Transportation of the wounded and injured in military conditions. Rules for carrying the wounded on stretchers in various conditions When transporting the wounded on stretchers, they carry
Carrying the affected persons without a stretcher can be carried out by one or two porters with or without stretcher straps.
The stretcher strap is a canvas belt with a length of 360 cm and width 6.5 cm, with a metal buckle at the end. At a distance of 100 cm From the buckle there is an overlay sewn from the same fabric, which allows you to pass the end of the belt through it and fold the strap in the shape of a figure eight (Fig. 33).
To carry the victim, the strap is folded either into a figure of eight or into a ring using a buckle. The folded strap must be correctly adjusted to the height and build of the porter: a strap folded in a figure of eight must be put on without sagging. thumbs outstretched arms (Fig. 33, a), and the strap, folded in a ring, is placed on the thumbs of one outstretched hand and the other, bent in elbow joint at right angles (Fig. 33, b).
To work with a stretcher, the strap is folded into a figure eight and put on so that its loops are located on the sides of the stretcher, and the crossing of the belt occurs on the back at the level of the shoulder blades (Fig. 33,V).
If there is no stretcher strap, it is easy to make: a ring - from two, an eight - from five waist belts.
Carrying the affected person by one porter using a stretcher strap can be done in two ways.
First way. The affected person is placed on his healthy side. A stretcher strap, folded in the form of a ring, is placed under the victim so that one half of the strap is under the buttocks, and the other, threaded under the armpits, is on the back. The free end of the strap should lie on the ground. Thus, loops are formed on the sides of the victim (Fig. 34, a).
The porter lies in front of the victim, with his back to him, inserts his hands into the loops of the strap the victim is wearing, pulls them onto his shoulders, ties the loops with the free end of the strap and places the victim on his back. Then the young man gradually rises, standing on all fours, on one knee and, finally, to his full height. The victim sits on a strap, pressed by it to the porter (Fig. 34, b). This method is convenient for those
that both hands of the porter remain free, and the victim does not have to hold on to the porter, since the strap holds him securely enough.
The disadvantages of this method include the pressure that the strap puts on the victim's back. Therefore, in case of wounds and damage chest They use not the first, but the second method of carrying on a strap.
Second way. The porter puts a strap folded in a figure eight on the victim’s legs, lays him on his healthy side and, pressing his back against him, puts the strap on himself so that the cross of it falls on his chest. Then the porter rises, as in the first method (Fig. 35). When carried in this way, the chest of the victim remains free, but the porter must support his arms, and the victim must hold on to the shoulders or waist belt of the porter. Both methods are not applicable for fractures of the hip, pelvis, or spine. Second
The method, in addition, cannot be used in cases of serious damage to both upper extremities.
If the victim is carried on a strap by two porters, then they, folding the stretcher strap into a figure eight, put it on themselves so that the cross of the strap of the strap is between them at the level of the hip joints, and the loop goes through one of the right and the other through the left shoulder. The bearers fall behind the victim, facing each other, one on the right and the other on the left knee, lift the victim and place him on their closed knees, then place the strap under the victim’s buttocks and stand on their feet (Fig. 36).
There are a number of ways to carry the affected person in the arms by one or two porters. Carrying the affected persons in the arms by one porter.
First way. The porter places the victim on an elevated place, turns his back to him, stands between his legs and kneels on one knee.
The victim grabs the bearer by the shoulders or holds on to his belt; the bearer takes the victim under the hips with both hands and stands up (Fig. 37).
Second way. Having dropped to one knee at the side of the victim, the porter takes him with one hand under his back, the other under his buttocks, and the victim clasps the porter by the shoulders. After this, the porter stands up.
Third way. For relatively long distances, it is most convenient to carry the affected person on the shoulder (Fig. 38).
It is more difficult for one person to carry the injured in his arms than on a strap. Therefore, these methods are used only when carrying short distances. Carrying the affected person in the arms of two porters can be done in several ways.
First way. The bearers join their hands to form a “seat” (“lock”). A “castle” can be made by connecting two hands (one hand of one porter and one hand of the other), three hands (two hands of one porter and one hand of the other) and four hands (Fig. 39, a, b iv).
In the first case, the porters, having one free hand each, can support the victim with them. In the second case, the victim
one of the porters can support with his hand. In the third case, the victim himself wraps his arms around the shoulders of the porters. The victim is placed on a “seat”, as when carried on a strap (Fig. 40, a and b). You can also use a waist belt folded into a ring as a “seat”.
Second way. One of the bearers approaches the victim from behind and picks him up under the armpits with his arms bent at the elbows; another bearer stands between the legs of the victim with his back to him and clasps his legs with his hands. The first bearer should not join his hands on the chest of the affected person, so as not to make it difficult for him to breathe (Fig. 41).
Third way. The bearers, approaching the victim, stand on one (healthy) side of him and kneel on one knee. The bearer, located at the head of the affected person, puts one hand under his back, the other under his lower back; The porter wraps his arms around the victim’s shoulders. Another porter, located at the feet of the affected person, places one hand under his buttocks and the other under his shins. Both porters, getting to their feet, lift the affected person. This method is suitable for carrying over short distances, as well as for placing the affected on a stretcher.
An indispensable method is to carry the injured on a stretcher.
Sanitary stretchers are designed to carry injured people in a lying position. They consist of two wooden or metal beams, two articulated steel struts with legs and a removable panel with a headboard (Fig. 42). The struts of the stretcher along with the legs are also removable; they are attached
to the beams with bolts and nuts; The hinges of the spacers are equipped with spring locks and latches, so that the stretcher cannot spontaneously fold when carrying or transporting the injured person on it.
The headboard is made in the form of a pillow, which is stuffed with hay (straw, grass, etc.). On both sides of the stretcher panel there are sewn “sleeves” that serve for putting the panel on the bars. At the foot and head ends of the panel, on the right and left, with the help of bolts holding the legs, two canvas belts with buckles are secured, intended for tying the rolled up stretcher. To reduce sagging, a transverse canvas strip is hemmed at the bottom of the front part of the panel.
