Menu English Ukrainian russian Home

Free technical library for hobbyists and professionals Free technical library


FUNDAMENTALS OF FIRST AID
Free library / Directory / Fundamentals of First Aid

Fractures. Health care

Fundamentals of First Aid (OPMP)

Directory / Fundamentals of First Aid

Comments on the article Comments on the article

fracture is a complete or partial violation of the integrity of the bone, accompanied by damage to the tissues surrounding the bone.

The classification of fractures according to their types is extensive. Fractures are divided into congenital, which are based on a violation of the processes of bone formation, and acquired. Acquired Distinguish traumaticarising under the action of a significant traumatic force, and pathological, which can develop even under normal load, with any bone diseases (bone tumor, purulent process in the bone - osteomyelitis, etc.).

Distinguish fractures complete (over the entire diameter of the bone) and incomplete (breaks).

Complete fractures are without displacement of the fragments formed during the fracture of the bone, and with their displacement. The displacement of fragments occurs due to the traction of the muscles that attach to the bone. In connection with the attachment of muscles to the bone in the same places, the displacement of fragments depending on the level of the fracture is always typical. There are displacement of fragments along the length, along the width, at an angle, along the axis, and - more often - mixed displacement of fragments.

Fractures are also divided into closedwhen the integrity of the integument (skin, mucous membranes) is maintained, and openwhen a traumatic force or bone fragment breaks the integument.

In the direction of the fracture line, fractures are distinguished oblique, transverse, T-shaped, spiral, comminuted (with the formation of several fragments). In cases where one fragment is introduced into another, they speak of impacted fractures.

Children's bones break much less frequently due to their elasticity, flexibility, thickness of the periosteum, and small body weight of the child. The following types of fractures are typical for children: fractures (fracture like a green branch), periosteal fractures, epiphysiolysis (separation of the cartilaginous part of the bone - the epiphysis from the spongy part - the metaphysis). Under the action of a traumatic factor of great force, other types of fractures are also possible.

Evidence. There are two groups of fracture symptoms. The presence of these symptoms allows you to accurately diagnose immediately at the scene. The absence of these symptoms does not rule out a fracture, as they are mild in some fractures.

Signs of a fractured limb

Credible Relatives

Abnormal mobility in the area of ​​the suspected fracture

Cracking or clicking sound in the bones at the time of the injury

Crepitus (characteristic crunching when palpated)

Pain at the fracture site under load (pressure) along the long axis of the bone

Unnatural position of the limb (for example, the heel or hand is turned out)

The presence of bone fragments in the wound in case of an open fracture

Limb deformity

Pain in the area of ​​the fracture on palpation

Impaired function of the injured limb

 

 

With open fractures, there is a wound, bleeding from it, bone fragments are visible in the wound, it is possible that the fragment protrudes above the wound. Fractures are severe injuries, with them at the time of injury, serious complications often occur: pain shock, severe bleeding, damage to vital organs (heart, lungs, kidneys, liver, brain), as well as large vessels and nerves. Sometimes a fracture is complicated by a fat embolism (the penetration of pieces of fat from the bone marrow into the venous and arterial vessels and the closure of their lumen by a fat embolus).

Later, with fractures, a number of complications can occur: poor healing of the fracture, lack of healing and the formation of a false joint at the fracture site, abnormal healing with unrepaired displacement of fragments, osteomyelitis (purulent inflammation of the bone and bone marrow), which develops more often with open fractures, when through a wound causative agents of purulent infection penetrate into the bone.

First aid consists of several consecutive steps. These include:

  • anesthesia - intramuscular or subcutaneous administration of analgesics; in their absence, analgin, acetylsalicylic acid, etc. are given orally;
  • transport immobilization - the creation of immobility in the area of ​​the fracture for the period of transportation of the victim to the hospital;
  • stop bleeding and apply a sterile dressing for open fractures;
  • warming the victim in winter and preventing overheating in summer.

