Fractures of bones

Bone fractures represent a violation of bone integrity, caused by violence or pathological process( tumor, inflammation, etc.) is called a fracture.

When fractures are almost always more or less damaged tissues surrounding the bone in the fracture. Fractures can occur as a result of direct exposure to mechanical force, i.e.with direct injury( for example, a fracture from a heavy object, falling and bruising on the edge of the sidewalk).They can also occur with indirect trauma, when the place of application of mechanical force does not coincide with the place of fracture( for example, fracture of the base of the skull when falling on the buttocks).How to apply folk remedies for fractures look here.

Fracture often leads to the displacement of bone fragments. It arises as a consequence of the application of the traumatic factor and under the influence of muscle traction, attached to bone fragments. The muscles attached to the ends of the broken bone are shortened, trying to bring the ends of the bone fragments together, moving them and holding them in the wrong position. In this case, the physiological contraction of the muscles, due to the inherent elasticity, is strengthened by reflex reduction due to painful stimuli coming from the fracture site.

If the skin above the site of the fracture is intact, the fracture is called closed. If, simultaneously with a fracture of the bone, a breach of the integrity of the skin has occurred and the resulting wound is in communication with the site of the fracture, then this is an open fracture.

Depending on the position of the body at the time of injury and the direction of the traumatic factor, there are different types of fractures: transverse, longitudinal, oblique, helical, comminuted and detachable.

Fracture can occur as a result of an uncoordinated contraction of muscles attached to the ends of various bones, for example in case of unsuccessful or unexpected sudden movements, when throwing a stone or trying to keep a lost balance.

• damage to the acute ends of fragments of large vessels, which leads to the development of either external bleeding in the open fracture, or

intraarticular hemorrhage( with closed fractures) with the development of hemarthrosis( blood in the joint);

• trauma to nerve trunks with bone fragments, which can cause shock or paralysis;

• Infection of the fracture and development of phlegmon, osteomyelitis or sepsis;

• damage to vital organs( brain, liver, lungs, spleen, etc.).

For a fracture are characterized by: sharp pain, which increases with any movement and load on the limb, changes in the position and shape of the limb, a violation of its function, edema at the site of the fracture, limb shortening, abnormal bone mobility.

Sharp local pain at the site of the rib fracture, inability to take a deep breath( leading symptom).Sharp soreness and bone crepitus at the site of the fracture, shortness of breath.

In the palpation of the fracture region - a sharp pain, often bone crepitation( crunching of broken bones).Conduct palpation of the limb should be very careful, with two hands, trying not to cause unnecessary pain, and especially not to cause complications( damage to fragments of blood vessels, muscles, skin, nerves).

With an open fracture in the wound, fragments of bones are visible, often one or more of them protrudes outward. In this case, palpation is prohibited.

1) traumatic and pathological;

2) for skin and mucous membranes at the fracture site - open and closed;with the displacement of the fragments and without displacement( width, angle, length, etc.);

3) for localization - on the epiphyseal, metaphyseal and diaphyseal;

4) by the feature of the fracture line - transverse, oblique, helical, splintered, nailed;

5) primary and secondary.

Fractures of the ribs are single and multiple. The reason - a fall on a protruding object, collision of a motor vehicle, trains. Multiple fractures of the ribs can lead to acute respiratory failure, especially in the elderly.

Correct and timely first aid is one of the most important moments in the treatment of fractures.

Immobilization of a limb at a fracture reduces pain and is one of the main moments in the prevention of shock, displacement of fragments, wound of vessels, nerves, muscles. Immobilization is achieved by imposing standard tires( Cramer, Dietrichs, Abolina) or using improvised tires from improvised materials( boards, skis, sticks, cardboard, etc.).

The tire should be applied directly on the scene and only then transport the patient. Any corrections, comparisons of fragments are not recommended. Carry the patient carefully, the limb and trunk should be lifted simultaneously, keeping at the same level all the time.

If the fracture is open before immobilization, the skin around the wound should be treated with an alcohol solution of iodine or other antiseptics and apply an aseptic bandage.

For the stable immobilization of the extremities, it is necessary to have at least two tires that are applied to the extremities from two opposite sides. In the absence of tires and ancillary material, immobilization should be done by bandaging the injured limb to the healthy part of the body: the upper limb - to the trunk with a bandage or a scarf, the bottom - to a healthy leg.

