Applying a sterile dressing to the wound. Aseptic wound dressing: what medicines to use? Features of the occlusive dressing
Any type of burn leads to damage to the skin or tissues. The wound surface must be anesthetized and properly treated to prevent the entry of microorganisms into it. Medicated burn dressings can help protect the wound and speed up healing.
Modern treatment of burn wounds involves the use of special dressings that disinfect, moisturize, and anesthetize the wound. Such dressings can have a different base: cotton fabric, plaster, hydroactive polymer, and others. They may contain an antiseptic, analgesic, regenerating drug or gelling agents to maintain the required level of moisture in the damaged area.
All types of wound dressings have two sides. One of them is intended for contact with damaged skin and tissues, therefore it must be sterile. The other - external - is devoid of a medicinal layer and serves for convenient fixation of the dressing.
There is a certain algorithm that must be followed when using medical dressings:
- First, it is necessary to stop the action of the etiological or pathological factor. If there is clothing on the damaged surface, it is removed or cut, freeing the burned arm, leg, shoulder, shin, thigh from further exposure to boiling water, hot oil or a chemical. The adhering part of the fabric must not be torn off. It is cut with scissors as far as possible, and the rest is left in the wound to avoid further injury.
- Now you need to cool the damaged area in order to anesthetize, relieve swelling and prevent further tissue damage. Such an event makes sense the first half hour after the injury. For cooling, the affected part of the body is placed under running cold water or immersed for 20 minutes. The water temperature should not be below 15 ° C. In parallel, you can use an anesthetic pharmacy.
- The bandage is applied to the damaged area in such a way that the burn surface is completely closed, but does not go beyond the wound by more than 2 cm around the perimeter.
After the dressing has been cut according to the area of the burn, the protective layer of the dressing is removed and applied to the body. For fixing, you can use a bandage or plaster.
When localized, a bandage is applied to each finger separately, and then the hand with the forearm is suspended on a tissue cut.
A bandage is not applied to the face, and the wound is treated openly with a solution of chlorhexidine and covered with ointment preparations.
The bandaging of the burnt area is carried out according to the instructions of the dressing used. As a rule, with burn wounds, the bandage must be replaced every 2-3 days. When providing first aid to the victim, it is not recommended to use anti-burn ointments, as they may affect the correct determination of the degree of injury.
Types of dressings
There are several types of bandages. Let's consider some of them with a detailed description.
| View | Characteristic |
| Aseptic | Aseptic dressing is used in the provision of emergency care for burns. A sterile bandage, an ironed diaper or cotton cloth, a clean bag is used as a dressing. The material can be dry or moistened with an antiseptic (alcohol tincture of calendula or propolis, vodka, potassium permanganate solution). The main goal is to close the wound surface from infection before sending the victim to a medical facility. |
| Mazeva | You can make it yourself or buy ready-made in a pharmacy. For home preparation, the remedy is applied to gauze or a bandage, and then applied to the wound and fixed. Most often, and are used for these purposes. Purchased ointment dressings are a mesh-based drug layer with protection from external influences. The most famous and widespread is a series of Voskopran ointment dressings. As a medicine, Levomekol, Dioxidin, Methyluracil ointment, Povidone-iodine can be used. |
| Wet | Wet-drying dressings are designed to protect, anesthetize and treat 2nd and 3rd degree burns. In case of wounds with a purulent inflammatory process, a base is applied with antiseptic solutions of furacilin, boric acid or chlorhexidine. In the presence of a scab in the wound of the 3rd degree, a wet-drying type of dressing with an antiseptic is also used to ensure the drying effect of the wound surface. Moisturizing, antiseptic and analgesic properties have ready-made gel dressings for burns Gelepran with miramistin and lidocaine. |
| Hydrogel | Hydrogel dressings for burns are a modern tool for the treatment and protection of the wound surface. One of three forms of this dressing can be purchased at a pharmacy:
The advantage of such a remedy is the removal of pain, maintaining the required level of moisture in the wound, protection against infection, providing cooling and cleansing the burnt area from necrosis products. Contraindication: do not use this remedy for wounds with a strong release of exudate. |
Bandages Banolind
Branolind burn dressing is a modern remedy for the treatment of burns and other wounds. It has a mesh cotton base. Branolind is an ointment dressing, the active ingredient of which is Peruvian balsam. Therapeutic impregnation has the following ingredients:
- ointment Branolind;
- glycerol;
- petrolatum;
- cetomacrogol;
- refined fat.
In the pharmacy you can buy a package of Branolind with 10 or 30 pcs. mesh bandages. It is also possible to buy the mesh by the piece. This remedy has shown itself to be an excellent way to protect against infection, accelerate regeneration, and relieve inflammation. Branolind is widely used in surgery after skin grafting for accelerated cell growth and trouble-free tissue engraftment.
The advantage is hypoallergenicity. Wound healing components of the ointment do not irritate even sensitive skin.
Based on consumer reviews, Branolind does an excellent job with non-healing wounds of any nature. Pregnancy and lactation are not contraindications for use. It can also be used for children and teenagers.
