OCD 3059

December 1942
Medical

Division

Bulletin No. 6

United States Dffiee of Civilian Defense

Washington,

D.

C.

This Bulletin outlines the program of the Medical Division of the United States
Office of Civilian Defense for nursing services which may be required in wartime to care
for civilians injured by enemy action or other hazards of war.
If they are to participate effectively in Emergency Medical Service, nurses must
be informed of the organization of the local Defense Council and the duties of other
branches of the United States Citizens Defense Corps. They should understand the
coordination of the Emergency Medical Service with other protective units of the
United States Citizens Defense Corps and be able to answer the questions of their
patients and the public concerning these activities. As disseminators of information
nurses share the responsibility for public morale.

TABLE 0F CONTENTS
Page

Page
The Office of Civilian Defense. .......
II. The Nursing Section of the Medical

1 C. Nursing Auxiliaries ...................

D. Red Cross Home Nursing ..........
E. Other Volunteers ...,..................

A. Regional Nurse Deputies and

10

B. State Nurse Deputies and

A. Warning System and Control

C. Local Nurse Deputies and

B. U. S2 Citizens Defense Corps .....

10

1. Medical Unit ..._......_.__.__._____

10

2. Enrollment at Civilian De
fense Volunteer Office ........

10

B. Casualty Stations. .............,......

C. U. S. Citizens Service Corps ......

10

C. Casualty Receiving Hospitals..--

D. Civilian Defense Auxiliary

III. The Emergency Medical Service .....

A. Field Casualty Units ................

10

11

D. Care of Patients in Homes ........

E. Insigne, Identification, and Dress
11

E. Emergency Base Hospitals .........

F. Nursing Service in Reception
IV. First-Aid Training for Nurses in the
Emergency Medical Service ........
, V. Blood and Plasma .....,...................

F. Personnel File for Emergency

Nursing Service ...... . .............

12

1. Graduate Nurses ..................

12

2. Nursing Auxiliaries .... .- .........

12

3. Volunteer Nurses Aides ........

12

VI. Chemical Casualties ........,...... [ ......

G. Relationship of Red Cross and
12

VII. Sanitary and Public Health Engi

H. Self-Protection Against Injury
VIII. Volunteers in Health, Medical Care,

13
I. Home Water Supply Precautions

13

A. Volunteer Services of Registered

J. Regional OHicesStates in each
B. Volunteer Nurses Aides. .......... -_

14

NURSING

PARTICIPATION

MEDICAL

I. THE OFFICE OF CIVILIAN DEFENSE

IN

THE

EMERGENCY

SERVICE

II. THE NURSING SECTION OF THE

MEDICAL DIVISION

The United States Ohice of Civilian Defense,

established by executive order of the President,

The work of the Medical Division of the

May 20, 1941, includes four operating branches:

Protection, War Services, Civil Air Patrol,
and Facility Security. The Protection Branch
is composed of a Protection Division, which
develops programs involving air raid warden
service, fire defense, control and communica
tions, transportation, blackouts, camouilage,
and protective construction; and the Medi
cal Division, which is responsible _for all
activities in the field of medical care and sani

.Oftice of Civilian Defense is organized accord

tation which are required to protect the civilian

population from the hazards of enemy action.
The War Services Branch is responsible
for over-all Defense Council organization
including Civilian Defense Volunteer OHices,
for the coordination of Civilian War Services
other than those of Civilian Protection, and for
the Citizens Service Corps, which is composed
of volunteers engaged in such Civilian War
Services.
To facilitate administration, the United
States is divided into nine Civilian Defense
Regions coterminous with the Army Service
Commands. In each Region, a Regional Di
rector and staff are assigned the responsibility
of assisting State and Local Defense Councils in
planning and carrying out the Civilian Defense
program within the States. Liaison oHicers of
the Army and Navy maintain close coopera
tion between the military establishments and
the Oiiice of Civilian Defense in the National
and Regional OHices.
State Defense Councils provide leadership
to local Defense Councils through a State di
rector or coordinator and his staff. It is the
local Defense Council which must assume the
major responsibility for Civilian Defense and
other essential activities of the civilian war
effort. (See "Organization Outline for Local
Defense Councils," prepared by the U. S. Office
of Civilian Defense.)

ing to the following functional linesfield cas

ualty service, hospital care, nursing service,
blood plasma production and distribution,
rescue-first aid, gas defense, sanitary engineer
ing, plant protection, and scientific develop
ment and research.
Effective nursing participation in the Emer
gency Medical Service program depends on close
integration between available medical and
nursing facilities. To accomplish this, the
Medical Division of the Office of Civilian De
fense provides nursing consultation and assist
ance to National, Regional, State, and local
authorities responsible for the development of
the emergency medical program.
A full-time nursing consultant has been as
signed from the United States Public Health
Service to the 'Medical Division of the Office of
Civilian Defense as a member of its staff and
chief of its Nursing Section. She maintains
direct contact with all Federal agencies con
cerned with nursing programs and liaison with
the National Nursing Council for War Service,
which is composed of representatives of the
national nursing organizations, the Red Cross,
and Federal agencies. The Subcommittee on
Nursing of the Health and Medical Committee
of the Office of Defense Health and Welfare
Services serves also as an advisory nursing
committee of the Medical Division.
The Nursing Section assists in the formula
tion of the Medical Division plans for nursing
participation in the Emergency Medical Service
program. In cooperation with the United
States Public Health Service, nursing schools
are stimulated to expand and accelerate their
programs of nursing education so as to meet
the expanding needs of the armed forces, of
war industries, of public health agencies, and of

civilian hospitals. The States are assisted in

making an inventory of nursing resources, and
in using the information to facilitate equitable
distribution of nursing services. The Nursing
Section also cooperates with the American Na
tional Red Cross on administrative problems
concerned with the recruitment and training
of Nu1ses Aides, the Home Nursing program,
and the Red Cross Enrollment Service for re
serves of graduate nurses.
These activities are promoted in the field
through Regional, State, and local Nurse
Deputies., Nurses in all vulnerable commu-_
nities in the target areas are listed and classified
by neighborhoods so as to be available for im
mediate service with field units, in Casualty
Stations, and in Casualty Receiving Hospitals
of the Emergency Medical Service. Nursing
executives are also being enlisted for the sup
plementary administration and supervision of
nursing services which may be needed in Emer
gency Base Hospitals into which casualties will
be evacuated in the event of enemy attack

5. To promote and assist State and local re

cruiting and training of Volunteer Nurses
Aides, nursing auxiliaries, and paid and vol
unteer assistants for civilian hospitals which
are to function as Casualty Receiving or Emer
gency Base Hospitals.
B. State Nurse Deputies
State Nursing Councils for War Service have
been organized in every State, composed of
representatives of the professional nursing or
ganizations of the State, the Red Cross, the
official State agencies with nursing programs,
and medical and lay groups. On the recom
mendation of the Medical Division of the
Office of Civilian Defense, a State Nurse
Deputy has been appointed in most States by
the State Chief of Emergency Medical Service
in consultation with the State Nursing Council.
As a member of the State Nursing Council,
she consults that group on professional nursing
questions and should be their nursing represent
ative on the State Defense Council.

upon coastal or other communities.

