SAINT PAUL

ILOI
FUNDAMENTALS OF NURSING

1A bandaging UNIVERSITY OF
Puncture
BANDAGING
TOPIC OUTLINE
1 EMERGENCY ACTION PRINCIPLES
2 SOFT TISSUE INJURIES
3 BURNS
4 FIRST AID
5 PREVENTION AND PROTECTION
6 BANDAGE
7 DRESSING
8 CLOSED CRAVAT
9 IMMOBILIZATION
10 BANDAGING TECHNIQUES
Abrasion
EMERGENCY ACTION PRINCIPLES
Getting started:
Plan of action
Gathering of needed materials
Remembering AID as initial response:
Ask for help
Intervene
Do no further harm

SOFT TISSUE INJURIES

an injury to the body that involves a break in the
continuity of tissues or of body structures either internal
or external; Caused by either blunt or penetrating trauma. Laceration
Two Classification of wound:
1 Closed wound - the soft tissue damage occurs
beneath the surface of the skin, leaving the outer
layer intact such as contusion, and crushing
injuries.

Avulsion

Signs and symptoms:

Pain
Swelling
Discoloration
Vomiting or coughing up of blood
Passage of blood in urine or feces
Sign of blood along mouth, nose and ear canal
Restlessness and symptoms of Shock
(Fainting) First Aid Management: “4 C’S”
First Aid Management: “CS” Control bleeding- RICE (Rest, Ice, Compress,
Cold application and Elevate)
Splinting Cover the wound with dressing and secure
2 Open wound with a bandage
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Care the dressing in place.
for Shock/Fainting: 3 P’s (Proper body Types
position- feet elevated above the level of the Simple A bandage strip which has sticking end;
heart, Proper body heat, and Proper transfer) Band-Aid but antiseptic at center. This center
Consult Physician portion is placed over
wound to be treated and sticking ends of
BURNS this bandage prevent slipping of bandage
is an injury involving the skin, muscles, bones, nerves, from place.
and blood vessels. This results from heat, chemicals,
electricity and other forms of radiation.
Depth:
1st Degree/ Superficial tissue destruction
involving epidermis only.
2nd Degree/Partial involves epidermis and
thickness part of dermis.
3rd Degree/Full thickness involves epidermis,
dermis, and underlying
Butterfly Wider wings portion on lateral sides and
organs.
bandage thin portion at center, to which wings are
SECOND DEGREE BURN attached. Similar something is with
butterfly bandage, which is thin at center
but contains no medicated antiseptic aid
at center, but sticky lateral ends.
(Applied to prevent wound gapping)

FIRST AID
Is an immediate help provided to a sick or injured person Donut Used in case of puncture wounds,
until professional medical help arrives or becomes bandage wherein a foreign object has entered
available. inside puncture wound
Objectives of First Aid (Impaled); for expulsion of which this
Preserve life. donut bandage is applied. Center hole of
Prevent further harm and complications. this bandage should come over or
Seek immediate medical help. encircle punctured wound and adhesive
Provide reassurance. tape is applied on sides of this bandage
for sticking purpose.
PREVENTION AND PROTECTION
Universal Precautions are a set of strategies developed to
prevent transmission of blood borne pathogens
Body Substance Isolation (BSI) are precautions taken to
isolate or prevent risk of exposure
from body secretions and any other type of body
substance such as urine, vomit, feces, sweat, or
sputum.
Personal Protective Equipment (PPE) is specialized
clothing, equipment and supplies that keep you from Triangular Also known as a cravat bandage, a
directly contacting infected materials. bandage triangular bandage is a piece of cloth put
into a right-angled triangle. It can be
BANDAGE used fully unrolled as a sling, folded as a
is a piece of material used either to support a medical normal bandage, or for specialized
device such as a dressing or splint, or on its own to applications, as on
provide support to or to restrict the movement of a part of the head.
the body. When used with a dressing, the dressing is
applied directly on a wound, and a bandage used to hold
 BANDAGING
painful or necrotic wounds, or are
pressure ulcers or donor sites.
Hydrogel can also be used for
second-degree burns and infected
wounds. The cooling gel makes
them effective at reducing pain and
speeding up the healing process.

Elastic Is a stretchable bandage used to create

bandage localized pressure. The elastic bandage is
then applied to hold the splint in place
and to protect it.

