BANDAGING

Y.S. PEK
 LEARNING OUTCTOMES
At the end of the session, the students should be able to:
1. define bandages and bandaging
2. list the types of bandages commonly used
3. state the purposes of bandaging
4. explain the principles of bandaging
5. explain nursing responsibilities in the care of patient
with bandages
6. carry out various types of bandaging correctly

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 Definition of Bandages
 A strip or roll of material such as gauze, muslins
or cloth that may be wrapped around body parts
to
➢secure a dressing
➢maintain pressure / compression
➢immobilize a limb or body parts

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 Definition of Bandaging
 The process of
covering a wound
or injured body
parts using various
types of bandages.

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 Purposes of Bandaging
1. Immobilization of injured body part
✓ Limit movement of injured body part such
as fractured femur

2. Support injured body part

✓ Support injured joint such as sprained ankle
✓ Support a wound on the abdomen to reduce
pain(abdominal binder)

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Immobilize Support

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 Purposes of Bandaging
3. Apply pressure
✓ to promote venous returns
✓ to stop and reduce bleeding
✓ to reduce swelling

4. Secure dressing
✓ hold a dressing or splint
in place

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 Purposes of Bandaging
5. Retain warmth
✓ for example, bandage on a joint with
rheumatoid arthritis

6. Reshape body contour

✓ for example, stump

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 Types of Bandages
1. Roller bandage (differ in size and material)
2. Triangular bandage

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 Roller Bandages
1. Gauze Bandage 2. Elastic bandage

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 Roller Bandages
3. Creepe Bandage 4. Compression
bandage

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 Triangular Bandage
 Non-stretch bandages
 Useful as slings for fractured arms, fractured
clavicle or dislocated shoulders
 As an arm sling

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 Appropriate Bandage Size
▪ Hand, head : 5.0 cm (2 inch)
▪ Ear, eye : 5.0 cm (2 inch)
▪ Hand, shoulder : 7.5 cm (3 inch)
▪ Finger : 2.5 cm (1 inch)
▪ Calf, thigh : 7.5 – 10cm (3 – 4 inch)
▪ Body : 10 – 15 cm (4 – 6 inch)

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 Principles of Bandaging
1. Assist patient to assume comfortable position on
bed or chair.
2. Choose the correct type and size of bandage.
3. Support the body part to be bandaged.
4. Always stand in front of the patient except when
applying a bandage to the head, eye and ear.
5. Make sure the body part to be bandaged is clean
and dry.
6. Cover wound with dressing before bandaging to
avoid friction on wound.
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 Principles of Bandaging
7. Hold bandage with the rolled part facing
upwards.
8. Start bandaging from
✓ inner to outer aspect
✓ far to near end (distal to proximal) to
promote venous return.
9. Always start and end with two circular turns.
10. Follow the normal body contour while
performing bandaging.

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 Principles of Bandaging
11. Overlap turns and cover 2/3 (two third) of the
previous turn.
12. Be sure the bandage is rolled firm (not too tight
and not too loose).
13. Cover the area 2 inches above and 2 inches below
the affected area / wound.
14. When bandaging a joint, ensures flexibility of
the joint.
15. Leave the fingertips or toe tips exposed for
observation of blood circulation.

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 Principles of Bandaging
16. Observe circulation by noting
✓ pulse
✓ surface temperature
✓ skin color
✓ sensation
17. End the bandage on the outer side of the body.
(DO NOT end a bandage on wound or at the
back of the body part.
18. Change stained or dirty bandage PRN because it
may cause infection.
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 Techniques of Bandaging
1. Circular turns
2. Spiral turns
3. Spiral reverse turns
4. Figure of eight
5. Recurrent turns - Stump bandaging
6. Triangular bandaging

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 Circular Turns
• It is used to
✓ start and end bandaging
✓ Hold dressing on the eye, finger, hand, etc.

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 Spiral Turns
 Used to bandage cylindrical parts of the body that
are fairly uniform in circumference.
 such as upper arm and upper leg.

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 Spiral Reverse Turns
 Used to bandage cylindrical
parts of the body that are not
uniform in circumference.
 Such as the lower leg or lower
forearm.

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 Figure of Eight
 It is applied above and below the joint, in such a way
that the turns is described as in the figure “8”.
 This method permits flexibility of the joint, such as
the elbow, knee and ankle.

