Technique of Applying Bandages

Technique of Applying Bandages

Roller Bandage

Circular Turn

In this bandage, one turn overlaps the previous turn completely. It should be used only which the part to be bandaged is of uniform thickness e.g. finger, wrist etc.

Procedure

• Explain the procedure.
• Wash hands.
• Gather necessary articles.
• Stand in front of the victim and support the injured part in a comfortable position.
• Apply the end of bandage to the part of the body to be bandaged.
• Encircle the body part a few times or as close as needed, each turns directly covering the previous turn.
• Secure the end of bandage with tape, metal clips or safety pin over an uninjured

Simple Spiral Turns

In this, the bandage ascends the body part with each turn overlapping the previous turn by one half or two third width of the bandage. Spiral turns are used to bandage parts of the body that are fairly uniform in circumference or are not same in thickness such as the upper arm or upper leg.

Procedure

• Make two circular turns to anchor the bandage.
• Continue spiral turns at about a 30 degree angle, each turn, overlapping the preceding one by two third the width of the bandage in closed turn.
• If it is open turn, do not overlap the each turn.
• End the bandage with two circular turns and secure the end.

Reverse Spiral

It is made by a number of spiral turns in which the bandage is reversed downwards up on itself at each circuit of the limb. Spiral turns are used to bandage cylindrical parts of the body that are not uniform in circumference such as the lower legs or the forearm.

Procedure

• Make two circular turns to anchor the bandage and bring the bandage upward at about a 30° angle.
• Place the thumb at the free hand on the upper edge of the bandage. The thumb holds the bandage while it is folded on itself.
• Unroll the bandage around about 15 cm; then turn the hand so that the bandage falls over itself.
• 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.
• End the bandage with two circular turns and secure.

Figure of Eight (Spica)

It can be used for joints at right angles to the body, for example wrist, ankle, knee joint and thumb. It is applied by passing the bandage obliquely round the limb, alternatively upward and downward, the loops resembling the figure of 8.

Procedure

•  Anchor the bandage with two circular turn around the desired part in the slightly flexed position.
• Encircle the part in figure of eight moving the bandage up and down the joint forming the pattern, each cover the two- third of the preceding loop and crossing in the same line.
• Apply until the bandage is used up or sufficiently protected.
• Secure the end.

Recurrent Bandage

This type of bandaging is used to cover the distal part of the body e.g. skull, stump of an amputation. It is also called capline bandage.

Triangular Bandage

A triangular bandage is a large triangle of cloth, usually a loose-weave cotton cloth, used in first aid. It is also called a 'cravat' (French for necktie) because it is sometimes folded to the shape of a long narrow band, for certain uses. A triangular bandage can be folded in the shape of a rectangle. It can substitute with any kind to linen, a piece of cloth, sheet, shirt, scarf or a handkerchief, or a thin towel etc. in an emergency. This type of bandage has many applications: 

• It can be placed over a large wound to absorb blood and stop bleeding, functioning as a trauma pad.
• Two triangular bandages can be used together to treat a wound. One can be used like a trauma pad to control bleeding, and another can be used to wrap the wound. D
• It can hold the trauma pad in place if first aid tape is not available.
• If a victim has an injured arm, a triangular bandage can be used as a sling, to support the arm in a bent position over the chest. A second cravat (folded as a long band) can be used around the torso as a strip, to immobilize the arm against the chest. This technique is called a sling and swathe.
• If a victim has a broken leg, the leg can be immobilized with a blanket between the legs and a couple of cravats to tie the legs together, firmly but not so tight as to restrict circulation.
• If a victim has a sprained ankle or wrist, a cravat can be used like an Ace bandage to wrap and support the appendage. Always remember, when wrapping, bandaging, or taping any wound, to avoid restricting circulation.
• In the case of a head wound, a triangular bandage can be wrapped over the forehead and around the top of the head to cover the wound. Do not use bandages over the eyes, nose, or mouth. Do not use bandages of any kind around the neck, because you might restrict circulation to the head.

Assisting Patient with Application Slings

Slings are used to provide support and protection for injured arm, wrist and hands for immobilizing on upper limb.

Arm Slings: Arm slings are commonly used to support injuries to the upper limb or to immobilize the upper limb in case of chest injury.

Elevation Slings: These are used to support a hand in a well-raised position to control bleeding or to immobilize the upper limb if there is a broken collar bone or there are rib injuries.

Purposes

• To support or immobilize parts of upper extremities.
• To limit the movement of upper extremity in presence of fracture, muscles strain and joint dislocation.
• To prevent dependent edema.
• To control pain.
• To promote rest.
• To aid healing.

