Bandage bandages. way. Back spica bandage. How to properly apply various bandages

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One of the important elements of first aid for wounds is the application of an aseptic bandage, which protects the wound from external influences and the ingress of microbes into it, causing various serious complications. Do not wash the wound with water.
Before applying a bandage, the skin around the wound must be disinfected with alcohol, iodine tincture. Having lubricated the skin around the wound with one of these agents, a sterile bandage is applied to the wound. If there is a special dressing bag on hand, it is better to use it.
An individual dressing bag produced by the medical industry consists of a gauze bandage 7 cm wide. At one end, a cotton-gauze pad 9x6 cm in size is tightly fixed, and the second pad can move freely.
The dressing is wrapped in paraffin paper, in the fold of which a pin is placed. The whole ego is enclosed in a rubberized shell with slightly notched edges (Fig. 15).

Rice. fifteen.

The incised edge of the package is torn off and the contents of the package wrapped in paraffin paper are removed. The paper is carefully unfolded, while not touching the side of the cotton-gauze pads with which they face the wound.
In the presence of a through wound, one of the pads covers the inlet, and the second, movable, wound outlet. The pads are reinforced with a bandage.
In addition to an individual dressing bag, the medical industry produces a small sterile dressing, which, when folded, is a bag. The content of the package consists of a cotton-gauze pillow, in expanded form, having a size of 24 x 32 cm, to which a gauze bandage 13 cm wide is fixed at one end.
To close extensive wounds, especially with burns, the victim must be wrapped in a clean, hot-ironed sheet.
Dressings are strengthening (to hold the dressing on the wound), pressing (to stop venous bleeding) and motionless (fixing).
Kerchief bandages are convenient for hanging the arm in case of some of its diseases and injuries. A scarf can be made from any scarf by folding it from corner to corner. The middle of the kerchief is brought under the forearm bent at the elbow joint to 90 °, so that the upper corner of the kerchief goes beyond the elbow, and the long ends are thrown over the neck and tied at the back.

Rice. 16.
Using a scarf (a, b),
The top of the scarf in the area of ​​the elbow joint is bent anteriorly and fixed with a safety pin (Fig. 16). In another version of the kerchief bandage, the top of the kerchief is placed along the anteroexternal surface of the thigh of the injured side and the long ends are tied at the back so that one end is longer. The free corner of the kerchief is lifted up, the kerchief is pulled over the forearm and elbow and tied on the back with the left long end of the back knot. If the scarf is not enough, its ends are lengthened with a bandage or twine.
The scarf can also be used to apply bandages to almost any area of ​​the body (Fig. 17, 18).

Rice. 17.
Bandage options:
a) on the shoulder; b) on the ankle joint; c) on the wrist joint: d) on the head

Rice. twenty.
T-shaped perineal bandage (a, b)
in
Rice. 19.

A sling bandage is a piece of gauze or bandage with longitudinal slits at the ends. It is convenient for strengthening small bandages in the area of ​​the nose, chin, forehead, and back of the head (Fig. 19).
The T-shaped bandage consists of two strips of gauze or bandage crossed at right angles. Such a bandage is convenient for the perineum (Fig. 20). The most common are gauze bandages.
When bandaging, certain rules must be observed: for example, the bandaged part of the body should be in a comfortable position, exactly in the one in which it should be after applying the bandage (physiological position). If you do not follow this rule and bandage the limb bent at the joint, and after applying the bandage, unbend it, then the bandage will go astray. Conversely, if you put a bandage on a straightened arm, and then bend the arm at the elbow joint, then the bandage will press, pull the arm and cause inconvenience. Given this, the elbow is bandaged in a bent position, the shoulder is in a position of slight abduction from the body, the fingers are in a slight flexion position with the possibility of thumb abduction. The lower limbs are bandaged with the leg extended, and the foot in a position at right angles to the lower leg.
Bandage the limbs, it is necessary from the periphery to the center, this prevents blood stasis. They bandage in one direction, more often clockwise, covering with the next round of the bandage part of the width of the previous one and pulling it so that the bandage lies firmly, creating uniform pressure. At the end of bandaging, the end of the bandage is torn along, the ends are wrapped in the opposite direction to each other and tied. The bandage is applied not very tight, so that it does not interfere with blood circulation, but also not very loose, so that it does not slip from the wound.
Circular bandage. The end of the bandage is pressed with the thumb of the left hand to the place to be bandaged, and with the right hand, unwinding the bandage, they make circular turns that lie one on top of the other and fix the first round (Fig. 21).
For a better fit and retention of the bandage on those parts of the body that have unequal thickness along their length (lower leg, thigh, forearm), it is advisable to apply a spiral bandage with kinks (Fig. 22).
Bandages on the head area for wounds of the crown, occiput, lower jaw. A piece of bandage 70-80 cm long is torn off, thrown over the crown of the head so that the equal ends of the bandage hang down in front of the ears. These ends are held with both hands in a taut state by the victim himself or by an assistant providing assistance. Then they make several rounds of the bandage around the head at the level of the forehead, and then, pulling down the ends of the ties, wrap them around them, after which the bandage is led somewhat obliquely, covering the back of the head towards the opposite tie, which is also circled around with a bandage and returned, placing the bandage on the crown of the head. closer to the forehead. Wrap the tie around again and make a back tour. The tours of the bandage gradually converge to the middle of the cranial vault and completely cover it in the form of a cap. After that, the ends of the vertical bandage are tied under the lower jaw (Fig. 23).
Bandage on the right eye. The bandage is fixed with fixing circular tours around the head, bandaging from right to left counterclockwise, then the bandage is led obliquely along the back of the head, taken out under the right ear, and the right eye is closed with it (Fig. 24). Then the moves of the bandage alternate: one through the eye, the second - around the head. When applying a bandage to the left eye, it is more convenient to bandage from left to right, leading the bandage from back to front under the left ear and then obliquely across the cheek, closing the sore eye. Oblique tours of the bandage, covering the eye, alternate with circular ones. A bandage-bridle can serve to close the lateral surface of the face, ear, lower jaw. Make 2-3 fixing circular moves around the head. From behind, the bandage is lowered obliquely to the back of the head and removed from the opposite side under the lower jaw, several vertical turns are made, then the bandage is led through the back of the head in front and, after several circular rounds, is fixed around the head (Fig. 25).
The bandage around the neck should be made light, avoiding unnecessary circular coils that restrict breathing. When bandaging the back of the neck and the back of the head, it is convenient to use a cruciform bandage. In circular moves, the bandage is strengthened around the head, then it is led through the back of the head obliquely from top to bottom, moving to the front surface of the neck, circles around the neck and again returns to the back of the head, leads obliquely up to the head, then around the forehead and again returns to the back of the head.

