Optimal positions of injured persons transportation, depending on the injury.

Type of injury	Position of the patient
Unconscious condition	Firm side position (throw back the head)
Injuries of front side of head and face	On back (throw back the head)
Injury of spin	On back (on rigid shield)
Fractures of pelvis bones	On back (with bent in knee and hip joint legs)
Fractures of low limbs	On back
Injuries of abdominal cavity and internal haemorrhage	On back (with semi-bent knees)
Injuries of occiput part of the head	On abdomen
Injuries of back, buttocks, dorsum of feet	On abdomen
Injuries of facial part of skull	Sitting
Injuries of chest	Semi-sitting
Fractures of ribs	Sitting or semi-sitting
Injuries of upper limbs	Sitting
Contusion, cuts, grazes	Sitting

In many regions there are already protocols of standardization of equipment for transportation of patients, the use of which contributes to better transportation of patients and quality of care.

Transporting patients with spinal cord injuries should be strictly horizontally on the back on a hard shield, and in its absence on a normal semi-soft stretcher on his abdomen. At the damage of the cervical spine transportation is always on the back, after immobilization throw back a head. It is forbidden to lay patients with spinal injury on the side!

Patients with rib fractures are transported in a sitting or semi-sitting position (depending on their general condition). Patients with exudative pleurisy, pneumothorax and penetrating chest injuries are transported in semi-sitting position or with a raised head end of the stretcher.

Patients who are unconscious because of the threat of aspiration of vomitus and falling back of tongue are transported in stable sideways position.

At that head is threw back. It is desirable to lay the patient on his right side, because in this case disorders of circulatory and respiratory systems are less pronounced (if he has not damaged the right half of the chest!) (Fig. 13).

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Figure 13.

Stable lateral position

At wounds of the abdomen and internal haemorrhage victim is laid on the back with a blanket under his knees to relax the abdominal muscles. Patients with fractures of the pelvis are transported on the back with supine in knee and hip joint legs; the hips should be draw; under the knees necessarily underlay a cushion. In fractures of the lower limbs under the injured limb underlay a pillow in the tire, folded blanket, etc. At haemorrhage from the limbs give raised position to the limbs.

In the presence of a wound, fracture or other damage to the occipital area of the head, the victim’s head is placed on a cotton-gauze circle. At skull fracture transportation is carried out on a stretcher on the back with lowered head of stretcher and without pillow. Around the head put a roll of blankets, clothing or moderately pressurized air slip circle. For fractures of the facial part of the skull, accompanied by haemorrhage from the nose, mouth, victims are transported in a sitting position. At the damage of the jaws the victims are laid on abdomen, under his forehead and chest underlay rolls (from clothing and improvised means).

Patients with burns are placed on intact wound, carefully wrap up with blankets and burnt side is covered with sterile sheets. Patients in a state of swelling of the lungs, during an attack of bronchial, cardiac asthma and respiratory failure are forbidden from laying in a horizontal position, they should be transported in a sitting position, children should be transported vertically holding position.

In the absence of special stretcher they can be made from improvised means: pole, ricker, board, coat, blanket, bag, etc. (Fig. 14).

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Figure 14.

Medical (a) and improvised stretcher (б, в).

Improvised stretcher firm, which can withstand heavy weight.

At transportation on hard improvised stretcher you should underlay something soft under the patient (clothing, grass and so on). Stretcher strap can be made of 2-3 belts, canvas, sheets, towels, thick ropes and other (Fig. 14).

If it is impossible to carry the stretcher in the apartment or on the stairs, the patient is transported on the blanket. In the extreme case, if it is impossible for some reason, stretcher is set at the entrance, and the patient is transported on hands, in elevator, on the stool or chair, which should be put there in advance.

For intrahospital transport we use gurney, which is a stretcher on wheels (Fig. 15).

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Figure 15.

The gurney (stretcher) for transporting patients

Transportation on a gurney is the most convenient and gentle way. The patient is placed on a gurney in a comfortable position, the patient's arms are fixed on the chest or abdomen, so that during transport they were not displaced. The position of the patient on the stretcher allows you to completely relax the muscles of the body, requires no extra effort from the patient. During transportation going behind medical professional continuously monitors the condition of the patient.

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