Stretcher length 221.5 cm, width - 55 cm, weight -9.5 - 10 kg. All stretchers are made the same size and are suitable for any type of transport.
The stretcher is deployed as follows: both porters unfasten their belts; then, pulling the handles, they open the stretcher and, resting their knees on the spacers, straighten them to the fullest extent. Each porter checks whether the locks of the spacers are well closed (Fig. 43, a and b).
The stretcher is rolled up like this: the porters simultaneously open the latches of the locks and, pulling the spreaders towards themselves, half fold the stretcher, and then turn them with their legs up. When the panel sags on the side opposite
legs, move the bars completely, place the stretcher on the legs and, folding the panels into three folds, tie them with belts.
To make it easier to carry the injured person on a stretcher, use a strap. Each porter puts on a strap in a figure eight so that its loops lie closer to the cloth. The handles of the stretcher are threaded through the loops. The front porter places his hands in front of the strap, the back one - behind it.
If stretchers are not available, they can be made from scrap materials. The affected people can be carried over a short distance on a blanket, etc. (Fig. 44).
A stretcher made from improvised means is convenient for work: two poles connected by wooden struts and intertwined with straps, wire or rope. A stretcher can be quickly made from 1-2 bags and 2 poles (Fig. 45).
To carry victims with spinal injuries, it is necessary to place a wide board on top of the stretcher panel, and on top of it - some kind of soft bedding (coat, raincoat, hay, etc.).
Carrying the injured on a stretcher over level ground is usually carried out by two porters at the command given by porter No. 1.
At the command “Stretcher,” the stretcher is deployed by the stretcher and placed on the ground next to the victim from the side of the wound, head end to head. The bearers kneel next to the victim on the opposite side.
On the command “Get hold of”, both porters simultaneously carefully lift the victim without getting up from his knees, move him forward and, on the command “Lower down”, carefully lay him down
on a stretcher. In this case, the damaged part of the body is given an elevated position and care is taken that it is not subjected to pressure.
After the victim is placed on a stretcher, the command “Take your places” is given. One bearer stands at the head end of the stretcher, facing the victim, the other stands at the foot end, with his back to him. At the command “On the straps”, the porters bend down, bending their knees, put the loops of the straps on the handles of the stretcher and grab the handles; At the command “Lift,” the porters straighten up and lift the stretcher. Raising and lowering the stretcher with the injured person must be done simultaneously and carefully.
At the command “Forward”, the porter standing in front takes a step right foot, and the second porter - with his left, and both continue to walk out of step.
At the command “Stop,” the porters stop.
At the command “Place,” the porters bend down and place the stretcher on the ground.
The victim is carried on a stretcher feet first. When moving on uneven terrain, it is advisable that the injured person be carried on a stretcher by 3 or 4 porters. When climbing a mountain or moving up stairs, the stretcher is turned with the head end forward (Fig. 46).
Victims who have lost a lot of blood and have suffered damage to their lower extremities must be carried feet first when being lifted. On steep climbs and descents must be maintained horizontal position stretcher; To do this, when moving uphill, raise their rear end, and when moving downhill, raise their front end.
Those wounded in the jaw are placed face down to avoid blood flowing into the respiratory tract, which can lead to a worsening of the condition; a bent one is placed under the forehead
in the elbow the victim’s arm, coat, etc. When wounded in the stomach, the injured are placed on their backs, their legs are bent at the knees, and a cushion of clothing is placed under the knees.
If the chest is injured, the affected persons are carried on a stretcher in a semi-sitting position, with clothes placed under their backs.
While driving, the front porter warns the person behind about any unevenness in the road. If there is any obstacle in the way of the porters, they place the stretcher on the ground, grab the middle part of the beams, lift and place the handles of the stretcher on the obstacle (if it is a fence, fence) or leave the stretcher on the ground hanging over the edge of the obstacle (if it is a ditch, ditch).
One porter holds the rear end of the stretcher, and the other, having climbed over the obstacle, takes over the stretcher. The porter, standing at the rear end of the stretcher, lifts and carefully advances the stretcher, and then crosses the obstacle himself.
When carrying the injured is carried out by women, in particular by sanitary guards, at least 4 people must participate in the carrying (Fig. 47).
While being carried on a stretcher, the condition of the victims and the condition of the applied bandages and splints should be monitored. When carried for a long time, the victim needs to change position, adjust the head of the head, adjust clothing, quench thirst (except for those wounded in the stomach), and protect from bad weather and cold. The rolled-up stretcher is carried by a stretcher link so that it is carried with the left hand.
An important element in the evacuation of the injured is the loading and unloading of ambulance transport. It should be borne in mind that loading onto a vehicle without a stretcher or transferring from one stretcher to another causes unnecessary suffering to the seriously injured person and harms him. Therefore, seriously injured people, especially those with broken bones, must be transported to their destination on the same stretcher on which they were first placed. Porters are obliged to promptly ensure that they receive a stretcher to replace those handed over with the injured.
Sanitary guards must know the basic rules for loading and unloading sanitary transport in order to be able to supervise the work of porters, and in some cases, participate in loading and unloading themselves. Loading of the injured onto all types of transport is carried out in such a way that the stretcher is installed first on the upper tier, and then on the lower. For road transport, stretchers with victims are brought forward with the head end first. Severely injured patients with fractures of the skull bones, limbs, and abdominal wounds must be placed only on the lower tier. An ambulance or truck, adapted for transporting the injured, must be prepared for loading: the tailgate (door) is folded back (open), the stretcher is removed from the body. Seats are adapted for seating.
