bandage

1. BANDAGE

2. CONTENT:
• INTRODUCTION.
• PURPOSE
• PRINCIPLE
• TYPES OF BANDAGE

3. DEFINATION
• Bandage is a strip of material used mainly to support
or immobilize a part of the body.
• Bandage is a strip or roll of cloth or other material
that may be bound around a part of the body in
variety of ways to secure a dressing maintain
pressure over a body part or immobilize a limb or
other part of the body.
• Bandage are available in roll of various widths are
materials, including gauze, elastic webbings, flannels
and muslin.

4. BANDAGING
• The process of covering a wound or injured part
using various material such as gauze, cotton,
elasticized knit, flannel is known as bandaging.
• A simple gauze dressing is often not enough to
immobilize or provide support to a wound. So, binder
and bandages are applied around or over to provide
extra protection and therapeutic benefits by creating
pressure, supporting wound and immobilize body
part.

5. PURPOSES:
• To support wound.
• To immobilize a fracture or dislocation and an injured
part so as to relieve pain.
• To maintain direct pressure over a body part.
• To secure dressing.
• To retain warth.eg. A flannel bandage on a
rheumatoid joint.
• To reduce swelling.

6. CONTD………..
• To assist the patient in lifting and moving.
• To prevent contamination of a wound.
• To improve venous blood flow from lower
extremities by applying pressure.

7. TYPES OF BANDAGE:
• Roller bandage
• Triangular bandage
• T. bandage
• Many tailed bandage

8. ARTICLES
• Bandage
• Padding
• Scissors
• Safety pin/ adhesive tape

9. TECHNIQUE OF APPLYING BANDAGES:
1. ROLLER BANDAGE:
• A roller bandage is a strip of gauze or cotton material
prepared in a roll. Roller bandages can be used to
immobilize injured body parts and tom muscles. Provide
pressure to control internal or external bleeding, absorb
drainage and secure dressings.
CIRCULAR TURN:
 In this bandage, one turn overlaps the previous turn
completely. It should be used only which the part to be
bandaged is of uniform thickness e.g. finger, wrist etc.

10. PROCEDURE
• Wash hands.
• Gather necessary articles.
• Stand in front of the victim and support the injured part
in a comfortable position.
• Apply the end of bandage to the part of the body to be
bandaged.
• Encircle the body part a few times or as close as needed
each turns directly covering the previous turn.
• Secure the end of bandage with tape, metal clips or
safety pin over an uninjured area.

11. SIMPLE SPIRAL TRUNS:
• In this, the bandage ascends the body part with each
turn overlapping the previous turn by one half or two
third width of the bandage. Spiral turns are used to
bandage parts of the body that are fairly uniform in
circumference or are not same in thickness such as
the upper arm or upper leg.

12. PROCEDURE
• Make two circular turns to anchor the bandage.
• Continue spiral turns at about a 30 degree angle,
each turn, overlapping the preceding one by two
third the width of the bandage is closed turn.
• If it is open turn, do not overlap the each turn.
• End the bandage with two circular turns and secure
the end.

13. REVERSE SPIRAL
• It is made by a number of spiral turns in which the
bandage is reversed downwards up on itself at each
circuit of the limb spiral turns are used to bandage
cylindrical parts of the body that are not uniform in
circumference such as the lower legs or the forearm.
 PROCEDURE:
• Make two circular turns to anchor the bandage and
bring the bandage upward at about a 30 drgee angle.
• Place the thumb at the free hand on the upper edge
of the bandage.

14. CONTD…….
• Unroll the bandage around about 15 cm, then turns
the hand so that the bandage falls over itself.
• Continue the bandage around the limb, overlapping
each previous turn by two thirds the width of the
bandage, make each bandage turn at the same
position on the limb so that the turns of the bandage
will be aligned.
• End the bandage with two circular turns and secure.

15. FIGURE OF EIGHT ( SPICA )
• It can be used for joints at right angles to the
body for example wrist, ankle, knee joint and
thumb. It is applied by passing the bandage
obliquely round the limb, alternative upward and
downward, the loops resembling the figure of 8.
PROCEDURE:
• Anchor the bandage with two circular turn
around the desired part in the slightly flexed
position.

