Rift Valley University Harar Campus
DEPARTMENT OF PHARMACY
Course Title :- FIRST AID AND ACCIDENT
PREVENTION
Unit Four (4) :- Dressing and
Bandages:
For 4th Year B.Pharm Student
By:-MENBERE DEBELE
(BSc. C/Nurse, B.Pharm)
02/11/2016 For 4th Year B.Pharm Student
by Menbere D.
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Dressing and Bandages:
• Content
• Dressings
• Bandages
• Application of bandages
• First Aid kits and supplies
02/11/2016 For 4th Year B.Pharm Student
by Menbere D.
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Dressing and Bandages
• Dressings= sterile covering over wound or
injured part
• Dressing is a cloth material applied to
cover an open wound.
• Bandages=materials to hold dressing in
place, secure splints, and support body
parts
• Roller gauze bandages
• Triangular bandages
• Elastic (ACE) bandages
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Dressing and Bandages:
• Dressing should be:-
– Sterile, but if it is not available clean
cloth, handkerchief, washcloth can be
used.
– Thick, soft and compressible so that
pressure is evenly distributed
– Lint- free
– Should cover larger than the wound
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Purpose of Dressing
• Control bleeding
• Prevent infection and
contamination
• Absorb blood and wound drainage
• Protect form further injury
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Wound Dressing Principles
• If exudate is present - Select one that
absorbs exudate.
• Keep wound bed moist but surrounding
skin dry
• Pack wounds loosely to avoid pressure on
new granulation tissue
• Fasten securely using tape, binders etc…
OR self-adhesive type dressing materials.
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Important points to be noted
• Don‘t use fluffy cotton or cotton balls as
a dressing (it is difficult to remove)
• Don’t remove a blood – soaked dressing
until bleeding stops
• Don’t pull off a dressing stuck to a wound.
• If it needs to be removed soak it off in warm
water.
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Types of Dressing
• Commercial dressing – dressing used in
most first aid situation
• Gauze pads – these are used for small
wound
• Adhesive strips – These are used for small
cuts and abrasions and are a combination
of sterile dressing and bandage.
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• Non adhesive - Gauze dressings in layers
are commonly used as a dressing for a
large wound.
• As it is very absorbent soft.
• Improvised dressing- Dressing that is
modified from any clean cloth material
such as hand kerchiefs
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Types of Wound Dressings
• Transparent film
• Impregnated nonadherent
• Hydrocolloids
• Clear absorbent acrylic
• Hydrogel
• Polyurethane foam
• Alginate
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Transparent film
Is used
• to provide protection against
contamination and friction,
• to maintain a clean moist surface that
facilitates cellular migration,
• to provide insulation by preventing
fluid evaporation, and
• to facilitate wound assessment
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Impregnated non-adherent dressings
• Are used to cover, soothe, and protect
partial- and full-thickness wounds
without exudate.
• Hydrogels
• are used to liquefy necrotic tissue or
slough, rehydrate the wound bed,
and fill in dead space
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Hydrocolloid dressings
• are used to absorb exudate;
• to produce a moist environment that
facilitates healing but does not cause
maceration of surrounding skin;
• to protect the wound from bacterial
contamination, foreign debris, and
urine or feces; and
• to prevent shearing.
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Clear absorbent acrylic dressings
• maintain a transparent membrane for
easy wound bed assessment,
• provide bacterial and shearing protection,
• maintain moist wound healing, and
• can be used with alginates to provide
packing to deeper wound beds.
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Polyurethane foams
• absorb up to heavy amounts of
exudate,
• providing and maintaining moist
wound healing.
• Alginates (exudate absorbers)
• are used to provide a moist wound surface
by interacting with exudate to form a
gelatinous mass, to absorb exudate, to
eliminate dead space or pack wounds, and
to support debridement.
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Applying sterile dressing
What to do
• Wash your hands
• Prepare a sterile dressing set
• Expose the wound site
• Apply sterile glove on your hands
• Clean the wound with antiseptics or saline
(warm salt water or soap & water can be
used if cleaning solutions are not
available)
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• Dry wound with sterile lint- free gauze pad
• Cover the wound with sterile lint- free
gauze pad
• Use a dressing large enough to extend
beyond the wound’s edges
• Hold dressing its corner.
• Place the dressing directly over wound, do
not slide it on.
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• Cover the dressing with one of the type of
bandage
• Do not touch any part of wound or any part
of dressing that will be in contact with the
wound
• Don’t cough, breath, or talk over the wound
or dressing.
