A dressing is considered to be medical or improvised means, the purpose of which is to fix the dressing material on the wound, increase the pressure on the vessels during bleeding, fix the arms, legs and other parts to ensure their immobility, prevent secondary infection of the wound surface, protect it from the adverse effects of the environment environment, prevention of edema.
They are classified according to different parameters:
- By duration of use (temporary, permanent).
- By appointment:
- reinforcing (plaster, adhesive, bandage),
- immobilizing (tire, gypsum).
- By the method of fixing the dressing material:
- bandage (gauze, mesh, tubular mesh, fabric bandage),
- kerchief (gauze or cloth in the form of a scarf),
- According to the properties of the materials used (soft or hard).
- By overlay method:
- spike-like and others
We are preparing material for dressing
In any first-aid kit, in addition to a wide variety of medicines (painkillers, antipyretic, anti-inflammatory, sedatives, etc.), there should be dressings. Their mandatory list:
- dressing bag
- bandages: sterile, elastic mesh-tubular,
- sterile cotton wool
- bactericidal patch
- a rubber tourniquet for temporarily squeezing large blood vessels in order to reduce blood loss,
- splint applied to the arm or leg during a fracture or dislocation.
The kit can be supplemented with ordinary band-aid, non-sterile gauze and medical tubular bandages, green paint, iodine, hydrogen peroxide.
All these accessories may be needed for dressings in cases of injuries that are accompanied by bleeding, dislocation, fractures and swelling or immobilization of the site.
Basic dressing rules
The skills of imposing the simplest dressings should everyone. They require certain skills, otherwise the bandage will not hold, weaken, slip, or, conversely, squeezing, disrupt blood circulation and even cause pain. To avoid this, you should master these simple rules:
- Wash your hands well with soap (if not possible, thoroughly wipe with a damp cloth with antibacterial properties).
- Treat the skin around the wound or the site of the disease with a disinfectant (alcohol, vodka). If the wound is fresh, then iodine.
- Position yourself so that you can see the victim’s face and the area you want to dress. The bandage surface, if this is possible in this situation, should be at the chest level of the one who is bandaging.
- The end of the bandage is held in the left hand, and rolled up - in the right. First, the free part is superimposed, fixed in two turns clockwise, and then, moving the right hand and helping it with the left, partially overlapping the previous round, move forward. The last two turns, like the first, overlap each other. The remainder of the bandage must be cut (do not tear!) Lengthwise and fix the bandage.
- The legs should be in a straightened position while applying the bandage, and the hands should be bent.
- A correctly made dressing completely fixes the dressing, does not move and does not compress damaged tissues, has an aesthetic appearance, if applied for a long time - marking with time and date of application.
The rules for applying more complex bandage dressings are not known to everyone, and they can be well mastered only after a long special training.
Some types of dressings and rules for imposing
A soft bandage (sticker) is used to close clean wounds that have undergone treatment: stitches after surgery, opened boils, etc. A pad of cotton wool and gauze is covered with a 2-layer bandage and glued with a special compound.
Adhesive is used in similar situations. Adhesive tape ribbons are attached to dry skin. Most often, these dressings are used for fractures of the ribs and cut wounds of the abdomen.
A gauze or tissue piece in the shape of a triangle is the main element of the scarf dressings. With their help, dressings, injured arm, foot are held. The hand (or foot) is placed on the spread out scarf. One of the ends of the scarf is wrapped on the back side, the other two are tied. If the arm is damaged, the bandage is attached to the neck, and if the foot is injured, just above the ankle.
Contour dressing is a good painless way to protect the surface of burn lesions of a large area. It is made in the form of shorts or a corset for fixing dressing material along the contour of the injury.
T-shaped - superimposed on the lower body during injuries or after operations on the rectum, genitals or perineum. One piece of a bandage is fixed on a belt, another - fixes dressing material in a crotch area, and in front fastens with a "belt".
The most common types of dressings are bandage. Bandages of different widths are used for them. The overlay rules are as follows: they begin to bandage from a narrower part, gradually moving to a surface with a larger circle to apply the bandage. Each next round should lie on the previous one. This dressing is firmly fixed at the very beginning and at the end of the procedure.
