Teachings about bandages. Rules for applying bandages of various types briefly

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.

Types of dressings according to the method of application

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

bandage;
elastic;
colloidal;
kerchief;
mesh-tubular

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.

tire (surgical, mesh, pins);
plaster;
adhesive;
transport

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. By 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.

Rules for applying bandage dressings by type of overlay.

	Dressing 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 across the back to 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 one turn of the bandage is made in the center of the joint; repeat circular revolutions above and below the previous layer several times, gradually closing the entire injured area; each new layer intersects with the previous one in the popliteal cavity; a fixing turn is done around the thigh Descending Turtle Bandage: make peripheral tours above and below the injured joint, while crossing the bandage in the popliteal cavity; all the following turns of the bandage are done in the same way, moving towards the center of the joint; fixing turn is performed at the level of the middle of the joint

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).

Dressing situations according to their type

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 damage to the head, 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.

Examples of applying some other dressings

	Dressing 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.

Rules for applying bandages for bleeding of various types

Type of bleeding	Description	Dressing 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 material, 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.

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KaragandaStateMedicalUniversity

Chairgeneralsurgeryandtraumatology

abstracton thetopic:

Desmurgy. Types of bandages. materials

Prepared:

group student 3-062

Klimenko A.A.

Checked: Kaipov S.K.

Karaganda-2017.

Introduction

The first information about the use of dressings dates back to ancient times. During the time of Hippocrates (5-4 centuries BC), sticky plaster, resins, and canvas were used to hold the dressing material. One of the classic bandage headbands is associated with the name of Hippocrates. There is information about the use in those days of special devices and dressings used in the treatment of fractures and the correction of various curvature of the spine and limbs.

A. Celsus (1st century AD) mentions bandages. In the works of Arab scientists 9-11 centuries. mention is made of gypsum for fractures (the injured limb was poured with gypsum slurry).

In the Middle Ages, bandages with traction were used. In the 14th century, a method of constant traction with a load for dislocations and fractures was described. In the 16th century, French surgeons used various devices and prostheses for this purpose. In the 17th century, a Schultes bandage was proposed for a limb [named after the German physician J. Schultes], consisting of interwoven strips of fabric. In the 18th century, the adhesive bandage came into use.

Before the use of antiseptics in surgery, the wound was covered with lint (split into separate threads with linen and cotton rags), which was held on the wound with a bandage, mostly cloth. The advent of gauze bandages has simplified the application of bandages.

By the middle of the 19th century, almost all existing bandage dressings had been created, and since then this section of desmurgy has developed little. In the future, the use of adhesive dressings (collodion, cleol, dressings with film-forming substances) and mesh dressings (stockings) made it possible to significantly save dressings. The doctrine of fixed bandages and bandages with traction as methods of treating fractures has received more and more widespread development. From slow-drying starch and adhesive dressings, surgeons switched to fast-hardening plaster dressings, improvised splints began to be replaced with standard and traction devices.

Great merits in the development of questions of desmurgy belong to domestic surgeons: N. I. Pirogov, G. I. Turner, A. A. Bobrov, R. R. Vreden, I. M. Kefer, M. II. Sitenko, N. M. Volkovich, N. N. Priorov, V. V. Gorinevskaya.

N. I. Pirogov put into practice a plaster cast, which he first applied in military field conditions. This dressing supplanted the starch dressing proposed by L. Seutin in 1840.

Mainquestions:

Desmurgy(from the Greek desmos - leash, connection, bandage, ergon - business, performance) - a section of medicine dedicated to dressings and their use.

The second definition of desmurgy is a branch of surgery that develops methods of application and techniques for applying dressings in order to protect wounds, pathologically altered and damaged tissues from the effects of the external environment.

conceptaboutdressing

Bandage- a means of long-term therapeutic effect on a wound, pathological focus or part of the patient's body using various materials and substances by holding them on the necessary part of the patient's body.

Dressings are usually applied in a dressing room. This is where the binding process takes place.

Bandaging is understood as a medical and diagnostic procedure, which consists in removing the old bandage, performing preventive, diagnostic and therapeutic manipulations in the wound and applying a new bandage. To perform the dressing, appropriate indications are needed.

Viewsdressingmaterial

Gauze

The main type of dressing material - gauze - cotton fabric, the threads of which are located loosely to each other. This structure of the material provides the gauze with its main property - hygroscopicity. In addition, gauze can be easily washed, sterilized, it is very light.

For ease of use in surgery, napkins, tampons, turundas, balls and bandages are prepared from gauze. They can be of various sizes. In particular, the bandages have a width of 5 to 20 cm.

The dressing may be sterile or non-sterile. Sterile dressing material is used for applying directly to the wound, non-sterile - for fixing dressings on a certain part of the body. Sterilization of dressings is generally carried out in an autoclave with high pressure steam. In some cases, factory radiation sterilization is carried out, and then the dressing comes in sealed polyethylene packages.

