Tire placement. Possible errors when applying transport tires Possible errors when applying transport tires

First aid for a fracture of a limb is giving the victim such a position in which he will not feel pain, and bone fragments will not further injure soft tissues. Competent splinting by a specialist increases the chances of the victim for a complete cure without consequences.

Exist different types tires, but it is customary to distinguish four varieties depending on the nature of the fracture:

• Universal, or stair, tire Kramer. This medical splint is a combination of individual parts, thanks to which it is possible to assemble structures of different heights and shapes.
• Tire Dieterichs. It consists of sliding parts, its functional purpose is traction. It is mainly used for hip fractures.
• Pneumatic medical splint. One of modern species, is a tight cover with a zipper, equipped with a pump for pumping air. It is used to immobilize the hands, forearms, legs, feet, lower legs, knee joint.
• An improvised tire made from improvised materials. These can be: a straight branch or a stick, a wire, a scarf, a sheet. It is worth paying attention to the search for such objects so that there are no sharp ends.

There are other varieties based on cotton-gauze bandages for fixing the head, cervical vertebrae, and shoulder joint.

Tire Diterikhs and the technique of its application

This type is used for hip fractures to avoid movements in the pelvic area. The splinting technique is simple and does not require special knowledge. The design itself consists of two slats, as well as a sole plate. The plates are adjusted to the size of a person: the end of the outer is inserted into the armpit, the end of the inner rests against the groin. Cotton pads are placed in the ankle area. The ends of both plates should protrude slightly beyond the sole. A plate is also firmly tied to the sole itself. The human torso, together with the structure, is tied with straps. The step of the belts is 25-30 cm.

Kramer's tire and its correct position

This medical splint is used for fractures of the upper and lower extremities. First, the doctor models the form on himself, then it is applied to the injured limb of the patient, the voids are laid with cotton wool. The design is wrapped with bandages. The Kramer splint is also suitable for ligament and tendon injuries. The overlay is the same as for a bone injury.

Basic rules for splinting

If the fracture has open wounds, then before applying any splint, it is necessary to treat the wound with an antiseptic. If the injury is closed, then the design can be applied to clothing.

The damaged joint is often fixed together with two neighboring ones. For example, fixation of a shoulder joint fracture starts from the fingertips to the shoulder. In case of a fracture of the lower leg, a plate is applied that affects the knee and ankle joints. This overlay algorithm is also used for other limb injuries. The rules for applying transport splints are applied when immobilizing the femoral joint and spine. Fixation of a hip fracture covers the entire leg. A fracture of the spine is accompanied by immobilization of the entire body of a person.

If bleeding is observed, then you should not rush to apply a tourniquet, you must wait for the doctor's instructions. If it is not possible to find out information from a specialist, then the patient is given a note indicating the exact time the tourniquet was applied.

The imposition of a splint from improvised material is fraught with the fact that the sharp ends can cut into the body of the victim, squeeze the nerve endings and blood vessels passing nearby. A bandage is not applied at the fracture site so that pressure does not cause pain.

If a person has an attack of hysteria, then it is necessary to get him out of this state as soon as possible, since the victim may develop traumatic shock. It is advisable to apply ice to the fracture site and give the person pain medication.

The above rules are the basis for any fractures.

Splinting for various fractures

upper limbs

In case of a fracture of the forearm, the bone is fixed with a Cramer splint on both sides: back and front. A kerchief bandage is thrown through the neck and fixes the arm in a bent position. A fracture of the shoulder joint is immobilized by fixing two adjacent joints. When a finger is fractured, the affected phalanx is fixed to adjacent healthy fingers.

lower limbs

In the absence of handy materials, the most in a simple way it is considered to tie a diseased leg to a healthy one. The rules for splinting themselves are as follows: a broken leg is plated on three sides, the back one starts from the sole and ends under the shoulder blade, the size of the outer side plate is from the sole to the armpit, the inner side plate covers the distance from the crotch to the end of the leg. Transport tires are fixed with belts. Transportation takes place in a supine position.

Shoulder girdle

In case of a fracture of the clavicle, it is enough to put a cotton ball in the armpit and put on a handkerchief thrown over the neck. The fracture of the scapula is immobilized with a lateral splint with skeletal traction. If there is no displacement of the processes, then the fracture is fixed with a Dezo bandage. This is a self-contained design that can be worn for a month.

