The rule of imposing a bandage and a tourniquet. Rules for the imposition of bandages. Rules for the imposition of a pressure bandage

First aid to the injured with wounds, fractures, dislocations, ligament injuries, bruises, burns and other things becomes almost impossible without the timely and correct application of the bandage. After all, due to dressing, additional infection of the wound is prevented, as well as stopping bleeding, fixing fractures, and even the healing effect on the wound begins.

Medical dressings and their types

The section of medicine that studies the rules of imposing bandages and harnesses, their types and methods of application, is called desmurgia (from the Greek desmos - leash, bandage and ergon - accomplishment, case).

According to the definition, the bandage is a method of treating injuries and injuries, which consists in using:

• Dressing material, which is superimposed directly on the wound;
• The outer part of the dressing, which fixes the dressing.

In the role of dressings, for various reasons, can act:

• Special dressings;
• Napkins;
• Cotton swabs;
• Gauze balls.

Types of dressings by the method of application

View	Description	Varieties
Protective or soft	They consist of a material that is applied to the wound, and a fixing bandage Used in most cases: with burns, bruises, open wounds	Bandage; Elastic; Colloidal; Kosynochnye; Mesh-tube
Immobilization or solid	Consist of dressing and tires They are used to transport the injured person, in the treatment of bone injuries and their elastic joints	Tire (surgical, mesh, pins); Gypsum; Glutinous; Transport

Primary care for injuries

The process of applying a dressing is called bandaging. Its goal is to close the wound:

• To prevent its further infection;
• To stop the bleeding;
• To have a curative effect.

General rules for the imposition of dressings for wounds and injuries:

1. Wash hands thoroughly with soap, if this is not possible, then at least treat them with a special antiseptic.
2. If the injury site is an open wound, then carefully treat the skin around it with alcohol solution, hydrogen peroxide or iodine.
3. Place the victim (patient) in a convenient position (sedentary, recumbent), while providing free access to the damaged area.
4. To stand in front of the patient's face in order to observe his reaction.
5. 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.
6. The hand should be bandaged in the bent at the elbow state, and the leg - in the straightened.
7. The first two or three coils (rounds) should be anchoring, for this the bandage is tightly wrapped around the narrowest intact place.
8. Further bandage follows with a uniform tension, without folds.
9. Each turn of the bundle covers the previous one about a third of the width.
10. When the injured area is large, one bandage may not be enough, then at the end of the first place the beginning of the second, reinforcing this moment in a circular turn.
11. Finish the dressing by making two or three fastening bandages.
12. As an additional fixation, you can cut the end of the bandage into two parts, cross them with each other, circle around the bandages and tie it together with a strong knot.

The main types of bandage dressings

Before studying the rules for applying bandages, one should familiarize oneself with the types of harnesses and the variants of their use.

Kinds of bandages	Cases of use
Thin bandages, the width of which is 3 cm, 5 cm, 7 cm, and the length of 5 m	They re-bandage the injured fingers
Medium bandages 10 to 12 cm wide, 5 m long	Suitable for dressing for head, forearm, upper and lower extremities (brushes, feet)
Large bandages, the width of which is more than 14 cm, and the length is 7 m	Used to apply bandages to the chest, thighs

Classification of bandage dressings:

1. By type:

• Aseptic dry;
• Antiseptic dry;
• Hypertensive moist drying;
• Pressing;
• Occlusal.

2. By the method of application:

• Circular or spiral;
• Eight-shaped or cross-shaped;
• Serpentine or creeping;
• Spicate;
• Turtle bandage: divergent and convergent.

3. 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 the imposition of soft bandages

Bandage bandages 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 are as follows:

1. The patient is placed in a convenient position:

• With injuries of the head, neck, thorax, upper limbs - sitting;
• With abdominal injuries, pelvic region, upper thighs - recumbent.

2. Select a bandage according to the type of damage.

3. Conduct the process of re-banding, using the basic rules of dressing.

If you have made a dressing, observing the rules of imposing 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 the imposition of bandages on types of overlap.