Plaster bandages are made from gauze, as well as cotton-gauze swabs.

cotton wool

Another type of dressing material is cotton wool. It can be either cotton or synthetic (viscose). However, the presence of its two types is more significant: hygroscopic (white wool) and non-hygroscopic (gray wool). White cotton wool is used when applying bandages in cases where it is necessary to promote the outflow of wound contents. Gray cotton wool is used when applying a compress bandage, as it prevents the evaporation of the medicinal substance to a greater extent and helps to retain heat.

Cotton wool is used as cotton-gauze tampons, balls, it is wound on sticks (for treating minor wounds, fistulous passages). The sterilization methods for cotton wool and gauze are identical.

Additionalfunds

In some cases, when applying bandages, additional funds are used. Ordinary cloth (for example, a kerchief), rubberized cloth (occlusive dressing for pneumothorax), plaster splints, transport tires, special splints, and other devices can be used.

Indications

1. The first day after the operation. The need for bandaging a day after the operation is due to the fact that in the presence of any wound (even, it would seem, hermetically sewn up), the lower layers of gauze always get wet with ichor during the first day, since fibrin of the wound edges has not yet occurred. The ichor is a good breeding ground for microorganisms. The purpose of the dressing on the first day after the operation is prophylactic - the removal of the wet dressing material and the treatment of the edges of the wound with antiseptics to prevent infectious complications.

2. The need to perform diagnostic manipulations in the wound, control the course of the healing process.

3. The need for medical manipulations: removal of sutures, removal of drainage, excision of necrotic tissues, washing with antiseptics, stopping bleeding, administering drugs.

4. Failure of the bandage to perform its functions (an immobilizing bandage does not provide immobility, a hemostatic bandage does not stop bleeding, an occlusive bandage does not create tightness, etc.).

5. Wetting the dressing. A dressing that gets wet with wound discharge or blood does not fulfill its function and is a conductor for a secondary infection.

6. The bandage has shifted from the place of application.

Withdrawalbandages

When removing the old bandage, two basic principles should be taken into account: a minimum of discomfort for the patient and compliance with asepsis standards.

For painless removal of the bandage, carefully peel off the gauze, while holding the skin around (with adhesive bandages), do not put pressure on the wound area, do not make sudden movements. When the dressing dries to extensive wounds, in some cases it is soaked with antiseptic solutions (3% hydrogen peroxide, 2-3% boric acid, etc.).

The removal of the upper non-sterile layers of the dressing (bandage, gauze) is carried out with gloved hands (all procedures in the dressing room are performed with rubber gloves!). After that, it is possible to remove the sterile dressing material that is in direct contact with the wound, as well as to perform all further manipulations with the wound, only with a sterile instrument. The material used during dressing is dumped into a kidney-shaped basin, and after its completion from the basin - into special tanks for disposal, while the basin itself and the used instruments are placed in a storage tank for disinfection.

Mainkindsbandages:

Classification by type of dressing material

Classification by purpose

Classification according to the method of fixing the dressing material

Classification by mechanical properties

Classificationonminddressingmaterial

desmurgia bandage fixation

The classification of dressings according to the type of material used is very simple. There are the following types of bandages:

* gauze bandages;

* fabric bandages;

* plaster bandages;

* splinting;

* special bandages (zinc-gelatin bandage in the treatment of trophic ulcers, etc.).

It should be noted that at present, gauze bandages are used to apply almost all dressings. From bandages or gauze, components are made for the so-called bandage-free dressings (sling-like, T-shaped, kerchief). Cloth dressings are used only in critical situations in the absence of bandages, then the available material at hand (fabric, clothing, etc.) is used to apply them.

Plaster bandages are applied using special plaster bandages - bandages sprinkled with gypsum (calcium sulfate). When splinting, the tires themselves are also fixed with ordinary gauze bandages (less often with special belts). When applying a zinc-gelatin bandage, gauze bandages are also used, but when bandaging, each layer of the bandage is impregnated with a special heated zinc paste.

Classificationonappointment

Classification by purpose is related to the function that the dressings are supposed to perform.

* Protective (or aseptic) bandage. Purpose - prevention of secondary infection of the wound.

* Medicinal dressing. The purpose is to provide constant access to the wound of the medicinal substance, which is usually moistened with the lower layers of the dressing.

* Hemostatic (or pressure) bandage. The purpose is to stop bleeding.

* Immobilizing bandage. Purpose - immobilization of a limb or its segment.

* Bandage with traction. Purpose - traction of bone fragments.

* Corrective bandage. Appointment - elimination of deformations.

* Occlusive dressing. Appointment - wound sealing (special bandage for chest wounds with open pneumothorax).

