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Fracture of the base of the skull. Providing assistance for a fracture of the base of the skull First medical aid for a fracture of the bones of the skull

With various injuries associated with significant shock loads, fractures of skeletal bones are possible. Depending on the place of occurrence of the fracture, the danger to further life activity also differs. In addition, as a result of erroneous actions on the part of others, a victim with a serious fracture (for example, if the spine is damaged) can be harmed, even fatal. At the same time, properly provided first aid for bone fractures will significantly reduce pain from the injury and provide the possibility of transporting the victim to the hospital without risk to his life and health.

In some cases, the victim himself can provide first aid for fractures. This possibility extends to fractures without displacement of the bones of the lower extremities with a moderate level of pain.

But in the vast majority of cases, first aid to the victim in case of fractures should be provided by people nearby, since as a result of the injury, the victim is not always able to move independently (with a number of injuries it is impossible to move categorically), and also, due to the specifics of the injury, is not able to independently apply a restrictive bandage or a splint (for example, in case of a broken arm or injury to the ribs).

Therefore, often the process of his recovery may depend on people who accidentally happened to be near the victim and qualified first aid, and in the event of serious injuries, the likelihood of saving a life.

First aid for fractures

The first aid algorithm for fractures will depend on the type of injury (which bone is fractured) and the severity of the injury. The main types of possible injuries and first aid measures for such fractures will be discussed below.

To determine the presence of a bone fracture without conducting an examination using medical equipment, you can check for the presence of the following symptoms in the victim:

  • the presence of intense pain in the injured limb, in many cases - increasing with time;
  • soreness of the limb on palpation;
  • the presence of swelling;
  • limited mobility of the limb and fingers, the impossibility or pain of making movements;
  • the presence of deformity of the injured limb;
  • the presence of abnormal mobility of the injured limb (flexion in the place of absence of the joint, excessively bent joint);
  • The occurrence in the area of ​​the alleged fracture of bruising.

First aid for a broken arm

First aid for a fracture of the hand of a closed type primarily consists in immobilizing the limb. To do this, a splint from improvised means is applied to the site of the alleged fracture. For this purpose, suitable materials can be used, for example, pieces of a board that match the length of a broken bone, and fixing agents, for which bandages, ropes, a towel, a scarf are suitable. Boards or similar items are located on different sides of the injured limb, and are fixed on the arm with bandages or similar materials. In this case, it is necessary to provide a gasket between the tire and the skin. To do this, you can use clothes or a layer of cotton wool.

On a note

In the event that there is a fracture of the bone, and not the elbow joint, the injured arm is bent at the elbow and fixed in a bent position.

Ensuring the immobility of the damaged bone is very important, since during transportation or simply when moving the injured limb, displacement of the bones with a rupture of the skin can occur. The main danger in this case is the likelihood of damage to the blood vessels in this case, which can cause significant blood loss, which poses a risk to the life of the victim.

After providing first aid for a fracture, it is necessary to take the victim to the hospital for qualified assistance.

First aid for a fracture of the forearm consists in the complete immobilization of the hand in the wrist and elbow joints. To do this, a splint is applied to the outer part of the arm bent at the elbow. For this, improvised material is taken (for example, pieces of a board) of such a length that the upper part reaches the middle of the humerus, and the lower part covers the forearm along the entire length, including the hand. A roller of fabric or bandage is inserted into the brush to ensure that the fingers are in a half-bent position. The indicated fragments of the board are connected to each other at a right angle, the arm is fixed to the tire using the appropriate material (for example, a bandage) and the limb fixed in this way is hung on a scarf tied around the neck or a cut of the bandage.

First aid for a shoulder fracture is provided by fixing the injured joint. To do this, a cotton roll is placed in the armpit under the injured arm, fixing it with a bandage through the shoulder area of ​​the healthy arm. The arm is slightly abducted at the shoulder joint and bent to a right angle at the elbow. To fix the fingers in a bent state, the victim is given a roll of bandage or cotton wool in his hand. Then it is necessary to ensure the fixation of the injured arm to the body, for which a splint is applied using the method similar to that described above, only the part of the splint on the humerus is made longer, almost to the armpit, and the fixing elements are located on both sides of the arm. After applying the splint and hanging the arm in a bent position at the elbow, the injured limb is wrapped to the body with a bandage or a tissue at hand. In this case, the bandage should cover the shoulder part of the arm and fix it by pressing it against the body.

After completing these steps, the victim must be taken to the hospital.

First aid for a fracture of the hand, due to certain specifics, it is advisable to start with the removal of existing jewelry on the fingers of the injured hand, as well as on the wrist itself, in which the fracture is suspected. Due to the development of edema in the future, the presence of foreign objects on the arm can become a serious problem, since due to the impossibility of removing them, such objects can become a serious obstacle to normal blood flow in the injured limb.

With a significant deformation of the hand, you should not try to correct its position on your own, since as a result of unskilled actions, you can only aggravate the problem. In this case, the injured limb must be provided with rest and a doctor should be called without taking independent actions to immobilize the damaged hand. To reduce pain, you can take some over-the-counter pain relievers (such as ibuprofen) and apply ice to the injured joint.