Duties ofState Nurse Deputy.
A. Regional Nurse Deputies
Nurse Deputies have been appointed to the
staff of the Regional Medical Officer in certain
Regions.
Field nursing consultants of the United States
Public Health Service, the Childrens Bureau,
and the American Red Cross are available to
the Regional Medical Officer and Regional
Nurse Deputy to assist them in developing the
nursing services necessary to carry out the
emergency medical program in their Region.
Duties of Regional Nurse Deputy.
1. To advise the Regional Medical Officer
concerning the nursing program of the Medical
Division, U. S. Office of Civilian Defense, with
in the Region.
2. To promote plans for nursing participation
in the Emergency Medical Service in States in
the Region in cooperation with the State Nurse
Deputies and with nursing consultants of
the United States Public Health Service, the
Childrens Bureau, and the Red Cross.
3. To conduct institutes and conferences
for groups of nurses throughout the Region on
subjects pertaining to nursing participation in
the emergency medical program.
4. To keep informed concerning the status
of nursing service available in the States of the
Region and to correlate their nursing programs.

The State Nurse Deputy is responsible to the

State Chief of Emergency Medical Service and
will assist him in making plans for nursing par
ticipation in the State emergency medical pro
gram by:
1. Mobilizing the available nursing personnel
of the State in collaboration with local Nursing
Councils for duty in the Emergency Medical
Service.
2. Interpreting the Emergency Medical Serv
ice program to nursing organizations and groups
throughout the State.
3. Assisting local Nurse Deputies by inform
ing them of developments in the Emergency
Medical Service program, aiding them in de
veloping an emergency nursing service, and
preparing instructional memoranda for their
information.
4. Assisting the State Hospital Officer in
planning for the recruitment and assignment of
nurses and nursing auxiliaries to Emergency
Base Hospitals if evacuation of patients from
Casualty Receiving Hospitals to these insti
tutions should become necessary.
5. Planning for the recruitment and assign
ment of nursing personnel for reception areas
in cooperation with State .evacuation au
thorities.

6. Assisting the Red Cross and hospitals V 3. In maintaining an active current iile (see
Appendix F) of all available nursing resources
in recruitment, training, and assignment to
in the community. This lile or a duplicate
duty of Volunteer Nurses Aides.
should be available to the local Chief of Emer
7. Compiling periodic reports summarizing
information from local Nurse Deputies in the
State concerning:
(a) Adequacy of nursing services in civilian
hospitals and in public health departments.
(b) Plans for correction of nursing dehcien
cies which may impede the war effort.
(c) Nurses and Nurses Aides available for
emergency duty with medical field units, in
Casualty Stations, and in Casualty Receiving
Hospitals.
(d) Nursing personnel available in various
parts of the State for nursing service in Emer
gency Base Hospitals.

gency Medical Service. In large cities it is de

sirable to classify the records according to
districts of the community in which nurses
reside or work, so that they may be available
promptly for service with Mobile Medical Field
Units and at Casualty Stations in their neigh
borhoods. In smaller communities or rural
districts one central file should be adequate.
4. In arranging with hospitals for assign
ment of nurses to mobile field units.
5. In assigning nurses enrolled in the Emer
gency Medical Service to duty in Casualty Sta
tions and in Casualty Receiving Hospitals
during emergencies.

C. Local Nurse Deputies {city,

county, or other subdivision
of the State)

6. In arranging for practice drills and for in

struction of nurses serving with the Emergency
Medical Service.

Medical Division Bulletin No. 1 recommends

that the Medical Advisory Board of the local

7. In providing for their iirst aid training,

in collaboration with the Red Cross, and their
instruction concerning self-protection against

Emergency Medical Service include a repre

sentative of the local nursing profession. It is
desirable that the responsibility for nursing

gas and procedures for cleansing of chemical

casualties.

participation in the Emergency Medical Serv

ice be delegated to one individual in each
locality. A local Nurse Deputy should-, there
fore, be appointed by each local Chief of
Emergency Medical Service in consultation with
the local Nursing Council for War Service.
The local Nurse Deputy should be a member
of the local Nursing Council and should repre
sent it on the local Defense Council.
Duties of Loca] Nurse Deputy
The local Nurse Deputy is responsible to the
local Chief of Emergency Medical Service for
adequate nursing participation in the local
emergency medical program. She will assist
him:
1. In recruiting and training nurses and nurs
ing auxiliaries for service with Mobile Medical
Field Units, in Casualty Stations, and in _Cas
ualty Receiving Hospitals of the Emergency
Medical Service. This activity is to be carried
on with the assistance of the nursing staffs
of local hospitals and local nursing and health
.
.
agencies.
2. In interpreting the Emergency Medical
Service program to local nursing groups.

8. In establishing centralized facilities for

the use of all local public health nursing re
sources to provide emergency nursing care in
homes and shelters. This activity should be
planned in collaboration with the local health
and welfare departments in order that care and
assistance may be provided for the sick and.
slightly injured through public health nurses
and medical social workers and that the serv
ices of physicians may be conserved in times of
emergency. Centralized recording of the need
for emergency nursing care in homes should be
coordinated with the community plan for
Casualty Information Service. The responsi
bility includes providing nursing care for: (a)
Slightly injured casualties sent home or to
temporary shelters after treatment at Casualty
Stations, (b) convalescent patients discharged
from hospitals to make room for casualties,
(c) ill persons in shelters and rest centers.
9. In assisting local chapters of the American
Red Cross and local Civilian Defense Volunteer
Offices in recruiting candidates for Nurses Aide
training; and in requesting the Nurses Aide
Committee to assign Nurses Aides for service
in an emergency.

10. In keeping current files on nursing defi

ciencies of local hospitals and health services

Station duty should be familiar with the pre

vention and treatment of shock, know the con

so as to be prepared to supplement their per

sonnel during periods of emergency, and in

tents and layout of the emergency medical

field kits, and be instructed in Casualty Station

reporting to the State Chief of Emergency

Medical Service concerning the local nursing
program.

procedures for admitting, treating, and dis

charging patients. If casualties at the station
have not been previously tagged, they should
be officially tagged on admission. The head
nurse must also be responsible for all entries in

III. THE EMERGENCY MEDICALSERVICE

the Casualty Record Book.

