First aid and transportation for a spinal fracture in a person. Signs of a spinal fracture

Types of spinal fracture

Compression fracture

It occurs most often among victims . Most often it is diagnosed in people over 60 years of age, in extreme sports enthusiasts, as well as in those patients who have long suffered from osteoporosis .

The most common fracture of the spine is compression

With this disease, irreversible consequences occur in the bone tissue, which causes its constant destruction. Sometimes such fractures are invisible to the patient and the doctor, since they never lead to spinal cord injuries. But such an oversight can ultimately lead to the development of deformities of the thoracic and cervical spine.

Comminuted fracture

A very severe form of pathology, when the spine splits into several parts. In this case, the patient’s intervertebral discs are also damaged, and the spinal cord may be injured . Due to the large number of complications and the high probability of death of the patient, it is necessary to strictly follow the rules of first aid and transportation.

A vertebral comminuted fracture is dangerous because it can damage the spinal cord

These types of fractures occur due to severe stress on the spinal column, most often in a standing position.

The following factors can cause this type of violation::

car crashes;
injuries caused by a fall from a height;
mechanical injury due to impact during diving;
playing sports and uneven physical stress on the spine;
weakness of bone tissue due to chronic or congenital diseases.

Attention! It is recommended, even after a minor injury to the spine or an impact in its area, in the absence of significant symptoms, to undergo an x-ray to rule out a compression fracture. If left untreated, it leads to serious complications.

Video: “Actions in case of spinal injury”

General rules for moving victims

Rules and methods for moving victims may vary depending on the nature of the injuries (blood loss, fractures, etc.), but there are several general principles:

When transporting a person with a cervical spine injury, his head and neck are immobilized, i.e. fixed to prevent movement. In all other cases, the victim is transported with his head turned to one side. This is necessary to avoid vomit getting into the respiratory tract, as well as asphyxia due to tongue retraction;
A person with significant blood loss is moved so that his legs are higher than his head. This position ensures blood flow to the brain;
When climbing stairs, as well as when being placed in a vehicle, the victim is carried forward with his head; when descending and being taken out of the vehicle, he is carried forward with his feet;
The one who carries the victim in front is appointed as the main one, his task is to carefully monitor the road, notice obstacles and direct the movement, coordinating the actions of other rescuers (example command: “on the count of three, raise the stretcher - one, two, three!”). At the same time, rescuers are strictly forbidden to move “in step”;
The one who carries the victim from behind monitors his condition, and if it worsens, warns others about the need to stop.

Symptoms of a spinal fracture

Only a specialist can make an accurate diagnosis after conducting a series of diagnostic procedures.

But you can suspect a spinal fracture based on its indirect signs.

In case of injury to the cervical and thoracic region, the patient suffers from severe pain, the cause of which is radicular syndrome. If the patient's spinal cord is affected, he will feel severe dizziness, problems with sensitivity in the arms and legs, may vomit, nausea and difficulty breathing are always present. Sometimes patients complain of irregular heart rhythm and severe suffocation.
With lower back injuries, signs of the so-called cauda equina syndrome appear. Its characteristic signs are severe pain, problems with moving the legs, discomfort in the perineum and lower extremities, and problems with the functioning of internal organs. Sometimes spontaneous cleansing of the intestines or bladder is observed. If a vertebra in the upper lumbar region is damaged, the patient may experience complete paralysis of the body below the fracture site.

Attention! Fractures in the lumbar region are considered less traumatic due to the structural features of the bones and additional protection of the spinal cord. But they always require careful handling of the patient and mandatory treatment.

Treatment

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In cases where a patient has a displaced fracture, specialists first set the patient’s displaced bones under anesthesia and only then apply a plaster cast.

If a fracture occurs in the soft tissue and several fragments break off from the bones, the patient’s treatment begins with surgery. The bones are restored piece by piece, collecting all the fragments in their original position and fastening them together with surgical knitting needles, screws, and bolts. Steel pins and plates can also be used for this purpose.

Only after successful surgery can a cast be applied to the injured leg. How long the joint healing process will take depends on the individual physiology of the person. But such injuries take longer to heal than other types of fractures.

