First Aid and Emergency Information

1 Fundamental Criteria for First Aid
2 Basic Measures for First Aid
3 First Aid for Special Wounds
4 First Aid for Fractures
5 First Aid for Climatic Injuries
6 First Aid for Bites and Stings
7 First Aid in Toxic Environments
8 First Aid for Psychological Reactions

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4-7. Lower Extremity Fractures (081-831-1034)
Figures 4-17 through 4-22 show how to apply splints to immobilize fractures of the lower extremities. Although padding is not visible in some of the figures, it is preferable to apply padding along the injured part for the length of the splint and especially where it touches any bony parts of the body.
Figure 4-17 Figure 4-18 Figure 4-19 Figure 4-20 Figure 4-21 Figure 4-22

4-8. Jaw, Collarbone, and Shoulder Fractures
a. Apply a cravat to immobilize a fractured jaw as illustrated in Figure 4-23. Direct all bandaging support to the top of the casualty’s head, not to the back of his neck. If incorrectly placed, the bandage will pull the casualty’s jaw back and interfere with his breathing.
Figure 4-23

CAUTION
Casualties with lower jaw (mandible) fractures cannot be laid flat on their backs because facial muscles will relax and may cause an airway obstruction.
b. Apply two belts, a sling, and a cravat to immobilize a fractured collarbone, as illustrated in Figure 4-24.
Figure 4-24
c. Apply a sling and a cravat to immobilize a fractured or dislocated shoulder, using the technique illustrated in Figure 4-25
Figure 4-25

4-9. Spinal Column Fractures (081-831-1000)
It is often impossible to be sure a casualty has a fractured spinal column. Be suspicious of any back injury, especially if the casualty has fallen or if his back has been sharply struck or bent. If a casualty has received such an injury and does not have feeling in his legs or cannot move them, you can be reasonably sure that he has a severe back injury which should be treated as a fracture. Remember, if the spine is fractured, bending it can cause the sharp bone fragments to bruise or cut the spinal cord and result in permanent paralysis (Figure 4-26A). The spinal column must maintain a swayback position to remove pressure from the spinal cord.
a. If the Casualty Is Not to Be Transported (081-831-1000) Until Medical Personnel Arrive
• Caution him not to move. Ask him if he is in pain or if he is unable to move any part of his body.
• Leave him in the position in which he is found. DO NOT move any part of his body.
• Slip a blanket, if he is lying face up, or material of similar size, under the arch of his back to support the spinal column in a swayback position (Figure 4-26 B). If he is lying face down, DO NOT put anything under any part of his body.
Figure 4-26
b. If the Casualty Must Be Transported to A Safe Location
Before Medical Personnel Arrive—

• And if the casualty is in a face-up position, transport him by litter or use a firm substitute, such as a wide board or a flat door longer than his height. Loosely tie the casualty’s wrists together over his waistline, using a cravat or a strip of cloth. Tie his feet together to prevent the accidental dropping or shifting of his legs. Lay a folded blanket across the litter where the arch of his back is to be placed. Using a four-man team (Figure 4-27), place the casualty on the litter without bending his spinal column or his neck.
Figure 4-27
o The number two, three, and four men position themselves on one side of the casualty; all kneel on one knee along the side of the casualty. The number one man positions himself to the opposite side of the casualty. The number two, three, and four men gently place their hands under the casualty. The number one man on the opposite side places his hands under the injured part to assist.
o When all four men are in position to lift, the number two man commands, “PREPARE TO LIFT” and then, “LIFT.” All men, in unison, gently lift the casualty about 8 inches. Once the casualty is lifted, the number one man recovers and slides the litter under the casualty, ensuring that the blanket is in proper position. The number one man then returns to his original lift position (Figure 4-27).
o When the number two man commands, “LOWER CASUALTY,” all men, in unison, gently lower the casualty onto the litter.
• And if the casualty is in a face-down position, he must be transported in this same position. The four-man team lifts him onto a regular or improvised litter, keeping the spinal column in a swayback position. If a regular litter is used, first place a folded blanket on the litter at the point where the chest will be placed.

4-10. Neck Fractures (081-831-1000)
A fractured neck is extremely dangerous. Bone fragments may bruise or cut the spinal cord just as they might in a fractured back.
a. If the Casualty Is Not to Be Transported (081-831-1000) Until Medical Personnel Arrive—
• Caution him not to move. Moving may cause death.
• Leave the casualty in the position in which he is found. If his neck/head is in an abnormal position, immediately immobilize the neck/head. Use the procedure stated below.
o Keep the casualty‘s head still, if he is lying face up, raise his shoulders slightly, and slip a roll of cloth that has the bulk of a bath towel under his neck (Figure 4-28). The roll should be thick enough to arch his neck only slightly, leaving the back of his head on the ground. DO NOT bend his neck or head forward. DO NOT raise or twist his head. Immobilize the casualty’s head (Figure 4-29). Do this by padding heavy objects such as rocks or his boots and placing them on each side of his head. If it is necessary to use boots, first fill them with stones, gravel, sand, or dirt and tie them tightly at the top. If necessary, stuff pieces of material in the top of the boots to secure the contents.
Figure 4-28 Figure 4-29
o DO NOT move the casualty if he is lying face down. Immobilize the head/neck by padding heavy objects and placing them on each side of his head. DO NOT put a roll of cloth under the neck. DO NOT bend the neck or head, nor roll the casualty onto his back.
b. If the Casualty Must be Prepared for Transportation Before Medical Personnel Arrive—
• And he has a fractured neck, at least two persons are needed because the casualty’s head and trunk must be moved in unison. The two persons must work in close coordination (Figure 4-30) to avoid bending the neck.
• Place a wide board lengthwise beside the casualty. It should extend at least 4 inches beyond the casualty‘s head and feet (Figure 4-30 A).
• If the casualty is lying face up, the number one man steadies the casualty’s head and neck between his hands. At the same time the number two man positions one foot and one knee against the board to prevent it from slipping, grasps the casualty underneath his shoulder and hip, and gently slides him onto the board (Figure 4-30 B).
• If the casualty is lying face down, the number one man steadies the casualty’s head and neck between his hands, while the number two man gently rolls the casualty over onto the board (Figure 4-30 C).
• The number one man continues to steady the casualty’s head and neck. The number two man simultaneously raises the casualty’s shoulders slightly, places padding under his neck, and immobilizes the casualty’s head (Figures 4-30 D, and E). The head may be immobilized with the casualty’s boots, with stones rolled in pieces of blanket, or with other material.
• Secure any improvised supports in position with a cravat or strip of cloth extended across the casualty’s forehead and under the board (Figure 4-30 D).
• Lift the board onto a litter or blanket in order to transport the casualty (Figure 4-30 E).
Figure 4-30

 

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