BANDAGING

Bandaging is both a science and an art. The proper bandage, properly applied, can aid materially in the recovery of the patient. A carelessly or improperly applied bandage can cause discomfort to the patient and may imperil his life. Thus, it is important that enlisted men of the Medical Department should become familiar with the various bandages and be able to apply them properly. The following pages will aid the student and the teacher; but the art of bandaging can be mastered only by constant practice. USE OF BANDAGES Bandages are employed to hold dressings, to secure splints, to create pressure, to immobilize (make immovable) joints and in correcting deformity. Bandages should never be used directly over a wound. They should only be used over a dressing. To To To To To support fractured bones immobilize dislocated shoulder or jaw apply pressure, stop bleeding and improve venous blood flow secure dressing in place retain splints in place

PRINCIPLES AND PRCEDURES Wash hands(wear gloves when necessary) Assist to assume comfortable position on bed or chair and support the body part to be bandaged. Always stand in front of the part/victim to be bandaged except when applying a bandage to the head, eye and ear. Be sure the bandage is rolled firmly. Make sure the body part to be bandaged is clean and dry. Assess skin before applying bandage for any breakdown. Observe circulation by noting pulse, surface temperature, skin color and sensation of the body part to be wrapped. Always start bandaging from inner to outer aspect and far to near end. When bandaging a joint, ensure flexibility of the joint. (Except immobilization of joint is required) Always start and end with two circular turns. Cover the area 2 inches above and 2 inches below the affected area Overlap turns and slightly stretch the bandage. Cover 2/3 of the previous turn. Where possible, leave fingertips or toe tips exposed for observation(adequacy of blood circulation)

End the bandage on the outer side of the body. Do not end bandage on wound or at the back of the body.

TYPES OF BANDAGES 1. Triangular bandage -could be used on many parts of the body to support and immobilize. 2. Crape Bandage -type of woven gauze which has the quality of stretching. 3. Gauze/cotton bandage -lightly woven cotton material. Frequently used to retain dressings fingers, hands, toes, feet, ears, eyes, head. 4. Adhesive bandage -used to retain dressing and also used where application of pressure to an area is needed. METHODS OF APPLYING BANDAGES Circular Spiral Spiral Reverse Figure of Eight Recurrent

I. CIRCULAR TURN Purpose: Used chiefly to anchor bandages and to terminate bandages. Usually are not applied directly over a wound because of the discomfort the bandage would cause. 1. Hold the bandage in your dominant hand, keeping the roll uppermost, and unroll the bandage about 8cm. This length of unrolled bandage allows good control for placement and tension. 2. Apply the end of the bandage to the part of the body to be bandaged. Hold the end down with the thumb of the other hand. 3. Encircle the body part a few times or as often as needed, making sure that each layer overlaps -2/3 of the previous layer. This provides even support to the area. 4. The bandage should be firm, but not too tight. Ask the client if the bandage feels comfortable. A tight bandage can interfere with blood circulation, whereas a loose bandage does not provide an adequate protection. 5. Secure the end of the bandage with tape or a safety pin over an uninjured area. Pins can cause discomfort when situated over an injured area. II. SPIRAL TURNS

Purpose: Used to bandage parts of the body that are fairly uniform in circumference, for example, the upper arm or the upper leg. 1. Make two circular turns. Two circular turns anchor the bandage. 2. Continue spiral turns at about a 30 degree angle, each turn overlapping the proceeding one by 2/3 the width of the bandage. 3. Terminate the bandage with 2 circular turns and secure the end as described for circular turns. III. SPIRAL REVERSE TURNS Purposes: Used to bandage cylindrical parts of the body that are not uniform in circumference, for example, the lower leg or forearm. 1. Anchor the bandage with 2 circular turns, and bring the bandage upward at about a 30 degree angle. 2. Place the thumb of your free hand on the upper edge of the bandage. The thumb will hold the bandage while it is folded on itself. 3. Unroll the bandage about 15cm (6 inches), and then turn your hand so that the bandage falls over itself. 4. Continue the bandage around the limb, overlapping each previous turn by 2/3 the width of the bandage. Make the bandage turn at the same position on the limb so that the turns of the bandage will be aligned. 5. Terminate the bandage with 2 circular turns and secure the end as described for circular turns. IV. RECURRENT TURNS Purposes: Used to cover distal parts of the body, for example, the ends of a finger, the skull or the stump of an amputation. 1. Anchor the bandage with two circular turns,. 2. Fold the bandage back on itself, and bring it centrally over the distal end to be bandaged. 3. Holding it with the other hand, bring the bandage back over the end to the right of the center bandage but overlapping it 2/3 the width of the bandage. 4. Bring the bandage back to the left side, also overlapping the first turn by 2/3 the width of the bandage. 5. Continue this pattern of alternating right and left until the area is covered. Overlap the preceding turn by two-thirds the bandage width each time. 6. Terminate the bandage with two circular turns. Secure appropriately. V. FIGURE 8 TURNS

