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Bandaging 130430003026 Phpapp02
Bandaging 130430003026 Phpapp02
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BANDAGING
DEFINITION:
Bandaging is the process of covering a wound or
an injured part.
USES:
Bandages are used for following purposes:
To prevent contamination of wound by holding
dressings 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 & control hemorrhage.
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To restrict movement / immobilize a
fracture or a dislocation.
To correct deformity.
To maintain pressure e.g. elastic bandages
applied to the improve venous return.
TYPES OF BANDAGES:
Triangular Bandage.
Roller Bandage.
Special Bandage. E.g. Many tail bandage,
T- bandage.
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MATERIALS COMMONLY USED FOR
BANDAGES:
Flannel
Cotton
Cotton gauze
Jute
Wool
Special materials like crape
bandage, elastic bandage & Domestic
material etc.
PARTS ROLLAR OF BANDAGE:
Head
Free End or tail.
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PARTS TRIANGULARLAR OF
BANDAGE
POINT
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Hold the roll of the bandage in the right
hand when applying bandage on the left
side, Hold the bandage with the roll
uppermost & apply the outer surface to the
skin, unrolling a few centimeters of the
bandage at a time.
Put some cotton wool on the part to be
bandaged so that the bandage does not
slip or cause cutting into the skin
underneath.
Bandage from below upward, & from
within outward.
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Hold the end of the of the bandage over
the outer aspect of the injured area & wind
the bandage around the part twice to fix it.
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2.Reverse Spiral:
This bandage is used for the parts where
the thickness varies e.g. legs & forearms.
It is applied in the same way as the
general spiral bandage, but each turn is
reversed as necessary to prevent gaping &
to make the bandage smooth.
3.Figure of Eight:
This bandage is used for elbow & knee
joints. This bandage is made by forming
two loops or oblique turns over a joint. The
turns alternately ascend & descend to
cover the part.
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4.Spica:
It is a form of the figure of eight
bandage. The turn is larger than the
other. It is used for joints at right angles
to the body, e.g. the
shoulder, groin, thumb.
5.Special Bandages:
A). Many Tail Bandage:
This bandage is usually used for
abdominal wounds & chest injuries. It is
prepared from a number of strips or tails
of flannel or cotton material. It is 4 to 6
inches wide & has sufficient length to
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STEPS OF APPLYING ROLLAR BANDAGE:
FIXING
ROLLING
SECURING
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SLINGS
Definition:-
Slings are used to provide support and
protection for injured arms, wrists and
hands or for immobilising an upperlimb
when there are arm or chest injuries.
Types of Slings:-
1 . Arm sling
2. Elevation sling
3. Improvised sling
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1.Arm Sling :-
This is used when there are injuries to the
upperlimb and for some chest injuries.
It holds the forearm across the chest but it
is only effective if the casualty sits or
stands.
When an arm sling is in the correct
position ,the casualty's hand will be slightly
higher than the elbow.. The base of the
triangular bandage should lie at the root of
the little finger leaving the finger nails
exposed.
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Method of Application:-
1. Ask the casualty to sit down and support
the forearm on the injured side with the
wrist and hand slightly higher than the
elbow.
2. Using the hollow between the elbow and
the chest slide one end of the triangular
bandage between the chest and forearm so
that its point reaches well beyond the
elbow.
3. Place the upper end over the shoulder on
the sound side and around the back of the
neck to the front of the injured side.
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4. Still supporting the forearm, carry the
lower end of the bandage up over the hand
and forearm and using a reef knot, tie off
on the injured side in the hollow above the
collar bone .
5. Bring the point forward and secure it to the
front of the bandage with a safety pin.
6. Check the circulation. If it is affected adjust
the bandage or the position of the sling.
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1: Arm sling
Support of forearm
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Forming sling
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2. Elevation Sling:-
This sling is used to support the hand and
forearm in a well raised position.
-If the hand is bleeding.
-There are complicated chest injuries.
-There are shoulder injuries.
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Method of Application:-
1 . The elbow is bent, the forearm is placed
across the chest in such a way that the
fingers touch the opposite shoulder. Now
the sling is applied
2. A clove-hitch is passed round the wrist
and the ends tied in the hollow above the
collar bone on the injured side.
Clove-hitch is made with a narrow bandage.
Two loops are made and laid one on top of
the other.
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A). Collar and Cuff Sling:-
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B. Triangular Sling:-
-This is used in treating a fracture of the
collarbone. It helps to keep the hand raised
high up giving relief from pain due to the
fracture.
Method of Application:-
1.Place the forearm across the chest with the
fingers pointing towards the opposite
shoulder and the palm over the breastbone.
2. Place an open bandage over the chest with
one end over the hand and the point
beyond the elbow.
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3.Improvised Sling:-
If no triangular bandages are available
slings may be improvised in several ways
to provide support-
(a) Turn the free end of a coat and pin it to
the clothing.
(b) Pass the hand inside the buttoned coat
or shirt.
(c) Pin the sleeve of the injured limb. to
clothing.
(d) Use mufflers, scarf, belt, tie or soft
cloth.
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Improvised sling
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Improvised sling
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SPLINTS
A splint is a rigid appliance, usually made of wood or
metal, which is tied to a fractured limb to support it
and prevent movement from taking place at the site
of fracture.
