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First aid for spinal injury. Providing first aid for spinal injuries

A spinal fracture is an extremely serious life-threatening injury. Any, even the most minor injury to the spine, not to mention the fracture of its bones, can cause lifelong suffering for the victim. For this reason, regardless of the type of injury, assistance to the patient is provided with the utmost care, immediately and with mandatory participation professional medical personnel and modern diagnostic equipment.

How is the human spine structured?

The spine is the support of the entire body. It consists of individual vertebrae, firmly connected to each other by ligaments and muscles. Between the vertebrae there are intervertebral discs. These are a kind of natural shock absorbers. They consist of a gelatinous core surrounded by a dense connective tissue. There are a total of 33 vertebrae in the spine: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (they are fused into a single bone), 5 coccygeal.

Each vertebra, in turn, consists of a body, an arch and seven processes (spinous, two transverse and four articular). The articular processes are connected above and below with similar processes of the overlying and underlying vertebrae. The vertebral arches form the spinal canal, in which the spinal cord. Intervertebral foramina are formed between two adjacent vertebrae, serving as the exit point for the roots. spinal nerves.

Causes of spinal fracture:

car crashes
"diver's injury"
falling from a great height
Osteoporosis is a disease that leads to weakening of bone tissue
metastatic lesion of the spine with malignant tumors. Metastases are called screenings cancerous tumor to other organs and tissues of the body. When the vertebral body is damaged by tumor metastasis, progressive destruction of the vertebral body occurs, and a fracture can occur with minimal external load.

Some types of vertebral fractures:

- compression fracture- this is the most common option spinal injuries. With this type of fracture, a decrease in the height of the vertebrae occurs. Typically, the mechanism of injury is a combination of forward flexion motion of the spine coupled with axial loading. There is a kind of pressing going on. spinal column, which the bones cannot withstand. This injury is very common among older people, especially women, and young people involved in extreme sports. Very often, fractures of this kind go unnoticed and manifest themselves as persistent back pain and progressive deformation of the spinal column. Most often, a compression fracture affects the 11th and 12th thoracic vertebrae, as well as the 1st lumbar vertebra.

comminuted fracture- This is the most severe spinal injury. With this type of fracture, a split of the vertebral bodies occurs. The spinal cord can be injured by vertebral fragments with any slight displacement.

In addition to the above, spinal fractures can be divided into subgroups as follows:

fractures can be single or multiple
with and without spinal cord injury
with damage to the spinal nerve roots and intervertebral discs without it
stable (the entire spine does not move) and unstable (occurs when the entire vertebral body is damaged simultaneously)
you can find a fracture of the body, arches and processes of a separate vertebra

Signs of a spinal fracture:

severe pain, often leading to loss of consciousness and fall blood pressure, in the area of injury. The exception is those cases when a person is “ready” for a fracture due to severe chronic disease(osteoporosis, cancer)
when nerve fibers are damaged or compressed by edema (the spinal cord itself, the roots of the spinal nerves), weakness (paralysis) occurs in the limbs at the level of injury, a decrease or complete loss of all types of tissue sensitivity
When a lumbar vertebra is fractured, urination and defecation disorders occur (incontinence), pain can radiate to the abdomen
When the sacral region is fractured, the victim experiences swelling, extensive hematoma, and pain when pressed. The patient cannot stand or walk
When the cervical and thoracic vertebrae are fractured, breathing becomes difficult, even stopping completely
with fractures of the cervical vertebrae, the head takes a forced position with tension in the neck muscles, and breathing problems occur. This injury almost always causes instant death.

Emergency first aid for a spinal fracture:

pain relief, any analgesic you have in maximum dosages(“Analgina”, “Pentalgina”, “Revalgina”, etc.)
fixation of the affected area of the body

Of course, it is simply not possible to fix any specific part of the spine in the conditions of pre-medical care. For this reason, it is customary to immobilize the entire spinal column. This is done using a rigid base in human's height. Rigid stretchers can be replaced with two boards.

As a last resort, you can use a soft stretcher, but on the condition that the patient will only want to lie on his stomach. This is far from the most the best option transportation of the victim, since it does not provide the opportunity to constantly monitor breathing and see the person’s facial expression.