16. CONTD…….
• Encircle the part in figure of eight moving the bandage
up and down the joint forming the pattern, each cover
the two third of the preceding loop and crossing in the
same line.
• Apply until the bandage is used up or sufficiently
protected.
• Secure the end.
 RECURRENT BANDAGE:
• This type of bandage is used to cover the distal part of
the body e.g. skull, stump of an amputation. It is also
called capline bandage.

17. TRIANGULAR BANDAGING
• A triangular bandage is used as an arm sling or as a
pad to control bleeding. It may also be used to
support or immobilize an injury to a bone or joint or
as improvised padding over a painful injury. A tubular
gauze bandage is used to retain a dressing on a finger
or toe.
OR
• “The long side of the triangle is called the base”, the
point opposite the base is called the “apex”, and the
points at each end of the base are called the “ends”
or “extremities”.

18. TRIANGULAR BANDAGE
• A triangular bandage is a large triangle of cloth,
usually a loose – weave cotton cloth used in first aid.
It can be substitute with any kind of linen a piece of
cloth shed, shirt scary or a big handkerchief, or a thin
towel etc. in many an emergency this type of
bandage has many application.
• It can be placed over a large wound to absorb blood
and stop bleeding, functioning as a trauma pad.
• It can hold the trauma pad in place if first aid tape is
not available.

20. CONTD……..
• Two triangular bandage can be used together to treat a
wound. One can be used like a trauma pad to control
bleeding and another can be used to wrap the wound.
• If a victim has an injured arm a triangular bandage can
bent position over the chest. A second cravat ( folded as
a long band) can be used around the torso as a strip to
immobilized the arm against the chest. This technique is
called a sling and swathe.
• If a victim has a broken leg the leg can be immobilized
with a blanket between the legs and a couple of cravats t
tie the legs together firmy but not so tight as to restrict
circulation.

21. CONTD……
• In this case of a head wound, a triangular bandage can be
wrapped over the forehead and around the top of head to
cover the wound. Do not use bandage over the eyes nose or
mouth. Do not use bandages of any kind around the neck
because you might restrict circulation to the head.
 Assisting patient with application slings:
 Slings are used to provide support and protection for injured
arm, wrist and hands for immobilizing on upper limb.
 Arm slings: arm slings are commonly used to support injuries
to the upper limb or to immobilize the upper limb in case of
chest injury.
 Elevation slings: there are used to support a hand in a well –
raised position to control bleeding as to immobilize the upper
limb if there is a broken collar bone or these are rib injuries.

22. Applying triangular bandages on hand
and foot:
• Triangular bandage also be used on the foot to
protect and support the injured part.
 PROCEDURE:
• Place the bandage on a flat surface; then put the
hand or foot in the center of the bandage.
• Pull the middle point up to the wrist or ankle.
• Bring the left point, then the right one over the front
and around the ankle or wrist
• Tie the point in front of the ankle or wrist with a
surface knot.

23. Applying triangular bandage on the head. The
bandage is applied on the head to protect the
scalp of the patient or to hold a dressing in it’s
place.
Procedure :
• Told the longest portion about an inch depending
upon the size of the bandage and the victim.
• Stand behind the patient and place the hand of
the bandage on the forehead just above the
eyebrows. The point of the bandage should hang
down at the back of the hand.
• Bring the ends around each side of the head just
above the ears.

24. CONTD…..
• Cross the ends over the point of the bandage near
the back of the neck.
• Bring the ends forward around the head above the
ears and tie them on the forehead over the hem of
the bandage.
• Steady the head with one hand and with the other
hand draw the point of the bandage downwards.
• Pill the point of the bandage over the crossed ends.
Tie or pin in to the bandage on the top of the head.

25. T-BANDAGE
• T-bandage looks like the letter t and is used to secure
rectal or perineal dressing and in the groin . Double t
binder is used for males and single t binder is used for
females.
 Procedure:
• Review medical record if medical prescription for
particular binder is required and reasons for application .
• Assist the patient to dorsal recumbent position.
• Have the patient raise hips and place horizontal band
around waist with vertical tails extending past buttocks
overlap waist band in front and secure with safety pin.