After 2 days, the initial treatment with constant traction is supplemented by lateral traction, in which lateral traction is applied to the condyle and tibia, their load is about three kilograms.

Symptoms become a signal to immediately consult a doctor. If the victim, for example, is in the forest, where there is no opportunity to quickly get to the emergency room, and the signs of severe injury are clearly expressed, it is necessary to provide the patient with first emergency aid. Consists of a number of stages:

Remember the importance of promptly transporting the victim to a hospital. Do not straighten the knee yourself; this is fraught with serious complications. You cannot bend or straighten your knee. If the fracture is open, stop the bleeding by applying a tourniquet

Tie just above the fracture. Remember or write down the exact time of application of the tourniquet. A tourniquet is made from any available materials, even from a torn shirt. Fix the leg motionless to avoid additional displacement of the joint or bone fragment. It is now permitted to transport the patient to the emergency room.

Treatment for a knee injury depends entirely on the type of fracture. Before treatment, a thorough X-ray analysis of the injury will be required. The doctor will rule out the absence of pathologies, then prescribe a course of therapy.

Anesthesia of the injured limb with local anesthetics.
Straightening and fixing the injured limb to real estate.
Applying a plaster cast to the area of the leg up to the ankle.

In case of a severe fracture of the knee cup with displacement (more than 2 mm), with multiple fragments, it is impossible to eliminate the displacement without surgery, the doctor’s actions:

Through surgery, the doctor restores the joint, putting it back together from the debris.
The kneecap is secured using knitting needles. When restoring a joint, a tie bolt and wire are used.
Multiple fragments are sewn together with a special cord made of lavsan, small fragments are removed.
A plaster bandage is applied for up to one and a half months.

In the postoperative period, a number of measures will need to be taken:

to avoid swelling, keep your leg elevated;
to reduce the risk of thrombosis and embolism, move your fingers and feet;
when you are allowed to walk, lean on your leg with maximum allowable strength, avoiding severe pain.

In order for the treatment result to be quick and positive, rehabilitation of physical and psychological health is necessary. If necessary, a psychologist works with patients who have received severe injuries.

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During treatment, control x-rays are taken to avoid pathologies. Remember, the timing of treatment depends on the complexity of the fracture.

After removing the cast, rehabilitation of the leg injury is indicated in the form of physiotherapy and physical therapy to minimize complications. If you do not follow the doctor's instructions, leg mobility can be restored over many months. Rehabilitation involves removing blood from the joint with a special injection.

After the x-ray, the traumatologist prescribes treatment, which depends on the nature of the injuries received. True, a conventional photograph in such cases may not be enough (this is typical for closed meniscal injuries with displacement).

Treatment of extra-articular fractures

Such fractures affect only the bones; the usual methods in such cases are used for treatment.

For simple cases, they resort to a method called conservative. From the name you can guess that we are talking about plaster casts or compression bandages.

The scheme is approximately the same:

accumulated blood is removed from the problem area;
An anesthetic is injected into the knee;
the joint is inspected, if the meniscus is intact, an immobilizing bandage or other bandage is applied.

First aid

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Next fact

It is very difficult for a person who understands little about medicine to determine whether a blow to the spine led to a fracture or a severe bruise. It is necessary to immediately bring the victim to his senses, preventing him from making sudden movements that could aggravate the condition. Also, those helping should not panic; their movements should be coordinated and firm.

As soon as the patient has returned to a normal psychological state, even the slightest movements of the body should not be allowed . It is necessary to explain to the patient that he should not stand up, sit down, or change his body position to one that is comfortable for him. You should immediately call for medical help, leaving the patient in the same position.

If it is impossible to call a doctor, you should try to assess the severity of the patient:

the patient must be conscious;
he should have a clear pulse;
presence of breathing is required;
The patient must have pain and tenderness in the extremities.

If a patient is diagnosed with all four factors, there is a high probability of a favorable outcome and a fairly rapid recovery. The patient can begin to be transported according to the rules.

In case of a spinal fracture, the patient must be given painkillers. If the slightest movement leads the victim to a state close to painful shock or gives rise to severe pain, there is swelling at the site of the injury, most likely a fracture has definitely occurred. Therefore, if medications are available, you can try to stabilize the patient’s condition.