Alginate Provides effective protection for

DRESSING
is a sterile pad applied to a wound to promote healing and
protect the wound from further
harm. A dressing is designed to be in direct contact with
the skin, as distinguished from a bandage, which is most
often used to hold a dressing in place.
Types
Hydrocolloid Used on burns, wounds that are
dressings emitting liquid, necrotic wounds,
pressure ulcers, and venous ulcers.
These are non-breathable self-
adhesive dressings that creates
moist conditions which help to heal
certain wounds; the surface is
coated with a substance which
contains polysaccharides and other
polymers which absorb water and
form a gel, keeping the wound
clean, protecting it from infection,
and helping it to heal more quickly.
Dressings wounds that have high amounts of
drainage, and burns, venous ulcers,
packing wounds, and higher state
pressure ulcers. It absorbs excess
liquid and create a gel that helps
heal the wound or burn more
quickly. Containing sodium and
seaweed fibers, these dressings are
able
to absorb high amounts of fluid,
plus they are biodegradable after
use.
Cloth Dressings Most commonly used dressing,
often used to protect open wounds
or areas of broken skin. They are
suitable for minor injuries such as
grazes, cuts or areas of delicate
skin.These dressings come in all
shapes and sizes, from small
coverings for fingers to larger ones
for wounds across wider areas of
the body. As well as pre-cut
dressings, these also come in a roll
option that is made to be cut to size.

Hydrogel Used for a range of wounds that are

leaking little or no fluid, and are
 BANDAGING
8 Pull the apex of the triangular bandage, then fold
and tuck

BANDAGING TECHNIQUES (TRIANGULAR

BANDAGE)

GENERAL RULES FOR APPLYING BANDAGES

1 Expose the limb to be bandaged. The limb should
be as dry and clean as possible
2 Position the body part to be bandaged in a normal
resting position (position of function). CHEST BANDAGE (ANTERIOR & POSTERIOR)
3 Check the circulation, motor and sensory function - Injury on the anterior or posterior chest
distal to where the bandage will be applied. 1 Place the apex of the bandage resting on the
4 Choose the appropriately sized and type of shoulder at the side of the affected area
bandage. Roller bandages range from 1/2 inch to 6 2 Allow the base to roll parallel to the ground just in
inches in width. The wider widths are used for the line with the xiphoid process
larger body parts. The 2-inch roller bandage is 3 Fold about 2 inches outward along the base
primarily used for the hand. The 3-inch roller 4 Carry both ends firmly around the posterior chest
bandage is used for the forearm, lower leg, and and tie a square knot at the back
foot. The 4-inch and 6-inch roller bandages are 5 Bring one end up to the shoulder where the apex is
used for the thigh and chest and tie a square knot
5 Pad bony areas and/or between skin surfaces (such 6 Fold the sides of the triangular bandage outward
as between fingers) that will be covered by the
roller bandage.
6 Apply the roller bandage. A roller bandage applied
to a limb is normally applied beginning with the
most distal point to be wrapped. The roller bandage
is normally secured with an anchor
wrap at the beginning and with a circular wrap at
the end.
7 Tape, clip, or tie the end of the bandage in a
position that is easy to reach.
8 Check the circulation below the wrapping. If the
wrapping is interfering with the casualty's
circulation, loosen the roller bandage and apply it
again.

PROCEDURE HAND OR FOOT BANDAGE

OPEN CRAVAT PHASE
- Injury on top of the head (Parietal Area)
1 Using a dry or moist triangular bandage
(Depending on the injury & medical protocols)
2 Fold and inch of the base twice
3 Put the bandage on the victim’s head just above the
eyebrows
4 Cross both ends of the triangular bandage on the
back of the head
5 With the apex of the triangular bandage on the
bottom of or tucked in the crossing
6 Tie a square knot on the forehead over the folded
area
7 Tuck loose ends
- Injury or burn injuries on the hand and foot
1 Place the hand (Palmar Surface) in the middle of
the triangular bandage with the wrist at the base
2 Place the apex over the fingers towards the wrist
passing the dorsal surface of the hand
3 Cross the ends on top of the wrist and tie with a
square knot
4 Pull the apex of the triangular bandage, then fold
and tuck
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CLOSED CRAVAT (BROAD OR SEMI BROAD) FOREARM OR KNEE BANDAGE

FOREHEAD BANDAGE
- Injury over the forehead
1 Place the center of the cravat over the pressure
dressing or injury covering the wound
2 Carry the ends around the posterior head and cross
both ends
3 Bring the ends back to the starting point
(Forehead) and tie the using a square knot.
- Injury over the ear, cheek, and jaw
1 Place center of cravat over the pressure dressing or
injured area
2 Begin spiral turns over the lower end and
descending flaps with the upper end, with each
turn covering two third of the preceding turn until
dressing is covered
3 Terminate by tying both ends in square knot

SHOULDER OR HIP BANDAGE

1 Start at the armpit, roll both upper and lower ends
2 Cross- over at the injured shoulder
3 Tie using a square knot at the opposite armpit
EYE BANDAGE
- Injury over the eye
1 Place the center of the cravat over the pressure
dressing or injury covering the wound
2 Carry the ends around the posterior head and cross
both ends
3 Bring the ends back to the starting point (Eye) and
tie the using a square knot of the affected eye.