Practice drills will be held for those who will

A. Field Casualty Units

be called upon to work together under emer

The Field Casualty Units of the Emergency

Medical Service provide medical care for the
injured at incidents and in Casualty Stations,
and ambulance transportation to Casualty
Receiving Hospitals for the severely injured.
In order that mobile teams of the Medical
Field Units may be available for immediate
action in the event of a sudden air raid, it is
desirable that primary units be organized from
the interne and resident staffs of hospitals.
Each mobile medical team consists of one
physician, one nurse, and two or more auxil
iaries. Nurses assigned to iield casualty service
should be experienced in Hrst aid. (For organi
zation of these units, see Medical Division
Bulletins Nos. 1, 2, and 4.)
Similar teams are organized from physicians
and nurses practicing in the community, who
may be mobilized when continuing field serv
ices are needed or when relief service is neces
sary to permit the immediate action teams to
return to duty in their hospitals. Plans must
be evolved to have adequate numbers of nurses
on call for this purpose at all times in every
neighborhood.
At the scene of an incident and in Casualty
Stations, nurses will assist physicians in giving
first aid and will supervise the work of trained
nursing auxiliaries. One of the nursing auxil
iaries should be assigned the responsibility of
tagging as soon as possible all casualties, whether
sent to a hospital or to a Casualty Station.

gency conditions. Such drills are conducted in

collaboration with other protection services
under the direction of the Commander of the
Citizens Defense Corps and the Chief of the
Emergency Medical Service.
C. Casualty Receiving Hospitals
All general hospitals in a community may be
included in the Emergency Medical Service
and may be called upon to serve as Casualty
Receiving Hospitals in time of emergency.
They are entitled to payment by the United
States Public Health Service for care of cas
ualties at a rate of $3.75 per patient day.
Nurses will serve as employees of the hospital.
Each hospital is specifically related to the Con
trol Center and to certain Casualty Stations
in the district where it is located, or to which
its facilities have been related. (See Medical
Division Bulletin No. 4.) The Field Unit
Leader of each hospital will appoint a nurse,
preferably a staff member, to act as supervisor
of nurses and nursing auxiliaries assigned to the
hospital field units.
Graduate and student nurses in the hos
pitals should be instructed in procedures for
the care and protection of patients during air
raids. They should be assigned specific re
sponsibilities in relation to the receiving and
classification of casualties, service in the re
suscitation room, and other emergency duties.
(See Medical'DivisionBulletin No. 3.)
Plians should be made for supplementing the

At Casualty Stations, for the care of the

minor air raid casualties, a head nurse is to be

nursing staffs of Casualty Receiving Hospitals

during periods of acute emergency. Through
the local Nurse Deputy of the Emergency
Medical Service, practicing and retired nurses

assigned to direct the activities of other nurses,

nurses aides, orderlies and assistants, and to

residing in the community should be registered

for emergency assignment to Casualty Receiv

assume responsibility for management of the

Station. All nurses assigned to Casualty

ing Hospitals. When possible, nurses selected

for such assignment should have been associated

B. Casualty Stations

previously with thc institution; otherwise, they

should be informed in advance of adminis

Base Hospitals for the reception of casualties

and other hospitalized persons whom it may

trative regulations and the location of special

facilities and equipment of the hospitals to

be necesssary to move from cities under attack.

which they may be assigned.

They are largely mental hospitals, convalescent

homes, and tuberculosis sanitoria, the occu

D. Cure oi Patients in Their Homes

pants of which can be transferred to other

institutions or to their homes. They possess,

The physician in charge of a Casualty Station

will determine the need for subsequent follow

or can readily be provided with, sufficient fa

cilities for the care of casualties or other patients

up nursing visits in the home or in temporary

shelters. Such visits are important to pre

who may be moved from civilian hospitals of

stricken cities. They will be entitled to pay

serve post-raid morale, as well as to assure

adequate medical care. Directions for nursing
care and treatment in the home must be given

ment by the United States Public Health Serv

ice at a per diem rate of $3.7 5 for the care of all

by the physician in charge of the patient.

Should subsequent medical care be required,
the patient is to be referred to his family phy
sician or to a clinic or hospital. Payment for
medical and nursing care of Emergency Medical
Service patients outside the hospital will be
made by the U. S. Public Health Service in
accordance with plans now being developed.
The Emergency Medical Service will assume
the responsibility for providing emergency
nursing service in homes. This may be carried
out through the health department or other
health agency, which should arrange to employ
all available public health nursing facilities
during post-raid periods. All agencies em
ploying public health nurses should pool their
resotuces for this purpose.
Each health or nursing agency should be pre
pared. to make its home nursing service avail
able for a local area in accordance with plans
prepared by the local Chief of Emergency
Medical Service and the local Nurse Deputy in
collaboration with the health' omcer and rep
resentatives of the local nursing agencies. A
few nurses in each locality or from each agency
should be organized into "mobile groups",
to meet unusual needs which may arise in any
section of the community.
All public health nurses should be instructed
in these plans, and those who have not recently
done clinical nursing should take a refresher
course. This may be done by attending in
stitutes on home bedside nursing provided by
the local visiting nurses association or by the
health department.

patients whose movement from the Casualty

Receiving Hospitals is necessitated by enemy
action. Each Emergency Base Hospital will
be administered by its existing administrative
staff or by the staff of the Casualty Receiving
Hospital which it serves. Its medical staff
will, when necessary, be supplemented by a
United States Public Health Service aiiiliated
unit. Each afliliated hospital unit consists of
15 physicians, commissioned in the inactive
reserve of the United States Public Health
Service. All or part of the unit will be acti
vated by the Surgeon General upon recommen
dation of the State Chief of Emergency Medical
Service and the Regional Medical Oiiicer to the
Chief Medical Officer of the Office of Civilian
Defense. Medical Consultants of the U. S.
Public Health Service may also be utilized for
part-time service at Emergency Base Hospitals.
A limited number of qualified nursing execu
tives will be given appointments in the United
States Public Health Service for assignment as
nursing supervisors in activated Base Hospitals
or to supplement the existing supervisory staff
of the institution. (See Circular Medical
Series No. 24, December 21, 1942.) Organi
zation of a general nursing reserve for duty at
Emergency Base Hospitals has been deferred
until the need becomes more imminent. How
ever, Nurse Deputies will maintain a roster of
nurses, nurses aides, and other auxiliaries in
the community, who will be available if required.
in an emergency.
When on active duty at the base, the medical
officers and the nursing executives who hold