To do this, the wounded person is given analgesics, for example, novocaine. If the swallowing reflex is normal, the patient can take the tablets orally. If even the slightest problems with breathing and swallowing are observed, taking tablet medications is prohibited. This can lead to dysphagia (abnormal constriction of the larynx), which can cause the patient to choke and die.

You can give and administer medications only if you know their dosages and contraindications.

If the patient is unconscious, he most likely suffered from painful shock and spinal cord injury. Sometimes this occurs due to severe pinching of the nerve root.

If the patient is not breathing and a pulse cannot be felt, it is necessary to immediately resuscitate the victim. Before starting, you should clear your mouth of vomit, if any. After this, artificial respiration must be performed.

The patient needs to pinch his nose and cover his mouth with a thin cloth, the oral cavity remains unclenched.
After this, a deep breath of air is taken and the patient exhales sharply into the oral cavity, the nose is immediately released after exhalation. In this position, the patient will exhale passively.
If the wounded person does not breathe, the action must be repeated.
It is also recommended to perform indirect cardiac massage. It is done in between artificial respiration. To do this, it is better to involve a second assistant.
He should stand at his side, placing his hands side by side on the patient's heart. For a better effect, they can be clasped in your fingers.
The arms are extended at the elbows and straightened to their full length. After this, strong pressure is applied to the chest.
The chest is pressed 3-5 cm, the pressure is intense, usually 1 click per second.
After every 30 presses, artificial inspiration is performed twice.

Attention! If the patient shows no signs of life, the heart should be started in this way before the ambulance arrives.
If transportation is carried out independently, this must be done all the way until the wounded person is in the hands of doctors.

General transportation rules

There are hopeless situations when it is impossible to get qualified help. If the transfer of a victim is urgent, it is necessary to remember that the further fate of the person may depend on how transport is carried out with a spinal fracture. There are general rules for dealing with such a situation:

In an extreme situation, rescuers must not forget about their own safety. Before providing assistance in a risk zone, you need to weigh your strengths and skills. Injury to the rescuer will only make the situation worse.
It is permissible to transfer a patient with a vertebral fracture to a stretcher only once. The following violation of the fixation of the victim’s body is possible only on the operating table.
Transportation of a victim with a spinal fracture should be carried out with the help of five people. The minimum number of rescuers is three.
The victim will be transferred onto the stretcher in one quick coordinated movement of several rescuers, while maintaining body position as much as possible.
On a hard stretcher, the victim lies on his back; this position will reduce the likelihood of vertebral displacement. A fabric cushion should be placed under the lumbar region. If the stretcher is only soft, the person can only lie on his stomach. In this case, the cushion is placed under the chest.
The injured person must lie strictly straight, so that the spine and limbs are in line.

Cervical region

Important nuances of transportation for a spinal fracture depend on which part of the spinal column is injured. The most dangerous is a fracture of the cervical spine. If a spinal cord injury occurs in this region, there is a high likelihood of death or severe disability.

The cause of such a fracture is most often a fall on the head from a height or when diving in an untested place, or car accidents with sudden braking. Symptoms of a fracture can be obvious or hidden. Among them:

Dizziness;
Numbness in the area of the fracture;
Headache;
Impaired motor activity of the limbs, tremor;
Paralysis;
Incontinence or lack of urine;
Anomaly of mobility of the vertebrae of the department;
Problems with breathing and cardiac function.

During transportation, the neck must be properly secured. Special designs have been developed for this:

Babichenko splint - the neck is stretched using straps attached to the head (Glisson loops). A counter-support is created in the area of the deltoid muscles or shoulder girdle.
Elansky tire. A softening roller is placed under the back of the head of the lying victim, two parts of the splint are applied under the neck and back, then the neck is firmly fixed with a cloth or bandage.
Shants collar. A special collar is carefully placed under the neck and secured in front with Velcro.
Kramer tire. The tire parts consist of ladder sections, which allows them to model the shape of the damaged area. One splint is applied to the head and shoulders, the second goes from the forehead to the sternum. The structure is secured with a bandage.