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Bandages
Bandages are used to-
• Hold a dressing in place over an
open wound
• Apply direct pressure over a
dressing to control bleeding
• Prevent or reduces swelling
• Provide support and stability for an
extremity or joint.
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Bandages should be clean but not
necessarily sterile
• Don’t apply a bandage directly over a
wound put sterile dressing first.
• Don’t bandage too tightly to restrict blood
circulation
• Don’t bandage loosely enough to allow
dressing to slip
• Don’t cover finger and toes, unless they are
injured, because they need to be observed
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• Don’t use elastic bandage over a wound
• Don’t apply a circular bandage around a
victim’s neck & strangulation may occur.
• Don’t starts a roller bandage above the
wound instead start below the wound and
work upward.
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Signs of bandage tightness
• Tingling of the finger or toe nails
• Blue or paleness skin color or
• Coldness of the extremity
• Inability to move the finger or toes
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General principles for bandaging
• Explain to the patient the reason and the
method of bandaging.
• Ensure patient comfort – toilet visit,
comfortable position, i.e. sitting down or lying
on the bed.
• Respect the patient’s physiological abilities.
• Ask the patient to participate.
• Ensure the patient’s dignity.
• If possible, always face the patient during the
course of bandaging.
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• Maintain constant contact with the patient,
monitor their condition.
• Prepare the aids within reach, near the
patient
• Before bandaging, the wound is first
protected with sterile material.
• Select the appropriate type of bandaging in
terms of size.
• During bandaging, the bandage roll is firmly
held in the dominant hand while it is
unrolled into the palm.
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• The bandaging always starts at the
narrowest point and proceeds to the
widest point upwards, towards the heart
(except for hand and toe bandaging),
• The turns should not be too tight or too
loose, the completed bandage is effective
and neat.
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Types of Bandage
1. Roller bandage- It comes in various width,
length and type of material.
2. Gauze Roller - Cotton, Rigid and non
Elastic
3. Elastic bandage- used for compression for
sprain and contusion
4. Improvised – when commercial roller
bandages are unavailable
5. Triangular bandage – applied fully
opened (not folded) – best used for arm
sling.
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Uses of triangular bandage
• Triangular bandage is the easiest
dressing tool.
• It is used to create fixation,
compression, protection and
support bandages.
• They are primarily used in first aid
due to their easy and quick
application
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Types of bandage……
1. Arm sling
What to do
• Support the forearm on the injured side,
• the wrist and hand slightly higher than the
elbow
• Place an open triangular bandage between the
forearm and chest with its point towards the
elbow and stretching well beyond it.
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• Pull the upper end over the shoulder on the un-
injured side and around the neck to rest on the
collar bone of the injured side
• Bring the lower end of the bandage over the hand
forearm, and tie to the other end at the hallow
above the collar bone.
• Bring the point around the front of the elbow,
and secure it to the sling with safety pin.
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2. Ring pad
Is formed from a narrow folded bandage
Procedure-
1. A couple of turns are looped around the
fingers
2. Wind the free end firmly round the loop
until the loop has been covered
3. Tuck the ends and a firm ring will be
formed
N.B:- Ring pad is used to stop bleeding from
the skull by being applied to the head across
the fore head.
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3. Scalp bandage
Procedure-
1. Place the base over the forehead
just above the eye brows
2. Cross the ends over the point
behind the head& carry forward to the
forehead.
3. Tie the knot in the center of the
forehead.
4. Pull the point down
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4. Hand or foot bandage
Procedure-
• Place the hand or foot on a fully open
bandage with the point away from the
casualty.
• Fold the point over the hand or instep.
• Bring the ends over round the wrist (or
ankle)
• Cross them & tie over point
• Bring the point down over the knot& pin it.
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Hand bandage A - Leg bandage,
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5. Elbow or Knee bandage
Procedure-
• Lay the point on the back of the arm (or front
of the thigh)
• Carry the ends round the joint (not to tight)
• Then cross them round again to tie them just
above the joint
• Bring the point down over the knot & pin it
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B – Knee bandage,
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6. Hip bandage
Procedure-
• Pass a narrow bandage round the body just
above the hip bones and tie over the hip on
the injured side.
• Apply an open bandage to the injured hip
slipping the point under the narrow
bandage.
• Pass the ends round the thigh & tie on the
outer side.