It should be noted that most often, conventional truck transport will be used to transport the affected, which, as a rule, is not suitable for transporting the affected. This transport has sharply traumatic properties. The position of the victim on traumatic modes of transport is of great importance for his condition. Severely affected patients are usually transported lying down, which reduces the ability to use the natural elasticity of the human musculoskeletal system to soften shocks. Hence, it is very important to correctly place the stretcher with the injured, depending on the severity of their condition. The higher the stretcher is raised and the further it is moved away from the central longitudinal axis of the car body, the greater the swing of vibrations of the stretcher and the more harmful the transportation. This leads to important rules related to the placement of the affected: 1) severely injured, especially with damage to the musculoskeletal system, fractures of the hip, spine, pelvis, must be placed in the bottom row and closer to the longitudinal axis of the machine; 2) if the nature of the injury and the condition of the victim allow transportation in a semi-sitting position, then in some cases it is more appropriate than transportation in a lying position; 3) to reduce additional mechanical trauma, ordinary road transport must be adapted for transporting the affected.
Among the simplest devices is the use of various types of bedding, and above all straw or hay. In this case, it is necessary that the stretcher rests on the mat everywhere, and its legs do not come into contact with the body of the car. This is achieved by creating a thickness of the bedding layer of at least 10 cm. Vehicles allocated for transporting seriously injured people are also equipped with ballast. Sand with a layer thickness of 10 is used as ballast. cm, which makes the additional load on the springs from 750 to 1000 kg. This in turn significantly improves transportation conditions.
To protect evacuees from rain and wind, a simple frame is constructed, covered with tarpaulin, plywood or boards. In winter conditions, a small iron stove can be installed in the body while observing the necessary fire safety measures.
A stretcher in an ambulance in an adapted truck can be installed in two or three tiers. Installation devices usually consist of racks with locks into which the handles of one side of the stretcher are inserted, and straps that support the handles of the opposite side of the stretcher. The lock consists of a socket for the handle of the stretcher and a folding lock that prevents the stretcher from jumping out during a push. The belt has a loop at the end that fits onto the handle of the stretcher.
Accommodation of victims in adapted vehicles can be done different ways. In addition, in some cases, trams, trolleybuses and other types of urban transport can be used to transport victims directly in the city.
In some ambulances, the locks for both handles of the head end of the stretcher are mounted on special carriages that move along the body.
The injured are loaded into an ambulance or bus by 2-3 porters and a driver; the upper rows of stretchers are loaded first, and then the lower rows. When transporting one or two affected stretchers, they are installed only at the bottom. During mixed transportation, two stretchers with the injured are placed in two tiers on the left side of the body, and the injured are placed on the right side, which can be transported while sitting. The ambulance is unloaded in the reverse order of loading.
When loading seriously injured people into a truck, the principle of loading remains the same as for ambulance vehicles (Fig. 48). Infectious patients are transported on special transport.
The sanitary squad accompanying the affected people during their transportation by car must ensure that the driver drives the car smoothly, without jerking, does not brake sharply, slows down on bad sections of the road, drives the car through contaminated areas only through special passages, taking into account detours and signal signs and etc.
Evacuation of those injured by rail in civil defense conditions is possible, as a rule, from the OPM to remote hospital sewers in a suburban area. For these purposes, temporary sanitary flights are recommended. They, as a rule, cannot be fully equipped to transport affected people with everything necessary.
The injured, evacuated at sanitary flights, are grouped according to the nature and severity of the injury. Each victim is given an envelope - an evacuation card, which contains all the medical documents for him. On the envelope, write down the number and type of carriage, tier and seat with a colored pencil.
It is necessary to place the affected people in a certain sequence - first take places away from the entrance, starting from the top tier. The most convenient way is to load cars from a platform or a special device - a ramp. When loading from vehicles or from the ground, it is necessary to use ladders, gangways and walkways.
When loading victims into all-metal passenger cars, stretchers can be fed through the windows of the cars.
Along the route, sanitary guards are required to monitor the health of the victims, adjust the bandages and provide assistance when changing the position of the injured person.
Loading of victims into freight cars is carried out by three porters; one of them is in the carriage and receives stretchers with the wounded, which are brought into the carriage with the head end first. It is important that at the foot end of the stretcher, at the moment when the head end is raised for loading into the carriage, at least two porters stand and hold the stretcher, since the load on the foot end is very large.
Satisfactory transportation conditions in a freight car under normal track conditions are provided at speeds up to 30 km at one o'clock. At high speeds The shaking and swaying of the car increases sharply.
Conditions for transportation by waterways depend on the type of water transport and the nature of the waterway. As a rule, all types of river transport provide very calm transportation conditions.
In civil defense conditions, airplanes and helicopters can be used in some cases to evacuate those affected. Loading the wounded onto an ambulance plane or helicopter, approaching them and loading them is carried out according to the same rules as for an ambulance.
The injured are placed on a stretcher head first, first on the upper, and then on the middle and lower tiers. Those affected with greater weight are placed on the lower tiers, and those affected in in serious condition those requiring observation and care - on average.
All types of ambulance transport must have the Red Cross sign.
- Source-
Training manual for sanitary squads. M.: Medicine, 1972.- 192 p.
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There are several ways to carry the wounded: by hand, using a stretcher strap, various types of stretchers, etc. All orderlies and medical instructors must know these methods.
Carrying the wounded by one orderly can be done by hand or using a stretcher strap.
Figure 2. Methods of carrying the wounded
If there is no strap for carrying the wounded, you can use waist belts folded in the form of a ring (of two belts) or a figure of eight (of three belts).
Carrying a wounded person without a stretcher by two orderlies can also be done by hand or using a strap.
To facilitate the work of orderlies and create the necessary conditions for the wounded, ambulance stretchers are used to carry the wounded. Orderlies and sanitary instructors must be fluent in practical techniques for using stretchers and have a good knowledge of the commands given during the work of the orderly unit.
The wounded are usually carried feet first, with the exception of climbing a mountain. However, when the lower extremities are injured, even when climbing a mountain, the wounded person must be carried feet first, since this creates the most comfortable position for him.
On steep ascents and descents you need to pay attention Special attention to maintain the horizontal position of the stretcher, for which, when moving uphill, raise the rear end of the stretcher, and when moving downhill, raise the front end. Typically, steep ascents and descents are overcome by a reinforced team consisting of three or even four people.
When carrying a wounded person on a stretcher, the orderly in front must warn about uneven roads or danger threatening ahead.
