Professional Documents
Culture Documents
Bandaging
Bandaging
DEFINITION:
Bandaging is the process of covering a wound or
an injured part.
USES:
Bandages are used for following purposes:
To prevent contamination of wound by holding
dressings in position.
To provide support to the part that is injured,
sprained or dislocated joint.
To provide rest to the part that is injured.
To prevent & control hemorrhage.
To restrict movement / immobilize a
fracture or a dislocation.
To correct deformity.
To maintain pressure e.g. elastic bandages
applied to the improve venous return.
TYPES OF BANDAGES:
Triangular Bandage.
Roller Bandage.
Special Bandage. E.g. T- bandage.
MATERIALS COMMONLY USED FOR
BANDAGES:
Cotton
Cotton gauze
Jute
Wool
Special materials like crape bandage,
elastic bandage.
PARTS ROLLAR OF BANDAGE:
Head
Free End or tail.
PARTS TRIANGULARLAR OF
BANDAGE
POINT
Head 5 4 to 6
Trunk 10 to 15 6 to 8
Leg 6 to 8 4
Arm 5 to 6 3 to 4
Fingers 2.5 2
Hand 5 3
Wrist 5 3
GENERAL PRINCIPLES: -
Select a bandage of proper size & suitable
material.
Put the patient in a comfortable position.
Support the injured area while bandaging.
If a joint is involved, flex it slightly.
Face the patient while applying the
bandage, except when applying it to the
head.
Hold the roll of the bandage in the right
hand when applying bandage on the left
side, Hold the bandage with the roll
uppermost & apply the outer surface to the
skin, unrolling a few centimeters of the
bandage at a time.
Put some cotton wool on the part to be
bandaged so that the bandage does not
slip or cause cutting into the skin
underneath.
Bandage from below upward, & from
within outward.
Hold the end of the of the bandage over
the outer aspect of the injured area & wind
the bandage around the part twice to fix it.
FIXING
ROLLING
SECURING
Support of forearm
Forming sling
2. Elevation Sling:-
This sling is used to support the hand and
forearm in a well raised position.
-If the hand is bleeding.
-There are complicated chest injuries.
-There are shoulder injuries.
Side bars
Distal -W
Parts of a Thomas splint :
A Thomas splint consists of four parts:-
1. A padded metal oval ring with soft
0
leather set at an angle of 120 to the inner
bar.
2. Two side bars-one inner and another
outer bars of equal length. They bisect
the oval ring
3. Distal end-where the two side bars are
joined in the form of a ‘W'.
4. Outer side bar is angled 2 inches below
the padded ring to clear the prominent
greater trochanter.
Uses of Thomas splint:-
1. To immobilise fracture femur anywhere.
2. As a first aid measure to immobilise the
lower limb injuries.
3. For transportation of an injured patient
4. In the treatment of joint diseases like TB
knee, septic arthritis etc.
Bohler-Braun (BB) Splint:-
This is Bohler's modification of Braun
splint. It consists of a heavy metallic frame
with four' pulleys:-
1. Proximal pulley prevents foot drop.
2. Second pulley to apply traction. in the line
of femur.
3. Third pulley to apply traction in the line of
supracondylar area of femur.
4. Fourth pulley to apply traction in line of the
legs.
Indications
Skeletal traction is applied through this
frame for comminuted trochanteric
fractures of the femur.
It is also used for the treatment of fracture
shaft femur and supracondylar fractures of
the femur.
Rarely it can be used for the fracture shaft
of tibia and fibula.
One important precaution which should be
taken while using the BB splint is to provide
support at the fracture site and not at the
knee joint to prevent angulation especially
in supracondylar fractures of femur.
Problems of BB Splint:-
1. Makes nursing care difficult
2. It is a heavy and cumbersome
frame.
3. It is associated with recumbent
problems like bedsores
,hypostatic pneumonia, renal
calculi, etc.
PNEUMATIC SPLINTS
These are the present generation splints
and are more aesthetic, light and effective.
They consist of the splints made up of
pneumatic material and can be easily
applied to the limbs by inflating it with air.
They provide a tight fit and are more
comfortable to the patient.
Most of the ambulances today carry these
splints which are easy to transport unlike
the crude and hard Thomas splints, etc.
Care of the Splints by the Nurse-
1. Padding- The splint should ,be well padded
at the bony prominences and at the injury
sites.
2. Bandage- This should be tied with optimum
pressure.
3. Exercises -Active exercises of the joints
and muscles should be permitted within
the splints.
4. Checking -Daily checking and adjustments
of the splints are recommended.
5. Neurovascular status- Distal neurovascular
status should be assessed daily.
NURSING CARE FOR PATIENTS TREATED
WITH SPLINTS
Nursing care assumes extreme importance
in patients treated with splints as most of
these patients are severely injured and are
bed ridden. This can be discussed under
two headings:-
A}-NURSING CARE BEFORE APPLICATION
OF THE SPLINT
Take consent.
Inform the patient about the procedure.
Remove any tight fitting clothes and change
them into easy to wear dresses.
Clean the affected part.
Select right sized splint.
Adequately pad the pressure points and the
perineum.
Apply the splint gently.
Check for the tightness of the weight cord.
After application check for the peripheral
pulses and nerve function.
Apply proper weight as per the directions of
the surgeon.
Foot end elevation may be required to give
the counter traction.
Note: Maximum permissible weight limits:--
a. Skin traction-4-5 kg
b. Skeletal traction-8.10 kg