Emergency first aid for a spinal fracture. Providing first aid for spinal injury What not to do after a snake bite

When a spine is fractured, sometimes the very first minutes between the accident and the arrival of the ambulance are extremely important. They say you can be lucky twice: the first time - if you fall successfully, the second - if you are nearby at that moment the right person, namely: someone who knows what first aid should be for a spinal fracture.

Missing something important, wasting time, unskilled erroneous actions - these are the factors, unfortunately, that often lead to serious post-traumatic complications and even fatal outcome. Elementary rules Every person needs to know how to provide first aid.

First aid for a spinal fracture

Most often, fractures and bruises of the spine are associated with:

traffic accidents
sports
active recreation
hazardous production (for example, construction)

While driving your car, finding yourself at a ski resort or near a water area among diving enthusiasts, you must always be prepared for an extreme incident and for the fact that someone may need your help.

Also, do not pass in your Everyday life past fallen elderly people. Many people develop the disease as they age osteoporosis leading to bone fragility. Thus, even everyday or street falls can cause a spinal fracture.

The insidiousness of a spinal fracture is that it is impossible to determine the degree of complexity of the injury from the first moment. The fracture is usually hidden under non-threatening external signs- scratches, bruises, and the victim himself may be conscious, talk and even try to get up.

Falls and accidents occur more frequently compression fractures:

wedge-shaped
explosive
splintered

Explosive and splintered are the most unfavorable of this entire series, since they indicate enormous impact force and are often accompanied by damage and even rupture spinal cord And state of shock the victim.

First aid for a spinal fracture

The first thing to do when providing first aid is to prohibit the patient from moving, much less trying to sit down.

Only an X-ray of the spine can give a complete picture of the injury. Until then, you are in the dark:

Is there a fracture at all?
Which department was affected?
How many vertebrae are broken
What type of fracture and is it stable?
Is there spinal cord damage?

This is all - the most important indicators for trauma, and the answers can only be obtained in a clinic, where the person must be taken as soon as possible.

Second: you need to call immediately Ambulance or rescue service

Before diagnosis, any fracture is considered as a potential fracture, and first aid to the victim should be provided as for a fracture.

If you are in a hard-to-reach place and rescuers will not arrive soon, then you may have to act on your own.

Factors to pay attention to when providing first aid:

Is the victim conscious?
Is there any breathing
Is the pulse palpable and is it full?
Does a person feel pain?

Four positive answers are a favorable sign, and you can begin to transfer the victim onto a stretcher and carefully transport him.
If the slightest movement causes unbearable pain, and the area above the bruise is swollen, a fracture has most likely occurred. For pain relief you can give injections of drugs:

Analgesics
Novocaine
Hydrocortisone or any other corticosteroid

If there is loss of sensation below the area of injury or twilight consciousness, painkillers in tablets cannot be given due to possible dysphagia

Unconsciousness may be a symptom painful or spinal shock. The first occurs due to nerve compression, the second due to spinal cord injury.

How to perform resuscitation for a fracture

Lack of breathing and pulse means the need for urgent resuscitation.
Resuscitation formula:

DP + D + CC, which means - airways + breathing + blood circulation

What to do if you are unable to breathe:

Check freedom respiratory tract:
Open the victim's mouth slightly and make sure there is no vomit there.
Do artificial respiration (ID) - until the ambulance arrives
Restore blood circulation:
if the patient’s chest remains motionless, then in the intervals between doses ID have to do heart massage.
In order not to aggravate the injury, under chest area during massage you need to put a blanket

A barely noticeable pulse indicates low blood pressure and insufficient blood circulation.
Blood pressure can be increased with the drug fast action, For example, heptamyl

Rules for transportation in case of fracture

At least three, or even better, five people must participate in transportation: each controls his own department
The victim must be placed on a hard stretcher on his back:
a piece of plywood, a shield, a door, a sleigh, etc.
If the carrier is soft, then transportation will have to be carried out on the stomach.
All parts of the spine, including the cervical spine and legs, must be secured using bandages, tourniquets, ropes, etc.
If you have cardboard and gauze, you can make a simple neck corset. If not, one person constantly fixes the position of the head, holding it level with their hands in the area of the ears

Sitting a person down, pulling him by the arms and legs, trying together or alone to turn him on his side when transferring him is strictly prohibited

Some manuals describe how to transfer a victim onto a stretcher literally step by step. The main thing is:

Consistency of all actions
Holding correct position all parts of the spinal column
Simultaneously turning the victim on his side on command
Placing the stretcher and returning to the back

Signs by which a fracture can be recognized

When you go on a road trip or on an extreme vacation, include in your first aid kit everything you need to provide assistance. emergency care

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 team 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 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 (with an 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 to the fracture site cold compress or ice.

