How does the human spine work?
The human spine is one of the main parts of the musculoskeletal system. It contains the spinal cord and contains a large number of nerve fibers. In addition, the condition of the spinal column largely affects a person’s posture, and damage to one of the segments can cause paralysis or other serious changes in the human body.
The structure of the spine is complex and multi-component. It includes:
- Vertebrae. They are the main component of the spinal column. They consist of several parts - the yellow and posterior vertebral ligament, body, processes. This structure allows for a high level of protection of the spinal cord from stretching or accidental damage.
- Intervertebral discs. In normal condition, they are responsible for shock absorption and keep bones from rubbing and being damaged by hitting each other.
- Ligaments. Adapted to connect vertebrae to each other.
- Tendons. The main purpose of such an element is to attach numerous muscles located nearby to the spine.
- Facet joints. The vertebrae owe their mobility to them.
Any part may be damaged due to heavy loads.
If this happens, it is important that the transportation of a victim with a spinal fracture is carried out carefully and competently. All vertebrae in the human body are divided into several sections: cervical, thoracic, lumbar, sacral and coccygeal. Trauma may be concentrated in each of these areas.
State institution of the Republic of Kalmykia
Do not transport the victim yourself if you are sure that qualified medical care will be provided soon. It is also necessary to remember that the less the victim is shifted, the better this will affect his future condition; the victim should not be moved unless absolutely necessary. Transportation of the victim must be carried out only after immobilization of the injured part of the body and provision of first aid to the appropriate extent. The choice of method or method of transportation depends on the nature and severity of the injury, the condition of the victim, the number of Persons providing assistance, the availability of auxiliary devices, the distance of transportation and other conditions.
If the victim is in satisfactory condition and does not have injuries to the lower extremities with typical signs of fractures, he can move independently, but with the obligatory assistance of an accompanying person. The accompanying person throws the victim's arm over his shoulders, holding it at the wrist, and grabs the victim by the waist or chest. A more reliable option is to move the victim between two accompanying persons. Victims with injuries to the skull, chest and abdominal organs, as well as spinal injuries should not be allowed to move independently. The first method of carrying on the back is used when the victim cannot move independently, but can hold onto the rescuer with his hands, clasping his neck, while the rescuer supports the victim’s hips with his hands. In the second method, the victim is held on the rescuer’s back with a “bag”, i.e. The rescuer holds the victim's hands, and the victim's legs hang freely. To carry the victim on the shoulder, the rescuer lifts the victim, holding him in the armpits, and places the lower abdomen on his shoulder. Then he wraps his hand around the victim’s legs and, holding him in this way, carries him. If the weight of the victim is small, then he can be carried by hand. To do this, the rescuer places one hand under the victim’s buttocks and the other under the back, lifts him up and carries him, while the victim wraps his arms around the rescuer’s neck, if his condition allows. It is best to carry the victim using several people. If the victim is conscious, he is carried while sitting in the arms of rescuers. When carried by several people, it is possible to connect the rescuers’ hands into a “lock” - from four, three, two HANDS. When carried on four arms connected in a complex lock, each rescuer takes his left forearm with his right hand, and his partner’s left forearm with his left, creating something like a “seat”. The victim is placed on this “seat” and clasps the rescuers’ necks with his hands. If the victim is severely weakened and cannot hold on to the rescuers’ necks, he needs additional support; for this, a “lock” of three hands is used. In this case, one of the rescuers, usually less strong, clasps his left forearm with his right hand, and his partner’s right forearm with his left. The second rescuer takes the right forearm of the first with his right hand, and supports the victim behind his back with his left. The two-arm “seat” allows rescuers to move upright and support the victim with their free hands.
