Overlapping the Cramer's tire at a fracture is a good fixation of a damaged limb after an injury. It is used to fully fix the limb to deliver the victim to the doctor, and at the same time not to aggravate the situation.
This medical accessory is a follower of the Dieterichs tire. You can re
The Cramer tire is a long ladder, it bends and takes the right shape, which allows it to be used for various damages. It can be used for both hands and feet. It is also allowed to use the device for rupturing tendons and ligaments.
To different extremities its own algorithm of actions when applying the Cramer transport bus.First you need to determine where the fracture occurred, and then provide emergency care.
Indications for the application of Cramer's tire to the upper limb are fractures associated with the shoulder joint.
Such a procedure can be carried out not only by the doctor, but also by any passerby who is at least familiar with the rules of care.
If the diagnosis is made, then further assistance is provided. The main thing you need to know:
Kramer's tire is a fairly new invention that takes a special place in trematology. Thanks to him, there is an opportunity to immobilize the victim before transporting him to the hospital.
This device is a flexible wire grating. Use it for fractures of the upper and lower extremities. With different injuries, the algorithm for overlapping the device is different.
Now a similar medical accessory can be bought in the store, which facilitates the provision of first aid in case of need. It is important to know how to properly apply the device. If there is no exact knowledge, then you should not do this, otherwise you can cause a lot of complications.
A source: http://pervpomosh.ru/tehnika-nalozheniya-shiny-kramera-pri-perelome.html
There are a number of rules for how to implement the bus overlap process.
It helps to fix the place of injury, therefore, this is the most important thing that you need to do with trauma.
Doctors in the hospital, or in the ambulance, carry out the technique of applying the Dieterichs bus only according to the established rules:
In the event of an injury, you need to immediately call an ambulance, and as she rides, proceed to the first medical aid, following the rules one can save a person's life. The Cramer tire has several ways of imposing, and it is divided into two separate types.
The algorithm is as follows:
To avoid complications and unpleasant consequences, it is necessary to know and follow all the rules of tire application for any fractures of the extremities.
The method is as follows:
While the tire is not imposed, it is not recommended to transfer the victim, after all it can only aggravate a situation and bring even more damage.
Overlapping the tire will help immobilize the injured limb, thereby securing further damage to it and infecting the wound.
A source: http://GidPain.ru/pomoshch/nalozhenie-shiny-pravila.html
In the provision of first aid in cases of injuries, it is especially important to create rest for the damaged organ, prepare the patient for transportation.
Peace reduces or eliminates pain and thereby prevents the development of traumatic shock or reduces its severity; reduces the risk of additional damage to soft tissues and internal organs with bone fragments, increases the resistance of tissues to infection, prevents the spread of infection beyond the wound and other severe complications.
One of the temporary measures to create rest for injuries is the imposition of tires when transporting the victim from the scene to a medical institution.
Time is calculated in minutes, but it can reach several hours and even a day.
Therefore, a well-placed and properly applied tire, creating a rest to the damaged organ, acquires special value.
Indications for tire overlap: damage to bones, joints, vessels and nerves; extensive damage to soft tissues, etc.
Rest of the damaged organ is created by special standard tires of Kramer, Dieterichs, and others.
In the absence of standard tires immobilization is provided by improvised means (plywood, boards, slats, sticks, skis of the necessary size and strength), and in special circumstances (when there is no material at hand), it is possible to fix a damaged arm to the trunk, a damaged leg - to a healthy one extremities.
The variety of immobilizing tires and bandages depends on the location of the damage. The technique of imposing tires is simple, but you will need certain knowledge, skills and skills.
Creating rest to the damaged body, it is necessary to observe a number of rules:
The most simple and affordable means of creating rest for skull injuries is a self-made tight cotton-gauze roll in the form of a "donut".
To do this, take a strip of gray cotton with a thickness of 5 cm, a width of 10-12 cm, a length of 45-50 cm, twist it into a tight tourniquet and wrap with a bandage.
The ends of the roller are connected and sewed together.
Formed cotton wool "bagel" carefully placed under the head and banded with circular turns of bandage.
The roller can be made of a towel, diaper or other (better than cotton) fabric.
For these purposes, use also a small or medium-sized pillow, a slightly inflated rubber bed.
Having prepared the victim for transportation, it should be laid on a wooden shield or on a stretcher and lying down to transport to the hospital.
