SEMI-FINAL COVERAGE

CHAPTER 5

(3 HOURS)
Intended Learning Outcomes:

At the completion of this coverage, the students shall be able to:

1. Explain the purposes of bandaging.

2. Enumerate and differentiate the different types and methods of bandaging
3. Demonstrate application of a figure-8 bandage.

Specific Instructions in the completion of this Chapter:

1. Set your learning goals. At the end of this module you are expected to attain the
Intended Learning Outcomes stated above.
2. Prepare the following materials:
• Disaster Nursing textbooks and other references
• Notebook, bond papers and writing materials
• Worksheets
3. Lecture notes are provided for you.
4. After the lecture, you are required perform a skills demonstration.

Key Terms

Bandage
Circular bandage
Spiral
Spiral Reverse
Figure of Eight
Recurrent
Let’s Start!

Bandaging
• Bandaging is both a science and an art. The proper bandage, properly applied, can aid
materially in the recovery of the patient.
• A carelessly or improperly applied bandage can cause discomfort to the patient and may
imperil his life. Thus, it is important to become familiar with the various bandages and be
able to apply them properly.

Purposes of Bandaging
1. To create pressure over an area to stop bleeding
2. To immobilize part of the body to restrict its motion
3. To support a part of the body
4. To prevent or reduce swelling as well as to assist in the absorption of tissue fluid
5. To correct a deformity
6. To secure a limb to a splint or posterior mold
7. Used to hold dressings in place
8. To protect wound from contamination
9. To apply and retain warmth over a joint as in rheumatoid arthritis
10. To apply pressure to lower extremities and aid in venous return
TYPES OF BANDAGES

1. Triangular bandage
-could be used on many parts of the body to support and immobilize.
2. Crape Bandage
-type of woven gauze which has the quality of stretching.
3. Gauze/cotton bandage
-lightly woven cotton material. Frequently used to retain dressings fingers, hands, toes,
feet, ears, eyes, head.
4. Adhesive bandage
-used to retain dressing and also used where application of pressure to an area is
needed.

METHODS OF APPLYING BANDAGES

- Circular
- Spiral
- Spiral Reverse
- Figure of Eight
- Recurrent
-
I. CIRCULAR TURN

Purpose: Used chiefly to anchor bandages and to terminate bandages. Usually are not applied
directly over a wound because of the discomfort the bandage would cause.

1. Hold the bandage in your dominant hand, keeping the roll uppermost, and unroll the
bandage about 8cm. This length of unrolled bandage allows good control for placement
and tension.
2. Apply the end of the bandage to the part of the body to be bandaged. Hold the end down
with the thumb of the other hand.
3. Encircle the body part a few times or as often as needed, making sure that each layer
overlaps ½ -2/3 of the previous layer. This provides even support to the area.
4. The bandage should be firm, but not too tight. Ask the client if the bandage feels
comfortable. A tight bandage can interfere with blood circulation, whereas a loose
bandage does not provide an adequate protection.
5. Secure the end of the bandage with tape or a safety pin over an uninjured area. Pins can
cause discomfort when situated over an injured area.

II. SPIRAL TURNS

Purpose: Used to bandage parts of the body that are fairly uniform in circumference, for example,
the upper arm or the upper leg.

1. Make two circular turns. Two circular turns anchor the bandage.
2. Continue spiral turns at about a 30 degree angle, each turn overlapping the proceeding
one by 2/3 the width of the bandage.
3. Terminate the bandage with 2 circular turns and secure the end as described for circular
turns.

III. SPIRAL REVERSE TURNS

Purposes: Used to bandage cylindrical parts of the body that are not uniform in circumference,
for example, the lower leg or forearm.

1. Anchor the bandage with 2 circular turns, and bring the bandage upward at about a 30
degree angle.
2. Place the thumb of your free hand on the upper edge of the bandage. The thumb will hold
the bandage while it is folded on itself.
3. Unroll the bandage about 15cm (6 inches), and then turn your hand so that the bandage
falls over itself.
4. Continue the bandage around the limb, overlapping each previous turn by 2/3 the width
of the bandage. Make the bandage turn at the same position on the limb so that the turns
of the bandage will be aligned.
5. Terminate the bandage with 2 circular turns and secure the end as described for circular
turns.
IV. RECURRENT TURNS

Purposes: Used to cover distal parts of the body, for example, the ends of a finger, the skull or
the stump of an amputation.

1. Anchor the bandage with two circular turns,.

2. Fold the bandage back on itself, and bring it centrally over the distal end to be bandaged.
3. Holding it with the other hand, bring the bandage back over the end to the right of the
center bandage but overlapping it 2/3 the width of the bandage.
4. Bring the bandage back to the left side, also overlapping the first turn by 2/3 the width of
the bandage.
5. Continue this pattern of alternating right and left until the area is covered. Overlap the
preceding turn by two-thirds the bandage width each time.
6. Terminate the bandage with two circular turns. Secure appropriately.

V. FIGURE 8 TURNS

Purposes: Used to bandage an elbow, knee or ankle, because they may permit some movement
after application.

1. Anchor the bandage with two circular turns.

2. Carry the bandage above the joint, around it and below it, making a figure eight.
3. Continue above and below the joint, overlapping the previous turn by two-thirds the width
of the bandage.
4. Terminate the bandage and above the joint with two circular turns and then secure
appropriately.

