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
his body.
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.
o 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.
o 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).
o 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 be
placed.
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