NURSING IN MALARIAL FEVER 6 1 



Great care must be taken to thoroughly wring the 

 blanket, especially at the ends; retention of hot water 

 in these places frequently leads to blistering of the 

 patient. The patient should be turned on to his side, 

 the blanket is well wrung out and folded lengthwise, 

 the edges must be close to the back of the patient 

 towards the middle of the bed. He is then rolled on 

 his back on to the under half of the damp, hot blanket, 

 which is folded round him from head to foot, and 

 covered with other and dry blankets. If profuse perspira- 

 tion does not occur, or the temperature rises, the pack 

 should be repeated. After the pack is removed, wrap 

 the patient in a warm, dry blanket and rub him with 

 warm dry towels. These packs must be hot, and in 

 desperate cases and with a patient deeply comatose a 

 certain amount of blistering may result. This is usually 

 due, not to the excessive heat, but to imperfect wringing 

 of the pack. When the temperature is so high that 

 hyperpyrexia is feared cold or even iced baths may be 

 required. The patient should be lowered in a sheet 

 into the bath at a temperature of 85 F., an assistant 

 supporting the head. Cold water is gradually added and 

 well mixed, or ice, if available, may be added. The tem- 

 perature of the patient must be taken frequently, every 

 five minutes, per rectum, as when once it begins to fall, 

 and has fallen below a point of danger, 102 F., it will 

 continue to fall after removal of patient from the bath, and 

 dangerous or even fatal collapse may occur if the tem- 

 perature has been too much reduced. Stimulants are 

 practically always required. When a bath is not available 

 cold or iced packing is sometimes employed. A half pack 

 is very useful, and can be managed single-handed. The 

 patient, stripped to the hips, is placed on his back on 

 a waterproof sheet or native mat, and large towels wrung 

 out of cold water are placed on his chest or abdomen, 

 completely covering them, and tucked in at the sides. 

 These towels are to be repeatedly changed and renewed 

 from a bucket of cold water placed at the bedside. This 



