|Bandages have three key uses: applying pressure to bleeding wounds; covering wounds and burns; and providing support and immobilization for broken bones, sprains, and strains. The three main types are triangular, Ace, and tubular.
TYPES OF BANDAGE
Made from cloth or from paper, these are exceptionally versatile. When they are made into a pad they can be used as a cold compress or for padding. When folded up they can be used to provide support or pressure; when unfolded they can be used as a support sling or cover bandage.
Used to provide support or secure dressings in place.
Larger ones are used to support joints or hold dressings in place, smaller tubular bandages are ideal for finger injuries.
General Principles of Bandaging
- Work with the injured person, explaining what you are doing.
- Work in front of the injured person where possible and from the injured side if you can.
- Bandage firmly over bleeding and securely over broken bones, but not so tight as to compromise circulation below the site of the injury.
- When wrapping bandages around an injured person, use the body’s natural hollows such as the knees, ankles, neck, and small of the back to slide the bandages gently into place.
- Be aware that most injuries swell—check regularly to ensure that the bandage is still comfortable. Also check that the bandage remains firmly secured, particularly if the injured person has to move, as movement can loosen the bandage.
- Secure bandages with tape, clips, a bow, or a square knot.
- Make sure that bandages, especially knots, do not press into the skin. Place padding between the bandaging and the skin as necessary.
These are amongst the most versatile of all items of first aid equipment. Usually made of washable cotton, they are also available in a disposable paper form. In its open form, a triangular bandage can be used as a sling or as a cover bandage.
TO USE AS A COLD COMPRESS OR PADDING OR TO APPLY PRESSURE WITH A DRESSING
- Used a narrow fold bandage.
- Fold the two ends into the middle.
- Keep folding the ends into the middle until the size is appropriate for use. Bandages are best stored in this way in a plastic bag in a dry place.
USING A TRIANGULAR BANDAGE
Making a broad fold to support broken bones or hold dressings loosely in place
- To make a broad fold, fold the point to the base of the bandage.
- Fold the bandage in half again. This is a broad fold.
Making a narrow fold to control bleeding
- To make a narrow fold, fold a broad fold in half again. This is a narrow fold.
TYING A SQUARE KNOT
When you tie a bandage, it is best to do so with a square knot. Square knots lie flat, so they do not press into the injured person, and they are easy to untie. Alternative fastenings include tying a bow, using a pin, securing with tape, or using a clip.
- Pass the right end of the bandage over the left and tuck it under.
- Bring both ends alongside each other.
- Pass the left end over the right and tuck it under.
- Pull both ends firmly to complete the knot.
FOOT COVER BANDAGE
- Fold a hem along the base of the triangular bandage. Place the victim’s foot on the bandage and bring the point down toward the victim’s ankle.
- Fold the bandage up over the foot.
- Fold the two ends of the bandage around the ankle and tie loosely.
- Pull the point of the bandage over the knot and tuck it away. The victim may find it comfortable to have the foot in an elevation sling.
Ace bandages are used to secure dressings or to provide support, particularly to sprains and strains. They are usually made of cotton, gauze, or linen and are secured in place with pins or tape.
TYPES OF ACE BANDAGE
There are three key types of Ace bandage, as pictured right:
Ace bandages come in a variety of sizes. For an adult, the following are recommended widths for different parts of the body:
Finger: ½ inch;
Hand: 1 inch;
Arm: 1 ½-2 inches;
Leg: 2-3 inches
Best used for applying light dressings
Used for securing dressings and providing support
Used for support, particularly for joint sprains
HOW TO APPLY AN ACE BANDAGE
- Partly unroll the bandage.
- Place the unrolled end below the injury and do two complete turns around the limb to secure the bandage in place.
- Bandage up the limb, using spiral turns. Be aware that conforming and crepe bandages mold to the shape of the body and while they should be applied firmly, take care not to over-stretch the bandage as this may impair circulation.
- Finish off with a single turn and secure in place. Secure with tape, clip, or by tying off.
- To tie off an Ace bandage, leave enough length to do complete turns of the limb. Cut down the middle of the bandage. Tie a knot at the bottom of the split and place both ends around the limb, one in each direction. Tie them in a bow or a square knot.
APPLYING TUBULAR GAUZE
These bandages come in several sizes. The smallest size is used to hold dressings on to fingers and toes. It comes with its own applicator and is best secured with tape.
- Cut two and half times the length of the finger or toe to be bandaged and push all of this on to the applicator.
- Place the dressing over the wound. Slide the applicator over the finger or toe.
- Hold the gauze at the base of the finger or toe and pull the applicator upward, covering the finger or toe with one layer of gauze.
- Above the finger or toe, twist the applicator twice and then push it back down, covering the finger or toe with another layer of gauze.
- Tape the gauze in place.
SIGNS AND SYMPTOMS OF REDUCED CIRCULATION
- Pale skin, becoming blue
- Skin feeling cold to the touch
- Injured person complains of tingling or loss of feeling
- Weak or slow pulse in an injured limb
- Slow capillary refill below the site of the bandage
- Look and feel for the signs and symptoms of reduced circulation. When bandaging, leave an area of skin exposed below the site of the injury to enable regular checks of circulation.
- Ask the injured person to report any tingling or loss of feeling.
- Gently squeeze the skin or the nail bed below the site injury and bandaging until the color disappears from the skin. When pressure is released, the color should return swiftly (color returns as the small blood vessels, the capillaries, refill with blood). If color does not return quickly, circulation may be restricted.
If there are signs that circulation is restricted, gently loosen the bandage (s). If the bandage is covering a wound or burn, do not remove dressings. If it is supporting a broken bone, take care to support the injury as you loosen and re-tie the bandage.
Bandages can cut off circulation, particularly as the injury swells. Check circulation below the site of the bandaging immediately after treatment and every 10 minutes thereafter.