Providing medical care for fractures, providing first aid for. Providing first aid for fractures Providing first aid for fractures

The most serious injury, not without reason, is considered a fracture. First aid, provided on time and in the required amount, can reduce the risk of complications, reduce the time of disability, and sometimes save a person from disability or death. To do this, you just need to immediately provide rest to the injured bones, numb the pain and transport the injured person to the hospital.

Types of fractures

A fracture is a violation of the integrity of a bone (complete or incomplete) that occurs under the influence of physical force or pathology. There are:

According to the position of the fragments relative to each other:

with offset;
without displacement.

According to the completeness of the fracture:

complete, when the bone is divided into 2 or more parts;
incomplete, or fracture, in which the bone breaks but is not completely torn.

Based on the presence of skin damage:

In fact, the classification of fractures is very extensive, but only traumatologists need knowledge of all its nuances, especially since they do not in any way affect the rules for providing first aid at the scene of an accident.

Symptoms of a fracture

There are several signs, the presence of which is highly likely to suggest a fracture.

The first of them is pain that occurs immediately at the time of injury, intensifying when moving the injured limb or when feeling it.

The next symptom is functional impairment. If the leg bones are broken, a person cannot stand on the injured limb; if an arm is injured, a person is unable to use it. Fractured ribs do not allow adequate breathing, and when the spine is damaged, the victim often loses the ability to move at all.

Deformity is a sign that is relevant mainly for fractures of the extremities. The presence of changes in the shape of a leg or arm clearly indicates displacement of fragments.

Pathological mobility is the fourth symptom characterizing a fracture. This term refers to sweat as the mobility of a limb in a place where a healthy person cannot have it.

Crepitus is a sound phenomenon that occurs when bone fragments rub against each other. It is heard as a crunching sound when the injured limb moves.

All these signs do not always appear during a fracture. There are, for example, impacted fractures, in which one part of the bone seems to fit into another. In this case, there may be no deformation or crepitus. A compression fracture of the spine is a variant of this injury: sometimes hours pass before its main symptoms appear and the person consults a doctor. Typically, a visit to the emergency room is made when signs of damage to the nerve roots or the spinal cord itself increase (the skin of the arms and legs becomes numb, weakness appears in the limbs, etc.)

Providing first aid for fractures should begin immediately, since the sharp ends of bone fragments can damage the main arteries, cut large nerve trunks, and the injury can cause shock.

First aid for fractures

The scope of first aid measures depends on many factors:

whether the victim’s fracture is open or closed;
whether it is the only one or whether there are multiple damages;
Are vital signs stable?
which bones were damaged.

First aid for a closed fracture

Ensuring the safety of the victim and the rescuer is a top priority. You should make sure that there is no threat to the health or life of others, and if necessary, move the injured person to a safe place.

Immobilization is the best way to prevent further deterioration of a person's condition. Any displacement of bone fragments relative to each other causes severe pain and can lead to a drop in blood pressure, rupture of blood vessels and nerves. Therefore, it is necessary to ensure complete immobility of the affected body segment.

Limb fractures

This is easiest to do for broken limbs. For immobilization, they use either special splints or improvised ones - boards, sticks, cardboard, you can even take glossy magazines rolled into a tube. The splint should be positioned to cover at least two joints adjacent to the broken bone - the upper and lower. There are only two exceptions:

You cannot put a splint on bare skin: it is better that there is at least one layer of fabric between it and the limb - clothing or a rag. It must be bandaged throughout. In exceptional cases, it is enough to tie it above and below the fracture site - this is better than not immobilizing it at all.

Attention! Never try to straighten an injured limb! This can aggravate the injury, causing tissue damage and shock. If the limb at the fracture site is bent, you should place a roll rolled up from clothing under it and only then bandage the splint.

Alternative methods of immobilization

There may be situations when there is nothing to make an improvised tire from. In this case, the anatomical features of the body should be used. So, when a leg is broken, the injured limb is bandaged to the healthy one, and when an arm is broken, it is bandaged to the body.

Finger fracture

Immobilization here is quite simple - the affected finger is bandaged to the adjacent healthy one along its entire length.

Fractured ribs

Perhaps the only fracture that does not require fixation. Previously, with this injury, the victim was given a pressure bandage on the chest. Currently, this method has been abandoned, as it worsens the course of the injury, promoting the development of pneumonia against the background of decreased respiratory function.

Pelvic fracture

There is no immobilization. The victim should be laid on his back, placing a tight cushion under his knees and spreading the patient’s hips to the sides (“frog pose”, in which the person will remain during the entire recovery period).

Spinal fracture

This injury is considered the most dangerous. The slightest displacement of vertebral fragments can lead to the intersection of nerve roots or the spinal cord. This will make a person disabled, and in some cases can even kill him. If a person says that he cannot feel his arms or legs, if he fell from a height or was in a car accident, he should be suspected of having a spinal fracture. Such a victim is placed on his back on a board the length of his height, securely tied and transported with all precautions to the hospital.

Note: in case of injuries to the thoracic and lumbar spine, the patient is placed on his back on a rigid, non-bending plane (position “b” in the figure). If it is not possible to create a non-bending plane or there is a large wound in the lumbar region, then the victim is placed on a soft stretcher on his stomach (position “a” in the figure).