In severe, complicated fractures, it is necessary to anesthetize the patient with intravenous injection of solutions of promedol( 2% - 1-2 ml);morphine( 1% - 1-2 ml in a solution of glucose 40% -10 ml) or isotonic sodium chloride solution( 0.9% -10 ml).At simple fractures it is possible to be limited to intramuscular introduction of solutions of analgin with dimedrolum. If there is no damage to the abdominal organs, then you should give plenty of drink. In severe fractures, 400 mg of polyglyukin or 400 ml of rheopolyglucin are prescribed, which is the beginning of treatment for developing traumatic shock.

Transportation for fractures of the bones of the lower extremities, gas, spine - lying;upper limbs - sitting, either in a hospital with traumatology department, or in an injury-point.

First aid: pain relief with analgin solution 50% - 2.0 intramuscularly, with multiple fractures, 1-2 ml of 2% promedol, elevated body position, oxygen can be administered.

Hospitalization: isolated fractures of one rib are treated on an outpatient basis;fractures of more than two ribs - in a surgical hospital, preferably in the thoracic department, as it is often timely to identify concomitant fractures of pneumo- and hemothorax, and fractures of the lower ribs - damage to the liver and spleen.

Skull fractures occur primarily in street or traffic trauma. The greatest danger in this case is not so much damage to the bones of the skull as to the possibility of damage to its contents, especially the brain, its membranes and blood vessels. Especially dangerous are open penetrating fractures of the skull, in which damage to the skin and the meninges creates especially favorable conditions for the penetration of the infection to the surface or the depth of the brain and the development of severe and even fatal complications( meningitis, encephalitis, brain abscess, etc.).

Depending on the location of the fracture, the fractures of the arch and the base of the skull are distinguished.

When recognizing fractures of the cranial vault, one should keep in mind both signs that depend on the damage to the skull bones( pain, hemorrhage, painful points when feeling, sometimes - a feeling of depression or crevice in the bones), and signs due to simultaneous damage to brain tissue, brainmembranes, blood vessels( loss of consciousness, vomiting, slowing of the pulse, increasing headaches, loss of speech, paralysis of the extremities, respiratory disorders, etc.).

For the fracture of the base of the skull, the following symptoms are characteristic: damage to the auditory nerve( hearing disorder), impaired facial nerve function( paralysis of mimic muscles on one side of the face - the face is "slanted" to the healthy side), the appearance of extensive hemorrhages in the eyes,ear a day after the injury, bleeding or bleeding and cerebrospinal clear fluid through the nose or ears.

For fractures of the skull, first aid should be provided at the site of the injury. It is necessary to perform thorough immobilization with the subsequent immediate transportation of the victim to the medical institution. It is strictly forbidden to move or carry the injured even for a short distance in order to avoid irreversible damage to the brain and spinal cord.
When discharging blood or cerebrospinal fluid from the ear, no rinsing should be done, but it is only necessary to apply a sterile bandage. With the decline of cardiac activity, patients inside receive 20-25 drops of cordiamine, corvalol or valocordin. To enhance the effect of medicines, it is necessary to resort to available skin irritants: hot bottles, warmers or mustard plasters to the legs and heart area.

Transport immobilization for skull fractures is best achieved by applying two or even three wire bars( Cramer or mesh) to the head, neck and shoulders, or, in the absence of them, bundles of flexible rods or bundles of aluminum wire. Head, neck and shoulders should be covered with a thick layer of cotton wool.
One longitudinal tire is placed from the forehead along the vertex, occiput, posterior surface of the neck and further along the spine. Two transverse tires are attached to it. One of them, attached over the crown, is bent along the contours of the lateral surfaces of the head, neck, and upper arms. Another tire is wrapped around the chest and at the level of the lower corners of the scapula is fastened to the rear with a longitudinal tire. Tied tires tightly bandage to the head, neck and trunk.

In the absence of tires, including improvised, injured with a fracture, the skulls are laid on a stretcher to which it is tied to avoid any movements. Under the head and neck put a large soft pillow or litter, and around the head of blankets or clothes make a roller.

It is necessary to transport such patients in conditions of careful monitoring of their condition( pulse, breathing, etc.) by accompanying persons who must ensure gentle, quiet transportation.

Jaw fractures occur, as a rule, with direct injury( stroke, fall, etc.).Most of these fractures are open, i. E.accompanied by damage to the skin or mucous membrane. If the jaw fractures in the absence of timely first aid and proper further treatment, the patient may have a number of serious complications and severe consequences( violation of the functions of chewing, swallowing and speech, facial disfigurement).

