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Bandaging Bandage is a material used to provide support either to a medical dressing or an injured part of the body. Very often the word bandage is used to refer to a dressing used on a wound. There are various bandaging techniques, each specifically targeting a particular area or a particular type of ailment. Orthopaedic Bandages Orthopaedic Bandages consists of cotton fabric of plain weave and is manufactured in various sizes. The Orthopaedic Bandages is generally supplied in a different packaging as per client''s requirements. Different Types of Bandages: A .Elastic Adhesive Bandages B. Cotton Crepe Bandages. C. Cotton Elastic Bandages. D. BELLADONNA Capsicum Plaster Perforated / Triangular Bandages. E. Perforated Tapes. F. Paper Tapes/Microporous Tapes. G. First Aid Dressing. BANDAGE ROLL A bandage roll is a cloth usually made of 100 percent cotton gauze. It serves as a cushion to protect the site of a wound. Available in varying sizes, the type of bandage roll to use depends on the characteristics of the wound. Application is best administered by a trained first aid provider. There are different types of bandage rolls based on material, usage and features. 1. Elastic Bandage - primarily is used to stop bleeding and reduce swelling. It also helps support a sprain in some cases. As a secondary dressing, this bandage roll also aids in holding splints and sterile pads in place using bandage clips. 2. Cast Padding - which is used to provide cushioning for a plastered wound. Cast padding usually is made of viscose fibers that help protect the skin from swelling. It conforms to the body's contours and allows the patient to move the affected body part freely. 3. Orthopedic Padding is a type of bandage roll used to protect the bulging bone of a wounded body part. Made of either natural or synthetic non-woven fabrics .It is soft and smooth and conforms to the shape of the wounded area. Unlike regular bandage strips, it has low moisture-retention to prevent the formation of ridges on the wound as well as possible skin maceration. It often is used directly on the wound under a casting material, so it has to be hypoallergenic and cushioned in order to prevent skin irritation. 4. Under-Cast Padding is a type of bandage roll that is made of soft, elastic and nonabsorbent polyester fiber. Also used to protect exposed bones and nerves, Under-cast padding is self-adhesive for easy application. It mostly is used to dress large wounds. General Bandaging Objectives A bandage can be applied for several reasons: To To To To To To secure sterile dressings in place provide compression which controls edema support joints, ligaments or muscles that have been injured, or to prevent injury support areas which are exposed to excessive or repeated stress provide a compression dressing to a wound to help stop bleeding re-shape body contours (e.g. amputation stump)

JENNIFER S. CRUEL, RN, MN CLINICAL INSTRUCTOR

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Bandaging Hints & Tips 1. Be organised. 2. The duration of treatment is a choice for the clinician and will be dependent upon a number of factors such as the severity of the injury and underlying condition of the patient and patient's lifestyle 3. The extension of the bandage is a clinical choice. If in doubt, it is advisable that the extension of the bandage should not exceed 50% to avoid over tightening. 4. If the patient complains of undue pain or discomfort the bandage should be removed and the injury and bandage application re-assessed. 5. When using adhesive products consider using a protective spray if the patient has delicate, or sensitive skin. 6. Bandage selection is important, be aware of the recommended indication for a product and select your bandage accordingly. 7. Do not use continuous, circumferential wraps of rigid tape as this may adversely affect circulation. 8. Excessive creasing, wrinkling or gaps between bandage wraps should be avoided as this may affect circulation or may create pressure points, blisters or skin breakdown. 9. With adhesive products as you may wish to protect bony areas, or other sensitive areas with a swab or petroleum dressing. 10. The area to be taped should be supported adequately in the correct position, and this position maintained during taping. Bandage Wrapping - is the process wherein a circular role of bandage is firmly rolled around the limb, most often to support dressing, or stop bleeding. To wrap the bandage on the limb, hold it transversely in the hand, and start rolling it around the limb with the outer side of the bandage roll applied to the inner side of the limb. The bandage has to be rolled from the inner side to the outer side. Though rare, in some cases, it is rolled upwards from below. The pressure on the part of the body being bandaged should be uniform. Once the rolling is done, the end of the bandage can be secured either by applying a safety pin or by giving it a slit and tying it around the limb. Bandaging Techniques The use of various bandaging techniques are determined based on the reason for which bandaging is required. The three most commonly used techniques of bandaging are spiral technique, ascending spica technique and diverging spica technique. Spiral bandaging is the simplest of the roller bandaging techniques. While rolling the bandage, in this method, the turns are done in spiral method, wherein each turn covers the two-third part of the preceding turn. Diverging Spica or Reverse Spiral Bandaging is most often used on body parts with varying circumference. Although the turns are made in spiral direction in this technique, the bandage is reversed on itself so that it stays firm on body parts with varying perimeters Once the bandage is secured, after a few spiral binds, the bandage is rolled with the thumb being placed over the lower border of the bandage on the outer side of the limb. Eventually the bandage is reversed downwards, and after passing it over the fixed thumb it is carried to the opposite side from under the limb, and rolled in reverse spiral technique above the preceding bandage wrap. Ascending Spica or Figure Eight Bandaging is considered to be the most useful roller bandaging technique. In this method, the bandage is alternately passed upwards and downwards over and under the limb, roughly resembling the figure 8 with each double turn.