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

Fixation of the affected area (using splints and bandages);
Cold compress on the injured area;
Providing complete rest to the injured limb until the doctor arrives.

Necessary first aid measures for bruises:

Apply something cold to the injury site;
A state of rest for the affected area;
A tight bandage to the bruise site.

If the injured person is crushed by weight, it is necessary to free him and, having determined the type of injury, provide appropriate first aid.

For non-penetrating spinal injuries and absence neurological symptoms The final diagnosis is made only after special studies. Therefore, the procedure for providing pre-medical and qualified surgical care It is carried out as for wounds in general.

Algorithm for providing first aid for penetrating spinal injuries.

Apply an aseptic bandage.
Ensure patency of the upper respiratory tract.
Anesthetize with non-narcotic and narcotic analgesics. Note. In case of high injuries to the cervical spine, do not inject narcotic analgesics due to the risk of respiratory depression.
Carefully (on command) place the victim on a hard board on his back.
Carry out simple anti-shock measures. Note. Warming the victim with heating pads should be done carefully due to the risk of burns.
Record pulsar blood pressure and neurological symptoms before the ambulance starts moving in order to assess their dynamics upon arrival at the hospital.
Transport the victim to the neurosurgical department.

Treatment of spinal injuries

Treatment of spinal injuries is carried out in neurosurgical hospitals with the participation of a urologist. Indications for emergency surgery for open injuries of the spine and spinal cord are penetrating wounds and the presence of foreign bodies in the spinal canal. In these cases, treatment begins with early (in the first 3-4 days) laminectomy. Before surgery, in addition to premedication, prophylactic antibiotics are administered and, if indicated, specific tetanus prophylaxis is carried out (PSCI or PSS in combination with SA).

V. Dmitrieva, A. Koshelev, A. Teplova

"First aid and treatment for open injuries spine" and other articles from the section

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 cardiac arrest, begin artificial ventilation and/or private massage hearts.

If cleaning is necessary oral cavity The foreign content victim should be held with his head, neck and chest 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 his 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 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. Complete everything general events performed for chest trauma.

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 the 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.

wounded called damage characterized by a violation of integrity skin, mucous membranes, and sometimes deep tissues and accompanied by pain, bleeding and gaping.

Pain at the time of injury is caused by damage to receptors and nerve trunks. Its intensity depends on:

the number of nerve elements in the affected area;
the reactivity of the victim, his neuropsychic state;
the nature of the wounding weapon and the speed of injury (the sharper the weapon, the fewer cells and nerve elements are destroyed, and therefore the less pain; the faster the injury is caused, the less pain).

Bleeding depends on the nature and number of vessels destroyed during injury. The most intense bleeding occurs when large arterial trunks are destroyed.

The gaping of a wound is determined by its size, depth and disruption of the elastic fibers of the skin. The degree of wound gaping is also related to the nature of the tissue. Wounds located across the direction of the elastic fibers of the skin usually have a larger gape than wounds running parallel to them.

Depending on the nature of tissue damage, wounds can be gunshot, cut, stab, chopped, bruised, crushed, torn, bitten, etc.

Gunshot wounds can be end-to-end, when there are entry and exit wound openings; blind, when a bullet or shrapnel gets stuck in tissue; And tangents, in which a bullet or fragment, flying tangentially, damages the skin and soft fabrics without getting stuck in them. In peacetime, shotgun wounds are often the result of an accidental shot while hunting, careless handling of a weapon, and less often as a result of criminal acts.
Incised wounds- have smooth edges and a small affected area, but bleed heavily.
Puncture wounds - with a small area of damage to the skin or mucous membrane, they can be of significant depth and represent great danger due to the possibility of defeat internal organs and the introduction of infection into them. With penetrating wounds of the chest, damage to the internal organs of the chest is possible, which leads to impaired cardiac activity, hemoptysis and bleeding through the mouth and nasal cavity. Simultaneous injuries to the internal organs of the chest and abdominal cavity are especially dangerous for the lives of victims.
Chopped wounds have unequal depth and are accompanied by bruising and crushing of soft tissues.
Bruised, crushed And lacerations are characterized jagged edges and are soaked with blood and dead tissue for a considerable extent. They often create favorable conditions for the development of infection.
Bite wounds Most often inflicted by dogs, rarely by wild animals. Wounds irregular shape, contaminated with animal saliva. The course of these wounds is complicated by the development acute infection. Wounds after bites from rabid animals are especially dangerous.