The orderlies must be able to overcome obstacles. To overcome a low fence or fence, orderlies must lower the stretcher to the ground, stand on both sides of it, grab the middle part of the bars and, carefully lifting the stretcher, lower the handles of the front end onto the obstacle. After this, one of the orderlies holds the rear end of the stretcher, and the other, having climbed over the obstacle, takes the stretcher. Having raised the stretcher, they both carry it over the obstacle and lower it onto the obstacle, on the other side of it, the handle of the foot end of the stretcher. After this, the second orderly climbs over the obstacle, takes his end of the stretcher and, together with the first, continues to move forward. When overcoming ditches, trenches, ditches, etc., the stretcher is placed on the edge of these obstacles.
When carrying on a stretcher, to give the wounded an appropriate position, it is necessary to take into account the nature and severity of the injury. Thus, to prevent blood and vomit from flowing into the respiratory tract, a person wounded in the jaw is placed face down, placing an overcoat roll or a duffel bag under the arm bent at the elbow.
A person wounded in the stomach is placed on a stretcher on his back and a roll of an overcoat, a duffel bag or a cushion made of some available material is placed under his knees. A wounded person in the chest is carried on a stretcher in a semi-sitting position, with a roll of an overcoat or a duffel bag placed under his back.
A wounded person with a spinal injury cannot be carried on a regular stretcher due to the sagging of the stretcher. Therefore, sheets of thick plywood or a wide light board are additionally placed on top of the stretcher, on which the wounded person is laid. This device creates fixation and relative immobilization of the spine.
The wounded must be pulled out and carried with their personal weapons, which are then handed over to the unit commander or surrendered along with the wounded at the medical station.
The speed of movement when carrying a wounded person on a stretcher on level ground should not exceed 2–2.5 km per hour. After every 300–500 m of travel, the stretcher link should rest for 3–5 minutes; The stretcher with the wounded must be lowered to the ground. After rest, the orderlies change places.
The speed is significantly reduced when carrying a wounded person at night, as well as when working in protective clothing or a gas mask. Under these conditions, stops are made every 150–200 m, and the rest is longer - up to 10 minutes. With an empty stretcher, the link moves at a speed of 4–5 km per hour.
In a combat situation, you often have to use homemade stretchers made on site from available material. They can be made of two poles connected together by two wooden planks and intertwined with a stretcher strap, rope or waist belts, etc. To carry the wounded at a close distance, you can use a raincoat, blanket or sheet.
Loading the wounded and sick onto ambulances and unloading them.
Ambulance vehicle UAZ-452A (39621)
The UAZ-452A ambulance vehicle has high cross-country ability (both axles are driven). The car body, with improved spring suspension, is equipped with ventilation and heating devices.
There are three main options for placing the wounded in a car: on stretchers - 4, sitting - 2; on a stretcher - 2, sitting - 5; only sitting - 7. Two or three orderlies are required to load and place the wounded.
Figure 2. Placement option in UAZ-452A
In the first case, the stretcher with the wounded is preliminarily placed on the ground in front of the rear door of the car; in the second case, the placement is done “on the fly.” When loading the wounded “on the move,” the front orderly alternately passes the handles of the stretcher to the driver located inside the body. Placement of the stretcher begins from the upper tier of the right or left side. The removal of the wounded is carried out in the reverse order.
Ambulance vehicle AS-66
The vehicle's equipment makes it possible to transport the wounded in three options: on stretchers - 9 people, on seats - 4 (1st option), on noses - 6, on seats - 10 (2nd option), on seats - 18 (3rd option) option).
Figure 3. Layout of stretchers in AS-66
It takes 3 minutes 30 seconds to prepare equipment for evacuating the wounded, according to the first option, 6–7 minutes according to the second option, 5 minutes 30 seconds according to the third option.
In a combat situation, trucks of various brands can be used to evacuate the wounded. They are equipped in advance with special devices that should not interfere with the transportation of goods.
Devices may consist of parts (brackets, straps, etc.) with the help of which a stretcher is secured to the body. During the Great Patriotic War, such devices were manufactured directly in units and were successfully used.
Figure 4. Option for placement in a truck
Due to the excessive stiffness of the springs of a truck, it is necessary to strive to maximize the use of its carrying capacity, which will provide greater peace to the transported wounded. Therefore it is more expedient
In general, use combined placement of the wounded (on stretchers and sitting) or add additional load (ballast). When transporting seriously wounded people in unequipped trucks, mattresses, hay, straw, branches must be placed on the floor of the body and covered with tarpaulins or blankets. Cars must be equipped with awnings.
To evacuate the wounded to hospitals, medical institutions, as well as when transporting them in cities, adapted buses, trams, trolleybuses and other types of urban transport can be used.
An-2 aircraft
An An-2 aircraft with one accompanying medical worker can transport 6 lying wounded or 10 seated wounded; 3 lying and 5 sitting. The placement of the wounded is carried out by three orderlies.
The wounded stretchers are placed head first, first on the upper, and then on the middle and lower tiers. The wounded with heavy weight are placed on the lower tiers, and the wounded who are in serious condition, requiring observation and walking are placed on the middle ones. During combined transportation, all stretcher wounded are first placed on the right side, and then the seated ones are placed along the left side.
To accommodate a stretcher wounded, two orderlies are required. The seated casualty goes through the right door and occupies the front right seat, and the accompanying medical worker goes through the left door and occupies the rear left seat. To place only seated wounded it takes 2 minutes, for combined placement - 3 minutes. It takes 8–10 minutes to place the wounded on stretchers.
In a combat situation, airplanes and helicopters in the ambulance version can be used to evacuate the wounded, transport medical personnel and medical equipment.
An ambulance with wounded must approach the aircraft from the left at a distance of 5 m at an angle of 45° to the fuselage.
Figure 5. Loading a wounded person onto an airplane
Helicopters
To land a helicopter, a small horizontal landing pad measuring only 50x50 m is required. This allows the helicopter to be widely used for evacuating the wounded directly from centers of mass destruction.
The ambulance must approach the helicopter from the left (front to back) along the transport loop at a distance of 7 m when loading the wounded through the side door and 10 m when loading through the cargo hatch at an angle of 45° to the hatch doors.
