BANDAGING – NURSING PROCEDURE – Nurse Info

BANDAGING (Definition, Purpose, General Principles, Types and Techniques)

Updated 2024

A bandage is
a strip of fabric used to dress and bind up wounds. In medicine, bandage
refines and elaborates upon this basic form, combining it with casts, slings,
and splints to heal all kinds of injuries. It is important to do the proper
bandaging technique when using and administering first aid on a wound or
injury. The main goal of placing a bandage on an injury is for immobilization,
protection, support or compression. If the bandaging technique is not done
properly, it could exacerbate the damage.

DEFINITION

A bandage is
any gauze or cloth material used for any of the purpose to support or to hold
or to immobilize the body part. Bandaging is a technique of application of
specific roller bandages to different parts of body

PURPOSE

To control bleeding by pressure
To immobilize sprained or fractured
limb
To hold a dressing or compress in
place
To secure splints in case of fracture
of deformity
To protect open wound from
contaminants
To provide support and aid in case of
varicose veins or impaired circulation

GENERAL
PRINCIPLES

The patient should be placed in a
comfortable position and it should convenient for the nurse
The position of the part to be ban
aged should be well supported and elevated if necessary
The nurse should stand directly in front
of the patient or facing part to be damaged
A bandage should accomplish its
purpose. It may be used to hold dressing in place, to support a part or to
immobilize
Apply and fix bandage at least two
circular turns around part is its smallest diameter, so that it can stay in
place
Skin surfaces should be separated.
They may be separated. They may be separated by either gauze or cotton. In the
application of casts, special padding is used over bony prominences
Always bandage to the right
Exert even pressure as far as
possible. The bandage should be done in the direction of the venous circulation
Do not cover the ends of the finger
or toes, unless it is necessary in order to cover the injury. It is necessary
to observe circulatory changes
Never apply a wet bandage. When wet
bandage applied, terms to shrink and become tight as it dries
Do not apply a bandage too loosely
because it may slip and expose the wound
All turns of bandage should be made
clockwise unless there is some special reason for doing otherwise the roll
should be held in the palm of the hand, with the free end of the bandage coming
from the part of the roll
Applying bandage, secure terminal
extremity by pinning with safety pins or strapping adhesive
Remove bandages by gathering folds in
a loose mass. Passing mass from one hand to the other
Examine the bandage part frequently for pain, swelling, etc

Bandaging Nursing Procedure - Important Key Points

ROLLER BANDAGE TYPES

A roller bandage is a strip of gauze or cotton material
prepared in a roll. Roller bandages can be used to immobilize injured body
parts (sprains and torn muscles), provide pressure to control internal or
external bleeding, absorb drainage, and secure dressings. Three types of
bandages are the Kerlex bandage, the gauze bandage, and the elastic bandage

Kerlex bandage: the bandage is absorbent, loosely woven, and
conforms easily to uneven surfaces, such as the hand, wrist, elbow, shoulder,
groin, knee, ankle, and foot. The Kling bandage is similar to the Kerlex’s
bandage. These bandages are used primarily for bleeding injuries

Gauze roller bandage: the gauze roller bandage is absorbent, loosely
woven, cotton fabric. It does not conform well to uneven surfaces and is not to
be used on areas prone to chafing such as shoulders, elbows, groin and other
jointed areas. It is used primarily on bleeding injuries on the upper arm,
forearm, thigh and lower leg

Elastic Roller Bandage: the elastic roller bandage is
composed of cloth and elastic that allows it to stretch and retract. It
conforms to uneven surfaces and applies even pressure to the area covered. It
is used to apply pressure and/or restrict movement. The elastic bandage is
normally used when a sprain needs to be immobilized. Make sure the bandage is
not right enough to restrict blood flow unless it is used as a pressure
dressing

TYPES

Circular bandage: the bandage is wrapped around the part with
complete overlapping of the previous bandage turn. This is used primarily for
anchoring a bandage where it is begun and where it is terminated

Spiral bandage: the bandage ascends in a spiral manner so
that each turn overlaps the preceding one by one half or two-thirds the width
of the bandage. The spiral turn is useful for the wrist, the finger and the
trunk

Figure-of-eight: the figure-of-eight turn consists of making
oblique overlapping turns that ascend and descend alternatively. It is
effective for use around joints, such as the knee, the elbow, and the ankle.