E. Emergency Base Hospitals

appointments as special nursing consultants of

the United States Public Health Service will be

A chain of institutions situated in relatively

safe sites in the interior of the coastal States

paid from Federal funds. All other nurses

and nursing auxiliaries on duty at a Base Hos

have been designated as potential Emergency

pital are to serve as employees of the institu

tion, whether administered by the State or

10cal government or as a voluntary hospital.
The obligation of the Federal Government is
limited to the payment of salaries and allow
ances of the officers and of the medical and
nursing consultants ofthe Public Health Serv
ice assigned to duty at the Emergency Base
Hospital, the provision of beds, mattresses and
a limited amount of surgical supplies, and the
per diem payment to the institutions of $3.7 5
per patient day. It is assumed that the re
mainder of the operating cost will be met by
State or local governments.
To supplementregular nursing services at
Emergency Base Hospitals, it will be necessary
to utilize auxiliary nursing personnel of the
institution which has been activated as a Base
Hospital, or personnel recruited from a Cas
ualty Receiving Hospital or other local sources.
In emergencies the American Red Cross, health
departments, and voluntary health `agencies
can be depended upon for assistance in supply
ing additional nursing and auxiliary personnel.
Provisions should be made to increase the pro
portion of nursing supervisors as the nursing
auxiliaries are increased. Under emergency
circumstances, it will be necessary to assign
relatively less important nursing duties to
auxiliaries so as to relieve the limited number of
graduate nurses for services requiring nursing
skill and responsibility.
F. Nursing Service in Reception
Areas
Reception areas are localities to which women
and children and the aged and iniirm may be
evacuated from cities under attack. Under
these circumstances the localities under attack
comprise the evacuation area. Plans for evac
uation have been prepared by the Joint Com
mittee on Evacuation which was organized by
the Office of Civilian Defense and the Office of
Defense Health and Welfare Services. In ad
dition to the appointing agencies, its member
ship includes the Childrens Bureau of the De
partment of Labor, the United States Public
Health Service, the United States Office of
Education, and the Bureau of Public Assistance
of the Social Security Board and the Medical
Division of the Office of Civilian Defense.
Under the supervision of Regional and State
Evacuation Officers, evacuees will be trans
ported to designated reception areas when

such action is considered necessary by military

authorities. Plans provide for the evacuation
of children and mothers, pregnant women, the
physically handicapped, the infirm, and those
who are unable to make private arrangements,
or who may wish to join a government party.
The responsibility for the supervision of
nursing service both in the evacuation and in
the reception areas will be assigned to local,
county, or State health departments, but pool
ing of all available public health nursing
resources should be achieved. Specific rec
ommendations for providing nursing services
in evacuation and reception areas will be issued
by the Joint Committee on Evacuation.
IV. FIRST AID TRAINING FDR NURSES IN
THE EMERGENCY MEDICAL SERVICE
The darkness, confusion, debris, and dirt at
most air raid incidents and the increasing in
tensity of air raids precludes administration of
first aid in the field other than covering of
wounds with shell dressings, control of hemor
rhage, prevention and care of shock and ad
ministration of morphine. Much of the first aid
work is performed by rescue workers who
extricate the injured from the debris of demol
ished. buildings and turn them over to the
mobile medical team. The majority of casual
ties are either killed or are so severely injured
that they require immediate transportationto
a hospital where they can promptly receive
shock therapy, blood and plasma transfusions
and skilled surgical care. The mortality among
air raid casualties is extremely high if treatment
of the severely injured is attempted in the field
and at Casualty Stations, or if transportation
to a hospital is delayed.
Casualty Stations have been established at
all hospitals and at sites remote from hospitals
for the care of minor casualties, who usually
comprise about a third of the total number of
injured. Here the nurses and auxiliaries will
have ample opportunity for work. Every nurse
must, therefore, be familiar with modern first
aid methods. Ten hours of instruction in ad
vanced first aid are required for U. S. Citizens
Defense Corps membership, but if no course in
first aid has been taken within 2 years, the 20
hour course is advisable. (See Appendix B.)
Student nurses should receive first aid instruc
tion earlier in their training than was formerly
the practice.

, By arrangement with the Red Cross, grad

uate nurses can complete an instructors train
ing course in first aid in 30 hours. Nurses so
trained should offer to serve as first aid in
structors if there is a shortage of qualiiled lay
first aid instructors in the community. Nursing
personnel will usually be more urgently needed
for other service.

plasma for the treatment of shock. All gradu

ate nurses and senior nursing students should
receive instruction in modern transfusion
methods, present day therapy for prevention
and treatment of shock, and the preparation
and care of transfusion equipment. Nurses
assigned to resuscitation teams will require
additional training from the team leaders.

Public health nurses should carry a limited

amount of first aid equipment in their bags in

VI. CHEMICAL CASUALTIES

case they are called upon for help. The amount

and type of such equipment should be decided
by each agency, but shouldinclude two tri
angular bandages, two medium sized shell
dressings, and several sterile compresses.
Nurses are in a position to give valuable

against gas and procedures for cleansing of

chemical casualties. They should be instructed
also in the first aid and definitive treatment of

advice to lay people concerning first aid equip

ment and to prevent unreasonable purchase and
hoarding of elaborate iirst aid kits. It is be
coming increasingly important to conserve
critical medical equipment and supplies for our
armed forces and our civilian hospitals.

V. BLOOD AND PLASMA

The United States Public Health Service and
the Medical Division of the Office of Civilian
Defense are assisting approximately 150 hos
pitals in the United States to establish and
maintain blood and plasma banks for emer

All nursesshould be taught self-protection

chemical injuries affecting the skin, eyes, and

respiratory tract. Courses for nurses on med
ical and nursing aspects of chemical warfare
should be provided in each community. Pri
ority in admission to these courses should be
given to nurses assigned to mobile field units
of the Emergency Medical Service and to Cas
ualty Receiving Hospitals.
Nurses properly informed about war gases
can render an important service to their com
munities by dispelling fear of chemical warfare.
They should be in a position to assist the local
Senior Gas Officers in teachingthe public that
self-cleansing is the only method which will
work in the face of the limited amount of time
available for treatment and the fact that gas

gency use. Funds have been provided for about

65,000 units of liquid and frozen plasma which
will be made available to the Emergency Medi
cal Service for the treatment of civilian cas

cleansing stations are feasible only for the

cleansing of injured persons and civilian pro
tection workers. (See Appendix H.)