Transport immobilization - the most important measure of first aid for fractures, it prevents additional displacement of fragments, provides rest to the injured part of the body, and prevents the development of traumatic shock. Carry out transport immobilization using standard tires: metal ladder or mesh, plywood splints, Dieterichs wooden tire or Thomas-Vinogradov metal tire, pneumatic inflatable) tires (Fig. 42).

Fractures. Health care

Fig.42. Pneumatic tire

In their absence, improvised means are used: boards, skis, ski poles, thick cardboard, books, thick tree branches, etc. (Fig. 43).

Fractures. Health care

Fig.43. Immobilization of the lower leg with the help of improvised means

Autoimmobilization is also used - fixing a broken limb to healthy parts of the body (the arm is bandaged to the body, the broken leg to the healthy leg) (Fig. 44).

Fractures. Health care

Fig.44. Autoimmobilization by foot-to-foot method

When performing transport immobilization, the following rules must be strictly observed:

1. Pain relief.

2. Giving the affected limb a mid-physiological position, in which the tension of the flexor and extensor muscles is balanced: a slight abduction is created for the arm in the shoulder joint, flexion in the elbow joint to an angle of 90-100 °, the average position of the forearm between supination and pronation (the forearm should rest on ulna), slight dorsal abduction in the wrist joint and flexion of the fingers; for the leg, its straightened position is provided with flexion at the knee joint at an angle of 5-10 ° and dorsiflexion at the ankle joint up to an angle of 90-100 °; during manipulations with a broken limb, it is necessary to carefully pull it along the length of the foot or hand in order to avoid additional displacement of fragments and increased pain.

3. Selection and modeling of a transport splint: a splint of such length is selected that it fixes the fracture site and captures one joint above and below the fracture site, then the splint is shaped into an immobilized limb; the fit of the tire is carried out along the healthy limb of the patient or the assisting person bends the tire on his own; the tire is wrapped with cotton wool and gauze, put on the patient over clothing; cotton pads are placed on the area of ​​\uXNUMXb\uXNUMXbbone protrusions; the tire is fixed to the limb with bandages, scarves or improvised means (towel, sheet, wide braid, etc.).

4. When applied, the splint should protrude beyond the fingertips of the upper and lower extremities to ensure rest, however, they must be left free from the bandage so that the state of the tissues of the fixed limb can be monitored.

Depending on the fracture site, the application of a transport tire, in addition to the general rules, has its own characteristics.

With a fracture humerus the tire should go from the shoulder joint on the healthy side through the back, the shoulder joint of the diseased side and through the entire arm. The tire is bent so that it repeats the average physiological position of the upper limb. After applying the splint to the hand, both ends of it are tied so that it does not move. In the axillary region, under the olecranon, cotton pads are placed in the brush; the tire is fixed on the arm with a bandage, after which the hand in the tire is additionally fixed with a scarf. The scarf lies on a healthy shoulder girdle with one long angle, the second long angle is thrown over the arm and directed to the sore shoulder girdle and the back of the neck, where it is tied at a right angle; a short angle covers the elbow joint from back to front and is fixed with a safety pin (Fig. 45).

Fractures. Health care

Fig.45. Transport immobilization with a ladder splint for shoulder fracture

Fracture forearms it is splinted in the same way, only the length of the tire is much less: from the fingertips to the middle third of the shoulder. In case of a fracture of small bones, the length of the splint should be from the fingertips to the middle third of the forearm; the position of the hand and fingers is straightened or the fingers are half-bent, in the wrist joint the hand is slightly bent to the back. After applying the tire, the hand is fixed to the body with a scarf so that the palmar surface of the forearm touches the body (Fig. 46).

Fractures. Health care

Fig.46. Transport immobilization with a ladder splint for a fracture of the forearm

Fractures hip and knee area immobilized more often with a wooden Dieterichs tire or wire ladder tires. The Diterichs wooden splint allows you to fix the limb and carry out traction along the length, therefore it is called a distraction splint (Fig. 47).

