In accidents, emergencies and natural disasters people get injured. Most often, these are fractures, which are accompanied by blood loss and pain shock. The success of further treatment largely depends on how timely and correctly the first aid was provided for open and closed fractures.
Guidelines and a poster about fractures to the stand are available after the article.
The main types of fractures
Most often, fractures are divided into closed and open. In the first case, the skin is not damaged, in the second - the skin is torn, and parts of the bone can protrude beyond the wound. With an open fracture, tissue infection occurs, so the recovery is longer.
According to the nature of damage to bones and adjacent tissues, the following types of fractures are distinguished:
- comminuted - the bone is destroyed with the formation of many fragments,
- complicated - along with the bone nerve fibers, internal organs are affected,
- displaced - bone fragments are displaced relative to each other,
Also, the fracture may be partial in the form of a crack. Such a violation of the integrity of the bone is more common in children due to the elasticity of the bone tissue.
Principles of first aid
With the help of first aid, you can significantly reduce the risk of complications - infection, pain shock, displacement of fragments. The principles of action are similar for open and closed fractures, but there are some nuances that need to be familiarized with.
First aid for fracture of limbs
Consider the algorithm of actions and the rules of first aid for fracture of the extremities:
- Look around and make sure that there is no danger to yourself and the victim.
- If a person is without signs of life, take resuscitation measures and only then provide assistance with a fracture.
- Call the SMP team.
- If there is arterial bleeding, take measures to stop it.
- Try not to change the position of the victim’s body and limbs, especially if a spinal fracture is suspected. If you need to remove clothes or shoes - do it carefully, starting with a healthy limb.
- Take measures to prevent pain shock.
- Provide immobilization.
Before the ambulance arrives, you need to be close to the victim, control breathing, pulse and consciousness, and try to calm him down.
If the fracture is open, you need to carefully, without changing the position of the injured limb, stop the bleeding by choosing the most suitable method. The area of skin around the wound must be treated with an antiseptic solution, then apply a clean dressing. After that, you can prepare the tire, which should correspond to the length and fix the damaged limb. Prior to the arrival of the ambulance brigade, the victim must be provided with peace. In case of a collarbone fracture, a roller should be inserted into the armpit, the arm should be bent at the elbow, suspended on the scarf and bandaged to the body.
Signs of a fracture
The main signs of a fracture that occurred are intense pain, swelling and pathological mobility in the injured area. There are additional signs that depend on the type and location of the fracture, but in order to suspect a fracture, three basic, and sometimes even one, severe pain are enough. The fact is that swelling is not always noticeable to an inexperienced eye. For example, in people with a dense physique it can be difficult to detect, and in some cases it may not be too pronounced. As for pathological mobility, it also cannot always be detected, for example, if the fracture is close to the joint.
The doctor will be able to accurately determine the presence of a fracture after radiography, and for first aid, any bone injury that is accompanied by severe pain that intensifies when you try to move will be considered a fracture. If subsequently it turns out that the injury is less serious, such as a bruise or dislocation, and first aid is provided as in a fracture, this will not do any harm to the victim, while underestimating the severity of the injury can lead to very serious complications.
First Aid Measures for Fractures
First aid for a fracture is immobilization, i.e. imparting immobility to the injured part of the body, and the speedy delivery of the victim to a medical facility. When conducting immobilization, it is important to follow the general rules:
- No need to try to give the injured bone the correct shape. This can lead to pain shock, as well as additional (secondary) injury to soft and hard tissues,
- If the fracture is open and broken parts of the bone are visible, one should not try to “push” them into the soft tissues. In case of comminuted fractures, it is not necessary to try to remove or set the fragments. It is necessary to immobilize in the position in which the affected area is located at the time of first aid,
- You cannot transport a victim with multiple injuries, including multiple fractures, as well as fractures of the spine and pelvis. First aid for fractures of this type is provided on site, and an ambulance is involved in the delivery to the hospital,
- With intense pain, you can give the victim a painkiller. Paracetamol, Analgin or any other over-the-counter pain reliever is suitable,
- In the cold season, it is necessary to ensure that the victim does not overcool, including that the injured limb does not overcool. To do this, you can throw something from warm clothing or a blanket on her, and give the victim a drink of hot tea (if possible).