ualties. Another 30,000 units of frozen plasma

made from blood collected by the Red Cross

VII. SANITARY AND PUBLIC HEALTH

for the Army has been acquired and distributed

in 500 unit lots among the larger cities. In
addition, 50,000 units of dried plasma are being
prepared for the Office of Civilian Defense by
commercial laboratories from biood collected
by the Red Cross for distribution to strategi
cally *located depots throughout the country,
from which it can be rushed to any city which
is in danger of exhausting its local supplies.
A unit of plasma is the amount derived from
500 cc. of blood. There will be available,
therefore, a reserve of approximately 145,000
units of blood plasma for emergency needs of
the civilian population.
Because of the importance of plasma in the
care of casualties, all nurses should be informed
of the technique of administering blood and

ENGINEERING
The Sanitary Engineering Section of the
Medical Division is composed of officers of the
United States Public Health Service. Through
a field staff of Sanitary Engineers in the Re
gional Offices of the Office of Civilian Defense,
it assists States and local communities in plan
ning for the protection and maintenance of safe
and adequate supplies of water, milk, and food
in the event of enemy action. This Section also
gives consultation to State and local health
departments and municipal officials concerning
emergency measures for the maintenance of
sewer service and refuse collection and disposal.
All nurses, but especially those engaged in
public health nursing activities, should be
familiar with this problem. They must be ready

to supply accurate information to thc public on

emergency measures, should these vital services
be interrupted. Instructions concerning emer
gency water and other sanitary precautions are
the responsibility of the State and local health
0Hicers. A list of home water supply precau
tions has been recommended by theiSanitary
Engineering Section of the Medical Division of
the Office of Civilian Defense in Sanitary Engi
neering Bulletin No. 1. )(See also Appendix I.)

VIII. VIILUNTEERS IN HEALTH,

MEDICAL CARE, AND NURSING
A. Volunteer Services of Registered
Nurses

ices provided by national, State and local agen

cies must be strengthened and extended to meet
rapidly mounting wartime needs. The per
sonnel of these organizations is seriously re
duced by the demands of the military services
and of the war industries, and additional vol
unteer help must be obtained if hospitals,
health departments, and voluntary health
agencies are to continue to function effectively.
B. Volunteer Nurses Aides
To meet the anticipated need for expansion
of nursing facilities, the United States Ofiice of
Civilian Defense in August 1941, requested the
American Red Cross to expand its Volunteer
Nurses Aide Corps and to revise and intensify
its training program for Nurses Aides. A
program sponsored by the two agencies was

Nurses volunteering to assist in the war pro

gram should confine their activities to the type
of service for which they are best prepared
nursing. Although they may be requested to
serve as air raid wardens or in other Civilian
Defense activities, they are more urgently
needed for nursing duties.
Examples of volunteer services which active
and retired nurses can best offer are:
1. Recruiting candidates for nursing schools.
2. Recruiting candidates for Nurses Aide
Courses in cooperation with Civilian Defense
Volunteer Omces and Red Cross N urses Aide
Committees.
3. Serving part-time in Casualty Receiving
Hospitals and with Medical Field Units.
4. Teaching Home Nursing and Nurse-s Aide
classes.
5. Supervising the care of children in day
nurseries.
Volunteers participating in the last two
activities are eligible for membership in the
U. S. Citizens Service Corps. (See Appendix
C.)
Most of these volunteer services will be on a
part-time basis. They can, therefore, be carried
out (a) by retired muses who have home re
sponsibilities, (b) by older nurses who are able
to work only part time, or (c) by those who give
extra time outside their regular nursing work.
It isthe patriotic duty of all inactive nurses

immediately inaugurated for the training of

100,000 N urses Aides. In collaboration with
the Medical Division of the Omce of Civilian
Defense, the curriculum was revised to meet
war needs. (For details of curriculum and
regulations regarding training of N urses Aides,
see "Guide for Training Nurses Aides," pub
lished by the United States Oiiice of Civilian
Defense, in collaboration with the Red Cross;
also Appendix F.)
The Red Cross has instructed each local
chapter undertaking a Nurses Aide Training
Program to organize a Nurses Aide Committee
composed of nurses and lay representatives,
the local Chief of Emergency Medical Service
and a representative of the local Civilian De
fense Volunteer OHice. To this committee is
assigned the responsibility for:
1. Determining local policies and safeguard
ing standards.
2. Recruiting candidates in cooperation with
the Civilian Defense Volunteer Omce.
3. Selecting volunteers meeting Corps re
quirements in` regard to age, education, and
availability.
4. Providing properly qualified nurse in
structors.
5. Administering and supervising the train
ing of the Corps.
6. Assigning Aides after completion of train

ablelto do so to return to full-time nursing for

the duration of the war.

ing to service in hospitals, health departments,

visiting nurse organizations and other health
agencies.

Nurses should assnune responsibility for pro

moting the use of volunteer service in hospitals
and health agencies. Health and welfare serv

emergency medical and nursing program of the

local Emergency Medical Service.

7. Coordinating the Aide service with the

In order to include the services of Volunteer

Nurses} Aides in the defense program, a Nurses
Aide Unit has been established in the United
States Citizens Defense Corps. The local De
fense Council determines membership in this
unit on recommendation from the local Red
Cross Chapter. Membership in the United
States Citizens Defense Corps implies certain
duties and privileges, and may be the basis for
receipt of medical care and financial aid from
Federal funds in the event of injury or death
sustained in line of duty.
Assignment of Nurses Aides for service in an
emergency is made by the Red Cross Volunteer
Nurses Aide Committee upon request of the
local Chief of Emergency Medical Service or
his Nurse Deputy. (For details and qualiiica
tions for membership and method of assign
ment of Nurses Aides, see. Medical Division
Memorandum No. 17, September 21, 1942.) A
member of the Nurses Aide Committee is as
signed the responsibility of keeping a current
roster of available Nurses Aides at the local
Red Cross Chapter Volunteer Nurses Aide
Corps Headquarters in order to facilitate emer
gency assignments. In large communities this
roster must be classified by districts in which
Nurses Aides reside.
Every nurse and every local and State Nurs
ing Council for War Service should promote the
Volunteer Nurses Aide Program, wherever
facilities for training are suitable, as an impor
tant wartime measure to relieve the nursing
shortage.
C. Nursing Auxiliuries
Under this heading are included practical

