Spinal Column Fractures
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 4-26 A).
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 sway back position (Figure 4-26 B).
If he is lying face down, DO NOT put anything under any part of
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.
- 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.
- 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).
- 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
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