Bandages and Binders [Autosaved].pptx

FIRST AID: NURSING FOUNDATION

1. Bandages and Binders

2. BANDAGES AND BINDERS A bandage is a piece of material used either to support a medical device such as a dressing or splint, or on its own to provide support to or to restrict the movement of a part of the body.  When used with a dressing, the dressing is applied directly on a wound, and a bandage used to hold the dressing in place. 

3. The Three Major Types Of Bandages Are: Roller Bandages, Tubular Bandages and Triangular Bandages. They are needy for: • Covering Wounds, • Applying Pressure Controlling Bleeding, OR • Supporting to Strain or Sprain.

4. There is a Specific Bandege Made for Each of These Tasks. Roller Bandages Roller Bandages are Long Strips of Material. Basically there a re t wo t ypes of Roller Bandages: • An Elastic Roller Bandage i s used to apply s upport t o a Strain or Sprain and i s wrapped around t he Joint Or Limb many t imes. It s hould be applied f irmly, but not tightly e nough to reduce c irculation. • Cotton or Linen Roller Bandages are used to cover gauze Dressings. They come in many different widths and are held in place tape, or pins clips. They can also b e u sed f or Wound Compression if n ecessary, as t hey a re typically s terile

5. 2. Tubular bandages Tubular bandages are used on fingers and toes because those areas are difficult to bandage with gauze .   They can also be used to keep dressings in place on parts of the body with lots of movement, such as the elbow or knee. 

6. 3. Triangular bandages Triangular bandages are made of cotton or disposable paper.  They have a variety of uses: • When opened up, they make slings to support, elevate or immobilize upper limbs.  This may be necessary with a broken bone or a strain, or to protect a limb after an operation.  • Folded narrowly, a triangular bandage becomes a cold compress that can help reduce swelling. They are used also foe applying pressure to a wound to control bleeding

7. Wrapping of Bandages TYPE OF APPLICATION: Figure E ight DESCRIPTION Overlapping application alternating with ascending and descending wrapping with each pass of the bandage crossing over previous wrapping, as in a figure eight.   USES Stabilizes joints, such as wrist or ankle, and helps maintain immobilization. 

8. Spiral bandaging Wrapping a limb in ascending path, partially covering previous wrapping while moving up the limb.  Uses : Promotes venous return. Effective when a bandage needs to be applied around an arm, leg, or wrist.  May be used to hold dressings in place. 

9. Spiral Reverse Similar to spiral, except the bandage is folded back (distally) halfway through each pass.  The appearance a basket weave is produced. Uses : May hold better on arms, legs, thighs (extremities that are wider at one end than the other-cone shape) than spiral alone.  Promotes venous return.  Holds dressings in place.

10. Circular Wrapping with continuous application in the same place, such as a wrist.   Uses : Stabilizes ankle, wrist, fingers, and toes.  Binds amputation stump in preparation for prosthesis fitting.  Holds dressings on the head. 

11. Recurrent Anchored at the top with several spiral wraps, then back and forth across the end of the extremity or head.  Finish with spiral reverse or figure eight.  Uses : Binds amputation stump in preparation for prosthesis fitting.  Holds dressings on the head. 

12. BASIC BANDAGING FORMS Each bandaging technique consists of various basic forms of bandaging.  The following five basic forms of bandaging can be used to apply most types of bandages: Circular Bandaging Circular bandaging is used to hold dressings on body parts such as arms, legs, chest or abdomen or for starting other bandaging techiques .  For circular bandage we used strips of cloth or gauze roller bandage or triangular bandage folded down to form strip of bandage (cravat).

13. In the c ircular b andaging t echnique the layers of bandage a re applied o ver t he t op of each o ther :. With the Roll On The Inner Aspect, Unroll The Bandage Either toward y ou or l iteraly , holding the l oose e nd u ntil i t is s ecured by the f irst c ircle of the Bandage. Two or Three turns m ay b e n eeded to cover an area adequately hold t he b andage in place with t ape or clip. Almost a ll b andaging techniques start and end with a few c ircular b andaging t urns.

