Ch. 10 - Dressing and Bandaging

10.1 Dressings Requirements: Sterile, meaning that any microorganisms and spores on the dressing have been killed Aseptic, meaning that it is free of bacteria Held in place with a bandage tightly enough to control bleeding but not so tightly that it stops blood circulation Soft, thick, and compressible so that it provides even pressure over the entire surface of the wound. 2

Types of dressings Occlusive – plastic wrap or other dressing that forms an airtight seal Compress – a thick, bulky, usually sterile dressing intended to stop or control bleeding Trauma – a 5-by-36 inch piece of thick, sterile, absorbent dressing that can be used to cover a larger area in cases of more serious or widespread injury Adhesive strips – a combination of a sterile dressing and a bandage, individually packaged and used for small wounds Adhesive tape – often used to hold the edges of wounds together, it comes in rolls of various widths. 3

PROGRESS CHECK 1. A sterile dressing is one on which there are no__________. (bacteria/microorganisms/viruses) 2. An aseptic dressing is free of ____________. 3. Use petroleum gauze when you don’t want the dressing to ____________. (get wet/shred/stick to the wound) 4. An occlusive dressing is ____________. (dry/moist/airtight) 5. A compress dressing is used to ____________. (control bleeding/prevent infection/absorb fluids oozing from the wound) 6. A 9-x-36-inch piece of thick, absorbent material is called a ____________ dressing. (occlusive/universal/compress) 4

10.2 Bandages Holds a dressing in place over a wound Creates pressure that controls bleeding Helps keep the edges of the wound closed Secures a splint to an injured part of the body Provides support for an injured part of the body 5

Bandage is too tight if: The skin around the bandage becomes pale or bluish in color (cyanotic). There is a bluish tinge to the nearest fingernails or toenails. The victim complains of pain, usually only a few minutes after you apply the bandage. The skin beyond the bandage (distal) is cold. The skin beyond the bandage (distal) is tingling or numb. You cannot feel the pulse beyond the bandage (distal), or it is very weak. Capillary refill is absent or diminished in the fingernails or toenails beyond the bandage (when you press on the nail, the nailbed does not immediately turn pink again) The victim cannot move his or her fingers or toes. 6

Bandages Triangular Bandages Cravat Bandages Roller Bandages Support fractures and dislocations Apply splints Form slings Make improvised tourniquets Cravat Bandages Roller Bandages 7

Vocabulary Occlusive- Waterproof and airtight Gauze pads- Commercially manufactured, individually wrapped sterile pads made of gauze Special pads- Large, thickly layered bulky pads used to control bleeding and stabilize impaled objects Bandage- Material used to hold a dressing in place Triangular bandage- Triangle-shaped piece of cloth used to apply splints and form slings 8

PROGRESS CHECK 1. Bandages are applied on top of a ____________. (wound/dressing/splint) 2. A bandage should normally not contact a ____________. 3. Cold, numb, or tingling skin distal to a bandage indicates the bandage is ____________. (too tight/too loose/controllinga bleeding) 4. A folded triangular bandage is a ____________ bandage. (roller/compress/cravat) 5. The easiest roller bandages to use are ____________. (gauze/elastic/self-adhering) 6. You should use an elastic roller bandage only in cases of ____________. (shock/profuse bleeding/fracture) 9

10.3 Principles of Dressing and Bandaging The dressing is opened carefully and handled so it does not get contaminated. The dressing adequately covers the entire wound. Bandages are not placed directly against the wound. Wounds are bandaged snugly, but not too tightly. Bandages are not too loose; neither the dressing nor the bandage should shift or slip. There are no loose ends of cloth, gauze, or tape that could get caught. The bandage covers all edges of the dressing. Tips of the fingers and toes are left exposed when arms and legs are bandaged. A small bandage on an arm or leg is covered with a larger bandage to more evenly distribute the pressure and to avoid causing a pressure point. Start a bandage on an arm or leg at the end nearest the hand or foot, then work upward to prevent applying the bandage too tightly. The body part is bandaged in the position in which it is to remain. Ask the victim how the bandage feels. Never use a circular bandage around the neck. 10

Cravat- A folded triangular bandage Vocabulary Cravat- A folded triangular bandage Roller bandage- A form-fitting bandage designed to be wrapped around a wound site 11

Applying Special Dressings and Bandages 1. Cover the wound with a bulky, sterile dressing. 2. Apply direct pressure with your hand over the dressing until bleeding stops. 3. Apply a firm roller bandage (preferably self-adhering) and monitor continuously for signs that the bandage is too tight. 4. If blood soaks through the original dressing and bandage, do not remove them. 12

Slings 1. Place one end of the base of an open triangular bandage over the shoulder of the uninjured side. 2. Allow the bandage to hang down in front of the chest so its apex will be behind the elbow of the injured arm. 3. Bend the arm at the elbow with the hand slightly elevated (four to five inches). When possible, the fingertips should be exposed so you can monitor for impaired circulation. 4. Bring the forearm across the chest and over the bandage. 5. Carry the lower end of the bandage over the shoulder of the injured side, and tie a square knot at the uninjured side of the neck; make sure the knot is at the side of the neck. 6. Twist the apex of the bandage and tuck it in or pin it at the elbow. 13

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PROGRESS CHECK 1. Material used for dressings should be as ____________ as possible. (strong/thick/clean) 2. Generally, the only dressing you should bandage in place while a wound is still bleeding is a ____________ dressing. compress/universal/pressure) 3. If blood soaks through the original dressing, you should ____________. (remove it/replace it with a new dressing/leave it in place and put a new dressing on top of it) 4. Make sure the bandage covers the entire ____________. (wound/dressing/extremity) 5. All loose ends of the bandage should be ____________. (tucked in/tied/cut off) 6. If you bandage across a joint, bandage it in ____________. (a straightened position/a bent position/the position in which it is to remain) 15