With penetrating chest wounds, damage to the internal organs of the chest is possible, which causes hemorrhages. When tissue bleeds, blood soaks into it, forming a swelling called a bruise. If blood permeates the tissues unevenly, then as a result of their moving apart, a limited cavity filled with blood is formed, called hematoma.

Signs of penetrating abdominal wounds, in addition to the wound, are the presence of diffuse pain, tension in the muscles of the abdominal wall, bloating, thirst, and dry mouth. Damage to the internal organs of the abdominal cavity can occur even in the absence of a wound, in the case closed injuries belly.

When presence of a foreign body in the wound, for example, a knife, it must not be removed. When providing first aid, the knife is fixed between two rolled up rolls of bandage attached to the body with a plaster.

All wounds are considered to be primarily infected. Microbes can get into the wound along with a wounding object, soil, pieces of clothing, air, and also when touching the wound with your hands. In this case, microbes that get into the wound can cause it to fester. A measure to prevent wound infection is the earliest possible application of an aseptic dressing to it, which prevents further entry of microbes into the wound.

Another dangerous complication of wounds is their infection with the causative agent of tetanus. Therefore, in order to prevent it, in all wounds accompanied by contamination, the wounded person is injected with purified tetanus toxoid or tetanus serum.

Bleeding, its types

Most wounds are accompanied by a life-threatening complication in the form of bleeding. Under bleeding refers to the release of blood from damaged blood vessels. Bleeding can be primary if it occurs immediately after damage to the blood vessels, and secondary if it appears after some time.

Depending on the nature of the damaged vessels, arterial, venous, capillary and parenchymal bleeding are distinguished.

Most dangerous arterial bleeding, at which for short term A significant amount of blood may leak from the body. Signs of arterial bleeding are the scarlet color of the blood and its flow out in a pulsating stream. Venous bleeding unlike arterial, it is characterized by a continuous flow of blood without an obvious stream. At the same time, the blood has more dark color.Capillary bleeding occurs when small vessels of the skin are damaged, subcutaneous tissue and muscles. At capillary bleeding the entire surface of the wound bleeds. Always life-threatening parenchymal bleeding, which occurs when internal organs are damaged: liver, spleen, kidneys, lungs.

Bleeding can be external and internal. At external bleeding blood flows out through a wound in the skin and visible mucous membranes or from cavities. At internal bleeding blood flows into tissues, organs or cavities, which is called hemorrhages. When a tissue bleeds, blood soaks into it, forming a swelling called infiltrate or bruise. If blood permeates the tissues unevenly and, as a result of their moving apart, a limited cavity filled with blood is formed, it is called hematoma. Acute loss of 1-2 liters of blood can lead to death.

One of dangerous complications wound is pain shock accompanied by dysfunction of vital functions important organs. To prevent shock, the wounded person is given an anesthetic with a syringe tube, and in its absence, if there is no penetrating wound to the abdomen, alcohol, hot tea, and coffee are given.

Before you start treating the wound, it needs to be exposed. At the same time, outer clothing, depending on the nature of the wound, weather and local conditions either removed or cut. First, remove clothes from the healthy side, and then from the affected side. In the cold season, in order to avoid chilling, as well as in emergency cases when providing first aid to victims who are in in serious condition clothing is cut in the wound area. Do not remove stuck clothing from the wound; it must be carefully trimmed with scissors.

To stop bleeding use a finger to press the bleeding vessel to the bone above the wound site (Fig. 49), giving the damaged part of the body an elevated position, maximum flexion of the limb at the joint, application of a tourniquet or twist, and tamponade.

Way finger pressure bleeding vessel to the bone is applied to a short time necessary for preparing a tourniquet or pressure bandage. Bleeding from the vessels of the lower part of the face is stopped by pressing the maxillary artery to the edge of the lower jaw. Bleeding from a wound in the temple and forehead is stopped by pressing the artery in front of the ear. Bleeding from large head and neck wounds can be stopped by applying pressure carotid artery to the cervical vertebrae. Bleeding from wounds on the forearm is stopped by pressing the brachial artery in the middle of the shoulder. Bleeding from wounds of the hand and fingers is stopped by pressing two arteries in the lower third of the forearm near the hand. Bleeding from wounds of the lower extremities is stopped by pressing femoral artery to the pelvic bones. Bleeding from foot wounds can be stopped by pressing on the artery running along the back of the foot.

