BANDAGING

 It is the process of covering a wound or an injured part

General use:

 To prevent contamination of wound by holding dressings in position.

 To provide support to the part that is injured or sprained.
 To provide rest to the part that is injured.
 To prevent and control hemorrhage.
 To maintain pressure

Dressing

= used to cover wounds, prevent contamination and control bleeding. In providing first aid we
commonly used self-adhesive dressings or gauze dressings :

• Adhesive dressings - used mainly for small wounds. They come in many different sizes,
including specific types for placement on fingertips.

• Gauze dressings - thick, cotton pads used to cover larger wounds. They are held in place
with tape or by wrapping with a gauze strip (bandage). Dressings must be sterile and absorbent
to deter the growth of bacteria, and should be left in place until the wound heals, unless it
needs to be regularly cleaned.

Bandage

= a piece of material used either to covering wounds, to keep dressings in place, to applying
pressure controlling bleeding, to support a medical device such as a splint, or on its own to
provide support to the body.

Three Types of Bandages:

1. Roller Bandage

= Used to support limbs, secure dressings and by applying pressure, to control bleeding. It is
available in three types:

 Cotton or linen roller bandages - used to cover gauze dressings. They come in many
different widths and are held in place with tape, clips or pins.

 Elastic roller bandage - used to apply support to a strain or sprain and is wrapped
around the joint or limb many times. It should be applied firmly, but not tightly enough
to reduce circulation.
 *The tip of the roller bandage is called the ‘tail’ and the rolled up part the ‘head’.

Correct size bandages (adults):

 Hand and fingers – 2.5 to 5 cm

 Lower arm, elbow, hand and foot – 7.5cm
 Upper arm, knee and lower leg – 10cm
 Large leg or trunk – 15cm

The key points when applying a bandage are:

 make sure the person is comfortable and tell them what you're doing
 work from the side of the injury so you do not have to lean across their body
 keep the injured part of the body supported in the position it'll be in when the bandage
is on
 use the right size bandage – different parts of the body need different widths of
bandage
 avoid covering fingers or toes when bandaging a limb so you can easily check the
circulation
 apply the bandage firmly, but not tightly, and secure the end by folding it over and tying
a knot in the end. You can also use a safety pin, tape or a bandage clip
 as soon as the bandage is on, ask if it feels too tight and check the circulation by
pressing on a fingernail or a piece of skin until it turns pale. If the colour does not return
straight away, the bandage may be too tight, so you should loosen it. Limbs can swell
up after an injury, so check the circulation every 10 minutes after you have put the
bandage on.

Methods of Applying Roller Bandage

 Circular - used to hold dressings on body parts such as arms, legs, chest or
abdomen or for starting others bandaging techiques or to cover a confined area of
an extremity. applicable in the case of small wounds. Circular bandaging is applied
only in the affected area. For circular bandage we used strips of cloth or gauze roller
bandage.

Application:
 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 turn directly covering the
pervious turn.
 Secure the end of the bandage with tape, metal clips or a safety pin over an uninjured
area.

 Spiral - used for cylindrical parts of the body. An elasticated bandage can also be
used to apply spiral bandaging to a tapered (to become progressively smaller toward
 one end) body part. Despite the increasing diameter of the body part, the elasticity
will allow the bandage to fit closely to the skin.

Application:
 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.

 Reverse Spiral - a spiral bandage where the bandage is folded back on itself by
180° after each turn. This V-shaped fold allows the bandage to fit to the tapered
shape of the body part all the way along.

Application:
 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 - involves two turns, with the strips of bandage crossing each other
at the side where the joint flexes or extends. It is usually used to bind a flexing joint
or body part below and above the joint.
Application:
 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.

 Recurrent - used for blunt (having a flat or rounded end) body parts consists partly
of recurrent turns. The bandage is applied repeatedly from one side across the top
to the other side of the blunt body part. To be able to fix the recurrent turns well,
not only the wound, but the entire length of the blunt body part should be covered.
Depending on the width of the bandage and the body part, successive turns either
cover the preceding turn fully or partially.

Application:
 Begin by holding the end of the bandage is place with one circular turn.
 Then, bring the roll down over the end of the body part and back up behind.
 When used on the head, the circular turn made and then turns are made over and back
across the top of the head.
 Subsequent turns are folded alternately to the right and left of the initial center fold.
 Keep your fingers in place at the top to secure the bandage until a circular turn or two
can be made to complete the bandage. Clip or tape in place.