How to avoid complications and further care
The main complication of burns is the development of a burn disease. It occurs when more than 5-10% of the area of all skin is affected. The complication is caused by a complex of violations in the functioning of various systems and organs. These include hypovolemia, intoxication, circulatory disorders, tachycardia, etc.
It is important to timely place a patient with an extensive burn in a specialized burn department. In a state of shock, the patient is given a number of therapeutic measures by specialists to eliminate pain, normalize breathing, and prevent median vascular and renal insufficiency.
Another complication of a burn can be sepsis. In order to avoid infection of the wound, the affected area is regularly treated with antiseptic agents, bandaged and the healing process is monitored.
To avoid burns, you should follow the safety rules, as well as protect children from possible sources of burn injuries.
The technique of applying an aseptic dressing is quite simple, but in order to perform the dressing correctly, a number of important rules must be observed. It is very important to use high-quality dressing material in this case.
In order to protect the wound from possible contamination and the ingress of foreign particles into it, it is necessary to apply an aseptic bandage on it as soon as possible.
The rules for applying a primary aseptic dressing are described in books on first aid. It is also necessary to remember that there are different types of fixation of an aseptic dressing.
In order to perform the dressing correctly, you must first treat the wound. To do this, in no case should it be washed with water. To treat and disinfect the damaged area, it is necessary to use special antiseptics or medical alcohol, a solution of brilliant green.
Aseptic bandage is a dressing consisting of a cotton-gauze pad and a bandage. It is better to purchase ready-made aseptic bandages at the pharmacy, which are sold in sterile packages. The bottom layer of the pad, which must be applied directly to the wound, is a multilayer sterile gauze. The top layer consists of cotton wool or other sterile hygroscopic material. In order to fix the bandage, special gauze ties are provided.
To apply a bandage to the wound, you need to get it out of the sterile package, without touching the pad, which will be in contact with the damaged area. The bandage should be applied with the gauze side to the wound and bandaged tightly. Dry aseptic bandage is designed to dry the wound. The blood released from it is absorbed by the hygroscopic material. If the wound does not bleed, you can apply a bandage, which is a regular sterile bandage folded in several layers. It is important to remember that as soon as the dressing gets wet through, it must be replaced immediately.
There are many ways to apply bandages. If the wound simply needs to be protected from possible infection, then the usual aseptic bandage is quite suitable. If the formation of the wound is accompanied by a fracture or dislocation, it is necessary to apply a fixing bandage. With it, you can fix the limb in a fixed position. If the patient's arm is injured, then a scarf is often used to fix the limb, a sterile bandage should be applied to the wound under it. A scarf can be used to bandage a limb so that it remains immobile. This will avoid possible complications. If the kerchief is short, then it can be lengthened with bandages or other dressings.
Tight bandages are used to stop bleeding. In this case, you can use the usual dressing bag, and then press the bandage to the wound with a tourniquet. It is important to remember that the tourniquet must be removed immediately after the bleeding stops. Imposing it for a long time can be dangerous.
It should be remembered that the size of the aseptic dressing must correspond to the size of the wound. To ensure tightness around the edges, the bandage is sometimes glued with creole. The bandage should not only cover the wound completely, but a supply of sterile tissue is needed on each side. It is enough to leave a margin of about 3 centimeters. If a bandage is applied to a postoperative wound and it is necessary to remove the drainage tube, then an incision can be made in it.
If the bandage is soaked through, but it is not possible to change it completely, you can apply a few more layers of bandage on top of it. You can also use another package designed for first aid. It is better that it does not consist of hygroscopic material, but of sterile gauze folded in several layers. It should be remembered that a soaked bandage can create a favorable environment for the development of pathogenic bacteria and their penetration into the wound, and this is completely unacceptable.
The imposition of an aseptic dressing requires a responsible approach. Before applying a bandage, it is necessary to treat the wound with antiseptics. Washing damaged areas with water is strictly prohibited.
Usage: orthopedics and traumatology. Improvement of regeneration processes by stabilizing pressure on soft tissues in the area of osteotomy. The essence of the invention: aseptic dressing contains a pad 1 made in the form of a tape of elastic material, under which a liquid-absorbing material 2 is laid. The ends of the pad 1 are provided with fixation elements 3 in the form of hooks or burr fasteners. 1 ill.
JUICE)3 SOVIET
SOCIALISTS fF.; SKIS
REPUBLIC (I) 5 A 61 F 13/00
STATE PATENT
USSR OFFICE (USSR STATE PATENT) DESCRIPTION OF THE INVENTION
"Restorative traumatology and orthopedics" (72) A.V. Pokkov (56) Timofeev N.S., Khenina A.N., Timofeev
N.N., Guidelines for junior medical personnel of the surgical dressing unit, - L : Medicine, 1983, p. 223.
Patent CLUA N. 3750666, cl. A 61 1
„„5Ц„„1803083 А1 (54) ASEPTIC BANDAGE (57) Usage: orthopedics and traumatology. Improvement of regeneration processes by stabilizing pressure on soft tissues in the area of osteotomy. Essence of the invention: the aseptic bandage contains a pad 1 made in the form of a tape made of an elastic material, under which a liquid-absorbing material 2 is laid.
The ends of the gasket 1 are provided with fixation elements 3 in the form of hooks or fasteners
"burdock". 1 ill.
