BANDAGING

DEFINITION OF A BANDAGE:

A strip of material used mainly to support and immobilize a part of the body.



USES:

• To support - fractured bone
• To immobilize – Dislocated shoulder/Jaw
• To apply pressure – Stop bleeding & Improve venous blood flow.
• To secure a dressing in place.
• To retain splints in place.
  

Principles & Procedures for applying Bandages

• Wash hands. (Wear gloves where necessary)
• Assist victim to assume comfortable position on bed or chair and support the body part to be bandaged.
• Always stand in front of the part/victim to be bandaged except when applying a bandage to the head, eye and ear.
• Be sure the bandage is rolled firm.
• Make sure the body part to be bandaged is clean and dry.
• Assess skin before applying bandage for any breakdown.
• Observe circulation by noting pulse, surface temperature, skin color and sensation of the body part to be wrapped.
• Always start bandaging from inner to outer aspect and far to near end.
• When bandaging a joint, ensures flexibility of the joint. (except if immobilization of joint is required).
• Always start and end with two circular turns.
• Cover the area 2 inches above and 2 inches below the affected area (wound).
• Overlap turns and slightly stretch the bandage.
• Cover two third 2/3 of the previous turn.
• Where possible, leave fingertips or toe tips exposed for observation (adequacy of blood circulation).
• End the bandage on the outer side of the body. Do not end a bandage on wound or at the back of the body.
  
  

Methods of applying Bandages

• Circular
• Spiral
• Reverse Spiral
• Figure of Eight

Circular Turn

• Circular turns are used chiefly to anchor bandages and to terminate bandages.
  Apply the end of the bandage to the part of the body to be bandaged
• Encircle the body part a few times or as needed, each turns directly covering the pervious turn.
• Secure the end of the bandage with tape, metal clips or a safety pin over an uninjured area.
  

Spiral Turn

• Spiral turns are used to bandage cylindrical parts of the body that are fairly uniform in circumference, such as upper arm and upper leg.
• Make two circular turns to begin the bandage.
• Continue spiral turns at about a 30-degree angle, each turn overlapping the preceding one by two-thirds the width of the bandage.
• Terminate the bandage with two circular turns, and secure the end as described for circular turns.

Spiral Reverse Turn
Spiral reverse turns are used to bandage cylindrical parts of the body that are not uniform in circumference, such as the lower leg or lower fore arm

• Begin the bandage with two circular turns, and bring the bandage upward at about a 30-degree angle.
• Place the thumb of the free hand on the upper edge of the bandage.
• The thumb will hold the bandage while it is folded on it self.
• Unroll the bandage about 4-6” then turn the hand so that the bandage is folded down
• Continue the bandage around the limb, overlapping each previous turn by two-thirds the width of the bandage.
• Make each bandage turn at the same position on the limb so that the turns of the bandage will be aligned.
• Terminate the bandage with two circular turns, and secure the end as described for circular turns.
  

Figure of Eight Turn

• The figure-of-eight method of bandage permits flexibility of elbow, knee and ankle without disturbing the dressing.
• Begin the bandage with two circular turns.
• Carry the bandage above the joint, around it, and then below it, making a figure eight-continue above and below the joint, overlapping the previous turn by two-thirds the width of the bandage.
• Terminate the bandage above the joint with two circular turns, and secure the end appropriately.

Apply a Triangular Bandage Sling

A triangular bandage sling is usually made from a muslin bandage, but any material that does not stretch (such as a fatigue shirt, trousers, poncho, blanket, or shelter-half) can be used. Fold, cut, or tear the material into a triangular shape.

• Insert the material under the injured arm so that the arm is in the center, the apex of the sling is beyond the elbow, and the top corner of the material is over the shoulder of the injured side.
• Position the forearm so that the hand is slightly higher than the elbow (about a 10 degree angle).
• Bring the lower portion of the material over the injured arm so that the bottom corner goes over the shoulder of the uninjured side.
• Bring the top corner behind the casualty's neck.
• Tie the two corners together so that the knot will not slip. The knot should fit into the "hollow" at the side of the neck on the uninjured side.
  

Triangular Bandage to the Head
Turn the base (longest side) of the bandage up and center its base on center of the forehead, letting the point (apex) fall on the back of the neck.

• Take the ends behind the head and cross the ends over the apex.
• Take them over the forehead and tie them.
• Tuck the apex behind the crossed part of the bandage and/or secure it with a safety pin, if available.

Head Bandaging

Vertical bandage carried twice forwards and once backwards. Continue to pass the vertical bandage backwards and forwards each time a little to the left and right alternately, locking it with the horizontal bandage. Finally, pass horizontal bandage twice around the head, and pin in front.


Eye Injury & Bandaging
A penetrating eye injury is usually caused by a sharp object which has gone in, or is protruding from the eye.Warning:

• Do not touch the eye or any contact lens.
• Do not allow casualty to rub eye.
• Do not try to remove any object which is penetrating the eye.
• Do not apply pressure when bandaging the eye.

Bandaging:

Support casualty’s head to keep it as still as possible.

• Ask casualty to try not to move eyes.
• Place sterile pad or dressing over injured eye.
• Ask casualty to hold this in place.
• Bandage dressing in place, covering injured eye.
• If penetrating eye injury, lie casualty on back, place pad around object and bandage in place.
• If chemical or heat burn, or smoke in eyes, flush with water
  

Jaw Injuries & Bandaging

• Before applying a bandage to a casualty's jaw, remove all foreign material from the casualty's mouth. If the casualty is unconscious, check for obstructions in the airway.
• The dressing and bandaging procedure outlined for the jaw serves a two fold purpose. In addition to stopping the bleeding and protecting the wound, it also immobilizes a fractured jaw. •When applying the bandage, allow the jaw enough freedom to permit passage of air and drainage from the mouth.

Bandaging:

• Place the bandage under the chin and carry its ends upward. Adjust the bandage to make one end longer than the other.
• Take the longer end over the top of the head to meet the short end at the temple and cross the ends over.
• Take the ends in opposite directions to the other side of the head and tie them over the part of the bandage that was applied first.
  

Finger Bandaging

For finger and hand bandaging take a roller bandage varying in width from one inch to three inches wide and five yards long.

• After the dressing has been applied take two or three turns around the finger to hold the bandage from slipping, then from left to right making the distances neat and even, carry the roll around the finger.
• The figure of eight, which has the advantage of giving better compression is made by carrying, the bandage away from the person applying it on the upper stroke, then around the hand and toward the person on the down stroke, making the crossing point in the middle of finger, as illustrated, and having each crossing point one half inch higher up than the one preceding.

Securing Bandage

To the secure bandage apply the following:

• Tape
• Metal
• Safety Pin
• Binders:
• Binders used to secure a dressing in the rectum and perineal area.
• Abdominal binders (Scultetus).
• Ensure that there are no wrinkles or creases in the binder.