With a slight deformity of the hand, to ensure normal transportation of the victim to the hospital, a splint can be applied, covering the forearm and hand of the injured hand from both sides to the beginning of the fingers. After fixing the hand in this way, the hand is hung on a scarf and the victim is transported to the hospital.

First aid for a broken finger is one of the most technically simple. If a finger fracture is suspected, a splint is applied using small sticks (fountain pens may also work) to which the injured finger is fixed with a bandage or patch. After that, the victim can be sent to the hospital for further examination.

Many fractures have characteristic visual features that differ from the above typical signs.

In particular, a fracture of the clavicle can be assumed if the smoothing of the supraclavicular fossa is visually fixed, the shoulder is lowered down and displaced towards the body, the head of the victim is tilted to the injured side. Also, a possible displacement of the bones can cause a violation of the integrity of the nerve fibers, which is expressed in a decrease in the mobility of the fingers on the hand from the side of the injury.

First aid for a fracture of the clavicle is similar to the actions for a fracture of the bones of the shoulder. To reduce the intensity of pain, you can give the victim some kind of analgesic.

After providing first aid for a fracture, the victim must be taken to the hospital.

First aid for broken ribs

In addition to certain problems during transportation to a medical facility, caused by pain from the movement of fragments of a broken bone, a number of fractures in themselves pose a danger to the internal organs, and, as a result, to the life of the victim. One of the types of such injuries is a rib fracture, since in a severe form of such an injury, the pointed ends of the ribs can damage the lungs or the heart.

Signs of the presence of this type of fracture are sharp pains in the injured area, which increase with breathing and various movements, and weaken with a sitting position without movement.

The lag of the injured side during breathing is visually noted, the breathing itself becomes superficial.

A separate risk factor for such injuries is the possibility of developing post-traumatic pneumonia.

First aid for a fracture of the ribs is to limit their movement by applying a tight bandage to the entire chest as you exhale. To do this, ask the victim to exhale completely and hold his breath. During this time, it is necessary to apply a tight bandage that limits the movement of the ribs during breathing. To reduce pain before such actions, it is advisable to give the victim an anesthetic. After applying such a bandage, it is necessary to give the victim a sitting position and take him to the hospital.

Also, dangerous injuries include a fracture of the sternum, since with this type of injury there is a possibility of damage to fragments of the bone of the internal thoracic artery, the heart bag and the heart itself.

First aid for a fracture of the sternum is actually similar to that used for fractures of the ribs. The difference lies in the fact that in order to reduce the likelihood of internal damage by the sharp edges of broken bones, when the victim takes a semi-sitting position, a roller from improvised materials (for example, from a rolled towel) is placed under the shoulder blades to extend the chest.

First aid for a fracture of the spine

Perhaps the most dangerous of the existing injuries is a fracture of the spine. With this type of injury, there is a possibility, due to the displacement of the vertebrae, of a violation of the integrity of the spinal cord, which, depending on the location of the injury, can lead either to paralysis of the lower extremities, and in case of a fracture of the thoracic vertebrae, to death due to the failure of nerve impulses from the brain to the intercostal muscles and heart for stimulating their activities.

Signs that indicate a spinal fracture may include:

  • Spontaneous urination and defecation
  • Paralysis of muscles below the injury
  • In the presence of a fracture in the region of the cervical or thoracic vertebrae - difficulty in breathing until it stops
  • Severe pain in the area of ​​injury

First aid for a fracture of the spine is to limit changes in the position of the body of the victim and keep the spine straight. It is also required to ensure the direct position of the head relative to the body. To do this, when the victim is lying on his back, his body is fixed on the sides to prevent a change in position, and the head must be kept in a position facing vertically upwards. At the same time, a fully straightened state of the spine is maintained. If the victim is in a cramped position (for example, in a car), it is necessary to evacuate him only in case of a clear threat to life (a vehicle that starts to ignite and threatens to explode the fuel tank). Any changes in the position of the body can cause damage to the spinal cord and death of the victim, so all actions must be performed with the utmost care and the largest number of assistants. Ideally, six to seven people are involved in laying a victim with such an injury on a stretcher, with one holding his head, one person holding each limb, the rest helping to move the torso. The most important thing is not to allow changes in the position of the spine. It is possible to transport the victim only on a flat hard surface (wide wooden shield).

First aid for a pelvic fracture

A fracture of the pelvic bones is also a rather severe injury that can threaten the life of the victim in case of complex forms of fracture and the lack of timely assistance.