Rice. 21.

Rice. 22.
Stages of bandaging the head with a cap (a, b, c)

Rice. 24.

Rice. 26 (a, b).

Bandages on the upper limbs. Spike bandage is applied to the area of ​​the shoulder, shoulder and hip joints. It is applied to the shoulder area as follows: the bandage is led from the healthy side of the armpit along the front surface of the chest and the outer surface of the diseased shoulder, wrapped around it from front to back, taken out of the armpit forward, wrapped around the shoulder again, but then the bandage is led along the back, surrounding chest, while the tour of the bandage lies slightly higher than the previous one, half covering it. And so they repeat the moves of the bandage until (Fig. 26) they cover the entire shoulder joint and shoulder girdle, fix the end of the bandage on the chest with a pin.
Rice. 27.

Fig. 28 Spiral bandage on the finger
Fig. 29 Bandage at the end of the finger
Fig. 30 Spike bandage on the thumb


A cruciform bandage on the back of the hand begins with circular fixing moves above the wrist joint, then the bandage is led obliquely down the back of the hand to the palm around the hand at the base of the fingers, and then the bandage is again led along the back of the hand through the wrist to the base of the fifth finger, cross the previous round, continue obliquely up and again surround the wrist (Fig. 27). The bandage on the fingers begins with circular moves of the bandage around the wrist, then the bandage is led in an oblique direction from top to bottom along the back of the hand to the end of the finger, twisted around it in spiral turns to the base and again returned through the back of the hand to the wrist (Fig. 28). In the same way, you can alternately bandage all fingers. On the left hand, the bandage begins with the little finger, on the right hand with the thumb. Bandage at the end of the finger. If it is necessary to bandage the end of the finger, then the bandage is first carried out in the longitudinal direction, starting from the base of the palmar surface of the finger to its base, the bandage is repeated again, but already closing the side surface, and then the finger is wrapped in spiral tours, starting from the base (Fig. 29 ).
The bandage on the thumb is made according to the spike-like type: they start with circular tours in the wrist area, then along the back of the hand they go to the end of the finger, wrap it around it spirally and again return to the wrist along the back surface of the finger. The bandage in the form of an ear rises higher and higher and covers the entire finger (Fig. 30).
If you need to quickly close a four-fingered hand with a bandage, leaving the first one free, then make a circular tour around the wrist, and then turn the bandage at a right angle and lead along the back of the hand, throw it through the fingertips to the palm and back to the back to the wrist. Having made several such returning moves, the brush is wrapped in spiral tours and the bandage is fixed on the wrist. The brush can also be bandaged like an eight-shaped bandage.
Bandages on the chest. Spiral bandage on the chest. A piece of bandage about a meter long is thrown over the right or left shoulder and left to hang freely. The chest is bandaged from the bottom up with the spiral moves of the bandage and its end is fixed. The end of the bandage hanging in front is thrown over the opposite shoulder girdle and tied behind with the other end (Fig. 31).
The cruciform bandage on the chest begins with circular tours of the bandage around the chest from below, then the bandage is led from right to top to the left, lifted to the left shoulder girdle, the bandage is led across the back to the right shoulder girdle and lowered obliquely into the left armpit, then lifted to the left shoulder girdle. Fix the bandage around the chest (Fig. 32).
Bandage on the mammary gland. This bandage is intended to keep the breast in an elevated position. When applying a bandage to the right mammary gland, the tours of the bandage begin in the usual direction from right to left around the chest below the mammary gland, then the bandage is led from right to top to the left, thrown over the shoulder girdle of the healthy side, obliquely encircle the back, going down to the right axillary fossa; from here, clasping the lower part of the gland, the previous move is fixed with a turn around the chest. The bandage is again led up, lifting the mammary gland, while the tour of the bandage is applied slightly higher than the previous one, thrown over the shoulder girdle and again repeat all tours of the bandage, gradually rising up (Fig. 33).