JENNIFER S. CRUEL, RN, MN CLINICAL INSTRUCTOR

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APPLYING A SLING Sling is used to support an injured part of your body. It is meant to immobilize the injured body part. Typically slings are used when a joint is damaged, dislocated or injured due to surgery. The most effective slings are generally made from a piece of triangular cotton bandage An arm or shoulder that is fractured or dislocated will greatly benefit from a shoulder sling. Learning how to make and apply a shoulder sling is easy; there is no need to take a first aid class. An Arm Sling is a bandage that is used to give support to an injured joint. The sling keeps the injured arm or shoulder immobile so that muscles, bones and tendons have time to heal. Three basic types of slings are used for arm and shoulder injuries. Types of Arm Slings 1. Standard Arm Sling The standard arm sling is intended for injuries to the forearm such as fractures or sprains. It supports the forearm so that it rests slightly parallel to the ground, with the wrist higher than the elbow. It is slung over the shoulder on the uninjured side of the body and tied to secure it in place. 2. Elevated or Shoulder Sling Slings are also used to aid in supporting the shoulder when injured. Like other types of slings, a shoulder or elevated sling is made from a triangular piece of cloth. The arm is placed over it so that the top point of the triangle is at the elbow and the wrist rests between the other two points, which are then brought up and tied behind the neck. There are variations to the shoulder sling, depending on the amount of immobility required, but all are designed to limit shoulder movement while the injury heals. 3. Collar-and-Cuff Sling The collar-and-cuff sling is used in upper arm injuries or in the case of a suspected dislocated collar bone or when a standard bandage is not available. The elbow hangs naturally at the side of the body and the hand of the injured arm is extended to the uninjured shoulder. A strip of cloth or a belt is wrapped around the wrist of the injured arm and the ends are wrapped around the neck and tie. The arm hangs comfortably with a collar-and-cuff sling, and is not completely immobile. If extra support is needed, bandages or wraps can be applied around the body and upper arm to hold the arm firmly at the chest. Making and applying a shoulder sling 1. Get a piece of cloth. The width should be roughly 5 feet. The sides should be approximately 3 feet in length. A smaller sized cloth can be used for children. If you have a bandana, you can use this instead. 2. Make a triangle out of the cloth. Hold one corner of the cloth and put it on top of the opposite corner diagonally. A triangle should form. You can also get your trusty scissors (one that can easily cut a cloth) and cut a triangular piece from the original square cloth. 3. Gently position the injured persons elbow on the top of the triangle where the apex is located. The wrist should be positioned midway at the bottom of the triangles edge. 4. Get the two end points of the triangle. One should go over the shoulder from the front and the other should come up from the back going towards the shoulder. 5. Secure these two points. Use a pin to secure them together or you can make a knot using both ends. The elbow should form a right angle so make sure to adjust the height and the knot accordingly.

JENNIFER S. CRUEL, RN, MN CLINICAL INSTRUCTOR

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