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British Standards for A.R.P. Requirements
PUBLIC HEALTH
AUGUST
4. Provisional Selection o[ Staff. A provisional selection of staff should be made with a view to their becoming familiar with their duties. N o t h i n g would shock the public more than delay and careless m e t h o d in handling the dead. T h e r e is need for a conference to be he!d of all selected staff to enable them to become acquainted with each other and to work as a team, z.e., transport, mortuary, clerical personnel ; registrars of deaths, registrars of cemeteries, etc.
5. Disposal of Animals (if unclaimed). (a) By destructor. (b) In the municipal controlled tipping. Our aim should be to dispose of the dead within a period of 48 hours. A n important factor in winning a war would be the maintenance of the morale of the people, and there can be no doubt that a well-thought-out scheme for the rapid and sanitary disposal of the dead, giving due consideration to the sentiments and susceptibilities of the relatives and civil population, would go a long way in this direction. This can only be achieved by preparation beforehand, instruction of the individual, periodical collective training of staffs, and by cordial co-operation between all parties concerned. R e m e m b e r that the greatest test of our A.R.P. organisation m a y well be in the first week of a war.
BRITISH STANDARDS FOR A.R.P. REQUIREMENTS The Home Office Air Raid Precautions Department has arranged with the British Standards Institution to prepare and issue on their behalf a special A.R.P. series of British Standards for Air Raid Precaution purposes. The preparation of these Standards will be under the control of a special Advisory Committee and in accordance with the usual practice of the B.S.I., will be carried out in the closest co-operation with Government Departments and the Industry concerned. All communications relating to this work should be addressed to the British Standards Institution, 28, Victoria Street, Westminster, S.W.1.
THE PREMATURE BABY* By V. MhRY CROSSE, M.D., D.P.H., M.M.S.A., D.R.C.O.G.,
Assistant Medical Officer (M. & C.W.), City of Birmingham. In 1981 a ward for 12 premature babies (with six single wards for breast-feeding mothers and isolation purposes) was opened at " Sorrento " Maternity Home, City of Birmingham. As the Home is a training school for pupil midwives (Certificate A), and is also responsible for the Refresher Courses for Post-Graduate Midwives, it has been the object of this ward to obtain good results with simple methods, such as the midwife can use in a patient's home.
Results of Work in Birmingham The resuks have been most encouraging. From 1931 until 1938 more than t,400 babies have passed through the ward, 55 per cent. of these being less than 4 lbs., and 95 per cent. less than 5 lbs. Of these, 63 per cent. have lived, and of the 37 per cent. death rate two-thirds have died within the first 24 hours of life (i.e., were admitted moribund). The actual results according to birth weight and maturity are as follows :-(I) Weight. Percentage Saved. 0-2 lb. 8.8 2-3 27 3-4 60 4-5 78 Over'5 lb. 94 (2) Maturity. Percentage Saved. 0-28 weeks 6.6 28-30 32 30-32 49 30_-34 78 34-36 91 Over 36 wet ks 90 In order to obtain thes~ results, special attention has been paid to certain characteristics of the premature baby, i.e., its low vitality, poor heat regulating centre, the difficulties ia feeding and its liability to cyanosis, infection and certain diseases. L o w Vitality The smaller the infant the less it should be handled. Infants are kept on their side (to avoid danger from regurgitation). After feeds the infants are placed on the right side, then changed to the left side midway between feeds. Oiling and changing are done in the cot with as little disturbance as possible. 1.
The Joint Consultative Committee of Institutions recognised by the Minister of Health for the Training of Health Visitors, and of Organisations of Health Visitors, has just issued a useful booklet for intending health visitors, entitled "Health Visiting as a Career." The booklet gives details of the usual work of a health visitor and notes as to method of entry, examination and salaries and conditions of service. The booklet is obtainable from the Joint Consultative Committee at 7, Victoria Street, S.W.1, price 2d.
The ward is kept at 70° F., this temperature being maintained by central heating and a gas fire. Air enters below the level of the cots, passing over the hot radiators ; and leaves by ventilators high up in the wall. The humidity is kept at 60-65 per cent. by means of steam kettles.
Dr. P. Stanley Blaker is due to retire from his appointment as medical officer of health for the county borough of Dudley at the end of October.
* Paper read at the Clinical Course for Medical Practitioners preceding the National Conference on Maternity and Child Welfare, London, June 26th, 1939.