Compiled by T. Kovalenko
Tehred M. Morgenthal Proofreader T, Vashkovich
Editor T. Ivanova
Order 1016 Circulation Subscription
VNIIPI of the State Committee for Inventions and Discoveries under the State Committee for Science and Technology of the USSR
113035, Moscow, Zh-35, Raushskaya emb., 4/5
Production and publishing plant "Patent", r. Uzhgorod, Gagarina street, 101
The invention relates to medicine, namely to orthopedics and traumatology.
The aim of the invention is to improve regenerative processes by stabilizing pressure on soft tissues in the area of osteotomy.
The drawing shows an aseptic bandage applied to the wound and fixed on the rods of the compression-distraction apparatus.
The aseptic bandage contains a retaining pad 1 made in the form of an elastic band. Under the pad 1 there is a material 2 that absorbs liquid.
The ends of the gasket 1 are provided with fixation elements 3. The fixation elements 3 can be made in the form of hooks. The latches 3 are hooked to the rods 4 of the compression-distraction apparatus 5.
Aseptic bandage is used as follows.
After osteosynthesis of the limb segment and osteotomy, the wound is sutured in the conventional way. 2-3 sterile wipes 2 are applied to the skin, which are pressed with a gasket 1, namely: one end of the gasket 1 is strengthened with hooks 3, for example, on one rod 4, and the other end , after pre-tensioning the gasket 1 on the opposite rod 4 of the apparatus 5. The length of the gasket 1 is adjusted by moving the fixation elements in the form of hooks 3, so that in the free state it is several centimeters less than the distance between the rods 4 of the apparatus
The use of the proposed aseptic dressing allows you to easily, almost instantly. to create and keep constant in time the necessary pressure force on soft tissues in the area of osteotomy. What helps prevent
10 formation of postoperative hematoma and prevents suppuration in the postoperative wound. In addition, the proposed aseptic bandage saves 1-2 meters of sterile gauze bandages on each
15 operated patients. Reduces the time of dressing the patient. The use of an aseptic dressing during the operation allows for urgent clamping in case of accidental damage to the vessels.
20 vessel through the soft tissue, for the required time, and stop the bleeding, which prevents blood loss.
Claim
Aseptic dressing containing
25 liquid-absorbing material and a retaining pad with fixation elements located on top of it, characterized in that, in order to improve regeneration processes by stabilizing pressure on soft tissues in the osteotomy zone, there is a retaining pad in it made in the form of an elastic band. and fixation elements - in the form of hooks located at its ends.
Providing first aid to victims with injuries, fractures, dislocations, ligament injuries, bruises, burns, and others becomes almost impossible without the timely and correct application of a bandage. Indeed, due to the dressing, additional infection of the wound is prevented, and bleeding stops, fractures are fixed, and even a therapeutic effect on the wound begins.
Medical dressings and their types
The branch of medicine that studies the rules for applying bandages and tourniquets, their types and methods of application, is called desmurgy (from the Greek desmos - leash, bandage and ergon - performance, business).
By definition, a bandage is a way to treat injuries and wounds, which consists in using:
- dressing material, which is applied directly to the wound;
- the outer part of the dressing, which fixes the dressing.
The role of dressing material, for various reasons, can be:
- special dressing packages;
- napkins;
- cotton swabs;
- gauze balls.
Description | Varieties |
|
Protective or soft | Consist of a material that is applied to the wound and a fixing bandage Used in most cases: for burns, bruises, open wounds |
|
Immobilization or solid | Consist of dressing material and splint They are used to transport the victim, in the treatment of injuries to bones and their elastic joints. |
|
Primary care for injuries
The process of applying a bandage is called dressing. Its purpose is to close the wound:
- to prevent its further infection;
- to stop bleeding;
- to have a healing effect.
General rules for dressing wounds and injuries:
- Wash your hands thoroughly with soap, if this is not possible, then you should at least treat them with special antiseptic agents.
- If the site of damage is an open wound, then gently treat the skin around it with an alcohol solution, hydrogen peroxide or iodine.
- Place the victim (patient) in a position convenient for him (sitting, lying), while providing free access to the damaged area.
- Stand in front of the patient's face to observe his reaction.
- Start bandaging with an “open” bandage from left to right, from the periphery of the limbs towards the body, that is, from the bottom up, using two hands.
- The arm must be bandaged in a bent at the elbow state, and the leg in a straightened state.
- The first two or three turns (tours) should be fixing, for this the bandage is tightly wrapped around the narrowest undamaged place.
- Next, bandage should be with uniform tension, without folds.
- Each turn of the bundle covers the previous one by about a third of the width.
- When the injured area is large, one bandage may not be enough, then at the end of the first, the beginning of the second is laid, strengthening this moment with a circular coil.
- Finish the dressing by making two or three fixing turns of the bandage.
- As an additional fixation, you can cut the end of the bandage into two parts, cross them together, circle around the bandage and tie with a strong knot.
The main types of bandages
Before studying the rules for applying bandage dressings, you should familiarize yourself with the types of tourniquets and options for their use.
Bandage classification:
1. By type:
- aseptic dry;
- antiseptic dry;
- hypertonic wet drying;
- pressing;
- occlusal.
