| Vacuum mattress | |
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 Vacuum mattress and its manual pump |
A vacuum mattress, or vacmat, is a medical device used for the immobilisation of patients, especially in case of a vertebra, pelvis or limb trauma (especially for femur trauma). [1] It is also used for manual transportation of patients for short distances (it replaces the stretcher). It was invented by Loed and Haederlé, who called it "shell" mattress (matelas coquille in French).
The full spine immobilisation (splint) is performed with: a rigid cervical collar, a vacuum mattress and a stretcher under it (the longitudinal stiffness of the mattress alone is not sufficient).
The vacuum mattress is put on a stretcher or possibly on a long spine board. The straps are put under the mattress, along its side, so they do not reach the ground. Then, the polystyrene balls are distributed evenly through the mattress by shaking its surface. (A section with fewer balls would be less rigid, conversely if balls are concentrated at any given point this becomes more rigid.) A sheet is put on the mattress, folded so it will be possible to pull it to wrap the casualty into using an S-fold and finally a team member should double-check the pump (manual or electrical) is set to either pump air out of the bag.
There are three ways to put the casualty on the vacuum mattress:
In all cases, the vacuum valve is up and at the feet of the casualty.
Once the casualty is on the mattress, the sheet is wrapped around him/her and the sides of the mattress are folded against their body. The top of the head must be kept clear (the mattress could retract when pumping out the air and thus compress the spine). The air is pumped until the mattress is rigid, then the valve is closed and the straps are fastened. [2] When only three team members are available and there is no scoop stretcher, the following procedure can be used:
While the lifting methods can induce a flexing of the spine, this rolling method can be hazardous for several reasons: the risk of a torsion of the spine when rolling, the risk when sliding the casualty on the mattress, the risk of anteversion of the hips (and thus of flexing of the spine) due to the weight of the legs when lifting the mattress to slide the board.
The vacuum mattress is an alternative to the use of a long spine board. Its advantages are:
Its drawbacks include:
A vacuum mattress consists of a sealed air-tight (typically polymer) bag enclosing small beads (typically polystyrene balls) and fitted with one or more valves. While at ambient air pressure, the beads free to move, but when the mattress has been moulded and the air evacuated, external atmospheric pressure locks the beads in place (jamming) and the mattress becomes rigid.
When used medically this principle allows a patient who is put onto the mattress (e.g. with a scoop stretcher), the sides of the mattress arranged around the patient and when the air inside is evacuated the mattress forms a conformal cradle allowing an injury to be stabilised, straps fastened, and the patient protected sufficiently well that they can be transported.
For this reason the bag is typically bigger than an adult human body (though the same principle may be employed to create an 'instant' cast to stabilise an injured limb). In use, a sheet is usually put on the vacuum mattress to:
A stretcher, gurney, litter, or pram is an apparatus used for moving patients who require medical care. A basic type must be carried by two or more people. A wheeled stretcher is often equipped with variable height frames, wheels, tracks, or skids.
A spinal board, is a patient handling device used primarily in pre-hospital trauma care. It is designed to provide rigid support during movement of a person with suspected spinal or limb injuries. They are most commonly used by ambulance staff, as well as lifeguards and ski patrollers. Historically, backboards were also used in an attempt to "improve the posture" of young people, especially girls.
Casualty movement is the collective term for the techniques used to move a casualty from the initial location to the ambulance.
Casualty lifting is the first step of casualty movement, an early aspect of emergency medical care. It is the procedure used to put the casualty on a stretcher.
Vehicle extrication is the process of removing a patient from a vehicle which has been involved in a motor vehicle collision. Patients who have not already exited a crashed vehicle may be medically or physically trapped, and may be pinned by wreckage, or unable to exit the vehicle because a door will not open.
A cervical collar, also known as a neck brace, is a medical device used to support and immobilize a person's neck. It is also applied by emergency personnel to those who have had traumatic head or neck injuries, although they should not be routinely used in prehospital care. They can also be used to treat chronic medical conditions.
The scoop stretcher is a device used specifically for moving injured people. It is ideal for carrying casualties with possible spinal injuries.