Loading the wounded into a helicopter can be carried out by 3 orderlies. In addition, the helicopter is capable of hanging in the air in one place, which allows the wounded to be lifted onto it from the ground without landing using a lifting cable and winch.
Loading the wounded from the ground into a helicopter in hover mode is carried out by 4–5 people. Having provided the wounded with the necessary medical care, the medical instructor prepares him to climb into the helicopter, for which he is placed on a stretcher and tied to it with stretcher straps. Hanging a stretcher with a wounded person attached to it is done using two Sh-4 straps or a special suspension system
Figure 6. View of the loading system
The length of the hanging loops formed by the Sh-4 straps is adjusted using the buckles on the straps. Before you start lifting, it is necessary to achieve such a position that the stretcher with the wounded is in a horizontal hanging position, which is achieved by adjusting the length of the hanging loops. A slightly wounded person can also be lifted onto a helicopter using a winch; To do this, a Sh-4 strap or a special suspension system is put on it on the ground in advance.
Along the way, the medical instructor is obliged to monitor the health of the wounded, correct bandages and provide assistance when changing the position of the wounded on a stretcher.
Medical centers and hospitals must have an exchange fund of stretchers and not allow the wounded to be transferred from one stretcher to another. In this regard, it is necessary to ensure that the sanitary stretchers are always in perfect order.
All types of ambulance transport must have the Red Cross sign, which is a red cross on a white background (white circle). On ambulances, the Red Cross sign is applied to the front, rear and side walls, and on the roof.
4. Methods of carrying the wounded
166. Carrying a wounded person by one person carried out using a stretcher strap or on your hands.
Rice. 9.19. Correctly fitted strap, folded in a figure eight
Rice. 9.20. Putting on the strap folded figure eight
Rice. 9.21. Properly fitted strap folded into a ring
167. Carrying a wounded person on a stretcher strap carried out in two ways.
First way. The wounded person is placed on his healthy side. A stretcher strap, folded in the form of a ring, is brought under the wounded person so that one half is under his buttocks, and the other, threaded under the armpits, is on the back. The free end of the strap should lie on the ground. Thus, loops are formed on the sides of the wounded person.
The person providing assistance lies in front of the wounded man, with his back to him, puts his hands into the loops of the strap worn on the wounded man, and pulls them onto his shoulders. He ties the loops with the free ends of the strap and places the wounded man on his back. Then he gradually rises, stands on all fours, on one knee and, finally, to his full height. The wounded man sits on a strap, pressed by it to the orderly.
This method is especially convenient in that both hands of the person providing assistance remain free, and the wounded person does not have to hold on to him, since the strap holds him quite securely. The disadvantages of this method include the pressure that the strap puts on the wounded person's back. Therefore, for chest injuries, not the first, but the second method of carrying on a strap is used.
Second way. The person providing assistance puts a strap folded in a figure eight on the wounded man’s legs, lays him on his healthy side and, pressing his back against him, puts the strap on himself so that the cross of it falls on his chest. Then it rises, as with the first method.
When carried in this manner, the wounded person’s chest remains free, but the person providing assistance must support his arms, and the wounded person must hold on to the shoulders or waist belt of the person providing assistance.
Both methods are not applicable for fractures of the hip, pelvis, or spine. The second method, in addition, cannot be used in case of serious damage to both upper extremities.
If there is no stretcher strap, it is easy to make: a ring - from two, an eight - from three waist belts.
Rice. 9.22. A strap folded into a ring is put on the wounded person for carrying.
Rice. 9.23. The first responder takes the wounded man onto his back
Rice. 9.24. Helper rises with wounded man
Rice. 9.25. A first responder carries a wounded man
Rice. 9.26. Carrying a wounded person on a strap folded in a figure eight
168. Carrying a wounded person in his arms
First way. The person providing assistance sits the wounded man on an elevated place, turns his back to him, stands between his legs and kneels on one knee. The wounded person grabs the person providing assistance by the shoulders or holds on to his belt; The person providing assistance takes the wounded man with both hands under his hips and stands up.
Rice. 9.27. Carrying a wounded person in your arms
Second way. Kneeling down on one knee at the side of the wounded man, the person providing assistance takes him under his back with one hand, under his buttocks with the other, and the wounded man holds on to his shoulders. After this, the person providing assistance stands up.
It is more difficult to carry a wounded person in your arms than on a strap. Therefore, this method is used only when carrying over a very short distance. The person providing assistance while carrying the wounded rests for 2-3 minutes every 150–200 steps. To rest, he chooses an elevated place (a rock, a stump), sits the wounded man down and sits down himself, observing the condition of the wounded man. If necessary, provides him with first aid (corrects a loose bandage, bandages him, gives him something to drink). If a wounded person being carried on a strap needs to be laid down, the person providing assistance first kneels, then on all fours, and then lies down and, carefully turning, places him on his right or left side (depending on the nature of the wound).
169. Carrying a wounded person together performed using a stretcher strap or on the hands (without a strap).
Rice. 9.28. Preparing to carry a wounded person on a strap folded in a figure eight
170. Carrying a wounded person using a stretcher strap. Having made a figure eight out of the stretcher strap, those providing assistance put it on themselves so that the cross of the strap is level between them hip joints, and the loop went over one’s right shoulder, and over the other’s left shoulder. The wounded person is placed on the cross of the straps as follows: those providing assistance stand facing one another on both sides of the wounded person, one lowers himself on his right knee, the other on his left; then they lift and sit the wounded man on his closed knees, place a strap under his buttocks and stand up.
Rice. 9.29. Carrying a wounded person on a strap folded in a figure eight
Rice. 9.30. Carrying a wounded person on a raincoat using a short pole
In trenches and communication passages, two people can carry a wounded person on a stretcher strap folded in a figure eight, according to the method shown above, or on a raincoat.