27. CONTD…..
• Single tail binder-bring the remaining vertical strip
over perineal dressing and continue up and under to
center of horizontal band. Bring the ends over the
waist band and secure vertical and horizontal bands
together with safety pin.
• Double tail binder bring the remaining vertical strips
over perineal or supra public dressing with each tail
supporting one side of penis. Continue drawings
ends behind and then downward in front of
horizontal band.

28. CONTD……
• Secure all thickness with a pin.
• Assess comfort level with a patient in lying, sitting
and standing positions. Readjust front pins as
necessary. Increase padding if any area rubs against
surrounding tissues.
• Instruct the patient regarding removal of bind
defecating or urinating and need to replace bind
afterwards.
• Record the procedure in nurses notes.

29. MANY TAILED BANDAGE
• It is a rectangular piece of strong cloth that has many
tails attached to the two longer sides used for
support of abdominal musculature and to prevent
wound dehiscence and evisceration following
abdominal surgery.
 Procedure :
• Position the patient with head slightly elevated and
knees slightly flexed.
• Place the fan ends of the binder under the patient.

31. CONTD….
• Apply a scultetus binder with the person lying supine on the
binder’s center with the tails equally extended to either side
and the binder’s top under the upper abdomen.
• Lightly powder the skin to reduce friction from the binder
against the skin.
• Then starting at the binder’s bottom, bring it each “tail”
across the abdomen, smoothing and gently pulling it tight.
• Overlap each succeeding tail at a slight upward angle, crossing
at the midline.
• Anchor each tail with your hand until securing it with the
opposite tail.
• If tails are too long, nearly fold them.
• Overlap the two top tails along a straight line and pin the
place.

32. CONTD…
• When the binder is properly applied, there is an even
pattern along the midline and a sung fit e.g.
comfortable, secure, but not tight.

33. Abdominal Binder / Large rectangular
 Procedure:
• Explain to the patient the procedure and the need
for application of binder.
• Gather necessary data regarding the size of the patient
and appropriate binder.
• Close curtains or the room door.
• Wash hands.
• Position the patient with the head slightly elevated and
knees slightly flexed.
• Fan – fold for the side of the binder towards the middle
of binder.

34. CONTD….
• Instruct and assist the patient to roll away from you
towards the raised side rail while firmly supporting
abdominal incision and dressing with hands.
• Place fan – folded ends of binder under the patient.
• Instruct the patient to roll over folded ends.
• Unfold and stretch the ends out smoothly on the fail side
of the bed.
• Instruct the patient to roll back into supine position.
• Adjust the binder so that the supine patient is centered
over the binder using symphysis pubis and costal margins
as lower and upper lands marks.

35. CONTD…
• Pull the distal end of the binder over the center of
the patient’s abdomen. When maintaining tension
on that end of the binder, pull the opposite ends of
the binder over center and secure with velcro closer
tabs or safety pins.
• Assess the patient’s ability to breathe deeply and
cough effectively.
• Ask the patient about comfort level.
• Adjust the binder as necessary
• Record the procedure.

36. BREAST BINDER
• A breast binder looks like a tight fitting sleeveless
vest and is used to apply pressure to the breast.
Purpose :
• To provide support after surgery.
• To support breast for comfort in case of
engorgement.
• To secure dressing.
• To compress breasts to help in suppression of
lactation following fetal loss or neonatal death.

37. PROCEDURE:
• Review the medical record if a medical
prescription for a particular bandage is required
and reasons for application.
• Explain to the patient the procedure and the
need for application of the binder.
• Assist the patient to supine position in the bed.
• Pad the area under the breasts if necessary.
• Place the binder under torso with the center of
the binder at midline.

38. CONTD….
• Bring the farther end over the patients breasts;
take the near end and place over the line one.
• Using velcro closure tabs, secure the binder at
the nipple level first. Continue closure process
above and then below the nipple line until the
entire binder is enclosed.
• Bring the shoulder straps over on either side of
the front and fix to the upper border of the
binder.
• Make appropriate adjustments including
individualizing the lift of shoulder straps.