Procedure

• Analyze the patient's current health.
• Keep an eye on the patient's upper extremity's movement, the presence of a suture line, their level of comfort, and the integrity of their skin.
• Explain the affected extremity's procedure.
• Check the pulses.
• Place the patient in a seated or prone position with the forearms at an angle, the wrist higher than the forearm, the hand higher than the wrist, and the fingers higher than the forearm—all in accordance with the patient's anatomical structure.
• With the binder in the middle and the sling open, drape it over the patient's torso. The triangle's apex should be at the elbow and its longest side should be at the wrist.
• Bring the binder level and pointing upward over the patient's neck on the affected side of the body before turning around. The longest side of the triangle will now extend vertically and horizontally on the unaffected side of the body.
• Bring the hand up to the neck on the affected side while crossing the lower binder point over the forearm.
• Reevaluate the forearm's angle and make any necessary adjustments to the posture.
• Use a square nut to fasten the sling's closure at shoulder level on the side that is not affected. Fold any leftover loose parts around the elbow, maintaining the fold, and secure with a safety pin.
• Add cushioning as necessary.
• Examine the sling being used to make sure it is providing adequate support, that the lower arm is elevated above the elbow, and that pressure is not being placed on the cervical vertebra.
• hand washing
• Analyze the skin's state, finger feeling, and distal pulses.
• Verify the shoulder and extremity's alignment.
• Record alignment, circulation, skin sensation, and the integrity of the affected extremity. Inquire about the patient's level of comfort. Document the patient's reactions to the administration of the sling.

Applying Triangular Bandages on Hand and Foot

Triangular bandage also can be used on the hand or the foot to protect and support the injured part.

Procedure

• Place the bandage on a flat surface; then put the hand or foot in the centre of the bandage.
• Pull the middle point up to the wrist or ankle.
• Bring the left point, then the right one over the front and around the ankle or wrist.
• Tie the point in front of the ankle or wrist with a square knot.

Applying Triangular Bandage on the Head

The bandage is applied on the head to protect the scalp of the patient or to hold a dressing in its place.

Procedure

• Fold the longest portion about an inch, depending upon the size of the bandage and the victim.
• Stand behind the patient and place the hand of the bandage on the forehead just above the eyebrows. The point of the bandage should hang down at the back of the head.
• Bring the ends around each side of the head just above the ears.
• Cross the ends over the point of the bandage near the back of the neck.
• Bring the ends forward around the head above the ears and tie them on the forehead over be the hem of the bandage.
• Steady the head with one hand and with the other hand draw the point of the bandage downwards. robnid ad ghind
• Pull the point of the bandage over the crossed ends. Tie or pin in to the bandage on the top of the head.

Binders

Binders are special wide bandages used for supporting specific parts of body and large dressings. They may be used to immobilize, provide comfort and support, secure dressing or exert pressure.

Types of Binders

• Abdominal binders
  • Large rectangular piece of heavy cotton muslin or flannel, which can be pinned at the center to fit the patient.
  • Synthetic binder with adhering straps, hooks and eyes.
  • Scultetus binders.
• Breast binder
• T-binder
  • Single tailed binder
  • Double tailed binder

T-Bandage

T bandage looks like the letter T and is used to secure rectal or perineal dressing and in the groin. Double T binder is used for males and single T binder is used for females.

Procedure

• Review the medical record to determine whether a prescription is needed for a specific binder and the basis for the application.
• Inform the patient about the process and the necessity of using the binder.
• Help the patient assume a dorsal reclining position.
• Place a horizontal band with vertical tails around the waist and the patient's hips raised. Put a safety pin in the front of the waistband's overlap.
• Bring the last vertical strip over the perineal dressing and continue up and under to the center of the horizontal band using a single tail binder. Vertical and horizontal bands should be brought over the waistband and pinned together with safety pins.
• Double tail binder: Position the remaining vertical strips so that each tail supports one side of the scrotum and rises upward on either side of the penis. Bring the strips over the perineal or suprapubic dressing. Continue drawing ends behind the horizontal band, then downward in front.
• Pin all thicknesses together.
• While the patient is lying, sitting, or standing, gauge their level of comfort. Front pins should be readjusted as needed. If any location scrapes against the nearby tissues, add more padding.
• Inform the patient that they must remove their binder before going to the bathroom or taking a shower and that they must replace it afterward.
• Take notes about the procedure for the nurses.

Many Tailed Bandage (Scultetus Binder)

It is a rectangular piece of strong cloth that has many tails attached to the two longer sides used for support of abdominal musculature and to prevent wound dehiscence and evisceration following abdominal surgery.

