Abstract
Introduction: If there’s a suspicion that a casualty suffers from a head and/or spine injury, while approaching the casualty one should follow the rules for stabilization of the cervical vertebrae. Therefore, in the fore mentioned situations and also every time one can’t exclude a suspected spinal injury, the casualty should be approached face on by the first aid Rescue Coordinator (to avoid the casualty moving his head in order to see the paramedic). While approaching an injured but responsive person, one should introduce oneself by name and function and tell the casualty not to move. When the casualty is reached, his cervical vertebrae should be immobilized manually. After the stabilization process is passed on to the second paramedic the first aid Rescue Coordinator should apply the medical rescue action sequence. If a casualty with a bleeding head wound shows symptoms of hypovolemic shock, one should continue the casualty assessment because bleeding can occur in a different parts of the body (an adult casualty rarely suffers from vast blood loss solely because of a skin wound to the head). Where evacuation is not required, the person with a spinal cord injury or suspected spinal cord injury should be immobilized in a position in which he was found. Evacuation will be required under following circumstances: where immediate or probable danger exists in the short term and threatens the life of a casualty or paramedic, when it is not possible to assess the condition of a casualty on the spot, when a casualty in a critical condition requires immediate first aid within a timescale of 1-2 minutes to avoid death (most frequently after-shock). If evacuation is needed, the casualty should be immobilized on a long spine board, after which his condition should be re- assessed. In case of a heavy haemorrhage, the bleeding should be exposed and stopped by direct pressure or with a pressure dressing on the wound. As a last resort a tourniquet should be applied above the wound (on the thigh or arm, depending on the source of bleeding). If a casualty’s body is punctured by a foreign body, it shouldn’t be removed, except in two instances; in situations where a foreign object is causing an airway obstruction, and when a foreign object lodged in a sternum inhibits the administration of CPR.
Keywords: evacuation, injury, haemorrhage, pressure dressing, tourniquet