• Pull the point down firmly & pin it
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C – Hip and thigh bandage
02/11/2016 For 4th Year B.Pharm Student
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7. Shoulder bandage
Procedure-
• Apply an open bandage with its center
over the injured shoulder.
• Pass the ends round the middle of the
upper arm & tie off on the outer side.
• Apply an arm sling. turn the point
down over the knot & pin it.
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8. Chest bandage (Front & back)
Procedure-
• Place the point over the shoulder
• Pass the ends backwards round the body&
tie in a reef knot directly below the point,
leaving one end long.
• Tie this long end of the knot to the point
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• Figure: Examples of splinting: A - Forearm fracture, B -
Upper arm fracture, C – Lower leg fracture (board and
anatomic splint), D - Upper leg fracture
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Bandaging material according to use
• Protection – protects the wound from the
cold, impurities, secondary infection, e.g.
square of gauze, gauze bandage, plaster, etc.
• Compression – fixing materials are applied
to strengthen the bones and joints,
• i.e. a broken bone; included are adhesive
plasters, starch bandage, plaster bandage etc.
• Fixation – maintains a particular part of the
body in the desired position, i.e. injury,
paralysis; used are e.g. starch, zinc paste
bandages, splints;
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• Extension – stretching and pressure
bandage is used for bleeding –
compression of vascular injuries, also
included in this category are elastic
bandages, compression stockings, leg
bandages – gauze bandage, triangular
bandage
• Redressing – protects the wound from the
cold, impurities, secondary infection, e.g.
• gauze square, gauze bandage, plaster, etc.
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Bandaging methods
• Circular turns- The bandage is applied in a
series of overlapping circular turns.
• This technique is used in minor wounds.
• Spiral turns- This technique is used on the
body parts that are narrowing or
widening such as limbs.
• Each subsequent turn partially overlaps
the previous layer, proceeding upwards.
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• Open spiral turns- The technique is a series
of turns that do not overlap and are
spaced out.
• This technique is used to attach splints or
as a dressing layer for a bandage.
• Figure of eight turns
• This technique is used for bandaging some
joints.
• The figure of eight technique is a series of
spiral turns applied in alternate directions.
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a - circular turns, b - spiral turns, c – open spiral turns,
d – figure of eight turns, e – spica turns,
4.4 First Aid kits and supplies
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4.4 First Aid kits and supplies
• First aid kits are classified based on the
assortment and quantity of first aid
supplies intended to deal with most types of
injuries and sudden illnesses that may be
encountered in the workplace.
• These may include major and minor
wounds; minor burns; sprains and
strains; and eye injuries.
• As each work environment is unique
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Types of first aid kits
• Class A Kits - Class A first aid kits are
intended to provide a basic range of
products to deal with most common
types of injuries encountered in the
workplace
including:
• major wounds, minor wounds (cuts and
abrasions), minor burns and eye injuries.
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• Class B Kits - Class B kits are intended to
provide broader range and quantity of
supplies to deal with injuries
encountered in more populated, complex
and/or high risk workplace
environments.
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First Aid Supply
• First Aid Supply Minimum Quantity for
Class A Kits
• Adhesive Bandage -16
• Adhesive Tape - 1
• Antibiotic Application- 10
• Antiseptic-10
• Breathing Barrier -1
• Burn Dressing (Gel soaked) - 1
• Burn Treatment - 10
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• Cold Pack – 1
• Eye covering -1
• First Aid Guide – 1
• Hand Sanitizer - 6
• Medical Exam Gloves – 2 Pair
• Roller Bandage - 1
• Scissors -1
• Splint - 0
• Sterile Pad - 2
• Tourniquet – 1
• Triangular Bandage - 1
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• First Aid Supply Minimum Quantity for
Class B Kits
• Adhesive Bandage -50
• Adhesive Tape - 2
• Antibiotic Application- 25
• Antiseptic - 50
• Breathing Barrier -1
• Burn Dressing (Gel soaked) - 2
• Burn Treatment - 25
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• Cold Pack – 2
• Eye covering -2
• First Aid Guide – 1
• Hand Sanitizer - 10
• Medical Exam Gloves – 4 Pair
• Roller Bandage - 2
• Scissors -1
• Splint - 1
• Sterile Pad - 4
• Tourniquet – 1
• Triangular Bandage - 2
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• First aid supplies for field trips shall also
include:
• (1) water;
• (2) reliable communication device;
• (3) liquid soap;
• (4) emergency contact numbers
• (5) medications, as needed, if the program
administers medications; and
• (6) plastic bags, for storage.
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