Immobilization rules for various fractures
Before transporting the victim to the hospital, the affected area must be fixed so that movements in this area do not exacerbate the injury.
Fractures of the fingers and toes:
In case of fractures of the fingers or toes, to immobilize it is enough to bandage the damaged finger to the adjacent one.
Fractures of the limbs:
In case of fractures of the limbs, a splint is applied. The tire can be made from any improvised material that is strong enough to hold the limb stationary.
It is necessary to impose a tire, observing the following rules:
- The tire is installed in such a way as to fix at least two joints - located above and below the fracture site,
- Between the tire and the skin, there must be a fabric layer,
- The tire must be firmly fixed, it is unacceptable that it hangs, because in this case, instead of a means of immobilization, it turns into an additional traumatic factor.
In case of fractures of the ribs, the victim needs to put a tight, pressing bandage on the chest, the purpose of which is to exert sufficient pressure so that the person breathes more at the expense of the abdominal muscles - this will provide fixation and reduce pain, since the chest moves when breathing. You should not talk with the victim, since speech also leads to increased pain.
Fractures of the spine and pelvis:
In case of fractures of the spine and pelvis, as well as multiple fractures, the victim should not be moved, people with sufficient qualifications should do this. However, if this is not possible, in order to provide first aid for fractures of this type, it is necessary to make a stretcher with a solid base, observing the maximum precaution, transfer the victim to them. Under the knees, it is necessary to put a roller made of fabric (you can use rolled-up clothes), after which the patient should be fixed on a stretcher with wide bandages or tissue replacing them and transported, avoiding sudden movements.
First aid for open fractures
First aid for open fractures as a whole consists of the same measures as for closed ones, however, in this case, it is necessary to stop bleeding, since large blood loss is more dangerous than the most difficult fracture. To stop bleeding, a bandage should be applied, and if necessary a tourniquet (see "First Aid for Bleeding"). It is advisable to treat the surface of the wound with an antiseptic (alcohol, iodine), but do not remove tissue scraps, fragments, etc. from the wound.
First aid for closed fracture
If you can call an ambulance, then do it. Then ensure the immobility of the damaged limb, for example, lay it on a pillow and provide rest. Put something cold on the supposed fracture zone. The victim himself can be given hot tea or an anesthetic.
If you have to transport the victim yourself, then first you need to lay a tire of any improvised materials (boards, skis, poles, rods, umbrellas).
Any two solid objects are applied to the limb from opposite sides on top of the clothes and are firmly, but not tight (so as not to disturb blood circulation), are fixed with a bandage or other suitable improvised materials (sash, belt, tape, rope).
Two joints need to be fixed - above and below the fracture site. For example, with a fracture of the lower leg, the ankle and knee joints are fixed, and with a fracture of the hip - all joints of the leg.
If nothing was at hand, then the injured limb should be bandaged to a healthy one (hand to the body, leg to the second leg).
Transportation of the victim with a broken leg is carried out in a prone position, it is desirable to raise the injured limb.
First aid for open fracture
An open fracture is more dangerous than a closed one, since there is the possibility of infection of the fragments.
If there is bleeding, it must be stopped. If the bleeding is minor, then just apply a pressure bandage. With severe bleeding, we apply a tourniquet, not forgetting to note the time of its application. If the transportation time takes more than 1.5-2 hours, then every 30 minutes the tourniquet must be loosened for 3-5 minutes.
The skin around the wound must be treated with an antiseptic (iodine, brilliant green). In the absence of it, the wound must be covered with a cotton cloth.
Now, a splint should be applied, just as in the case of a closed fracture, but avoiding the place where bone fragments protrude outside and deliver the victim to a medical facility.
Do not try to set the bone and carry the victim without applying a tire!
A healthy lifestyle for you is, first of all, ...
Prevention of pain shock
Due to damage to the soft tissues and nerve fibers during a fracture, severe pain occurs. If you do not provide assistance in this direction, a traumatic shock may begin, which is life threatening.
To avoid this condition, you need:
- give the victim 3-4 tablets of analginum or 1-2 tramadol (or another pain medication),
- apply a cold compress to the injury site - ice, snow, etc.