Compress bandage

A compress bandage is used in the treatment of inflammatory infiltrates, thrombophlebitis, etc. A compress bandage provides a long-term effect on the tissues of a drug solution that does not have the ability to evaporate. Most often, semi-alcoholic (or vodka) compresses are used, as well as compresses with ointments (Vishnevsky ointment).

The overlay technique is as follows: a cloth or a napkin moistened with a medicinal substance is placed on the skin, waxed paper or polyethylene is placed on top, then gray cotton wool. In this case, each next layer of the dressing should overlap the previous one along the perimeter by 2 cm. The bandage is usually fixed with a bandage.

Occlusive dressing

An occlusive dressing is used for open pneumothorax - a chest wound that communicates with the pleural cavity. The purpose of the bandage is to seal the wound tightly to prevent atmospheric air from entering the pleural cavity. To apply it, it is convenient to use an individual dressing bag, which consists of two sterile cotton-gauze swabs and a bandage in a sterile package made of rubberized fabric.

Application method: the bag is opened, a rubberized tissue is applied to the wound with an inner sterile surface, a cotton-gauze swab is applied to it, and a bandage bandage is placed on top. The rubberized fabric does not allow air to pass through, and its tight fixation with a swab and bandage provides the necessary tightness of the wound.

Classificationonwaycommitsdressingmaterial

Classification according to the method of fixing the dressing is the division of all dressings into two groups: non-bandage and bandage.

Bandage free:

* adhesive;

* adhesive plaster;

* scarf;

* sling-like;

* T-shaped;

* a bandage from a tubular elastic bandage (retilast, etc.). Bandages:

* circular;

* spiral;

* creeping;

* cruciform (eight-shaped);

* turtle (converging and diverging);

* returning;

* spike-shaped;

* bandage Deso;

* headband;

* Hippocratic hat;

* mono and binocular.

BandagelessbandagesAdhesive

The dressing is fixed on the wound with glue. It is possible to use cleol, collodion and BF-6 glue. The most commonly used cleol is a special glue, which includes rosin resins and diethyl ether.

After laying sterile napkins on the wound, a strip of cleol 3-5 cm wide is applied directly along their edge to the skin. After that, after 30-40 s, stretched gauze is applied and smoothed through a layer of matter (sheet, towel). After gluing, the edges of the gauze are slightly peeled off along the periphery and the excess part of it is cut off with scissors, smoothing out the sharp corners. The gauze is then pressed against the skin again. Thus, the edges of the gauze are completely glued and do not bulge, which ensures reliable fixation of the dressing.

With repeated application of an adhesive bandage, an excess layer of glue remains on the skin, which is easily removed with diethyl ether (worse, with alcohol).

The advantages of the adhesive bandage are the speed and ease of application, as well as the small size of the bandage and convenience for the patient.

Disadvantages: the possibility of an allergic skin reaction to cleol, insufficient fixation strength (on moving parts of the body). Such dressings are not used on the face and perineum, as they cause irritation of sensitive skin. In addition, diethyl ether vapors can cause burns to mucous membranes.

Most often, adhesive dressings are used for wounds on the body, in particular after operations on the organs of the chest and abdominal cavities, retroperitoneal space.

Adhesive plasterbandage

The dressing is fixed with adhesive tape. At the same time, several strips of adhesive tape are glued, protruding 3-4 cm beyond the edges of the sterile dressing. For reliable fixation, it is important to dry the skin thoroughly beforehand.

In addition to a simple adhesive plaster, a bactericidal one is used - a ready-made dressing with sterile gauze and an adhesive plaster base. Recently, a whole series of special strips of adhesive tape has appeared with a dressing material of various shapes in the center. The application of such a patch does not require pre-laying sterile wipes, which greatly simplifies the procedure.

Advantages - the same as for adhesive bandages. In addition, it is possible to use adhesive bandages for small wounds on the face.

Disadvantages of adhesive bandages: an allergic reaction is possible, they are not applicable on the hairy parts of the body, they are not strong enough when applied in the area of the joints, as well as when the bandage gets wet or wet dressings are applied to the wound. To reduce the frequency of skin allergic reactions, hypoallergenic types of adhesive plasters have been developed.

kerchiefbandage

The scarf is now rarely used, mainly as a means of first aid at home. Usually a triangular piece of cotton or gauze is used. Options for using a kerchief bandage in the presence of wounds of various localization are shown in fig. 3-1.

sling-likebandage

Sling - a strip of fabric, cut in the longitudinal direction from two ends, leaving an uncut section in the center.

Rice. 1. Kerchief bandage: a - on the head; b - on the upper limb; in - on the crotch

Currently, the sling dressing is used in three versions: for wounds in the nose, on the chin and in the occipital region (2). Often, instead of a strip of fabric, a wide gauze bandage or a cut tubular bandage (retilast) is used.