14. 2. Spiral Bandaging Spiral bandages are usually used for cylindrical parts of the body.  An elasticated bandage can also be used to apply spiral bandaging to a tapered body part.  Despite the increasing diameter of the body part, the elasticity will allow the bandage to fit closely to the skin.  With each spiral turn, part of the preceding turn is generally covered by 1/3 of the width of the bandage.   

15. 3. Figure-Of-Eight Bandaging Figure-of-eight bandage 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.  The figure - of - eight bandage can be applied using a roller bandage in two ways: Following a circular turn around the middle of the joint, the bandage should fan out upwards and downwards. 

16. The turns should cross at the side where the limb flexes.  • The figure-of-eight turns can also be applied from a starting point located below or above the joint crease, working towards the joint itself.  The cross-over points will be located at either the flexing or extending side of the joint;  the side where the turns do not cross remains uncovered. 

17. 4. Recurrent Bandaging Recurrent bandaging is used for blunt 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 recurring 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 successively turns either cover the preceding turn fully or partially.

18. 5. Reverse Spiral Bandage Reverse spiral bandage is 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.  This type of bandaging is required when using non-elasticated bandages.  The development of elasticated fixing bandages, which are applied to tapered body parts using the spiral technique, means that the reverse spiral technique is far less commonly used nowadays. 

19. APPLICATION ROLLER BANDAGES Select the appropriate bandage material for the injury.  Use gauze or a flex roller for bleeding injuries of the forearm, upper arm, thigh, and lower leg Use a flexible roller bandage for bleeding injuries of the hand,wrist,elbow,shoulder,knee,ankle,and foot.  

20. -Use an elastic roller bandage for amputations, arterial bleeding and sprains.  -It is best to use a bandage with some degree of stretch in the weave.  This will make the bandage easy to use and more likely to stay in place for many hours.  -However, the correct application technique is essential to provide comfort and adequate support for the affected part. 

21. Select the appropriate width of bandage The width of the bandage to use is determined by the size of the part to be covered.  As a general guide, the following widths are recommended: -Hand and fingers - 50 mm -Lower arm, elbow, hand and foot - 75 mm. -Upper arm, knee and lower leg - 100 mm.  -Large leg or trunk - 150 mm. 

22. Prepare the patient for bandaging Position the body part to be bandaged in a normal resting position (position of function), Ensure that the body part that is to be bandaged is clean and dry. Apply the anchor wrap .  - Lay the bandage end at an angle across the area to be bandaged.  -Bring the bandage under the area, back to the starting point, and make a second turn.  -Fold the uncovered triangle of the bandage end back over the second turn.

23. Cover the triangle with a third turn ,completing the anchor. - Use a circular wrap to end other bandage patterns, such as a pressure bandage, or to cover small dressings(A) - Use a spiral wrap for a large cylindrical area such as a forearm, upper arm, calf, or thigh.  The spiral wrap is used to cover an area larger than a circular wrap can cover (B).  -Use a spiral reverse wrap to cover small to large conical areas, for example, from ankle to knee.(C)

24. - Use a figure eight wrap to support or limit joint movement at the hand, elbow, knee, ankle, or foot (D).  - Use a spica wrap (same as the figure eight wrap) to cover a much larger area such as the hip or shoulder.  - Use a recurring wrap for anchoring a dressing on fingers, the head, or on a stump (E). 

25. Check the circulation after application of the bandage.  Check the pulse distal to the injury.  Blanch the fingernail or toenail, if applicable.  - Inspect the skin below the bandaging for discoloration.  - Ask the patient if any numbness, coldness, or tingling sensations are felt in the bandaged part.  Remove and reapply the bandage, if necessary.

26. Elevate the injured extremities To reduce swelling (edema) and control bleeding, if appropriate.  Donut Bandage The Donut Bandage is used to put pressure around an impaled object without putting pressure on the object itself. 

27. BINDERS A binder is a wide, flat piece of fabric that is applied to support a specific body part or to hold a dressing in place.  Commonly used binders include the arm sling and the T-binder, a T-shaped strap.  Some binders are made of elasticized material.  Most use hook-and-loop fasteners (Velcro). 

