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First aid techniques for traumatic injuries - immobilization

Views: 2     Author: Site Editor     Publish Time: 2022-10-22      Origin: Site

A fracture is a complete or partial break in the continuity of a bone structure. It is most common in children and the elderly, but also occurs in young and middle-aged people; with timely and appropriate treatment, most patients can recover their original function; a small number of patients can be left with varying degrees of sequelae.

Types of fractures.

  1. Closed fracture: the skin at the fracture is intact and the fracture end is not connected to the outside world.

  2. Open fracture: The trauma wound is deep to the fracture or the fracture end pierces the skin to expose the surface of the body.

  3. Compound fracture: the fracture end damages blood vessels, nerves or other organs, or is accompanied by joint disarticulation, etc.

  4. Incomplete fracture: the integrity and continuity of the bone is not completely interrupted.

  5. Complete fracture: the integrity and continuity of the bone is completely interrupted.

2. The causes of fracture

(1) Direct violence

The fracture is caused by the direct action of violence on a part of the bone, resulting in a fracture of the injured part, often with varying degrees of soft tissue injury. For example, if a wheel hits the lower leg, a fracture of the tibiofibular stem occurs at the place of impact.

(2) Indirect violence

Indirect violence is caused by longitudinal conduction, leverage or torsion, such as a fall from a height and landing on the foot, the trunk is sharply flexed forward due to gravity, and a compression or burst fracture occurs at the junction of the thoracolumbar spine.

3. Proprietary signs of fracture

Pain, swelling, deformity, bone rubbing sound, functional impairment, hemorrhage.

4、Fracture treatment

(1) Reset

The fracture ends that have been displaced after the fracture will be restored to normal or close to the original anatomical relationship in order to regain the brace role of the bone. The methods of repositioning include closed repositioning and surgical repositioning.

(2) Fixation

After fixation, the fracture is easily re-displaced because it is unstable, so different methods should be used to fix it in a satisfactory position to make it heal gradually.

Commonly used fixation methods are: small splints, plaster bandages, external fixation braces, traction brake fixation, etc. These fixation methods are called external fixation.

If it is fixed by surgical incision with plates, steel pins, intramedullary pins, screws, etc., it is called internal fixation.

(3) Functional exercise

Through muscle contraction of the injured limb, increase the blood circulation of the tissue around the fracture, promote fracture healing, prevent muscle atrophy, and prevent joint adhesion and joint capsule contracture by active or passive activities of the unfixed joint, so that the function of the injured limb can be restored to the normal state before the fracture as soon as possible.

5、Fixation material of fracture: splint

Fixation material splint or its substitutes (such as wood, bamboo stick, bark, etc.). The dressing needs to be lined with soft materials such as cotton, gauze, towels, etc. between the splint and the skin, and then the splint is tied and wrapped with a triangular towel, bandage or rope.

(1) Fixation of upper limb fracture

The splint is placed on the outer side of the fractured upper arm, and the protruding part of the fracture should be padded, then the elbow and shoulder joints should be fixed, and the upper arm should be flexed and suspended in front of the chest with a triangular towel, and then the injured limb should be fixed in the thorax with a triangular towel.

(2) Fixation of lower limb fracture

Lower leg fracture fixation method: Place the splint on the outside of the fractured lower leg, with padding on the protruding part of the fracture, then fix the upper and lower ends of the wound and the knee and ankle joints (8-way fixation of the ankle joint), and then fix the top of the splint.

Thigh fracture fixation method: place the splint on the outer side of the fractured thigh, the protruding part of the fracture should be padded, then fix the upper and lower ends of the wound and the ankle and knee joints, and finally fix the lumbar, iliac and ankle parts

(3) Fixation of vertebral fractures

6. Fixation of cervical fracture

Use a cervical brace or head immobilizer to prevent further injury to the cervical spine, which can cause damage to the vital center and thus lead to cardiac and respiratory arrest and death.

b. Fixation of thoracic and lumbar spine fractures

Use a spinal board or multiple people moving together to keep the head, trunk and lower extremities in a straight line to prevent causing paraplegia.

6、First aid principles and precautions.

  1. Pay attention to the wound and general condition. If the wound is bleeding, the bleeding should be stopped first and the fracture should be fixed only afterwards. If there is shock or respiratory or cardiac arrest, resuscitation should be performed immediately.

  2. When dealing with open fractures with exposed fracture ends, clean and disinfect the area, wrap the wound with gauze, position the injured limb as normal as possible and let the fracture ends retract naturally, and forbid to send the exposed fracture ends back into the wound to avoid wound contamination and re-stabbing the blood vessels and nerves, and then dress and fix.

  3. For fractures of the thigh, calf, and spine, the patient should generally be fixed in place, and the injured limb and trunk should not be moved too much during fixation to avoid increasing the patient's pain and injury to the nerves and blood vessels, and do not reset blindly to avoid aggravating the degree of injury.

  4. In order to fix the fracture securely and firmly, the length and width of the splint used to fix the fracture should be commensurate with the fractured limb, and its length should generally exceed the upper and lower joints of the fracture.

  5. The splint used for fixation should not directly contact the skin. When fixing, soft materials such as gauze, triangular towel pad, towel and clothing can be used between the splint and the limb, especially the ends of the splint, the protruding parts of the joint bones and the interstitial parts, which can be appropriately thickened to avoid skin abrasion or local tissue compression necrosis.

  6. The tightness of fixation and binding should be appropriate, too loose to achieve the purpose of fixation, too tight to affect blood circulation, resulting in limb necrosis. When fixing the limbs, the finger (toe) ends should be exposed so that the blood circulation of the limbs can be observed at any time. If you find that the fingers (toes) are pale, cold, numb, painful, swollen, and the nail bed is bruised, it means that the fixation and binding are too tight and the blood circulation is not good, so you should immediately loosen and re-bind the fixation.

  7. When fixing fractures of the extremities, the upper end of the fracture break should be tied first and the lower end of the fracture end should be tied later. If the binding order is reversed, it will lead to re-dislocation. For upper limb fixation, the limb should be tied in flexion (flexed elbow); for lower limb fixation, the limb should be tied in extension.

  8. When fixing a fracture, the upper end of the fracture should be tied first, followed by the lower end. Reversal of the binding order may lead to repositioning of the broken end.

  9. The upper limb should be fixed in a flexed elbow position; the lower limb should be fixed with the limb extended (pulled) straight.

  10. To prevent heat stroke in summer and to keep warm in winter.

  11. To prevent shock caused by pain, the casualty can be given appropriate application of sedative painkillers under the guidance of a doctor.

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