Rice. 2. Sling-like bandage on the nose, chin and occipital region

T-shapedbandage

A T-shaped bandage is used for injuries in the perineum. With such localization, the application of adhesive and adhesive bandages is impossible, and the use of bandages is extremely difficult. A T-shaped bandage is applied after operations on the rectum, perineum, sacrum and coccyx, after opening paraproctitis.

For a T-shaped bandage, a rectangular piece of gauze is used (or to give elasticity - a dissected tubular bandage, retilast), cut from below into four strips. Gauze is placed under the patient's lower back, the upper strips of gauze are tied on the belt, and the lower ones are carried out inside and outside each thigh, also tying them together.

Bandagefromtubularelasticbandage

Tubular elastic bandage (retilast) provides reliable fixation of the dressing on various parts of the body due to its elasticity and elasticity. There are different sizes (numbers) of the bandage, which allows you to use it, starting from bandages on the finger and ending with bandages on the chest and abdomen (Fig. 3). In addition, it is possible to modify dressings from retilast: cutting a window, using it for a sling-like or T-shaped bandage, for bandaging a stump (the free part of the bandage is tied in a knot on the stump), etc.

Rice. 3. Retilast bandages on various parts of the body

Generalregulationsbandaging

The imposition of bandages has a number of advantages: they provide more reliable fixation of the dressing in case of injuries in the limbs, especially on moving parts - in the joints; do not cause allergic reactions, are easily modified, allow to increase pressure (pressure bandage). At the same time, bandaging the torso (chest and abdomen) requires a large number of bandages and is quite inconvenient for the patient.

When applying bandage dressings, one should adhere to the general rules of bandaging, which can be divided into rules regarding the position of the surgeon and the patient, and the bandaging technique itself.

bandaging technique

1. It is necessary to choose the appropriate size of the bandage (when bandaging on the finger - 5-7 cm wide, on the head - 10 cm, on the thigh - 14 cm, etc.).

2. The bandage is applied from the periphery to the center, from the intact area to the wound.

3. When applying a bandage, the head of the bandage should be in the right hand, the canvas - in the left. The head of the bandage should be open, which contributes to uniform even rolling of the bandage. The free length of the canvas should not exceed 15-20 cm.

4. Any dressing begins with the imposition of circular tours (tour - turn of the bandage) to secure the beginning of the bandage.

5. Bandage tours are applied from left to right (in relation to the bandaging), with each subsequent round usually overlapping the previous one.

6. When applying a bandage to the conical sections of the limb, bends of the bandage should be made.

7. Fix (tie) the ends of the bandage should not be on the wound area, on the flexion and supporting surfaces.

The finished bandage must meet the following requirements:

* the bandage must reliably perform its function (fixing the dressing on the wound, immobilization, stopping bleeding, etc.);

* the bandage should be comfortable for the patient;

* the bandage should be beautiful, aesthetic.

SeparatekindsbandagepovtongueCircular

A circular (circular) bandage is the beginning of any bandage bandage (helps to secure the end of the bandage), and can also be an independent bandage when applied to small wounds. The peculiarity of the bandage is that each subsequent round is laid exactly on the previous one.

Spiral

A spiral dressing is used to cover larger wounds on the limbs or torso. It is a classic bandage dressing, in which all the rules of bandaging are fulfilled. In particular, the tours overlap the previous ones by one or two thirds.

On the parts of the limbs, close in shape to the cylinder (thigh, shoulder), impose the usual spiral bandage; close in shape to a cone (lower leg, forearm) - a spiral bandage with kinks (Fig. 3-4 a). At the same time, it is desirable to make bends on one surface, without pulling on the bandage and alternating them with ordinary tours.

Fig.4. Bandage bandages: a - spiral with kinks; b - bandage on the finger. The numbers indicate the tours of the bandage

When applying a spiral bandage to the finger, it must begin and end at the wrist to prevent the bandage from slipping. In this case, tours from the finger to the wrist should go only along the back surface of the palm (Fig. 4 b).

creeping

The creeping bandage resembles a classic spiral bandage, but differs in that the tours do not overlap each other.

Such a bandage is applied in the presence of multiple wounds on the limbs (for example, after phlebectomy for varicose veins of the saphenous veins of the lower limb) for preliminary fixation of the dressing on the wounds, then switching to a spiral bandage.

cruciform(octagonal)

A cruciform (or eight-shaped) bandage is applied to surfaces with an irregular configuration. Mainly used for dressings on the chest, neck and ankle (Fig. 5).

Skullsshya(converginganddivergent)

A tortoise bandage is applied to the knee and elbow joints. It provides reliable fixation of the dressing - and in these mobile areas. Depending on the order of imposition of tours, two equal types of it are distinguished: convergent and divergent (Fig. 6 a).

