BANDAGE.pptx

bandage

1. BANDAGE

2. CONTENT: INTRODUCTION. PURPOSE PRINCIPLE TYPES OF BANDAGE

3. DEFINATION Bandage is a strip of material used mainly to support or immobilize a part of the body. Bandage is a strip or roll of cloth or other material that may be bound around a part of the body in variety of ways to secure a dressing maintain pressure over a body part or immobilize a limb or other part of the body. Bandage are available in roll of various widths are materials, including gauze, elastic webbings, flannels and muslin.

4. BANDAGING The process of covering a wound or injured part using various material such as gauze, cotton, elasticized knit, flannel is known as bandaging. A simple gauze dressing is often not enough to immobilize or provide support to a wound. So, binder and bandages are applied around or over to provide extra protection and therapeutic benefits by creating pressure, supporting wound and immobilize body part.

5. PURPOSES: To support wound. To immobilize a fracture or dislocation and an injured part so as to relieve pain. To maintain direct pressure over a body part. To secure dressing. To retain warth.eg. A flannel bandage on a rheumatoid joint. To reduce swelling.

6. CONTD……….. To assist the patient in lifting and moving. To prevent contamination of a wound. To improve venous blood flow from lower extremities by applying pressure.

7. TYPES OF BANDAGE: Roller bandage Triangular bandage T. bandage Many tailed bandage

8. ARTICLES Bandage Padding Scissors Safety pin/ adhesive tape

9. TECHNIQUE OF APPLYING BANDAGES: ROLLER BANDAGE: A roller bandage is a strip of gauze or cotton material prepared in a roll. Roller bandages can be used to immobilize injured body parts and tom muscles. Provide pressure to control internal or external bleeding, absorb drainage and secure dressings. 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.

10. 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 area.

11. SIMPLE SPIRAL TRUNS: 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.

12. 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 is closed turn. If it is open turn, do not overlap the each turn. End the bandage with two circular turns and secure the end.

13. 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 drgee angle. Place the thumb at the free hand on the upper edge of the bandage.

14. CONTD……. Unroll the bandage around about 15 cm, then turns 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.

15. 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, alternative 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.

16. CONTD……. 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 bandage is used to cover the distal part of the body e.g. skull, stump of an amputation. It is also called capline bandage.

17. TRIANGULAR BANDAGING A triangular bandage is used as an arm sling or as a pad to control bleeding. It may also be used to support or immobilize an injury to a bone or joint or as improvised padding over a painful injury. A tubular gauze bandage is used to retain a dressing on a finger or toe. OR “The long side of the triangle is called the base”, the point opposite the base i s called the “apex”, and the points at each end of the base are called the “ends” or “extremities”.

18. TRIANGULAR BANDAGE A triangular bandage is a large triangle of cloth, usually a loose – weave cotton cloth used in first aid. It can be substitute with any kind of linen a piece of cloth shed, shirt scary or a big handkerchief, or a thin towel etc. in many an emergency this type of bandage has many application. It can be placed over a large wound to absorb blood and stop bleeding, functioning as a trauma pad. It can hold the trauma pad in place if first aid tape is not available.

19. CONTD…….. Two triangular bandage 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. If a victim has an injured arm a triangular bandage can bent position over the chest. A second cravat ( folded as a long band) can be used around the torso as a strip to immobilized 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 t tie the legs together firmy but not so tight as to restrict circulation.

20. CONTD…… In this case of a head wound, a triangular bandage can be wrapped over the forehead and around the top of head to cover the wound. Do not use bandage 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: there are used to support a hand in a well – raised position to control bleeding as to immobilize the upper limb if there is a broken collar bone or these are rib injuries.

21. Applying triangular bandages on hand and foot: Triangular bandage also be used on 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 center 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 surface knot.

22. 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 it’s place. Procedure : Told 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 hand. Bring the ends around each side of the head just above the ears.

23. CONTD….. 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 the hem of the bandage. Steady the head with one hand and with the other hand draw the point of the bandage downwards. Pill the point of the bandage over the crossed ends. Tie or pin in to the bandage on the top of the head.

24. 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 medical record if medical prescription for particular binder is required and reasons for application . Assist the patient to dorsal recumbent position. Have the patient raise hips and place horizontal band around waist with vertical tails extending past buttocks overlap waist band in front and secure with safety pin.

25. CONTD….. Single tail binder-bring the remaining vertical strip over perineal dressing and continue up and under to center of horizontal band. Bring the ends over the waist band and secure vertical and horizontal bands together with safety pin. Double tail binder bring the remaining vertical strips over perineal or supra public dressing with each tail supporting one side of penis. Continue drawings ends behind and then downward in front of horizontal band.

26. CONTD…… Secure all thickness with a pin. Assess comfort level with a patient in lying, sitting and standing positions. Readjust front pins as necessary. Increase padding if any area rubs against surrounding tissues. Instruct the patient regarding removal of bind defecating or urinating and need to replace bind afterwards. Record the procedure in nurses notes.

27. MANY TAILED BANDAGE 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.

28. CONTD…. 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 it 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, nearly fold them. Overlap the two top tails along a straight line and pin the place.