171. Carrying a wounded person in your arms(without straps) is also carried out in two ways.
Rice. 9.31. Carrying a wounded person in two hands (3-hand lock)
Rice. 9.32. Carrying a wounded person in two hands (4-hand lock)
First way. Those providing assistance join their hands to form a seat (“lock”). The seat can be made by connecting three arms (two arms of one person and one arm of the other); the free hand placed on the shoulder of the first person serves to support the wounded man sitting on the “castle”.
If the wounded person is able to clasp the shoulders of those providing assistance, he can be carried by making a seat of four joined hands.
The wounded person is seated on the seat, as when carried on a strap. A folded waist belt can also be used as a seat.
Second way. One of those providing assistance approaches the wounded man from behind and picks him up under the armpits with his arms bent at the elbows; the other stands between the legs of the wounded man with his back to him and clasps his legs with his hands. The first should not join his hands on the chest of the wounded person, so as not to make it difficult for him to breathe.
This method is convenient for carrying a wounded person along communication passages and trenches. It cannot be used for broken limbs.
Rice. 9.33. Carrying a wounded person in their arms
Third way:
Those providing assistance, approaching the wounded person, both stand on one (healthy) side of him and go down on one knee;
The person providing assistance, located at the wounded man’s head, puts one hand under his back, the other under his lower back;
The wounded person wraps his arms around the shoulders of the person providing assistance;
The other, located at the wounded man’s feet, places his hand under his buttocks and the other under his shins.
Both, getting to their feet, lift the wounded man.
This method is used for carrying over short distances.
Carrying the wounded on stretchers .Placing the wounded on a stretcher
172. The techniques indicated in the description of the third method are also used when laying on a stretcher, but in this case those providing assistance can go down on both knees. If three people are present when laying down, one of them supports the head and back of the wounded person, the second - the pelvis, the third - the legs.
In cases where the wounded person needs to be placed on a stretcher as quickly as possible, those providing assistance, without kneeling down, lift the injured person from the ground, holding his clothes.
Rice. 9.34. Carrying a wounded person over a short distance. Loading onto a stretcher
Rice. 9.35. Loading the wounded onto a stretcher (lifting from the ground by clothes)
Rice. 9.36. Single pole stretcher, raincoat and straps
Carrying the wounded in the trenches on a stretcher
173 . It is inconvenient to carry the wounded in trenches and communication passages on ordinary stretchers, as they get stuck at turns. It is better to use an improvised stretcher made using a pole, a raincoat, or the strap of a medical stretcher.
The stretcher pole (round block) must be strong, 160–200 cm long, 5–6 cm wide in the middle.
The wounded person is transferred as follows:
A raincoat-tent is placed on a strap folded into a ring;
The wounded man is laid on a raincoat, its corners are tied in knots above his head and legs;
A pole is placed under the head and foot knots of the raincoat and secured with a stretcher strap;
Those providing assistance simultaneously lift the stretcher and carry it, and always walk “out of step.”
In full-profile communication passages, the stretcher is carried on the shoulders, in shallow trenches and communication passages - on the hands.
Rice. 9.37. Carrying a wounded person in a shallow passage on a stretcher made of one pole, a raincoat and a strap
Rice. 9.38. Changing the position of those providing assistance when carrying a wounded person on right and left turns
174. The wounded are carried a short distance on blankets and raincoats; in this case, three military personnel are working.
Rice. 9.39. Carrying a wounded person on a raincoat (blanket)
Rice. 9.40. Stretcher made of two poles and straps
Rice. 9.41. Stretcher made of two poles and two bags
175 . For work under normal conditions (not in trenches), a stretcher made of two poles connected by wooden struts and intertwined with straps, wire or rope is convenient.
A stretcher can be quickly made from one or two bags and two poles.
In case of spinal fractures, the stretcher panel must be replaced with a wide board. A raincoat or hay is placed on it.
Rules for carrying a wounded person on a stretcher
176. Those providing assistance when carrying the wounded on stretchers work according to teams.
Commands are given by the person walking behind. At the command “Stretcher”, those providing assistance deploy the stretcher and place it on the ground next to the wounded person on the side of the wound with the head end towards the wounded person’s head. They themselves stand next to the wounded man on the opposite side, remove his duffel bag, equipment (anything that restricts breathing or interferes with loading); the duffel bag is placed at the head.
By command "Take on" simultaneously and carefully lift the wounded man without getting up from his knees, move him forward and on command "Lower it" carefully placed on a stretcher. In this case, the wounded part of the body is given an elevated position and care is taken that the wound site is not subjected to pressure.
After the wounded person is placed on a stretcher, the command is given "In places". One providing assistance stands at the head end of the stretcher, facing the wounded person, the other stands at the foot end, with his back to him. By command "On the straps" those providing assistance bend down, bending their knees, put the loops of the straps on the handles of the stretcher and grab the handles; on command "Lift" straighten up and lift the stretcher. Raising and lowering a stretcher with a wounded person must be done simultaneously and carefully.
Rice. 9.42. Carrying a wounded person in the mountains. Climb
Rice. 9.43. Carrying a wounded person in the mountains. Descent
By command "Forward" the one standing in front takes a step forward with his right foot, and the one standing behind takes a step forward with his left foot, and both continue to walk out of step.
By command "Stop" they stop. By command "Bet" bend down and place the stretcher on the ground. If it is necessary to turn the stretcher in place without lowering it to the ground, the command is given “Left, right, around.” The one walking in front goes left (right), around, and the second one turns on the spot in the same direction.
177 . The wounded person is carried on a stretcher feet first. When going uphill, the stretcher is turned with the head end forward. The wounded, who have lost a lot of blood, and those wounded in the legs, must be carried feet first when ascending. On steep ascents and descents, it is necessary to maintain a horizontal position of the stretcher;
To do this, when moving uphill, the rear end of the stretcher is raised, and when moving downhill, the front end is raised.
178. The wounded person in the jaw is placed face down to prevent blood from flowing into the respiratory tract, which can lead to suffocation, and his arm bent at the elbow or a duffel bag is placed under the forehead.
179. A person wounded in the stomach is placed on a stretcher on his back, his legs are bent at the knees, and a cushion of clothing is placed under his knees.
