Immobilization in pelvic and spinal trauma: rules

Transportation in pelvic bone fractures

Pelvic ring fractures require careful evacuation to prevent bone fragment displacement and internal organ damage. Movement must be carried out strictly on a stretcher.

Rigid base. This is a mandatory requirement. A wooden or plywood backboard must be placed under the patient.
"Frog" position. To relax muscles, the patient's legs must be semi-flexed at the knee and hip joints.
Bolster. A dense bolster made from clothing, a rolled blanket, or a duffel bag is placed under the knees.
Fixation. The victim must be strapped to the stretcher to prevent accidental movement during transport.

Immobilization in spinal injuries

The patient's position during transport depends on the level of the back injury and the type of available stretchers.

1. Thoracic and lumbar spine fractures:

Primary method (on a backboard). The patient is placed supine. A small bolster is placed under the knees. The victim must be strapped to the rigid stretcher.
Alternative method (on a soft stretcher). If a rigid backboard is not available, transportation in the supine position is prohibited. In this case, the patient is placed prone, and a bolster is placed under the chest.

2. Cervical and upper thoracic spine fractures: Transportation is carried out on a stretcher in the supine position. For immobilization, a bolster is placed under the victim's neck.

Test your knowledge on this topicTasks from the "General Surgery" course bank — instant answers and explanations.

Vacuum immobilization stretchers (VIS)

VIS are used for spinal and pelvic fractures and severe multiple trauma. They consist of a sealed double cover, the internal volume of which is 2/3 filled with small expanded polystyrene beads.

Technique of use:

The victim is placed into the unrolled mattress.
The mattress is tightly laced up.
Air is evacuated using a pump (it is necessary to create a negative pressure of 500 mmHg and maintain it for 8 minutes).
As the air is removed, the expanded polystyrene beads move closer together and interlock tightly, providing rigidity to the entire structure.

Position modeling: If the patient needs to be placed in a specific position (e.g., semi-sitting), this is done directly during the air removal period while the mattress is still pliable.

Standard limb splints

In addition to spinal and pelvic injuries, standardized splints are used for immobilization:

Cramer wire ladder splint. Used for the lower extremity. A mandatory condition is that the splint must be molded to the shape of the leg and encompass the joints above and below the fracture site.
Medical pneumatic splints. Available in several modifications: for fixing the hand and forearm, the foot and lower leg, as well as the knee joint.

How to memorize

For the thoracic/lumbar spine: Backboard — Supine, Soft — Prone. If the stretcher is rigid, place the patient supine (bolster under the knees). If soft, place them prone (bolster under the chest).

Class and exam questions

In what position is a patient with a pelvic fracture transported?

The patient is transported in the "frog" position: supine with legs semi-flexed at the knee and hip joints. A bolster must be placed under the knees, and the patient must be secured to a rigid backboard.

How to transport a victim with a lower back injury if rigid stretchers are unavailable?

In the absence of a rigid backboard, transportation in the supine position is prohibited. On a soft stretcher, the patient is placed prone with a bolster under the chest.

How do vacuum immobilization stretchers (VIS) become rigid?

Inside the cover are expanded polystyrene beads. When air is evacuated with a vacuum pump, the beads move closely together and interlock, creating a rigid frame conforming to the body shape.

Confused about something? Ask AIThe AI tutor has read the material on "Immobilization in pelvic and spinal trauma" and will explain it in simple terms.

What else to study on this topic

Technique of molding the Cramer wire ladder splint
Specifics of using pneumatic splints for the hand and forearm
Features of pneumatic splints for the foot and lower leg
Algorithm for securing a patient in a semi-sitting position in a vacuum mattress

Master the entire topic in the "General Surgery" course

This is a summary. The course covers everything tested in classes and exams.

Complete study guide on "Immobilization in pelvic and spinal trauma" and 3,335 more pages of the subject
Assignments and quizzes after every topic — just like in a colloquium
AI tutor answers questions on the topic anytime
70 video lessons on the subject

Open full review Subject curriculumfrom 599 ₽ per month

Immobilization in pelvic and spinal trauma