Recurrent-stumps bandage: after a few circular turns to
anchor the bandage the initial end of the bandage is placed in the center of
the body part being bandaged, well back from the tip to be covered. Recurrent
bandages are used for gingers for the hand and for the stump of an amputated
limb

T-bandage: it is used to secure rectal or perineal dressing.
The double “T” bandage is used for males and single “T” bandages is for the
females. The strips of the “T” bandage are brought between the patients leg and
is pinned to the waist band in front

MATERIALS

Gauze
Muslin
Rubber
Elastic
Flannel
Crinoline for plaster
Adhesive

ASSESSING
BEFORE APPLYING BANDAGE

Inspect and palpate the area for
swelling
Inspect for the presence of and
status of wounds
Note the presence of drainage
(amount, color, odor, and velocity)
Inspect and palpate for adequacy of
circulation (skin temperature, color and sensation)
Ask the patient about any pain
experienced (location, intensity, onset and quality)
Assess the ability of the patient to
reapply the bandage when needed
Assess the capabilities of the
patient regarding activities of daily living (to dress, comb hair, bath)

EQUIPMENT

Clean
bandage of the appropriate material and width, safety pin, adhesive tape, and
special metal clips

PROCEDURE

Explain to patient
Make sure that the area to be
bandaged is clean and dry
Stand opposite to the patient if
possible
Support the affected part adequately
ensuring correct body alignment to prevent deformity and impair circulation
Keep bandage roll uppermost with free
and above site to be bandaged
Bandage from below to upward
Cover two – thirds of previous turn,
avoid loose edges
Take requires number of turns so that
purpose is achieved.
Secure the end of the bandage with
tape. Metal clips or a safety pin over an uninjured area
Document the site and type of bandage
used

SPECIAL
BANDAGES

Eye bandage (monocular): bandage of
1.5-2 width is required. Place the free end of bandage at temporal region on
the same side of eye to be bandaged. A piece of tape is passed under bandage on
side of eye and tie so as to prevent
bandage from sliding over good eye
Binocular bandage: figure-of-eight
technique is used. Start from right temporal region take one turn. Around head,
down over the left eye, under right ear right eye to right to left temple.
Repeat around heal to right temple following previous pattern until both eyes
are covered
Ear-mastoid bandage: bandage with 2
feet width and 5 yards length is required make circular turns around head above
ears, beginning on affected side. Follow with circular turns. The first turn is
taken beneath occiput, and carried high over to opposite side of head below ear
Jaw Barton bandage: used in fracture
of lower jaw and to hold dressing on chin. Bandage of 2 inches width and 5-6
yards length is required. Begin at nape of neck below occiput, carry bandage
obliquely up, behind and close to ear, then under chin and up in front of left
ear to top of head
Cape line bandage (head bandage): a
double roller bandage of 2 feet width and 8 yards length is required. Place
center of bandage in middle of forehead and carry roller in opposite direction
to occipital. Cross rollers one over other. The roller in inferior position in
brought over head to middle of forehead
Shoulder spica: a bandage of 2 ½
inches width and 8 yards is required. The spica may be either descending or
ascending. The ascending type is most commonly used. While applying bandage,
stand at side which is to be bandage. A pad must be placed in axilla.

BANDAGING
TECHNIQUES

Guidelines
in Using Dressing and Bandages

There are
certain guidelines to follow to ensure proper bandaging technique.

Use a dressing that is large enough
to go beyond at least 1 inch of the wound edges
For exposed body tissues or organs,
make sure to cover the wound with non-stick dressing, e.g. moistened gauze or
plastic. Secure the dressing using adhesive tapes or bandages
For bandages over a point, keep the
joint immobilized by creating a bulky dressing
Ensure that the bandage is tight but
not too tight to cut off circulation. Signs that circulation is cut off include
color change (to bluish) especially of the extremities, tingling sensation,
feeling cold, or swelling. Once these begin to show, loosen the bandage.
Bandaging technique will depend on,
the first aider’s skills, the size and location of the wounds, and the
materials available

Triangular
Bandage

The first
bandaging technique to be discussed is the triangular bandage. The triangular
bandage is one of the most standard contents of a first aid kit. It has plenty
of uses, such as a sling to support an injury to the upper body, padding for
major wounds and a bandage for immobilization purposes. It is quite easy to
make and they are as follows:

