12 inches (fig. 13-7). You must consider the type of
injury before deciding on the position. The casualtys
injuries may prevent you from using the standard
position. For example, if a person with a chest wound
has trouble breathing, you will raise the head slightly,
and place the patient in a sitting or semi-sitting
position. If a casualty is vomiting or bleeding around
the mouth, place the patient on the side or back with the
head turned to one side and lower the feet. If the face is
flush rather than pale, or if you have any reason to
suspect head injury, do not raise the feet. Instead, keep
the head level with or slightly higher than the feet. If
the casualty has broken bones, you must judge the best
position for both the fractures and for shock. A
fractured spine must be immobilized before the
casualty is moved at all to avoid further injuries. A
helpful mnemonic: If the face is red, raise the head; if
the face is pale, raise the tail (feet).
Conserve Body Heat.Loss of body heat can
cause shock to develop or to become worse. Keep the
casualty warm. Cover the patient with blankets or any
dry material. Do not overheat the casualty.
Relieve Pain.-Pain is a major cause of shock.
Treatment of injuries will often reduce pain. Pain may
also be relieved by slightly repositioning the casualty.
Under mass casualty conditions, you may have to
administer morphine to certain types of casualties to
relieve pain. The condition under which morphine may
be administered will be discussed in the Morphine
Administration section. Morphine must never be
administered if there is evidence of severe or
Injuries to Bones, Joints, and Muscles
Injuries to bones, joints, and muscles are some of
the most common situations that you will encounter.
These injuries can range from the simple to the critical
and life threatening. Whether the injury is mild or
severe, your ability to provide quick and efficient
emergency care may prevent further pain and injury.
An essential part of em emergency treatment for
fractures consists of immobilizing the injured part with
splints so the sharp ends of broken bones will not move
around and cause further damage to nerves, blood
vessels, or vital organs. Splints are also used to
immobilize severely injured joints or muscles and to
prevent the enlargement of extensive wounds. You
must have a general understanding of the types and
uses of splints.
SPLINTS.Whether ready made or improvised,
splints must fulfill certain requirements. They should
be lightweight, but must be strong and fairly rigid.
They should be long enough to reach the joints above
and below the fracture. Splints should be wide enough
so that the bandages used to hold them in place will not
pinch the injured part.
Splints must be padded on the sides that touch the
body; if they are not properly padded, they will not fit
well and will not adequately immobilize the injured
part. If you have to improvise the padding for a splint,
you can use articles of clothing, bandages, cotton
blankets, or any other soft material. If the casualty is
wearing heavy clothes, you may be able to apply the
splint on the outside, allowing the clothing to serve as
part of the required padding.
To apply a splint to an injured part, fasten it in
place with bandages, strips of adhesive tape, articles of
clothing, or any other available material. If possible,
one person should hold the splint in position while
another person fastens it. Figure 13-8 shows a properly
placed splint for a fractured femur.
Although splints should be applied snugly, they
should never be tight enough to interfere with blood
circulation. Remember to leave the fingers or toes
exposed. If the tips of the fingers or toes become blue
or cold, you will know that the splint or bandages are
too tight. You should examine a splinted part
approximately every half hour, and loosen the
fastenings if the circulation appears to be impaired.
Figure 13-7.Position of casualty for treatment of shock.