Bandaging
USES
A bandage is used to hold a dressing in place over a wound, to create pressure
over a bleeding wound for control of hemorrhage, to secure a splint to an injured
part of the body, and to provide support to an injured part.
GENERAL PRINCIPLES
1. A bandage should never be applied directly over a wound; it should be used
only to hold in place a dressing which covers a wound.
2. A bandage should be applied firmly and fastened securely. It should not be
applied so tightly that it stops circulation or so loosely that it allows the
dressing to slip. If bandages work themselves loose or become unfastened,
wounds may bleed, they may become infected, and broken bones may
become further displaced.
TRIANGULAR AND CRAVAT BANDAGES
Triangular bandage is used for the temporary or permanent bandaging of wounds,
the immobilization of fractures and dislocations, and as a sling for the support of
an injured part of the body.
In making a triangular bandage:
1. a square of material about 3 by 3 feet, or slightly more, is folded diagonally
to make one bandage, or may be cut along the fold to make two.
2. The long side of the triangle is called the “base”, the point opposite the
base is called the “apex”, and the points at each end of the base are called
the “ends” or “extremities”
ROLLER BANDAGES
Roller bandage is used to hold dressings in place, to support an injured part, to
create pressure for control of hemorrhage, and to secure a splint to an injured
part in order to immobilize it.
In applying Roller Bandage:
1. The roll should be held in the right hand so that the loose end is on the
bottom
2. The outside surface of the loose end is next applied to the part and held
there with the left hand.
3. The roll is then passed around the part by the right hand, which controls the
tension and direction of the bandage.
4. Two or three of the initial turns of a roller bandage should overlie each
other to secure the bandage.
CONTROL OF PRESSURE
1. In bandaging an arm or leg, the entire extremity should be covered to
maintain uniform pressure. The fingers or toes should be left exposed so
the circulation in these parts can be checked.
2. An extremity should be bandaged in its final position, since bending will
change the pressure of parts of the bandage.
3. It is safer to use a large number of turns rather than a few too firmly applied
turns to secure splints or dressings. This is particularly important in applying
a wet bandage, or one that may become wet while securing a wet dressing.
A wet bandage will be unduly tightened when it dried if allowance has not
been made for shrinkage.
4. Bandage turns should overlap to completely cover the skin, since any
uncovered skin may be pinched between the turns. To prevent chafing and
irritation when two parts are bandaged together, skin surfaces should be
separated by absorbent material.
ANCHORING THE BANDAGE
1. Lay bandage end obliquely across top of wrist and then bring under wrist
and back to starting point
2. Fold uncovered triangle of end back over second turn
3. Cover by third turn, completing the anchor
FASTENING
1. The end of the bandage is folded back upon itself to form two ends which
can be tied
2. The end of the bandage is split lengthwise for a suitable distance and a
simple knot tied at the end of the tear
3. The split ends are then brought around in opposite directions and tied. The
square knot is the best type of knot for tying bandages. It will hold firmly
and can be easily unfastened
REMOVING
Bandage scissors are preferable when the bandage is to be removed by cutting.
Interference with the underlying dressing and wound should be carefully avoided.
Folds should be gathered up when the bandage is merely unwound.
TAILED BANDAGES
Tailed bandages are used to secure dressings to parts which do not lend
themselves to roller bandage applications.
a. T-bandage: a T-shaped bandage consisting of a vertical strip of material
sewn or pinned to the center of a horizontal strip. This bandage may be
used as a scalp, ear, eye or perineum bandage
b. Double T-bandage: made by sewing two vertical strips of material to
the center of a horizontal strip and about 4 inches apart. May be used to
hold dressings on the chest, back or perineum.
c. Four Tailed bandage: a piece of material 4 to 6 inches wide and about
30 inches long with each end cut about 12 or 14 inches down its middle,
leaving the center piece about 12 or 14 inches in length. The four tailed
bandage is used to hold dressings on the jaw, nose, forehead and back of
the head.
d. Many tailed bandage: the ends are cut into desired number of tails
about 16 inches in length and the uncut portion is about 20 inches in
length.
SPLINTING
Purpose
To immobilize the fragments of a broken bone. Fixing the fragments of a broken
bone will prevent the jagged edges of the bone from tearing blood vessels and
nerves, will reduce and sometimes actually prevent shock and will greatly reduce
the pain induced by fracture.
GENERAL PRINCIPLES
a. All fractures of long bones should be splinted “where they lie” before
movement or transportation of any kind is attempted.
b. In applying a splint, the joint above the fracture and the joint below the
fracture should be immobilized
c. The splint should be so applied that it does not interfere with the circulation
of the splinted part
d. The splint should be padded to prevent injury to the limb or discomfort to
the patient
e. Traction is required for most fractures of long bones to overcome muscle
contraction and associated shortening. Traction overcomes muscle
contraction and lessens shortening and thus regains or maintains normal
length of the bone
f. Splints may be improvised from boards or sticks, rolled magazines or
newspapers
Eurielle Audrey S. Miole
BSN IV - B
