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Unconscious patients, in whom the circumstances of the accident suggest spine damage (fall from a height), usually require specialist medical assistance.
When giving first aid, it is important to ensure that the unconscious patient is breathing properly. Conscious patients most often complain of pain in the damaged part of the spine. So it is important to look at the painful area without repositioning your body. Bruises, abrasions or deformations in this area generally support this suspicion. When providing help to an injured person, remember not to take the sick buried in, e.g. with rubble, scaffolding or other objects out from under the objects, but to remove these objects from the patient.
When treating an injured person, do not lift the head and hips or the shoulders and hips as this may shift the damaged vertebrae and damage the spine.
The sick person should be moved to a stretcher, door or board, preferably with several people without changing the position of the body.
If a cervical spine injury is suspected, the head should be covered on the side, e.g. with sand bags, and bandaged across the forehead to the ground, or secured with a rigid cervical collar. Shoulders should be bandaged in a similar way, and in the event of damage to the thoracic or lumbar spine, we also bandage the pelvis and lower legs. A rolled-up blanket can be placed under the knees to prevent rotation of the body during transport.
It is best to transport the patient to the hospital in the supine position, on a hard surface. It must not be moved from a stretcher to a stretcher, but must be transported on a stretcher or other items on which it has been placed directly at the scene of the accident until it is examined by a specialist in hospital. During transport, care must be taken to keep the airways open, which is especially important in patients with paralysis of all limbs. In these patients expectoration and coughing are impossible, therefore the patient should be placed upside down during transport. If breathing is disturbed (the patient develops cyanosis), mouth-to-mouth artificial respiration may be required.
Damage to the cervical spine
It occurs as a result of a blow to the head, a fall from a height over the head, or a head jump into the water. Damage most often occurs at the fifth to seventh cervical vertebrae.
The type of damage (fracture or sprain) is determined on the basis of a radiological examination.
In the case of neurological changes that cannot be explained by conventional radiological examinations, a CT scan or magnetic resonance imaging is indicated.
Surgical treatment requires unstable fractures, and rapid surgical intervention within 6 hours – incomplete transverse paralysis syndrome (progressive or not), visible pressure on the core due to displaced bone fragments.
Damage to the thoracolumbar spine
It arises when falling from a height on the buttocks, back, straightened legs, and sudden strong bending. In case of damage to the thoracic segment, even slight displacements cause neurological disorders such as paraplegia.
Spine injuries in the lumbar region, especially below the second lumbar vertebra, rarely result in neurological disorders.
The level and type of damage (fracture, dislocation) is determined on the basis of a conventional radiological examination. In patients with neurological disorders, supplementary tomography or magnetic resonance imaging is indicated.
Patients with dislocation fractures and incomplete neurological syndrome as well as documented compression of the spine based on tests such as tomography and magnetic resonance are eligible for surgical treatment for up to 6 hours. In the postponed period – unstable injuries without neurological symptoms and significant displacements in complete total paralysis syndrome.
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