How to Care for the Insane: A Manual for NursesGranger, William D.
Science
How to Care for the Insane: A Manual for Nurses
Granger, William D.
Psychiatric nursing
Opium, in some of its forms, is a common household remedy. To an adult,
not more than one grain should be given; it should not be repeated more
than once, nor less than six hours after the first dose. It would be
better if never given, except by a physician's order. Under no
circumstances should any one but a physician give it to a weak or old
person, or to a young child.
Opium, is given in ordinary doses to relieve pain, to check diarrhoea,
to relax spasm of muscles, and to produce sleep. The sleep from opium is
generally quiet and refreshing, and one from which the patient can be
easily aroused.
An attendant will frequently be told when the medicine is given and
directed to note and report its effect.
_Opium Poisoning._--The taking of opium is a frequent way of committing
suicide by persons outside of asylums. Sometimes patients manage to save
their doses, or they steal it from the tray, or, if there is some sent to
the ward for repeated doses, they secure it through the carelessness of an
attendant, or occasionally it is secretly sent to patients by officious
outside friends,--thus poisoning by opium sometimes occurs among asylum
patients.
The full symptoms of poisoning are profound coma, pupils contracted to
pin-points, and which do not respond to light; very slow respiration,
often not more than four or six times a minute, but heavy and labored.
Sometimes the effect of the drug is but partial, the patient can be
aroused for a moment, but falls to sleep again, or the symptoms may be
even less pronounced.
The treatment of opium poisoning, before the physician comes, consists in
giving _very_ strong coffee, or tea, an emetic, and in trying to keep the
patient awake by walking him about, or, if this is not possible, to keep
him from falling into deeper coma, by shaking, calling loudly in the ear,
and striking and slapping the body with wet towels.
_Chloral._--This is a white crystal, with a pungent, burning taste. It is
always dispensed, dissolved in water, and should be further diluted when
given to a patient. The dose is from ten to thirty grains. It is too
powerful a drug to be given, except upon the order of a physician.
Chloral is given to produce sleep, which is usually quiet and natural. The
effect lasts about four or six hours.
The symptoms of poisoning are not so marked as to make it easy to know
that they are caused by chloral. There is generally a weak heart and
pulse, and feeble respiration, and the patient is in a deep sleep, from
which he may be aroused; or the coma may be profound, and continue
uninterrupted till death.
The treatment consists in giving an emetic, stimulants, coffee, and, if
necessary, performing artificial respiration.
_Hyoscyamine and Hyoscine._--These are extracts, from the leaves and
seeds, of the plant hyoscyamus.
These are very powerful medicines, and are never given except on the order
of a physician. They are always given in solution.
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