Recognition of jaw fractures in typical cases is not particularly difficult. In addition to the common signs characteristic of fractures in general( pain, pain points, mobility of fragments with a specific sound of rubbing ends of the bone), a number of very characteristic symptoms are observed in fractures of the jaws. These include, first of all, the displacement of a number of teeth or the incorrect closing of all teeth, the violation of normal bite, as well as the difficulty or impossibility of chewing, difficulty in swallowing, painful salivation, slurred speech, etc. Fractures of the jaws are often accompanied by fractures of the teeth.

It should be borne in mind that with some( complex) fractures of the lower jaw, tongue lagging may occur, which can cause choking.

For jaw fractures, the first aid is as follows. If, with a fracture of the lower jaw, there is an abnormality of the tongue causing difficulty in breathing, then it is necessary to fix the tongue with a pin.

For this purpose take an ordinary safety pin and in the middle pierce the tongue through, retracting from its tip by 1.5-2 cm. After fastening the pin to it, attach a piece of thick thread or bandage that is strengthened to the button or other piece of clothing of the patient. If the victim is unconscious, and to strengthen the tongue is not possible, then to avoid suffocation, the patient's head is turned to the side. Even better in such cases, put the patient down face, i.e.on the stomach, and under the forehead and chest place a bundle of clothing or some dense object. With any method of fixing the tongue and laying the victim behind such patients, who are in serious condition, constant monitoring is required.

Temporary fixation of fractures of the jaws is achieved by imposing a sling-like bandage, which should closely bring the injured jaw to a healthy jaw to use the latter as a tire for the immobilization of fragments.

Fractures of the ribs are very frequent and occur both from a straight line( at the point of application of force, for example when striking), and from an indirect trauma( for example, at the point of inflection of the ribs when the thorax is compressed).There are single and multiple fractures of the ribs. Fractures are observed most often in elderly people and mainly in the area of ​​IX-X ribs.

Recognition of the fracture of the ribs usually does not cause difficulties, since it has very characteristic signs: a sharp local pain, which increases with palpation, inspiration, coughing, sneezing, and also when trying to squeeze the chest in the transverse or other direction. Owing to the intensification of pain with deep inspiration and movements, patients with rib fractures breathe superficially, fearing to cough, and retain a forced position. However, in some cases, many of the listed characteristics of rib fractures may be absent and then recognition becomes possible only with the help of an X-ray.

If, at the fracture of the ribs, there is also damage to the pleura and lung tissue, air from the damaged lung can be injected into the pleural cavity when breathing, and thence into the loose fatty tissue of the thoracic wall under pressure from the pleura wound where subcutaneous emphysema is formed. In such cases, when you feel your chest under your skin, there is a crackling of air bubbles. Often when the tissue of the lung is damaged, hemoptysis is observed.

If damaged by rib fragments, not only the pleura, but also other tissues, up to the skin, a wound occurs, in which atmospheric air enters the chest cavity freely and breathes freely( open pneumothorax).In these cases, the victims often have a severe general condition: pale or cyanotic skin, severe shortness of breath, frequent pulse and other phenomena of shock.

First aid for rib fractures is achieved by applying a tight bandage( from bandages, towels or bands of adhesive plaster) to the chest. To reduce pain and cough, the patient should be given 1-2 tablets of analgin or baralgina, and in the absence of painkillers, it is recommended to drink 50-100 g of vodka or cognac. During transportation, the patient is given a semi-sitting position.

If there is an open pneumothorax on the wound of the chest wall after the usual treatment( described above), several layers of gauze wipes and a layer of cotton wool are applied. All this is covered from above with a piece of oilcloth and sealed with stripes of adhesive plaster, then carefully banded. The presence of an individual dressing packet allows you to directly apply a rubberized skin to the wound on the inner sterile side, and cotton wool on top of it, and only after that perform tight bandaging.

Fractures of the clavicle

Fractures of the clavicle occur quite often, especially in children and adolescents. They arise either from a straight line( for example, a blow when falling forward), or from an indirect( falling on an elongated arm) injury.

It is quite easy to recognize the fracture of the collarbone. During examination, feeling and measurement, a change in the usual shape of the bone and the entire region of the upper arm, sensation of pain, the definition of the sharp edges of the bone fragments under the skin, shortening the length of the clavicle, lowering the shoulder and the entire arm downwards, limiting the active movements of the upper limb.