Carrying the victim “one after another by two rescuers” can be carried out in different ways. In the first option, one of the rescuers stands behind the victim and grabs him under the back and buttocks. The second rescuer, with his back to the first, stands between the victim’s legs and grabs him under the legs and knees. In another option, one of the rescuers holds the wounded man by the armpits. This method of carrying is convenient if the victim is unconscious. Transporting the victim using a chair. This method is used to overcome narrow passages or stairs. The victim is seated on a hard chair, carried by two rescuers, one is behind the victim, the other is facing him. Transporting the victim by dragging. In this way, unconscious victims with injuries to the musculoskeletal system are moved over a short distance, excluding the possibility of transportation under their own power or carrying.
For this you can use a blanket, a piece of tarpaulin, outerwear, etc. The victim is dragged onto the canvas, holding his clothes in the shoulder area, or the necessary material is placed under him. Transportation in this way is best done on a relatively smooth soil surface, so that there are no sharp objects, branches, stones, glass, etc. in the way. Every 3-5 minutes it is necessary to stop to rest and examine the victim. Victims with injuries to the spine and pelvic bones should not be moved in this way. Carrying the victim using a strap. It is a strip of durable fabric about 3.5 meters long, 5-7 cm wide. The material for the strap can be tarpaulin, waist belts, towels, sheets, rope, etc. This method cannot be used for fractures of the hip, spine, pelvis, or upper limbs.
Carrying a victim using a stretcher is the safest way to transport victims. As a rule, emergency medical services have special stretchers. Most often, improvised stretchers made from scrap materials are used to save the victim. To do this, you need to have on hand two poles 2.7-3.0 m long (you can use skis), which are connected to each other by spacers at a distance of 60-70 cm. Then they are rewound with fabric strips or ropes so that a kind of “bed” is formed. Instead of ropes, you can use a coat or raincoat. Doors, tabletops, wide boards, etc. can also be used as stretchers.
Lifting the stretcher must be carried out simultaneously by all rescuers. Rescuers carrying a stretcher must walk out of step, with short steps and not very quickly. The person walking in front must warn the person behind about obstacles encountered. The victim should be monitored by someone walking behind. When climbing uphill, to level the stretcher, the person walking in front lowers the stretcher as much as possible, and the person walking behind tries to raise it as high as possible; when descending from the mountain, the opposite is true. The victim must be carried feet first down the stairs and out of the vehicle and head first up the stairs and into the vehicle. If the chest or neck is damaged, the victim must be transported in a semi-sitting position (the angle between the limbs and the torso should be 45°). Victims with abdominal injuries are transported on stretchers in a supine position. If the spine is damaged, the victim must be transported in a supine position on a rigid base (board, boards, etc.). An unconscious victim must be transported lying on his side or stomach, thus preventing vomit and blood from entering the lungs. In case of burns to the back and buttocks, the victim is transported lying on his stomach. Victims with damage to the pelvic bones, if a fracture of the pelvis or spine is suspected, are transported in a supine position with the hips and knees bent and legs spread to the sides (“frog” pose). When transporting a victim with massive blood loss or if internal bleeding is suspected, it is advisable to raise the foot end of the stretcher or the victim’s legs by placing a cushion under them.
Main Causes of Injury
The list of main causes of injury:
- Strong squeezing. Occurs when a person falls awkwardly or accidentally lands on their buttocks or head. In this case, there is a lot of pressure and two types of fractures - compression and comminuted. Compression is characterized by a significant decrease in vertebral height. When the length is reduced by more than 50%, surgical intervention is often the only treatment option. A comminuted fracture is much more dangerous, because in this case the vertebra begins to fragment into many fragments - they can damage not only the spinal cord, but also muscles and ligaments. It is precisely because of the appearance of bone fragments that immobilization of a victim with a spinal fracture is necessary.
- Strong stretch. In this case, ligaments and nerves, as well as intervertebral discs, suffer more. Such fractures are called decompression fractures. People who work a lot with heavy weights, play sports, as well as the elderly and children are at particular risk. In addition, osteoporosis, as well as other diseases that contribute to the thinning of bone tissue, can provoke the frequent occurrence of fractures.
Transportation for a spinal fracture
Transportation with a spinal fracture is carried out exclusively by experienced doctors. If proper attention is not paid to the position of a person's body, the injury may worsen. Let's consider the basic requirements for transporting a patient.