For the treatment of the crown of the head, neck, nose, or chin, a sling-like dressing is used, which is constructed from a bandage or strip of fabric with longitudinally cut ends.
The most reliable are circular dressings. Their strength is due to the fact that the turns of the bandage lie on top of one another. Suitable for dressing any part of the body.
Spiral like circular. But after several revolutions, the bandage is deflected slightly to the side, overlapping the one in front of him by half. Most often they are imposed on the limbs.
To bandage the hands, ankles, neck, chest area, use a cruciate or spike bandage.
The tortoise bandage can be seen on a bandaged elbow or knee.
Rigid dressings are made by hardening substances (starch, gypsum) or solid materials (metal, plastic, etc.). They are imposed during transportation or to immobilize a part of the body for a long period.
Everyone should know and be able to do the simplest dressings, as injuries can be obtained anywhere, even at home.
How are dressings applied? What is the blending technique? According to their purpose, they distinguish:
- hemostatic (pressure) dressings - stop bleeding by creating a certain pressure on the desired area of the body,
- protective (aseptic) - prevent infection of the wound,
- medicinal (usually partially saturated with medicine) - provide long-term access of the drug to the wound,
- bandages with stretching - straighten broken bones, for example, tibia,
- immobilizing - immobilize a limb, mainly with fractures,
- deformity dressings - corrective,
- sealing wounds (occlusal), for example, for injuries of the chest, are needed so that the victim can breathe.
The following types of dressings are available:
- solid - with the use of solid materials (Cramer bus and others),
- soft - using soft raw materials (bandage, cotton wool, gauze and others),
- hardening - plaster dressings.
What is the Deso Dressing for? The technique of applying it is unsophisticated. Using it, fix the upper limbs with dislocations and fractures of the shoulder. For the manufacture of this dressing requires the following tools:
- bandage (width 20 cm).
It should be noted that the right hand is bandaged from left to right, and the left - in the reverse order.
So, let's find out how the “Deso” dressing is made. Its overlay technique is as follows:
- Set the patient facing you, calm down, explain the course of forthcoming actions.
- Put the gauze wrapped in gauze into the armpit.
- Bend your forearm at an angle of 90 ° in the elbow joint.
- Hold your forearm to your chest.
- Perform a pair of fixing tours of the bandage over the chest, injured arm in the shoulder area, back and armpit from the side of a workable arm.
- Lead the bandage through the armpit of the competent side along the front chest surface obliquely on the shoulder girdle of the inferior region.
- Get down on the back of the injured shoulder under the elbow.
- Round the elbow joint and, holding the forearm, direct the bandage obliquely into the armpit of the healthy side.
- Take the bandage from the armpit on the back to the sore forearm.
- Guide the bandage from the shoulder girdle along the frontal plane of the shoulder under the elbow and go around the forearm.
- Point dressings on the back to the armpit of the healthy side.
- Repeat the bandage tours until the shoulder is firmly fixed.
- Complete the bandage with a pair of reinforcing tours on the chest, a sore arm in the shoulder, back.
- Pin the end of the dressing with a pin.
By the way, if a bandage is applied for a long time, the bandage tours need to be stitched.
Do you know what a cap is? The overlay technique is easy to remember. This dressing can simultaneously perform the functions of fixation, stop bleeding, fix drugs and prevent infection from entering the damaged surface. In fact, it is universal.
How does it overlap? If the patient is conscious, one person can bandage him. If the victim has lost his senses in order to make a high-quality bandage, the medical worker must attract an assistant.
Cut off a meter tape from the head of the bandage and put the middle on the parietal region. Its ends should hang freely, like the ties of a baby’s cap. During the procedure, they should be held by the victim himself or by the assistant paramedic.
Take a pair of reinforcing tours around the entire skull. Then lay out the cap itself. After the blocking tour, go to the area of the tie, wrap the bandage around it and put it on the back of the head to the second strap. There, in the same way, wrap a bandage around it and lay a tour on the skull area from the forehead.