To create peace for neck injuries, a cardboard-gauze collar is used.
Take a sheet of cardboard, from which a figured piece is cut about 435X145X80 mm in size. The workpiece is wrapped with a layer of cotton wool and gauze or some kind of cloth.
Two ribbons are sewn to the ends of the cardboard blank, and the collar is ready for use.
The technique of laying the collar is simple: raise the victim's head, draw a cardboard-gauze collar under his neck and tie the ribbons in front of the neck.
There is another available way to create peace for neck injuries - using a cotton-gauze collar.
Take a layer of cotton with a thickness of up to 20 cm, a width of 40 cm, a length of 90 cm, wrap it with gauze and lay around the neck.
Vatu is strengthened with coils of bandage with a slight tension, so that there is no compression of the neck (breathing should be free).
If there is no possibility of using these methods of immobilization of the neck, a small pillow can be placed under the neck and shoulders of the patient a bundle of clothes: the head is thrown back, which allows to reach the extension of the cervical spine and prevent compression of the dorsal the brain.
Remember! When carrying out immobilization of the damaged organ, any manipulation is unacceptable to shocks, rough and sharp movements, excessive excesses of the cervical spine.
It is necessary to ensure reliable peace and rapid transportation of the victim to the hospital. Care of the patient during transportation is of great importance.
The head and trunk of the victim should be slightly raised, it is desirable to apply cold to the head (a bubble with ice or cold water).
Ensure that dressings do not obstruct breathing.
In the case of vomiting, the head should be turned sideways, to release the oral cavity from vomit.
In severe injuries, when a patient has a tongue and breathing difficulties, he needs to open mouth, grab the tip of the tongue with a napkin or a handkerchief and, pulling it to yourself, hold in such position.
If the latter fails, it is necessary to sew the tongue along the middle line with a needle and thread and in a tightened position to attach it to the skin of the chin.
For the immobilization of the thoracic and lumbar spine, in the absence of standard tires, it is not uncommon to use improvised means - wooden slats, sticks, boards, skis, etc.
Used material for this purpose (length of the victim's growth) is fastened together. On the shield formed, carefully place the victim (on his back), placing small rollers under his lower back and knees.
Then fix it to the shield, without squeezing the body, and transport it to the hospital.
For fractures of the ribs and sternum, a spiral bandage with a "shoulder strap" is recommended to create rest in the chest.
For this bandage, you can use a towel or sheet, folding them into three layers and roll into a roll, wide bandages.
That the bandage does not slip, it is possible to sew the shoulder straps to the string ("sword belt").
To fix the damaged side of the chest, you can apply an adhesive plaster. Glue it tile from the sternum to the spine.
The victim is transported sitting, half-sitting or with a slightly raised upper body.
To immobilize bone fragments with fractures of the clavicle, shoulder blade, head and neck of the shoulder, a bandage dressing is convenient. Take a kerchief with two long ends and one short one.
The middle of it is brought under the forearm bent at the elbow joint to 90 °.
One end of the kerchief is placed between the forearm and the body and is led through the healthy shoulder, the other one located in front of the forearm, through the sore shoulder, and then both ends tied behind the neck.
The top of the kerchief (the third end of it) is bent at the elbow joint anteriorly and secured with a pin. A kerchief can be made from any scarf, having folded it from a corner on an angle.
In fractures of the clavicle, the shoulder often resorts to another method of immobilization - the bandage of the injured upper limb to the trunk.
Initially, the injured arm is slightly withdrawn to the side, a cotton-gauze roll is placed in the axillary region, and then, bending it at a right angle in elbow joint and tightly pressing to the chest, pribintovyvayut circular turns of bandage from the healthy side of the chest in the direction of the patient, to torso.
Immobilization of the limb in fractures of the humerus is carried out by means of a wire (ladder) tire. To do this, the arm is slightly and gently removed from the trunk, the forearm is bent at the elbow joint at a straight or acute angle, by placing a cotton-gauze roll into the armpit.
Then, on the back of the neck and shoulder, lay the cotton-gauze pad, and on the palm of the hand a little cotton wool, which the victim covers with his fingers.
Take a long, long (1 m) wire tire and, after bending it up according to the contours of the hand, the back surface of the injured arm, leading from the healthy shoulder through the back and shoulder, shoulder and forearm to the base fingers.