Rice. 49. Points of finger pressure of arteries

Apply to small bleeding arteries and veins pressure bandage : the wound is covered with several layers of sterile gauze, bandage or pad from an individual dressing bag. A layer of cotton wool is placed on top of sterile gauze and a circular bandage is applied, and the dressing material, pressed tightly to the wound, compresses blood vessels and helps stop bleeding. A pressure bandage successfully stops venous and capillary bleeding.

However, when heavy bleeding should be imposed above the wound, use a tourniquet or twist from available materials (belt, handkerchief, scarf - Fig. 50, 51). The tourniquet is applied as follows. The part of the limb where the tourniquet will lie is wrapped in a towel or several layers of bandage (lining). Then injured limb lift, stretch the tourniquet, make 2-3 turns around the limb to slightly compress the soft tissue, and secure the ends of the tourniquet with a chain and hook or tie it with a knot (see Fig. 50). The correct application of the tourniquet is checked by the cessation of bleeding from the wound and the disappearance of the pulse in the periphery of the limb. Tighten the tourniquet until the bleeding stops. Every 20-30 minutes, relax the tourniquet for a few seconds to drain the blood and tighten again. In total, you can keep the tightened tourniquet for no more than 1.5-2 hours. In this case, the wounded limb should be kept elevated. To control the duration of application of the tourniquet, remove it in a timely manner or loosen it, a note is attached under the tourniquet or to the victim’s clothing indicating the date and time (hour and minute) of application of the tourniquet.

Rice. 50. Methods to stop arterial bleeding: a — tape hemostatic tourniquet; b - round hemostatic tourniquet; c — application of a hemostatic tourniquet; g - application of twist; d — maximum flexion of the limb; e - double loop of trouser belt

When applying a tourniquet, serious mistakes are often made:

apply a tourniquet without sufficient indications - it should be used only in cases of severe arterial bleeding that cannot be stopped by other means;
the tourniquet is applied to bare skin, which can cause pinching and even death;
the places for applying the tourniquet are chosen incorrectly - it must be applied above (neutral) to the bleeding site;
the tourniquet is not tightened correctly (weak tightening increases bleeding, and very strong tightening compresses the nerves).

Rice. 51. Stopping arterial bleeding by twisting: a, b, c - sequence of operations

After the bleeding has stopped, the skin around the wound is treated with a solution of iodine, potassium permanganate, brilliant green, alcohol, vodka or, in extreme cases, cologne. Using a cotton or gauze swab moistened with one of these liquids, the skin is lubricated from the edge of the wound from the outside. You should not pour them into the wound, as this will, firstly, increase the pain, and secondly, damage the tissue inside the wound and slow down the healing process. The wound should not be washed with water, covered with powders, ointment applied to it, or cotton wool should not be applied directly to the wound surface - all this contributes to the development of infection in the wound. If the wound contains foreign body, under no circumstances should it be removed.

If the viscera prolapses due to an abdominal injury, they cannot be reset abdominal cavity. In this case, the wound should be covered with a sterile napkin or a sterile bandage around the prolapsed entrails, a soft cotton-gauze ring should be placed on the napkin or bandage, and a not too tight bandage should be applied. If there is a penetrating wound to the abdomen, you should neither eat nor drink.

After completion of all manipulations, the wound is covered with a sterile bandage. If sterile material is not available, pass a clean piece of cloth over an open flame several times, then apply iodine to the area of the dressing that will be in contact with the wound.

For head injuries The wound can be covered with bandages using scarves, sterile wipes and adhesive tape. The choice of dressing type depends on the location and nature of the wound.

Rice. 52. Applying a headband in the form of a “cap”

So, for wounds of the scalpheads a bandage is applied in the form of a “cap” (Fig. 52), which is strengthened with a strip of bandage behind lower jaw. A piece of up to 1 m in size is torn off from the bandage and placed in the middle on top of a sterile napkin covering the wounds on the crown area, the ends are lowered vertically down in front of the ears and held taut. A circular securing move is made around the head (1), then, having reached the tie, the bandage is wrapped around the bandage and led obliquely to the back of the head (3). Alternating moves of the bandage through the back of the head and forehead (2-12), each time directing it more vertically, cover the entire scalp heads. After this, strengthen the bandage with 2-3 circular moves. The ends are tied with a bow under the chin.

