12
décembre 2016

Technique d’extraction rapide à l’aide d’un drap

Rédigé par PhilippeL   85 commentaires   Mis à jour le  12/12/2016

(ou d’un dispositif disponible dans le commerce, technique dite du « boa »)

Je ne vous ferai pas l’affront de revenir sur la présentation de l’équipe et des postes occupés par chacun, ni sur les explications de la « période d’or », deux sujets brillamment abordés par mes collègues.

Mais ma position de « secouriste » au sein de l’équipe m’amènera à davantage vous proposer des articles concernant la prise en charge des victimes que concernant la césarisation à proprement dit.

Mon champ de possibilités est donc vaste mais il m’apparait logique de vous présenter en premier lieu la technique d’extraction rapide à l’aide d’un drap. Car celle-ci, issue de la méthode PHTLS (Pré-Hospital Trauma Life Support), est simple, rapide, extrêmement efficace et émerge peu à peu dans différents milieux (ambulanciers, secours, …).

 

QUAND ?

Victime traumatisée en état critique nécessitant un soin ou un transport d’extrême urgence

Victime traumatisée empêchant l’accès à une victime critique

 

POURQUOI ?

Cette technique permet d’extraire au plus vite, la victime assise dans un véhicule par deux sauveteurs en s’aidant d’un simple drap, tout en respectant l’axe tête-cou-tronc, en solidarisant de façon fiable l’axe vertébral supérieur avec la ceinture scapulaire, de soulever d’un bloc le tronc de l’automobiliste, de le faire pivoter et enfin de le tirer sur un plan dur jusqu’à sa position horizontale. Exemple : sortie immédiate (cf article sur la « golden hour »)

 

AVEC QUOI ?

  • 1 attelle cervicale préalablement posée sur la victime
  • 1 ou plusieurs draps (ou système acheté dans le commerce), préalablement roulé sur lui-même et tenu en cette position avec du ruban adhésif (ou du sparadrap)

Par la suite :

  • Plan dur
  • Immobilisateur de tête
  • Sangle araignée
  • (ou plan dur puis Matelas Immobilisateur à Dépression)

 

 

COMMENT ?

 

  • Un premier secouriste assure le maintien de la tête de la victime
  • Un second secouriste roule sur lui-même le drap, avec l’aide d’un tiers ou en bloquant une extrémité dans une portière
  • Il place ensuite le milieu de ce rouleau sur la partie avant de l’attelle cervicale
  • Il croise les deux brins à l’arrière de l’attelle cervicale et veille à serrer suffisamment le dispositif, le cou de la victime étant protégé par l’attelle cervicale
  • Il rabat ensuite les deux brins vers l’avant en passant sur les épaules de la victime puis les glisse sous ses aisselles

A cet instant, les deux brins apparaissent à l’arrière du dos de la victime : le premier secouriste peut relâcher le maintien tête et le second peut enfin saisir les deux brins comme « poignées d’extraction » et extraire la victime

N. B. : le dégagement des pieds de la victime peut s’avérer nécessaire par le secouriste qui assurait auparavant le maintien-tête

 

Risques ?

  • Non-respect ou manque d’entraînement à cette technique, ce qui engendrerait un risque de mobilisation de l’axe tête-cou-tronc

 

Efficacité ?

  • Maintien  permanent de l’axe tête-cou-tronc
  • Rapidité d’exécution

 

SIMPLE, RAPIDE, EFFICACE, LA VIDEO PROPOSEE PAR UN CONFRERE  :

 

Références : PHTLS - Ecole de Soins ambulanciers de Genève

Relecture : Christophe COGNET, instructeur PHTLS

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