Fig.5. Bandage bandages: cruciform bandage on the chest, back of the head and ankle joint

Rice. 6. Bandage bandages: a - turtle bandage: converging and diverging; b - returning bandage on the brush; in - spike-shaped bandage; g - bandage Deso

returningbandage

The bandage is used to apply bandages to the stump of a limb or to a hand. Provides end face closure. To do this, some of the tours are applied vertically through the end of the stump (hand), and they are fixed with horizontal tours at its base (Fig. 3-6 b).

Spike

Spike bandage is used in the presence of wounds in the area of the shoulder girdle, shoulder joint and upper third of the shoulder (Fig. 3-6 c). The imposition of other types of bandages in this area does not provide reliable fixation: at the slightest movement, the bandage slides down onto the shoulder.

BandageDeso

Bandage Deso - one of the types of immobilizing dressing applied with a regular gauze bandage. It is used for immobilization of the upper limb as a means of first aid, transport immobilization and auxiliary immobilization after operations (Fig. 3-6 d).

Feature of the bandage: when applied to the left hand, bandaging starts from left to right, on the right - from right to left (an exception to the general rules of bandaging).

Bandageson thehead

The Hippocratic cap is applied with a double-headed bandage or two separate bandages. One of them is tours in the sagittal direction from the forehead to the back of the head and back, gradually shifting them to cover the entire surface of the head. At the same time, circular rounds are made with the second bandage, fixing each round of the first bandage. The cap is the simplest and most convenient bandage on the scalp, in which the occipital region can also be closed. They begin to apply a bandage with the fact that a bandage is placed over the head on the parietal region, the ends of which hang down (they are usually held by the victim, slightly pulling). The bandage tours begin with a circular one, gradually “lifting” them to the center of the scalp. When applying tours, the bandage is wrapped around the string every time. After closing the entire scalp with tours, the bandage is tied under the lower jaw, and the end of the bandage is fixed to it. The method of bandaging one and both eyes to a certain extent resembles an eight-shaped bandage. It is important to note that when the dressing is applied correctly, the ears, nose and mouth should remain completely open. All of these types of dressings have their advantages and disadvantages. In each case, choose the most appropriate method of fixing the dressing on the wound.

Rice. 7. Bandage headbands: a - Hippocratic cap; b - cap; c - mono- and binocular

Conclusion

Desmurgy is of great importance both in medicine in general and in surgery in particular. Knowledge of all the rules for applying bandages and, most importantly, the ability to use them correctly is necessary for a doctor of any profile. Proper use of dressings prevents postoperative complications, traumatic complications, reduces patient discomfort, in addition, without the absence of dressings after operations, it can reduce the entire treatment process.

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Types of dressings according to the method of application
View	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	bandage; elastic; colloidal; kerchief; mesh-tubular
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.	tire (surgical, mesh, pins); plaster; adhesive; transport

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.

Types of bandages	Use cases
Thin bandages, the width of which is 3 cm, 5 cm, 7 cm, and the length is 5 m	They bandage injured fingers
Medium bandages 10 to 12 cm wide, 5 m long	Suitable for bandaging injuries of the head, forearm, upper and lower extremities (hands, feet)
Large bandages whose width is more than 14 cm and the length is 7 m	Used to apply bandages on the chest, thighs

Bandage classification:

1. By type:

aseptic dry;
antiseptic dry;
hypertonic wet drying;
pressing;
occlusal.

2. By 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 - sitting;
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.

Rules for applying bandage dressings by type of overlay.
Type of	Dressing rule
circular bandage	Superimposed on the wrist, lower leg, forehead and so on. The bandage is applied spirally, both with and without kinks. Bandaging with kinks is best done onbody parts, which have the canonical form
creeping bandage	Superimposed for the purpose of preliminary fixationdressing material 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 across the back to the right forearm across, from where the bandage is again carried out along the chest towards the left armpit, while crossing the previous layer; 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 Diverging Turtle Headband: one turn of the bandage is made in the center of the joint; repeat circular revolutions above and below the previous layer several times, gradually closing the entire injured area; each new layer intersects with the previous one in the popliteal cavity; a fixing turn is done around the thigh Descending Turtle Bandage: make peripheral tours above and below the injured joint, while crossing the bandage in the popliteal cavity; all the following turns of the bandage are done in the same way, moving towards the center of the joint; fixing turn is performed at the level of the middle of the joint

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).

Dressing situations according to their type
Name	When superimposed
"Cap"	For injuries to the frontal and occipital part of the head
Simple	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 basis of the rule for applying bandages on the head is 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 timelymedical care, then with a general head injury, it is recommended to apply the simplest version of the bandage - a “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.

Examples of applying some other dressings
Type of	Dressing rule
Simple	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 - 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.

Rules for applying bandages for bleeding of various types
Type of bleeding	Description	Dressing 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. Type of applied bandage - 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).

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.