In extreme conditions, the neck can be secured using improvised means. A corset made of a thick layer of cotton wool rests on the chin and the back of the head from above, and from below into the shoulder girdle. Such an improvised fastening, as well as the Shants collar, can be used only in the absence of breathing and swallowing problems.

Fracture of the thoracic and lumbar spine

The fracture is usually caused by excessive flexion, putting too much pressure on the shoulders. With a minor fracture or slight compression of the vertebra, it can be confused with a bruise. In severe cases, the consequences of injury can lead to disability and death. Symptoms of a fracture of the thoracic and lumbar spine:

Pain in the chest and spine;
The muscles at the site of injury are tense, the protrusion of the spinous process is visible;
Limited mobility of the spine (it is difficult for the victim to bend or straighten);
With injury to the lower thoracic vertebrae, symptoms may be similar to acute abdomen;
It is impossible to take a straight body position due to pain.

To carry out transportation, the neck is first fixed.

After moving the victim onto the splint, it is necessary to immobilize the victim’s body using belts. The head is covered with blankets rolled into tubes. After fixation, it is necessary to re-check the victim’s pulse and breathing.

Transportation of a victim with a spinal fracture

The main danger of this type of injury is the high probability of displacement of the damaged area of the spinal column and the resulting fragments. Such a displacement worsens the patient’s condition several times and can disrupt the integrity of the spinal cord. Until the diagnosis is confirmed or proven, the patient must remain as calm and motionless as possible.

If the patient needs to be carried to a vehicle or brought into the hospital building, you should use the following mandatory tips :

The stretcher must be carried by at least three people to ensure minimal trauma; the stretcher must be carried by five assistants;
it is important that the patient is on the most flat surface possible, so that no part of the body bends or rises, this will eliminate additional violations;
if the stretcher has a soft surface, the victim is placed on his stomach;
if a rigid stretcher is used, the patient is placed on his back;
if it is possible to use bandages, cardboard or ropes, you can make a corset from them to fix the neck and use them to secure the arms and legs, this will reduce the patient’s mobility;
if there are no materials at hand to fix the neck, an assistant must hold it, and the head should not be allowed to turn;
It is necessary to shift the patient at the same time, clearly coordinating the actions of the assistants.

Pay attention to how to properly transport a victim with a spinal fracture

Find out what to do for other spinal injuries:

What is Atlanta subluxation and what are the consequences of the injury?
The consequences and treatment of a spinal bruise in the coccyx area are described in the following article
Symptoms and methods for diagnosing a coccyx fracture can be found on the page
Find out how to distinguish a sacral bruise from a fracture, to do this, follow this link

Main Causes of Injury

This type of spinal injury often occurs for the following reasons:

Due to an accident;
Due to a person falling from a height;
When doing extreme sports;
Improper diving into a body of water.
Methods for determining back injury and its diagnosis

In order to correctly provide first aid for an injury, it is important to quickly identify the severity of the injury and determine the subsequent course of action. This includes restricting a person’s movement, as well as transporting the victim to a medical facility.

To a person far from medicine, these two processes will seem very complicated. However, there are certain signs by which you can determine that the victim has a spinal fracture. So, the symptoms of injury:

The patient is unconscious and in an unnatural position;
The victim experiences severe pain in the back area. Moreover, the patient’s condition worsens at the slightest movements;
Complete paralysis of all limbs of the body is possible if the spinal cord is ruptured during the process of injury;
In case of neck fractures, cardiac arrest and cessation of breathing may occur.

It is customary to use radiography and magnetic resonance therapy as informative methods for diagnosing injury, however, as you have already understood, it is not always available after injury, and in order to avoid complications, it is extremely important to pay attention to the reasons mentioned above in the text

What should you not do if you have a spinal fracture?

If you suspect such an injury, the following manipulations are strictly prohibited::

pull the patient by the lower or upper limbs;
sit the patient down or lift him into an upright position;
attempts to independently realign the vertebrae or otherwise influence the spinal column;
give any medications for impaired swallowing functions or confusion.

If there is a real opportunity to call the attending physician to the victim, it is strictly forbidden to transport the patient on your own. Improper transportation can worsen the patient's condition several times and lead to disability or mortality.

Video: “Proper transportation for a spinal fracture”