BANDAGES

PURPOSES

Bandage:
Holds dressing in place over a wound
Creates pressure that control bleeding
Help keeps 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

PRINCIPLES OF BANDAGING

Bleeding is controlled; generally, you

should not bandage any wound with
anything other than a pressure bandage
until bleeding has stopped.
Always wash your hands before bandaging
a 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;
when possible, you should tie
bandage ends in square knot, and
then tuck them under, if the knot
causes discomfort, place a gauze or
cloth pad under it.
The bandage covers all edges of the
dressing
Tips of the fingers and toes are left
exposed when arms and legs are
bandaged so you can check for
impaired circulation

A small bandage on arm or leg is

covered with a larger bandage or
more evenly distribute the pressure
and to avoid creating a pressure point
The body part is bandaged in a
position in which it is to remain
Ask the victims how the bandage
feels; if its too tight, loosen it and
make it comfortable but snug
Never use a circular bandage around
the neck; it could cause strangulation

The most common kind of bandage is

the adhesive strip, such as BandAid.
There are many types and sizes
of bandages.
Narrow Bandage
Used to wrap feet, lower legs, hands
and arms
Wider Bandage
Used for thighs and trunks

TRIANGULAR BANDAGES
Made from unbleached cotton cloth
approximately 40 inches square; square is
folded diagonally, then cut along the fold.
A triangular bandage is easy to apply and
can be handled so the part over the
dressing wont be soiled.
When applied correctly, a triangular
bandage can be used on most parts of the
body and does not slip off.
Can be used fully opened or folded into a
cravat;

COMMONLY USE TO:

Support fractures and dislocations
Apply splints
Form slings
Make improvised tourniquets

In an EMERGENCY you can make a

triangular bandage from:
Clean handkerchief
Cotton towel
Clean piece of shirt
If a regular bandage is too short, tie a
second bandage to one end.

CRAVAT BANDAGES

Folded, a triangular bandage can be a

cravat
To make a cravat, make a 1- inch fold
along the base of the triangular bandage
To make a wide cravat, bring the point to
the center of the folded base, then place
the point underneath the fold.
To make medium cravat, make a wide
cravat, then fold lengthwise along the line
midway between the base and the new top
of the bandage
To make narrow cravat, make a medium
cravat, then repeat the lengthwise fold one
more time.

ROLLER BANDAGES
The most popular and easy to use
bandage is a self adhering (nonelastic), form fitting roller bandage.
Comes in variety of widths and length
ranging from inch to 12 inches wide
and as long as 10 yards.

Methods of Application of Roll

Bandages
Circular
With the roll on the inner aspect,
unroll the bandage either toward you
or laterally, holding the loose end
until it is secured by the first circle of
the bandage.
Two or three turns maybe needed to
cover an area adequately.

Spiral
Begin with the circular method. After
securing with one or two complete
overlaps, place the bandage to
overlap one-half or two thirds of the
width and in this manner move up
the extremity to provide even
support.
Tape or clip the bandage in place.

Reverse spiral
Begin as you would for the spiral bandage
When the thumb is secured by the first
turn, hold your thumb on the bandage as
it approaches the side nearest you and
fold over, reversing the direction
downward. Repeat this step with each
turn, overlapping as before.
When the desired area is covered, end
with a circular wrap and secure with a
tape or a clip.

Recurrent fold
This can be adapted for use many parts of the
body.
Used for the finger, hand, toe or foot.
Also applicable for use as head dressing or on the
stump of an extremity
To apply
hold the end of the bandage in place with one
circular turn
bring the roll down over the end of the body part
(finger, hand, toe, foot, stump) and back up
behind.

Over the head, the circular turn is made,

and turns are made over across the top of
the head.
On a Balkan frame, Subsequent turns are
folded alternately to the right and left of the
initial center fold.
Keep your fingers in place at the top to
secure the bandage until a circular turn or
two can be made to complete the bandage
Clip or tape in place.