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 there is such an opportunity, then it is best to use the API -individual dressing package, which is a bandage with two attached cotton-gauze pads. One of them is fixed, and the other moves freely along it.

Applying an aseptic dressing

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 of hygroscopic cotton wool (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.

Splint dressing

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 casualty 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.

Desmurgy is the doctrine of bandaging. There are the following types of bandages.

Bandage it is used for small or tightly sutured wounds, for approaching the edges of granulating wounds (Fig. 3), for rib fractures (Fig. 4), and also after reduction of umbilical hernias (Fig. 5). A patch bandage is applied from the coil of an adhesive patch after it is unwound or with a bactericidal adhesive patch after the protective film is removed from it. apply with a sticky side directly on small wounds, abrasions, scratches after their treatment with an iodine alcohol solution or over strips of various shapes (Fig. 1). The strips should capture areas of the skin in the circumference of the dressing (Fig. 2).

Zinc gelatin dressing used to provide constant pressure for varicose ulcers of the lower leg.

Powdered gelatin (200 g) is placed in cold water (200 ml) to swell. Excess water is drained and a vessel with softened gelatin is placed in a water bath (in another vessel with boiling water), stirred until it becomes liquid. Mix 100 g of oxide with 300 ml of water and add 100 g of glycerin. This mushy mass is added with stirring to the gelatin and then poured into a flat cup, where it solidifies into a paste. Before applying a zinc-gelatin bandage, the paste must be heated in a water bath and, when the paste becomes mushy, lubricate the skin of the foot and lower leg with it; a bandage bandage is applied on top (4-5 layers), additionally smearing each layer with paste.

Cleol bandage used in the same cases as the patch. A gauze rolled up in several layers is applied to the affected area, the skin in a circle is smeared with cleol. When it starts to dry out (threads form between the finger and the skin when touching it), a gauze napkin is applied in one layer, pulling it and pressing it tightly against the skin smeared with cleol. Cut off excess gauze. Sometimes, when applying bandage dressings, for their greater strength, the skin around the wound is lubricated with cleol.

Cleol recipes: pine or spruce resin 30 g, 100 g, linseed oil 0.1 g or rosin 40 g, alcohol 95 ° 33 g, ether 15 g, sunflower oil 1 g. When adding antiseptic substances to cleol () or () you can lubricate them with abrasions, scratches and superficial cuts. Healing takes place under a film covering the wound.

collodion dressing used in the same cases as the patch. Having covered the wound with a dressing, a gauze napkin is applied over it. Its free edges, adjacent directly to the skin, are moistened with collodion and wait until it dries (Fig. 6).

Bandages with rubber adhesive. With uniform lubrication of the applied bandage with rubber glue (rubber solution in a mixture of ether with), you can protect it from getting wet.

Such dressings are useful in young children to protect the wound from wetting with urine.

kerchief bandages. A kerchief is a triangular piece of cloth or a scarf folded diagonally (Fig. 7). Its long side is called the base, the angle opposite it is called the top, and the other two angles are the ends. Kerchief dressings are used most often when rendering. The most convenient sling for hanging the arm (Fig. 8). The middle of the scarf is placed at a right angle, the top is directed to the elbow, one end goes between the body and the arm, the other over the arm. The ends are tied around the neck. To improvise a scarf, you can use a strip of cloth, a towel (Fig. 9), the floor of a jacket (Fig. 10). A kerchief can be applied to any part of the body, for example, it can cover the entire scalp (Fig. 11), mammary gland (Fig. 12), hand (Fig. 13), area (Fig. 14), buttocks (Fig. 14). . 15), lower leg (Fig. 16), (Fig. 17). Having folded the scarf along the base in the form of a tie, it can be used to apply a bandage on the axillary region and shoulder girdle (Fig. 18). Two kerchiefs, one of which is folded with a tie, can cover the area (Fig. 19), the buttock area and the upper thigh (Fig. 20).

I approve

Director of GBOU secondary school No. 484

S.P. Fedechkina

"_____" ___________ 201___

PLAN-SUMMARY

conducting a lesson on vocational medical training with students 10 class

"___" _________ 201__

Topic: "Desmurgy. Types of dressings and rules for their application".

The purpose of the lesson: 1. To give an idea of the main types of dressings and the rules for applying them in first aid.

Tasks:

1. Introduce students to the classification of dressings.

2. To form primary skills in applying bandages.

3. To instill in students self-confidence in the provision of first aid.

Lesson type: combined

Equipment: tables, visual aids. (gauze bandage tires

Literature used: 1. Smirnov A.T. Fundamentals of medical knowledge and a healthy lifestyle.

M., Education, 2002.

2. Sokolova N.G. A new nurse's guide. Phoenix 2002.

p/n

Lesson stages

Methods

Teacher activity

Activity

students

Organizational

moment.

