📆 𝗪𝗘𝗘𝗞𝗟𝗬 𝗘𝗫𝗣𝗘𝗥𝗧 𝗖𝗢𝗟𝗨𝗠𝗡 ⚡️ By the head of the “Tactical Medicine Courses” project, call sign “Latysh” 📌 Exclusively for the Severny Veter channel When a spinal fracture is suspected and there is a simultaneous threat of asphyxiation, rescuers face an extremely difficult dilemma in which the cost of a mistake is equally high on both sides. On one hand, any careless movement can displace unstable vertebrae and damage the spinal cord, potentially causing paralysis or death. On the other, an airway blocked by vomit, blood, or the tongue falling backward can kill within minutes, leaving no time for hesitation. In these critical situations, which are common in combat, a blast wave or fall can cause both spinal trauma and airway obstruction. A measured decision must therefore be made based on an assessment of which threat is more immediate. When is it acceptable to place a casualty with a suspected spinal fracture in the recovery position? Only in exceptional circumstances, when all other methods of restoring airway patency have been exhausted or are impossible. These include uncontrollable vomiting or heavy bleeding into the mouth when the casualty cannot cough effectively, and when an airway adjunct or suction equipment is ineffective. It is essential to understand that even a perfectly executed turn carries a risk of further spinal injury. That risk must be justified by the immediate threat to life posed by suffocation. The technique requires at least three rescuers. Each person is responsible for stabilizing a specific section of the spine: ▪️ The first rescuer holds the head and neck, keeping them immobile relative to the torso. ▪️ The second stabilizes the shoulder girdle and chest. ▪️ The third controls the pelvis and lower limbs. The movement must be synchronized, carried out on a clear command, without jerking, and while maintaining the straightest possible alignment of the spine. After turning the casualty, a soft support made from rolled clothing or bandages should be placed beneath the head and neck to maintain a neutral position and prevent sideways bending. Only when these conditions are met can rescuers hope to avoid aggravating the existing injury. However, all available alternatives should be considered before attempting such a risky maneuver. If the tongue is obstructing the airway, an oral or nasal airway adjunct may help restore airflow without changing the casualty's body position. The triple maneuver known as the Safar maneuver—head tilt, jaw thrust, and mouth opening—can also help restore airway patency. However, when a cervical spine injury is suspected, head tilt is contraindicated; only the jaw-thrust technique should be used. If fluid or vomit has accumulated in the mouth, rescuers may attempt to clear the oral cavity carefully using a finger wrapped in gauze, or use a suction device if one is available. The bottom line: Placing a casualty with a suspected spinal fracture in the recovery position should be considered only after carefully assessing the situation and only when there is a genuine threat of asphyxiation that cannot be resolved by other means. Experience shows that this procedure requires a high level of skill and coordinated teamwork. Any mistake can have fatal consequences. In combat conditions, where medical assistance is often provided in extreme circumstances, understanding these details and being able to make the right decision quickly is not merely a medical skill—it can be a matter of life and death for the wounded. ⚡️⚡️⚡️⚡️ Severny Veter t.me/warriorofnorth/22900