- 1Cramer Overlay Technique: Algorithm and Rules, Indications, Video
2Overlapping a tire on a broken limb
- 2.1Cramer's tire and its correct application
- 2.2Fix a damaged shoulder
- 2.3Application for trauma to the forearm
- 2.4Rules for superimposing a broken limb
- 2.5Tires for fixing the lower leg
- 2.6Fracture of cervical department
- 3Technique of imposition of immobilizing tires and bandages for injuries
4Preparation for the implementation of the regulation "Overlapping of ladder tires"
- 4.1Treadmill (Cramer)
5Kramer ladder tires: description and method of application
- 5.1Detailed description
- 5.2Overlapping of Cramer's tire on hands
- 5.3How do I apply a Cramer bus to my feet?
Cramer Overlay Technique: Algorithm and Rules, Indications, Video
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 read about the rules of imposing the Dieterichs bus here.
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.
- If the injury touched the bones of the shoulder girdle, then the bandage firmly fixes the elbow, shoulder, wrist joint. The hand should be closed at the elbow.
- When the femurs are damaged, the limb is important to completely immobilize by fixing. The shinning starts from the armpit and ends with a foot. The knee and ankle joint is inactive.
- If the shin is injured, the splinting starts from the knee joint. In the case where there is bruising, then wounds are applied bandages or tissue to avoid infection. The application of the Cramer's tire to the lower limb completely fixes it. It is superimposed in three different places. For more information on how the Cramer tire overlaps with a shin fracture, see here.
- The broken limb should be fixed in the correct position. This will help avoid complications.
- Before the procedure, the patient must be anesthetized so that there is no pain shock.
- To help yourself can only be when a person is reliably versed in the topic. Otherwise, more harm can be done.
Indications for the application of Cramer's tire to the upper limb are fractures associated with the shoulder joint.
- Anesthetize the patient. It is desirable to carry out the procedure to face the patient, while carefully painting each of its actions, in order to avoid panic in the injured.
- The patient is seated in a comfortable position.
- If there is bleeding, then it must be stopped. For this, a bandage is applied.
- Cover the tire with cotton wool.
- The arm is bent at the elbow at a right angle. The wrist is sent to the trunk. The palm is inserted into the palm to create a semi-bent position of the fingers.
- Put the cotton pads under the protruding bones and axillary cavity.
- Lock the device on your arm with a spiral bandage. When bandaging move from the palm up.
- Also, for fixing, put on a bandage bandage.
- The patient is transported to the hospital.
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.
- Soothe the injured and give him an anesthetic. Be sure to explain each of its actions. We can not allow the victim to start moving from fear.
- Take 2 Cramer tires, always put cotton.
- One is put in the form of a cap on the head. It should cover the crown, ears and shoulders.
- The second is put on the back. Arrange it between the shoulder blades. Pass over the head to the forehead, connect with the first.
- Cross and bandage.
- Urgently call an ambulance.
- Strong pain. The patient may lose consciousness.
- Changing the shape of the injured limb in comparison with the healthy one.
- Inability to stir or vice versa excessive looseness of the limb.
- Possible bleeding if it is an open fracture.
If the diagnosis is made, then further assistance is provided. The main thing you need to know:
- The procedure is carried out only if they know exactly how to implement it.
- The patient needs to be reassured. Give him painkillers. Comfortable to seat or put.
- Every action needs to be explained so that the patient is not scared.
- After fixing and immobilizing the limb, you need to wait for the doctors to arrive. Do not yourself transport the patient to a medical facility.
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
Overlapping a tire on a broken limb
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:
- First the patient should calm down and concentrate as much as possible on the words of the doctors, so that if necessary, they should help them. Panic and hysteria are eliminated in the first place.
- The patient should listen carefully, what will be the whole essence of the procedure, so that his careless movements do not interfere with the doctors and not aggravate the situation.
- In the event that the clothing is obstructed by the tire, it must be cut.
- The tire is only used after a fracture is confirmed. First, the doctor does the examination.
- To the healthy part of the limb, the inner and outer parts of the tire are applied.
- Shoes during the procedure are not removed. Everything is fixed with an eight-shaped bandage. The tire should also be secured in the armpit. By all rules, the tire should support the foot by 10 centimeters.
- The outsole part of the tire inserts its outer part through a special metal eyelet.
- In the groin area, the inner part of the tire is superimposed, which is then fixed by a bridge with the outer part.
- At the points of contact between the tire and bones, you need to arrange the cotton rollers. So the skin will not be squeezed, ignoring this point it is possible to provoke necrosis in the future.
- The axillary basins of the injured end are fixed at the level of the thigh and healthy shoulder-strap.
- Wand - twist is fixed to the cord in the web, which is threaded into a special hole.
- When the bars firmly take place in the inguinal and axillary region, the stick is stopped twisting. After that, it is firmly fixed to the protrusion of the outer tire.
- The injured limb is fixed to the tire with a spiral winding of the bandage, starting from the ankle and ending with the region of the hip joint.
Cramer's tire and its correct application
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.
Fix a damaged shoulder
The algorithm is as follows:
- The patient should take the most convenient position.
- First, the tire is being prepared for operation. This is done very simply. On the basis of the wire is cotton wool and completely bandaged, and then the cover is put on the oilcloth.