Fractures. Health care

Fig.47. Transport immobilization of a hip fracture with a Dieterichs splint

Three tires are prepared to fix the thigh with ladder splints. The rear splint should run from the level of the shoulder blade through the hip joint along the back of the leg through the heel to the toes. The tire is slightly bent at the level of the knee joint and at an angle of 90-100° at the level of the ankle joint. The inner tire runs along the inner surface of the leg from the inguinal region to the end of the heel, turns at a right angle to the plantar surface of the foot. The outer splint is placed from the armpit through the lateral surface of the torso and leg to the end of the heel, where it meets the inner splint and is secured with tape. Cotton-gauze pads are applied to the area uniting the lateral surfaces of the hip, knee and ankle joints and the heel. The tire is fixed to the lower limb with gauze bandages, scarves or other improvised means.

Fracture shin bones fixed in the same way. First, the rear tire is applied, then the U-shaped one - so that the crossbar of the letter P is located on the sole, and its long sides run along the inner and outer surfaces of the leg. The splint is applied from the fingertips to the middle third of the thigh (Fig. 48).

Fractures. Health care

Fig.48. Transport immobilization of a tibia fracture with a ladder splint

With a fracture foot bones и one of the ankles only the rear tire is superimposed - from the fingertips to the middle third of the lower leg.

Fractures spine can be at different levels: in the cervical, thoracic, lumbar regions. In case of damage in the cervical spine, a collar made of cotton wool and soft cardboard is applied to the victim, which is wrapped around the neck and fixed with spiral bandage moves (Schanz collar) (Fig. 49).

Fractures. Health care

Fig.49. Immobilization of a fracture of the cervical spine with a cotton-gauze collar Shants

Transport the victim lying on his back. In cases of spinal fractures in the lower thoracic and lumbar sections, the injured person is placed on his back on a stretcher shield, with a 6-8 cm high roller under the fracture area, or evacuated on a conventional stretcher in the prone position - with a large roller under the chest.

With fractures pelvis the victim is placed on a stretcher on his back, with a large roller under the area of ​​​​the knee joints. The legs should be bent at the hip and knee joints and abducted in the hip - the "frog" pose.

In the absence of special shield-stretchers, they are equipped with improvised means (boards, doors, countertops, plywood, etc.).

Fractures of the lower and upper jaws fixed with a bandage bandage that supports the lower jaw. You can first put a flat board or ruler between your teeth.

Fracture immobilization clavicle more often performed with the help of cotton-gauze rings, three scarves. Cotton-gauze rings or kerchiefs rolled up in the form of rings are put on the areas of the shoulder joints, the victim raises the shoulder girdle and brings the shoulder blades together: in this position, the rings are tied with a kerchief on the back with each other. It is possible to carry out transport immobilization by pressing the upper limb of the injured side to the body and fixing it with a Dezo bandage (see Fig. 64, b).

Required equipment: analgesics, typical transport or improvised splints, Dieterichs splint, bandages, scarves, individual dressing bags, cotton or cotton-gauze pads, sanitary stretchers.

Authors: Aizman R.I., Krivoshchekov S.G.

 We recommend interesting articles Section Fundamentals of First Aid:

▪ Diathesis

▪ Abdominal pain in children

▪ Tetanus

See other articles Section Fundamentals of First Aid.

Read and write useful comments on this article.

<< Back

Latest news of science and technology, new electronics:

Artificial leather for touch emulation 15.04.2024

In a modern technology world where distance is becoming increasingly commonplace, maintaining connection and a sense of closeness is important. Recent developments in artificial skin by German scientists from Saarland University represent a new era in virtual interactions. German researchers from Saarland University have developed ultra-thin films that can transmit the sensation of touch over a distance. This cutting-edge technology provides new opportunities for virtual communication, especially for those who find themselves far from their loved ones. The ultra-thin films developed by the researchers, just 50 micrometers thick, can be integrated into textiles and worn like a second skin. These films act as sensors that recognize tactile signals from mom or dad, and as actuators that transmit these movements to the baby. Parents' touch to the fabric activates sensors that react to pressure and deform the ultra-thin film. This ... >>

