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

2. 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-

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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-