The main signs of a pelvic fracture are as follows:

  • Changing the shape of the pelvis
  • Inability to sit, stand, raise a leg without assistance
  • The presence of subcutaneous hemorrhages in the perineum and inguinal region
  • Inability or difficulty urinating
  • The presence of severe pain in the abdomen and tension of the abdominal muscles

First aid for a pelvic fracture consists in giving the body of the victim the correct position and delivery to the hospital for assistance. Due to the specifics of this injury, it is impossible to fix the bones with improvised means. The main direction of assistance is to give the body of the victim the correct position for delivery to the hospital. To do this, position the victim on a stretcher with the help of as many assistants as possible (optimally, three people should be involved in positioning a person on a stretcher). The victim is located on his back, the surface of the stretcher should be hard and even, a roller 20 to 30 cm high should be placed under the knees, the legs should be in a slightly divorced position.

If the victim complains of severe thirst, it is necessary to provide him with plenty of fluids, since this symptom may indicate possible damage to the arteries and the presence of internal bleeding. If you complain of severe pain in the lower abdomen, you should not drink, as this symptom may indicate the presence of ruptures of the internal organs.

First aid for broken legs

A fracture of the femur is characterized by severe post-traumatic shock, which, without the provision of appropriate assistance, can lead to the death of the victim. Therefore, if there is suspicion of this type of fracture, it is necessary to give the victim the strongest available painkillers.

First aid for a hip fracture, regardless of the location of the fracture, is in the form of fixing the injured limb in line with the body.

To do this, a double-sided splint is applied using long fixing devices. From the outside of the leg, the splint is applied from the armpit to the heel, being fixed to the body and leg with bandages or similar material. On the inside of the leg, the splint is applied from the groin to the heel. A so-called footrest is attached under the foot, a fragment of fixing material that limits the possible sagging of the injured leg.

This fragment of the tire is tied to the other two elements so as to support the foot, after which it is bandaged to it. At the same time, one should not forget about the need to create a tissue layer between the rigid elements of the tires and the skin surface.

After providing first aid for a fracture, the victim is transported to the hospital.

One of the most common types of injury is a broken leg. Although not very dangerous, in the event of improper fusion, such an injury in the future can significantly limit the mobility of the limb.

This type of fracture is diagnosed according to the typical signs of a fracture described above.

First aid for a fracture of the lower leg is to limit the mobility of the leg along its entire length. To do this, a double-sided splint is applied to the leg, which captures the leg from the area of ​​the femoral joint to the foot. The foot is fixed according to the recommendations for the previous case at an angle of ninety degrees to the line of the injured leg.

After that, it is necessary to deliver the victim to the hospital.

The occurrence of fractures of one of the bones of the foot is also a fairly common type of injury.

The likelihood of such a fracture can be determined based on typical signs. At the same time, a feature of this type of injury is slight pain in the area of ​​the fracture, so many victims, suspecting the usual sprain, do not seek help in a timely manner, which worsens the healing process and aggravates the injury.

First aid for a fracture of the foot is its complete immobilization. To do this, a two-way splint is applied to the leg, blocking movement in the ankle and knee joint. Fixing elements (for example, pieces of a board or a pipe) should slightly, by 15-20 centimeters, go above the knee joint for its reliable immobilization. The foot, in the absence of significant displacement and deformation, is fixed at an angle of ninety degrees to the line of the lower leg with the help of a footrest. The principle of such fastening is described above.

After providing first aid, you need to show the injured doctor to determine further treatment.

First aid for a skull fracture

The list of the most dangerous injuries also includes fractures of the bones of the skull. This fact is due to the fact that with such an injury, an inevitable concussion of the brain occurs, and with fractures with a significant displacement of the bones, trauma to the brain tissues can occur, which will lead to significant disorders (memory loss, impaired perception - loss of hearing, vision, and so on), and with very significant damage - will lead to the death of the victim.

Signs that indicate the presence of this fracture include the following:

  • Disturbance of the shape of the skull
  • Bleeding from the nose, ear, or mouth
  • Fainting condition of the victim, loss of consciousness
  • Vomit
  • Decreased heart rate
  • Sensory dysfunction
  • Speech disorder
  • Limb dysfunction

First aid for a skull fracture is complicated by the high probability of an open wound at the fracture site and the need to apply an antiseptic dressing to it.

First you need to treat the skin around the wound, for which they use any alcohol-based agent (for example, a solution of iodine, or brilliant green), while performing cleansing movements from the edge of the wound outward.

If there is obvious contamination in the wound, it must be washed with a disinfectant solution (for example, dilute one tablet of furacilin in a liter of water). Then a sterile napkin is applied to the wound itself, after which the wound is bandaged.

To facilitate further diagnosis of the victim's condition, no alcohol-containing drugs should be given. Over-the-counter analgesics can be used to relieve pain.

A feature of this injury is also a high probability of violations in the cervical vertebrae. Therefore, before transporting the victim, it is necessary to fix the head of the victim. To do this, you can make a "collar" from improvised materials, with which to ensure a stable position of the head face up. The height of the collar should be equal to the distance from the victim's collarbone to the edge of the lower jaw. As a manufacturing material, thick paper or fabric folded in several layers can be used. The main condition is not to change the position of the victim's head when applying the collar.