of hospitals. The local Chief of Emergency

Medical* Service, his Nurse Deputy, and the
local hospitals and local Nursing Councils will
decide how the assistance of nursing auxiliaries
can be used most effectively for emergency
service.
Nursing auxiliaries assigned to medical Held
units must complete an approved first aid
course. To identify them as members, they
will be entitled to wear the insigne of the
Medical Unit on conforming with regulations
for membership in the Citizens Defense Corps.
(See Appendix B.) Nursing auxiliaries may
also give volunteer service which entitles them
to membership in the Citizens Service Corps.
(See Appendix C.)
D. Red Cross Home Nursing Course
The Red Cross is responsible for the teaching
of home nursing. To aid in teaching this course
a new textbook, "Red Cross Home Nursing,"
has been prepared under the direction of the
Red Cross Nursing Service (July 1942), to
replace the previous text on "Home Hygiene
and Care of the Sick." Nurse instructors for
this course must be approved by the American
Red Cross. Volunteer instructors should reg
ister at the local Civilian Defense Volunteer
Ofiice. The course should be adapted to the
needs of the group enrolled for training.
These courses are designed to increase the
resourcefulness of citizens in dealing with illness
or injuries in the home. With the increasing
shortage of nurses, women must be prepared
to care for illness in their homes, especially
in rural communities.
While instruction in home nursing is not

nurses, persons who have not completed under

graduate training, paid hospital aides trained
under the auspices of NYA or WPA, hospital
attendants, and others who have had nursing
training less than that required for graduate
nurses.
A iile of names and addresses of nursing

designed to prepare them for community par

ticipation in nursing, it is the policy of the Red
Cross to encourage home nursing students to

auxiliaries should be kept by the_loca1 Nurse

may be used as auxiliaries in the Emergency

Medical Service after they have completed the
20-hour first aid course.

Deputy. This file should include information

on the amount and kind of training, as well as
availability for service locally and away from
home. To gather this information, the Nurse
Deputy should seek the cooperation of societies
and registries of practical nurses, of schools and
organizations giving auxiliary nursing training,
of local representatives of NYA and WPA, and

help their neighbors in time of need. In com

munities where there are no hospital "facilities
for training Nurses Aides, selected students
who have completed the home nursing course

E. 0ther Volunteers
Volunteers who have learned to assist in the
care and other services required for the sick
and injured are of inestimable service to

cvcry community. Suggestions for the ways in Health, Medical Care and Nursing" pub
in which volunteer assistants may be trained lished by the United States 0Ece of Civilian
for service are given in the' bulletin "V01unteers Defense. (See also Appendix C.)

A. Warning System and Control

Center
The presence of enemy airplanes is reported
by the Aircraft Warning Service of the Army
to its Regional Information Centers. A Civil
Air Raid Warning OHicer notiies District
Warning Centers, which in turn notify the
Control Centers in the path of the invading
planes to prepare for a possible air raid. The
Control Center of a community is the head
quarters of the Commander of the Citizens De
fense Corps and his technical staff, which in
cludes the Chief of Emergency Medical Service.
The Control Center receives air raid warnings
and transmits them to the proper recipients;
it orders the sounding of air raid alarms; it re
ceives reports from wardens concerning air
raid damage; and it dispatches operating units
of the protective services to the site of an inci
dent. Details of the operation of the Control
Center with particular regard to the Emergency
Medical Service are described in Medical Di
vision Bulletin No. 4. Nurses will be sum
moned for emergency service in accordance
with the plan developed in each community.
B. United States Citizens Defense
Corps
The United States Citizens Defense Corps
is an organization of citizens trained to carry
out the protective measures necessary in the
event of enemy attack. It should be organized
in each locality with an adequate number of
deployable units under local control.
Regulations of the OHice of Civilian Defense
prescribe the eligibility, training, and duties of
the members of the Citizens Defense Corps
entitled to wear or use its prescribed insignia.
(See Regulations 3, U. S. Citizens Defense
Corps, amended to August 1942.)
Members of each unit are required to take an

nursing auxiliaries, orderlies, rescue workers,

and members of stretcher teamsenroll as
members of the Citizens Defense Corps through
the local Chief of Emergency Medical Service.
For membership, graduate nurses are required
to complete the advanced first aid course (10
hours). They may also be required to take
such other courses as may be prescribed by the
Office of Civilian Defense.
2. Enrollment at Civilian Defense Vol
unteer Office.-The local Civilian Defense
Volunteer Office enrolls all persons in the com
munity who wish to volunteer their services.
A complete file of volunteers at this office re
veals the total volunteer personnel of the com
munity. Cooperation with it is necessary in
order to maintain a comprehensive appraisal of
the number and classification of citizens of the
community who are prepared to defend the
home front. Although professional members
of the Medical Unit may not be required to
register individually at the Volunteer Office,
the Chief of Emergency Medical Service should
arrange to have the names of physicians and
nurses who are members of the Medical Units
recorded there.
As agreed by the Office of Civilian Defense
and the American Red Cross, all Nurses Aides
should be registered at the local Civilian De
fense Volunteer Office. The Nurses Aide Com
mittee of the Red Cross is responsible for keep
ing the Volunteer Office informed of the number
and names of those who have completed train
ing~and who have been enrolled in the Red
Cross Nurses Aide Corps and in the Nurses
Aide Unit of the Citizens Defense Corps.
C. United States Citizens Service
Corps

official oath faithfully to discharge their duties.

1. Medical Unit.The personnel of the
Medical Unit of the U. S. Citizens Defense

The U. S. Citizens Service Corps is an or

ganization of volunteer civilian workers who
carry out the many civilian war jobs necessary
in every community. It is the policy of the
Citizens Service Corps to encourage to the

Corpsdoctors, nurses, nurses aides, other

fullest extent the work of established agencies.

l0

For existing volunteer groups working with

such agencies, membership in the U. S. Citizens
Service Corps is a recognition of the service
which they are already rendering. In addition,
there may be volunteers organized directly
under committees of the local Defense Council
when new activities are required which cannot
satisfactorily be performed through existing
agencies. Members of the U. S. Citizens
Service Corps are registered in the local Civilian
Defense Volunteer Oflice. Qualiiications and
regulations for membership and prescribed
insigne are described in the handbook, "The
U. S. Citizens Service Corps.
D. Civilian Defense Auxiliary Group
Not all nurses are assigned to emergency
service in medical units. Essential services in
hospitals and elsewhere must be continued dur
ing and following an air raid or other disaster,
and those responsible for such services may be
enrolled in the Civilian Defense Auxiliary
Group. When it is necessary for them to move
through restricted areas, they will be identified
by armbands with the basic Civilian Defense
insigne, all in blue, not the medical unit
insigne. The word "nurse" may be stenciled
on the band outside the insigne.
Nursing assistants and attendants in hos
pitals or in other essential services may also be
members of the Civilian Defense Auxiliary
Group. If it is necessary for these workers to
move during or immediately following an air
raid, identification will be required, and they
will wear armbands with the Civilian Defense
Auxiliary Group insigne.
Upon recommendation of the local Chief of
Emergency Medical Service, nurses and nursing
auxiliaries may be authorized by local Defense
Councils to be included in the Civilian Defense
Auxiliary Group and to wear and use its pre
scribed insigne.
E. lnsigne, Identification, and Dress
for Nurses
Insigne.Nurses who are enrolled members
of a Medical Unit of the U. S. Citizens Defense
Corps wear the insigne prescribed for that unit,
the Caduceus on the basic Omce of Civilian
Defense design. The arm band with this
insigne is worn only while actively engaged in
the performance of duties or while in transit to
or from places of duty to identify the nurse as
a member of the unit. The wear or use of a

