1. Lamorinda Community Emergency Response Team
Unit 4a - Bandaging and Splinting
01/01/2017
Lamorinda Community Emergency Response Team
Unit 4a: Bandaging and Splinting
Released: 5 February 2018
Lamorinda CERT

2. Community Emergency Response Team
Personal safety is ALWAYS the number one priority
Work as a team
Wear personal protective equipment…gloves, helmet, goggles, N95 mask and boots
The CERT goal is to do the
Greatest Good for the Greatest Number
Hope for the best but plan for the worst
Visual 4a.1
Lamorinda CERT

3. Wound Care Objectives of wound care: Control bleeding
Prevent secondary infection
Treatment of wounds:
Clean wounds – don’t scrub
Apply dressing
Apply bandage to hold dressing in place
No Hydrogen Peroxide
Visual 4a.2
Lamorinda CERT

4. Tourniquets
Tourniquets are an effective means of arresting life- threatening external hemorrhage from limb injury
Their use remains a subject of much debate
Tourniquets are often discouraged in contemporary pre-hospital civilian trauma care
The Combat Application Tourniquet (CAT) has been found to safely and effectively occlude blood flow with a low incidence of adverse events
Visual 4a.3
Lamorinda CERT

5. Tourniquets
Tourniquets effectively stop blood flow and all tissue beyond the tourniquet should be considered forfeited due to loss of oxygen to the cells
Once applied, write date and time on the tourniquet or skin and leave the tourniquet in place
Israeli Bandage
SWAT-T
Visual 4a.4
Lamorinda CERT

6. Rules of Dressing
Dressings are in direct contact with the wound and should be sterile if at all possible
Dressings reduce the risk of infection
Dressings stop bleeding and start clotting
Dressings absorb any excess blood, plasma or other fluids
Bandages hold dressings in place
Band-Aid® and like products combine dressing and bandage. The adhesive plastic is perforated to allow airflow.
Do not use solid plastic to hold a dressing in place, the wound needs oxygen from air to heal.
Visual 4a.5
Lamorinda CERT

7. Rules of Dressing
In the absence of active bleeding, remove dressing, flush and check wound at least every 4-6 hours, redress as necessary
If there is active bleeding, redress OVER existing dressing and maintain pressure and elevation
Visual 4a.6
Lamorinda CERT

8. Rules of Dressing After applying a dressing, always check CSM:
Circulation
Assess COLOR, TEMPERATURE, CAP REFILL
Sensory
Ask patient about presence or absence of SENSATION, (e.g. numbness, tingling, lack of feeling)
Motor
Ask patient to MOVE affected fingers and toes
Visual 4a.7
Lamorinda CERT

9. Dressing a wound
Irrigate the wound to remove as much contamination as possible.
Use tweezers if possible to remove any glass shards, splinters or other solid material from the wound.
Dab the wound with cotton or cloth, do not scrub.
Visual 4a.8
Lamorinda CERT

10. Dressing a wound Cover the wound with a dressing.
Secure the dressing with a bandage.
Visual 4a.9
Lamorinda CERT

11. Bandaging over a Dressing
Place dressing over wound
Make a “Tail” on the roller gauze so the bandage can be secured and won’t come undone.
Wrap around the “Tail” on the first pass and fold over the “Tail” after the first pass.
Visual 4a.10
Lamorinda CERT

12. Bandaging over a Dressing
Periodically put “half twists” in the roller gauze to make the bandage tighter and snug. Always wrap starting distal to proximal to avoid creating a tourniquet.
Tie off the roller gauze by opening up the remainder of the roller gauze and making a loop under the forearm.
Tie the two ends of the gauze together in a bow tie. Completed bandage maintains pressure on the wound and will not slide on the forearm.
Visual 4a.11
Lamorinda CERT

13. Treating Amputations Control bleeding and elevate part
Treat for shock if present
Save tissue parts, wrapped in clean cloth
Place in baggy with patient’s name, date and time
Keep tissue cool, not frozen
Keep tissue with the victim
Duct tape to body, out of victim’s sight
Visual 4a.12
Lamorinda CERT

14. Treating Impaled Objects
Immobilize
Don’t move or remove
Control bleeding
Clean and dress wound
Wrap
Visual 4a.13
Lamorinda CERT

15. Guidelines for Splinting
Support the injured area
Assess CSM
Circulation
Sensory
Motor
Splint injury in the position that you found it
Don’t try to realign bones
Immobilize the joints above and below the injury
After splinting, recheck CSM below the injury sight
Visual 4a.14
Lamorinda CERT

16. Treating an Open Fracture
DO:
Cover wound
Splint fracture without disturbing wound
Place a moist 4” x 4” dressing over bone end to prevent drying
DO NOT:
Draw exposed bones back into tissue
Irrigate wound
Visual 4a.15
Lamorinda CERT

17. Treating Nasal Bleeding
Causes: blunt force, skull fracture, non-trauma related issues
Blood loss can lead to shock
Victims may become nauseated and vomit if they swallow blood
Pinch the nostrils together, lean forward
Put pressure on the upper lip just under the nose
Use hemorrhagic nasal packing such as Celox
Treating Nasal Bleeding
Visual 4a.16
Lamorinda CERT

18. Anyone who is unconscious is “Immediate”
Exercise
Anyone who is unconscious is “Immediate”
Visual 4a.17
Lamorinda CERT