IMMOBILIZATION

ARM SLING
- Broken forearm bone (Radius or Ulna)
1 Place outward folded base vertically with the apex
positioned over the elbow of the affected arm
EAR, CHEEK & JAW BANDAGE
2 Pull both ends around the neck and tie using a
- Injury over the ear, cheek, and jaw square knot (Don’t be too tight)
1 Start with the middle of the cravat over the 3 Make several twist or make a simple knot with the
pressure dressing covering the ear, cheek, and jaw apex
2 Carry one end over the top of the head and the 4 Hide the knot
other end under the chin
5 Check skin color, temperature, and condition
3 Cross the ends at the opposite side of the injured
area
4 Bring one end around the forehead and the other
around the back of the head
5 Tie using a square knot over the pressure dressing
or injured area
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7 Carry the roll around the limb and back. The
bandage should be at about the same location as
the half-twist, but higher.
8 Continue applying the bandage using the spiral
reverse technique. The turns should be in line and
uniform as shown in figure.
9 When you reach the top of the area to be
bandaged, secure the bandage with a circular
wrap.
10 Tape, clip, or tie the end of the bandage (see
figure.

BANDAGING TECHNIQUES (ELASTIC BANDAGE)

SPIRAL WRAP(OPEN AND CLOSED)

- used to cover the forearm, upper arm, calf, or
thigh. It is not used to cover elbows, knees,
fingers, or toes
1 Apply an anchor wrap.
2 Wrap the limb in a spiral manner. On each turn,
overlap about one-third of the previous turn. Keep
the bandage tight enough to apply pressure to the
limb, but not tight enough to impair blood
circulation.
3 Continue wrapping until the entire portion of the FIGURE OF EIGHT WRAP
limb has been wrapped. - Used to limit joint movement of the hand,
4 Secure the bandage with a circular wrap. elbow, knee, ankle, or foot. Figure 6-6 shows
a figure-eight wrap applied to a hand.
5 Tape, clip, or tie the end of the bandage.
1 Apply padding (usually gauze applied between
the fingers or toes, around bony areas, and/or in
hollow areas).
2 Apply an anchor wrap below the joint
3 Bring the roller bandage up diagonally and across
the joint (wrist).
4 Wrap the roller bandage around the limb above
the joint.
5 Bring the roller bandage down across the joint
diagonally so that it crosses the upward portion of
the figure-eight wrap.
6 Take the roll behind the body part (fingers) and
up diagonally across the joint again.
SPIRAL REVERSE WRAP Overlap two-thirds of the previous upward wrap.
- Used to apply pressure to a limb, the spiral 7 Take the roll behind the body part (wrist area) and
reverse wrap can also be used. It is especially down again diagonally, overlapping the previous
useful when applying pressure to the calf downward wrap.
(lower leg) since it follows the contours of the 8 Continue alternate upward and downward
limb more closely than does the spiral wrap. diagonal wraps until the joint is sufficiently
1 Secure the bandage at the ankle with an anchor supported.
wrap. 9 Apply a circular wrap above the joint.
2 Apply about four spiral turns. 10 Tape, clip, or tie the end of the bandage.
3 Place the thumb of your free hand on the upper
edge of the uppermost turn and apply firm
pressure to hold the bandage in place.
4 Unwind about six inches of bandage from the roll.
5 Give the roll a half-twist so the bandage is
directed downward. The upper edge of the turn
should be parallel to the lower edge of the
previous turn and overlap it by two-thirds of its
width.
6 The wrap continues in the same direction (figure RECURRENT WRAP
shows counterclockwise).
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-
Used for a stump (amputated limb), finger, or
hand.
1 Apply an anchor wrap above the stump.
2 Bring the bandage down diagonally across the
front of the limb and around the stump, encasing
the edge of the dressing. Hold the bandage in
back so it will not slip.
3 Bring the bandage to the front.
4 Move diagonally up across the front of the limb,
forming an "X" pattern with the downward
diagonal.
5 Encircle the "X" pattern at the anchor point with
one complete turn.
6 Form the first recurrent (running back to the
source). Put your thumb on the top of the bandage
to keep it in place, make a fold, bring the bandage
down, over the far side of the dressing, and up the
back. Hold the dressing in place on the back of
the limb with your index finger.
7 Form the second recurrent. Make a fold at the
back and bring the bandage down, over the
opposite side of the dressing, and up the front.
8 Form the third recurrent. Make a fold at the front,
then bring the bandage down over the center of
the dressing and up the back.
9 Lock the recurrents in place with a complete turn
3 to 4 inches from the bottom of the stump (below
the anchor wrap).

10 Move diagonally across the stump from the

locking turn encasing the edges of the
recurrents; then move back diagonally forming
another "X" pattern
11 Overlap the "X" pattern with half the width of the
bandage (circular turn).
12 Tape, clip, or tie the end of the bandage.