The tire is bandaged to the arm and partially to the trunk. The hand is hung on a scarf to the neck. Tire should be applied over clothing.
In the absence of a wire tire, improvised means can be used to immobilize a damaged limb, for example a bundle of brushwood of sufficient length (1 m or more). It is laid on the back surface of the entire upper limb and pribintovyvayut or tied to it with strips of matter.
For shinaniya limbs can be used two plates. They are placed on the outer and inner surfaces of the shoulder and pribintovyvayut to it, and the hand hangs on a scarf to the neck. Sometimes to create rest, the limb is bandaged to the trunk.
Immobilization of limbs with fractures of the bones of the forearm and hand is achieved using a short wire bar or improvised means.
For this, the forearm is carefully bent at right angles to the elbow joint, a little cotton wool is placed on the palm of the patient and he clamps it with his fingers.
A wire tire covered with a cover is bent at right angles, modeled along the contour of the hand, the back surface of the shoulder from the upper third of it to the base of the fingers and pribintovyvayut circular turns of bandage to hand. The hand is hung on a scarf to the neck.
When immobilizing the forearm and brush with improvised means, a little cotton wool is placed in the palm of the patient, then stacked on the back and palmar surface from the elbow to the tips fingers, for example, two strips of plywood (cardboard, plates, etc.), wrapped with cotton, they are bandaged with circular rounds of bandage to the forearm, and the hand is suspended on a scarf to neck.
To ensure the rest of the damaged arm, you can only use a bandage bandage (or a hem of the shirt) and attach the limb to the trunk.
The immobilization of fragments in fractures of the bones of the lower extremities is especially important in preventing damage to blood vessels, nerves, traumatic shock and other complications.
The rest of the lower limb with a fracture of its bones is best ensured by the standard tires of Diterichs, Kramer.
In the absence of standard tires to immobilize the limbs resort to improvised means (sticks, skis, slats, boards, plywood, etc.).
They should be of sufficient length to fix the 3 joints (hip, knee and ankle).
Technique of immobilization of bone fragments in the case of hip injuries with tires from improvised material: by placing it on the bony protuberances, i.e.,
on the wing of the ilium, hip, knee and ankle joint thick layer of cotton wool (for prevention decubitus), take 2 slats of the appropriate length, wrap them with cotton wool or other soft materials and submerge to extremities.
A longer rod is laid along the outer surface of the limb from the axillary region to the foot, short, the rail - along the inner surface from the crotch to the inner edge of the foot. The stop is set at an angle of 90 °. Both racks are looped around the bandage, straps or strips of matter to the trunk and limbs.
In the absence of improvised means for immobilization of the injured limb, the simplest method of fixation is used - "leg to foot".
For this, a healthy leg is laid next to the damaged one and tied in several places with a towel or straps.
After finishing the splinting of the leg, the injured person in the supine position is transported to the trauma department.
Ankle limb improvised means for fracture of the lower leg: around the ankle and knee joints lay a layer of cotton or soft tissue (to prevent pressure sores) used for splicing objects (for example, slats) are wrapped with cotton wool or cloth, then one rack is laid on the outside, the other - on the inner surface of the thigh, shank and feet, grasping 2 joints (one above, the other below the bone fracture); Both racks in circular turns of bandage or stripes of gauze are fixed to extremities. If you do not have the necessary trimming tools at hand, you can use (as with hip fractures) the way to fix the "leg to the leg."
Immobilization for fractures of the ankles and bones of the footis achieved by imposing a wire (ladder) tire on the limb. To do this, put a cotton-gauze lining on the area of the ankles and heels.
The shortened tire is modeled along the contour of the gastrocnemius muscle, the heels and feet are stacked on the back surface the injured leg from the upper third of the leg to the toes of the foot and bandage to it, fixing the shin and stop.
With these damages, you can also sew splints of plywood, cardboard, plates, etc.
The area of the ankles and heels is covered with cotton wool and wrapped with a soft cloth; then take the improvised material and also wrap it with a cloth, then stack it one strip of the tire along the outer, and the other - along the inner surface of the limb from the upper third of the shin to the edge of the foot and both tires tightly bandage to foot.
If you do not have improvised means for shinirovanija extremities, it is possible to impose on an ankle joint and a stop an eightfold bandage. The injured are referred to the hospital in a lying or sitting position.