Purpose: to organize children, set them up to study the material. 1 minute.

Conversation

Hello guys! Sit down.

Checking for students in class.

Welcome teachers.

They sit down.

Update

basic knowledge.

Target:

Reveal Knowledge

students about the upcoming lesson and previously acquired knowledge. 5 minutes.

Explanation

knowledge

How do you understand the concepts of injury and bandage?

What can you say about the rules

providing first aid to the victim in these cases?

See Appendix 1

Reply to

questions raised

in their own words, explain previously acquired knowledge on the topic of the lesson.

Learning new

material.

Purpose: to expand

knowledge about the topic.

The concept of desmurgy.

Dressing rules

The story and demonstration of dressings in compliance with the rules of imposition

Open your workbooks, write down the topic of the lesson and the main concepts.

I bring the main concepts on the topic of the lesson to the record in the exercise books.

Desmurgy- the doctrine of bandages. A bandage should be understood as something that is applied to a wound, burn, fracture for therapeutic purposes. Depending on the purpose, dressings can be used to hold medicinal substances in the wound, protect affected areas from contamination, stop bleeding, and create rest and immobility of the injured part of the body in case of fracture, dislocation, etc. The dressing material must be sterile.

The application of a bandage may be designed to protect some part of the body from external influences or to fix it in a certain position. Some bandages are used to tighten some part of the body.

When applying a bandage, you must follow a number of rules. The bandage should not be very loose and move along the surface of the body, but it should not be very tight and compress tissues that are sensitive to mechanical stress. Such places should be protected with padding or other means so that the dressing itself does not injure the skin.

During the dressing, you should stand facing the patient as much as possible.

From the very beginning of the bandaging, it is necessary to ensure that the part of the body being bandaged is in the correct position. Changing its position during the ligation process usually has a negative effect on the manipulation. In addition, the dressing can form folds in the places of bending, making the entire bandage of poor quality. The direction of the turns should be the same in all layers of the dressing. A change in direction can cause part of the dressing to shift or wrinkle, which naturally reduces the quality of the dressing.

The width of the bandage should be selected so that it is equal to the diameter (or slightly larger) of the part of the body being bandaged. Using a narrow bandage not only increases the dressing time, but can also cause the bandage to cut into the body. The use of a wider bandage makes manipulation difficult. When using tubular bandages, choose such a diameter that you can easily pull it over a pre-bandaged area of \u200b\u200bthe body without great difficulty.

The bandage should be held in the hand so that the free end makes a right angle with the hand in which the roll of the bandage is located.

Dressing should be started from the narrowest place, gradually moving to a wider one. Under this condition, the bandage holds better.

The dressing should begin with the imposition of a simple ring in such a way that one end of the bandage protrudes slightly from under the next turn applied in the same direction. By bending and covering the tip of the bandage with the next turn, it can be fixed, which greatly facilitates further manipulations. The ligation ends with a circular coil.

When dressing, you should always remember the purpose of the dressing and apply as many turns as necessary to facilitate its function. An excessive amount of bandage is not only economically inexpedient, but causes inconvenience to the patient and looks very ugly.

See annex 2.

Fix in

textbooks basic concepts on the topic of the lesson

Rules and methods for applying bandage dressings

Bandage bandages (requirements and rules for bandaging)

A bandage rolled into a roll is called a head (roll), and the free part is called the beginning. There are narrow, medium and wide bandages. Narrow bandages are used when bandaging fingers, medium bandages for the head and limbs, wide bandages for the chest, abdomen, pelvis and large joints.

Rules for applying bandages.

Take a bandage of the desired width, depending on the bandaged part of the body. Ensure a comfortable position for the victim and the accessibility of the bandaged part from all sides.

The caregiver is facing the victim to monitor his condition.

The bandage is usually opened from left to right. To do this, the head of the bandage is taken in the right hand, and the beginning - in the left, so that the roll is located on top. An exception is made for bandages on the right half of the face and chest.

Bandaging is usually carried out from the periphery to the center. They start with fixing circular tours (moves). The head of the bandage is directed upwards.

The bandage is rolled out evenly on the bandaged surface, pulling it and not tearing it away from it.

Bandaging should be done with two hands: one rolls out the head of the bandage, the other straightens its tours.

When applying a bandage, each new tour of the bandage overlaps the next one by half or two thirds of its width.

The bandage cannot be twisted. The bandage ends with circular tours. The end of the bandage is torn longitudinally and tied in a knot on the side opposite to the injury and the one on which the victim will lie.

The nature of bandaging is determined by the shape of the parts of the body on which the bandage is applied (conical, cylindrical), the severity of the muscles, the presence of joints. Taking into account these anatomical features, the following types of bandage dressings have been developed:

1. circular (circular),

2 . spiral,

3. cruciform (or eight-shaped),

4.spike,

5.turtle,

6. returning.