The general cooling of the body contributes to the development of pain shock, therefore, in the cold season, the victim needs to be covered. Immobilization also helps prevent shock.
Immobilization is a set of measures aimed at ensuring the immobility of a damaged limb. For this, various tires are used, including those made from handy materials - sticks, boards, rods, etc.
Tire Overlay Rules
When applying a tire, a number of rules must be observed:
- You need to apply it as soon as possible. Fracture is accompanied by edema, which will not allow splinting correctly.
- The tire is applied after anesthesia, and not vice versa.
- The subject is applied on both sides of the damaged limb, fixed with a bandage throughout, except for the fracture site.
- In case of a fracture of the femur, the splint is superimposed from the axilla to the foot.
- If the fracture is open, the wound is first treated, a sterile or clean dressing is applied, and only then they can undergo splinting.
- Blood must be stopped before the tire is applied. If a harness was used, the tire is laid so that it can be removed without violating the immobilization.
- The hand is suspended on the dressing, if the leg is broken - something soft is placed under it.
- In the cold season, a damaged limb is wrapped in a warm cloth.
- To control blood circulation, the first phalanges of the fingers are left open.
When transporting the victim to a medical facility, it is necessary to ensure the correct position of the body. In case of fracture of the patient’s legs, they are transported in the “lying” position, placing a soft roller under the injured limb. In case of a fracture of the arm, transportation is allowed while sitting.
First aid for skull fractures
During various events, fractures of the skull bones are possible, but at first it is difficult to understand whether the brain is damaged. Therefore, the victim must be taken to the hospital as soon as possible.
The sequence of assistance for fractures of the skull bones is as follows:
- To create immobility of the head, a cotton-gauze bagel, sling-like bandage or handy means (clothes, blanket) are used, forming a roller around the head.
- If the person is unconscious - release the oral cavity from the vomit and begin resuscitation.
- To normalize the work of the heart, if possible, give an infusion of Corvalol (up to 20 drops).
If the wound was formed in the back of the head or the victim is unconscious - you need to transport it on your side. This provision will prevent the development of suffocation due to vomiting or retention of the tongue.
If the victim has a nasal bone fracture - it must be transported in the half-sitting position. If the jaw is broken - in a sitting position, and those who have lost consciousness - lying on their stomach. In case of a fracture, the lower jaw is immobilized with a sling-like bandage, and if the upper jaw is broken, a ruler or piece of plywood is inserted between the jaws, which are fixed to the head.
First aid for fractures
First aid for pelvic fracture
When falling from a height, accident or shock, a pelvic bone fracture may occur. First aid in this case is provided before the arrival of the ambulance brigade. To do this, you need:
- Take measures to prevent traumatic shock.
- Put the victim on a hard surface.
- Give the body a “frog” position. Bend the legs at an angle of 45 0 in the knees and in the TBS, slightly spread apart. Under the feet, put a soft roller from clothes or blankets.
If necessary, the pose of the "frog" of a person can be transported to a medical facility.
As in the case of other fractures, it is necessary to control physiological parameters, monitor the pulse rate, respiration. You need to talk with the victim, try to calm him down, and if you lose consciousness, turn your head to the side to prevent asphyxiation with vomit.
Often eyewitnesses of the incident do not have special knowledge and therefore, trying to provide first aid to the victim, they make gross mistakes. Incorrect actions can increase recovery time and, in the worst case, cost the victim a life.
When a fracture is prohibited:
- Give something to drink or eat, except in cases of prevention of pain shock.
- Try to straighten a damaged leg or arm.
- With an open fracture, remove bone fragments from the wound.
- Without the need to move the victim, change the position of the injured limb.
- Independently “fix” broken bones.
- Pour iodine, alcohol and other means directly into the wound (cause pain shock).
- Use contaminated materials to treat wounds and dressings.
When a fracture is prohibited
Measures to prevent pain shock should be reported to the ambulance arrived. Information about painkillers or alcohol can be helpful if general anesthesia is required for subsequent fracture treatment.
- Buyanov V.M., Nesterenko Yu.A. First Aid (7th Edition, 2000)
- D. V. Marchenko “First aid for injuries and accidents” 2009