When moving the victim on a stretcher, control the stable position of the head relative to the body. After positioning on a stretcher, ensure that the position of the head is fixed by covering it on the sides with improvised materials (for example, folded clothes).

After that, you can proceed to the delivery of the victim to the hospital.

First aid for a broken nose

Fractures of the bones of the nose are one of the most common types of injuries to the facial part of the head. In this case, along with a non-life-threatening fracture of the nasal bones, a more serious injury that threatens the life of the victim may occur. Therefore, it is necessary to carefully examine the condition of the victim.

Signs of this type of fracture can be:

  • Profuse bleeding from the nose. At the same time, it is also worth establishing the fact of the presence of hidden bleeding (along the back wall of the larynx).
  • Nose deformity
  • Difficulty in nasal breathing
  • Swelling of the tissues of the nose, cheekbones, eyelids, rapid formation of puffiness and bruising under the eyes.

In the case of leakage from the nose, in addition to blood, a yellowish transparent liquid with a high probability, a fracture of the base of the skull can be assumed. This injury is very dangerous and requires the immediate transport of the victim to the hospital with the greatest possible care.

First aid for a broken nose is to stop the bleeding resulting from this injury. To do this, the victim is placed in a sitting position with a slight tilt of the body and head forward to prevent blood from flowing into the trachea and esophagus.

Then it is necessary to plug the nasal passages with gauze or bandage rolled into tubes. The use of cotton swabs for this purpose is allowed only if they are tightly wrapped with several layers of bandage. In order to speed up the stop of bleeding, you can moisten the swabs with hydrogen peroxide.

After that, in order to reduce the intensity of bleeding, you can apply cold to the bridge of the nose (for example, an ice pack or just a cold bottle of water).

You should not try to restore the shape of the nose yourself, this will only lead to additional damage to broken bones.

After carrying out these actions, it is necessary to deliver the victim to the hospital.

First aid for an open fracture

It should be noted that the methods of first aid for fractures described above imply the presence of closed fractures, without displacement or with slight displacements of the edges of broken bones. First aid for a closed fracture mainly consists of immobilizing the broken bones and taking the victim to the hospital for further assistance.

In the event of a significant displacement of bone fragments with a breakthrough of the skin and damage to blood vessels, it requires first of all to stop the bleeding that has formed, and only after this, the application of a splint, taking into account the characteristics of the injury. Most often, such knowledge is required when providing first aid for fractures of the limbs.

To stop bleeding, apply a tourniquet or tight bandage just above the site of the fracture.

The best option for stopping bleeding is a specialized medical tourniquet, but if it is not available, you can use other available materials, for example, a small diameter rubber hose. In the absence of such materials as well, a tight bandage of inelastic material will be required.

With this type of injury, the tourniquet must be applied in any case above the wound.

The imposition of the first turn of the tourniquet is carried out with a slight tension, gradually increasing the tension on the remaining turns. The application of the tourniquet continues until the bleeding stops completely, after which the tourniquet is fixed with the existing fastener or tied.

In the absence of a medical tourniquet and its substitutes, a tight bandage can be applied, for which any durable inelastic material of sufficient diameter (for example, a thick rope) is taken, tied into a circle with a diameter twice the circumference of the limb. From the outside of the limb, a stick of the required length and diameter is inserted under the knot or into it, after which the bandage is tightened by rotating the stick. After the bleeding stops, it is necessary to fix the wand to prevent spontaneous unwinding.

The maximum time for applying a tourniquet should not exceed two hours on the legs and one and a half hours on the hands in the warm season. In the cold period, the specified time is halved.

If it is impossible to deliver the victim to the hospital during the specified time, it is necessary to gradually loosen the tourniquet, controlling the recurrence of bleeding. With a constant resumption of bleeding, it will be necessary to periodically remove the applied tourniquet to temporarily restore blood circulation for 15-20 minutes with clamping the main bleeding vessel with your fingers.

It is necessary to apply a sterile napkin to the wound itself (or, in case of intense bleeding, to tampon it with a cotton swab wrapped in several layers of a sterile bandage), and then bandage it.

The next aspect of assistance should be anti-shock therapy. The intensity of pain in different types of fractures varies greatly, but with open forms, the pain is usually especially strong, since such injuries are caused by significant external force and are accompanied by multiple injuries. Prolonged pain, in addition to taking strength from the victim, can lead to cardiac arrest due to the intense action of hormones released during stress.

To reduce pain in this type of fracture after stopping the bleeding and before applying the splint, it is necessary to provide the victim with effective anesthesia. To do this, it is desirable to use over-the-counter combined analgesics, which are freely sold in pharmacies and do not have a clearly defined lethal dose. It can be: from tablets - pentalgin, ketanov, ibuprofen or just analgin in large (two or three tablets) dosages; Pentalgin and ketanov are also used from injectable preparations. It is advisable to remember these names in order to be able to obtain these drugs at a nearby pharmacy or to purchase in advance and store them in a first-aid kit.

Under no circumstances should alcohol be given to the victim. This “folk remedy”, in addition to increasing pressure, which will lead to additional blood loss, will weaken the body and direct forces from restoring damaged tissues to breaking down the resulting alcohol.