A type	Rule of dressing
Circumsted bandage	It is superimposed on the wrist, lower leg, forehead and so on. Bandage is superimposed spirally, as with kinks, and without them. Bandaging with kinks is best done on parts of the body that have the canonical form
Creeping bandage	It is applied for the purpose of preliminary fixing of the dressing material on the injured area
Cross-shaped dressing	It is superimposed in difficult places During the dressing, the bandage should describe the figure-eight. For example, a cruciform bandage on the chest is carried out as follows: Stroke 1 - make several circular revolutions through the thorax; Stroke 2 - a bandage through the thorax is made 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 re-drawn along the chest in the direction of the left axillary cavity, while crossing the previous layer; Stroke 4 and 5 - bandage is re-guided through the back in the direction of the right armpit, making an eight-step step; Fixing stroke - the bandage is wrapped around the chest and fixed
A spicate bandage	It is a kind of eight. Its superposition, for example, on the shoulder joint is performed according to the following scheme: Stroke 1 - bandage is carried through the thorax from the side of the healthy armpit to the opposite shoulder; Stroke 2 - bandage bypass the shoulder in front, on the outside, behind, through the axilla and lift it obliquely over the shoulder, so as to cross the previous layer; Stroke 3 - bandage is carried through the back back to the healthy armpit; Move 4 and 5 - repeat the moves from the first to the third, observing that each new layer of bandage is superimposed slightly higher than the previous one, forming at the intersection of the pattern of "spikelets"
Tortoise Headband	Used to bandage the area of the joints Divergent turtle bandage: On the center of the joint make one turn of the bandage; Repeat circular turns on the top and bottom of the previous layer several times, gradually closing the entire injured place; Each new layer intersects with the preceding one in the popliteal cavity; The fixing turn is made around the hip 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 a similar way, moving towards the center of the joint; The fixing turn is performed at the midpoint of the joint

Head bandaging

There are several types of headbands:

1. "cap";

2. Simple;

3. "bridle";

4. "the cap of Hippocrates";

5. one eye;

6. on both eyes;

7. Neapolitan (in the ear).

Situations of imposing dressings in accordance with their type

Name	When superimposed
"Cap"	With injuries of the frontal and occipital part of the head
Simple	With slight injuries of the occipital, parietal, frontal part of the head
"Bridle"	When injuries of the frontal part of the skull, face and lower jaw
"The Cap of Hippocrates"	There is damage to the parietal part
One eye	If one eye is injured
In both eyes	When both eyes are traumatized
Neapolitan	In case of ear trauma

The rule of imposing bandages on the head lies in the fact that regardless of the type, the dressing is carried out with bandages of medium width - 10 cm.

Since in any trauma it is very important to provide medical assistance in time , it is recommended to impose the most simple version of the bandage - "cheepets" - with a general head injury.

Rules for the imposition of a bandage "cap":

1. A piece about a meter long is cut from the bandage, which will be used as a string.

2. Its middle part is applied to the crown.

3. The ends of the string are held with both hands, it can be done either by an assistant or by the patient himself, if he is conscious.

4. Apply a fixing layer of bandage around the head, reaching the string.

5. Begin to wrap the bandage around the string and on to the head.

6. After reaching the opposite end of the string, the bandage is wrapped again and held around the skull slightly above the first layer.

7. Repeatedly cover the entire scalp with a bandage.

8. When making the last tour, the end of the bandage is tied to one of the straps.

9. The straps are tied under the chin.

Examples of overlapping of some other dressings

A type	Rule of dressing
Simple	Run a bandage twice around the head. The next step is to make the kink and bandage begin to overlap (from the forehead to the back of the head), slightly higher from the circular layer. On the back of the head, another bend is made and they lead the bandage from the other side of the head. The moves are fixed, after which they repeat the procedure, changing the direction of the bandage. The technique is repeated until the top of the head is completely covered, while remembering to fix every two oblique turns 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. Take him back to the temechka through the left ear, respectively. Make three such vertical turns, after which the bandage from under the right ear is carried to the front of the neck, obliquely across the back of the head and around the head, thus fixing the previous layers. The next step is again lowered from the right side under the lower jaw, trying to completely cover it horizontally. Then the bandage is carried to the nape, repeating this step. Once again repeat the course through the neck, after which finally fixing the bandage around the head
One eye	The bandage begins with two reinforcing layers of bandage, which lead in case of a trauma of the right eye from left to right, left - from right to left. After that, the bandage falls from the side of the injury to the back of the head, wound under the ear, slants through the cheek and covers the eye and is fixed in a circular motion. The step is repeated several times, covering each new layer of bandage the previous one by about half

Bandages with bleeding

Bleeding is a loss of blood in violation of the integrity of blood vessels.

Rules for the imposition of bandages for bleeding of various types

Type of bleeding	Description	Rule of dressing
Arterial	The blood is bright red and beats with a strong pulsating jet	Tightly squeeze the place above the wound with a hand, a tourniquet or a twist from the fabric. Type of superimposed bandage - pressing
Venous	Blood is colored in a dark cherry color and flows evenly	The injured part of the body should be raised higher, the gauze should be applied to the wound and tightly bandaged, that is, a pressure bandage The tourniquet is applied underneath the wound!
Capillary	Blood is excreted evenly from the entire wound	Apply a sterile bandage, after which the bleeding should quickly stop
Mixed	Combines the characteristics of previous species	Apply a pressure bandage
Parenchymal (internal)	Capillary bleeding from internal organs	Make a dressing using a plastic bag of ice

General rules for the imposition of bandages for hemorrhages from the limb:

1. Bint put under the limb, slightly above the wound site.
2. Attach a packet of ice (ideally).
3. Harness strongly stretch.
4. Tie the ends.