332
2. Poor Heat-Regulatlng Centre
AUGUST
4. Provisional Selection o[ Staff. A provisional selection of staff should be made with a view to their becoming familiar with their duties. N o t h i n g would shock the public more than delay and careless m e t h o d in handling the dead. T h e r e is need for a conference to be he!d of all selected staff to enable them to become acquainted with each other and to work as a team, z.e., transport, mortuary, clerical personnel ; registrars of deaths, registrars of cemeteries, etc.
5. Disposal of Animals (if unclaimed). (a) By destructor. (b) In the municipal controlled tipping. Our aim should be to dispose of the dead within a period of 48 hours. A n important factor in winning a war would be the maintenance of the morale of the people, and there can be no doubt that a well-thought-out scheme for the rapid and sanitary disposal of the dead, giving due consideration to the sentiments and susceptibilities of the relatives and civil population, would go a long way in this direction. This can only be achieved by preparation beforehand, instruction of the individual, periodical collective training of staffs, and by cordial co-operation between all parties concerned. R e m e m b e r that the greatest test of our A.R.P. organisation m a y well be in the first week of a war.
BRITISH STANDARDS FOR A.R.P. REQUIREMENTS The Home Office Air Raid Precautions Department has arranged with the British Standards Institution to prepare and issue on their behalf a special A.R.P. series of British Standards for Air Raid Precaution purposes. The preparation of these Standards will be under the control of a special Advisory Committee and in accordance with the usual practice of the B.S.I., will be carried out in the closest co-operation with Government Departments and the Industry concerned. All communications relating to this work should be addressed to the British Standards Institution, 28, Victoria Street, Westminster, S.W.1.
THE PREMATURE BABY* By V. MhRY CROSSE, M.D., D.P.H., M.M.S.A., D.R.C.O.G.,
Assistant Medical Officer (M. & C.W.), City of Birmingham. In 1981 a ward for 12 premature babies (with six single wards for breast-feeding mothers and isolation purposes) was opened at " Sorrento " Maternity Home, City of Birmingham. As the Home is a training school for pupil midwives (Certificate A), and is also responsible for the Refresher Courses for Post-Graduate Midwives, it has been the object of this ward to obtain good results with simple methods, such as the midwife can use in a patient's home.
Results of Work in Birmingham The resuks have been most encouraging. From 1931 until 1938 more than t,400 babies have passed through the ward, 55 per cent. of these being less than 4 lbs., and 95 per cent. less than 5 lbs. Of these, 63 per cent. have lived, and of the 37 per cent. death rate two-thirds have died within the first 24 hours of life (i.e., were admitted moribund). The actual results according to birth weight and maturity are as follows :-(I) Weight. Percentage Saved. 0-2 lb. 8.8 2-3 27 3-4 60 4-5 78 Over'5 lb. 94 (2) Maturity. Percentage Saved. 0-28 weeks 6.6 28-30 32 30-32 49 30_-34 78 34-36 91 Over 36 wet ks 90 In order to obtain thes~ results, special attention has been paid to certain characteristics of the premature baby, i.e., its low vitality, poor heat regulating centre, the difficulties ia feeding and its liability to cyanosis, infection and certain diseases. L o w Vitality The smaller the infant the less it should be handled. Infants are kept on their side (to avoid danger from regurgitation). After feeds the infants are placed on the right side, then changed to the left side midway between feeds. Oiling and changing are done in the cot with as little disturbance as possible. 1.
The Joint Consultative Committee of Institutions recognised by the Minister of Health for the Training of Health Visitors, and of Organisations of Health Visitors, has just issued a useful booklet for intending health visitors, entitled "Health Visiting as a Career." The booklet gives details of the usual work of a health visitor and notes as to method of entry, examination and salaries and conditions of service. The booklet is obtainable from the Joint Consultative Committee at 7, Victoria Street, S.W.1, price 2d.
The ward is kept at 70° F., this temperature being maintained by central heating and a gas fire. Air enters below the level of the cots, passing over the hot radiators ; and leaves by ventilators high up in the wall. The humidity is kept at 60-65 per cent. by means of steam kettles.
Dr. P. Stanley Blaker is due to retire from his appointment as medical officer of health for the county borough of Dudley at the end of October.
* Paper read at the Clinical Course for Medical Practitioners preceding the National Conference on Maternity and Child Welfare, London, June 26th, 1939.
332
2. Poor Heat-Regulatlng Centre