2. According to the overlay method:
- circular or spiral;
- eight-shaped or cruciform;
- serpentine or creeping;
- spike-shaped;
- tortoiseshell bandage: divergent and convergent.
3. By localization:
- on the head;
- on the upper limb;
- on the lower limb;
- on the stomach and pelvis;
- on the chest;
- on the neck.
Rules for applying soft bandages
Bandage dressings are relevant in most cases of injuries. They prevent secondary infection of the wound and minimize the adverse effects of the environment.
The rules for applying a soft bandage bandage are as follows:
1. The patient is placed in a comfortable position:
- with injuries to the head, neck, chest, upper limbs - sedentary;
- with injuries of the abdomen, pelvic region, upper thighs - recumbent.
2. Choose a bandage, according to the type of damage.
3. The bandaging process is carried out using the basic rules for bandaging.
If you made a dressing, following the rules for applying sterile dressings, then the compress will meet the following criteria:
- completely cover the damaged area;
- do not interfere with normal blood and lymph circulation;
- be comfortable for the patient.
Bandage Rule |
|
circular bandage | Superimposed on the wrist, lower leg, forehead and so on. The bandage is applied spirally, both with and without kinks. Dressing with kinks is best done on which they have a canonical shape |
creeping bandage | Superimposed for the purpose of preliminary fixation of the dressing on the injured area |
cruciform bandage | Superimposed in difficult configuration places In the course of dressing, the bandage should describe the figure eight. For example, a cruciform chest bandage is performed as follows: move 1 - make several circular turns through the chest; move 2 - a bandage through the chest is carried out obliquely from the right axillary region to the left forearm; move 3 - make a turn through the back on the right forearm across, from where the bandage is again carried out along the chest towards the left armpit, while the previous layer is crossed; move 4 and 5 - the bandage is again carried out through the back towards the right armpit, making an eight-shaped step; fixing move - the bandage is wrapped around the chest and fixed |
spike bandage | It is a kind of eight-shaped. Its imposition, for example, on the shoulder joint is performed according to the following scheme: move 1 - the bandage is carried out through the chest from the side of a healthy armpit to the opposite shoulder; move 2 - with a bandage they go around the shoulder in front, along the outside, behind, through the armpit and raise it obliquely to the shoulder, so as to cross the previous layer; move 3 - the bandage is carried out through the back back to a healthy armpit; moves 4 and 5 - repetition of moves from the first to the third, observing that each new layer of the bandage is applied slightly higher than the previous one, forming a “spikelet” pattern at the intersection |
Turtle headband | Used to bandage the area of the joints
Descending Turtle Bandage:
|
head bandaging
There are several types of headbands:
1. "bonnet";
2. simple;
3. "bridle";
4. "hat of Hippocrates";
5. one eye;
6. on both eyes;
7. Neapolitan (in the ear).
Name | When superimposed |
For injuries to the frontal and occipital part of the head |
|
With mild injuries of the occipital, parietal, frontal part of the head |
|
"Bridle" | In case of injuries of the frontal part of the skull, face and lower jaw |
"Hippocratic Hat" | There is damage to the parietal part |
One eye | Injury to one eye |
For both eyes | When both eyes are injured |
Neapolitan | For ear injury |
The rule of bandaging the head is based on the fact that, regardless of the type, the dressing is carried out with bandages of medium width - 10 cm.
Since in case of any injury it is very important to provide it in time, in case of general head damage, it is recommended to apply the simplest version of the bandage - the “cap”.
Rules for applying a bandage "bonnet":
1. A piece about a meter long is cut off from the bandage, which will be used as a tie.
2. Its middle part is applied to the crown.
3. The ends of the tie are held with both hands, this can be done either by an assistant or by the patient himself, if he is in a conscious state.
4. Apply a fixing layer of bandage around the head, reaching the tie.
5. They begin to wrap the bandage around the tie and further, over the head.
6. Having reached the opposite end of the tie, the bandage is again wrapped and carried around the skull a little above the first layer.
7. Repeated actions completely cover the scalp with a bandage.
8. Making the last round, the end of the bandage is tied to one of the straps.
9. Straps tie under the chin.
Bandage Rule |
|
Spend a bandage twice around the head. The next step in front is a bend and the bandage begins to be applied obliquely (from the forehead to the back of the head), slightly higher from the circular layer. At the back of the head, another bend is made and the bandage is led from the other side of the head. The moves are fixed, after which the procedure is repeated, changing the direction of the bandage. The technique is repeated until the top of the head is completely covered, while not forgetting to fix every two oblique strokes of the bandage |
|
"Bridle" | Make two turns around the head. Next, the bandage is lowered under the lower jaw, passing it under the right ear. Raise it back to the crown through the left ear, respectively. Three such vertical turns are made, after which a bandage from under the right ear is carried out on the front of the neck, obliquely through the back of the head and around the head, thus fixing the previous layers. The next step is again lowered on the right side under the lower jaw, trying to completely cover it horizontally. Then the bandage is carried out to the back of the head, repeating this step. Once again repeat the move through the neck, and then finally fixing the bandage around the head |
One eye | The bandage begins with two reinforcing layers of the bandage, which is carried out in case of injury to the right eye from left to right, the left eye - from right to left. After that, the bandage is lowered from the side of the injury along the back of the head, wound under the ear, covers the eye obliquely through the cheek and is fixed in a circular motion. The step is repeated several times, covering each new layer of bandage with the previous one by about half. |
Dressings for bleeding
Bleeding is the loss of blood in violation of the integrity of the blood vessels.