TRIANGULAR AND CRAVAT BANDAGES

The triangular bandage, also known as the handkerchief bandage, is used for the
temporary or permanent dressing of wounds, fractures, dislocations, etc., and for slings. It is very
valuable in first-aid work since it is quickly and easily applied, stays on well, and can be improvised
from any kind of cloth, such as a piece of a shirt, an old sheet, a large handkerchief, etc.
Unbleached muslin is generally used in making triangular bandages, although linen, wool, silk;
etc., will answer the purpose. In making triangular bandages a square of material about 3 by 3
feet, or slightly more, is folded diagonally to make one bandage or may be cut along the fold to
make two bandages. 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."
These bandages may be used either as a triangle or as a cravat, the latter being made from the
triangle by bringing the apex to the base and folding it upon itself a sufficient number of times to
obtain the width desired. The names of the-various triangular and cravat bandages indicate the
part of the body to which the bandage is applied.
PROCEDURES

I. TRIANGLE OF FOREHEAD OR SCALP (fronto-occipital)

- Used to retain dressings on the forehead or scalp.
1. Place middle of base of triangle so that edge is just above eyebrows and bring apex
backward, allowing it to drop over back of head (occiput).
2. Bring ends of triangle around to back of head, above ears, and cross them over apex at
occiput.
3. Carry ends around to forehead and tie them in square knot.
4. Turn up apex of bandage toward top of head. Pin with safety pin or tuck in behind crossed
part of bandage.

II. TRIANGULAR ARM SLING (brachio-cervical triangle)

-Used for fractures or injuries of hand, wrist, and forearm.
1. Arm to be put in sling should first be bent at elbow so that little finger is about a hand's
breadth above level of elbow.
2. Drop one end of triangle over shoulder on injured side and let bandage hang down over
chest with base toward hand and apex toward elbow.
3. Slip bandage between body and arm. Carry lower end up over shoulder on injured side.
4. Tie the two ends, by square knot, at back of neck. Knot should be on either side of neck,
not in middle, where it could cause discomfort when patient is lying on back.
5. Draw apex of bandage toward elbow until snug, bring it around elbow to front, and fasten
with safety pin or adhesive tape.

III. TRIANGULAR ARM SLING

- Another version of this sling is frequently used where it is desirable to support the
forearm, without pressure on the collarbone or shoulder of the injured side.
2. Start as in (1).
3. and pass lower end of bandage under injured shoulder. Ends of fingers should extend
slightly beyond base of triangle.
4. Tie ends. Secure apex to sling at elbow by tucking in or with safety pin.

IV. SHOULDER-ARMPIT
- (bis-axillary) Used to hold dressings in the armpit (axilla) or on the shoulder.
1. Place middle of cravat in armpit over dressing.
2. Carry ends upward and over top of shoulder.
3. Cross ends lnd bring them across back and chest respectively to opposite armpit where
they are tied.

V. TRIANGLE OF CHEST OR BACK

- Used to retain dressings on burns or wounds.
 1. Drop apex of triangle over shoulder on injured side. Bring bandage down over chest (or
back) to cover dressing and so that middle of base of bandage is directly below injury.
Turn up a cuff at base.
2. Carry ends around body and tie in square knot.
3. Bring apex down and tie to one of ends of first knot.

VI. TRIANGLE OF SHOULDER

- Used to retain dressings on shoulder. Requires two bandages, one a triangle, and the
other a cravat.
1. Place center of cravat at base of neck on injured side, and tie just forward of opposite
armpit.
2. Place apex of open triangle under cravat at base of neck and over dressing on injured
shoulder and upper arm.
3. Tuck apex under cravat at neck.
4. Cross ends of base and tie around arm; secure apex to cravat at neck by tucking in 6r
with safety pin.

VII. TRIANGLE OF FOOT

- Used to retain dressings of considerable size on the foot.
1. Center foot upon bandage at right angles to base. Heel should be well forward.
2. Carry apex of triangle over toes, and cover back of foot to ankle.
3. Tuck excess fullness of bandage into small pleats on both sides of foot.
4. Cross each half of bandage toward opposite sides of ankle. Bring ends of triangle around
ankle. Tie ends in square knots.

VIII. TRIANGLE OF HAND

- Used to retain dressings of considerable size on the hand.
1. Place middle of base of triangle well up on palmar surface of wrist.
2. Carry apex around ends of fingers and cover back (dorsum) of hand to wrist.
3. Tuck excess fullness of bandage into small pleats on both sides of fingers.
4. Cross each half of bandage toward opposite sides of wrist.
5. Bring ends of triangle around wrist.
6. Tie ends in square knot.

FOLDING TRIANGULAR BANDAGES

- for storage and shipment
1. Bandage unfolded.
2. Fold once left to right.
3. Fold ends right to left.
4. Fold apex down to form square.
5. Fold in half, right to left.
6. Fold down through center
Points to Remember!

• Handle carefully to prevent contamination.

• Don’t apply bandages until bleeding has stopped.
• Don’t remove original dressing if blood soaks through.
• Ensure that the dressing completely covers the wound.
• Do not place bandages directly on wounds (only sterile dressings).
• Bandage wounds snugly but not tightly.
• Bandages should not be loose; dressing and bandage should not slip or shift.
• Ensure that there are no loose ends that could catch on things.
• Cover all edges of the dressing with the bandage.
• Leave tips of fingers and toes exposed when bandaging arms and legs.
• Bandage a body part in the position it should remain.
• Never use a circular bandage around a victim’s neck.
• Some situations require improvisation.
• No hard-and-fast rules; use adaptability and creativity.
• Use materials on hand and methods you can best adapt.
• Use materials that are as clean as possible.
• Never touch the wound directly.
• Control bleeding.
• In an emergency can use if clean
• Handkerchief
• Washcloth or towel
• Sheet or pillowcase
• Sanitary napkin
• Plastic wrap can be used as part of an occlusive dressing
• Never use
• Elastic bandages
• Fluffy cotton or cotton balls
• Paper towels, toilet tissue, or other materials cling when wet