With a neck injury , larynx or back of the head, a cruciform bandage is applied (Fig. 53). In a circular motion, the bandage is first strengthened around the head (1-2), and then above and behind the left ear it is lowered in an oblique direction down onto the neck (3). Next, the bandage goes along the right side surface of the neck, covers its front surface and returns to the back of the head (4), passes above the right and left ears, and repeats the moves made. The bandage is secured by moving the bandage around the head.

Rice. 53. Applying a cross-shaped bandage to the back of the head

For extensive head wounds , their location in the face area is better to apply a bandage in the form of a “bridle” (Fig. 54). After 2-3 securing circular moves through the forehead (1), the bandage is passed along the back of the head (2) to the neck and chin, several vertical moves (3-5) are made through the chin and crown, then from under the chin the bandage goes along the back of the head (6) .

A sling-shaped bandage is applied to the nose, forehead and chin (Fig. 55). Place a sterile napkin or bandage under the bandage on the wounded surface.

Eye patch start with a securing move around the head, then the bandage is applied from the back of the head under right ear on the right eye or under left ear on the left eye and after that they begin to alternate strokes of the bandage: one through the eye, the second around the head.

Rice. 54. Applying a headband in the form of a “bridle”

Rice. 55. Sling-shaped bandages: a - on the nose; b - on the forehead: c - on the chin

On the chest apply a spiral or cruciform bandage (Fig. 56). For a spiral bandage (Fig. 56, a), tear off the end of a bandage about 1.5 m long, place it on a healthy shoulder girdle and leave it hanging obliquely on the chest (/). Using a bandage, starting from the bottom of the back, bandage the chest in spiral moves (2-9). The loose ends of the bandage are tied. A cross-shaped bandage on the chest (Fig. 56, b) is applied from below in a circular manner, fixing with 2-3 moves of the bandage (1-2), then from the back on the right to the left shoulder girdle (J), fixing in a circular move (4), from below through the right shoulder girdle ( 5), again around the chest. The end of the bandage of the last circular move is secured with a pin.

For penetrating chest injuries A rubberized sheath must be applied to the wound with the inner sterile surface, and the sterile pads of an individual dressing bag should be placed on it (see Fig. 34) and bandaged tightly. In the absence of a bag, a sealed bandage can be applied using an adhesive plaster, as shown in Fig. 57. Strips of plaster, starting 1-2 cm above the wound, are glued to the skin in a tiled manner, thus covering the entire wound surface. Place a sterile napkin or sterile bandage in 3-4 layers on the adhesive plaster, then a layer of cotton wool and bandage it tightly.

Rice. 56. Applying a bandage to the chest: a - spiral; b - cruciform

Rice. 57. Applying a bandage with an adhesive plaster

Of particular danger are injuries accompanied by pneumothorax with significant bleeding. In this case, it is most advisable to cover the wound with an airtight material (oilcloth, cellophane) and apply a bandage with a thick layer of cotton wool or gauze.

On top part a sterile bandage is applied to the abdomen, in which the bandaging is carried out in successive circular motions from bottom to top. A spica bandage is applied to the lower abdomen and groin area(Fig. 58). It begins with circular moves around the abdomen (1-3), then the bandage moves with outer surface thigh (4) moves around it (5) along the outer surface of the thigh (6), and then again makes circular moves around the abdomen (7). Small non-penetrating abdominal wounds and boils are covered with a sticker using an adhesive plaster.

Rice. 58. Overlay spica bandage: a - on the lower abdomen; b - on the groin area

On the upper limbs Spiral, spica and cruciform bandages are usually applied (Fig. 59). The spiral bandage on the finger (Fig. 59, a) begins with a move around the wrist (1), then the bandage is led along the back of the hand to the nail phalanx (2) and spiral moves of the bandage are made from the end to the base (3-6) and in reverse A bandage is secured to the wrist (8-9) along the back of the hand (7). If the palmar or dorsal surface of the hand is damaged, a cross-shaped bandage is applied, starting with a fixation move on the wrist (1), and then along the back of the hand to the palm, as shown in Fig. 59, b. Spiral bandages are applied to the shoulder and forearm, bandaging from bottom to top, periodically bending the bandage. Bandage on elbow joint(Fig. 59, c) are applied, starting with 2-3 moves (1-3) of the bandage through the ulnar fossa and then with spiral moves of the bandage, alternating them on the forearm (4, 5, 9, 12) and shoulder (6, 7, 10, 11, 13) with crossing in the ulnar fossa.