Type of bleeding | Description | Bandage Rule |
Arterial | Blood has a bright red color and beats with a strong pulsating jet | Tightly squeeze the place above the wound with your hand, tourniquet or tissue twist. Bandage type - pressure |
Venous | Blood turns dark cherry color and flows evenly | Raise the damaged part of the body higher, apply sterile gauze to the wound and bandage it tightly, that is, make a pressure bandage The tourniquet is applied from below the wound! |
capillary | Blood is released evenly from the entire wound | Apply a sterile bandage, after which the bleeding should stop quickly |
mixed | Combines the features of the previous types | Apply pressure bandage |
Parenchymal (internal) | Capillary bleeding from internal organs | Bandaging using a plastic bag with ice |
General rules for applying bandages for bleeding from a limb:
- Place a bandage under the limb, slightly above the wound site.
- Attach an ice pack (ideally).
- Stretch the tourniquet strongly.
- Tie the ends.
The main rule for applying a bandage is to place the tourniquet over clothing or a specially lined fabric (gauze, towel, scarf, and so on).
With the right actions, the bleeding should stop, and the place under the tourniquet should turn pale. Be sure to put a note under the bandage with the date and time (hours and minutes) of the dressing. After first aid, no more than 1.5-2 hours should pass before the victim is taken to the hospital, otherwise the injured limb cannot be saved.
Rules for applying a pressure bandage
Pressure bandages should be applied to reduce all types of external bleeding at bruised sites, as well as to reduce the size of the edema.
Rules for applying a pressure bandage:
- The skin adjacent to the wound (about two to four cm) is treated with an antiseptic.
- If there are foreign objects in the wound, they should be carefully removed immediately.
- As a dressing material, a ready-made dressing bag or a sterile cotton-gauze roller is used, if there is none, then a bandage, a clean handkerchief, and napkins will do.
- The dressing is fixed on the wound with a bandage, scarf, scarf.
- Try to make the bandage tight, but not pulling the damaged area.
A well-applied pressure bandage should stop bleeding. But if she still managed to soak in blood, then it is not necessary to remove it before arriving at the hospital. It should simply be bandaged tightly from above, after placing another gauze bag under the new bandage.
Features of the occlusive dressing
An occlusive dressing is applied to seal off the damaged area to prevent contact with water and air. Used for penetrating wounds.
Rules for applying an occlusive dressing:
- Place the victim in a sitting position.
- Treat the skin adjacent to the wound with an antiseptic (hydrogen peroxide, chlorhexidine, alcohol).
- An antiseptic wipe is applied to the wound and the adjacent area of the body with a radius of five to ten cm.
- The next layer is applied with a water- and air-tight material (necessarily with a sterile side), for example, a plastic bag, cling film, rubberized fabric, oilcloth.
- The third layer consists of a cotton-gauze pad, which plays the role of constipation.
- All layers are tightly fixed with a wide bandage.
When applying a bandage, it should be remembered that each new layer of dressing should be 5-10 cm larger than the previous one.
Of course, if possible, it is best to use the PPI - which is a bandage with two cotton-gauze pads attached. One of them is fixed, and the other moves freely along it.
Applying an aseptic dressing
An aseptic dressing is used in cases where there is an open wound and it is required to prevent contamination and foreign particles from entering it. This requires not only correctly applying the dressing, which must be sterile, but also securely fixing it.
Rules for applying an aseptic dressing:
- Treat wounds with special antiseptic agents, but in no case use water for this purpose.
- Attach gauze directly to the injury, 5 cm larger than the wound, previously folded in several layers.
- From above, apply a layer (easily exfoliated), which is two to three centimeters larger than gauze.
- Tightly fix the dressing with a bandage or medical adhesive tape.
Ideally, it is better to use special dry aseptic dressings. They consist of a layer of hygroscopic material that absorbs blood very well and dries the wound.
To better protect the wound from dirt and infection, additionally glue the cotton-gauze bandage on all sides to the skin with adhesive tape. And then fix everything with a bandage.
When the bandage is completely saturated with blood, it must be carefully replaced with a new one: completely or only the top layer. If this is not possible, for example, due to the lack of another set of sterile dressings, then the wound can be bandaged by first lubricating the soaked bandage with iodine tincture.
Splint dressing
When providing first aid for fractures, the main thing is to ensure the immobility of the injury site, as a result, pain sensations decrease and displacement of bone fragments is prevented in the future.
The main signs of a fracture:
- Severe pain at the site of injury that does not stop for several hours.
- Pain shock.
- With a closed fracture - swelling, edema, deformation of tissues at the site of injury.
- With an open fracture - a wound from which bone fragments protrude.
- Limited movement or their complete absence.
Basic rules for applying bandages for fractures of the limbs:
- The dressing must be of the immobilization type.
- In the absence of special tires, you can use improvised things: a stick, a cane, small boards, a ruler, and so on.