Rice. 31.


Rice. 32.

Spiral chest bandage


Rice. 33 (a, b).

Rice. 35 (a, b).

Rice. 34.

Rice. 37.

Bandage on the abdomen and groin area. When closing the wound of the upper and middle part of the abdomen, a spiral bandage is sufficient. In the lower abdomen, especially in the pelvic region, such a bandage usually does not hold well and slips, so it has to be combined with a spike-shaped bandage, which can close the inguinal and gluteal region along with the adjacent areas of the thigh and pelvis. The bandage can have many options, depending on where the crossover of the bandage tours will be located - in front, behind or on the side. On fig. 34 shows a spike-shaped bandage on the inguinal region. In circular tours, the bandage is fixed around the abdomen, then it is led from back to front, from left to right through the groin to the inner surface of the thigh. It circles the bandage around the thigh, and then, rising along the front surface through the groin, encircles the back semicircle of the body and goes back to the inguinal region. The bandage can be applied in an ascending or descending type, depending on where the first rounds of the bandage go - above, in the groin, or below, on the thigh. The bandage is fixed with circular tours around the abdomen.
Bandages for lower limbs. A bandage is applied to the thigh, as to the forearm and shoulder. In the upper part of the thigh, it can be fixed with a transition to the pelvis in the form of a spike-shaped bandage. A spiral bandage with kinks is also applied to the lower leg, reaching to the knee joint. Converging and diverging dressings (turtle) are applied in the area of ​​bent joints, more often knee and elbow. The convergent bandage in the area of ​​the knee joint begins with circular bandages through the patella, the following tours of the bandage diverge above and below the previous ones, crossing in the popliteal fossa (Fig. 35).
The diverging bandage begins with circular tours of the bandage above or below the knee joint. The turns of the bandage gradually converge towards the center, completely covering the knee area. The retractable bandage is convenient for bandaging round body surfaces. It is also used to close the amputation stump. With several circular rounds, the bandage is strengthened in the transverse direction around the thigh; then they bend it at a right angle and lead it down along the thigh, surrounding the end of the stump from front to back (Fig. 36). Having reached the transverse turns, the bandage is again bent at a right angle and a circular strengthening tour is made. Such transverse and longitudinal turns are repeated until the stump is completely closed. The bandage on the heel can be in the form of a turtle, converging or diverging. Bandaging begins through the most protruding part of the heel, and subsequent rounds are layered above and below the first, partially overlapping them (Fig. 37). You can fix these tours with an oblique bandage through the sole. The bandage on the ankle joint, if you do not need to cover the heel, is performed according to the type of eight-shaped.
Rice. 39.

Rice. 38.
Bandage on the heel
It starts with circular tours above the ankles, then the bandage crosses the rear of the foot obliquely, it is led along the sole, returned to the rear of the foot upwards, the posterior semicircle of the lower leg is circled above the ankles and again in the form of a figure eight, the previous moves are repeated (Fig. 38). Fix the bandage with circular tours over the ankles.
If it is necessary to close the entire foot, then, starting with circular tours above the ankles, the bandage, without pulling, is circled several times in the longitudinal direction from the heel to the big toe along the lateral surfaces of the foot, and then the foot is wrapped around the foot with washing moves, starting from the fingers (Fig. 39 ).
Small dressings can be strengthened not by bandaging, but by gluing to the skin in places where bandages or kerchiefs do not adhere well or take a long time to apply. For this purpose, strips of adhesive tape can be used.
To strengthen the bandage with an adhesive plaster, its strips are cut in such a way that they can extend beyond the edges of the bandage by 5-6 cm.

Microbes that enter the wound along with a wounding object, earth, from clothes, from the air and when touched by hands, can cause purulent inflammation, tetanus, gas gangrene. Therefore, after stopping the bleeding, it is necessary to treat the edges of the wound with tincture of iodine or alcohol and apply a sterile bandage.

If it is necessary to undress the victim to apply a bandage, the clothes must first be removed from a healthy limb. Dress up in reverse order.

The dressing consists of two parts: a sterile napkin or cotton-gauze pad, which directly closes the wound, and a material, usually a bandage, with which they are fixed. Various fabrics are used as improvised means, preferably cotton or linen.