When applying a splint, it is also necessary to take into account the specifics of the injury. The previous recommendations apply to fractures with slight displacement of the bone edges, in which the method of applying the splint is determined by the caregiver. In this case, the method of splinting is determined by the place where the bone fragments emerge from under the skin. The tire should not be applied directly to visible bone fragments, or to the wound itself. The fixing elements of the splint (that is, fragments of boards or pipes of the required length) are superimposed on the sides of the existing wound to ensure the immobility of the injured limb and prevent additional injuries due to the movement of broken bones.

The bones of the skull are the strongest of all the bones of the human skeletal system, and this is not surprising, because the skull protects the brain from damage.

The bones of the skull can withstand very severe loads, but they can also break if the blow is delivered with great force.

simple fracture - there is a violation of the integrity of the bones of the skull, but the skin is not damaged.

Linear skull fracture - a thin crack in the skull. There are no fragments, compression, or pathological changes in the shape of the skull.

Depressed skull fracture - violation of the integrity of the cranium, with compression of the bone inside.

Open comminuted skull fracture - the bones of the skull come out, there are wounds on the head.

The cause of a skull fracture can only be an injury received during an accident, accident, fight, sports, etc.

Skull fracture symptoms

You should be aware that the symptoms of a skull fracture may not be present immediately after the incident, but develop gradually over 24 hours.

Naturally, if some kind of accident happened to a person, then it can be assumed that he has a fracture of the bones of the skull. But, nevertheless, you should pay attention to some signs confirming this assumption:

  1. Carefully examine the patient's head - the presence of a wound on the head indicates that, most likely, there is a skull injury.
  2. Bleeding or discharge of pink fluid from the ears and nose clearly indicates that the head was hit hard.
  3. Hemorrhages in the eyes are the first sign of a concussion and a skull injury.
  4. The consciousness of the victim is confused, he inappropriately answers questions and clearly does not orient himself in the situation.
  5. Periodic irritability, anxiety, desire to go somewhere.
  6. Speech is slurred and incoherent.
  7. Nausea and possibly vomiting.
  8. Rigidity (numbness) of the occipital muscles.
  9. The face is swollen, the outlines of the necks and nose are smoothed.
  10. Drowsiness is an unpleasant symptom that precedes loss of consciousness.
  11. Loss of consciousness and convulsions are a very bad sign, indicating that the skull is broken, and bone fragments have entered the brain.

When there is at least one of the symptoms listed above, but the person, in general, does not feel bad and does not want to go to the hospital, you should not pay attention to his protests, since people in this position are not able to adequately assess the situation.

Therefore, ignoring the protests of the injured, everything must be done so that he gets to a medical facility as quickly as possible.

First aid for a skull fracture

If there is reason to think that a person may have a skull fracture, immediately call an ambulance and then begin to provide first aid, which consists of the following actions:


What absolutely can not be done if a skull fracture is suspected

Knowing these rules can save the victim's life or save him from disability.

So you can't:

  1. In the absence of health workers, move a person unless absolutely necessary (this, in addition to a traumatic brain injury, will add damage to the spinal cord).
  2. If fragments of the skull are visible on the head, in no case do not remove them. Since such actions will not end in anything good. That is, a priori, a person will either die or remain disabled.
  3. In no case should the victim be allowed to get up, even if he claims that everything has passed and he is already well.
  4. You can not leave the injured one even for two or three minutes. Whatever happens around, there should be a person near the victim who controls his condition.
  5. It is forbidden to give any medicine.
  6. Even when the nose and ears of the victim are clogged with dirt and blood, you should not try to wash them yourself, since, with a fracture of the base of the skull, such actions often lead to infection of the meninges.

Do not forget that people injured in accidents can have not only a fracture of the bones of the skull, but also other injuries, such as that.


From an anatomical point of view, the skull has two main sections: facial and cerebral. In turn, the brain is subdivided into two more: the base, which has a more complex structure and the arch. First aid tactics do not depend much on the department. There is little difference between open and closed fractures. Consider all the nuances.

With a closed fracture, there is no damage to the skin and deeper tissues.

From the point of view of a doctor, a fracture is considered open if there is damage to the aponeurosis, the tendon-muscular helmet that covers the cranial vault. This subtlety becomes known during the operation, at the first aid stage, the presence of any wound implies a potentially open fracture.

If you cannot determine whether it is a fracture or not, it is better to play it safe and resort to the most useful actions.

Most often, with a fracture of the bones of the skull, a linear fracture occurs, when the displacement of the fragments does not occur. The mechanism of injury will help to suspect a fracture and, therefore, to develop tactics for it, as a rule, this is a strong blow to the head.

The bones of the skull are particularly strong, with a strong blow, they can also crack.

A simple layman can meet with such damage, and here it is important not to get confused, but competently and consistently take all measures to save lives. Movements and actions must be not only coordinated, but also performed in a certain sequence.