Movements must be repeated, and with each next round you need to overlap the previous one by about a third. With the help of such moves, the entire scalp of the skull is completely covered with dressing tissue. It turns out a gauze cap that looks like a bonnet. The bandage is fixed as follows: tear the end of the bandage, fasten with a knot and tie under the tie. Then tie the straps together.
Do you know that a cap can stop the blood? The overlay technique in this case is somewhat different. Cut hair in the area of injury and check for foreign inclusions. If possible, disinfect the wound or its edges. It must be remembered that an antiseptic (mainly alcohol) can contribute to the appearance of pain shock. Therefore, carefully carry out the procedure. Then put a clean gauze napkin in two layers on an open wound, then a squeezing pillow from a bandage bag. Next, apply the dressing according to the above algorithm.
If you do not have a specific pillow on hand, use a dressing bag or tightly folded things, preferably clean. The pressure pad should completely cover the wound, overlap the edges and not be deformed. Otherwise, it will push the edges of the wound and increase its size.
During breakfast, lunch and dinner, the straps on the cap can be relaxed. At the time of sleep, it is not recommended to untie them, since the bandage can move out.
What is the technique for applying a pressure dressing? This species is mainly used to stop minor bleeding and reduce extravasation in joints and periarticular soft tissues. Put a gauze-cotton roller on the wound and tightly fix it with a bandage, without squeezing the vessels. Sometimes paramedics use elastic compression dressings for damaged ligaments or venous insufficiency.
It is known that bleeding is capillary (blood secretion on a large surface of the body), arterial and venous. Arterial blood gushes and has a scarlet color, and venous - pours out in a steady stream, dark.
What is the pressure dressing technique in the circumstances? With a small external bleeding from a vein or from capillaries, apply a tightening bandage without squeezing the limb. This method will not save if there is severe mixed or arterial bleeding. Pinch the artery with your finger above the wound (determine the point by pulsation) while the assistant is preparing a tourniquet. Put a note under the harness, in which indicate the time of its application.
How is the glove created? The technique of applying it is quite simple. This dressing is used for injuring fingers. To apply it, you need to have a needle and a syringe, a narrow bandage (4-6 cm), balls, a tray, gloves, an antiseptic and an analgesic.
Seat the patient and face him (monitor his condition). Anesthetize the bandage. Perform 2-3 circular rounds around the wrist, and then direct the bandage obliquely along the dorsal surface of the hand to the nail of the thumb of the right hand and the left to the nail phalanx of the little finger (do not cover ½ of the nail phalanx with a bandage to observe the condition of the limb).
Then, in spiral turns from the nail to the base of the finger, close it, and cross the bandage on the back surface and point it towards the wrist (from left to right). Take a tour around your wrists. Band the remaining fingers in the same way. Complete the bandage with circular rounds and tie. It should be noted that the bandage “Knight's glove” can be supplemented with a scarf bandage.
Many do not know the technique of applying a spiky bandage. As a rule, it fixes the shoulder joint with pathology of the shoulder and armpit. You should have a bandage (width 12-16 cm), a sterile napkin, scissors, a kidney-shaped basin, pin, tweezers on hand.
Here you need to perform the actions in the following sequence:
- Turn to face the patient.
- Draw two reinforcing circle circles around the shoulder on the non-prostrate side.
- Run the third round obliquely from the armpit to the back along the front of the shoulder.
- The fourth round continues the third.
- In the fifth circle, circularly cover the shoulder (outer, inner surfaces, front and back) and bring it to the back, crossing with the fourth round.
Why is the mittens needed? The technique of applying it is completely simple. It is used for injuries and burns of the hand, frostbite. To make this dressing you need to prepare a needle and a syringe, napkins, a bandage (width 8-10 cm), a tray, an analgesic, balls, antiseptic and gloves.
In this case, you need to do the following:
- Seat the patient and face him to monitor his condition.
- Perform 2-3 circular reinforcing turns in the wrist area.
- Fold the bandage 90 ° on the back of the wrist.
- Guide the bandage along the back of the hand to the tops of the fingers, and then go to the palm of your hand and reach the wrist.
- Repeat the third step three to four times, simultaneously covering four fingers.