Regardless of the level of injury, it is advisable to perform fixation cervical spine spine. Even if it is not damaged, unnecessary movements of the spinal column will bother the victim. This can be done using a homemade neck collar. The height of the collar should be equal to the length of the neck, i.e. pass from lower jaw the patient to the collarbones. The collar can be made from cardboard or other hard material: cut to size, covered with cotton wool or a soft rag, and wrapped with a bandage on top. You can also use other available means, for example: tightly rolled clothes, bags of sand, books, etc.

Laying the patient on a backboard or any other base is carried out very carefully, with synchronized movements while supporting all parts of the spine.

plant a patient
put him on his feet
pull legs and arms
try to put the cervical or any other vertebrae in place on your own
give medications to a victim with swallowing dysfunction or loss of consciousness
transport the patient to the hospital while sitting

In medicine, a wound is any damage to the mucous membranes, skin, as well as various tissues and internal organs caused by the influence of any force, accompanied by pain symptom varying intensity, gaping, as well as different types bleeding.

Many types of wounds require immediate medical attention, as well as first aid measures before doctors arrive. The life of the victim often depends on the correctness and timeliness of providing first aid.

General First Aid Information

Of course, providing first aid for injuries has many features, which depend on the type of injury, its location, the condition of the victim, the location of the incident and other factors.

First health care in case of injuries includes the following actions:

First aid for a gunshot wound

Upon receipt, first aid emergency care is carried out according to a certain algorithm, regardless of which part of the body is wounded. The only exception is a head wound.

It is important to call immediately ambulance, while simultaneously assessing the condition of the victim and establishing the location of the injuries received.

If a person is unconscious, you should not try to revive him; you can immediately begin to provide assistance by first tilting his head back and turning him to the side so that air passes into the lungs without any obstacles.

There is no need to try to move or carry the victim, or to turn him into any other position in which, in the opinion of the person providing first aid for injuries, he will be more comfortable.

It is important not to cause any other harm to the person. It is best not to change the victim’s position.

If a bullet remains in the wound or another foreign object is sticking out of it, you should not pull it out, since such objects, as a rule, restrain bleeding by blocking damaged vessels; removing them from the wounds will provoke increased bleeding and complicate the condition.

You should also not try to clean the wound from blood clots, dead tissue and other elements., since such actions usually lead to infection of the damage. If the wound is on the stomach and internal organs are visible protruding from it, under no circumstances should you try to reduce them.

The main purpose of providing first aid when receiving a gunshot wound is to stop the bleeding, for which its type should be established.

When blood comes out of the wound in a pulsating stream and has a bright scarlet color. In this case, it is necessary to find the damaged artery in the wound and block it with a finger or pack the wound.

When there is blood dark color and flows out of the damage without pulsation or pressure. In this case, it is necessary to apply a tourniquet (if a limb is injured).

If the wound is above the level of the heart, then the tourniquet should be applied above the wound; if the localization of the damage is below the heart area, then the tourniquet should be applied under the wound. If the torso is injured, the wound must be tightly packed.

Then apply a thick pressure bandage and wait for the doctors to arrive.

Actions in case of knife and stab wounds

The first step is to determine the nature of the wounds received and their number. If there are several wounds, then priority in providing first aid is the one that has largest size, is bleeding heavily or is in a life-threatening location. Such places include the inner surface of the thighs, the upper third of the abdominal cavity, the area chest, neck.

If a knife is sticking out of the wound, you cannot pull it out, as it will stop the bleeding. You should not be afraid of infection of the wound with a cutting object stuck in it. Bacteria and other microorganisms begin to actively multiply only 6 - 8 hours after entering the wounds, and during this time the victim will already be taken to the hospital and receive qualified assistance specialists.

PMP for head injuries

When receiving any head wound or injury, first aid should always be aimed at stopping the existing bleeding.

It is important to remember that even with a minor injury, bleeding can be very severe, which often frightens people.

This is explained by the fact that all the vessels on the surface of the head are located very close to the skin, and therefore any damage causes quite intense bleeding, but wounds in this area heal very quickly. Important feature head is also the fact that the bones of the skull are very close to the skin surface and thin soft tissues , That's why the best way

Rules for applying a pressure bandage for a head injury:

Cover the wound area with a sterile gauze pad and press it firmly against the cranial bones.
Use a bandage to secure the applied bandage.
If the pressure of the applied bandage turns out to be insufficient to stop the bleeding, and it opens again, you can simply squeeze the edges of the injury with your hands.

