Immobilization of fractures of the clavicle, ribs and spine (1974) Pt. 3 of 3

in fractures of the clavicle the shoulder joint must be immobilized and relieved of the weight of the arm place a large wad of cotton wool in the ailla of on the injured side support the forearm with a sling made out of a triangle of cloth or a square piece of cloth folded into a triangle tie two ends over the uninjured shoulder and pin the third end so as to support the elbow immobilize the arm against the chest with a sling exerting leverage on the arm and pulling on the clavicle so as to prevent overlapping of the broken ends of the bone improvised methods can be used to immobilize the Upper Limb in fractures of the clavical for example a newspaper folded into a wad can be placed in the axilla on the injured side a tie can be used to take the weight off the shoulder by attaching it to the forearm and round the neck and the arm can be immobilized against the thorax with a belt in a simple Clos fracture of the rib the arm must be supported on the injured side with a sling across the opposite shoulder the sling consisting of a triangle of cloth is is put on in the same way as for a fracture of the cicle two ends are tied over the uninjured shoulder and the third end is pinned in such a way as to support the elbow if the fracture is open the first thing to do is to pad the wound well with a thick bandage prepare a wide Square out of adhesive bandages stuck to each other make a thick absorbent bandage out of cotton wool and gwes or sterile compresses and place it on the Square with the sterile surface uppermost leaving a wide adhesive area all around apply the bandage to the wound attaching it carefully all around to the [Music] skin support the arm on the injured side with a [Music] sling tying two ends over the shoulder on the uninjured side and pinning the third end so as to support the elbow move the injured person in the recovery position on his injured side constantly taking care that his head and shoulders are well raised injuries of the spine may be of varying degrees of severity there may be fractures without displacement of bone the spinal cord being unaffected or there may be displacement of bone causing pinching or section of the spinal cord injuries without displacement of bone May according to the site of the fracture cause localized pain p in the neck kidney area or back when the spinal cord is affected the subject complains not only of localized pain but also of numbness or of pins and needles in the lower limbs or in all four Limbs and sometimes he may not even be able to move them if one of these signs or symptoms is present and in every case in which the injured person is in a coma after falling or being struck damage to the spine must be suspected and the following rules must be observed in moving him a stretcher must be made ready with pillows at his back and behind his neck a cradle splint must be prepared with a blanket or rug folded into rolls he must be lifted into to the splint all of a piece by four first a helpers acting simultaneously he must be moved without swinging the stretcher exceptionally in emergency cases such as a fire a casualty with a spinal injury may be moved using improvised measures but it is essential always to immobilize his Limbs and to use for four helpers to place him on his back on a hard surface and move him all of a piece that is to say it is imperative never to flex his body and never to turn his head in relation to his trunk since he may at any moment go go into shock he must be given immediate treatment