First medical aid( PMP) for fractures: tire application, hemostatic harness, transportation of the affected person
Every person can get into an emergency situation. And in this case, knowing the rules of first aid can save lives. The main thing is to keep the clarity of thinking and not to try to perform manipulations for which special training is needed.
Rules for the provision of the
PMP The task of the person who provides first aid is not to make the victim worse than he is now. It should relieve the pain and provide peace to the damaged area. This is the main task of first aid( PHC) in fractures.
First of all, it is necessary to assess the severity of the condition of the victim and to identify the place of injury. Then, if necessary, stop the bleeding. Before the arrival of qualified care is not recommended to move a person, especially if he has a fracture of the spine or there is damage to the internal organs. In some emergency situations, evacuation from the scene is vital. In this case, use a rigid stretcher or shields.
Isolated trauma requires a slightly different approach. It is necessary to immobilize the injured limb with a tire, giving it the most physiological position. It is necessary to fix the joint before and after the fracture. If there are no other complaints, the victim is transported to a medical institution.
Open or closed fracture?
PMP in fractures depends on the shape, type and severity of the lesion. During the examination of the victim it is necessary to determine the type of fracture, as, depending on this, the first aid will be slightly different. The setting of any diagnosis is based on certain criteria. In the case of a fracture, there are relative and absolute signs that indicate the presence of trauma.
- Pain. When tapping, trying to change the position of the injured limb, there is discomfort.
- Edema. Hides the picture of the fracture, is part of an inflammatory response to damage, squeezes soft tissue and can move bone fragments.
- Hematoma. Indicates that the integrity of the vasculature was compromised at the injury site.
- Function violation. It manifests itself in the limitation of mobility or inability to withstand the usual load.
- Strange, unnatural position of bone, its deformation.
- The presence of mobility where it has never been.
- Presence of crepitation( air bubbles) under the skin.
- With an open fracture with the naked eye, damage to the skin and bone fragments are visible.
That's how without the use of complex technology can determine the presence and appearance of the fracture.
Fracture of the bones of the upper limb
PMP with fractures of the forearm is to give the limb the correct position and fix it to the trunk. To do this, you need to bend your arm at the elbow so that you get a right angle, and press the palm to the victim's chest. To apply a tire, select a material that is longer than the forearm with the brush. It is fastened to the limbs in the presented position, then the arm is suspended from the bandage, which is a piece of cloth, bound with a ring and thrown over the neck to exclude the possible load.
Shoulder fracture requires a slightly different tactic. The position of the limb is also given at an angle of ninety degrees, but two tires are applied:
- outside the shoulder so that it falls below the elbow;
- on the inner surface of the arm from the armpit to the elbow.
Tires are initially bandaged separately, and then fixed together. The hand must also be hung on the strap, kerchief or any piece of cloth that is at hand. To transport the victim to the hospital you only need to sit.
Fracture of the bones of the lower limb
In order to provide PMP for fractures of the legs, you need to stock up a large number of long and wide tires( boards, pins, etc.).Immobilizing the limb with a hip fracture, the first tire should go outside, the upper end resting in the pit of the armpit, and the other - reaching the foot. The second tire goes from the crotch to the foot, somewhat protruding for it. Each of them is bandaged separately, and then together.
If there is no material for the tire, the injured limb can be bandaged to an intact leg.
The fracture of the lower leg requires the same fixation as the hip fracture. In the hospital, the victim is delivered solely lying down.
Fractures of the ribs and jaw
Since there is nothing to fix them with a broken rib, a tight bandage is applied to the chest. The victim is recommended to breathe exclusively with the help of abdominal muscles, without loading the thorax. If bandages are not enough, you can use pieces of cloth or scarves. It is important that the person does not lie down in any case, because acute fragments of the ribs can damage the lungs, the heart, and pierce the diaphragm.
Fracture of the jaw - often the result of a fight or a fall. Therefore, it is reasonable to assume that the victim has concussion. The first help in this case is to cover the person's mouth, give him analgesics and fix the jaw with a bandage, tying her ends to the top. The main thing is to monitor the position of the tongue so that it does not block the airways. If the victim is unconscious, then it must be laid on his side or face down. Transport immobilization in case of head fractures should be in a horizontal state. This will help to avoid loading the damaged bones and prevent asphyxiation.
