Thursday, 21 May 2015

Knowledge of handling spinal injuries can be a boon at the time of distress

Knowledge of handling spinal injuries can be a boon at the time of distress

The recent Nepal Earthquake has made all of us question ourselves and our system- Are we prepared to face such calamity? Natural disasters like earthquake come unannounced. But what is needed on our part is better awareness and knowledge to tackle such situations. At the time of earthquake, a large number of people lose their lives due to lack of information on handling medical emergencies. 

It is well known not the earthquake that causes deaths, but the building debris that fall on the person which causes injuries of the neck and the spine  during that period. When an earthquake strikes, people often bend down to save their lives. In such a situation, the rubble from the buildings fall directly on a person’s back, which leads to traumatic spinal injuries and the most common of them, are spinal fractures and cervical injuries. Traumatic spinal injuries often cause neurological deficits; which if not treated well in time, can in future lead to permanent neurologic injury. Untrained rescue workers are the first one to offer help but they are not aware how a person who has suffered back and neck injury needs to be immobolised before being lifted. It is pull drag method which further aggravates the condition of the affected person.

Spinal Immobilization, in-field care, proper lifting techniques and transport during rescue operations plays a very important role while coping up with a natural calamity, and especially, for the trauma patients. Certain things need to be kept in mind while handling spinal emergencies. The injured person should not be dragged. At least 5 or more people should be there to carry the patient, with one holding and supporting the head, one supporting the neck and shoulder, minimum two people standing on opposite sides of the patient holding the back and the pelvic area and one person holding the legs. Immediately shift the patient and make him lie on a hard board. Make sure that there is no abnormal twisting, turning or bending of the neck and back. Another thing to be kept in mind is that the neck should be immediately immobilized by a hard cervical collar, as failing to do so can cause cervical injury. Proper transportation and timely treatment can save many lives.

Always remember, our safety lies in our own hands. At the time of earthquake, it is important not to panic and maintain calm. The moment, you feel that an earthquake is coming move out to an open area or to the middle of the street, and stay away from electricity poles, trees and buildings, as they might fall down. Also, avoid using lifts on case of moving out of a building. But, if you can’t move out, follow the simple technique of “Drop, Cover and Hold On”. Hide under a sturdy desk or table and hold its legs firmly. You can also, sit next to a sofa or bed in a foetal position for your safety. Stay away from windows and lamps. If driving, stop your car at the side of the road and not in the middle especially, under a highway. In a crowded place like malls or restaurants, you can protect your head with your arms and hide under a seat or table. New theory has been propounded that if you lie next to triangular object, then the chances of the survival are the maximum since the debris don’t directly hit but slide down. According to this if you hide under a hard board, the heavy debris can break it and lead to more serious injuries.

Proper education regarding disaster management and how to handle any medical emergency at the time of any natural disaster, if given right at the school level can making our coming generation, a well prepared and more responsible citizen who is capable enough of helping a fellow citizen in such times of distress. It is important that general public is also trained in basic trauma care like proper lifting and carrying of injured person to prevent further aggravation of Spinal and neck injury.

Dr Sudeep Jain
Spine Surgeon
Director
Spine Solutions India
Naraina Vihar, New Delhi



 

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