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Figure of Eight

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 Recurrent Turns
 Used to bandage distal parts of body
 Example: fingers, head, stump, eyes, ears

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 Triangular Bandage
 Used to support and immobilize arms and elbow

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Triangular Bandage

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 NURSING RESPONSIBILITIES
1. Ensure effective communication
➢Inform procedure to patient.
➢Provide privacy to maintain patient’s dignity.

2. Ensure patient’s safety

➢Position the patient in a comfortable position.
➢Identify the correct part to be bandaged.
➢Apply dressing if needed.
➢Ensure bandage is not too tight to prevent
disturbance of circulation.

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 NURSING RESPONSIBILITIES
3. Ensure accuracy of procedure
➢ Ensure the correct type and size of bandage.
➢ Practice the principles of bandaging.
➢ Prepare sufficient equipment to prevent waste of time and
energy.
4. Observation
➢ Observe patient’s response to bandaging and assess
circulation of affected limbs to detect early complication.
5. Documentation
➢ Document and report if any abnormalities so that
immediate treatment can be taken.
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 Circulation Chart
1. Colour
✓ the colour should be pink
✓ capillary refill time - less then 2 seconds
2. Swelling – no increase in swelling
3. Temperature – the extremities should be
warm
4. Movement of extremities
5. Sensation
✓ patient able to feel the distal end of injured part
✓ Patient’s complaints: tingling , numbness, pain

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 Assessing Capillary Refill Time

Pressure is applied to
nail bed until it turns
pale/white then release
to observe

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1 Begin and end bandaging

2 Circular turn

3 Spiral turn

4 Spiral reverse turn

5 Figure of eight

6 Stump bandaging

7 Triangular bandaging
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 Skill 1: Begin and End Bandaging
1. Begin the bandage with two circular turns.
2. End the bandage above the joint with two
circular turns.
3. Secure the bandage appropriately with
✓ bandage clip or
✓ Adhesive tape / micropore or
✓ safety pin

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 Secure the badage

 Bandage clip
 Adhesive tape / micropore
 Safety pin
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 Skill 2: Circular Turn
1. Hold rolled bandage facing upwards.
2. Start bandaging with two circular turns.
3. Continue bandage with circular turns.
4. Ensure each turn covers 2/3 the surface of previous
turn.
5. End bandaging with two circular turns.
6. Tidy and secure bandage with adhesive
tape/plaster/safety pin at the side or front of limb.

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Circular Turn

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 Skill 3: Spiral Turn
1. Continue spiral turns at about a 30° angle towards
the proximal part of the affected part.
2. Ensure each turn covers 2/3 the surface of previous
turn.
3. End bandaging with two circular turns.
4. Tidy and secure bandage with adhesive
tape/plaster/safety pin at the side or front of limb.

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Spiral Turn

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 Skill 4: Spiral Reverse Turn
1. Continue spiral turns at about a 30° angle towards
the proximal part of the affected limb.
2. Place the thumb of the free hand on the upper edge
of the bandage.
3. Fold bandage downwards on top of the thumb.
4. Continue the bandage around the limb.
5. Ensure each turn covers 2/3 the surface of previous
turn.
6. End bandaging with two circular turns.
7. Tidy and secure bandage with adhesive
tape/plaster/safety pin at the side or front of limb.

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Spiral Reverse Turn

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 Skill 5: Figure of Eight
1. Continue subsequent turns above the joint, around it
and then below it, making a figure of eight above and
below the joint.
2. Ensure each turn covers 2/3 the surface of the
previous turn.
3. End bandaging with two circular turns.
4. Tidy and secure bandage with adhesive
tape/plaster/safety pin at the side or front of the
limb.

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Figure of Eight

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Skill 6: Stump Bandaging

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Triangular bandage

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REEF / SQUARE KNOT MODEL

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 How to tie a reef knot
1

1. Cross the left end of the rope to the right end from
below.

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How to tie a reef knot

2. Bring the two ends up.

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 How to tie a reef knot
3

3. Cross the right end of the rope to the left end from
below.

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 How to tie a reef knot
4

4. Pull on both ends to tighten.

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 How to release a reef knot

1. One hand holding one end of the triangle bandage, the

other hand holding at the reef knot.

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 How to release a reef knot
2

2. Pull the end of the triangular bandage and the

reef knot will be released.

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Arm Sling

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