Basic transport positions of the victim
There are several important requirements that determine how transportation with a spinal fracture is carried out. These include:
- Complete immobilization of a person. The body must be firmly secured to the stretcher or whatever replaces it. It is best to tie the person by the arms and legs. If a stretcher is not available, several boards can be tied together, taking into account that the head must remain in the correct position.
- Transportation if a spinal fracture is suspected should be carried out by at least three specialists. Experienced doctors say that assistance should be provided by five ambulance officers.
- If you do not have anything hard to carry, the patient takes a position on a soft stretcher and is turned onto his stomach.
- Immobilization for a spinal fracture is important for problems with any part of the spine. It is important to prevent displacement and also not to damage the victim’s spinal cord.
If you suspect that the cervical spine may be affected, you need to design a special corset that maintains immobility.
Transportation while unconscious
In this case, it is important to tilt the victim’s head and make sure that there is no vomit in his mouth. Please note that the person cannot tell you about his condition in any way, so you should transport him with you with caution.
Transportation for circulatory disorders
In this case, it is worth recording the damage and trying with all your might to isolate the hematoma that appears at the damaged site.
Transportation in case of breathing problems
In this case, during transportation the person needs to be given artificial respiration. Make sure your head is tilted slightly. Do not give the person painkillers in pill form.
Providing first aid in case of road traffic accidents
Main causes of death in road accidents:
- injuries incompatible with life - 20% - delay of ambulance - 10% - incorrectly provided first aid or inaction of eyewitnesses - 70%.
Why does this happen, how can I help a person injured in an accident? After all, in a driving school everyone learns the rules of first aid in case of an accident. But for some reason, the majority remain either indifferent to the grief of others or do not know how to help. We urge all motorists not to remain indifferent and familiarize themselves with (or repeat) the basic principles of first aid in case of an accident.
Accidents often occur in areas far from hospitals. This is one of the main reasons when an ambulance cannot quickly get to the scene of an accident. And this pre-hospital period is in our hands. The ability to provide assistance at this stage is greatly appreciated.
Ensuring safety at the scene of an accident.
1. Turn on the hazard warning lights and install a warning triangle.
2. Assess the situation and have confidence in your own safety, otherwise the number of victims may increase. A car with a gasoline engine burns out in 5-7 minutes, there is a possibility of an explosion. Therefore, it is necessary to turn off the engine, disconnect the battery (disconnect the wires from the battery by all possible means, tear it out, cut it, unscrew it). If a car crashes into a pole with power lines, the lines may be broken. You need to be careful.
3. Calling ambulance and rescue services. Let the following emergency numbers be always stored in your phone book:
“03” in Russia is an ambulance service “01” in Russia is a fire service, but through it you can always call an ambulance and rescue service
Sequence of assistance in case of an accident.
1. Call an ambulance.
2. It is necessary to remove the victim from the car. This is a very important moment, as the severity of the injuries can be aggravated. The main injuries in road accidents are traumatic brain injury, injuries to the thoracic region and lower extremities. Before removing the victim from the car, it is necessary to eliminate everything that could interfere with this. They pull the person out by grabbing him by the armpits.
Since in an accident a person receives various types of injuries, bruises, fractures, no sudden movements should be made. Under no circumstances should you jerk or stretch your limbs. And also, under no circumstances bend your limbs and torso. If there is a suspicion of a spinal fracture, then the patient is placed on his stomach so that the fracture site remains in relative peace.
3. After removing the victim, everything must be done as carefully as possible and his condition must be assessed as quickly as possible. First, you need to remove the constricting clothing to ensure the flow of oxygen (remove the tie, tear the clothes, loosen the belt, etc.). Any careless movement or pressure can only increase the pain, be careful.