Purposes: Used to bandage an elbow, knee or ankle, because they may permit some movement after application. 1. Anchor the bandage with two circular turns. 2. Carry the bandage above the joint, around it and below it, making a figure eight. 3. Continue above and below the joint, overlapping the previous turn by two-thirds the width of the bandage. 4. Terminate the bandage and above the joint with two circular turns and then secure appropriately. TRIANGULAR AND CRAVAT BANDAGES The triangular bandage, also known as the handkerchief bandage, is used for the temporary or permanent dressing of wounds, fractures, dislocations, etc., and for slings. It is very valuable in first-aid work since it is quickly and easily applied, stays on well, and can be improvised from any kind of cloth, such as a piece of a shirt, an old sheet, a large handkerchief, etc. Unbleached muslin is generally used in making triangular bandages, although linen, wool, silk; etc., will answer the purpose. In making triangular bandages 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 bandages. 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." These bandages may be used either as a triangle or as a cravat, the latter being made from the triangle by bringing the apex to the base and folding it upon itself a sufficient number of times to obtain the width desired. The names of the-various triangular and cravat bandages indicate the part of the body to which the bandage is applied. PROCEDURES I. TRIANGLE OF FOREHEAD OR SCALP (fronto-occipital) - Used to retain dressings on the forehead or scalp. 1. Place middle of base of triangle so that edge is just above eyebrows and bring apex backward, allowing it to drop over back of head (occiput). 2. Bring ends of triangle around to back of head, above ears, and cross them over apex at occiput. 3. Carry ends around to forehead and tie them in square knot. 4. Turn up apex of bandage toward top of head. Pin with safety pin or tuck in behind crossed part of bandage. II. TRIANGULAR ARM SLING (brachio-cervical triangle) -Used for fractures or injuries of hand, wrist, and forearm. 1. Arm to be put in sling should first be bent at elbow so that little finger is about a hand's breadth above level of elbow.

2. Drop one end of triangle over shoulder on injured side and let bandage hang down over chest with base toward hand and apex toward elbow. 3. Slip bandage between body and arm. Carry lower end up over shoulder on injured side. 4. Tie the two ends, by square knot, at back of neck. Knot should be on either side of neck, not in middle, where it could cause discomfort when patient is lying on back. 5. Draw apex of bandage toward elbow until snug, bring it around elbow to front, and fasten with safety pin or adhesive tape. III. TRIANGULAR ARM SLING Another version of this sling is frequently used where it is desirable to support the forearm, without pressure on the collarbone or shoulder of the injured side. 2. Start as in (1). 3. and pass lower end of bandage under injured shoulder. Ends of fingers should extend slightly beyond base of triangle. 4. Tie ends. Secure apex to sling at elbow by tucking in or with safety pin. IV. SHOULDER-ARMPIT (bis-axillary) Used to hold dressings in the armpit (axilla) or on the shoulder. 1. Place middle of cravat in armpit over dressing. 2. Carry ends upward and over top of shoulder. 3. Cross ends lnd bring them across back and chest respectively to opposite armpit where they are tied. V. TRIANGLE OF CHEST OR BACK Used to retain dressings on burns or wounds. 1. Drop apex of triangle over shoulder on injured side. Bring bandage down over chest (or back) to cover dressing and so that middle of base of bandage is directly below injury. Turn up a cuff at base. 2. Carry ends around body and tie in square knot. 3. Bring apex down and tie to one of ends of first knot. VI. TRIANGLE OF SHOULDER Used to retain dressings on shoulder. Requires two bandages, one a triangle, and the other a cravat. 1. Place center of cravat at base of neck on injured side, and tie just forward of opposite armpit. 2. Place apex of open triangle under cravat at base of neck and over dressing on injured shoulder and upper arm. 3. Tuck apex under cravat at neck. 4. Cross ends of base and tie around arm; secure apex to cravat at neck by tucking in 6r with safety pin.

VII. TRIANGLE OF FOOT Used to retain dressings of considerable size on the foot. 1. Center foot upon bandage at right angles to base. Heel should be well forward. 2. Carry apex of triangle over toes, and cover back of foot to ankle. 3. Tuck excess fullness of bandage into small pleats on both sides of foot. 4. Cross each half of bandage toward opposite sides of ankle. Bring ends of triangle around ankle. Tie ends in square knots. VIII. TRIANGLE OF HAND Used to retain dressings of considerable size on the hand. 1. Place middle of base of triangle well up on palmar surface of wrist. 2. Carry apex around ends of fingers and cover back (dorsum) of hand to wrist. 3. Tuck excess fullness of bandage into small pleats on both sides of fingers. 4. Cross each half of bandage toward opposite sides of wrist. 5. Bring ends of triangle around wrist. 6. Tie ends in square knot. FOLDING TRIANGULAR BANDAGES for storage and shipment 1. Bandage unfolded. 2. Fold once left to right. 3. Fold ends right to left. 4. Fold apex down to form square. 5. Fold in half, right to left. 6. Fold down through center