Ribs

When the ribs are fractured, splinting is to immobilize them when breathing. in the best way it is considered to tie a sheet around the chest, allowing them to perform respiratory function abdominal muscles. The victim should not talk and take a lying position, so that the fragments of the ribs do not damage the internal organs.

Spine

In case of damage to the spine, a splint made of a rigid material is applied to a person's height. In this case, the peculiarity is that the victim cannot move. It is carefully shifted to the place of laying the structure, the body is fixed with straps. Belt pitch - up to 30 cm.

Pelvic bones

This type of injury, especially a coccyx fracture, is often accompanied by severe painful sensations. Immobilization of the patient occurs in the supine position with a roller placed under the hips. Fixation of a fracture of the femoral neck occurs according to the principle of damage to the lower extremities. Such injuries are dangerous damage to blood vessels.

Neck

Injuries to the neck are fixed with a Chance collar, which prevents the head from moving. This is a voluminous dense cotton-gauze bandage, which has different sizes - from a baby to an adult. It can be worn for several weeks, depending on the indication of the doctor, removing at night.

Now let's talk about how to perform transport immobilization with standard splints for injuries of bones, joints and soft tissues of the extremities, as well as transporting a patient to a hospital

Immobilization- creation by means of various means of immobility of the damaged part of the body.

There are transport and medical immobilization.

Transport immobilization- ensuring the immobility of the injured part of the body for
creation favorable conditions transportation, delivery of the victim to a medical facility
waiting.
Transport immobilization is carried out with the help of soft bandages, a variety of factory-made tires: wooden, plywood, wire, mesh, plastic, pneumatic.

Rules for imposing transport tires

• Apply tires directly at the scene of the accident
• Patient transfer without immobilization is unacceptable
• It is not recommended to take off shoes, clothes from the patient, as this not only causes pain, but can also cause additional injury.
• Before applying the splint, it is necessary to cut the patient's clothing at the seam (if it cannot be removed) at the site of injury and carefully examine; in the presence of bleeding, stop it, apply an aseptic dressing to the wound and inject an analgesic.
• Place the injured limb in as comfortable a physiological position as possible before splinting.
• When applying a splint, with closed fractures (especially of the lower extremities), make an easy and careful traction of the injured limb along the axis, which should be continued until the dressing is completely completed.
• Immobilize with a splint two joints adjacent to the injury site (above and below the injury site), and in case of fractures of the shoulder and hip, three joints.
• When transferring a patient with a splint to a stretcher, the injured limb or body part should be carefully supported by an assistant.

Rule "Thrice Caution"

During transport immobilization, it is recommended to follow the rules conditionally called “three times carefully”:
1. Carefully apply a bandage
2. Carefully place the transport bar
3. Carefully transfer, transfer to a stretcher and transport the victim

Underwater rocks

• The use of unreasonably short tires violates the rule of immobilization - the creation of immobility.
• The imposition of rigid standard splints without first wrapping them with cotton and gauze.
• Incorrect tire modeling in accordance with the anatomical localization of the damaged area
• Insufficient fixation of the tire to the injured limb with a bandage.
• When applying a hemostatic tourniquet, closing it with a bandage is a gross mistake.
• Insufficient warming of the immobilized limb in winter leads to frostbite, especially in case of bleeding

Tires: vacuum, disposable, Kramer, Dieterichs

Rules for imposing transport tires

1. The tire must be applied so that it is securely
immobilized two adjacent to the injury site
joint (above and below damage), and with some
injuries and three joints (with a fracture of the hip or shoulder),

2. When immobilizing limbs, it is desirable to give
physiologically correct position.

3. With closed fractures (especially of the lower extremities)
it is necessary to make a light and gentle traction
injured limb along the axis, which follows
continue until the end of immobilizing
bandages.

4. With open fractures, when they protrude from the wound
bone fragments, when providing first aid, set them
it does not follow. Imposing sterile dressing, limb without
pre-tightening and reduction of fragments
fixed in the position in which it is.

1. The victim should not take off his clothes and shoes, as
it might cause him too much pain. In addition, clothing
left on the victim, usually serves in the area
damage by additional tire padding.

6. You can not impose a hard tire directly on
naked body. It must first be lined with soft
lining (cotton, towel, hay, etc.). Need
make sure that the ends of the tires do not cut into the skin and do not
squeezed blood vessels or nerves passing through
near the bones, and also so that the skin is not squeezed
where there are bony prominences.