civilian defense lapel emblem or other oiiicially

prescribed article with the same insigne is a
matter of local option. But whether it be arm
band or other "oHicial article," its wear or use
must be restricted to those nurses who have
been appointed by the Chief of Emergency
Medical Service as active or reserve members
of a Medical Unit and enrolled by the local
Defense Council.
Identification cards are ordinarily pro
vided for `all members of the Citizens Defense
Corps. This card bears the individuals signa
ture and the signature of the authorized repre
sentative of the local Defense Council, and
states that the member is entitled to wear the
insigne of the unit to which he or she is assigned.
Dress.No special uniform has been recom
mended for nurses enrolled in the Emergency
Medical Service because it is important at this
time to conserve materials and labor for mil
itary needs. Nurses do not need a special
uniform to show that they are performing essen
tial wartime duties.
The way in which nurses dress for emergency
field service is determined locally. Outer
clothing to be worn in an emergency should
be assembled and put aside, ready for immedi
ate use, to avoid delay in reporting for duty.
The type of duty to which the nurse is assigned,
climate, and local conditions must obviously
determine modification of nurses dress. As
a member of a medical team assigned to
work in a Casualty Station, the nurse could
have -a topcoat ready to put on over her white
uniform and, by exchanging her cap for a helmet
and putting on her arm band, be ready on
short notice to leave the hospital with her team.
For outdoor service at incidents, a white uni
form would be impracticable because of the
debris, dust, and dirt caused by bombing.
A dark-colored wash dress for summer and a
dress of heavy material or a sweater and wool
skirt for winter would be advisable. Helmets
must be worn if available; otherwise a small
close-fitting hat or cap could be substituted.
In some localities nurses have decided that a
short white butcher or carpenter apron, known
as a "blitz apron", is practical for wear in
Casualty Stations. Nurses have made these
aprons themselves, providing generous pockets
to carry such articles as flash light, skin pencils,
or identification tags. Such aprons. may prove
useful in an emergency situation, but the de

cision to make and use them is left to local Nursing Auxi1ia1ies.The local Nurse
, Deputy should have access to a iile of the
option.
names of those in the community who are avail
The public health nurse may wear her regular
able to assist nurses in an emergency. The
uniform and uniform coat, adding a helmet
names in such a file would include those of
and arm band, if she is working as an enrolled
practical nurses, undergraduates who left the
member of a Medical Unit. Her regular indoor
uniform would be suitable for wear in a Cas
hospi.tal before completing nursing training,
ualty Station. If she is called into the hospital
to give emergency service, she may 'wear her
public health indoor uniform, if the hospital
approves. No arm band is necessary when
working in the hospital.
F. Personnel File for Emergency
Nursing Service
Personnel {iles should be arranged alpha
betically according to geographic subdivisions
of the city so that the names of those residing
in each section or neighborhood of a city or
rural area may be readily available. This is
essential to facilitate emergency assignment of
nursing personnel in their immediate or ad
jacent neighborhoods. In large cities, a dupli
cate sectional list should be kept at the district
control center or at a hospital, a health sta
tion, or other central place of registry for each
geographic division.
Graduate Nurses.The local Nurse Dep
uty should have the following information on
tile for every graduate nurse available for
emergency service:
1. Full name and year of graduation from
nursing schools
2. Home address and telephone number.
3. Business address and telephone number.
4. Name of agency where employed.
5. Type of present nursing work.
6. Speciiic assignment for emergency nursing
service.
7. Hours available for emergency service
(applies particularly to married nurses with
families).
8. Availability for nursing work away from
home community.
9. States in which registered as a registered
nurse.
10. Completion of First Aid Course.
11. Completion of other courses for emergency
service (specify).
12. Special experience, such as surgical or
operating room supervisor, anesthetist, Xray
assistant, maternity supervisor, hospital ad
ministrator, public health.
12

persons who have completed hospital training

projects under the auspices of the National
Youth Administration or Works Progress Ad
ministration, hospital attendants, and others
who have had auxiliary training.
The information on file for this group should
include:
1. Full name.
2. Home address and telephone numberf
3. Business address and telephone number.`
4. Type of present work.
5. Name of agency where employed.
6. The amount and kind of training for
auxiliary nursing service.
7. Completion of First Aid Course.
8. Availability for work away from home
community.
Volunteer N urses Aides.-A complete cur
rent roster of Nurses Aides is kept at the local
Red Cross Chapter Volunteer N urses Aide
Headquarters. In large cities the Nurses Aide
file should be classified according to the dis
tricts of the city in which aides reside so that
they will be available for emergency assignment
in their neighborhood. The Chief of Emergency
Medical Service or his Nurse Deputy can then
summon help for any section of the city by
calling the Nurses Aide Committee member or
representative of that district. In a similar
manner hospitals could be supplied promptly
with additional Nurses Aides from the roster of
those residing in their vicinity.
G. Relationship of Red Cross and
0CD
To secure unity of effort and avoid duplica
tion of facilities in meeting civilian needs aris
ing from enemy action, a joint statement was
issued on May 21, 1942, by the Chairman of
the American National Red Cross and the
Director of the U. S. Office of Civilian Defense,
for the guidance of local Red Cross Chapters
and Defense Councils. This statement pro
vides, in par t, as follows:
In the event of bombing or other enemy
attack, it is the responsibility of local Defense
Councils as the representatives of Government

to scc that adequate provision is made for all

nccdcd services. During enemy attack, all
services are directed from the control center by
the Commander of the Citizens Defense Corps.
Responsibility for the care of those injured as a
result of enemy action rests with the Emerg
ency Medical Service of the Citizens Defense
Corps under the direction of the Chief of the
Emergency Medical Service.
Red Cross Chapters assist the Emergency
Medical Service by (a) training and furnishing
lists of persons trained in First Aid to be en
listed by the Emergency Medical Service as
members of stretcher teams; (b) recruiting and
training Volunteer Nurses Aides who will be
utilized by the Emergency Medical Service at
hospitals, Casualty Stations, and First Aid
Posts; (c) providing dressings, bandages, and
supplementary equipment as the Chapter may
decide in consultation with the Chief of Emerg
ency Medical Service; (d) equipping and oper
atifig emergency ambulances to be assigned to
the Emergency Medical Service and to serve
under its direction; (e) providing supplement
ary transportation for slightly injured and for
Emergency Medical personnel. During the
emergency period, ambulance units will be
under the direction of the Chief of Emergency
Medical Service or his Transport Officer.
During natural disasters the Emergency
Medical Service of the Office of Civilian De
fense will be utilized by the Red Cross in giving
its usual disaster service.