First aid( transport immobilization) in case of fractures of the clavicle is performed as follows: a large bundle of tightly compressed cotton wool is put into the armpit, the arm is bent at the elbow and the shoulder is tightly bandaged to the trunk, the forearm is suspended on the kerchief.

Fractures of the hands. Fractures of the shoulder.

Fractures of the humerus can occur under the influence of both direct and indirect injuries( stroke, falling on the arm, twisting it, etc.) in its middle part( the most frequent fractures), in the region of the upper or lower end. The most severe fractures are observed in the elderly.

Recognition of a fracture in the middle part of the humerus, as a rule, does not cause any difficulties. In this case, there are usually "classical" signs of fractures - pain, pain points, impaired function, bruising, characteristic limb deformity, shortening, abnormal( excessive) mobility, scraping sound of rubbing bone fragments, etc.

Detection of fracture of upper humerus oftencauses significant difficulties, since the signs of this fracture in many ways resemble signs of a bruise or dislocation in the shoulder joint.

In order to distinguish the fracture of the neck of the humerus from the dislocation of the shoulder joint, it should be borne in mind that with a fracture there is no "springy" fixation of the limb, so characteristic for dislocations, but, on the contrary, abnormal mobility can be determined in the fracture region. In addition, with a fracture, a more significant hemorrhage is observed than with dislocation;The articular head of the humerus is in the usual place at the fracture, i.е.in the articular cavity.

A special difficulty is the recognition of fractures of the lower end of the humerus. For this character of trauma, the following signs are characteristic: large hemorrhage and as a consequence - significant swelling in the joint area, pain points, the sound of rubbing bone fragments, abnormal mobility.

First aid for fractures of the bones of the upper limb is in the implementation of transport immobilization, and with open fractures, in addition, in the treatment and application of bandages to the wound.
When superimposed transport buses of the upper limb, a certain position should be given, namely:

1) the arm is more or less withdrawn in the shoulder joint and bent at the elbow at a straight or acute angle;

2) palm facing the stomach;

3) the brush is slightly bent to the rear, the fingers are half-bent, for which the ball is put into the palm of the patient, a bandage or a thick band wrapped in gauze, which the victim covers with fingers. Fixing of fingers in the straightened position is erroneous and unacceptable.

In the armpit, insert a tight roller, which is strengthened with bandages through the shoulder of a healthy arm. You should also put cotton pads around your chest and on the back of your neck.
The long( not less than one meter) and wide tire is bent according to the dimensions and contours of the injured hand so that the tire starts from the shoulder joint of a healthy hand, lies on the back and the suprapatrusal area, then on the backside of the shoulder and forearm and terminates at the base of the fingers,those.captured the entire limb.
After lining the tire with cotton( or lining it with quilted cotton bedding), it is bandaged to the arm and partially to the body. The hand is suspended on a kerchief or is also bandaged to the trunk.

Forearm fractures

Forearm fractures are common injuries in people of all ages. As in the shoulder area, the forearm should distinguish between the fractures of the middle part of the bones of the forearm and the fracture of their upper and lower ends. As a result of the blow, and more often when falling on the arm, a fracture of both the forearm bones( ulnar and radial) or one of them may occur.

With regard to recognition of fractures of the upper end of the forearm bones, it is necessary to take into account all that has been said about the recognition of fractures of the lower end of the humerus, since both are in most cases intraarticular fractures of the bones of the elbow joint. Here it should only be added that in fractures of the elbow process with displacement of the fragments between them, one can probe the transverse cleft or the occlusion.

In case of fractures in the middle part of both forearm bones, there are all typical signs of fractures: pain, limb deformation, abnormal mobility, crushing of bones, etc. In these cases, as a rule, bone fragments are displaced at an angle( most often in the form of an obtuse angle,open to the rear), as well as to the side and along the periphery.

With a fracture of the lower extremities of the forearm bones, a typical deformity of the limb in the fracture region is immediately evident when viewed from the bone, and the bone and the part of the forearm adjacent to it, as it were, are shifted to the rear with respect to the entire forearm. In addition, there are other signs of fractures: swelling, painful points, restriction of movements and more.

First aid measures include transport immobilization, and with open fracture, in addition, wound treatment and the imposition of a sterile bandage. Transport immobilization for fractures of the forearm is as follows. The arm is given the same position as in fractures of the humerus.

The tire is bent at an angle corresponding to the angle of flexion of the elbow joint, giving it the shape of a groove. The tire must be at least from the upper third of the shoulder to the ends of the fingers. Tire, as usual, lined with cotton. In the tire thus prepared, a hand is laid, placing and pribintovyvaya tire mainly on the extensor surface of the affected limb. The hand is suspended on a kerchief.

