TRANSPORT OF ACCIDENT VICTIMS

When dealing with a wounded or unconscious person, it is crucial to examine in the same place where he was found, without moving or transporting the victim until first aid care has been provided since, otherwise, there is a risk of aggravating the situation and causing new wounds.

Only in extreme situations (fire, electrocution, asphyxia, flooding, trapping, etc.) should the victim be transported with the maximum care to the closest place where first aid can be provided.

When transporting the patient or the accident victim take into account that the body should be moved as little as possible.

TRANSPORT WITHOUT STRETCHER

This is required when the accident victim must be moved quickly away from the place where he is, or when it is not possible to reach the scene with a stretcher.

1. Transport of an accident victim with a single lifeguard
   
   For the initial transport (unless other resources are available) turn the victim backwards, tying his wrists together with a handkerchief or cloth.
   
   The lifeguard should kneel astride the victim,and place his head under the tied wrists. He should then creep forward, sliding the accident victim across the floor (see picture 7-93).
   
   
   
   Picture 7-93: Creeping method.
   
   
   The evacuation may also be done on the back of the lifeguard or carrying the victim on his shoulders (see pictures 7-94 to 7-97).
   
   
   
   
   Pictures 7-94 to 7-97: Fireman method.



2. Transport of an accident victim with several lifeguards
   
   When there are two or more lifeguards, they should make a settee with two hands, carrying the victim on it. Each lifeguard holds the accident victim with an arm under the thighs, holding each other's wrists; the other pair of hands will provide support for the back (see picture 7-98). The «three hand settee» may also be used (see picture 7-99).
   
   
   
   Picture 7-98: Two hand settee.
   
   
   
   
   Picture 7-99: Three hand settee.
   
   
   A chair may be used as a stretcher in case of emergency (see picture 7-100). The victim may also be transported in a similar position without the chair.
   
   
   
   Picture 7-100: Transport with chair
   
   
   When it is necessary to pass the victim through an opening or small compartment, a rope may be used to lift the accident victim up (see picture 7-101).
   
   
   All these methods will be used only when there is no suspicion of a lesion in the spinal column (unless there is a life threatening situation). In such case, immobilise as indicated in SPINAL COLUMN IMMOBILISATION (refer to IMMOBILISATION AND BANDAGES).
   

   
   

   

   Figura 7-101: Lifting with a rope

TRANSPORT WITH STRETCHER

The ideal procedure for carrying injured patients is the stretcher.

The Neil-Robertson stretcher (OTHER MATERIAL OUTSIDE THE DRAWERS, first aid A) is the most recommended for use on
board, since in it the subject is held in place and may be lifted, making it ideal for vertical
transport.

Pictures 7-102 and 7-103: Neil-Robertson stretcher.

The vacuum shaped mattress (OTHER MATERIAL OUTSIDE THE DRAWERS, first aid A) adapts itself to the patient and complete horizontal immobilisation is guaranteed during transport.

Pictures 7-104 and 7-105:
Vacuum shaped
mattress.

Improvised stretchers may be used when other resources are not available, using a door, ironing board or a wide wooden board; a hand ladder; two paddles held together with ropes, blankets or clothes with long sleeves, etc.

For the transport of an injured patient in a stretcher the following rules must be taken into account:

1. Carry the stretcher to the place where the accident victim is, and not vice versa.
2. Place the injured victim with paramount care, always respecting the block head-neck-trunk-legs:
   
   Place the stretcher on the floor. Lift the victim as smoothly as possible until he is placed on it. The "bridge method" may be used (see picture 7-106).
   
   
   
   Picture 7-106: Bridge method.
   
   
   If there is suspicion of spinal column fracture, immobilise as indicated in SPINAL COLUMN IMMOBILISATION, (refer to IMMOBILISATION AND BANDAGES).
   
   When the accident victim is conscious, lay him on his back unless there is a thorax wound; in such case place in a semi sitting position. If unconscious, place in lateral recumbent position (refer to Chapter 1.5), unless there is suspicion of column fracture. In this case, whether conscious or not, if there is vomit, place sideways (see picture 7-107).




Picture 7-107: Sideways placing of an immobilised spinal column.

3. Cover up as required, since the cold seriously harms the shock patient just the same as it would an injured person. Immobility, haemorrhage and trauma reduce cold tolerance.



4. Hold to prevent him from falling. The subject must be held with straps or bands, since any sudden movement may displace the patient out of the stretcher, whether conscious or not, and in such case the patient's own movements may cause him to fall.



5. Lift the stretcher with care. For the transport of the patient, both carriers must kneel at each end of the stretcher. The one situated at the feet of the patient gives the order for both to stand up together. During the transport both carriers must alternate their step, always keeping the stretcher horizontal (see pictures 7-108 and 7-109).
   

Pictures 7-108 and 7-109: Stretcher transport.