With a closed fracture

The mechanism becomes clear, but what to do if there is no x-ray? In this case, the injury is regarded as a fracture, and the first thing to do if a person is unconscious is to lay him on a hard and even surface and turn his head to one side.

After that, an ambulance brigade is immediately called, upon arrival of which medical assistance is provided. It is absolutely impossible to administer injections and give drugs to the victim on your own, this can negatively affect his state of health.

You need to turn your head very carefully and slowly.

An important stage in first aid is fixing the head of the victim

After you need to immobilize the head, it is very simple to do. There are standard tires for this, for example, the Elansky tire, but if it is not at hand, you can also use improvised means. You will need a piece of plywood or a wide board of small thickness, which is placed on the head, shoulders, upper chest. The width of the board is enough for the width of the head, so that it is a couple of centimeters larger, the head is located on its side. After that, a small thickness roller made of cloth is placed under the head. In this position, the head is fixed to the tire or plywood with a bandage, and the chest of the victim is also bandaged to it. When the doctors arrive, the main thing is not to interfere with their work with your unnecessary advice. After a person in a horizontal position on a stretcher is taken to the hospital.

With an open form

The patient is transported to the hospital on a stretcher

This type of fracture implies the presence of a wound and bleeding from it, sometimes profusely. In such a situation, a sterile bandage is applied, if possible. It must be firmly fixed, but it is worth constantly remembering that in the event of a fracture, due to a tightly applied bandage, the bones can move and injure the brain.

If there is a prolapse of the brain, then nothing needs to be set and put in its place, the bandage is simply applied from above.

When the bleeding is stopped by a bandage, applying a tourniquet for a skull fracture is simply unrealistic. You can proceed to the stage of immobilization, as already described above.

Constant control

Depending on the situation, one or another type of dressing may be needed.

It is important to constantly monitor vital functions:

  • consciousness.

In case of respiratory arrest, all measures are taken to restore it, “mouth to mouth” or “mouth to nose”. If a person is restless, it is necessary to constantly ensure that he does not get up, if necessary, they resort to fixing the victim. Movements can provoke displacement of fragments and additional trauma to the brain of the victim. Applying cold to the head will help prevent permanent brain damage, reduce the risk of bleeding, and reduce the risk of further complications.

Skull fractures are often observed (1.5-3% of all fractures). Most often, skull fractures occur as a result of street trauma (tram, car, motorcycle) and on railways. Industrial injuries of the skull are observed almost exclusively in the heavy mining industry (mines, shafts, etc.) and in construction.

Skull fractures are of particular importance because of their proximity to the brain. There are several forms of skull fractures: 1) fractures in the form of cracks and fissures; 2) comminuted fractures, in which bone fragments of various sizes are formed; fragments can be displaced and embedded in the dura mater and brain, and therefore fractures are distinguished with or without depression; 3) perforated and fenestrated fractures, having a roundish shape with loss of bone substance; such fractures include gunshot fractures of the skull, fractures from wounds with sharp objects (punching) - nails, hooks; these fractures may be accompanied by destruction of the brain.

There are closed and open, or complicated, skull fractures. With the latter, there is a huge danger of infection, which can penetrate to the fracture site and into the brain.

Closed skull fractures. With closed fractures of the skull, the outer integument of the skull is intact.

Symptoms with closed fractures of the cranial vault are sometimes not pronounced enough. Determination of a fracture, its edges, or a depression at the site of depression is usually hampered by a hemorrhage (hematoma) over the fracture site. Nevertheless, in some cases, when feeling, it is possible to determine the impression and even the mobility of the fragments. Skull fractures are accompanied by variously expressed phenomena of concussion.

Recognition of skull fractures is helped by paralysis, paresis, which are the so-called focal symptoms, phenomena of increased intracranial pressure and radiography. Damage to the frontal lobes does not give focal symptoms. In childhood, due to the special elasticity of the bones of the cranial vault, there are more often limited impressions.

Open skull fractures. Open fractures of the skull are characterized by the presence of a wound. Recognition of an open fracture of the cranial vault is not difficult. To do this, carefully spread the edges of the wound after shaving the hair and lubricating the skin and the edges of the wound with iodine tincture. Probing the wound for the purpose of diagnosis is completely unacceptable due to the possibility of infection in the depth of the wound. Recognition of skull fractures is helped by radiography, which makes it possible to establish the nature of the fracture, direction, crack, fracture with depression, etc.

Open fractures can be accompanied by damage only to the dura mater, and in some cases this membrane and the brain.

First aid . In case of skull fractures, first aid and the fight against the phenomena of concussion and initial shock are of great importance. The patient should be given a horizontal position, put ice on his head. In case of respiratory arrest, it is necessary to resort to artificial respiration and injection of lobelin (1 ml of a 1% solution). After the patient has come to his senses and the phenomena of the initial shock have passed, he should be sent to a medical institution.

