DRESSINGS AND BANDAGES

Dressings:

A dressing is a protective covering applied to a would to prevent infection, to absorb discharge, to control bleeding and to avoid further injury.

An efficient dressing should be sterile and have a high degree of porosity to allow for oozing and sweating.

1. Adhesive Dressings

These sterile dressings are of different kinds and consist of a pad of absorbent gauze of cellulose, held in place by a layer of adhesive material.  The surroundings skin must be dry before application and all the edges dressing are supplied in paper or plastic covers.

2. Non Adhesive Dressings

Readymade sterile dressing:  The dressing consists of layers of gauze covered by a paid of cotton wool with an attached roller bandage to hold it in position.  The dressing is endorsed and sealed in protective covering and is supplied in various sizes.

Gauze dressing: Gauze in layers is commonly used as a dressing for large wounds as it is very absorbent, soft and pliable.  it is liable to adhere to the would however, this may assist the clotting of blood the dressing should be covered by one or more layers of cotton wool.

Improvised dressing: These can be from any clean soft absorbent material such as the inside of a clean handkerchief, a piece of linen, a clean paper handkerchief or cellulose tissue.  They should be covered and retained in position by such materials as are available.

3. Application of Dressings

Great care must be taken in handling and applying dressings.
Wash your hands thoroughly.
Avoid touching any part of the wound with the fingers of any part of the dressing which will be in contact with the wound.
Do not cough or talk over the wound or the dressing.
Dressing must be covered with adequate pads of cotton wool, extending well beyond them and retained in position by a bandage or strapping.
If a dressing to wound do not try to remove it.  Cover it with sterile dressing after cutting away whatever can be removed.

4. Bandages

These are made from flannel, calico, elastic net or special paper.   They can be improvided by any of the above material or from stocking or ties.

Bandages are used to:
- maintain direct pressure over a dressing to control bleeding.
- retain dressings and slings in position.
-prevent or reduce swelling.
-provide support for a limb or joint.
- restrict movement.
assist in lifting and carrying casualties.

Bandages should be applied firm enough to keep dressing and splints in position but not to so light as to cause injury to the part or to impede the circulation of the blood.  A bluish tinge of the finger or nails may be a danger sign that the bandages are too tight; loss of sensation is another sign.

5. Types of Bandages

There are two types of bandages.  They are

1. Triangular bandages
2. Roller bandages

5.1 Triangular Bandages

A triangular bandage is made by cutting a piece of calico 100 cm square from corner to corner so as to give two bandages.  It has three borders.  The longest is called the base and the other two the sides.  There are three corners, the one opposite the base is called the point the other two are called the ends.

5.2  Uses of Triangular Bandages:

• As a whole cloth spread out fully.
• As a broad bandage.  Bring the point to the center of the base and then fold again to the same direction.
• As a narrow bandage.  Fold broad bandage once again.
• When a smaller size bandage is needed fold the original so as to bring the ends together.  

5.2.1. Tying the Bandage

• For tying bandage a reef knot must be always used.  To make a reef knot take the ends of the bandage one in each hand cross the end in the right hand under and then over the end in the left hand thus making a turn.  Then across the end now in the right hand cross the end in the right hand over and then under the end in the left hand thus making a second turn.

• The usual granny knot should not be used as it is likely to come loose.

• The knot should be made where it does not hurt the skin or cause discomfort.Tuck the loose ends of the bandages out of sight.
• When not in use the triangular bandage should be folded narrow.  Bring the two ends to the center and fold again.  It becomes a packet which measures 16 cms x 9 cms, handy to carry.

Slings

Uses of Slings

• supporting injured arms, and
• prevention of pulling by upper limb of injuries to neck and shoulder chest.

Different types of slings

The arms sling

The arm sling is used in the case of broken ribs, injured arm, wrist and hands after the application of  plaster casts or splints and bandaging.

Applying the sling

Apply according to the picture given.

Collar and Cuff Sling

This collar and cuff sling is used for supporting the wrist only.

Triangular Sling

A triangular sling is useful for treating the fracture of collar bone.  The procedure of typing traingular sling is given in the figure below.

Improvised Slings

Slings can be improvised by way of turning free end of the coat and pinning it to the sleeve.  By way of passing the hand inside the buttoned shirt or coat or by using soft cloth, ties, mufflers etc.

5.2.2 Banding with the triangular bandage.

• For the scalp - Fold the narrow hem of the base of bandage which is opened and place it on the forehead just above the eye brows.   Take two ends backwards and after placing the body of the bandage over the head, the points hanging near the nape of the neck.  Cross the  two ends of the bandage and take them forward above the ears to meet on the forehead where they are tied.  Then press the patient head, draw the points firmly downwards and pit it to the bandages after taking it upwards.

5.3 Roller Bandage

Roller bandages are used in first aid posts and hospitals.  They are made up of cotton material or flannel with loose mesh.  They are of different lengths as well as widths.

5.3.1  Width of Roller Bandages

• For toes and fingers it should be one inch.
• For arm and head it should be 2.5 inches.
• For legs it should be 3.5 inches.
• For body it should be 6 inches.

5.3.2 General rules for the application of roller bandages

• You should see that the roll the bandage should cover two thirds of the earlier layer.
• You should bandage from below to upwards over the limb.  
• You should see that the bandage should not be too tight or too loose

5.3.3 Application

For applying roller bandages there are 4 methods.  They are as follows:

• Simple spiral -  Simple spiral is used on finger or uniform surfaces.  These bandages are just carried in spirals.

• Riverse spiral - Reverse spiral is modified spiral in which the rolls is reversed downwards on itself at each round.  It must be used where the thickness of the part varies like the leg, forearm.etc.

• Figure of eight -  Figure of eight bandage is applied obliquely alternatively up and down, so that the loops appear like the figure of eight.  It is used for joints like knee, elbow etc.,

• The spica - The spica is modified figure of eight and it is useful for bandaging the thumbs, groin, shoulder and hip.