7. For all open damage, before proceeding to
immobilization, it is necessary to apply aseptic
bandage.

In case of damage to the joints for transport
immobilization use the same means and methods as
and bone damage.

8. During the application of immobilizing dressings and
transferring the victim to a stretcher
be extremely careful with the part of the body that
must be supported by a special assistant.

9. The tire must be carefully attached to the damaged
limbs, constituting with it a single whole.

Incorrect immobilization can be not only
useless but also harmful.

Possible errors when applying transport tires

1. The use of unreasonably short tires violates the rule
immobilization.

2. Applying rigid standard tires without prior
wrapping them with cotton wool and gauze.

3. Incorrect tire modeling according to
anatomical localization of the damaged area.

4. Insufficient fixation of the splint to the injured limb
bandage.

5. Insufficient warming of the immobilized limb in winter leads to frostbite, especially in case of bleeding.

When splinting, the following mistakes are often made:

• 1. Do not place a soft pad under the splint, which leads to pressure on the bony protrusions and causes pain; possible formation of bedsores.
• 2. The splint is short and the hand or foot hangs down.
• 3. There is no cotton-gauze roller on which the brush is fixed.
• 4. The tire is not firmly fixed.
• 5. Immobilization of the hand is not completed by hanging it on a scarf.

Tire rules

• 1. It is necessary to ensure the immobility of at least 2 joints - one above, the other below the fracture site, and in case of a fracture of large bones, even 3;
• 2. The center of the tire must be at the fracture site;
• 3. The splint bandage should not compress large vessels, nerves and bone protrusions; put a soft tissue on the protrusions of the bones;
• 4. The tire is firmly fixed with a bandage, scarf, waist belt, straps throughout, and not just at the level of the damaged segment.
• 5. It is necessary to apply "cold" to the fracture site (a bladder with ice, well water, cold lotions, etc.) to reduce pain, and also give the victim an anesthetic.

Further treatment

Further treatment of most closed and all open fractures is carried out in a hospital setting. Here, the reduction of fragments is carried out, if necessary, with the help of special devices, and therapeutic immobilization is carried out in various ways - with a plaster cast, constant traction, or with the help of special compression-distraction equipment, which not only holds the fragments in the correct position, but also presses them against each other . Sometimes you have to resort to surgery, fastening the fragments with metal plates, rods, screws, etc. With some closed P. (for example, fingers, individual bones of the hand, foot, one of the bones of the forearm, etc.), outpatient treatment is prescribed in a polyclinic, a trauma center . In these cases, the victim should know that a plaster cast correctly applied by a doctor may turn out to be tight in a few hours, because. increased swelling at the fracture site. If there are signs of compression (pain, pallor or cyanosis of the fingers), you should immediately consult a doctor, do not hesitate to cut the bandage. It must also be remembered that in the treatment of immobilization fractures, complete rest of the limb is not only not necessary, but harmful, because. leads to weakening of muscles, labor mobility of joints, slows down fusion. Therefore, it is necessary to practice at home therapeutic gymnastics, performing, as directed by the doctor, movements in which the immobility of the fragments is not disturbed (for example, movements of the fingers in case of a fracture of the shoulder, forearm, movements in the elbow in case of a fracture, brush, etc.). Hospital treatment also includes exercise therapy, massage, physiotherapy, etc. It is equally important to properly treat after fracture healing and removal of immobilization. It should be carried out under the supervision of a physician. Often in the process of treating fractures of the bones of the lower extremities, patients use crutches. The detail is possible only with the permission of the doctor. Crutches must be adjusted to the height of the patient so that when using them, most of the body weight falls on the arms, and not on the armpits.

In the treatment of fractures great importance has a balanced diet. Food should be easily digestible, complete in calorie content and composition. Of particular value are saturated with vitamins and mineral salts fresh fruits and vegetables.

Prevention of fractures consists in the strictest observance of safety regulations at work, in agriculture, in transport, and when playing sports.

Types and signs of fractures. Signs of dislocations in the joints. Rules and methods of first aid for fractures of bones and dislocations. Tire rules. Splinting and immobilization of joints in certain types of fractures and dislocations using standard and improvised means

Types and signs of fractures

1. Types of fractures. Fractures are closed, in which the integrity of the skin is not broken, there is no wound, and open, when the fracture is accompanied by injury to soft tissues.

According to the degree of damage, the fracture is complete, in which the bone is completely broken, and incomplete, when there is only a fracture of the bone or its crack. Complete fractures are divided into fractures with displacement and without displacement of bone fragments.