H. Self-Protection Against Injury

From \Vur Gases
Certain general rules which apply to all gases
must be followed, since it is hazardous to base
gas defense on exact diagnosis of the gas by
an individual.
1. If indoors when the warning of gas is
sounded, stay there. (This warning will be
given by the local air raid warden by use of
large wooden hand rattles.) Close doors and
windows; turn off air conditioning; stop up
fireplaces; avoid basements; go upstairs. If
out of doors, get out of the gassed area by
walking, not running, preferably against the
wind or at right angles to it.
2. War gases may affect the eyes, skin, or
lungs. Prevention of injury depends largely
upon prompt use of simple remedies which

persons otherwise uninjured can best apply to

themselves.
3. If exposed to war gases:
(a) Get out of the area as directed in rule 2,
and into a building. Before going inside, if you
have been in direct contact with the gas,
remove outer clothing and shoes and leave
them outside.
(b) Wash hands with soap and water.
(c) Irrigate or wash out the eyes at once
(this must be done within 5 minutes or not
at all), with generous amounts of a solution of
baking soda (one tablespoonful of baking soda
to a quart of water). If no soda is available, use
plain water.
(d) If liquid gas gets on the skin:
(1) Use pieces of cloth or cleansing tissues to
blot as much of the liquid as is possible
from the skin. Do not rub the skin, as
this will spread the liquid.
(2) To the contaminated areas of the skin,
apply a household bleaching solution full
strength. If not immediately available
do not waste time looking for the solu
tion; bathe immediately with soap and
running water.
(e) Take a shower or bathe with running
water, using plenty of soap.
(f) If respiratory distress develops, lie down
and remain quiet until seen by a physician.
(g) Do not get excited. Follow these in
structions without wasting time. Seek medical
attention as soon as possible.
Remember: Soldiers require gas masks be
cause they must remain in the ;gas-contam
inated area. Civilians who have no responsi
bility in civilian protection, requiring them to
remain in exposed areas, can get out of the
gassed area and can safely protect themselves.
Self-help is best because it is quickest.

I. Homo Waltor Supply Precautions

The following home water supply precautions
are recommended by the Sanitary Engineering
Section of the Medical Division of the Office of
Civilian Defense:
1. Keep available at least one quart bottle
filled with drinking water for each person in the
house. Interrupted water service may not be
restored immediately.
2. Turn water faucets off everywhere in the
house, if water service fails. When the water

comes on, if open faucets have been forgotten,

water will be wasted, damage may result from
Hooding, and water pressure may be lowered
0ver the city.
3. Do not fill bath tubs with water during or
following air raids. Such action, if taken
simultaneously in many homes, will seriously
reduce water pressure, limit the volume of
water, and cause a dangerous shortage of water
for fire fighting.
4. Leave water valves alone. Trained work
ers will shut off all necessary valves. The
Water Department will know if the service has
been turned off.
5. A telephone report is not necessary. The
air raid warden will promptly report troubles
in his area. Telephones are needed for im
portant omcial calls.
6. Discontinue, immediately, use of Hush
toilet, if water service goes off. Follow the
directions of the Health Department. Body
wastes will accumulate in the bowl and the
small volume of water stored in the home is
insufiicient to continue Hushing.
A sanitary excreta bag has been developed
which consists of an outer bag of waxed paper
and a water proof lining completely lined with
an absorbent material. This bag may be used
in any supporting frame container or may be
,. set in the toilet. After use, the top of the
bag can be rolled down, forming a small pack
age, and tied with a string; disposal may be in
trash or garbage cans, collected by the regular
municipal collection service, or by such other
means as may be prescribed by local authorities.
Information concerning the availability of
sanitary excreta bags may be secured from the
Sanitary Engineers in OCD Regional Omces or
in local or State Health Departments.
7. Protect health by boiling drinking and
cooking water if the Health Department so
advises. Disruption of water mains by bomb
ing may drain sewage from sewers or house
plumbing into the water main. Boil all drink
ing and cooking water for five minutes during
the first 24 hours after water service is restored.
8. Accept chlorine tastes in drinking water
without complaining. I t is a sign of safety.
Because of a water main break, or, for some
other reason, the health and water depart
" ments may increase the amount of chlorine
temporarily.

9. Do not drink water obtained from sources

other than the tap or drinking water carts
operated by the authorities. It is dangerous
to use water of unknown quality from wells and
springs, when the public water supply fails.
10. Do not believe or repeat rumors con
cerning water. The health authorities know
the water supply facts and will advise the
public. The origin of rumors may be sub
versive. Rely on the health and water
departments.

J. Regional Gfiices
States in Each Region
Region 1-17 Court Street, Boston, Mass.:
Connecticut, Maine, Massachusetts, New
Hampshire, Rhode Island, Vermont.
Region IIChanin Building, 122 East 42d
Street, New York, N. Y.: Delaware, New
Jersey, New York.
Region IIIRoom 1554, Baltimore Trust
Building, Baltimore, Md.: District of Col
umbia, Maryland, Pennsylvania, Virginia.
Region IVCandler Building, Atlanta, Gia.:
Alabama, Florida, Georgia, Mississippi,
North Carolina, South Carolina, Tennessee.
Rggion Vl530 Standard Building, Cleveland,
Ohio: Indiana, Kentucky, Ohio, West
Virginia.
Region VI2620 Civic Opera Building, 20
North Wacker Drive, Chicago, Ill.: Illinois,
Michigan, Wisconsin.
Region VIICity National Bank Building,
Omaha, Nebr.: Colorado, Iowa. Kansas,
Minnesota, Missouri, Nebraska, North Da
kota, South Dakota, Wyoming.
Region VIIIMercantile National Bank
Building, Dallas, Tex.: Arkansas, Louisiana,
New Mexico, Oklahoma, Texas.
Region IX1355 Market Street, San Fran
cisco, Calif.: Arizona, California, Idaho,
Montana, Nevada, Oregon, Utah, Wash
ington.
For nursing consultation by Federal Agency
Field Consultants, requests should be sent to
Regional Medical Officers. For nursing con
sultation by the State Nurse Deputy, requests
should be sent to the State Chief of Emergency
Medical Service.

U. s. covznumsur rnmrmc omc: 504727