The main rule of dressing is to place a tourniquet over clothing or specially placed cloth (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 attach a note to the bandage with the date and time (hours and minutes) of the dressing. After providing first aid, it should not take more than 1.5-2 hours before delivery of the victim to the hospital, otherwise the injured limb will not be saved.

Rules for the imposition of a pressure bandage

Pressing dressings should be applied to reduce all types of external bleeding in places of bruising, as well as to reduce the size of the edema.

Rules for the imposition of a pressure bandage:

1. The skin adjacent to the wound (about two to four cm) is treated with an antiseptic.
2. If there are foreign objects in the wound, they should be removed immediately.
3. As a dressing material, use is made of a ready-made bandage package or a sterile cotton-gauze roll if this is not the case, then a bandage, a clean handkerchief, napkins will do.
4. The dressing is fixed on the wound with a bandage, scarf, scarf.
5. Try to make the bandage tight, but not pulling the damaged place.

Qualitatively applied pressure bandage should stop bleeding. But if she managed to soak up blood all the same, then you do not need to remove her before going to the hospital. It should simply be topped tightly from above, first placing another gauze bag under the new bandage.

Features of the occlusive dressing

An occlusive dressing is applied to ensure a sealed insulation of the damaged area in order to prevent contact with water and air. It is used for penetrating wounds.

Rules for the imposition of an occlusive dressing:

1. Place the victim in a sitting position.
2. Treat the skin adjacent to the wound with an antiseptic (hydrogen peroxide, chlorhexidine, alcohol).
3. On the wound and the adjacent area of the body with a radius of five to ten cm, an antiseptic napkin is applied.
4. The next layer is applied waterproof and airtight material (necessarily sterile side), for example, a plastic bag, food film, rubberized cloth, oilcloth.
5. The third layer consists of a cotton-gauze pad, which plays the role of constipation.
6. All layers are densely fixed with a wide bandage.

When applying the dressing, remember that each new layer of dressing should be larger than the previous one by 5-10 cm.

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

Application of an aseptic dressing

Aseptic dressing is used in cases where there is an open wound and it is required to prevent contamination and foreign particles from getting into it. For this it is required not only to apply the dressing correctly, which must necessarily be sterile, but also securely fix it.

Rules for the imposition of an aseptic dressing:

1. Treat wounds with special antiseptic means, but in no case should water be used for this purpose.
2. Attach directly to the injury gauze, a size larger than the wound by 5 cm, previously folded into several layers.
3. Top layer of absorbent cotton (easily stratified), which is larger than the gauze by two to three centimeters.
4. Tighten the dressing tightly with a bandage or medical adhesive plaster.

Ideally, it is better to use special dry aseptic bandages. They consist of a layer of hygroscopic material that absorbs blood very well and drains the wound.

To better protect the wound from getting dirt and infection, additionally glue the cotton-gauze dressing from all sides to the skin with the help of adhesive plaster. And then fix it with a bandage.

When the dressing is completely soaked with blood, it must be replaced neatly with a new one: completely or only the top layer. If this is not possible, for example, due to the absence of another set of sterile dressings, the wound can be wound up, having previously moistened the soaked bandage with iodine tincture.

Overlay of tire bandages

When providing first aid in case of fractures, the main thing is to ensure the immovability of the injury site, as a result, to reduce pain and to prevent the displacement of bone debris in the future.

The main signs of a fracture:

• Severe pain in the area of the injury, which does not stop for several hours.
• Pain shock.
• With a closed fracture - swelling, swelling, tissue deformation in the area of damage.
• With an open fracture, a wound from which the bone fragments protrude.
• Limited movement or total absence.

The main rules of dressing for limb fractures:

1. The dressing should be immobilized.
2. In the absence of special tires, you can use improvised things: stick, cane, small boards, ruler, and so on.
3. Ensure the victim's immobility.
4. To fix the fracture, use two tires wrapped with a soft cloth or cotton wool.
5. Put tires on the sides of the fracture, they must grasp the joints below and above the damage.
6. If the fracture is accompanied by an open wound and heavy bleeding, then:

• Above the fracture and wound a tourniquet is superimposed;
• A bandage is applied to the wound;
• On the sides of the injured limb, two tires are applied.

If you impose any type of bandage wrong, then instead of providing first aid, you can cause irreparable harm to the health of the victim, which can lead to death.