In the direction of the fracture line relative to the long axis of the bone, transverse (a), oblique (b) and helical (c) fractures are distinguished. If the force that caused the fracture was directed along the bone, then its fragments can be pressed into one another. Such fractures are called impacted.

In case of damage by bullets and fragments flying at high speed and having great energy, many bone fragments form at the fracture site - a comminuted fracture is obtained (e).

Fractures: a - transverse; b - oblique: c - helical; g - driven in; d - splintered

Signs of broken bones. With the most common fractures of the limb bones, severe swelling, bruising, sometimes flexion of the limb outside the joint, and its shortening appear in the area of ​​injury. In the case of an open fracture, the ends of the bone may protrude from the wound. The injury site is sharply painful. At the same time, abnormal mobility of the limb outside the joint can be determined, which is sometimes accompanied by a crunch from friction of bone fragments. It is unacceptable to specifically bend the limb to make sure that there is a fracture - this can lead to dangerous complications. In some cases, with bone fractures, not all of these signs are detected, but the most characteristic are sharp pain and severe difficulty in movement.

A rib fracture can be assumed when, due to bruising or compression chest the victim notes severe pain with deep breathing, as well as when feeling the place possible fracture. In case of damage to the pleura or lung, bleeding occurs or air enters the chest cavity. This is accompanied by respiratory and circulatory disorders.

In the event of a spinal fracture, severe pain in the back, paresis and paralysis of the muscles below the fracture site. Involuntary excretion of urine and feces may occur due to dysfunction of the spinal cord.

With a fracture of the pelvic bones, the victim cannot stand up and raise his legs, as well as turn around. These fractures are often combined with damage to the intestines and bladder.

Fractures of bones are dangerous by damage to the blood vessels and nerves located near them, which is accompanied by bleeding, a disorder of sensitivity and movement, of the damaged area.

Severe pain and bleeding can cause the development of shock, especially if the immobilization of the fracture is not timely. Bone fragments can also damage the skin, as a result of which a closed fracture turns into an open one, which is dangerous due to microbial contamination. Movement at the fracture site can lead to serious complications, so it is necessary to immobilize the damaged area as soon as possible.

2. Signs of dislocations in the joints

A dislocation is a displacement of the articular ends of the bones. This is often accompanied by a break joint capsule. Dislocations are often noted in the shoulder joint, in the joints mandible, fingers. With a dislocation, three main signs are observed: complete impossibility of movements in the damaged joint, severe pain; forced position of the limb, due to muscle contraction (for example, with a dislocation of the shoulder, the victim keeps his arm bent at the elbow joint and retracted to the side); change in the configuration of the joint compared to the joint on the healthy side.

Swelling due to hemorrhage is often noted in the joint area. The articular head in the usual place can not be probed, in its place the articular cavity is determined.

3. Rules and methods of first aid for bone fractures and dislocations

General rules first aid for broken bones.

To inspect the fracture site and apply a bandage to the wound (in case of an open fracture), clothes and shoes are not removed, but cut. First of all, the bleeding is stopped and an aseptic bandage is applied. Then the affected area is given a comfortable position and an immobilizing bandage is applied.

An anesthetic is injected under the skin or intramuscularly from a syringe tube.

For immobilization of fractures, standard splints contained in the B-2 kit or improvised means are used.

First aid for dislocations consists in fixing the limb in the position most convenient for the victims, using a splint or bandage. The doctor should correct the dislocation. A dislocation in a particular joint can be periodically repeated (habitual dislocation).

4. Rules for imposing tires. Splinting and immobilization of joints in certain types of fractures and dislocations using standard and improvised means

General rules for splinting for fractures of limb bones.
- tires must be securely fastened, well fix the fracture area;
- the splint cannot be applied directly to a bare limb, the latter must first be covered with cotton wool or some kind of cloth;
- creating immobility in the fracture zone, it is necessary to fix two joints above and below the fracture site (for example, in case of a fracture of the lower leg, the ankle and knee joints are fixed) in a position convenient for the patient and for transportation;
in case of hip fractures, all joints should be fixed lower limb(knee, ankle, hip).

First health care with hip fractures. General Rules for Imposing Tires

Hip injuries are usually accompanied by significant blood loss. Even with a closed fracture femur blood loss in the surrounding soft tissues is up to 1.5 liters. Significant blood loss contributes to the frequent development of shock.