Mastering the simplest ways of splinting with injuries will help you to provide the necessary assistance to a person, and sometimes to save his life.
A source: https://ftiza.info/tehnika-nalozheniya-immobiliziruyushhih-shin-i-povyazok-pri-travmah/
Transport immobilization should be performed qualitatively and provide complete rest to the damaged part of the body or its segment. All actions must be thought out and executed in a certain sequence.
When carrying out transport immobilization, the following basic rules should be observed:
transport immobilization of the damaged part of the body should be performed at the site of the injury and, if possible, in the early period after injury or damage.
The earlier immobilization is performed, the less the additional injury to the area of damage.
Accordingly, the general and local reaction of the organism to trauma will be less expressed;
Before imposing the transport immobilization, it is necessary to inject the patient with a subcutaneous or intramuscular anesthetic.
It should be remembered that the action of an anesthetic drug occurs only after 5 to 10 minutes.
Before the onset of analgesic effect, the imposition of transport tires is unacceptable, because all these actions are very painful for the patient even after anesthesia;
means of transport immobilization are imposed, as a rule, on top of shoes and clothes. Undressing the injured person causes additional trauma, and this should be avoided;
immobilization of the injured limb is performed in a functional position.
The upper limb is bent at the elbow joint at an angle of 90 °, the hand is placed palm to the stomach, or Fits palm on the surface of the tire (it is recommended to put a wad of gray cotton in the brush), fingers of the brush are half-bent.
The lower limb is slightly bent at the knee joint, the ankle joint is bent at an angle of 90 °;
Flexible tires must be pre-bent in accordance with the contours and position of the damaged part of the body;
Before imposing the means of transport immobilization, one should protect the bony projections (ankles, crests of the iliac bones, large joints) with layers of gray wool of sufficient thickness. The pressure of hard tires in the area of the bony projections leads to the formation of pressure sores;
in the presence of a wound, a bandage is applied to it and only then the tire is bandaged. Do not apply a bandage and strengthen the tire on the injured limb with the same bandage;
in cases where damage is accompanied by external bleeding, before imposing transport immobilization it is necessary to stop bleeding reliably performed by a pressure bandage, a tamponade of a wound or to apply hemostatic tourniquet. In this case, the tires are superimposed so that the harness is clearly visible and can be removed without dislodging the tire. The harness lock must be located at the front and easily accessible.
Do not apply metal tires without sufficient preliminary wrapping with cotton wool and bandages.
This is caused by the possibility of a pressure sore from direct pressure on soft tissues.
When transporting in winter, metal tires, cooling, can cause local frostbite;
means of transport immobilization in most cases are attached to the damaged areas of the body by bandaging. The bandage should closely cover the limb without causing a disturbance in blood circulation;
Before transporting in cold weather, the limb with the superimposed tire must be insulated with warm clothes or blankets. If the limb is in the shoe, then relax the lacing.
Compliance with these general rules is mandatory when performing transport immobilization of damage to any location.
Errors in the performance of transport immobilization make it ineffective and often lead to serious complications.
the use of unreasonably short tires and improvised means. As a result, the means of transport immobilization do not provide complete immobilization of the area of damage;
imposition of means of transport immobilization without preliminary wrapping them with cotton wool and gauze bandages. The reason for the error, as a rule, is haste or the lack of pre-prepared tires for overlapping tires;
not executed or insufficiently carefully executed bending of the wire bars in accordance with the contours and position of the damaged part of the body;
insufficient fixation of the tire to the damaged part of the body with a bandage. Saving the bandage in such cases does not allow keeping the tire in the position necessary for immobilization;
the ends of the tires are too long, or they are not sufficiently secured when they are tied. This contributes to additional traumatization, creates inconvenience during transportation, does not allow to give the limb a comfortable position;
An infrequent, but very dangerous error is the closure of the hemostatic bundle by bandaging while reinforcing the tire. As a result, the tourniquet is not visible and it is not removed in time, which leads to the necrosis of the limb.
Complications of transport immobilization. The use of rigid bandages of transport immobilization in the provision of first aid to victims can lead to such complications as compression of the limb and the formation of pressure sores.
Contraction of the limb.It comes as a result of overly tight bandaging, uneven stretching of bandage tours, increase in edema of tissues.