Using a Splint:-
If a splint is not used properly, it may cause damage.
Therefore, remember the following points when
using a splint:-
1.Make sure that the splint is well padded. This is
particularly important when splints are improvised
from pieces of wood which are uneven.
2. Make sure that the splint is sufficiently long to
immobilize the joint above and the joint below the
fracture.
3. Make sure that the bandage used to secure. The
splint have the knot tied on the splint and not on
the fleas.
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IMPORTANT SPLINTS IN ORTHOPAEDIC
OTHER THAN PLASTER SPLINTS
Splints occupy a very special place in the
treatment methodologies in orthopaedics.
Any material which is reasonably hard like a
rolled newspaper, card board, wooden
planks, books, etc. can function as a splint.
However these are crude and are mostly
useful during first aid treatment of bone
and joint injuries.
Refined splints used in orthopaedics are:-
plaster of Paris splints,
Thomas splints,
Bohler-Braun splints,
Aeroplane splints.
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PLASTER SPLINTS-
1.Thomas Splint:-
This is one of the very commonly used
splints in orthopaedics.
It was discovered by H.O. Thomas in
1876 to assist for ambulatory
treatment of TB knee.
It is now widely used for the
treatment of shaft fractures of femur,
knee injuries etc.
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Metal oval ring
2 inch angulation at outer bar
Side bars
Distal -W
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Parts of a Thomas splint :
A Thomas splint consists of four parts:-
1. A padded metal oval ring with soft
0
leather set at an angle of 120 to the
inner bar.
2. Two side bars-one inner and another
outer bars of equal length. They bisect
the oval ring
3. Distal end-where the two side bars are
joined in the form of a ‘W'.
4. Outer side bar is angled 2 inches below
the padded ring to clear the prominent
greater trochanter.
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Uses of Thomas splint:-
1. To immobilise fracture femur anywhere.
2. As a first aid measure to immobilise the
lower limb injuries.
3. For transportation of an injured patient
4. In the treatment of joint diseases like TB
knee, septic arthritis etc.
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Bohler-Braun (BB) Splint:-
This is Bohler's modification of Braun
splint. It consists of a heavy metallic frame
with four' pulleys:-
1. Proximal pulley prevents foot drop.
2. Second pulley to apply traction. in the line
of femur.
3. Third pulley to apply traction in the line of
supracondylar area of femur.
4. Fourth pulley to apply traction in line of the
legs.
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Indications
Skeletal traction is applied through this
frame for comminuted trochanteric
fractures of the femur.
It is also used for the treatment of fracture
shaft femur and supracondylar fractures of
the femur.
Rarely it can be used for the fracture shaft
of tibia and fibula.
One important precaution which should be
taken while using the BB splint is to provide
support at the fracture site and not at the
knee joint to prevent angulation especially
in supracondylar fractures of femur.
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Problems of BB Splint:-
1. Makes nursing care difficult
2. It is a heavy and cumbersome
frame.
3. It is associated with recumbent
problems like bedsores
,hypostatic pneumonia, renal
calculi, etc.
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PNEUMATIC SPLINTS
These are the present generation splints
and are more aesthetic, light and effective.
They consist of the splints made up of
pneumatic material and can be easily
applied to the limbs by inflating it with air.
They provide a tight fit and are more
comfortable to the patient.
Most of the ambulances today carry these
splints which are easy to transport unlike
the crude and hard Thomas splints, etc.
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Care of the Splints by the Nurse-
1. Padding- The splint should ,be well padded
at the bony prominences and at the injury
sites.
2. Bandage- This should be tied with optimum
pressure.
3. Exercises -Active exercises of the joints
and muscles should be permitted within
the splints.
4. Checking -Daily checking and adjustments
of the splints are recommended.
5. Neurovascular status- Distal neurovascular
status should be assessed daily.
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NURSING CARE FOR PATIENTS TREATED
WITH SPLINTS
Nursing care assumes extreme importance
in patients treated with splints as most of
these patients are severely injured and are
bed ridden. This can be discussed under
two headings:-
A}-NURSING CARE BEFORE APPLICATION
OF THE SPLINT
Take consent.
Inform the patient about the procedure.
Remove any tight fitting clothes and change
them into easy to wear dresses.
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Clean the affected part.
Select right sized splint.
Adequately pad the pressure points and the
perineum.
Apply the splint gently.
Check for the tightness of the weight cord.
After application check for the peripheral
pulses and nerve function.
Apply proper weight as per the directions of
the surgeon.
Foot end elevation may be required to give
the counter traction.
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Note: Maximum permissible weight limits:--
a. Skin traction-4-5 kg
b. Skeletal traction-8.10 kg
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Bed pan and urinecan has to be given with
care to avoid disturbance to the injured
site.
Care of the back is very important to
prevent bedsores .
Sponge bath the patient everyday.
To prevent soiling of the bed sheets and the
bed but proper rubber sheets.
Attend to the hair and nails of the patient.
Arrange to supply proper diet to the
patients being treated on splints. .
Instruct the patient to carry out active
exercises of the unaffected joints.
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Isometric exercises for the immobilised
joints.
Change the splint if the canvas gets soiled.
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THANK YOU
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