39. CONTD…
• Instruct and observe skill development in self –
care related to reapplying a breast binder.
• Wash hand.
• Observe underlying skin for integrity circulation
and characteristics of the wound and comfort
level of the patient
Record the application of the binder, condition of
skin and circulation, integrity of dressing and
comfort level key points in the use of binder are:
• Blinders are applied so that firm, even pressure
exerted.

40. • Binders should not impair neuromuscular or
pulmonary functions.
• Wrinkled binders are uncomfortable and may
cause tissue damage.
• Binders are secured so that there is no
movement and friction against underlying skin
surfaces.
• Pins or knots are placed away from wound
edges or tender areas.
• Binders are applied with the body part in
anatomical alignment and with joints in
position of function.

41. • The skin surfaces underneath a binder should
be inspected are frequent.
• Binders that causes discomfort should be
removed and reapplied.
• Talcum powder may be applied to skin
surface.
• Soiled or moist binders may promote
infection if applied over skin surface that
are not intact.

42. Purpose of Triangle Bandage:
 To support or immobilized parts of upper
extremities.
To limit the movement of upper extremly in
presence of fracture, muscle strain and
dislocation.
To prevent dependent edema.
To control pain.
To promote rest.
To aid healing.

43. Procedure :
• Assess the patient’s presenting condition.
• Observe the condition of the patient’s upper
extremity of mobility, skin integrity.
• Assess pulses.
• Position the patient sitting or supine with
forearms at angle with fingers higher than
hand, the hand higher the wrist, and the wrist
higher than the forearm, all the anatomically
correct alignment.

44. CONTD..
• Open the sling and place over the patient
torso with binder centered under the arm.
Place the longest side at the wrist and apex of
triangle extending behind the arm at the
elbow.
• Bring the lower binder point over the forearm
and hand up to the neck on the affected side.
• Reassess the angle of the forearm and adjust
the position needed.

45. • Secure closure of sling at shoulder level on
unaffected side using square not and fold
remaining loose areas by binder around elbow
and maintain fold and secure with safety pin.
• Apply padding as needed.
• The applied sling for adequancy of support
inspect.
Position of the lower arm above the level of the
elbow and avoidance of pressure on the cervical
vertebra.
• Wash hands.

46. • Evaluate distal pulses, sensation of finger and
condition of skin.
• Inspect alignment of the shoulder and
extremity.
• Ask the patient regarding the level of comport
and report the patient’s responses application
of slings.
• Record alignment, circulation, sensation and
skin integrity of affected extremity.

47. Applying T. Bandage on the head:
• The bandage is applied on the head to protect
the scalp of the patient or to hold a dressing in
the place.
Procedure :
• Fold the longest portion about an inch,
depending upon the size of the bandage and the
victim.
• Stand behind the patient and place the hand of
the bandage on the forehead just above
eyebrows. The point of the bandage should hang
down at the back of the head.

48. CONTD…
• Bring the ends around each of the head just above the
ears.
• Cross the ends over the point of the bandage near the
back of the neck.
• Bring the ends forward the ends forward around the
head above the ears and the tie them on them on the
forehead and the hem of the bandage.
• Steady the head with one hand and with the other
hand draw the point of the bandage downwards.
• Pull the point of the bandage over the crossed ends tie
or pin in to the bandage on the top of the head.

49. REEF KNOT
• It is used to secure the end of the triangular
bandage. It is also known as square knot.
Procedure :
• Take the two ends of the bandage on each
hand cross the end in the right hand under
and then over the end in the left hand making
a turn.

50. • Then cross the end now in the right hand over
and then under the end in the left hand thus
making a second turn. Now the knot must be
placed where it doesn’t make discomfort.
• Now the knot must be placed where it does’t
make discomfort.

51. CLOVE HITCH
• It is used in restraining the patient
Make two blentical loops, loop A and B. Pass
loop A in front of loop B. Apply it in the arm to
be restrqined pad the loop enough while
applying it. Tie the free end of the bandage to
the bed.