The basic rules for applying bandages are as follows:

The caregiver should be facing the victim in order to navigate without causing additional pain by dressing;

To prevent pain, maintain the damaged part of the body in the position in which it will be after dressing;

It is better to start bandaging from the bottom up, unwinding the bandage with your right hand, and holding the bandage with your left and straightening the bandage moves: roll out the bandage without tearing it away from the body, clockwise, overlapping each previous move by half;

Bandage the limbs from the periphery, leaving the tips of intact fingers free;

When fixing the end of the bandage with a knot, it should be on the healthy part so as not to disturb the victim.

When providing first aid in case of injury, you must not:

Rinse the wound under water or even with some medicinal substance, cover it with powder and lubricate it with ointments, as this prevents it from healing, promotes the entry of dirt from the surface of the skin into it and causes suppuration;

It is impossible to remove sand, earth, pebbles, etc. from the wound, since it is impossible to remove everything that pollutes the wound in this way. It is necessary to carefully remove the dirt around the wound, cleaning the skin from its edges outward so as not to contaminate the wound; the cleaned area around the wound should be lubricated with tincture of iodine before applying a bandage;

Remove blood clots, foreign bodies from the wound, as this can cause severe bleeding.

When providing first aid, various types of dressings are used, taking into account the site of injury.

Bandage head and neck.

Bandages on the parietal and occipital region in the form of a "bridle"(Fig. 8, a). After 2-3 fixing moves around the head, the bandage is led through the back of the head to the neck and chin. Next, several vertical strokes are made through the chin and crown, after which the bandage is led to the back of the head and fixed in circular motions. An eight-shaped bandage can also be applied to the back of the head.

Rice. 8. Headband in the form of a "bridle" (a) and in the form of a "cap" (b)

Headbands in the form of a "cap" impose on the scalp (Fig. 8, b). Cut off a bandage 0.5 m long, put it on the crown and lower the ends down in front of the auricles. Make 2-3 locking moves around the head. Further, pulling down and somewhat to the sides the ends of the ties, wrap the bandage around them on the right and left alternately and lead it through the occipital, frontal and parietal parts of the head. The ends of the ties are tied with a knot under the chin.

Eye patch(Fig. 9, a) start with fixing moves counterclockwise around the head, then through the back of the head the bandage is led under the right ear to the right eye. Then the moves alternate: one through the eye, the other around the head. When applying a bandage to the left eye, fixing moves around the head are made clockwise, then through the back of the head under the left ear and on the left eye. When applying a bandage to both eyes, after fixing moves, alternate moves through the back of the head to the right eye, and then to the left.

Sling bandage for nose, lips, chin, face(Fig. 9, b, c, d). A sterile napkin is applied to the wound, then the uncut part of the bandage, the ends of which are crossed and tied at the back.

a B C D)

Rice. 9. Eye patch (a), nose patch (b),

on the forehead (c) on the chin (d)

Bandage bandages of the chest and abdomen.

Spiral chest bandage starts with 2–3 circular moves, and then the bandage moves spirally, covering each previous move by two-thirds (Fig. 10, a). A spiral bandage in various combinations is used for wounds of the chest, abdomen, limbs, fingers, and hands. When applying a spiral bandage to the chest, unwind the end of the bandage about 1 m long, which is placed on the left forearm and left hanging obliquely on the right side of the chest. With a bandage, starting from the bottom from the back, the chest is bandaged in spiral moves from right to left, then, with a move from the left armpit, the bandage is connected with the free end over the right shoulder.

A type of spiral bandage is spike bandage. It is a spiral bandage with kinks. It is placed on the thigh, on the thumb.

cruciform, or eight-shaped, bandage(Fig. 10, b) is convenient for bandaging the joints, the back of the head, neck, hand, chest. With penetrating wounds of the chest, pneumothorax can develop, so you need to stop air access to the pleural cavity as soon as possible. To do this, apply a cotton-gauze pad from a dressing bag, napkins or several layers of clean cloth in the form of small squares. An air-tight material is applied over them: oilcloth, plastic bag, adhesive plaster. The edges of the airtight material should extend beyond the edges of the cotton-gauze pads or napkins covering the wound. The sealing material is reinforced with a bandage bandage.

Rice. 10. Chest Bandage:

a - spiral; 6 - cruciform

Bandages for upper and lower extremities.

When bandaging the limbs, one should follow the rule - the first moves should be superimposed on the lower part of the limb; further bandaging is carried out in an upward direction. This method of dressing avoids the accumulation of venous blood in the free, unbandaged parts of the limbs.

A spica bandage is usually applied to the shoulder and hip joints. The first moves are usually imposed on the shoulder or on the hip. Then bandage is bandaged in the direction of the joint with spike-shaped passages. In the area of ​​​​the joint, with the help of circular moves, they pass when bandaging the shoulder joint to the chest, when bandaging the hip joint - to the stomach. These dressings are completed when the shoulder joint is ligated - on the chest, when the femoral joint is ligated - on the stomach.

On the shoulder, forearm, thigh and lower leg, spiral or more durable spike-shaped bandages are applied.