- Fasten the previous turns in a circular tour in the wrist area, bending the bandage 90 ° in advance.
- Lead the bandage along the back to the tops of the fingers, wrapping it with spiral-shaped strokes following to the base of the fingers.
- Return the bandage to the wrist through the rear of the brush. In a round tour, fix the previous turns.
- Apply a spiky bandage to your thumb.
- Complete the wrap with circular rounds around the wrist and tie.
By the way, so that your fingers do not stick together, you need to put gauze scarves between them. The mittens can be complemented by a kerchief strap to immobilize a limb.
And what is the technique of applying a bandage to the head? Bandage-cap we examined above. It is known that for bandaging the skull using several varieties of dressings with different purposes:
- "Hippocrates Cap". To apply this bandage, use two bandages or a bandage with two heads. Take the bandage head in your right hand, make circular loops and fix the bandage rounds, which, diverging or converging, should gradually close the cranial vault.
- Bandaging the right eye, the bandage is moved from left to right, and the left - in the opposite direction. A bandage around the head is fixed in a circular circular motion, then lowered to the back of the head and held obliquely and upward under the ear from the bandage zone, covering the damaged eye with it. They grab the curved stroke in a circular manner, then again make an oblique move, but slightly higher than the previous one. Alternating oblique and circular turns, envelop the entire area of the eye.
- Bandage on two eyes. The first fixing circular tour is performed, and the next is transferred along the crown of the head and forehead down. Then make a top-down curve of the envelope surrounding the left eye. Next, the bandage is moved around the back of the head and again perform a bottom-up curved stroke covering the right eye. В итоге все очередные витки бинта пересекаются в районе переносицы, незаметно окутывая оба глаза и спускаясь вниз. В конце бинтования перевязь укрепляют горизонтальным круговым туром.
- The Neapolitan bandage begins to perform with circular turns around the head. Next, the bandage is lowered from the unfriendly side to the area of the ear and mastoid process.
- Bandage "Bridle" is mainly applied to close the chin area. First perform a fixing circular tour. The second turn is led obliquely to the nape of the neck and is transformed into a vertical position under the jaw. Moving the bandage in front of the ears, they make a couple of turns around the head, and then from under the chin they lead it obliquely to the back of the head or on the other side and, turning it into horizontal turns, fix the bandage. In order to completely close the lower jaw after fixing horizontal strokes, you need to lower the head of the bandage crookedly down the back of the head and go to the neck along the front of the chin. Next, rounding the neck, you must return. Then, lowering the bandage a little below the chin, it is lifted vertically, fixing the band around the head.
The technique of applying an occlusive dressing is known only to health workers. Consider it as detailed as possible. Occlusive dressings provide hermetic isolation of the injured area of the body, preventing its contact with air and water. To make such a device, it is necessary to place water- and air-tight material, for example, rubberized fabric or synthetic film, on the wound and the adjacent area of the skin with a radius of 5-10 cm, and fix it with an ordinary bandage. Instead of a bandage, you can use wide bands of adhesive tape.
It is known that a modern and reliable application of an occlusive dressing is especially important when the patient has a penetrating chest wound and pneumothorax has developed.
Everyone should analyze the application of dressings. The technique of applying a sealing (occlusive) bandage is as follows:
- If the wound is small, prepare 1% iodine, a tupfer, and a dressing pack. Seat the victim and treat the skin around the injury with an antiseptic. Then lay the rubber sheath of the private set on the wound with the sterile side and place cotton-gauze bags over it. Next, you need to fix it all with an ear-shaped bandage (if the injury is at the level of the shoulder joint) or spiral to the chest (if the injury is below the level of the shoulder joint).
- If the wound is extensive, prepare 1% iodine, tupfer, petroleum jelly, sterile wipes, a wide bandage, oilcloth and a gauze-cotton swab. Give the victim a semi-sitting position and treat the skin around the wound with an antiseptic. Then apply a sterile cloth to the damage and lubricate the skin around it with petroleum jelly. Next, put the oilcloth so that its edges protrude 10 cm beyond the wound. After that, put a gauze-cotton swab that covers the film by 10 cm and fix it with a bandage on the chest or with a spiky bandage.