Treatment of closed fractures that are not accompanied by cerebral phenomena indicating an increase in intracranial pressure (slow pulse) is conservative, but patients should be under medical supervision for a long time. The patient needs complete rest. With phenomena of increased intracranial pressure, with fractures with impression of fragments, a craniotomy is performed to destroy the pressure and remove the embedded fragments (fragments).

Treatment of open skull fractures. Open skull fractures require immediate surgery. The operation consists in the primary treatment of the wound after the preliminary treatment of the skin. During this operation, all foreign particles, non-viable tissue particles, bone fragments that have lost contact with the periosteum are removed. The hole in the bone is expanded with wire cutters. An intact hard shell is not opened unless there is evidence for this. Stitching is permissible, only in fresh cases. Before suturing, the wound is irrigated or sprinkled with penicillin, and the soft tissues are infiltrated with a solution of penicillin.

Contaminated wounds are not sutured and loosely packed.

Postoperative period. In the postoperative period, they are mainly monitored for the possibility of infection. In inflammatory conditions of the edges of the wound, the sutures must be removed, the wound must be opened wide and the graduate inserted.

Fractures of the base of the skull. Fractures of the base of the skull are most often formed when falling on your head or on your feet. These fractures are not palpable. X-ray examination helps clarify the diagnosis.

Recognition. The diagnosis can be made on the basis of the anamnesis, as well as secondary phenomena from the brain and cranial nerves. Recognition is helped by a bruise that appears a day after the injury in certain places: 1) with damage to the anterior cranial fossa - in the eyelids; 2) in case of damage to the anterior and posterior cranial fossa - in the throat; 3) in case of damage to the posterior cranial fossa - in the region of the mastoid process. Bleeding from the nose indicates damage to the frontal and ethmoid bones; bleeding from the external auditory canal occurs with fractures of the middle cranial fossa and the pyramid of the temporal bone. In some cases, there is an outflow of cerebrospinal fluid from the same holes. Sometimes there is a rupture of the eardrum. Skull base fractures can damage the cranial nerves and most commonly the facial abducens and oculomotor nerves.

With fractures of the base of the skull, due to irritation of the meninges, meningeal phenomena are often observed. Blood may be found in the cerebrospinal fluid obtained from a spinal puncture, which also indicates a fracture of the base of the skull. In severe cases, lumbar puncture has therapeutic value by lowering intracranial pressure.

Forecast. Fractures of the base of the skull are of great danger due to the possibility of infection from the cavities (ear, nose, frontal sinuses) and therefore the prediction is often unfavorable. Damage to important brain centers leads to immediate death.

Treatment . The patient is prescribed complete rest. The head should be raised. Do not rinse the ear canals and nose. Nasal tamponade can be done only with severe bleeding.

A small graduate can be inserted into the external auditory canal (but not deep). An aseptic bandage is placed on the ear area. To reduce the increased intracranial pressure that has appeared, 10.0-20.0 40% glucose solution is injected into the vein; in more severe cases, a lumbar puncture is done and some cerebrospinal fluid is released, which reduces headaches and dizziness.

To prevent the development of infection, the administration of a solution of penicillin with streptomycin is prescribed. The patient should be kept in bed for at least 4-5 weeks, until all brain symptoms disappear.

The human skull is a collection of twenty-three different bones that are connected together and perform a protective function of the brain and sensory organs, as well as their storage.

A skull fracture is a rather dangerous injury, in which there is a huge percentage of death or disability of the victim. Subsequent treatment and its effectiveness largely depends on the provision of first aid to the victim and his hospitalization in a medical facility.

A skull fracture in a child occurs in 30% of all cases of this injury, and it is at a young age that there is the greatest risk of death, prolonged coma, or subsequent disability.

Classification

There is a closed (without damage to the nearest soft tissues) and an open fracture of the skull (with damage to the skin).


Also, injuries are distinguished by their traumatic nature:

  • a depressed skull fracture is an indentation under the force of the bones in the area of ​​\u200b\u200bthe cranium. Often, this type of injury poses a risk to the blood vessels, meninges, and cerebral fluid. In most cases, damage of this type is accompanied by profuse hemorrhage;
  • perforated fractures of the skull - mainly such injuries occur with a gunshot wound to the head, and their outcome is the immediate death of a person;
  • fractures of the bones of the skull of a comminuted type - the characteristic signs of this injury are fragments of bone chipped off as a result of trauma. There is a strong possibility that broken bone fragments can damage the medulla. The outcome of such an injury is equivalent to the outcome of a depressed fracture, but most often the result is deplorable;
  • linear fractures of the human skull - the safest damage that occurs without displacement of bone fragments. During this type of injury, there is a great survival rate for the victim.

Causes

Skull fractures often occur for the following reasons:

  • falls from great heights;
  • strong traumatic impact on the head area with a heavy object;
  • classes in sports sections;
  • road accidents;
  • various unfavorable incidents of natural or mechanical origin;
  • active and extreme recreation in summer;
  • formed ice in the winter season;
  • martial arts;
  • production non-compliance with safety rules.

