The head is immobilized by means of a sling, which is secured under the chin and tied to a stretcher. If the victim is unconscious and there is a danger of strangulation by a sunken tongue, the head should be secured with bandages in a lateral position. For this purpose a bandage is put around the head and under the chin, the ends of which are firmly tied to the handles of the stretcher.
The lower jaw is immobilized through the application of a bandage, the passages of which go around the head and under the chin.
Fractures of the cervical spine are immobilized in the same manner as head fractures. A wounded person with a fracture of the thoracic spine is laid on his back, on a board and tied to it. If there is no board, it is sufficient to place the casualty on a stretcher and tie him in such a way that his body remains motionless while being carried.
If the casualty is unconscious he is laid on his stomach with rollers under his upper chest and forehead to prevent suffocation by a sunken tongue or inhalation of the vomit.
The abdominal position is also the mode of transport for lumbar spinal fractures.
For pelvic fractures the victim is placed on a board or directly on a stretcher with the legs bent at the knees and a bolster under the knees. Even before laying the victim the pelvis is bandaged tightly.
For rib fractures the chest is bandaged tightly with bandages or a towel.
The extremities are the most common to be immobilized. At least two adjacent joints above and below the fracture should be immobilized (three at hip and shoulder fractures), which ensures complete rest of the broken limb.
The upper extremity is easiest to immobilize by hanging it with bandages or a scarf on a sling that is tied around the neck. The lower extremity can also be immobilized by tying both legs together.
If the forearm bones are fractured, two splints are used on both sides of the forearm, palm and back. When immobilizing the tibia and femur, splints are applied on the inside and outside of the injured lower extremity.
The most convenient for immobilization is the Kramer wire “ladder” splint, which can be bent to give it the appearance of a broken limb.
It should be remembered that ensuring immobility of the fracture site reduces pain and prevents further displacement of bone fragments, which may cause additional damage to soft tissues, nerves and co-vessels.