It is difficult to fully study the application of dressings. The overlay technique, of course, is useful to everyone. It is known that there are complete plaster casts and incomplete ones. The latter include crib and langeta.
These dressings can be unlined and with a cotton-gauze lining. The former are used in the treatment of fractures, and the latter in orthopedic practice. So, the technique of applying plaster casts is as follows:
- Before applying the dressing, put or lay the patient so that he does not have unpleasant sensations when bandaging.
- For a fixed limb or part of the body, use special stands, racks to give it a pose in which it will be after the procedure is completed. Cover all bone protrusions with gauze-cotton pads to prevent pressure sores.
- Drive the plaster bandage in a spiral, bandage without tension, rolling it over the body. Do not tear off the bandage head from the bandaged surface so that wrinkles do not appear. Smooth with a palm each layer, model according to the outlines of the body. With this technique, the bandage becomes monolithic.
- Over the fracture zone, on the folds, strengthen the bandage, which can include 6-12 layers, with additional bandage rounds.
- During bandaging, the position of the limb is forbidden to change, as this leads to the appearance of folds, and they will compress the vessels and a bedsore will appear.
- During the procedure, support the limb with the whole palm, and not with your fingers, so that dents do not appear on the bandage.
- In the process of applying gypsum, monitor the pain of the patient and his facial expression.
- Fingers of the lower and upper limbs always leave open so that blood circulation can be judged by their appearance. If the fingers are cold to the touch, turn blue and swell, then venous stasis has arisen. In this case, the bandage needs to be cut, and possibly replaced. If the patient complains of terrible pain, and the fingers become cold and white, then the arteries are transmitted. Therefore, immediately cut the bandage along, part the edges and temporarily strengthen with a soft bandage until a new bandage is applied.
- At the end, the edges of the dressings are trimmed, tucked out, and the resulting roller is smoothed with a plaster mash. After it is covered with a layer of gauze and again smeared with gruel.
- At the end, write on the bandage the date of its application.
It is known that it is forbidden to cover a wet dressing with a sheet before drying. It will dry on the third day.
Therefore, the technique of applying bandage dressings is known to us. Among other things, you need to follow some rules of bandaging:
- always face the patient
- bandaging, start with a tour of bandage,
- bandage is applied from the bottom up (from the periphery to the center), from left to right, minus special bandages,
- with each subsequent turn of the bandage overlap the previous half or 2/3,
- bandage with both hands
- applying a bandage to the cone-shaped parts of the body (lower leg, thigh, forearm), to better fit it after every couple of turns of the bandage, do it torsion.
The technique of applying soft dressings is known to many. These dressings are divided into the following types: bandage, glue (colloidal, adhesive plasters, glue) and kerchief. They are created like that.
Glue dressings are used mainly for trifling injuries and to the wound area, regardless of its location. If hair grows in the area, it is shaved in advance.
To make a bandage dressing, you need a dressing applied to the wound, attach a pair of strips of adhesive patch to healthy areas of the skin. Unfortunately, this design has an unreliable fixation (especially when wet), and skin maceration can occur underneath.
Cleol is called resin, a pine resin dissolved in a mixture of ether and alcohol. Cover the wound with a bandage, and smear the skin around it with a potion and let it dry a little. With gauze, close the dressing and skin areas treated with cleol. Press the edges of the napkin firmly to the skin, and cut off the non-adhered excess gauze with scissors. What are the disadvantages of this dressing? It does not adhere well enough, and the skin is contaminated with dried cleol.
A colloid dressing differs from the previous one in that the gauze is glued to the skin with collodion - a mixture of ether, alcohol and nitrocellulose.
We examined the types, the technique of applying dressings. We have studied an extensive topic. Of course, you now know how to help a person who is injured. For bandaging the toes of the foot, hands, narrow bandages (3-5-7 cm) are used, the head, forearm, hands, lower legs are medium (10-12 cm), the mammary gland, thighs, chest are wide (14-18 cm).
If the bandage is applied correctly, it does not interfere with the patient, is neat, closes the damage, does not disrupt lymph and blood circulation, and firmly holds on to the body.