After applying a bandage and stopping the bleeding, it is necessary to call an ambulance, and lay the victim on his back so that his head and shoulders are elevated.

To secure the dressing material applied to the wound, a thick scarf-type bandage is often applied.

How to help a victim with an abdominal injury

They can often be dangerous, since damage to internal organs often occurs, which can lead to very serious complications, for example, the appearance of hidden internal bleeding or peritonitis, which is an inflammation of the peritoneum. With such wounds, the main difficulty is that at first glance it is impossible to assess the depth and danger of the wound.

An important feature of wounds to the abdominal area is that the deep and dangerous wound may look relatively normal and not cause concern, but a wound that does not pose a serious threat may look quite terrible, severe and cause panic.

In addition, with such wounds there is also high risk infection.

The main areas of first aid for abdominal injuries are: determining the type of bleeding and stopping it, as well as maximum reduction risk possible infection and the spread of shock.

An important point is also that the injury can be of a different nature, for example, be transverse or longitudinal, and first aid in these cases will have some differences.

If there is a longitudinal wound, the person lies flat on his back, but with a transverse wound, it is very important to lay the person on his back and bend his knees. This measure will reduce tension and pressure on the wound.

If organs or part of the intestine are visible in the wound, there is no need to try to correct them and put them in place. In this case, before applying a bandage, it is necessary to cover the wound with clean polyethylene and then apply a wide bandage on top, without tightening the bandage. Before the ambulance arrives, you need to monitor the condition of the victim.

First aid for chest wounds

First aid measures for victims depend on whether the person is conscious or not. If the victim is conscious, the first thing you should do is ask him to cover the wound with his palm, and then sit the person down, tilting him in the direction of the wound.

The important point is that if you tilt the patient to the other (healthy) side, then the blood that flows in the affected part, with its weight, will put pressure on the undamaged lung, as well as on the heart, squeezing them, which will disrupt their work, and serious complications will arise.

You should not place a person with the wound facing up, since it is very important that the blood has a free exit from the chest cavity. In addition, if the victim is positioned with the wound upward, then air will be sucked into the chest cavity and it will be very difficult to stop this process.

To prevent air from entering the wound, it must be covered with a bandage, but before this, the victim should be asked to tightly close it with his hand. Having prepared the materials for the bandage, you should remove your hand and immediately apply a gauze pad to the wound, which should be covered on top with a piece of polyethylene or a lot of material that does not allow air to pass through. Such a bandage must be bandaged so that air cannot penetrate anywhere, or the edges of the polyethylene must be glued with a plaster around the entire perimeter.

If the victim is unconscious, then you need to close the wound with your own hand, and apply a bandage with polyethylene as soon as possible and call an ambulance.

It is also very important that the person is wound down. The patient’s condition should be monitored until he is transferred to the hands of doctors, and one must be prepared for the fact that cardiopulmonary resuscitation measures may be required at any time.

How to stop bleeding and apply a tourniquet

Arterial bleeding in the area of the neck, limbs or head, until doctors arrive, you can stop it temporarily by finger pressing the damaged vessel. The artery should be pressed slightly above the location of the bleeding, in the place where the vessel is shallow, where there is not a large number of muscles and it can be pressed tightly to the bone.

There are also certain points at which the artery can be compressed to quickly stop bleeding with a finger, fist or palm. As a rule, they coincide with places where the pulse can be easily felt.

Arterial bleeding must be stopped as quickly as possible, since a person’s life depends on it. If such bleeding is not stopped in time, then death can occur in a period of 15 to 50 minutes, depending on the intensity of the blood flow.

One of effective ways stopping arterial as well as venous bleeding is. This creates circular pressure on body tissues and blood vessels that are pressed against the bone. But applying a tourniquet is only possible if the limbs are damaged; in other cases this method cannot be used.

Not only special medical devices can be used as a tourniquet, but also a piece of thick elastic, a soft rubber tube, a tie, a handkerchief (except for small handkerchiefs) folded diagonally, a waist belt, any piece of strong material or a rubber bandage. The tourniquet can also be replaced with a cuff from a medical tonometer.

It is important that when applying a tourniquet there is no pinching skin , therefore it is recommended to apply it after wrapping the limb thick fabric or a towel.

