Simple Fracture. The first aid to be rendered is:- (a) Reassure the patient and make him comfortable. (b) Apply splints with any common article like stick or ply board or card board to immobilize the fracture. (c) Relieve him of discomfort and pain and keep the patient warm. 9. In Case of Compound Fracture. The first aid to be rendered is:- (a) Bleeding should be stopped immediately. (b) Remove foreign objects, if any, but do not meddle too much. (c) Cover the wound with a clean pad with light bandage. (d) Apply appropriate splints. (e) Transfer the patient to the nearest hospital immediately. Treatment of Fractures 10. Fracture of the Jaw Bone. (a) Apply Barrel Bandage.  252 (b) Warn the patient not to speak. (c) Instruct the patient to sit. (d) In lying cases, place patient on his chest, his head projecting outside the stretcher canvas, properly supported with bandages secured on stretcher handle. 11. Fracture of the Clavicle. In fracture of the clavicle we need to:- (a) Support the arm of injured side by passing a narrow folded bandage under the arm pit and tying it on the back of the shoulder. (b) Put a pad in arm pit, apply greater arm sling and fix the arm with a narrow fold bandage tied across the elbow to lower chest. 12. Fracture of the Ribs. When ribs are fractured following action is taken:- (a) Uncomplicated. Restrict the movement of chest on fracture side, with broad-fold bandage, one above and one below the fracture side, half overlapping each other. Support the arm of injured side with greater arm sling. (b) Complicated. Put the patient on the affected side and support the position by long fold blankets. Send the patient immediately to the nearest hospital. 13. Fracture of the Shoulder Blade and the Upper Limb. Fix the elbow to the affected side and put the finger in a position touching the opposite shoulder. Secure the hand in position by cuff sling. Secure the limb firmly to the chest by two broad bandages one on shoulder and the other at the elbow level and knot on opposite side. 14. Fracture of the Lower Limb. (a) Fix the injured limb to the sound limb with four narrow folds. (b) Apply long wooden splint from axilla to just beyond the foot on each side. Secure them by seven broad folds bandages tied at chest, pelvis, ankles, both thighs below the fracture, both legs, and knees. (c) In case of fracture of the pelvis, apply Thomas splint if available, otherwise the methods described in (a) and (b) should be used for immobilization of lower limb before evacuation of injured person to the nearest hospital. 15. Fracture of the Spine. Fractures of spine are to be very carefully handled. We have to:- (a) Treat any case of back injury as a fracture of the spine. There will be severe pain and shock in all cases. (b) Make the patient still. Do not allow the patient to move about. (c) If unconscious see that the tongue does not fall back and choke the patient. (d) Get medical aid at the earliest. (e) Apply broad bandages for thigh and knees. (f) Carry the patient face downwards on a board placed lengthwise on the stretcher.  253 16. Fracture of the Skull. It may injure the brain, nervous system or the arteries and cause concussion and compression. It may be caused by direct or indirect blow. (a) If Breathing is Normal. Lay the casualty on back with shoulders and head raised with cushions. Turn the head to one side. (b) If Breathing is Abnormal. Lay the casualty in a three quarter prone position. Apply pads under the chest and draw up the upper knee. (c) Do not give anything to drink. (d) Do not disturb the patient. (e) Keep air passage clear. (f) Treat for shock. PART III : DISLOCATION, SPRAIN & STRAIN 17. Dislocation. Dislocation means displacement of one or more bones at a joint. The joints which are more frequently dislocated are the shoulder, elbow, lower jaw, thumb and the fingers. (a) Signs and Symptoms of Dislocation. (i) Severe pain at or near the joint. (ii) Fixity of the joint or loss of power. (iii) Deformity of joint and un-natural position of the limb. (iv) Swelling at the joint. (b) First Aid in Dislocation. (i) Do not try to reduce the dislocation. (ii) Tie sling or bandage to immobilize the joint, apply cold compress to reduce the swelling. (iii) Send the patient to the nearest hospital for early treatment. 18. Sprain. A Sprain is the wrenching of the ligaments and tissues around the joint. (a) Signs and Symptoms of Sprain. (i) Pain at the joint. (ii) Inability to use the joint. (iii) Swelling and later bruising. (b) First Aid for Sprain. Place the joint in a comfortable position and apply a firm bandage. Prevent movements. Keep the bandage wet with cold water to avoid swelling. Later gently massage over the muscle and apply a crepe bandage. Analgesics should be given. Whenever you are in doubt whether an injury is a sprain or dislocation or fracture, treat it as a fracture. 19. Strains. A strain is the over stretching of a muscle. (a) Signs and Symptoms of Strain. (i) There is sudden sharp pain.  254 (ii) There may be swelling or severe cramp. (iii) Further exertion is difficult or impossible. (b) First Aid for Strain. Place the patient in the most comfortable position. Support the injured part. Give cold compress. 20. Crepe Bandage. A crepe bandage is made of elastic material which stretches and binds firmly around the joint to which it is applied. It thus helps in reducing swelling and movements at the affected joint, thereby minimizing pain and giving it rest. It is used in sprains and strains around joints. It can be washed and used again. CONCLUSION 21. It is essential for all human beings to take proper precautions whenever they hurt themselves. Injuries can result in different kinds of fractures; the cadets should also be trained to treat various type of fractures to avoid complications at later stages.  255 LESSON PLAN : H 7 INTRODUCTION TO YOGA AND EXERCISES Period - Two Type - Lec/Demo/Prac Code - H7 Year - III (SD/SW) Training Aids 1. Computer Slides, Charts, Pointer, Black Board and Chalk. Time Plan 2. (a) Introduction - 05 Min (b) Historical Perspective and Purpose of Yoga - 10 Min (c) Potential Benefits of Yoga for Adults - 10 Min (d) Potential Problems - 10 Min (e) Asanas - 40 Min (f) Conclusion - 05 Min INTRODUCTION 3. Yoga is a commonly known activity for physical, mental, and spiritual disciplines which originated in ancient India. Yoga is one of the six orthodox schools of Hindu philosophy. One of the most detailed and thorough expositions on the subject are the Yoga Sutras of Patanjali. Various traditions of yoga are found in Hinduism, Buddhism, Jainism and Sikhism. AIM 4. To teach the NCC cadets the practice of Yoga exercises. PREVIEW 5. The class will be conducted in the following parts:- (a) Part I - Historical Perspective and Purpose of Yoga. (b) Part II - Potential Benefits of Yoga for Adults. (c) Part III - Potential Problems. (b) Part IV - Asanas. PART I : HISTORICAL PERSPECTIVE AND PURPOSE OF