Fixation, one of the four basic techniques of trauma first aid, is mainly used when a fracture is sustained; therefore, it is important to understand the symptoms of fracture and the key points of first aid before learning the fixation method in order to use it correctly.
(I) Classification of fractures.
A complete or incomplete fracture of the human skeleton due to trauma is called a fracture. Different types of fractures can be caused by different external forces, and the fracture end that is directly connected to the outside world is called open fracture, while the one that is not connected to the outside world is called closed fracture. According to the degree of fracture, it can be divided into complete fracture and incomplete fracture. According to the direction of the fracture line, it can be divided into transverse fracture, oblique fracture, comminuted fracture, compression fracture, etc. It can also be divided into femur fracture, ulnar fracture, radius fracture, etc. according to the name of the bone. Different types of fractures have different methods of treatment and management.
(B) Main symptoms of fracture.
The symptoms of fracture are not exactly the same depending on the type and location of the fracture, but the local symptoms of fracture are mainly as follows
1. pain: pain at the fracture site, increased pain with activity, significant local pressure pain, and available bone friction sounds.
2, swelling: due to the injury of small blood vessels and soft tissue injury edema at the fracture end, so the fracture site can appear swollen.
3. Deformity: Due to the misalignment of the fracture end, the limb is often bent, rotated, shortened and other deformities occur, and when the fracture is completely severed, pseudo-articular-like abnormal activities may also occur.
4.Dysfunction: After the fracture is broken, the original skeletal lever support function of the limb is lost, such as the upper limb fracture cannot be carried or lifted, and the lower limb fracture cannot be walked or stood.
5. Hemorrhage: When the fracture end punctures large blood vessels, the casualty often suffers from hemorrhage and goes into shock. Hemorrhage is mostly seen in pelvic fractures.
(C) First aid points of fracture
Temporary fixation of fracture is to stabilize the injured area without making it active, so that the injured person will not stab the blood vessels and nerves due to the broken bones during transportation and bumping, to avoid additional injury and to reduce the pain of the injured person, and the main points are
l, stop bleeding: to pay attention to the wound and general condition, such as wound bleeding, should first stop bleeding, after bandaging fixed.
2.Padding: In order to make the fixation proper and stable and prevent the skin of the protruding part from wearing, the bone protrusion should be padded with soft things such as cotton or cloth, so that the splint and other fixation materials do not directly contact the skin.
3, do not move the fracture site: in order to prevent the broken end of the bone from stabbing the nerve, blood vessels, should not be moved at will when fixed; exposed broken bone can not be sent back to the wound, so as not to increase pollution. However, when the scene of first aid, moving the injured limb is inevitable, such as the risk of re-injury to the wounded, to move the wounded to a safe place, and inevitably to move the injured limb when dressing fixed, then one person can hold the wound above, another person holding the lower end of the wound turns the longitudinal axis of the limb for traction in the opposite direction, so that the broken end of the bone is separated without distorting the injured limb, and then move in the same direction while traction In addition, another person can be fixed, fixed should first tie the upper end of the break, after tying the lower end, and then fix the upper and lower joints of the broken end.
4, fixed, tied the right amount of elasticity, too loose easy to slip off, lose the role of fixed, too tight will affect blood circulation. When fixation should be exposed finger (toe) tip, so as to observe the blood flow, such as found finger (toe) tip pale or bruised, may be fixed bandage too tight, should be relaxed re-bandage fixed. After the fixation is completed, record the time of fixation and send to the hospital quickly for further consultation and treatment.
(iv) Materials for fracture fixation.
1, splint: used to support the fixed injured limb, its length and width should be adapted to the injured limb, and the length should generally span the upper and lower joints of the injury. No splint can be used when the healthy side of the limb, branches, bamboo, thick cardboard, newspaper rolls, etc. instead.
2, dressings: for padding such as cotton, cloth, clothing, etc.; for wrapping and binding the splint available triangular towel, bandage, belt, bandana, rope, etc., but not with wire, wire.
(E) Methods of fracture fixation.
1, forearm fracture fixation method: with splints, two splints can be placed on the palm side and dorsal side of the forearm, can be placed on the affected side of the palm of the casualty a cotton, let the casualty hold the palm side of the splint end, so that the wrist joint slightly dorsiflexion, and then fixed, and then the forearm suspended in front of the chest with a triangle. When there is no splint, the forearm on the injured side can be flexed with the hand end slightly higher and suspended from the chest with a triangular scarf, and then a triangular scarf can be used to fix the injured arm on the chest (see Figure 34).
2, the upper arm fracture fixation method: when there is a splint, the injured limb can be flexed and attached to the chest, a splint can be placed on the outside of the injured arm, padded and then fixed with two cloth straps to fix the upper and lower ends of the fracture and hang it on the chest, and then the upper arm can be fixed on the chest with a triangular towel (or cloth strap). When there is no splint, the upper arm can be fixed on the chest side with a triangular towel by naturally hanging down, and the forearm can be hung on the chest with another triangular towel: or the forearm can be hung on the chest first, and the upper arm can be fixed on the chest with another triangular towel (see Figure 35).
3, the method of fixation of calf fracture: when there is a splint, place the splint on the outside of the calf, the length of which should be from the mid-thigh to the heel, and fix it with a bandage segment after the knee and ankle are padded, and then
The two lower extremities are fixed together, and the foot is fixed with “8” bandage, so that the palm of the foot is at right angles to the calf. Without splints, the two lower limbs can be aligned side by side, and the knee and ankle are padded and then fixed with bandages in sections, and then “8” shaped bandages are fixed on the foot so that the foot is at right angles to the calf (see Figure 36 and 37).
4, thigh fracture fixation method: the splint is placed on the outside of the injured limb, its length should be from the axilla to the heel, the two lower limbs aligned side by side, padded knee, ankle joint after the bandage segmental fixation. Use “8” bandage to fix the foot so that the palm of the foot is at right angles to the calf. If there is no splint, the foot can also be fixed with a healthy limb (see Figure 38, 39).
5, the clavicle fracture fixation method: let the patient sit straight chest, dressing fixed personnel with a knee top in the patient’s back between the two scapulae, two hands to gradually pull the patient’s shoulders back, so that the chest as far forward as possible, and then fixed, the method is in the injured two axillary pads, two triangular towels respectively in the two shoulder joints tightly around two weeks in the center of the count knot, knot should be pulled tightly triangular towels, so that the two shoulders slightly back open, people after the knot will The patient should bend the elbow joints and cross the wrists in front of the chest, and use another triangular scarf to go around the thorax at the flat elbow and fix the upper limb with a knot in front of the chest. Can also use a bandage in the chest, two shoulders after the opening for “8” shape fixed (see Figure 40)
6, vertebral fracture fixation method: vertebral fracture rescue process, the most important thing is to prevent spinal bending and twisting, not with a soft stretcher and unarmed handling. If there is an open fracture with cerebrospinal fluid flow, it should be bandaged with pressure first. When fixing, 4 – 6 people should support the head, shoulders, back, hips and lower limbs of the casualty with their hands, and lift the casualty onto the hardwood board with the same action. In the case of cervical vertebrae fracture, the casualty should lie on his back and put a neck brace on the casualty as soon as possible, and when there is no neck brace, sand bags or clothes can be used to fill the head and neck on both sides to prevent the head from shaking from side to side, and then fix it with cloth. The thoracic vertebrae should be lying flat, and the lumbar vertebrae fracture should be lying prone on a hard board, using clothes and other padding to stuff the neck and waist, and using cloth to fix the casualty on the board.