The main signs of hip injuries:
- pain in the hip or joints, which sharply increases with movement;
- movement in the joints is impossible or significantly limited;
- in case of hip fractures, its shape is changed and abnormal mobility at the fracture site is determined, the hip is shortened;
- movements in the joints are impossible;
- there is no sensitivity in the peripheral parts of the leg.

The best standard splint for hip injuries is the Dieterichs splint.

Immobilization will be more reliable if, in addition to conventional fixation, the Dieterichs bus is strengthened with plaster rings in the area of ​​the trunk, thigh and lower leg. Each ring is formed by applying 7-8 circular rounds of a plaster bandage. Only 5 rings: 2 - on the trunk, 3 - on the lower limb.

In the absence of a Dieterichs tire, immobilization is performed with ladder tires.

Immobilization with ladder tires. To perform immobilization of the entire lower limb, four ladder splints 120 cm long each are required, if the splints are not enough, it is possible to immobilize with three splints.

Tires must be carefully wrapped with a layer of gray cotton wool of the required thickness and with bandages. One tire is bent along the contour of the back surface of the thigh, lower leg and foot with the formation of a recess for the heel and lower leg muscles.

In the area intended for the popliteal region, arching is performed in such a way that the leg is slightly bent at the knee joint. The lower end is bent in the shape of the letter "L" to fix the foot in the position of flexion at the ankle joint at a right angle, while the lower end of the splint should capture the entire foot and protrude 1-2 cm beyond the fingertips.

Two other tires are tied together along the length, the lower end is L-shaped bent at a distance of 15-20 cm from the lower edge. An elongated tire is placed along the outer surface of the trunk and limb from the armpit to the foot. The lower, curved end wraps the foot over the rear tire to help prevent sagging.

The fourth splint is placed along the inner lateral surface of the thigh from the crotch to the foot. Its lower end is also bent in the shape of the letter "L" and wound behind the foot over the bent lower end of the elongated outer side tire. Tires are reinforced with gauze bandages.

Similarly, in the absence of other standard splints, as a necessary measure, the lower limb can be immobilized with plywood splints.

As soon as possible, ladder and plywood tires should be replaced with Dieterichs tires.

Errors when immobilizing the entire lower limb with stair splints:

1. Insufficient fixation of the outer elongated splint to the body, which does not allow reliable immobilization hip joint. In this case, immobilization will be ineffective.

2. Poor modeling of the rear ladder rail. There is no recess for the calf muscle and heel. There is no splint bend in the popliteal region, as a result of which the lower limb is immobilized fully extended at the knee joint, which in case of hip fractures can lead to compression of large vessels by bone fragments.

3. Plantar sagging of the foot as a result of insufficiently strong fixation (there is no modeling of the lower end of the side tires in the form of the letter “G”).

4. Insufficiently thick layer of cotton wool on the tire, especially in the area of ​​\u200b\u200bbone protrusions, which can lead to the formation of bedsores.

5. Compression of the lower limb with tight bandaging.

Transport immobilization with improvised means for hip injuries: a - from narrow boards; b - with the help of skis and ski poles.

Immobilization by improvised means. It is carried out in the absence of standard tires. For immobilization, wooden slats, skis, branches and other objects of sufficient length are used to ensure immobilization in the three joints of the injured lower limb (hip, knee and ankle). The foot must be set at a right angle at the ankle joint and pads of soft material should be used, especially in the area of ​​bony prominences.

In cases where there are no means for transport immobilization, the foot-to-foot fixation method should be used. The injured limb is connected in two or three places with a healthy leg, or the injured limb is placed on a healthy one and also tied in several places.

Transport immobilization in case of damage to the lower extremities using the "foot to foot" method: a - simple immobilization; b - immobilization with slight traction

Foot-to-foot immobilization of the injured limb should be replaced by standard splint immobilization at the earliest opportunity.

The evacuation of victims with hip injuries is carried out on a stretcher in the prone position. To prevent and timely detect complications of transport immobilization, it is necessary to monitor the state of blood circulation in the peripheral parts of the limb. If the limb is naked, then the color of the skin is monitored. With unremoved clothes and shoes, it is necessary to pay attention to the complaints of the victim. Numbness, coldness, tingling, increased pain, the appearance of throbbing pain, cramps in the calf muscles are signs of circulatory disorders in the limb. It is necessary to immediately relax or cut the bandage at the site of compression.