After installing the splint, the conscious victim is given the strongest painkiller available (dexketoprofen, ketorolac, baralgin). This is necessary in order to reduce the chance of development. Cold applied to the fracture site also helps relieve pain. A bottle of cold water, a heating pad with ice, a bottle of soft drink taken from the refrigerator - any of these items will reduce the degree of swelling and the volume of the hematoma and reduce the intensity of pain.

Traumatologists say: “In case of an open fracture, we first treat the wound, then we deal with the fracture.” This approach is optimal, because while you are looking for material for a splint or giving the victim pain pills, he may simply bleed to death.

For an open fracture, first aid is to immediately stop the bleeding. The easiest way to deal with capillary bleeding is to simply bandage the wound and it will stop. In case of damage to the main vessels (especially arteries), a pressure bandage is applied, and if this does not help, then a hemostatic tourniquet is installed above the wound.

For your information!

You can use anything as a tourniquet - rope, tie, belt. Laces, wires, etc.

Rules for applying a tourniquet:

Always apply a tourniquet above the bleeding site:
- in case of injuries to the shoulder, forearm or hand - on the shoulder;
- for hip injuries. Shins or feet - on the thigh.
It is necessary to place a cloth under the tourniquet - this way you can avoid additional trauma to the skin.
A note should be placed under the tourniquet, which should indicate the exact time it was applied and the contact information of the person who applied it.
The duration of application of the tourniquet is no more than 2 hours in summer and 1-1.5 hours in winter.
If transportation of the victim is delayed, the tourniquet should be loosened every 20-30 minutes for 3-5 minutes, pressing the bleeding site with a gauze swab, bandage, or individual dressing bag for this period.

After the bleeding has completely stopped, immobilization of the injury site, pain relief, and transportation of the victim to the nearest medical facility should be done.

What to do if a child has a fracture

The rules for providing first aid to children are similar to those we described above. Detailed video instructions for helping a child who has broken a bone are given below:

A lot depends on the timeliness and quality of first aid provided for a fracture. The wrong tactics or lack thereof can make a person disabled, put him in a hospital bed for a long time, and sometimes lead to his death. By providing first aid for a broken bone, you will give the person a huge chance for a quick, and most importantly, complete recovery.

Bozbey Gennady Andreevich, emergency doctor

Fracture is a complete or partial damage to a bone under a load that exceeds the strength of a specific area of the skeleton.

There are two types of fractures: open And closed. At open fractures The upper tissues are also damaged, so the open wound should be treated first.

How to act in case of fractures?

Take the victim out of the incident area to a safer place.
If the fracture is "open"- stop the bleeding and apply an aseptic bandage (link).
In case of a fracture, it is important to ensure the immobility of the damaged part of the body. This can be done by applying a splint ( over clothes). You can use improvised materials as a tire: sticks, narrow boards, plywood, cardboard etc. Don't forget to smooth out the sharp edges of the improvised tire. If the fracture is “open”, you cannot apply a splint on the side of the bone fragments! In the absence of splints, the injured limb can be bandaged to a healthy part of the body (for example, an injured leg to a healthy leg, an injured arm to a torso).
After applying the splint, secure it with bandages, but not too tightly, so as not to disrupt blood circulation.
Apply to the damaged part (on the bandage) ice.
Cover and warm the victim.
Call "ambulance".

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A fracture is a bone injury that disrupts its integrity. Traumatic fractures are divided into open (there is damage to the skin in the fracture area) and closed (the skin is not broken).

With an open fracture, the injury is beyond doubt. A closed fracture is not so obvious, especially if it is incomplete, when part of the diameter of the bone is broken, often in the form of a crack.

All fractures are characterized by:

sharp pain with any movements and loads;
change in the position and shape of the limb, its shortening;
dysfunction of a limb (impossibility of usual actions or abnormal mobility);
swelling and bruising in the fracture area.

Providing first aid for fractures limbs largely determines the outcome of the injury: the speed of healing, the prevention of a number of complications (bleeding, displacement of fragments, shock) and has three goals:

creating immobility of bones in the fracture area (which prevents displacement of fragments and damage to them by the edges of blood vessels, nerves and muscles);
prevention of shock;
prompt delivery of the victim to a medical facility.

First aid for a closed fracture

If it is possible to call an ambulance, then do so. Then keep the injured limb immobile, for example, place it on a pillow and keep it at rest. Place something cold on the suspected fracture area. The victim himself can be given hot tea or a painkiller to drink.

If you have to transport the victim yourself, you must first apply a splint from any available materials (boards, skis, sticks, rods, umbrellas).

Any two solid objects are applied to the limb from opposite sides on top of clothing and secured securely, but not tightly (so as not to interfere with blood circulation) with a bandage or other suitable materials at hand (sash, belt, tape, rope).

It is necessary to fix two joints - above and below the fracture site. For example, in case of a tibia fracture, the ankle and knee joints are fixed, and in case of a hip fracture, all joints of the leg are fixed.

If there is absolutely nothing at hand, then the damaged limb should be bandaged to the healthy one (arm - to the body, leg - to the second leg).

A victim with a broken leg is transported in a lying position; it is advisable to elevate the injured limb.

First aid for an open fracture

An open fracture is more dangerous than a closed one, since there is a possibility of infection of the fragments.

If there is bleeding, it must be stopped. If the bleeding is minor, then applying a pressure bandage is sufficient. For heavy bleeding 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). If it is absent, the wound should be covered with cotton cloth.

Now you should apply a splint, just as in the case of a closed fracture, but avoiding the place where bone fragments protrude outward and take the victim to a medical facility.

You cannot try to set the bone and move the victim without applying a splint!