- Keep the victim immobile.
- To fix the fracture, use two splints wrapped in soft cloth or cotton.
- Apply tires on the sides of the fracture, they should capture the joints below and above the damage.
- If the fracture is accompanied by an open wound and profuse bleeding, then:
- a tourniquet is applied above the fracture and wound;
- a bandage is applied to the wound;
- two splints are placed on the sides of the injured limb.
If you apply any type of bandage incorrectly, then instead of providing first aid, you can cause irreparable harm to the health of the victim, which can lead to death.
What is bandaging (overlay technique)? Who Should Study Desmurgy? You will find answers to these and other questions in the article.
A bandage is a hard or soft device that fixes dressing raw materials on the surface of the body (sometimes containing medicinal and other substances). He studies dressings, methods of applying them, as well as the rules for healing wounds, the medical section of desmurgy.
Classification
How are bandages applied? What is the overlay technique? By purpose, they distinguish:
- hemostatic (pressure) dressings - stop bleeding by creating a certain pressure on the desired part of the body;
- protective (aseptic) - prevent infection of the wound;
- medicinal (usually partially impregnated with a mixture) - provide prolonged access of the drug to the wound;
- bandages with stretching - straighten broken bones, for example, tibia;
- immobilizing - immobilize the limb, mainly with fractures;
- dressings that eliminate deformities - corrective;
- sealing wounds (occlusive), for example, with chest injuries, are needed so that the victim can breathe.
There are the following types of bandages:
- solid - with the use of solid materials (Kramer's tire and others);
- soft - using soft raw materials (bandage, cotton wool, gauze and others);
- hardening - plaster bandages.
"Deso"
What is the Deso bandage for? Its overlay technique is unsophisticated. With the help of it, the upper limbs are fixed in case of dislocations and fractures of the shoulder. To make this dressing, you need the following tools:
- pin;
- 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 bandage is made. Its overlay technique is as follows:
- Seat the patient facing you, reassure, explain the course of the upcoming actions.
- Roller wrapped with gauze, put in the armpit.
- Bend your forearm at an angle of 90 ° at the elbow joint.
- Press your forearm to your chest.
- Perform a couple of fixing tours of the bandage on the chest, injured arm in the area of the shoulder, back and armpit from the side of the working arm.
- Guide the bandage through the armpit of the active side along the frontal chest surface obliquely on the shoulder girdle of the diseased area.
- Move down the back of the injured shoulder under the elbow.
- Go around the elbow joint and, holding the forearm, direct the bandage obliquely into the armpit of the healthy side.
- Move the bandage from the armpit along the back to the sore forearm.
- Guide the bandage from the shoulder girdle along the frontal plane of the ailing shoulder under the elbow and around the forearm.
- Guide the dressing along the back to the armpit of the healthy side.
- Repeat the rounds of the bandage until the shoulder is firmly fixed.
- Complete the bandage with a couple of fixing rounds on the chest, on the sore arm in the area of the shoulder, on the back.
- Pin the end of the bandage with a pin.
By the way, if the bandage is applied for a long time, the bandage tours need to be stitched.
Bandage cap
Do you know what a headband is? Its 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 is it applied? If the patient is conscious, one person can bandage him. If the victim has lost consciousness, in order to make a quality bandage, the medical worker should involve an assistant.
Cut off a meter tape from the head of the bandage and put it in the middle on the parietal region. Its ends should hang freely, like the strings of a baby's cap. During the procedure, they must be held by the victim himself or by the assistant of the health worker.
Around the entire skull, make a couple of fixing tours. Then lay out the cap itself. After the blocking round, reach the tie area, wrap the head of the bandage around it and bring it to the back of the head to the second strap. There, in the same way, wrap a bandage around it and put a tour on the cranial area from the side of the forehead.
Movements should be repeated, and each next round should overlap the previous one by about a third. With the help of such moves, the entire scalp area of the skull is completely covered with a dressing cloth. It turns out a gauze cap, similar to a cap. The bandage is fixed as follows: tear the end of the bandage, secure with a knot and tie under the tie. Then tie the straps together.
Do you know that a cap bandage can stop the bleeding? The overlay technique in this case is somewhat different. Cut off the hair in the area of injury and check it for foreign matter. Disinfect the wound or its edges if possible. It must be remembered that an antiseptic (mainly alcohol) can contribute to the appearance of a painful shock. Therefore, proceed carefully. Then, on the open wound, apply two layers of a clean gauze napkin, then a squeezing pad from a bandage bag. Next, apply a bandage according to the above algorithm.
If you do not have a specific pad on hand, use a dressing bag or tightly folded items, preferably clean. The pressure pad should completely cover the wound, cover the edges and not deform. Otherwise, it will push through the edges of the wound and increase its size.
During breakfast, lunch and dinner, the straps of the headband can be relaxed. At the time of sleep, it is not recommended to untie them, as the bandage can move out.
Bleeding
What is the technique for applying a pressure bandage? This type is used primarily to control minor bleeding and reduce extravasation in the joints and periarticular soft tissues. Apply a gauze-cotton roller to the wound and fix it tightly with a bandage without squeezing the vessels. Sometimes healthcare providers use elastic compression bandages for ligament injuries or venous insufficiency.