First aid for fractures of the leg. General Rules for Imposing Tires

The main signs of damage to the lower leg:
- pain at the site of injury, which increases with movement of the injured leg;
- deformity at the site of damage to the lower leg;
- movement in the ankle joint is impossible or significantly limited;
- Extensive bruising in the area of ​​injury.

Immobilization is best achieved with a 120 cm L-curved modeled back ladder splint and two 80 cm side ladder or plywood splints. The top end of the splints should reach mid-thigh. The lower end of the side ladder rails is curved L-shaped. The leg is slightly bent at the knee joint. The foot is set in relation to the lower leg at a right angle. Tires are reinforced with gauze bandages.

Immobilization can be performed with two 120 cm long ladder splints.

Mistakes in transport immobilization of leg injuries with stair splints:

1. Insufficient modeling of the stair splint (there is no recess for the heel and calf muscle, there is no arching of the splint in the popliteal region).

2. Immobilization is performed only with the rear ladder rail without additional side rails.

3. Insufficient fixation of the foot (the lower end of the side splints is not bent in an L-shape), which leads to its plantar sagging.

4. Insufficient immobilization of the knee and ankle joints.

5. Compression of the leg with tight bandaging while strengthening the tire.

6. Fixation of the limb in a position where the tension of the skin over the bone fragments (anterior surface of the lower leg, ankle) is maintained, which leads to damage to the skin over the bone fragments or the formation of bedsores. Tension of the skin by displaced bone fragments in the upper half of the leg is eliminated by immobilization of the knee joint in the position of full extension.

Immobilization of shin injuries with three stair splints: a - preparation of stair splints; b - overlay and fixation of tires

Immobilization of leg injuries in the absence of standard splints can be performed by improvised means.

First aid for shoulder fractures. General Rules for Imposing Tires

Signs of shoulder fractures and damage to adjacent joints:
- severe pain and swelling in the area of ​​damage;
- the pain increases sharply with movement;
- changes in the shape of the shoulder and joints;
- movements in the joints are significantly limited or impossible;
- abnormal mobility in the area of ​​the shoulder fracture.

Immobilization with a ladder splint is the most effective and reliable method of transport immobilization for shoulder injuries.

The tire should capture the entire injured limb - from the shoulder blade of the healthy side to the hand on the injured arm, and at the same time protrude 2-3 cm beyond the fingertips. Immobilization is carried out with a ladder rail 120 cm long.

The upper limb is immobilized in the position of a small anterior and lateral abduction of the shoulder. To do this, a lump of cotton wool is placed in the axillary region on the side of the injury, the elbow joint is bent at a right angle, the forearm is positioned so that the palm of the hand is facing the stomach. A cotton wool roller is put into the brush.

Tire preparation

The length is measured from the outer edge of the scapula of the victim to the shoulder joint and the tire is bent at this distance at an obtuse angle;

Measure the distance from the upper edge of the shoulder joint to the back of the victim's shoulder. elbow joint and bend the tire at this distance at a right angle;

The assisting person additionally bends the tire along the contours of the back, back of the shoulder and forearm.

The part of the tire intended for the forearm is recommended to be bent in the form of a gutter.

Having tried on a curved tire to the healthy arm of the victim, make the necessary corrections.

If the tire is not long enough and the brush hangs down, its lower end must be increased with a piece of plywood tire or a piece of thick cardboard. If the length of the tire is excessive, its lower end is folded.

Two gauze ribbons 75 cm long are tied to the upper end of the tire wrapped in gray cotton and bandages.

The tire prepared for use is applied to the injured arm, the upper and lower ends of the tire are tied with braids and the tire is strengthened by bandaging. The hand, together with the splint, is hung on a scarf or bandage.

To improve the fixation of the upper end of the tire, two additional pieces of bandage 1.5 m long should be attached to it, then bandage bands should be drawn around the shoulder joint of a healthy limb, crossed, circled around the chest and tied.

Transport immobilization of the entire upper limb stair rail:

a - applying a tire to the upper limb and tying its ends;
b - strengthening the tire by bandaging; c - hanging a hand on a scarf

When immobilizing the shoulder with a ladder splint, the following errors are possible:

1. The upper end of the tire reaches only the shoulder blade of the diseased side, very soon the tire moves away from the back and rests on the neck or head. With this position of the splint, immobilization of injuries to the shoulder and shoulder joint will be insufficient.
2. The absence of ribbons on the upper end of the tire, which does not allow it to be securely fixed.
3. Bad tire modeling.
4. The immobilized limb is not suspended on a scarf or sling.