Fractures of the hand and finger

Fractures of the hand and fingers are most often the result of direct injury( stroke, falling of a heavy object on the wrist, impact by moving mechanisms, etc.).Recognition of fractures of the hand bones is based on the presence of the following signs: swelling of the rear of the hand, pain at a certain point when the hand is squeezed into a fist, the bone fragments crack, etc. Recognition of fractures of finger phalanges is based on the presence of restriction of finger movements, their deformation( curvature), local swelling andtenderness, particularly when jerking or pulling on the finger.

First aid( transport immobilization) for fractures of the hand bones and phalanges of the fingers is performed in the following sequence. The injured hand is given the characteristic for fractures of the bones of the upper limb position described above. Make a tire in the form of a groove from the elbow joint to the ends of the fingers( it is better if the tire just comes over them).In the prepared chute put cotton bedding, and in the affected brush give a tight tight cotton-gauze ball. The tire is firmly bandaged to the injured arm from its palmar surface. The hand is suspended on a kerchief.

In the presence of open fractures of the hand or fingers before the transport immobilization, the wound is treated according to a standard procedure and a sterile dressing is applied.

Pelvic fractures of the pelvis

Fractures of pelvic bones are among the serious injuries, often accompanied by lesions( tears) of the pelvic organs( bladder, ureter, rectum, etc.), traumatic shock phenomena. They, as a rule, occur as a result of automobile accidents, road injuries, falls from a height.

The recognition of fractures of the pelvic bones is based on changes in the shape of the pelvis, the inability to stand, walk, lift the leg, swelling and sharp pain in the area of ​​the fracture that is strengthened by squeezing the pelvis, the presence of hemorrhages in the perineum, inguinal or lumbar region, etc.

First Aidpatients with fractures of pelvic bones include the conduct of appropriate anti-shock measures( in the presence of traumatic shock), the implementation of transport immobilization. There is no special fixation here. The victim is laid in a horizontal position on a rigid stretcher or on a wooden shield. The legs are attached to a semi-bent and slightly dilute position( "frog position"), for which thick thick rollers, folded blankets, clothes are placed under the knees. If there is a rupture of the symphysis( pubic bone) and damage to the front of the pelvis, you should tighten the pelvis with the towel and the upper thighs.

It is necessary to transport patients with pelvic fractures with extreme caution.

Femur fractures

Fractures of the femur are not only frequent, but they are also one of the most serious and dangerous injuries, as they are often accompanied by traumatic shock and other complications.

There are fractures of the upper and lower ends of the femur and its middle part.

From the fractures of the upper end of the femur, it is most difficult to diagnose and treat the fracture of its neck, which can occur both inside the hip joint( intraarticular) and outside of it( extraarticular).These fractures are often the result of trauma in the elderly( mainly in women) and arise mainly due to the fall and bruise of the upper thigh.

Due to poor blood supply to the upper end of the femur, especially the head, the fractures of the femoral neck grow very slowly, and therefore patients are forced to stay in bed for a long time. Given this, as well as the elderly age of many such patients, it is not surprising that they often develop severe and dangerous complications( pneumonia, pressure sores, etc.).

Fracture of the femoral neck

The recognition of fracture of the femoral neck is based mainly on the presence of the following symptoms: pain in the hip and its shape, the characteristic position of the foot when it is all turned( rotated) outward or inside( which is particularly easy to establish by the position of the foot), limb shortening, impaired function( impossibility of active lifting of the leg), pain points, sometimes crunching of bones, etc.

Recognition of hip fractures in the middle and lower parts does not usually cause difficulties, because they have all the typical signs of fractures, which have already been described in detail. It should be noted a very significant and characteristic displacement of fragments that significantly alter the shape of the thigh.

Transport immobilization in case of hip fractures should begin only after the first aid measures for traumatic shock, bleeding or injury, if these complications of injury occur. It is carried out as follows.

1) Take wire or wooden tires of two sizes: one long( from the armpit to the foot) and another short( from the crotch to the foot).Both tires are carefully lined with cotton bedding;wire bending tires. "^ along the contours of the corresponding limb.

2) The prepared tires are tightly banded to the trunk and to the injured leg, with the long tire being laid on the outer surface of the trunk and the leg, and the short one on the inner surface of the leg. It is very useful to put a third tire on the back surface of the limb, also bending it along the contours of the back surface of the foot and especially taking care of placing the foot at a right angle to the shin axis.