First aid for an open fracture
PMP with an open fracture should be provided as soon as possible. In such a situation, the risk of complications such as pain shock, collapse, massive bleeding increases significantly.
Therefore, the algorithm of action is:
- Inspect the victim and assess his condition.
- Give him an analgesic to prevent traumatic shock.
- Treat the skin around the wound with a peroxide solution, iodine or any other antiseptic.
- Use a sterile gauze pad to gently drain the bottom and edges of the wound.
- Folded several times a sterile bandage to put on the wound, but do not press it.
- Carry out immobilization from improvised means.
- Do not put fragments in any way!
- Call an ambulance.
PMP with closed fracture will have similar stages, except for those points where it is said about wound treatment.
Immobilization is the immobilization of a damaged part of the body. It is necessarily produced with fractures of bones and joints, rupture of nerve and muscle fibers, burns. Because of pain, the patient can make sudden movements, which can aggravate his injuries.
Transport immobilization consists in giving the victim immobility while he is taken to a medical institution. Since during the movement some shaking is inevitable, a good fixation of the patient allows to avoid aggravation of the situation.
There are rules, under which the application of the tire will pass the least painful for the injured.
- The tire should be large enough to fix the joint above and below the fracture site. And if the thigh is damaged, the entire leg is immobilized.
- The tire is formed either on the healthy limb of the victim, or on himself, so as not to cause the patient additional inconveniences.
- Apply a tire over the clothing to avoid infection of the wound.
- To avoid bedsores in places where the bone is close to the skin, soft material is placed under the tire.
- The tire is not fixed on the side where the broken bone protrudes, because it is strictly forbidden to refit it before coming to the hospital.
Types of medical tires
Medical bus can be several modifications, depending on the purpose of its use. There are prosthetic tires, which hold the affected area in one position, and replace the missing part of the bone.
There are the following types of immobilization tires:
- The Cramer tire is a fine wire grid that is covered on top with several layers of bandage or soft fabric. The frame can be given any shape that is necessary in a particular case, this makes it universal.
- Dieterichs tire - consists of two wooden boards with holes drilled in them, through which belts or cloth are stretched. Another set includes a small flat bushing, which is inserted into the hole, fixing the tire at the desired level.
- Pneumatic medical tire is a sealed chamber inside which an injured limb is laid. Then air is compressed between its walls, and a part of the body is securely fixed.
- Shantz's tire is a collar-fixer used for spine diseases, as well as for preventing displacement of cervical vertebrae during back injuries.
PMP for bleeding
Bleeding is a consequence of a violation of the integrity of the vessel wall. It can be external or internal, arterial, venous or capillary. The ability to stop blood is necessary for human survival.
PHC with bleeding implies compliance with certain rules.
- To wash a bleeding wound it is necessary only in the event that in it or her have got caustic or poisonous substances. In the case of other contaminants( sand, metal, earth), rinse the damaged area with water can not.
- Do not lubricate the wound at all. This prevents healing.
- The skin around the wound is mechanically cleaned and treated with an antiseptic solution.
- Do not touch the open wound with your hands or clean blood clots, as these blood clots restrain bleeding.
- Only a doctor can remove foreign bodies from the wound!
- After applying the tourniquet, immediately call an ambulance.
The dressing is applied directly to the wound. To do this, use a sterile bandage or clean cloth. If you doubt the sterility of the material, it is better to drip on it with iodine so that the stain is more than a wound. On top of the fabric put a roller of bandage or cotton wool and tightly it banded. If the bandage is correctly applied, the bleeding stops and it does not get wet.
- Attention: when the fracture is open and the protruding bone is tightly bandaged and set the bone is prohibited! It is enough to apply a bandage!
Application of harness or twist
The hemostatic tourniquet can become both an aid in the fight against bleeding, and aggravate the severity of the condition of the victim. This manipulation is resorted only in the case of very severe bleeding, which can not be stopped by other methods.
If you do not have a medical rubber harness at hand, an ordinary thin hose will do. In order not to pinch the skin, you can put a twist on clothing( sleeve or trouser leg) or put a piece of any dense fabric. The extremity is wrapped several times so that the turns do not overlap each other, but there are no gaps between them either. The first is the weakest, and with each subsequent it is necessary to tighten more strongly. The hemostatic cord can be tied up when the blood stops moving. It is necessary to record the time of laying the harness and fix it in a conspicuous place. In the warm season, you can keep it for up to two hours, and in the cold - only an hour.