The areas of the elbow and knee joints are bandaged with eights (Fig. 11, a), and the bandage moves should cross in the articular fossae, namely on the elbow - in the cubital fossa, on the knee - in the knee fossa.

Rice. 11. Bandaging the finger and knee

(beginning and end of bandaging)

The so-called "thimble-like" bandages are applied to the fingers (Fig. 11, b). They begin by applying a bandage folded several times over the finger; then the bandage is strengthened on the finger with the help of further moves. The finger can also be bandaged in the normal spiral bandage method using a narrow bandage. When bandaging all the fingers of the hand, the so-called “glove” is applied. When bandaging the fingers of the hand, auxiliary moves are always superimposed from the back, and not from the palmar surface of the hand. The palm must be free, except in cases where the palm itself is injured.

Bandages convenient and quick to use for small wounds, abrasions. A sterile napkin is applied to the wound and fixed with strips of adhesive tape.

Bandages are used to secure the dressing, pressure on some part of the body - mainly to stop bleeding, prevent tissue swelling or keep a limb or other part of the body immobile. There are bandages strengthening, pressing and immobilizing (immobilizing), permanent (applied for a long time) and temporary. Among the permanent dressings, there are hardening (from plaster bandages) and splints (used for fractures to compare bone fragments). Permanent dressings are applied, as a rule, with severe injuries; their condition requires medical supervision. Of the reinforcing dressings, the most common are plaster, adhesive and bandage. Often, bandaging techniques are used when applying other types of dressings.

Contour, mesh and specially made cloth bandages are becoming more and more widespread.

Bandage also called a dressing (usually gauze and cotton wool) applied to a wound, a purulent focus, etc. Such dressings are aseptic (sterile dressings are used for them) and antiseptic (contain antimicrobial agents). Their purpose is different. So, for example, they protect the wound from external contamination, absorb liquid (wound discharge), have a therapeutic effect on the wound due to drugs applied to the dressing, suppress the vital activity of microorganisms in the wound, etc.

Everyone should be able to apply the simplest bandages. In everyday life, strengthening, bandage and pressure bandages are most often used. There are many different bandage options; their imposition requires certain skills, since an incorrectly made bandage soon weakens, slips, and disrupts blood circulation. causes pain. It takes quite a lot of time to learn how to apply complex bandage bandages well. The imposition of the simplest dressings can be mastered much faster, following certain rules.

1. The bandage is applied from a sterile material with clean, well-washed hands with soap; the skin around the wound or the focus of the disease (abscess, etc.) is treated with a disinfectant solution (alcohol, in its absence, vodka, cologne, etc.), with a fresh wound, tincture of iodine.

2. When applying a bandage, the injured (patient) should lie or sit in a position that is comfortable for him, and the bandager is located nearby so that he can see the patient's face (keep an eye on whether he causes pain) and the entire bandaged surface.

3. The leg is bandaged in a straightened position, and the arm is bent or half-bent at the elbow and slightly retracted from the body.

4. The free end of the bandage is taken in the left hand, and its rolled up part in the right. The bandage is rolled around the limb, torso or head in the direction from left to right (clockwise), grabbing the end of the bandage with the first two turns (rounds) and holding each round with the freed left hand. Starting bandaging from a thinner part of the body, gradually moving towards a thicker one (on the limbs, usually from the hand or foot to the body). The first 2 rounds of the bandage should completely cover each other in order to secure the end of the bandage well, and each subsequent turn should partially cover the previous one, securing it. If the bandage lies unevenly on the body, then it is necessary to “tip” it (turn it over). The last 2 rounds of the bandage, like the first two, are superimposed on each other, then the bandage is cut along, both ends are tied in a knot (the bandage should not be torn, as one of the ends may break). Strong tension on the bandage can cause pain.

5. For dressing, a sterile bandage produced in the package is usually used, and in its absence, any material ironed with an iron or a previously washed bandage. It is convenient to use an individual dressing bag for dressing, which contains both a sterile cotton-gauze pad and a bandage to secure it.

6. The bandage should completely cover the damaged area of ​​the body (wound, ulcer, etc.) in order to prevent the ingress of pathogenic microbes, protect against further trauma, and ensure the effect of drugs applied to it.

7. The bandage should not compress the tissues, cause their strong tension. and consequently, increase pain, impede breathing and blood circulation.

8. The technique of applying a bandage to any part of the body should provide the opportunity to move freely, without causing inconvenience. do not cause the injured (sick) unnecessary pain.

9. A properly applied bandage should look neat, aesthetically pleasing, and, if possible, not disfigure the contours of the limb, head or torso.

Subject to the above rules, the bandage will prevent secondary infection of the wound, will constantly help to suck out the discharge, such as pus, will stop small bleeding (capillary or venous), in some cases will serve for temporary immobilization (immobilization), which will reduce pain in the damaged area, prevent the development significant tissue edema, etc.