4. Assess the condition of the victim. First, it is necessary to assess the state of vital functions; the nature of first aid will depend on this:
- breathing: the normal number of breaths per minute in an adult is 16-20, in children - 20-23. The victim may develop both rapid breathing (25-30) and rare breathing (8-10), which may indicate the development of shock; — pulse: it is better to feel it on the carotid (neck) or radial artery (in the place where the watch is worn). Normally 60-80, in children 80-90. A rapid or slow pulse (less than 60), or irregular, may be a sign of shock; - reaction of the pupils: in healthy people, the pupil narrows in light and dilates in darkness. If the victim's pupils are dilated and do not respond to light, this is a sign of a life-threatening condition. - skin: normally pink in color and warm to the touch. When fainting and bleeding, they become pale and cold. In case of severe respiratory distress and blood loss - cyanotic. Rescuers should have 5-10 seconds for such an assessment. Because in these cases every minute is important.
Resuscitation of a victim with signs of clinical death.
Each of the following signs is not the main and reliable sign of clinical death. The diagnosis is made when all or most of the following symptoms are present:
- lack of consciousness;
- lack of breathing;
- absence of pulsation in large vessels (carotid or femoral). It is better not to check the pulse on the radial artery, since at systal pressure (upper) 50-60 mmHg. he is already disappearing;
- pupil dilation;
- change in color of the skin and mucous membranes (appearance of pallor or, more often, pronounced cyanosis).
Clinical death is the period between life and death in which there are no clinical signs of life, but vital processes in the body are still ongoing. This is the period when a person can be saved. When providing resuscitation in the first 3 minutes, the probability of salvation is 75%; if the time extends to 5 minutes, the probability of salvation is 25%. And if it lasts more than 10 minutes, then it is already impossible to save the person. Because in seemingly a matter of minutes, a person’s brain dies.
General principles of resuscitation:
- the victim must be placed on a hard surface;
— a cushion is placed under the neck to prevent the tongue from sinking;
- indirect cardiac massage with artificial respiration. The ratio of the number of chest compressions and artificial breaths is 15 compressions per 2 breaths when assisted by one person, 5 compressions per 1 breath when assisted by two people. The total number of breaths is 12-16 per minute, chest compressions are 60-70 per minute. Blowing air should take 1-2 seconds. Punching the chest should be 4-5 cm, in children 2-3 cm and is done with the base of the palm of one hand. The massage is continued until cardiac activity is completely restored.
Signs of effective resuscitation:
- the appearance of pulsation in the carotid artery;
- constriction of the pupils;
- the skin becomes pink;
- appearance of spontaneous breathing.
General principles of first aid in case of an accident.
- stopping bleeding;
- if there is no breathing, begin artificial respiration;
- in the absence of a pulse, perform indirect cardiac massage along with artificial respiration;
- treat wounds, apply a bandage. For fractures, apply splints.
Car first aid kit.
Dressings have been added to the new composition of car first-aid kits, since the previously included 3 bandages were not enough to provide assistance to even one victim. The exclusion of medications is due to the fact that in hot weather the temperature can reach 40-50 degrees Celsius. This is a very serious violation. At high temperatures, drugs can change their properties and be life-threatening. And drugs such as analgin and activated carbon have nothing to do with saving a person’s life.
The composition of the car first aid kit is designed to provide first aid for severe injuries that may threaten human life. The Law further states: “At the same time, the driver may, at his own discretion, store in the first aid kit medicines and medical products for personal use, taken by him independently or recommended by the attending physician and available for free sale in pharmacies.” In addition to the composition of the car first aid kit, recommendations for its use have been developed.
What are the possible mistakes during immobilization?
Due to the fact that many people have no idea how to perform immobilization for a spinal fracture, common mistakes appear:
- Incorrect fixation of the victim’s head and neck increases pressure on the first cervical vertebra and other components of this section.
- The absence of a special supporting cushion of clothing under the patient’s back causes injury to the thoracic region.
- Transportation for a fracture of the lumbar spine without twisted clothing under the pelvis and chest of a person when moving him on his stomach.
To prevent the accident from ending in serious complications, strictly follow the instructions, monitor the patient’s condition and correctly convey all the details of the situation to the doctors who arrived at the scene.