It is known that bleeding is capillary (bleeding on a large surface of the body), arterial and venous. Arterial blood gushes and has a scarlet color, and venous blood pours out in an even stream, dark.
What is the technique for applying a pressure bandage in these circumstances? In case of small external bleeding from a vein or from capillaries, apply a squeezing bandage without squeezing the limb. This method will not save if there is severe mixed or arterial bleeding. Clamp the artery with your finger above the wound (determine the point by pulsation) while the assistant prepares the tourniquet. Place a note under the tourniquet indicating the time of its application.
Finger injuries
How is the glove bandage made? Its application technique is quite simple. This bandage is used for injuries of the fingers. To apply it, you need to have a needle and syringe, a narrow bandage (4-6 cm), balls, a tray, gloves, an antiseptic and an analgesic.
Seat the patient and stand facing him (control his condition). Anesthetize the bandaged area. Perform 2-3 circular rounds around the wrist, and then direct the bandage obliquely along the dorsum of the carpal surface to the nail of the thumb of the right hand, and of the left hand 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, with spiral turns from the nail to the base of the finger, close it, and cross the bandage on the back surface and point to the wrist (left to right). Perform a fixing tour around the wrist. Bandage the remaining fingers in the same way. Finish the bandage with circular rounds and tie off. It should be noted that the "Knight's Glove" bandage can be supplemented with a kerchief bandage.
Spike type
Many do not know the technique of applying a spike-shaped bandage. She, as a rule, fixes the shoulder joint in case of pathology of the shoulder and armpit. You should have on hand a bandage (width 12-16 cm), a sterile napkin, scissors, a kidney-shaped basin, a pin, tweezers.
Here you need to follow the steps in the following order:
- Turn around to face the patient.
- Draw two fixing circular circles around the shoulder on the ailing side.
- Swipe the third round obliquely from the armpit to the back along the front of the shoulder.
- The fourth turn continues the third.
- With the fifth circle, circularly cover the shoulder (outer, inner surfaces, front and back) and bring it to the back, crossing with the fourth round.
"Mitten"
What is the "Mitten" bandage for? The application technique is quite simple. It is used for injuries and burns of the hand, frostbite. To make this bandage, you need to prepare a needle and syringe, wipes, a bandage (width 8-10 cm), a tray, an analgesic, balls, an antiseptic and gloves.
In this case, you need to do the following:
- Sit the patient down and stand facing him to monitor his condition.
- Anesthetize.
- Perform 2-3 circular fixing turns around the wrist.
- Bend the bandage 90° on the dorsal carpal surface.
- Move the bandage along the back of the hand to the tops of the fingers, and then go to the palmar surface and reach the wrist.
- Repeat the steps of the third step three to four times, simultaneously covering four fingers.
- With a circular tour in the wrist area, secure the previous turns by bending the bandage 90 ° in advance.
- Lead the bandage along the back to the tops of the fingers, wrapping it in spiral-shaped moves, following to the base of the fingers.
- Return the bandage to the wrist through the back of the hand. Fasten the previous turns with a circular tour.
- Put a spica bandage on your thumb.
- Complete the bandage with circular tours around the wrist and tie.
By the way, so that the fingers do not stick together, you need to put gauze scarves between them. "Mitten" can be supplemented with a kerchief bandage to immobilize the limb.
Head bandage
And what is the technique of applying a bandage on the head? We considered the bandage cap above. It is known that several types of bandages are used for bandaging the skull, which have different purposes:
- "Cap of Hippocrates". To apply this bandage, two bandages or a bandage with two heads are used. Take the head of the bandage in your right hand, make circular turns and fasten the bandaging tours, 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 is fixed around the head in a circular circular motion, then lowered to the back of the head and held under the ear from the bandaged area obliquely and upwards, covering the damaged eye with it. The crooked move is grabbed in a circular way, then an oblique move is made again, but slightly higher than the previous one. Alternating oblique and circular turns, envelop the entire eye area.
- Bandage for two eyes. The first fixing circular round is performed, and the next one is transferred down the crown and forehead. Then a curved coil is made from top to bottom, enveloping the left eye. Next, the bandage is moved around the back of the head and again a curved move is made from the bottom up, covering the right eye. As a result, all the next turns of the bandage intersect in the region of the bridge of the nose, imperceptibly enveloping both eyes and going down. At the end of bandaging, the bandage is strengthened with a horizontal circular tour.
- The Neapolitan baldric begins with annular coils around the head. Then the bandage is lowered from the ailing side to the area of the ear and mastoid process.
- The bridle sling is mainly applied to close the chin area. First, a fixing circular tour is performed. The second coil is led obliquely to the back of the head on the neck and under the jaw is transformed into a vertical position. Moving the bandage in front of the ears, a couple of turns are made around the head, and then from under the chin they are led obliquely to the back of the head or on the other side and, having transferred to horizontal turns, the bandage is fixed. 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 anterior region of the chin. Further, rounding the neck, it is necessary to return. Then, lowering the turn of the bandage a little below the chin, it is lifted vertically, fixing the bandage around the head.