In the absence of standard splints, immobilization is carried out using a medical scarf, improvised means or soft bandages.

Immobilization with a medical scarf. Immobilization with a scarf is carried out in the position of a slight anterior abduction of the shoulder with the elbow joint bent at a right angle. The base of the scarf is circled around the body about 5 cm above the elbow and its ends are tied on the back closer to the healthy side. The top of the scarf is wound up on the shoulder girdle of the damaged side. The resulting pocket holds the elbow joint, forearm and hand.

The top of the scarf on the back is tied to the longer end of the base. The injured limb is completely covered by the scarf and fixed to the body.

Immobilization by improvised means. Several boards, a piece of thick cardboard in the form of a gutter can be placed on the inner and outer surfaces of the shoulder, which creates some immobility in the event of a fracture. Then the hand is placed on a scarf or supported by a sling.

Immobilization with a Deso bandage. In extreme cases, immobilization for fractures of the shoulder and damage to adjacent joints is carried out by bandaging the limb to the body with a Deso bandage.

Properly performed immobilization of the upper limb greatly facilitates the condition of the victim and special care during evacuation, as a rule, is not required. However, the limb should be periodically inspected so that with increasing edema in the area of ​​damage, compression does not occur. To monitor the state of blood circulation in the peripheral parts of the limb, it is recommended to leave the end phalanges of the fingers unbandaged. If there are signs of compression, the tours of the bandage should be loosened or cut and bandaged.

Transportation is carried out in a sitting position, if the condition of the victim allows.

First aid for fractures of the forearm. General Rules for Imposing Tires

Signs of fractures of the bones of the forearm:
- pain and swelling in the area of ​​injury;
- the pain increases significantly with movement;
- movements of the injured hand are limited or impossible;
- change in the usual shape and volume of the joints of the forearm;
- abnormal mobility in the area of ​​injury.

Ladder splint immobilization is the most reliable and effective type of transport immobilization for forearm injuries.

The ladder splint is applied from the upper third of the shoulder to the fingertips, the lower end of the splint will stand 2-3 cm. gauze roller to hold the fingers in a half-flexed position.

A ladder splint 80 cm long, wrapped in gray cotton and bandages, is bent at a right angle at the level of the elbow joint so that the upper end of the splint is at the level of the upper third of the shoulder, the splint section for the forearm is bent in the form of a groove. Then applied to a healthy hand and correct the shortcomings of the modeling. The prepared splint is placed on the sore arm, bandaged all over and hung on a scarf.

The upper part of the splint designed for the shoulder must be long enough to securely immobilize the elbow joint. Insufficient fixation of the elbow joint makes immobilization of the forearm ineffective.

In the absence of a ladder tire, immobilization is carried out using a plywood tire, a plank, a scarf, a bunch of brushwood, a shirt hem.

Transport immobilization of the forearm:
a - a ladder tire; b - improvised means (using planks)

First aid for dislocations of limbs

The most common traumatic dislocations are caused by excessive movement in the joint. This happens, for example, with a strong blow to the joint area, a fall. As a rule, dislocations are accompanied by a rupture of the articular bag and separation of the articular articular surfaces. An attempt to compare them does not bring success and is accompanied by severe pain and springy resistance. Sometimes dislocations are complicated by fractures - fracture-dislocations. The reduction of traumatic dislocation should be as early as possible.

Help with dislocations.

Since any, even a slight movement of a limb causes unbearable pain, first of all, it is necessary to fix the limb in the position in which it ended up, providing it with peace at the stage of hospitalization. For this, transport tires, special bandages or any available means are used. To immobilize the upper limb, you can use a scarf, the narrow ends of which are tied through the neck.

In case of dislocation of the lower limb, tires or boards are placed under it and from the sides and the limb is bandaged to them.

In case of dislocation of the fingers of the hand, the entire hand is immobilized to any flat solid surface. In the area of ​​​​the joints between the tire and the limb, a layer of cotton wool is laid.

In case of dislocation of the lower jaw, a sling-like bandage is brought under it (reminiscent of a bandage worn on the hand by the attendants), the ends of which are tied in a cross way at the back of the head.

After applying a splint or fixing bandage, the victim must be hospitalized to reduce the dislocation.