A cervical fracture, commonly called a broken neck, is a fracture of any of the seven cervical vertebrae in the neck. Examples of common causes in humans are traffic collisions and diving into shallow water. Abnormal movement of neck bones or pieces of bone can cause a spinal cord injury, resulting in loss of sensation, paralysis, or usually death soon thereafter, primarily via compromising neurological supply to the respiratory muscles and innervation to the heart.
External fixation is a surgical treatment wherein Kirschner pins and wires are inserted and affixed into bone and then exit the body to be attached to an external apparatus composed of rings and threaded rods — the Ilizarov apparatus, the Taylor Spatial Frame, and the Octopod External Fixator — which immobilises the damaged limb to facilitate healing. As an alternative to internal fixation, wherein bone-stabilising mechanical components are surgically emplaced in the body of the patient, external fixation is used to stabilize bone tissues and soft tissues at a distance from the site of the injury.
Outdoor emergency care (OEC) was first developed by the National Ski Patrol in the 1980s for certification in first aid, and other pre-hospital care and treatment for possible injuries in non-urban settings. Outdoor emergency care technicians provide care at ski resorts, wilderness settings, white-water excursions, mountain bike events, and in many other outdoor environments.
A traction splint most commonly refers to a splinting device that uses straps attaching over the pelvis or hip as an anchor, a metal rod(s) to mimic normal bone stability and limb length, and a mechanical device to apply traction to the limb.
Stabilization is a process to help prevent a sick or injured person from having their medical condition deteriorate further so that they can be treated. Examples include while the person is waiting for medical treatment and in the intensive care unit.
A vacuum splint is a device like a small vacuum mattress that is used in emergency medicine as a temporary splint. Vacuum splints operate by extracting air from the splint itself to enable the thousands of polystyrene balls inside the splint to mold around the injured body part similar to an orthopedic cast. Vacuum splints are primarily used by paramedics to splint trauma-related injuries, joint dislocation, subluxation, and extremity fractures.
Australian mobile intensive care ambulances (MICA) are well-equipped ambulances staffed by highly trained paramedics dispatched to emergency situations where patients require a higher level of care than a regular ambulance can provide.
Grady straps are a specific strapping configuration used in full body spinal immobilization.
Combat medics of the United States military may put themselves at greater risk than many other roles on the battlefield. In recent conflicts, the enemies faced by a professional army may not have respect for the laws of war and may actively target combat medics for the significant value they have in keeping the unit combat-effective. Since the non-combatant status granted to medics may not always be respected, modern combat medics carry weapons for personal defense and in most Western armies are virtually indistinguishable from regular infantrymen.
Vacuum bag moulding is the primary composite manufacturing process for producing laminated structures. It is common in the aerospace industry.
Spinal precautions, also known as spinal immobilization and spinal motion restriction, are efforts to prevent movement of the bones of the spine in those with a risk of a spine injury. This is done as an effort to prevent injury to the spinal cord in unstable spinal fractures. About 0.5-3% of people with blunt trauma will have a spine injury, with 42-50% of injuries due to motor vehicle accidents, 27-43% from falls or work injuries, and the rest due to sports injuries (9%) or assault (11%). The majority of spinal cord injuries are to the cervical spine, followed by the thoracic and lumbar spine. Cervical spinal cord injuries can result in tetraplegia or paraplegia, depending on severity. Of spine injuries, only 0.01% are unstable and require intervention.
Tooth mobility is the horizontal or vertical displacement of a tooth beyond its normal physiological boundaries around the gingival (gum) area, i.e. the medical term for a loose tooth.
A Neil Robertson stretcher (NRS) is a type of rescue stretcher designed for the purpose of safely transferring an injured person by either lowering or lifting them to a place of safety. It is constructed from wooden slats and canvas. It features the patient being wrapped in canvas and secured using robust canvas straps, with a lifting rope affixed to a head-mounted ring and a guideline tied near the ankles, serving to halt the stretcher's movement. It has been utilized by the Royal Navy for nearly a century. The Neil Robertson stretcher has been widely adopted in Australia and other countries, and has been credited with reducing the risk of further injury to patients during transport.