For correct application, the injured limb is slightly lifted up, while the tourniquet or other device is stretched and, without weakening the tension, wrapped around the application site several times, after which the structure is secured.

If the tourniquet is loosely tightened, stagnation of venous blood is created, but the bleeding does not stop. Incorrect application of the tourniquet will be indicated by blue discoloration of the integument of the limb, and venous bleeding may noticeably increase.

Bleeding when the tourniquet is applied correctly arterial type stops immediately, the limb quickly turns pale, and vascular pulsation disappears.

It is important not to tighten the tourniquet more than is necessary to stop the bleeding, since in this case, crushing of the underlying soft tissues, such as blood vessels, nerve fibers and muscles, can occur, which often leads to paralysis of the injured limb in the future.

After applying a tourniquet, it is important to quickly apply a bandage to the wound and immobilize the limb. b, preventing it from remaining without blood supply long time, otherwise there is a serious threat of tissue necrosis. It is important that the tourniquet is on the limb and compresses it for no longer than 1.5 hours.

Spinal-spinal. This injury damages the spine and spinal cord and is therefore at risk of clinical death. The most common conditions for injury to occur are impact or compression of the spine, excessive simultaneous curvature of the spine, or a jump from a height.

Signs. The patient may complain of back pain, unusual sensations in this area (burning, decreased sensitivity). The strength of the limb muscles during certain movements is reduced on one or both sides (needs to be checked with a variety of movements in each of the symmetrical joints). When palpated, the muscles of the limbs are relaxed. Sensitivity to touching or lightly pricking the skin is impaired more often in the area of the feet and hands. There is urinary retention or incontinence.

If these signs cannot be identified and there is no bone damage visible through a soft tissue defect, it is necessary to look for signs of a spinal fracture. To do this, you need to check the patient’s reaction to axial unloading and loading of the spine by pushing with increasing intensity on the head and heels of the victim and pulling them along the axis of the spine. Then you should palpate and tap the spinous processes of the spine and the space between them, sequentially, first from the cervical region, then from the sacrum. In this case, you need to tap the processes with your middle finger, and with the neighboring ones (second and fourth), lying side by side on the surface of the back, feel the degree of tension of the muscles lying under your fingers during your strike. Mark the place of greatest tension - a sign of a possible fracture. Then palpate other parts of the spine located 1-1.5 and 2-3 cm outward on both sides of each of the spinous processes. Limited tenderness on examination is also a sign of spinal injury.

Help. If there is a wound, it is necessary to treat its edges with an antiseptic solution and apply a sterile bandage. At any stage of transportation, ensure that the patient's spine and head remain motionless. Long-term transportation is possible only on a board with a dense, even bedding, to which the patient is tied in a position on his back or, worse, on his stomach. If there is no way out, if you have to transport on a soft stretcher, lay the victim with his back up. When transferring, for example, from the ground to a shield, it is necessary to place your palms under the patient so that there is no sagging of any part of the spine while at the same time, on command, lifting him from the ground. Control the patient's breathing, as it may stop. If there is a fracture of the cervical spine, during transportation it is extremely necessary to ensure a stationary position of the head relative to the body (for example, with bolsters in the neck, head).

If hospitalization is delayed, the patient is placed on a hard bed on his back, with flat bolsters placed under his head and lower back.

It is necessary to provide the victim with complete rest, since spinal injuries are, if not the most severe, then at least one of the most severe.

Sequencing:

1. Call an ambulance.

2. Lay the victim on his back on a hard surface (board) and ensure that he is completely motionless.

3. Prevent neck mobility by wearing a cervical collar or applying pads made of soft fabric (clothing, blankets, etc.) to the sides of the neck.

4. Give the victim 2 painkiller tablets.

5. Observe the condition of the victim before arrival medical workers.

In cases of respiratory arrest and/or cessation of cardiac activity, begin artificial ventilation and/or closed cardiac massage.

If it is necessary to clean the victim's mouth from foreign contents, his head, neck and chest should be held in the same plane, while another person (assistant) turns him.

Transferring the victim onto a hard surface (stretcher) is carried out with maximum care with the help of at least 3 people (slide 4.5.43).

In this case, one person places his hands under the shoulders (in the area of the shoulder blades) on both sides, positioned on the side of the head, thereby fixing it.

