Chapter 9 Dressings, Bandaging, and Immobilization Techniques EMR 9-1 1-

Introduction The EMR must be familiar with different types of dressings, bandages, and immobilization techniques to properly care for patients with wounds and fractures This chapter discusses types of dressings, application of dressings, bandaging materials, and immobilization devices used by Emergency Medical Responders (EMRs) EMR 9-2 1-

Identify Different Types of Dressings Learning Objective 1 Identify Different Types of Dressings DRESSINGS Sterile, absorbent materials placed directly over a wound Protect open wound from further injury and contamination Gauze dressings Cont. EMR 9-3

Identify Different Types of Dressings Learning Objective 1 Identify Different Types of Dressings DRESSINGS Trauma dressings Universal dressings Occlusive dressings Non-adherent dressings Hemostatic dressings Improvisational dressings EMR 9-4

Bandage Types and Methods Learning Objective 2 Bandage Types and Methods for Using Bandages BANDAGES Generally made of strips of cloth Hold dressings securely in place Provide pressure Protect the wound Roller bandages Cont. EMR 9-5

Bandage Types and Methods Learning Objective 2 Bandage Types and Methods for Using Bandages BANDAGES Elastic bandages Military compresses Triangular bandages Tourniquets Improvisational bandages EMR 9-6

Bandage Types and Methods Learning Objective 2 Bandage Types and Methods for Using Bandages METHODS OF BANDAGING EMR must be familiar with various methods Recurrent bandage Spiral bandage Figure-of-eight bandage EMR 9-7

Bandage Types and Methods Learning Objective 2 Bandage Types and Methods for Using Bandages ADDITIONAL BANDAGING APPLICATIONS Type and location of wound dictate bandage choice Neck wounds Eviscerations Straddle injuries Cont. EMR 9-8

Bandage Types and Methods Learning Objective 2 Bandage Types and Methods for Using Bandages ADDITIONAL BANDAGING APPLICATIONS Impaled objects Avulsions or amputations Eye injuries Head injuries Shoulder and hip injuries EMR 9-9

Bandage Types and Methods Learning Objective 2 Bandage Types and Methods for Using Bandages BASICS OF DRESSING AND BANDAGING Always use PPE Keep dressings as sterile or clean as possible Control bleeding by using pressure Cover the entire surface of a wound with a dressing Cover area above and below dressing with a bandage Cont. EMR 9-10

Bandage Types and Methods Learning Objective 2 Bandage Types and Methods for Using Bandages BASICS OF DRESSING AND BANDAGING Anchor initial turn of a roller or elastic bandage For additional security, use twists Secure the end of the roller or elastic bandage Do not wrap bandage too tightly If tourniquet is applied, seek rapid transport; note time EMR 9-11

Basics for Using Splinting Devices Learning Objective 3 Basics for Using Splinting Devices SPLINTING Classifications Slings and swathes Flexible splints Rigid splints Pneumatic splints Traction splints Cont. EMR 9-12

Basics for Using Splinting Devices Learning Objective 3 Basics for Using Splinting Devices SPLINTING Improvised splinting techniques T-shirt Belt Magazine, book, or newspaper Blanket, sleeping bag, or ground mat Bedroll or pillow EMR 9-13

Steps in Properly Splinting Extremities Learning Objective 4 Steps in Properly Splinting Extremities BASICS OF SPLINTING Wear PPE Expose the area Control bleeding Stabilize above and below fracture site Assess for CMS before and after splinting Cont. EMR 9-14

Steps in Properly Splinting Extremities Learning Objective 4 Steps in Properly Splinting Extremities BASICS OF SPLINTING Loosen splint if change in sensation Loosen splint if decrease in pulse If no pulse, gentle traction and slight rotation If no pulse, package and transport If possible, place in natural position Cont. EMR 9-15

Steps in Properly Splinting Extremities Learning Objective 4 Steps in Properly Splinting Extremities BASICS OF SPLINTING Foot bent at 90-degree angle Hand with a grip No weight put on injured limb Elevate above heart and apply cold packs Pad gaps in splint No cravats or straps over injury site EMR 9-16

Methods for Immobilizing Patients Learning Objective 5 Methods for Immobilizing Patients FULL BODY IMMOBILIZATION Backboard provides spinal immobilization Apply cervical immobilization device The EMR must be adept Maintain neutral inline alignment Place according to manufacturer specifications EMR 9-17

Methods for Immobilizing Patients Learning Objective 5 Methods for Immobilizing Patients SHORT BACKBOARD Short spinal immobilization devices (SSIDs) Cervical or other spinal injury Used for a patient in a sitting position Temporarily stabilizes during transfer to long backboard EMR 9-18

Methods for Immobilizing Patients Learning Objective 5 Methods for Immobilizing Patients LONG BACKBOARD Used for full-body immobilization Nose, navel, and toes in a straight line Modified logroll Seven-person lift CMS checked before and after move EMR 9-19

Methods for Immobilizing Patients Learning Objective 5 Methods for Immobilizing Patients RAPID EXTRACTION EMR must make decision quickly Requires manual stabilization of the spine Time permitting, move SSID to long backboard Time does not permit, perform rapid extraction Check CMS before and after move EMR 9-20

Methods for Immobilizing Patients Learning Objective 5 Methods for Immobilizing Patients PEDIATRIC CHALLENGES Child’s head is larger in relation to the body Neutral inline alignment may be compromised To maintain correct jaw angle Use pediatric longboard EMR 9-21

Methods for Immobilizing Patients Learning Objective 5 Methods for Immobilizing Patients HELMET CHALLENGES Special safety precautions to be considered If helmet on, secure to backboard Place extra padding under shoulders If airway and breathing compromised, must remove helmet carefully EMR 9-22

Summary The EMR must understand the basics for applying various types of dressings, bandages, splints, and spinal immobilization devices Practicing and mastering the skill sets in each area will prevent further injury to the patient EMR 9-23 1-