Procedure

• Position the patient with head slightly elevated and knees slightly flexed.
• Place the fan ends of the binder under the patient.
• Apply a scultetus binder with the person lying supine on the binder's center, with the tails equally extended to either side and the binder's top under the upper abdomen.
• Lightly powder the skin to reduce friction from the binder against the skin.
• Then starting at the binder's bottom, bring its each 'tail' across the abdomen, smoothing and gently pulling it tight.
• Overlap each succeeding tail at a slight upward angle, crossing at the midline.
• Anchor each tail with your hand until securing it with the opposite tail.
• If tails are too long, neatly fold them.
• Overlap the two top tails along a straight line and pin in the place.
• When the binder is properly applied, there is an even pattern along the midline and a sung fit e.g. comfortable, secure, but not tight.

Abdominal Binder/Large Rectangular

Procedure

• Inform the patient of the process and the necessity of applying a binder.
• assemble the information that is required for the patient's size and the 10b appropriate binder.
• Close the room door or the drapes.
• hand washing
• The patient should be positioned with their legs slightly bent and their head slightly lifted.
• Fan-fold the side of the binder in the direction of the binder's middle.
• As the patient is being helped to roll away from you and toward the elevated side rail, firmly hold the abdominal incision and dressing in place with your hands.
• Lay the patient on the fan-folded ends of the binder.
• Tell the patient to roll the ends that are folded over.
• On the opposite side of the bed, unfold and evenly spread out the ends.
• Tell the patient to resume rolling over into the supine position.
• Using the symphysis pubis and costal borders as lower and upper land marks, adjust the binder so that the supine patient is positioned over the binder.
• Pull the binder's distal end over the patient's abdomen's midsection. Pull the opposing ends of the binder over the middle, keeping strain on that end, and fasten with safety pins or Velcro closure tabs.
• Examine the patient's capacity for deep breathing and productive coughing.
• Ascertain the patient's level of comfort.
• If required, adjust the binder.
• Keep track of the process.

Breast Binder

A breast binder looks like a tight fitting sleeveless vest and is used to apply pressure to the breasts.

Purposes

• To provide support after surgery.
• To support breasts for comfort in case of engorgement.
• To secure dressing.
• To compress breasts to help in suppression of lactation following fetal loss or neonatal death.

Procedure

• If a medical prescription is required for a certain binder and the reasons for application, review the medical record.
• Inform the patient about the process and the necessity of using the binder.
• Help the patient get into a supine position in bed.
• If necessary, padded the region beneath the breasts.
• With the binder's center on the midline, place it beneath the torso.
• Place the near end over the first breast and the farther end over the patient's breasts.
• Binder should initially be fastened at the nipple level using Velcro closure tabs. When the entire binder is closed, continue the closure technique above and then below the nipple line.
• Fix the shoulder straps to the upper border of the binder by crossing them across on either side of the front.
• Make the necessary modifications, such as customizing the lift of the shoulder straps. Develop self-care skills linked to reapplying a breast binder by instructing and observing.
• hand washing
• Examine the underlying skin for integrity, circulation, and wound features (if any), as well as the patient's level of comfort.
• Keep track of the binder application, skin and blood circulation health, dressing integrity, and level of comfort.

Key points in the use of binders are:

• Binders are used to apply a tight, equal pressure.
• Binders shouldn't interfere with pulmonary or neuromuscular processes.
• Binders that are wrinkled are uncomfortable and risk tearing tissues.
• Binders are fastened such that there is no rubbing or movement against the skin's surface underneath.
• Pins or knots are positioned far from the borders of wounds or sensitive areas.
• Binders are applied while the body component is aligned anatomically and while the joints are in their functional positions.
• If applied to damaged skin surfaces, soiled or damp binders may foster infection.
• Inspections of the skin surfaces below a binder should be done often.
• Uncomfortable binders should be taken off and reapplied.
• The skin surface may be covered with talcum powder.

Reef Knot (Square Knot)

It is used to secure the end of the triangular bandage. It is also known as square knot.

Procedure

• Take the two ends of the bandage on each hand; cross the end in the right hand under and then over the end in the left hand thus making a turn.
• Then cross the end now in the right hand over and then under the end in the left hand thus making a second turn.
• Now the knot must be placed where it doesn't make discomfort. Now the knot must be placed where it doesn't make discomfort.

Clove Hitch

It is used in restraining the patient.

• Make two identical loops, loop A and loop B.
• Pass loop A in front of loop B
• Apply it in the arm to be restrained.
• Pad the loop enough while applying it
• Tie the free end of the bandage to the bed.