The second person places their hands (palms) on the buttocks (under the hip bones) and lower back.

The third one holds the legs at the knees and upper shins.

On command, all three simultaneously lift the victim and place him on a rigid stretcher or shield.

First aid for chest injury

General activities:

Call an ambulance

I. To make breathing easier:

1) give the victim a body position that makes breathing easier: sitting, half-sitting (except for cases of injury associated with a fracture of the sternum - in these cases the victim must be placed on his back)

2) provide air flow and unfasten and/or loosen clothing that restricts breathing;

3) wipe the temples with a cotton swab moistened with ammonia and let the victim smell it;

4) limit speech mode (exclude unnecessary communication with the victim).

II. To improve cardiac activity:

5) give the victim 15-20 drops of Corvalol (Valocordin, Valoserdin).

III. Anti-shock measures:

6) give orally 2 tablets of an anesthetic (analgin, baralgin, sedalgin, tempalgin, etc.);

7) apply cold to the injury site (ice pack, snow, etc.);

8) exclude the victim’s movements (complete rest);

9) if necessary, immobilize (limit mobility) the injured area of the chest (ribs, collarbone, sternum);

10) warm (cover warmly) the victim;

11) monitor the condition of the victim until the arrival of medical workers.

In case of chest injury In addition to general assistance measures, you need:

1) treat the skin around the wound with an antiseptic (5% tincture of iodine, etc.);

2) cover the wound with sterile material (wipes);

3) apply a pressure bandage (for a penetrating wound, apply an occlusive bandage);

4) apply cold to the wound.

In case of chest trauma, damage to the bone frame of the chest (ribs, collarbone, sternum) is most likely.

First aid for broken ribs:

1. Ensure that all of the above general measures taken in case of chest injury are carried out, taking into account the peculiarities of immobilization of rib fractures.

2. Limit the mobility of rib fragments by applying several strips (10-15 cm) of adhesive tape to the fracture area.

First aid for a clavicle fracture:

1. Perform all general measures taken in case of chest injury.

2. Limit the mobility of the clavicle at the fracture site by applying cotton-gauze rings or hang the arm bent at the elbow joint on a scarf to the neck and fix it with circular bandages to the body (slide 4.5.44).

Waiting for the arrival of medical workers or transporting the victim is carried out in a sitting position.

First aid for a sternum fracture

Carry out all general measures taken in case of a chest injury, taking into account the particular position of the victim’s body with this injury (the victim must be laid on his back, on a hard surface).

! Remember: in all cases of chest injury, the victim must be urgently taken to a medical facility.

April 20, 2018

Trauma is a health disorder, violent damage to an organ or the body as a whole, caused by external influence.

Before the ambulance arrives, it is prohibited to carry injured people. The only exceptions are those cases when the patient needs to be taken out of danger.

One of the most common injuries is considered to be a fracture - a violation of the integrity of the bone, which is accompanied by sharp pain, swelling and deformation of the bone at the site of impact.

When providing first aid for a fracture or dislocation, you need to:

Anesthetize the affected area;
Treat the wound (if open fracture), stopping the bleeding and applying a bandage;
Provide the broken bone with a state of rest using splints (they can be made from scrap materials: boards, sticks), fixing them on at least two joints with the center of the splint at the fracture site;
Apply a cold compress or ice to the fracture site.

Applying splints for a fracture femur, the inner one needs to be fixed from the groin to the heel, and the outer one - from armpit to the heel, while trying not to lift your leg.

If the spine is fractured, but the back is injured, without lifting it, fix it with a wide board or turn it to a position facing down.

If the pelvic bones are damaged, place the patient on a wide board, spread his knees apart, bringing his feet together.

When assisting with broken ribs, bandage the victim's chest. If this is not possible, try to pull it off with a towel while exhaling.

Transportation of patients with fractures should be carried out only on stretchers. Attempts to straighten a dislocation or match bone fragments on your own, without the help of a doctor, are prohibited, as they may have irreparable consequences.

If the victim has a head injury, you need to:

Lay the injured person on his back, ensuring him peace and immobility;
If there is a wound, treat it and apply a sterile bandage;
Place a tight bandage on the head, first securing it on both sides with rollers;
Apply something cold to the affected area;
If the victim is unconscious or his injury is accompanied by vomiting, carefully turn his head to the side.

First aid for sprains: