Instruction manual

PROFICIENCY IN SURVIVAL CRAFT AND RESCUE BOATS OTHER THAN
FAST RESCUE BOATS
15 17
the organs enclosed and protected by the pelvis may be seriously damaged
when the bony structure is fractured. In particular, there is danger that the
bladder will be ruptured.
There is also danger of severe internal bleeding; the large blood vessels
in the pelvic region may be torn or cut by fragments of the broken bone. The
primary symptoms of a fractured pelvis are severe pain, shock, and loss of
ability to use the lower part of the body.
The victim is unable to sit or stand. If the victim is conscious, there may
be a sensation of “coming apart.” If the bladder is injured, the victim’s urine
may be bloody. Do not move the victim unless ABSOLUTELY necessary.
The victim should be treated for shock and kept warm but should not be
moved into the position ordinarily used for the treatment of shock. If you must
transport the victim to another place, do it with the utmost care. Use a rigid
stretcher, a padded door, or a wide board.
Keep the victim supine. In some cases, the victim will be more
comfortable if the legs are straight, while in other cases the victim will be more
comfortable with the knees bent and the legs drawn up. When you have
placed the victim in the most comfortable position, immobilization should be
accomplished. Fractures of the hip are best treated with traction splints.
Adequate immobilization can also be obtained by placing pillows or folded
blankets between the legs as shown in figure 15-22 and using cravats, roller
bandages, or straps to hold the legs together, or through the use of MAST
garments. Fasten the victim securely to the stretcher or improvised support,
and evacuate very carefully.
Fig.15-22 Immobilizing a fractured pelvis
15.2.3 Control of Haemorrhaging
The best way to control external bleeding is by applying a compress
to the wound and exerting pressure directly to the wound. If direct pressure
does not stop the bleeding, pressure can also be applied at an appropriate
pressure point. At times, elevation of an extremity is also helpful in controlling
haemorrhage. The use of splints in conjunction with direct pressure can be
beneficial. In those rare cases where bleeding cannot be controlled by any
of these methods, you must use a tourniquet. If bleeding does not stop after
a short period, try placing another compress or dressing over the first and
securing it firmly in place. If bleeding still will not stop, try applying direct
pressure with your hand over the compress or dressing.