Sticker- the simplest bandage that surgeons use to close the so-called "clean", for example, postoperative wounds and small abscesses (furuncle, etc.). It consists of a cotton-gauze pad applied to the wound, covered with gauze on top, which is fixed to the skin with special compounds, mainly cleol. As a rule, such bandages are applied to the trunk, neck or face.

Bandages used in the same cases as stickers. Narrow strips of plaster are applied over the dressing. Sometimes plaster bandages are used to bring the edges of the wound closer together. In this case, the end of the patch strip is glued to an intact skin area, then the edges of the wound are brought together by hand and the other end of the patch strip is glued on the opposite side of the wound to intact skin (the wound is closed with a dressing). A similar method is sometimes also used to stop minor bleeding. To provide first aid for small incised wounds after disinfection, a plaster bandage can be applied directly over the wound with its complete closure. It should be remembered that when applying such dressings, it is necessary to protect the tissues from strong compression, especially on the fingers of the hand, where tight wrapping (around the entire finger) can soon lead to increased pain, circulatory disorders, manifested by blue and cold finger, the appearance of pronounced tissue edema, which testifies to a prelum of vessels and disturbance of outflow of blood. In such a case, you should immediately change the bandage and apply it more freely.

A wide-spread type of adhesive bandage is a bandage with a bactericidal patch, used for small wounds, abrasions, burns, etc. A bactericidal patch is an adhesive bandage with a narrow gauze swab in the middle (the gauze is impregnated with bactericidal agents).

kerchief bandage used to hold a dressing or suspend an injured arm. In the first case, for example, when applying a bandage to the hand, spread a scarf, put a damaged brush on top of it so that one of the ends can be wrapped on the back surface, and then the other two ends are tied, the end of the scarf remaining under them is turned off and, if required , slightly tighten towards the forearm. Apply a kerchief bandage on the foot in the same way. To do this, the damaged foot is placed on a spread scarf, one of its ends is turned to the back surface, then the two remaining ends are tied around the ankle (just above the ankle joint). The scarf should be large enough to wrap around the entire foot, including the heel. In the case of hanging an injured hand on a scarf, a hand is placed in the straightened scarf, one end of the scarf is passed between the body and the hand, and the other is taken out on the shoulder of the same hand. Both ends are tied (it is desirable to place the knot not on the neck), after which the remaining free end of the scarf is wrapped around the elbow and fixed on the front surface of the bandage with a pin.

contour bandages more often used for a large area of ​​skin lesions, such as burns. They can be prepared from special cotton-gauze blanks. Such dressings may take the form of shorts, a corset, chain mail, etc. The advantage of such dressings is that they can be changed relatively quickly and painlessly.

Mesh bandages differ from bandage ones in that they are held for a long time and securely on any part of the body, including on the head, joints or torso. When using these dressings, the consumption of dressings is significantly reduced. These bandages are very convenient for applying to one or more fingers. Mesh bandage is available in several sizes. It is important to choose it correctly, since a small bandage will strongly compress the tissue, and an oversized bandage will slide off without fixing the dressing applied to the damaged area. For better fixation of the bandage on the finger of the hand, you should take a mesh bandage of sufficient length so that you can unscrew it (as if turning it inside out and making a second layer).

Bandage bandages, as already noted, are used very widely.

The most common are sling-shaped, circular, spike-shaped, eight-shaped bandage bandages.

sling bandage superimposed on the nose or chin, as well as on the entire face. The width of the bandage should be sufficient to cover the corresponding damaged part of the face or the entire face. The length of the bandage should be about one and a half head circumferences. The bandage is cut along the two ends, leaving the middle intact (for example, according to the size of the chin). The uncut part is applied to the wound (abscess), the ends are crossed on both sides and tied at the back.

circular bandage- the simplest bandage bandage. It is used to cover a small area of ​​the body, such as the eye, ear, forehead, but is most convenient on the neck, shoulder, wrist. With this bandage, each subsequent round of the bandage is superimposed on the previous one (similarly to the first rounds of other bandages).

spike bandage it is usually used for parts of the body that are long (for example, arms, legs). The bends of the bandage (“rollover”) must be done on the same line so that a figure resembling an ear is formed. This bandage begins and ends with circular rounds of the bandage, which provides better fixation of the ends of the bandage.

Eight bandage most often used on joints (shoulder, elbow, knee), for example, with ligament injuries, effusion in the joint. The first rounds of the bandage begin to be applied below the damaged joint, then they proceed to bandaging above the joint, after which they again go down. As a result of such bandaging, a figure resembling a figure eight is formed. Usually they alternate eight-shaped tours with circular ones, gradually covering the entire surface of the skin above the joint.

Changing the bandage applied to a small wound, if allowed by the doctor, can be done at home. However, with increased pain, the appearance of bleeding, you should still contact a medical institution. More complex dressings, as a rule, are changed after dressing in a dressing room, since there is a high risk of additional infection of the wound. Each patient must carefully handle the bandage, make sure that it does not slip (if necessary, bandage it from above without removing it). The bandage should be kept clean, even if the damaged area of ​​the body is used for some work (for example, a fingertip should be worn on the finger, a glove or mitten should be worn on the hand).