First signs


Depending on the nature and severity of the damage that has occurred, the signs may differ slightly from each other, but experienced doctors have identified common symptoms of a skull fracture that will greatly help in diagnosing it:

  • increased and incessant headaches;
  • severe nausea and aspiration of vomit;
  • the formation of bruises around the eye area symmetrical to each other;
  • poor or completely absent reaction of the eye pupils;
  • with strong pressure on the brain stem, the work of the respiratory function and the circulatory process worsens;
  • bleeding from the nose and ear openings;
  • disruption of the cardiovascular system;
  • a strong excited state or complete immobilization;
  • confusion or loss of consciousness;
  • uncontrolled urination.

As soon as such signs are detected, immediately seek qualified assistance and adequate treatment.

First aid for a skull fracture


First of all, as soon as there is a suspicion of skull fractures - call an ambulance, who can immediately provide the necessary assistance and stabilize the condition of the victim.

If the victim is conscious and his condition seems to be stable - put him in a horizontal position, in no case using pillows. Next, it is necessary to carry out a complete fixation of the head and upper part of the human body with the help of improvised objects. The wounded area must be treated with any antibacterial agents and a sterile bandage applied to it. If the ambulance is delayed, use ice compresses to improve the patient's condition. If there are no problems with respiratory functions, give the victim any pain reliever.

In a state of unconsciousness, the patient is also laid on a hard surface, but already in a sideways position, the head of the injured person is turned on its side so that the vomit masses that may occur during injury do not cause aspiration. All items of clothing and accessories must be removed, and the body of the victim must be fixed in a half-turn with the help of rollers or a blanket.


If the respiratory function has undergone a disruption of its work, then the victim must undergo an artificial respiration procedure. In the case of intense hemorrhages and a drop in blood pressure, a solution of polyglucin or gelatinol is used, which are administered to the patient intravenously. If the victim is in an excited state, then there is a need to inject him with the drug suprastin.

It is very responsible to approach the procedure of anesthesia, as some medications can increase the intensity of hemorrhage.

Diagnostic methods

First of all, upon arrival at the medical facility, the doctor finds out from the patient or his companion the reasons for the appearance of this injury and its first manifestations.

Then, in order to exclude neurological damage in case of a skull fracture, the doctor conducts a study in which he determines the correct functioning of the sense organs, muscles and reflexes. The pupils of the eyes are also examined to see if they have a reaction to light rays, the stability of blood pressure and the location of the tongue are checked.


After confirming or excluding neurological abnormalities, the doctor proceeds to establish an accurate diagnosis. To establish the nature and identify the presence of an injury, a qualified doctor prescribes a complete examination using x-rays in two projections, as well as computed and magnetic resonance imaging.

Very often, the unstable condition of the patient interferes with diagnostic methods and confirmation of the diagnosis, and the structure of the bone tissue does not allow the detection of skull fractures. In such situations, doctors prescribe treatment based on their professionalism and the signs of damage.

Medical tactics

Depending on the severity of the damage that has occurred, an experienced specialist chooses the tactics of treatment, it can be both conservative and operative.

A conservative method of treatment is to follow all the recommendations prescribed by the doctor. The main thing in this therapeutic method is to adhere to strict bed rest. With a frequency of 2-3 days, the patient undergoes a lumbar puncture procedure to reduce the amount of fluid that has entered the organs during an injury. Doctors also perform a subarachnoid insufflation procedure. In parallel with this, the patient must take medications that are aimed at reducing the production of CSF - diuretics.

Physical loads should be excluded for six months. The patient for some period after recovery should be registered in a traumatic and neurological room.

If any other treatment methods are needed, the doctor will prescribe them individually for each patient.

Severe injuries are treated with surgery. Its task is to remove broken-off fragments of bones and tissue sections that have undergone necrotization. And also during the operation, experienced specialists pump out the blood accumulated in the organs, and the state of nerve endings and blood vessels is normalized. Such manipulations are carried out under general anesthesia.

Internal intervention may also be required when a purulent infection has occurred during a fracture, and antibiotics and other medicines cannot cope with it. In such cases, surgical intervention is prescribed by a qualified neurosurgeon who has fully studied the patient's medical record and the nature of the injury.

After the complete end of treatment, the beginning of the rehabilitation period is scheduled. It is aimed at developing and restoring the motor functions of the human body, since with prolonged immobilization, muscle atrophy often develops, and performance due to this deteriorates significantly. Rehabilitation consists in observing the correct diet, doing physiotherapy exercises, attending specialized massage and physiotherapy procedures. The duration of the recovery period also depends on the diagnosis and is determined by your doctor.

Possible Complications

With untimely treatment or non-compliance with medical recommendations, unpleasant consequences may develop after a skull fracture:

  • partial or complete loss of hearing and vision;
  • the occurrence of meningitis;
  • development of pneumocephalus;
  • decrease in mental abilities;
  • children after trauma significantly lag behind in development;
  • complete or partial paralysis of the human body;
  • the occurrence of epilepsy;
  • persistent headaches;
  • cerebral hypertension.