- In the image of a healthy hand, the required bending of the tire is created. The injured hand is fixed only at a right angle, in a bent position.
- If necessary, the patient can take painkillers, in some cases it is better to inject.
- If there is bleeding, then first it must be stopped. Necessarily full sterility is observed, the risk of infection in this case is high enough.
- It is forbidden by the bandage, fixing the tire to close the tourniquet.
- The tire is applied over the clothes. Both shoulder, elbow and wrist joints are fixed simultaneously. The roller of cotton wool should be in the places of contact of the tire and joints.
- Bandage of the hand follows from the wrist to the elbow, and after that you need to use a bandage bandage.
- The fingertips must necessarily be open and the full immobility of the hand should be observed.
Application for trauma to the forearm
- The patient occupies a comfortable position, the tire should be prepared and, if necessary, an anesthetic should be used.
- The hand bends at an angle of 90 degrees, with such a trauma it is necessary to give a man a hand wadded cushion, this will provide a half-bent condition of the fingers.
- The rollers are also located in the armpit and in the places where the bones protrude.
- A spiral bandage is applied, starting from the palm of your hand. Keep a hand on the kerchief and wait for the arrival of an ambulance.
Rules for superimposing a broken limb
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:
- The injured limb should be in the most convenient and at the same time correct position, only then it is possible to start the process of laying the tire.
- If the arm is broken, then it is removed in the shoulder joint, and a special roller is placed in the axillary region. At this point, the hand must be bent by 90 degrees. Fingers and wrist joint should be slightly bent.
- In the case when the leg is injured, it is removed from the hip joint, the knee is unbent, and the foot should be only at a right angle.
- The fingers of the hands or feet should be in the free position during the application of the tire. This will allow you to monitor the condition of the injured limb.
- The tire must be superimposed with the utmost care, the movement of the broken ends of the bone is not allowed at the moment when it rises. To ensure that everything went well, the injured arm or leg should be held above and below the injury. Also, in order to avoid the displacement of fragments, at the time of supporting the limb, it can be slightly stretched.
- The tire should be longer than the fracture itself, beyond its limits.
- If the finished tire was not, then it can easily be built from improvised means, using strips of solid cardboard, boards, rods, skis, reeds. Sometimes even improvised means there is no, it is optimal in such a situation to pinch the injured leg to a healthy one, and fix the hand near the trunk. A person should be taken to the hospital as soon as possible.
Tires for fixing the lower leg
- First, the patient should be soothed, comfortably seated and, if necessary, given an anesthetic;
- The tire is applied to the second healthy foot, the leg needs to be bent at an angle of 90 degrees;
- The tire is located under the 90-degree ankle joint, its length reaches the middle of the thigh;
- The second tire is located, beginning from the outer part of the thigh and ending with the internal part of the ankle;
- On the places of the protrusions attach a cotton swab and tightly fix everything.
Fracture of cervical department
- First, you need to calm the person so that he does not panic, if necessary, give painkillers tablets. Be sure to call the doctors and report on the fracture.
- The first tire is put on the head in the form of a cap, it will close the shoulders, ears and temechko.
- The second tire is installed strictly between the shoulder blades, rises up and through the parietal zone rises to the forehead.
- Thus, the two tires cross.
- Both tires need to be fixed together with a bandage and wait for the arrival of an ambulance.
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
Technique of imposition of immobilizing tires and bandages for injuries
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:
- Provide reliable immobilization. Remember that usually with fractures of the limbs should be recorded fracture site and 2 nearby joints, one above, the other - below the fracture site; with a fracture of the thigh, three joints are immobilized: the hip, knee and ankle.
- Before you immobilize, you need to prepare a tire - lay it all over with cotton and gauze or put on on it a special cover; Cover the protruding parts of bones with cotton-gauze pads to avoid formation decubitus.
- When the tire is applied, give the injured limb a midship physiological position that relieves muscular tension. This is achieved by easy bending of large joints at an angle of 5-10 °.
- With closed fractures of the bones, before applying the tire, carefully pull the limb along the axis, and place the tire over clothing and shoes.
- With open fractures, traction and repair of bone fragments can not be performed. They should be recorded in the position that they acquired as a result of trauma.
- With open fractures, you must always apply a pressure bandage to the wound, if necessary, stop the bleeding - a tourniquet, and then the tire. A tourniquet is placed over the clothing (it should be in sight), and in the accompanying sheet indicate the time of its overlap. Harness on the limbs can be kept no more than 1 - 2 hours.
- If it becomes necessary to remove clothing from a victim, remove it first with a healthy arm or leg, and then with a damaged one. Put on the clothes in reverse order - first on the damaged limb, and then on the healthy one.
- When removing or putting on clothes, do not lift or put the victim.
- When transferring a patient to a stretcher or from a stretcher, the assistant must support the injured limb.
- You can not flex the tire according to the shape of the limb on the patient.
- To impose tires it is necessary very carefully (it is better with assistants) to not cause excessive pain to the victim and not cause additional damages.
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/
Preparation for the implementation of the regulation "Overlapping of ladder tires"
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
Kramer ladder tires: description and method of application
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.
Overlapping of Cramer's tire on hands
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.
How do I apply a Cramer bus to my feet?
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/