Pressure bandages most often used to temporarily stop bleeding from a wound. It is also used to reduce hemorrhage in the joint cavity and surrounding tissues. Usually, a dense cotton-gauze roller is applied to the wound and bandaged tightly. It should be remembered that tight bandaging of some parts of the body where the vessels pass, for example, in the popliteal fossa, contributes to their compression, which can lead to very serious consequences (up to gangrene of the limb). In some cases, so-called compression bandages from a special elastic bandage are used, for example, with venous insufficiency after suffering thrombophlebitis (inflammation of the veins). Such bandages can be used to apply an elastic pressure bandage for damage to the ligaments of the joints. However, such dressings do not immobilize the joint, they perform their function better during movements. For the same purpose, some special knitwear is used, for example, stockings, stockings, tights, and for joints - knee pads, elbow pads, wristlets, etc.

Basic principles of bandaging:

• Make sure the person is in a comfortable position and understands what you are doing.
• Apply the dressing from the side of the wound so you don't have to reach across your body to get to it.
• Maintain the injured part of the body in the same position as it will be after applying the dressing.
• Apply the right size bandage - different body parts require different widths of bandages.
• If possible, when bandaging an arm or leg, do not cover your fingers so that you can easily check the circulation.
• Apply the bandage tightly, but not too tight, at the end secure the bandage by tucking it in and tying the ends in a knot. You can also use a safety pin, sticky tape, or a special retainer.
• Once the bandage has been applied, ask the person if it is too tight and test the circulation by pressing on the nail or skin until the area turns pale. If the color does not return immediately, the bandage is probably too tight and needs to be loosened. The limbs may swell after an injury, so check circulation every 10 minutes after bandaging.

There are three main types of dressings: circular, longuet and kerchief

Circular bandages

There are three types of bandages for a circular bandage:

• rare weave fabric (gauze bandage)- provides ventilation of the wound, but does not put pressure on the wound and does not support the joints;
• elastic bandage conforms to the shape of the body and is used to fix dressings and support soft tissue injuries, such as sprains;
• rubber bandage used for reliable support of damaged joints.

How to apply a circular bandage:

• hold the folded part of the bandage over the damaged area, unfolded - below it;
• wrap the damaged area twice to keep the end of the bandage in place;
• continue wrapping the limb, applying a bandage in a spiral, so that each new layer covers the previous layer by one to two thirds;
• at the end, apply another layer of bandage and secure the ends.

When applying a bandage to the elbows and knees (for fixing the bandage or for sprains), bend the joint slightly, apply a figure-eight bandage and wrap most of the limb on both sides of the joint.

When applying a bandage to the hand (for fixing a bandage or for sprains), start at the back of the wrist and apply the bandage diagonally across the back of the hand to the end of the little finger, without covering the thumb.

Longuets

Splints are used to fix bandages on fingers and toes or to support injured joints. They are made in the form of a fabric tube without seams. They are also elastic for use on joints such as the ankle. Longuets, made of gauze in the form of a tube, are applied to the fingers and toes, but they do not apply pressure and do not stop the bleeding.

Before applying the splint, you may need to cut it to size. Some splints come with a special device (applicator), which is installed on the damaged area and helps to apply a bandage.

kerchief bandages

Bandages can be used to bandage large areas of the body, to support limbs, or to secure a bandage.

If you are using a kerchief to support your arm, keep it wide.

• have the person hold their arms to their chest and support the injured arm while you apply the bandage;
• stretch the bandage under the arm and behind the neck;
• stretch the other half of the bandage over the arm so that both ends meet at the shoulder, and tie them in a knot;
• tuck the tails of the knot under the elbow or pin them with a pin.

If you are using a kerchief to support a leg or to bandage a large area of ​​your body, fold it in half lengthwise so that the end of the triangle reaches the middle of the long corner. Then fold it in half again in the same direction to make a wide strip.

Or incisions during surgery, subsequent dressing is often required. They help to injure the wound less, reduce the risk of dangerous microbes and contaminants getting into it, and prevent children from disturbing the suture area, combing them or peeling off the crusts. This helps to heal wounds by primary intention - this term refers to an even fusion of the edges with little or no scar or with a thin, delicate scar. In applying bandages, especially when it comes to bandaging, there are several stages, they also include the treatment of wounds with antimicrobial and antiseptic components. In the hospital, dressings are performed in a special room, but if the wound is not dangerous, dressings can often be done at home, by the parents themselves.

Types of bandages in children

In children, in order to close a wound or fix a limb, several types of dressings are used:

• Adhesive plasters
• Bandage
• Gypsum
• Polymer

The last two types are used only in a hospital, for the immobilization of injured limbs with or. When treating wounds or fixing injured limbs, parents can use the first two types.