29. CONTD… 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.

30. Abdominal Binder / Large rectangular Procedure: Explain to the patient the procedure and the need for application of binder . Gather necessary data regarding the size of the patient and appropriate binder. Close curtains or the room door. Wash hands. Position the patient with the head slightly elevated and knees slightly flexed. Fan – fold for the side of the binder towards the middle of binder.

31. CONTD…. Instruct and assist the patient to roll away from you towards the raised side rail while firmly supporting abdominal incision and dressing with hands. Place fan – folded ends of binder under the patient. Instruct the patient to roll over folded ends. Unfold and stretch the ends out smoothly on the fail side of the bed. Instruct the patient to roll back into supine position. Adjust the binder so that the supine patient is centered over the binder using symphysis pubis and costal margins as lower and upper lands marks.

32. CONTD… Pull the distal end of the binder over the center of the patient’s abdomen. When maintaining tension on that end of the binder, pull the opposite ends of the binder over center and secure with velcro closer tabs or safety pins. Assess the patient’s ability to breathe deeply and cough effectively. Ask the patient about comfort level. Adjust the binder as necessary Record the procedure.

33. BREAST BINDER A breast binder looks like a tight fitting sleeveless vest and is used to apply pressure to the breast. Purpose : To provide support after surgery. To support breast for comfort in case of engorgement. To secure dressing. To compress breasts to help in suppression of lactation following fetal loss or neonatal death.

34. PROCEDURE: Review the medical record if a medical prescription for a particular bandage is required and reasons for application. Explain to the patient the procedure and the need for application of the binder. Assist the patient to supine position in the bed. Pad the area under the breasts if necessary. Place the binder under torso with the center of the binder at midline.

35. CONTD…. Bring the farther end over the patients breasts; take the near end and place over the line one. Using velcro closure tabs, secure the binder at the nipple level first. Continue closure process above and then below the nipple line until the entire binder is enclosed. Bring the shoulder straps over on either side of the front and fix to the upper border of the binder. Make appropriate adjustments including individualizing the lift of shoulder straps.

36. CONTD… Instruct and observe skill development in self – care related to reapplying a breast binder. Wash hand. Observe underlying skin for integrity circulation and characteristics of the wound and comfort level of the patient Record the application of the binder, condition of skin and circulation, integrity of dressing and comfort level key points in the use of binder are: Blinders are applied so that firm, even pressure exerted.

37. Binders should not impair neuromuscular or pulmonary functions. Wrinkled binders are uncomfortable and may cause tissue damage. Binders are secured so that there is no movement and friction against underlying skin surfaces. Pins or knots are placed away from wound edges or tender areas. Binders are applied with the body part in anatomical alignment and with joints in position of function.

38. The skin surfaces underneath a binder should be inspected are frequent. Binders that causes discomfort should be removed and reapplied. Talcum powder may be applied to skin surface. Soiled or moist binders may promote infection if applied over skin surface that are not intact.

39. Purpose of T riangle B andage: To support or immobilized parts of upper extremities. To limit the movement of upper extremly in presence of fracture, muscle strain and dislocation. To prevent dependent edema. To control pain. To promote rest. To aid healing.

40. Procedure : Assess the patient’s presenting condition. Observe the condition of the patient’s upper extremity of mobility, skin integrity. Assess pulses. Position the patient sitting or supine with forearms at angle with fingers higher than hand, the hand higher the wrist, and the wrist higher than the forearm, all the anatomically correct alignment.

41. CONTD.. Open the sling and place over the patient torso with binder centered under the arm. Place the longest side at the wrist and apex of triangle extending behind the arm at the elbow. Bring the lower binder point over the forearm and hand up to the neck on the affected side. Reassess the angle of the forearm and adjust the position needed.

42. Secure closure of sling at shoulder level on unaffected side using square not and fold remaining loose areas by binder around elbow and maintain fold and secure with safety pin. Apply padding as needed. The applied sling for adequancy of support inspect. Position of the lower arm above the level of the elbow and avoidance of pressure on the cervical vertebra. Wash hands.

43. Evaluate distal pulses, sensation of finger and condition of skin. Inspect alignment of the shoulder and extremity. Ask the patient regarding the level of comport and report the patient’s responses application of slings. Record alignment, circulation, sensation and skin integrity of affected extremity.

44. Applying T. Bandage on the head: The bandage is applied on the head to protect the scalp of the patient or to hold a dressing in the 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 eyebrows. The point of the bandage should hang down at the back of the head.

45. CONTD… Bring the ends around each 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 the ends forward around the head above the ears and the tie them on them on the forehead and the hem of the bandage. Steady the head with one hand and with the other hand draw the point of the bandage downwards. Pull the point of the bandage over the crossed ends tie or pin in to the bandage on the top of the head.

46. REEF 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 making a turn.

47. 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 does’t make discomfort.

48. CLOVE HITCH It is used in restraining the patient Make two blentical loops, loop A and B. Pass loop A in front of loop B. Apply it in the arm to be restrqined pad the loop enough while applying it. Tie the free end of the bandage to the bed.