Shin bones fractures

Shin bones fractures are the most frequent fractures of the lower extremities. As a rule, they arise under the influence of a strong direct or indirect injury and are accompanied by more or less significant damage to soft tissues( muscles, skin).

Recognition of fractures of both bones of the shin or one tibia is usually easy, since they always have typical signs of fractures. Due to the superposition of the tibia in fractures, the sharp ends of its fragments often break through the skin and thus make a closed fracture into an open one. Fractures of the bones of the lower leg are often accompanied by shock, and fracture of the head of the fibula may cause damage to nerve trunks and large blood vessels.

Transport immobilization for crus fractures is carried out as follows. The first tire( not less than one meter in length) is laid on the inner surface of the lower limb, starting from the middle of the thigh, and its end is bent by the horseshoe to cover the foot through the sole. The second tire is laid on the outer surface of the lower limb.
Both tires are carefully lined with cotton bedding, bend along the contours of the foot and bandage to it. To hold the foot in a position at right angles to the shin, you can also use a large tire that is placed on the back of the thigh and lower leg, leading to the plantar surface of the foot.

Fractures of the foot bones

Fractures of the foot bones occur usually under the influence of direct trauma( impact by some instrument, falling of heavy objects on the foot, etc.).Open fractures are frequent.

Recognition is based on the presence of common signs of fracture. Fracture is accompanied, as a rule, by a large swelling of the rear of the foot, which, together with the presence of painful points, is a convincing evidence of bone fracture. When trying to get sick, you feel a sharp pain.

First aid consists in transport immobilization, which is performed as follows. The metric tire is folded at a right angle and adjusted to the posterior surface of the tibia. The length of the tire is from the upper third of the leg to the ends of the toes( it is better if the tire extends 2-4 cm beyond the ends of the fingers).The tires put a cotton bed. The tire is bandaged to the injured leg along its posterior and plantar surface.

Fractures of the spine are among the very serious damages. The special severity of vertebral fractures is that they can be accompanied by squeezing or damage to the spinal cord, which in turn causes paralysis of the extremities, pelvic organs.

The cause of vertebral fractures is most often an indirect trauma( falling from a height, jumping into water, squeezing with heavy objects, etc.).

Recognition of vertebral fractures, as a rule, does not cause special difficulties. In addition to the usual signs of fracture( pain, etc.), such symptoms as protrusion and sharp soreness of the spinous processes of the damaged vertebrae, sharp soreness, and sometimes the total inability of any movements in the spine.

In the presence of compression or injury of the spinal cord, paralysis( immobilization) of limbs, loss of body sensitivity below the fracture region, impaired functions of the pelvic organs( retention of urine and feces) are observed.

In case of fractures of the spine, first aid should be given with the utmost care. One should remember the special severity of these injuries and the inadmissibility of flexion of the spine or any movements in it, so as not to cause or increase the compression( damage) of the spinal cord.

Special temporary fixation for these severe fractures is not required, as unloading the spine and some of its immobilization is best achieved by carefully placing the victim on a stretcher in the position on the abdomen, with the shoulders and head resting with pillows or rollers.

Lifting the patient from the ground and laying him on a stretcher is as follows: lying on the ground patient carefully turn down the belly, and only then in this position carefully 3-4 people lift and lay it on a stretcher.

When the patient lies still on his back, he can not be lifted by the arms and legs because of the danger of flexing the spine and squeezing the spinal cord. It is less dangerous to take the patient by the shoulders and legs when he is turned on the stomach, since the spine is in the extension position, but in this case it should be strictly monitored so that when lifting the patient, do not bend his spine.

It is best to put your hands under the upper half of the chest and under the pelvis of the patient, while others are preparing to lift his head and legs. To lift and lay such a victim on a stretcher, on a shield, etc., a solid surface should be followed simultaneously by a team.

If a patient with a fracture of the spine is placed on his back, then a wooden shield, a sheet of plywood, a wide board, other objects with a firm flat surface should be placed on the usual soft stretcher to again prevent dangerous flexion of the spine. This is the case with the most common fractures in the thoracic and lumbar vertebrae.
If there is a fracture of the cervical vertebrae, then the victim is put on a stretcher on his back, and a pillow or a bundle of clothes is put under the neck( sometimes under the shoulders).It is very good to put a "collar" around your neck. For this, the neck is wrapped with a thick layer of cotton wool, which is bandaged with a gauze bandage.