Minor wounds, plaster bandages for children

For the treatment of small wounds and abrasions, in order to close them from external influences, an adhesive plaster can be used. Today, pharmacies sell two types of adhesive plaster - rolled , with a continuous adhesive surface, and bactericidal , in the center of which there is a layer of material impregnated with bactericidal components. Rolled usually do not seal the edges of the wound, but fix bandages made of gauze or other materials. Bactericidal plasters are used to close small wounds and cuts, scratches.

In case of minor wounds, after washing and treating the wound, the protective layer is removed from the adhesive plaster, and without touching the wound with hands, stick it on, covering the area of ​​damage with a bactericidal part. The edges are tightly fixed with a sticky part to the skin.

With smooth edges of the wound, in order to reduce its edges, you can use a special polymer plaster-clip . Pre-wounds are treated, then the edges are brought together, and fixed in such a position that healing is actively formed.

note

Change the patch as the central layer is impregnated or as directed by the doctor, for small wounds, as it gets dirty.

Bandages: immobilization and wounds

For immobilization of a limb in case of dislocations or fractures, any type of bandage is suitable - sterile and non-sterile. For dressing open wounds or injuries, only a sterile bandage and gauze dressings should be used.

In case of damage to the limbs with suspected dislocations, fractures or sprains, in order to less traumatize the damaged area before a doctor's examination, are shown immobilization bandages . They are superimposed due to bandages of different widths, as well as tires (dense improvised structures). The damaged area must be tightly fixed within the boundaries of two joints to the tire by winding the bandage in order to completely immobilize the affected part. After that, you need to go to the emergency room. If the damage is extensive, it is worth calling an ambulance and ensuring that the child is completely immobile before it arrives.

If this is a dressing on a wound, it is necessary to pre-treat it - rinse with hydrogen peroxide, miramistin or furacillin, treat the edges of the wound with antiseptics. All procedures should be carried out only with cleanly washed hands, without touching the surface of the wound and its edges.

All dressings used in the treatment of wounds are only sterile. If sterile materials are not at hand, clean, ironed handkerchiefs, pieces of cotton white fabric, ironed with a hot steam iron should be used.

Before bandaging the wound, several layers of sterile gauze are applied to its surface, the edges should not fiber and scatter into threads so that they do not fall into the wound. After applying the gauze layer, the wound is bandaged, doing it in a circular motion from left to right, the free end is held with two fingers of the second hand, fixing it with two turns of the bandage.

note

When treating a wound, cotton cannot be applied to it, its fibers stick to the edges, and then it is very difficult to remove them, which will bring pain and additional discomfort to the child. Only gauze or special materials can be applied over an open wound.

Stop bleeding from a wound

If the resulting wound is accompanied by bleeding, it must be stopped before applying the bandage. Bleeding can be of three types - arterial, with lesions of arteries of different sizes, venous or capillary.

At arterial bleeding blood flows under pressure, in pulsating waves, bright scarlet. You can stop such bleeding by applying a tourniquet above the artery, tightly squeezing it and stopping the flow of blood.

The duration of applying such a tourniquet in the summer is up to 30-60 minutes, in the winter - up to 90 minutes. Directly on the skin or on a piece of paper placed under the tourniquet, you need to indicate the time of application, this is extremely important for doctors.

At venous bleeding dark blood flows out in an even stream. You can also stop it by applying a tourniquet below the wound zone. The rules for applying it are similar, you also need to record the time when the tourniquet was applied.

capillary bleeding usually the most insignificant, the blood oozes evenly from the entire surface of the wound, it is red in color, flows out without pressure. You can stop it by pressing a clean cloth or sterile bandage to the wound area for 5-10 minutes.

After stopping the bleeding, they already begin to treat the wound and apply a bandage, and also, if necessary, show the child to the doctor.

Proper dressing

It is important to use only sterile material, which should always be in the first aid kit, but if it is outdoor conditions, any clean cloth should be used for a temporary dressing. The larger the wound, the wider and thicker the bandage should be.. If this is a small wound, let's say a bactericidal plaster or a small cotton-gauze bandage. A piece of cotton wool should be wrapped with a bandage so that its fibers do not fall into the wound, and applied over the wound, fixing it with bandage or adhesive tape. It is able to absorb blood and ichor, purulent discharge, tissue fluid. Pharmacies today sell ready-made cotton-gauze dressings and wound care products made from modern materials.

When fixing the bandage with a bandage, it is not tightly attached, rolling it over the surface. Initially, a fixing turn of the bandage is made, then another one, and after that the bandage is gradually bandaged from the center to the periphery, each subsequent skein half overlaps the previous one.

What should you know about bandages?

If the wound size is less than 2 cm, dressing is not required (unless it is a stab and deep wound). After treatment, you can cover it with a bactericidal plaster or a special coating (BF glue, films for treating wounds). It is important that such a bandage be perforated so that the wound breathes and does not get wet, and heals well.

Conventional wounds that are treated with dressing and bandaging are opened by unwinding the bandage and exposing the wound. If the material has dried to the wound, you can soak it with hydrogen peroxide or a solution of miramistin, furacilin. You can not remove dried bandages with a jerk, this causes pain and violates the integrity of the wound, worsening its healing.