28. Applying A Binder Wash the hands before and after applying or adjusting a binder Use Standard Precautions.  If the client's skin is intact, gloves are not necessary.  • Be sure the binder is a size appropriate for the client.  Rationale: Using an incorrect size will not be effective and may cause damage.  • Apply the binder firmly enough to give support but not too tightly Rationale: If the dressing is not applied firmly in place, bleeding could occur, or the dressing's movement could irritate the area. 

29. • If using a binder to hold a client's body part in place or a dressing in place, be sure it is firm enough to be effective.  Rationale : A binder that is too tight might cause unnecessary discomfort or constrict circulation . A binder that is too loose will not support or hold the body part or dressing in place. Fasten the binder from the bottom up, to give upward support.  Rationale: Applying it from the top down will exert downward pressure and defeat the purpose of the binder.  Make sure the binder has not slipped upward.  Rationale: This could hinder breathing and impair gas exchange . 

30. • Make sure the binder has not slipped down.  Rationale: This would loosen the binder and not give adequate support.  .  Rewrap the binder every 2 to 4 hours and check the dressing.  Rationale: The client's movements tend to loosen the binder.  When rewrapping the binder , assess the client's skin and check the dressing for amount and character of drainage .  Check the wound at the sam e time. 

31. 1) T-Binder A T-binder gets its name from its shape.  Although not used frequently today, the nurse may see a T-binder used in home care.   A T-binder can also be manufactured as a first aid measure.  It is used to hold rectal or perineal dressings in place.  It may also be used to hold a perineal pad in place for the incontinent or menstruating female client.  The top longer band is placed around the client's waist and the perineal strap is brought between the legs.  It is fastened with Velcro or may be pinned in place in an emergency.  (Be very careful not to stick the client or yourself with the pins.)

32. 2) Abdominal Binder An abdominal binder is a wide, flat piece of fabric that is secured around the trunk of the client's body to support the abdomen or dressings on the abdomen.  Most frequently, the binder is secured with Velcro.  The abdominal binder is most often used after abdominal surgery to hold large dressings in place.  Rarely, it is used after childbirth, particularly after cesarean delivery.  To apply the abdominal binder, place the center of the binder at the level of the client's waistline on his or her back.  Wrap the ends of the binder snugly over the client's abdomen and secure it with the Velcro straps.  Remember , the binder is secured at the bottom first , working upward .  Rationale: This provides the most support.  Nursing Alert It is important to check the position of the binder frequently particularly if the client is mobile.  The binder could move up and inhibit respiration or could slip down and lose its effectiveness. 

33. 3) Tape Instead of bandages and binders, strips of hypoallergenic tape are sometimes used to hold a client's dressings in place.  Tape also may be used to give support, as for sprained ankles, fractured ribs, or fractured toes.  There are several kinds of tape that allow ventilation and help to prevent skin maceration (skin softening and breakdown due to moisture accumulation and lack of circulation).  To provide more comfort, clip the client's hair close to the skin (particularly on hairy body areas) before applying large tape

34. dressings because hairs stick to the tape and make removal painful.  Always remove tape in the direction of hair growth for less discomfort.  If tape is difficult to remove, carefully apply acetone to the skin at the edge of the applied strip to loosen the adhesion.  Keep moistening the skin close to the adhesive as you gently peel off the tape.  Nursing Alert Be careful with acetone and other substances used to remove tape adhesive.  Never use these liquids near an open flame, the client's eyes, or on an open wound!  Be alert that some clients may be allergic to tape or to acetone.  Also, remember that acetone will remove nail polish and paint from surfaces and may damage other surfaces, such as latex or plastic. 

35. 4) Montgomery Straps Tape straps or Montgomery straps may be used if frequent dressing changes are needed.  These straps allow the dressing to be changed without having to remove tape from the client's skin with each change.  This measure helps prevent skin irritation because the tape remains in place when the dressings are changed.  General Nursing Care Of The Client With A Bandage Or Binder • Wear gloves and follow Standard Precautions if the client's skin is not intact.  Rationale: It is important to help prevent the spread of infection.