Petgugu Global cat litter 15.04.2024

Taking care of pets can often be a challenge, especially when it comes to keeping your home clean. A new interesting solution from the Petgugu Global startup has been presented, which will make life easier for cat owners and help them keep their home perfectly clean and tidy. Startup Petgugu Global has unveiled a unique cat toilet that can automatically flush feces, keeping your home clean and fresh. This innovative device is equipped with various smart sensors that monitor your pet's toilet activity and activate to automatically clean after use. The device connects to the sewer system and ensures efficient waste removal without the need for intervention from the owner. Additionally, the toilet has a large flushable storage capacity, making it ideal for multi-cat households. The Petgugu cat litter bowl is designed for use with water-soluble litters and offers a range of additional ... >>

The attractiveness of caring men 14.04.2024

The stereotype that women prefer "bad boys" has long been widespread. However, recent research conducted by British scientists from Monash University offers a new perspective on this issue. They looked at how women responded to men's emotional responsibility and willingness to help others. The study's findings could change our understanding of what makes men attractive to women. A study conducted by scientists from Monash University leads to new findings about men's attractiveness to women. In the experiment, women were shown photographs of men with brief stories about their behavior in various situations, including their reaction to an encounter with a homeless person. Some of the men ignored the homeless man, while others helped him, such as buying him food. A study found that men who showed empathy and kindness were more attractive to women compared to men who showed empathy and kindness. ... >>

Random news from the Archive

Optical relay will help speed up the Internet 13.10.2012

A new micro-optical device, developed by researchers at the University of Minnesota, could significantly increase the speed of downloading files from the Internet, as well as reduce the cost of transferring data over the global network. The tiny device uses the power of light to switch a microscopic trigger at high speed. This allows the signal to be processed using light rather than electrical current, resulting in higher performance and lower power consumption.

The development of scientists is based on the discovery of 2008, when it was found that nanoscale channels can be used to create a force sufficient to mechanically move the optical waveguide. The new device succeeded in amplifying this effect so much that with the help of light it is possible to completely control the mechanics of the optical analogue of an electromechanical relay. In other words, scientists were the first to use the optical-mechanical effect to amplify optical signals without converting them to electrical ones. The new device has two optical waveguides, between which is placed a donut-shaped microscale resonator. This optical resonator amplifies light hundreds of times.

Due to the resonance effect, the optical signal in the first waveguide is greatly amplified in the resonator and generates a very strong optical power in the second waveguide. The second waveguide oscillates like a tuning fork and changes the properties of the optical signal. Since the power of the second optical signal can be many times higher than the first, the device functions as a mechanical relay that amplifies the input signal.

So far, the new optical relay operates at a frequency of a million cycles per second. The researchers plan to increase the frequency to several billion cycles per second. Although, it should be noted that the current indicators are high enough so that the optical relay can significantly increase the speed of information transfer.

Other interesting news:

▪ Micron phone camera sensor

▪ hemp meat

▪ The most capacious hard drive for automotive systems

▪ Toads are evolving before our eyes

▪ Developed paper that turns heat into electricity

News feed of science and technology, new electronics

 

Interesting materials of the Free Technical Library:

▪ site section Spectacular tricks and their clues. Article selection

▪ article Criminal law. General and Special part. Crib

▪ article How do plants and animals manage to live in the desert? Detailed answer

▪ article Electrician for the repair and installation of lighting networks. Standard instruction on labor protection

▪ article Thermometer with timer function or thermostat control. Encyclopedia of radio electronics and electrical engineering

▪ article Ball between fingers. Focus Secret

Leave your comment on this article:

Name:


Email (optional):


A comment:





All languages ​​of this page

Home page | Library | Articles | Website map | Site Reviews

www.diagram.com.ua

www.diagram.com.ua
2000-2024