Occlusal view
The technique of applying an occlusive dressing is known only to health workers. Let's consider it in as much detail as possible. Occlusive dressings provide hermetic isolation of the injured area of the body, preventing its contact with air and water. For the manufacture of such a device, it is necessary to place a water- and air-tight material on the wound and the adjacent skin area with a radius of 5-10 cm, for example, a rubberized fabric or a synthetic film, and fix it with an ordinary bandage. Instead of a bandage, you can use wide strips 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.
Each person should analyze the application of bandages. The technique for applying a sealing (occlusive) dressing is as follows:
- If the wound is small, prepare 1% iodanat, tupfer and a dressing personal bag. Sit the victim down and treat the skin around the injury with an antiseptic. Then apply the rubber sheath of the private set to the wound with the sterile side, and place cotton-gauze packs on top of it. Next, you need to fix it all with a spike-shaped bandage (if the injury is at the level of the shoulder joint) or a spiral bandage on the chest (if the injury is below the level of the shoulder joint).
- If the wound is extensive, prepare iodanat 1%, tupfer, petroleum jelly, sterile wipes, a wide bandage, oilcloth and gauze-cotton swab. Give the victim a semi-sitting position and treat the skin around the wound with an antiseptic. Then apply a sterile napkin to the damage and lubricate the skin around it with petroleum jelly. Next, apply an oilcloth so that its edges protrude 10 cm beyond the wound. After that, apply a gauze-cotton swab that overlaps the film by 10 cm, and fix it with a bandage on the chest or a spike-shaped bandage.
Gypsum variety
It is difficult to fully learn the application of dressings. The overlay technique, of course, is useful to everyone. It is known that there are complete plaster bandages and incomplete ones. The latter include a bed and a splint.
These bandages can be unlined and lined with cotton gauze. The former are used in the treatment of fractures, and the latter in orthopedic practice. So, the technique of applying plaster bandages is performed as follows:
- Before applying the bandage, seat or lay the patient down so that he does not have any discomfort when bandaging.
- For a fixed limb or body part, use special stands, racks to give it a pose in which it will be after the procedure is completed. Cover all protrusions of the bones with gauze-cotton pads to prevent bedsores.
- Lead the plaster bandage in a spiral, bandage without tension, rolling it over the body. Do not tear off the head of the bandage from the dressing surface so that wrinkles do not appear. Smooth each layer with the palm of your hand, model according to the outlines of the body. With this technique, the bandage becomes monolithic.
- Above the fracture zone, on the folds, strengthen the bandage, which may include 6-12 layers, with additional bandage tours.
- During bandaging, it is forbidden to change the position of the limb, as this leads to the appearance of folds, and they will squeeze 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 a cast, watch the patient's pain sensations and his facial expression.
- Always leave the fingers of the lower and upper limbs 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 congestion has occurred. In this case, the bandage must be cut, and possibly replaced. If the patient complains of terrible pain, and the fingers become cold and white, then the arteries are compressed. Therefore, immediately cut the bandage lengthwise, spread the edges and temporarily strengthen with a soft bandage before applying a new bandage.
- At the end, the edges of the bandage are cut, tucked out, and the resulting roller is smoothed with a mixture of plaster. After that, cover with a layer of gauze and again coat with gruel.
- At the end, write the date of its application on the bandage.
It is known that it is forbidden to cover a wet bandage with a sheet before drying. It will dry out on the third day.
Rules
Therefore, the technique of applying bandage bandages is known to us. Among other things, you need to follow some rules of bandaging:
- always stand facing the patient;
- bandaging start with a fixing tour of the bandage;
- apply the bandage from bottom to top (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 (shin, thigh, forearm), for a better fit, twist it every couple of turns of the bandage.
soft views
The technique of applying soft bandages is known to many. These bandages are divided into the following types: bandage, adhesive (colloidal, adhesive plaster, glue) and kerchief. They are created like this.
Adhesive bandages are used mainly for minor injuries and on the wound area, regardless of its location. If hair grows in the area, it should be shaved beforehand.
To make an adhesive bandage, you need a dressing raw material applied to the wound, attach a couple of strips of an adhesive plaster to healthy areas of the skin. Unfortunately, this design has an unreliable fixation (especially when wet), and maceration of the skin can occur under it.
Cleol is called resin - pine resin dissolved in a mixture of ether and alcohol. Cover the wound with a bandage, and lubricate the skin around it with a drug and let it dry a little. With gauze, close the bandage and skin areas treated with cleol. Firmly press the edges of the napkin to the skin, and cut off the excess gauze that has not stuck to the skin with scissors. What are the disadvantages of this bandage? It does not stick firmly enough, and the skin is contaminated with dried glue.
The collodion bandage differs from the previous one in that gauze is glued to the skin with collodion - a mixture of ether, alcohol and nitrocellulose.
Requirements
We have considered the types, technique of applying bandages. We have covered a broad topic. Of course, you now know how to help a person who has been injured. Narrow bandages (3-5-7 cm) are used to bandage the toes, hands, heads, forearms, hands, lower legs - medium (10-12 cm), breast, thigh, chest - wide (14-18 cm).
If the bandage is applied correctly, it does not interfere with the patient, is neat, closes the damage, does not disturb the lymph and blood circulation, and is firmly attached to the body.