Stretch the piece of fabric that will
be used. Opt to use a long stretch to create more triangular bandages, which
can be used in the fracture
Cut the fabric into a square,
approximately 3 ft multiply 3 ft. cut the square diagonally into two equal
halves, creating two triangle
There are two ways to sterilize the
bandages (sterilizing will reduce infection risk). First option is to pull the
bandage in boiling water. The second option is to soak the bandage in hydrogen
peroxide or any other disinfectant. Dry before use
If possible, iron the triangular bandage,
so it can be easily used during a time of need

Roller
Bandage

The second
bandaging technique to be discussed is the roller bandage. Similarly, the
roller bandage is a standard for many first aid kits and has many practical
uses. These include controlling bleeding, pressure bandage and keeping the
dressing in place. The following are the steps to make a roller bandage:

Allow the individual to stay in a
position where they are most comfortable. Give enough support to the affected
part before beginning to apply the bandage. Hold the “head” end of the bandage
while using the “tail” end to wrap the affected part. Wrap the affected area
only a few centimeters at a time to ensure that tightness is maintained
After each turn, begin with a locking
turn to hold the start of the bandage in place
One has two options, whichever is
more applicable. Begin from the middle part of the affected part or limb moving
toward an outward direction. The second option is to begin with the narrowest
part, below the dressing, and moving upward
Ensure that each turn of bandage will
cover two thirds of the prior turn of bandage
Cover the dressing or padding used
completely
Finish with a straight turn at the
end of the bandage. Use an adhesive tape to secure the roller bandage in place

CONCLUSION

Many
bandages are simple to use and are available in hospitals and the community.

Many of the
products can be bought over the counter and used without any supervision from a
healthcare professional. Because of the range of products available today, it
is no longer necessary to be able to carry out the many complicated bandaging
techniques that used to be taught in nurse training, such as the application of
the many-tailed bandage or the thumb spica. However, this does not detract from
the fact that bandaging is a skill and the application of proper bandages
requires thorough training and assessment of competence.

Selecting an appropriate method of fixation requires thought, identification of the main objectives, and common sense. The overriding objective must be to retain a dressing or support a limb but consideration must also be given to the practicalities of the patient’s daily life.

**BANDAGING (Definition, Purpose, General Principles, Types and Techniques)**

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BANDAGING PROCEDURE – KEY POINTS

Bandaging is an essential nursing procedure that involves the application of dressings and bandages to wounds or injuries. Here are key points to consider when performing bandaging procedures:

Hand Hygiene:
- Wash hands thoroughly before and after the procedure to prevent the risk of infection.
Assessment:
- Assess the wound type, size, and condition before choosing an appropriate dressing and bandage.
- Evaluate the patient’s skin condition and any allergies to materials or adhesives.
Gathering Supplies:
- Ensure all necessary supplies are readily available, including dressings, bandages, tape, scissors, and any prescribed topical medications.
Explain the Procedure:
- Communicate the procedure to the patient, explaining the purpose and expected outcome.
- Obtain informed consent if required.
Positioning:
- Position the patient comfortably, exposing the wound while maintaining their privacy and dignity.
Wound Cleaning:
- Clean the wound gently with a prescribed solution or sterile saline.
- Use aseptic technique to minimize the risk of infection.
Dressing Application:
- Apply the appropriate dressing, ensuring it covers the wound adequately.
- Choose dressings based on the wound’s characteristics, such as moisture level and depth.
Bandage Selection:
- Select a suitable bandage material, considering the purpose (compression, support, or protection).
- Ensure the bandage is of the correct size and length to secure the dressing adequately.
Technique:
- Employ proper bandaging techniques to secure the dressing without impairing circulation or causing discomfort.
- Be mindful of tension and avoid applying the bandage too tightly.
Securing the Bandage:
- Use appropriate fastening methods, such as clips, adhesive strips, or self-adherent bandages.
- Ensure the bandage is secure but not too tight to allow for adequate blood circulation.
Labeling and Documentation:
- Clearly label the dressing with the date, time, and initials.
- Document the procedure, including wound assessment, type of dressing used, and the condition of the surrounding skin.
Education:
- Educate the patient and caregivers on proper care, signs of infection, and when to seek medical attention.
- Provide written instructions for home care if applicable.
Follow-up:
- Schedule follow-up appointments to monitor the wound’s progress and reassess the bandaging as needed.
- Modify the bandaging technique based on the wound’s healing trajectory.