Figure Eight Bandage

Consist of oblique overlapping turns
that ascend and descend alternately.
Used around the knee, elbow, ankle
and wrist

Equipment
Elastic or other bandage of
appropriate width
Tape, pins or self closures
Gauze pads
Clean gloves, if indicated

Assessment
Review the medical record, physicians
orders and nursing plan of care and assess
the situation to determine the need for
bandage.
Assess the affected limb for pain and
edema.
Perform neurovascular assessment of the
affected extremity. Assess body parts distal
to the site for evidence of cyanosis, pallor,
coolness, numbness, tingling and swelling
and absent or diminished pulses.
Assess the distal circulation of the
extremity after the bandage is in place and
at least every four hours.

Planning
The expected outcome is achieved
when applying a figure eight bandage
is that the bandage is applied correctly
and without injury or complications.
Patient maintains circulation to the
affected part and remains free of
neurovascular complication.

IMPLEMENTATION
1.

Review the medical record and

nursing plan of care to determine the
need for a figure eight bandage.

Rationale: Reviewing the medical

record and plan of care validate the
correct patient and correct procedure
and reduces risk of injury
2.

Identify the patient. Explain the

procedure to the patient. Rationale:

Patient identification validates the

correct patient and correct
procedure. Discussion and
explanation help ally the anxiety and
prepare patient what to expect.

3. Perform hand hygiene and put

on gloves if contact with drainage is
possible. Rationale: Hand hygiene

and gloving prevent the spread of

microorganisms.

4. Close the room door and

curtains. Place the bed at an
appropriate and comfortable
working height. Rationale: Closing

the door and curtains provide

privacy. Proper bed height helps
reduce back strain.

5. Assist the patient to a comfortable

position with affected body part in a
normal functioning position. Rationale:

Keeping the body part in a normal

functioning position promotes circulation
and prevents deformity and discomfort.
6. Hold the bandage roll with the roll
facing upward in one hand. Hold the free
end of the roll in the other hand. Hold
the bandage so it is close to the affected
body part. Rationale : Proper handling

of the bandage allows application of even

tension and pressure.

7. Wrap the bandage around the limb

twice, below the joint, to anchor it.

Rationale: Anchoring the bandage

ensure that it will stay in place.

8. Use alternating ascending and

descending turns to form a figure eight.
Overlap each turn of the bandage by
one-half to two thirds of the width of the
strip. Rationale: Making alternating

ascending and descending turns helps to

ensure the bandage will stay in place on
a moving body part.

9. Unroll the bandage as you wrap not

before wrapping. Rationale: Unrolling the

bandage with wrapping prevents uneven

pressure which could interfere with blood
circulation.

10. Wrap firmly but not tightly. Assess

the patients comfort as you wrap. If
patient reports tingling, itching,
numbness, or pain, loosen the bandage.

Rationale: Firm wrapping is necessary to

provide support and prevent injury, but
wrapping too tightly interferes with
circulation. Patients complaints are
helpful indicators of possible circulatory
compromise.

11. After the area is covered, wrap the

bandage around the limb twice, above
the joint, to anchor it. Secure the end of
the bandage with tape, pins or self
closures. Avoid metal clips. Rationale:

Anchoring at the end ensures the

bandage will stay in place. Metal clips can
cause injury.

12. Remove your gloves, if worn, and

discard them. Place the bed in the lowest
position with the side rails up. Make sure
the call and all necessary items are within
easy reach. Rationale: Repositioning the

bed and having items nearby ensure

patient safety.

13. Assess the distal circulation after the

bandage is in place. Elastic may tighten as it is
wrapped. Rationale: Frequent assessment of

distal circulation ensures patient safety and

prevents injury.

14. Elevate the wrap extremity for 15 to 30

minutes after application of bandage. Rationale:

Elevation promotes venous return and reduces

edema.

15. Lift the distal end of the bandage and assess

the skin color, temperature and integrity. Assess
for pain and perform a neurovascular
assessment of the affected extremity at least
every four hours. Rationale: Assessment aids in

prompt detection of compromised circulation

and allows for early intervention for skin
irritation and other complications.

