BANDAGING

Process of covering a wound and an injured part

USE
To prevent contamination of wound by holding dressing in position

To provide support to the part that is injured, sprained or dislocated joint.

To provide rest to the part that is injured To prevent and control hemorrhage To restrict movement/immobilize a fracture or a dislocation To correct deformity To maiantain pressure

TYPES:

Trianglular bandage

Roller bandage
Special bandage:

E.g. Many Tail bandage, T-Bandage

PARTS

Head Free End or Tail

PRINCIPLE OF BANDAGING
1. Wash Hands, wear gloves if necessary 2. Assist patient to comfortable position(bed, chair and support the body part to be bandage)d 3. Always stand in front of the part/victim to be bandaged except when applying bandage to head ,eye and ear.

4. Be sure that the bandage is rolled firm.

5. Make sure that the body part to be bandaged is clean and dry. 6. Assess skin before applying bandage for any breakdown 7. Observe circulation by noting pulse, surface, temperature,skin color and sensation of the body part to be wrapped

8. Always start bandaging from inner to outer aspect and far to near end

9. When bandaging a joint ensure flexibility of the joint except if immobilization is required
10. Always start and end with two circular turns 11. Cover the area 2 inches above and 2 inches below the affected area/wound 12. Overlap turns and slightly stretch the bandage. 13. Cover 2/3 of the previous turn 14. If possible/leave fingertips or toe tips exposed for observation, for adequacy of blood circulation 15. End the bandage at the outer side of the body.do not end bandage on wound or at the back of the body

GENERAL PROCEDURES FOR APPLYING BANDAGES

1. Identify the purpose

2. Identify the part to be supported

3. Assess any previous bandage or binders for effectiveness of comfort Note the time in place and color,temperature,sensation,and skin condition of affected body part. 4. Plan the specific prcedure to be used 5. Wash hands 6. Obtain appropriate bandage and fastening device

7. Plan for time to recheck the patient.

8. Identify the patient. 9. Explaine procedure to the patient 10.Provide for privacy and position patient 11.Remove soiled or used bandage or binders;if present wash your hands. 12.Use specific technique planned 13.Examine for neatness.no wrinkles,security

14. Assess circulation,motion and sensation to badages 15. Question the patient regarding comfort 16. Wash your hands 17. Evaluate following criteria

Effectiveness in holding dressing in place

Safety regarding maintaining tissue integrity 18. Document on progress notes or flow sheet

Time
Type of bandage applied Area to which applied Assessment of circulation, motion and sensation Length of time device off and condition of skin underneath (reapplication )

SPECIAL CONSIDERATIONS
Wrap an elastic bandage from the distal area to the proximal area to promote venous return. Avoid leaving gaps in bandage layers or exposed skin surfaces because this may result in uneven pressure on the body part. Observe the patient for an allergic reaction because some patients can't tolerate the sizing in a new bandage. Laundering it reduces this risk.

Launder the bandage daily or whenever it becomes limp; laundering restores its elasticity. Always keep two bandages handy so one can be applied while the other bandage is being laundered.
When using an elastic bandage after a surgical procedure on an extremity (such as vein stripping) or with a splint to immobilize a fracture, remove it only as ordered rather than every 8 hours.

HOME CARE

If the patient will be using an elastic bandage at home, teach him or a family member how to apply it correctly and how to assess for restricted circulation. Tell him to keep two bandages available so he'll have one while the other is being laundered.

COMPLICATIONS
Arterial obstruction

decreased or an absent distal pulse,

blanching or bluish discoloration of skin, dusky nail beds,

numbness and tingling or pain and cramping,

cold skin Edema can occur from obstruction of venous return. Allergic reaction Skin irritation.

DOCUMENTATION
Record the date and time of bandage application and removal; the application site, bandage size, skin condition before application, skin care provided after removal, and complications; the patient's tolerance of the treatment; and any patient teaching.

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