Knowing the main types of bandage dressings and combining them, you can apply a bandage to any part of the body.

Headband "Cap".

It is applied in case of damage to the scalp. This headband is simple, comfortable and securely kept on the head. The tape of a wide bandage (holder) is placed in the middle on the parietal region. Its ends fall vertically down, in front of the auricles. They are held in a tense and somewhat retracted position by the victim himself or by an assistant. Start the bandage with a circular tour around the head over the holders. On the second circular round, having reached one holder, the bandage is wrapped around it and turned obliquely upwards onto the frontal bone. The bandage goes to another holder, while closing the forehead and part of the parietal region. On the opposite side, the bandage is also wrapped around the holder and directed to the occipital region, covering part of the occiput and crown. Thus, with each new round, the bandage shifts by half its width, gradually closing the entire arch of the head. The end of the bandage is attached to one of the holders. Holders are tied under the chin.

Bandage on the brush "Glove ».

Such a bandage is used in cases where it is necessary to bandage each finger individually, for example, with extensive burns, inflammatory or skin diseases of the hand. The bandage is started with fixing circular tours around the wrist area, and then the bandage is directed along the back surface to the nail phalanx of the fifth finger of the left hand (on the right hand, bandaging starts from the second finger). Spiral tours close it and return along the back of the hand to the wrist. Having made a turn around the wrist, they pass along the back surface to the fourth finger. Bandage it, and then alternately, in the same sequence, bandage the third and second fingers. A spike-shaped bandage is applied to the first finger. The transition of the bandage from finger to finger is carried out along the back surface, while the palmar remains free. When finished, the bandage resembles a glove.

It must be remembered: if the transitional tours go along the palm of your hand, then when the brush moves, the bandage quickly unties and slides off. Finish the bandage with circular tours around the wrist area.

Bandage on the elbow joint .

In case of damage to soft tissues in the area of the elbow joint (wound, burn, inflammation), a tiled bandage is applied - a variety of eight-shaped.

There are two equivalent options - convergent and divergent. The choice is determined by the site of damage. So, in case of damage to the elbow bend, a divergent bandage is more beneficial, and in case of damage to the shoulder and forearm, a converging one. Before applying a bandage to the arm of the victim, it is bent at a right angle in the elbow joint. When applying the converging version, the bandage begins with a fixing circular tour around the forearm, 10–12 cm below the elbow joint. Then the bandage is directed obliquely upwards to the lower third of the shoulder in front of the cubital fossa. Having rounded the shoulder, the bandage is lowered obliquely down on the forearm. As a result, the bandage moves resemble a figure eight. The eight-shaped tours, when repeated, each time shift by half the width of the bandage towards the elbow joint, gradually covering the entire damaged surface. The last rounds of the bandage are applied circularly through the elbow joint.

The diverging tiled bandage begins with a circular tour through the elbow bend. Then the eight-shaped moves, gradually shifting by half the width of the bandage to the sides of the shoulder and forearm, diverge and cover a significant area.

Consolidation. Purpose: to systematize the knowledge gained in the lesson, to determine the area of their practical application 5 min.

Conversation

Our lesson opens up the concept of desmurgy to you. This is the next lesson from the general topic of the lesson “Threatening conditions of the body. Assistance Measures. All the acquired theoretical knowledge and the basics of practical skills will be useful to you in later life. Each of you, unfortunately, will face the problem of providing assistance. Let's repeat the main questions of the lesson:

What is desmurgy?

Name the types of bandages?

What are the main bandages?

Tell us the rules for applying bandages during the first
help.

They answer the questions asked.

Homework.

Purpose: to repeat and consolidate the material received in the lesson. 3 min.

Study abstract materials. Individual task: prepare messages on the topic of the lesson.

Record homework in diaries.

Lesson summary 1 min.

Today at the lesson I put

biology teacher

Ivanova I.V.

Attachment 1.

SURVEY: MAIN SYMPTOMS OF INJURIES.

Question 1. Pain, bruising, swelling, dysfunction, hematoma.

ANSWER:

Diagnosis: Contusion - damage to soft tissues without breaking the integrity of the skin.

Question 2. Absence of acute pain immediately after injury, swelling (1.5 - 2 hours after injury), dysfunction.

ANSWER:

Diagnosis: Stretching is a closed damage to soft tissues without violating their anatomical integrity.

Question 3. Acute pain, impaired movement in the joint, hemorrhage in soft tissues, in the joint.

ANSWER:

Diagnosis: Rupture is a closed injury of soft tissues with violation of their anatomical integrity.

Appendix 2

Emergency care for bruises, sprains, ruptures.

Pain relief (analgesics).

Immobilization of the limbs with a soft bandage bandage.

Cold on the damaged area on the first day, on the second day - heat.

Transportation of the patient to a trauma center or hospital.