180. The person wounded in the chest is carried on a stretcher in a semi-sitting position, with a duffel bag placed under his back.
181. A wounded person with a spinal injury is carried on a stretcher with a rigid, non-sagging bed (sheets of thick plywood and boards are attached to the stretcher).
182. While moving, the person in front warns the person behind about all the unevenness of the road. If there is any obstacle on the way (fence, fence, barbed wire, trench, communication channel, ditch), those providing assistance place the stretcher on the ground, stand on both sides of it, they take hold of the middle part of the beams, lift and place the handles of the stretcher on the obstacle (if it is a fence, fence) or leave the stretcher on the ground hanging over the edge of the obstacle (if it is a moat, ditch). In this case, one holds the rear end of the stretcher, and the other, having climbed over the obstacle, takes over the stretcher. The person standing at the rear end of the stretcher lifts and carefully advances the stretcher, and then crosses himself.
183. When carrying out a wounded person, those providing assistance must take his weapons and equipment with them. When carrying a wounded person in winter, he must be well covered and provided with a heating pad. In order not to transfer the wounded from the stretcher, he is transferred to the medical station along with them, and in return others receive from the exchange fund.
184. average speed movement when carrying a wounded person on a stretcher on flat terrain is 2–2.5 km per hour. After each half kilometer, those providing assistance rest for 3–5 minutes. After resting, they change places.
In areas visible to the enemy, the wounded must be transported secretly, observing the rules of camouflage.
Transportation of the wounded on a ski-stretcher and on a drag boat
185. In winter, depending on the nature of the terrain, time of day and enemy fire, the wounded are transported on ski-stretchers and drag boats. Drag boats can be used at other times of the year.
If you have to work in deep, loose snow, those providing assistance get on skis. When crawling, they remove them and attach them to a ski-stretcher or drag.
It is advisable to use ski-stretchers for transportation from a shelter where several wounded are concentrated, or from a company medical post to an ambulance post or a battalion medical station.
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At serious injuries, as well as if they are suspected, special attention is paid to transporting victims, since improper movement can aggravate the injury, becoming an additional damaging factor. The doctors' recommendation is that specialists should transport a seriously injured person, so it is best not to do this yourself, but to call an ambulance. Unfortunately, this is not always possible.
You have to transport the victim yourself in the following situations:
- Imminent danger to life where the injury occurred. For example, if the victim is on a railway track, in a burning building, a smoke-filled room, a building that may collapse at any moment, etc.
- There is no way for an ambulance to arrive.
There are three types of transportation in total:
- Emergency. Carried out in the presence of an immediate threat to life, as quickly as possible, any suitable method of removing a person from danger zone to the nearest safe place. Such transportation can be very traumatic for the victim, but the goal is to save a person’s life, so the rules for moving victims are neglected in this case;
- Short term. It is carried out by the people who are close to the victim. In this case, there is a need to choose the optimal method of moving the victim so as not to cause discomfort, increase pain, or cause secondary injury. As a rule, in this case, transportation is not carried out too far, but to the nearest place where the person can receive professional help or where he can wait for it in a safe environment;
- Long lasting. Transportation by the forces and means of specialists, as convenient and safe as possible for the victim. Usually carried out after first aid has been provided on site and pain relief has been provided.
In cases where it is not possible for an ambulance to arrive, long-term transportation has to be carried out by others.
Preparing to transport victims
When preparing to transport a person in need of assistance, you should keep in mind:
- The victim must be carefully examined to get an idea of the nature of the injuries. The condition of the spine, head, neck, chest, abdomen, pelvic area and extremities should be assessed. Make sure that the person is conscious, if he is unconscious, you need to check the pulse and breathing;
- If there is a suspicion of severe injuries, multiple combined injuries, the victim should be transported only as a last resort, if there is no hope for an ambulance to arrive. In case of such injuries, the victim should be moved, if possible, in the position in which he is located.
General rules for moving victims
Rules and methods for moving victims may vary depending on the nature of the injuries (blood loss, fractures, etc.), but there are several general principles:
- When transporting an injured person cervical spine spine, his head and neck are immobilized, i.e. fixed to prevent movement. In all other cases, the victim is transported with his head turned to one side. This is necessary to avoid vomit getting into the respiratory tract, as well as asphyxia due to tongue retraction;
- A person with significant blood loss is moved so that his legs are higher than his head. This position ensures blood flow to the brain;
- When climbing stairs, or when placed in vehicle the victim is carried forward with his head, when descending and being taken out of the vehicle - forward with his feet;
- The one who carries the victim in front is appointed as the main one, his task is to carefully monitor the road, notice obstacles and direct the movement, coordinating the actions of other rescuers (example command: “on the count of three, raise the stretcher - one, two, three!”). At the same time, rescuers are strictly forbidden to move “in step”;
- The one who carries the victim from behind monitors his condition, and if it worsens, warns others about the need to stop.
Types of transportation of victims depending on injury and condition
It was stated above that in case of serious combined injuries, the victim should be moved without changing his position. Now let's look at the positions in which victims should be transported in other, less severe situations.
- Stable position on your side. Victims should move in this position in the following cases:
a) attacks of vomiting;
b) being in an unconscious state;
c) for burns or other non-penetrating injuries to the back of the body (back, buttocks, back of the thighs); - Seated or semi-sitting position used in the following situations:
a) neck injuries;
b) chest injuries;
c) fractures of the collarbone, arms; - Lying on your back with your legs elevated:
a) injuries abdominal cavity;
b) suspicion of internal bleeding;
c) the presence of large blood loss; - Lying on your back with legs slightly apart and a cushion placed under the knees (“frog pose”):
a) in case of spinal injury, spinal cord injury or suspected similar injury;
b) in case of a fracture of the pelvic bones or suspicion of it.
During transportation, it is necessary to constantly monitor the condition of the victim, remembering that it can worsen at any time. If this happens, it is necessary to stop and begin resuscitation measures (mouth-to-mouth breathing, mouth-to-nose breathing, chest compressions). Resuscitation is carried out until a doctor appears or until breathing and pulse are restored.