2. Tubular Bandage

= made of seamless tubular fabric, are useful for holding dressings in place, but are cannot be
used to control bleeding because they do not exert sufficient pressure. There are two types:

= using the tubular bandage applicator is quite straightforward. Slide the tubular bandage on
the outside of the applicator then slip it over the body part you wish to apply the bandage. Pull
off one end of the bandage while releasing it slowly until the end. Double it on the applied area
to finish where you started.

 Tubular gauze for covering a finger or toe (comes with an applicator).

 Tubular elasticated bandage for supporting injured joints.

3. Triangular bandage

= can be broad-folded, narrow-folded or it can also be opened and used as a scalp bandage or
to form a sling.

 Broad-folded
= used to immobilize and support an injured limb, secure a dressing or stabilize a splint.
To make a broad-fold bandage.

 Open out the bandage and place it on flat, dry and clean surface.
 Fold the bandage horizontally in half, so that the point touches the centre of the
base.
 Fold the bandage horizontally in half again.

Application:

 Place the center of the bandage on the elbow .

 Move each end of the bandage opposite each other.
 One end goes away and the other towards the patient. As you roll the bandage, slightly
overlap each side.
 Continue the movement till you reach the forearm on one end the biceps on the other
end.
 Advice the patient to bend the elbows and bring the two points together.
 Lock the end points by making a square knot.
 You may apply an arm sling using a cravat to support the elbow bandage application.
  Narrow-fold bandage
= used to immobilize and support a foot or ankle, or to secure dressing. To make a
narrow-fold bandage:
 Open out the bandage and place it on a flat, dry and clean surface.
 Fold the bandage horizontally in half, so that the point touches the centre of the
base.
 Fold the bandage horizontally in half again.
 Fold the bandage horizontally in half again.

Methods of Triangular Bandage Application:

 Scalp bandage
= used to apply pressure to control hemorrhage from wounds of scalp, or to hold
dressings on wounds of ear or lower scalp.

 Ensure the casualty is sitting down and the necessary dressing has been applied
to the scalp wound.
 After folding a hem along tis base, place the bandage (hem side down
) on the casualty’s head.
 Grasp the two end ‘tails’, cross them over one another, bring them round to the
casualty’s forehead and tie them together.
 Take the other loose end up and secure on top of the casualty’s head.

 Arm sling
= used to support an injured upper limb and to immobilize an arm if the casualty has
chest injury. It supports the arm horizontally.

Application:
 Ask the casualty to support their arm with their other hand. Gently slide the
triangular bandage underneath the arm. The point of the triangle should be
underneath the elbow of the injured arm. Bring the top end of the bandage
around the back of the neck.
 Fold the lower end of the bandage up over the forearm to meet the top of the
bandage at the shoulder of the injured side.
 Tie the two ends of the bandage together in a reef knot above their collar bone
and tuck in the free ends.
  Adjust the sling so that it supports their arm all the way to the end of their little
finger.
 Make sure that the edge of the bandage by the elbow is secured by twisting the
fabric and tucking it in, or using a safety pin to fasten.
 Check the circulation in their fingertips every 10 minutes. Press their nail for 5
seconds until it turns pale, then release to see if the colour returns within 2
seconds.

If a triangular banadage is not available it is possible to improvise an arm sling using

either a buttoned up jacket or an unzipped jacket.
 Jacket with buttons: place the hand of the inujured limb in the between the
buttons. The hand will then rest on the lower button.

 Jacket with zip: unzip the jacket and fold up the jacket over the injured arm and
secure it with a safety pin to the top of the jacket.

 Elevation sling
= this type of sling supports the forearm and hand in a raised position, with the
fingertips touching the casualty’s shoulder. This sling can help to control bleeding and
minimise swelling in the forearm or hand.
= used to support an injured limb, and at the same time help reduce pain, swelling and
the bleeding.
Application:

 Ask the casualty to support their injured arm, across the chest, with their fingers resting
on the opposite shoulder.
 Lay the triangular bandage over their chest, on top of the injured arm, with one end
over their uninjured shoulder. Hold the point of the bandage just below the elbow on
the injured side.
 Tuck the lower part of the bandage underneath the injured arm. Bring it diagonally
across their back to meet the other end of the bandage at their shoulder.
 Tie the two ends of the bandage together in a reef knot above their collar bone and tuck
in the free ends.
 Make sure that the edge of the bandage by the elbow is secured by twisting the fabric
and tucking it in, or using a safety pin to fasten.
 Check the circulation in their thumb every 10 minutes. If it’s too tight, then loosen the
sling and readjust.

Generalizations:

= Bandages can be used to secure dressings, control bleeding, immobilize and support limbs
and to reduce swelling.