16. Remove and change the bandage at least

once a day or per physician order or facility
policy. Cleanse the skin and dry thoroughly
before applying a new bandage. Assess the skin
for irritation and breakdown. Rationale:

Changing bandage as ordered prevents skin

irritation and allows for close inspection of the
skin to detect changes. Cleaning and drying the
skin before application reduces the risk for skin
irritation and breakdown.

17. Perform hand hygiene. Document the time,

date and site the bandage was applied and the
size of bandage used. Include the skin
assessment and care provided before
application. Document the patients response to
the bandage and the neurovascular status of the
extremities. Rationale: Hand hygiene prevents

the spread of microorganisms. Documentation

promoted continuity of care and communication.

APPLYING ROLLER BANDAGE

OVER A DRESSING:

1. Place the end of the roller bandage on

the dressing, then wrap it around the
body part in a circular fashion
2. Crisscross the bandage over itself as
you circle until the complete wound area
is covered. Do not cover the fingers & toes
3. Fasten the bandage in place with tape

Properly applied bandages:

Promote healing
Prevent severe complications
Help victim stay comfortable
Bandages should be properly applied
and well secured.

Two most common mistakes in bandaging:

1. Bandaging too loosely
2. Bandaging too lightly
SIGNS THAT A BANDAGE IS TOO TIGHT:
The skin around the bandage becomes pale or bluish
in color (cyanotic)
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
The victim cannot move his or her fingers or toes.

Sling
A

bandage that provide support

for an arm or immobilize an
injured arm, wrist or hand.

Purpose:

1. Used to restrict movement of a

fracture or dislocation

2. To support muscle sprain

3. To support a splint or secure dressing
A sling should distribute the supported
weight over a large area not the back
of the neck to prevent pressure on the
cervical spine nerves.
Equipment: commercial arm sling
ABD gauze pad

Implementation
1. Review the medical record
and nursing plan of care to
determine the need for the use
of sling. Rationale: Reviewing

the medical record and plan of

care validates the correct
patient and procedure and
prevents injury.

2. Identify the patient. Explain the

procedure to the client. Patient
identification validates the correct patient
and correct procedure. Discussion and
explanation help ally the anxiety of the
patient for what to expect.. Review the
medical record and nursing plan of care to
determine the need for the use of sling.

Rationale: Reviewing the medical record

and plan of care validates the correct
patient and procedure and prevents injury.

3. Perform hand hygiene. Rationale :

Hand hygiene prevents the spread of

microorganisms.

4. Close the room door or curtains.

Place the bed at an appropriate
comfortable working height if necessary.

Rationale : Closing the door or curtain

provides privacy. Proper bed height helps
reduce back strain.

5. Assist the patient to a sitting position.

Place the patients forearm across the
chest with the elbow flexed and palm
against the chest. Measure the sleeve
length if indicated. Rationale: Proper

positioning facilitates sling application.

Measurement ensures proper sizing of
the sling and proper placement of the
arm.

6. Enclose the arm in the sling, making sure the

elbow fits into the corner of the fabric. Run the
strap up into the patients back and across the
shoulder opposite the injury, the down the chest
to the fastener at the end of the sling. Rationale:

This position ensures adequate support and

keeps the arm out of dependent position,
preventing edema.

7. Place the ADD pad under the strap, between

the strap and the patients neck. Ensure that the
sling and forearm are slightly elevated and at a
right angle to the body. Rationale: Padding

prevents skin irritation and reduces pressure on

the neck. Proper positioning ensures alignment,
provides support and prevents edema.

8. Place the bed in the lowest position, with the

side rails up. Make sure the call bell and other
necessary items are within reach. Rationale:

Having the bed at proper height and leaving the

call bell and other items within reach ensure
patient safety.

9. Check the patients level of comfort, arm

positioning and neurovascular status of the
affected limb every four hours or according to
facility policy. Assess the axillary and cervical skin
frequently for irritation and breakdown.

Rationale: Hand hygiene prevents the spread of

microorganisms. Documentation promotes
continuity of care and communication.

10. Perform hand hygiene.

Document the time and date the
sling was applied. Document the
Patients response and the
neurovascular status of the
extremity.