At the scene of the incident, first of all, it is necessary to stop the victim’s bleeding, apply bandages to the wounds, and fix bone fractures with splints. Only after this can it be carried, loaded and transported to a medical facility, as quickly and carefully as possible.
Immobilization is the creation of immobility (immobility) of a limb or other part of the body in case of damage, inflammatory or other painful processes, when the damaged (sick) organ or part of the body needs rest. It can be temporary, for example, for the period of transportation to a medical facility, or permanent, for example, to create the conditions necessary for the fusion of bone fragments, wound healing, etc.
Transport immobilization is one of the most important first aid measures for dislocations, fractures, wounds and other severe injuries. It should be carried out at the scene of the incident in order to protect the damaged area from additional injury during the delivery of the victim to a medical facility, where this temporary immobilization, if necessary, is replaced with one or another permanent immobilization.
Carrying and transporting victims without immobilization, especially those with fractures, is unacceptable, even over a short distance, because this can lead to increased displacement of bone fragments, damage to nerves and blood vessels located next to the moving bone fragments. With large wounds of soft tissue, as well as with open fractures, immobilization of the damaged part of the body prevents the rapid spread of infection; in case of severe burns (especially of the extremities), it contributes to a less severe course in the future. Transport immobilization occupies one of the leading places in the prevention of such a formidable complication of severe injuries as traumatic shock.
At the scene of an accident, you most often have to use improvised means for immobilization (for example, boards, branches, sticks, skis), to which the damaged part of the body is fixed (bandaged, reinforced with bandages, belts, etc.). Sometimes, if there are no available means, you can provide sufficient immobilization by pulling the injured arm to the body, hanging it on a scarf, and in case of a leg injury, bandaging one leg to the other.
Immobilization using improvised means:
a, b - with a fracture of the spine;
c, d - immobilization of the hip;
d - forearms;
e - collarbone;
f - shins.
The main method of immobilizing an injured limb while the victim is being transported to a medical facility is splinting. There are many different standard transport splints that are commonly applied by medical professionals such as emergency services. However, in most cases of injury, you have to use so-called improvised splints, which are made from scrap materials.
It is very important to carry out transport immobilization as early as possible. The splint is placed over clothing. It is advisable to wrap it with cotton wool or some other soft cloth, especially in the area of bony protrusions (ankle, condyle, etc.), where the pressure exerted by the tire can cause abrasion and bedsores.
If there is a wound, for example in cases of an open fracture of a limb, it is better to cut the clothing (possibly at the seams, but in such a way that the entire wound becomes easily accessible). Then a sterile bandage is applied to the wound and only after that immobilization is carried out (the belts or bandages securing the splint should not put too much pressure on the wound surface).
In case of severe bleeding from the wound, when there is a need to use a hemostatic tourniquet, it is applied before splinting and is not covered with a bandage. You should not strongly tighten the limb with separate rounds of the bandage (or its substitute) for “better” fixation of the splint, because this may cause poor circulation or nerve damage. If, after applying the transport splint, it is noticed that constriction has occurred, it must be cut or replaced by applying the splint again. In winter or in cold weather, especially during long-term transportation, after splinting, the damaged part of the body is wrapped warmly.
When applying improvised splints, you must remember that at least two joints located above and below the damaged area of the body must be fixed. If the splint does not fit well or is not sufficiently fixed, it does not fix the damaged area, slips and can cause additional injury.
Transportation of victims
The most important task of first aid is to organize fast, safe, gentle transportation (delivery) of a sick or injured person to a medical institution. Causing pain during transportation contributes to the deterioration of the victim’s condition and the development of shock. The choice of transportation method depends on the condition of the victim, the nature of the injury or illness, and the capabilities of the first aid provider.
In the absence of any transport, the victim should be transported to a medical facility on a stretcher, including improvised ones.
Stretcher
a - medical;
b, c - improvised.
First aid also has to be provided in conditions where there are no available means or there is no time to make an improvised stretcher. In these cases, the patient must be carried in his arms. First aid also has to be provided in conditions where there are no available means or there is no time to make an improvised stretcher. In these cases, the patient must be carried in his arms. One person can carry the patient in his arms, on his back, on his shoulder.
Carrying the victim by one porter:
a - on the hands; b - on the back; c - on the shoulder.
Carrying using the “hands in front” and “on the shoulder” method is used in cases where the victim is very weak or unconscious. If the patient is able to hold up, then it is more convenient to carry him on his back. These methods require a lot physical strength and are used when carried over short distances. It is much easier for two people to carry by hand. It is most convenient to transfer a victim who is unconscious in the “one after another” manner.
If the patient is conscious and can hold himself independently, then it is easier to carry him in a “lock” with 3 or 4 hands.
Carrying the victim by two porters:
a - “one after another” method;
b - “lock” of three hands;
c - “lock” of four hands.
The stretcher strap makes it much easier to carry by hand or on a stretcher.
In some cases, the patient can cover a short distance on his own with the help of an accompanying person, who throws the victim’s arm over his neck and holds it with one hand, while the other clasps the patient’s waist or chest.
The victim can lean on the stick with his free hand. If it is impossible for the victim to move independently and there are no assistants, transportation by dragging on an improvised drag - on a tarpaulin or raincoat - is possible.
Thus, in a wide variety of conditions, the first aid provider can organize the transportation of the victim in one way or another. The leading role in choosing means of transportation and the position in which the patient will be transported or transferred is played by the type and location of the injury or the nature of the disease. To prevent complications during transportation, the victim should be transported in a certain position according to the type of injury.
Very often, a correctly created position saves the life of the wounded and, as a rule, contributes to his rapid recovery. The wounded are transported in a supine position, on the back with bent knees, on the back with the head lowered and raised lower limbs, on the stomach, on the side.
Position |
State |
| lying on your back |
|
| on your back with your knees bent |
|
| on the back with raised lower limbs and lowered head |
|
| on the stomach |
|
| on the side | unconsciousness |
| half-sitting with legs extended |
|
| half-sitting with bent knees |
|