On shoulder joint (Fig. 60) the bandage is applied starting from the healthy side from the armpit along the chest (1) and the outer surface of the injured shoulder at the back through armpit shoulder (2), along the back through the healthy armpit to the chest (3) and, repeating the moves of the bandage until the entire joint is covered, secure the end to the chest with a pin.

Rice. 59. Bandages on the upper limbs: a - spiral on the finger; b - cruciform on the hand; c - spiral to the elbow joint

Bandages on lower limbs in the area of the foot and lower leg are applied as shown in Fig. 61. The bandage on the heel area (Fig. 61, a) is applied with the first stroke of the bandage through its most protruding part (1), then alternately above (2) and below (3) the first stroke of the bandage, and for fixation, oblique (4) and eight-shaped (5) moves of the bandage. On ankle joint apply an eight-shaped bandage (Fig. 61, b). The first fixing stroke of the bandage is made above the ankle (1), then down to the sole (2) and around the foot (3), then the bandage is moved along the back of the foot (4) above the ankle and returned (5) to the foot, then to the ankle (6 ), secure the end of the bandage with circular moves (7-8) above the ankle.

Rice. 60. Applying a bandage to the shoulder joint

Rice. 61. Bandages on the heel area (a) and on the ankle joint (b)

Spiral bandages are applied to the lower leg and thigh in the same way as to the forearm and shoulder.

Bandage on knee-joint apply, starting with a circular move through the patella, and then the moves of the bandage go lower and higher, crossing in the popliteal fossa.

For wounds in the perineal area T-shape is applied bandage or bandage with a scarf (Fig. 62).

Rice. 62. Crotch bandage

When providing first aid for injuries, immobilization of the affected area and transportation to a medical facility can also be carried out according to indications.

What to do if you are bitten by a snake?

1. Since any movements increase lymph and blood circulation, promoting the spread of poison from the bite site, the victim must be ensured complete rest in a horizontal position.

2. If the snake bites through clothing, it must be removed to provide access to the wound. In addition, traces of poison may remain on it.

Since the affected limb, as a rule, will swell, it is necessary to free it from the rings of the bracelets.

3. To prevent infection from getting into the wound, it is covered with a plaster or a sterile bandage is applied, which is loosened as swelling develops.

Until now, some emergency aid manuals suggest that in the first 10-15 minutes after a snake bite, actively remove the venom from the wound by suctioning it out. Sucking out the poison does not pose a threat to the person providing assistance, provided that the oral mucosa is intact (no erosions).

This procedure will indeed remove some poison, but it will be too small to have a significant effect on the outcome. In addition to having no clinical advantage over other first aid methods, venom sucking is time consuming and can deepen the damage.

4. A compressive bandage with a pressure of 40-70 mmHg must be applied along the entire length of the bitten limb. Art. on upper limb and 55-70 mm Hg. Art. to the lower limb.

Previously, the use of a compression bandage to slow lymph flow and therefore the spread of venom was only recommended for snakebites with neurotoxic venom, but the effect has later been proven for other venomous snakes.

The only problem is the correct application of the bandage: weak pressure is ineffective, excessive pressure can cause local ischemic tissue damage. In practice, it is enough that such a bandage comfortably compresses the limb without causing discomfort, and allows you to effortlessly slip a finger under it.

5. Drink plenty of fluids will help speed up the removal of snake venom and tissue decay products from the body.

6. Analgesics will reduce painful sensations, antihistamines will reduce allergic reaction for snake venom.

7. After first aid is provided, the victim must be taken to the nearest medical institution. As mentioned above, the victim must be provided with physical rest, therefore transportation is carried out only on a stretcher; The bitten limb can be bandaged to a board or stick for immobilization.

What should you not do after a snake bite?

Contraindicated:

Incisions and cauterization of the wound, injecting the bite site with any drugs (including novocaine, adrenaline), introducing oxidizing agents into the bite area. It is only possible to treat the edges of the wound with iodine for the purpose of disinfection.
Application of a tourniquet. Application of a tourniquet not only prevents the spread of poison, but rather aggravates the development of ischemic complications against the background of disseminated blood coagulation and tissue trophic disorders.
Drinking alcohol. Alcoholic drinks increase the rate of absorption of snake venom and the degree of intoxication.