When the limb is compressed, pulsating pains appear in the area of limb injury, peripheral parts it swells, the skin becomes cyanotic or pale, fingers lose mobility and sensitivity.
When these symptoms appear, the bandage should be cut at the site of compression, and if necessary - bandaged.
Pressure sores.Prolonged tire pressure on a limited area of the limb or trunk results in impaired blood circulation and tissue necrosis.
The complication develops as a result of insufficient modeling of flexible tires, the use of tires without wrapping them with cotton wool and insufficient protection of bone protrusions. This complication is manifested by the appearance of pain, a feeling of numbness in a limited area of the limb.
When these signs appear, the dressing should be weakened and take measures to eliminate tire pressure.
Careful implementation of the basic rules of transport immobilization, timely monitoring of the injured, careful attitude to his complaints allow timely to prevent the development of complications associated with the use of transportation means immobilization.
It is a metal frame in the form of a rectangle made of wire with a diameter of 5 mm, transverse direction in the form of a ladder with a gap of 3 cm stretched a thinner wire with a diameter of 2 mm (Fig. 12).
Ladder tires are produced in length 120 cm, width 11 cm, weight, kg and length 80 cm, width 8 cm, weight, kg. The tire is easily modeled, has a high plasticity, is easily disinfected.
Modeling is the process of changing the shape of the tire according to the shape and position of that part of the body on which this tire will be applied.
Stairways must be prepared in advance for use.
To do this, the tire along the entire length should be covered with several layers of gray compress rubber wool, which is held on the tire by a gauze bandage.
In some cases, previously prepared padding gauze pads of the appropriate size are used.
Technique of application. Pick up the prepared tire for the desired length. If necessary, shorten the tire unnecessary part of it bend.
If it is necessary to have a longer tire, then two staircases are connected to each other, putting an end to one another.
Then the tire is modeled, respectively, of the damaged part of the body, applied to it and pribintovyvayut.
A source: http://poznayka.org/s6595t1.html
Immobilization (immobilization) of the limbs for any body injuries or painful processes for the period transportation to the clinic is the most important measure of first aid, especially with fractures and severe injuries.
It should be carried out immediately in order to protect the injured area from additional injuries.
It is inadmissible to transport and transport the victim without immobilization, even for short distances, as this will lead to bone displacement and injury to nearby blood vessels and nervous endings.
On the road most often using handy tools (branches, sticks, belts, skis). The main and most secure way of immobilization is splinting.
Medical devices intended for this purpose include Kramer ladder tires. The object of the present invention is convenience and reliability.
Used for various fractures.
The tire consists of a whole set of ladder sections having different shapes, as well as fixing belts. It is very durable and creates a reliable fixation. Cramer transport tires are very flexible and can take any shape of the body.
The predecessor of this design is the Dieterichs tire, which consisted of wooden devices. With open fractures, it is applied to the naked body (with closed ones on clothes), after covering the wound with a sterile dressing and stopping the bleeding.
It is forbidden to remove foreign objects and insert fragments of bones.
Before applying the design to the limbs, it must be wrapped with cotton and then secured with bandages. The main thing is not to overtake. In cold weather, especially if there is a long transportation, the damaged and splined part of the hand should be wrapped with a warm cloth.
Bandages are attached to the corners of the medical device, which are previously twisted with a flagellum. At the time of fastening, there should be no wrinkles or irregularities on the dressing.
The Cramer's tire (photo attached) is fixed on the back of the shoulder. It can be used for fractures of the forearm.
Be sure to see that the hand was in a physiological position (right angle at the elbow joint), turn the palm towards the trunk.
At a fracture of the hips, all the joints of the extremities are necessarily ligated. Fit the design to make yourself, so as not to disturb the position of the injured thigh. Apply the device from the foot to the armpit (where the broken bone appears).
If the shin is damaged, the Cramer's tire should be placed from the phalanx of the fingers to the top of the thigh. With significant fractures, the posterior structure is fixed laterally. In the case of a fracture of the foot, two ladders are made.
The victims who are in an unconscious state are transported to the hospital only on the abdomen with a roller under the head and chest.
This is necessary in order to prevent asphyxiation. In the period of transportation, the pulse and breathing rate of the patient should be closely monitored.
Remember: incorrect immobilization can worsen trauma and the general condition of a person.
A source: http://monateka.com/article/93921/
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