Applying bandages is a fundamental skill in first aid and nursing care, used to protect wounds, control bleeding, support injured limbs, and prevent further injury.
Definition
Bandaging is the process of covering a wound or injured part using various materials, such as gauze, elasticized knit, flannel or muslin.
Purposes
- To support the wound.
- To immobilize a fracture or dislocation.
- To immobilize an injured part so as to relieve pain.
- To prevent contamination of a wound.
- To control hemorrhage and to improve venous blood flow from lower extremities by applying pressure.
- To secure a dressing.
- To maintain splints in position.
- To retain warmth (e.g., a flannel bandage on a rheumatoid joint).
- To prevent or reduce swelling.
Types of bandages
- Triangular bandage.
- Roller bandage.
- Special bandages:
a. Many tailed bandage.
b.”T” bandage.
Articles
- Roller bandages (according to the body part).
- Scissors.
- Safety pin/adhesive strip.
- Padding material.
| Gerneral guide to the width of the roller bandage used according to the body part | ||
| Part to be bandaged | Width | |
| 1 | Fingers | 1 inch |
| 2 | Arm | 2 – 2.5 inches |
| 3 | Leg | 3 – 3.5 inches |
| 4 | Trunk | 4 – 6 inches |
| 5 | Head | 2 inches |
Principles of bandaging
- Use a tightly rolled bandage of the correct width.
- Support the part to be bandaged throughout the procedure.
- Always stand in front of the patient, except when applying a capeline bandage.
- Bandage a limb in the position in which it is to remain, e.g., forearm and hand should be prone.
- Hold the bandage with the head of roll uppermost and apply the outer surface of the bandage to the part, never unroll more than a few inches of bandage at a time.
- Apply bandage from medial outward and from below upward maintaining even pressure throughout.
- Begin the bandage with a firm oblique turn to fixit and allow each successive turn to cover two-thirds of the previous one with the free edges lying parallel.
- Make any reverse or crossing line on the outer side of the limb except, when this brings the bandage over a wound or bony prominence, in which case, it must be on the front of the limb.
- Pad the axilla or groin when bandaging these parts, so that two surfaces of skin do not touch each other beneath the bandage.
- Finish off with a straight turn above the part, hold the end, and fasten with the safety pin.
1) Circular Turn
Used chiefly to anchor bandages or to bandage certain areas, such as the proximal aspect of a finger or a wrist.
| Steps in procedure | Rationale | |
| 1 | Apply the end of bandage to the part of the body to be bandaged. | |
| 2 | Encircle the body parts a few times or as close as needed, each turn directly covering the previous turn. | Provides even support to the area. |
| 3 | Secure the end of bandage with tape, metal clips or a safety pin over an injured area. | Clips and pins can be uncomfortable when situated over an uninjured area. |
2) Spiral Turn/Simple Spiral
Spiral turns are used to bandage parts of the body that are fairly uniform in circumference, such as the upper arm or upper leg.
| 1 | Make two circular turns to anchor the bandage. |
| 2 | Continue spiral turns at about a 30° angle, each turn, overlapping the preceding one by two-thirds the width of the bandage. |
| 3 | End the bandage with two circular turns. |
3)Spiral Reverse Turn
Spiral reverse turns are used to bandage cylindrical parts of the body that are not uniform in circumference, such as the lower leg or forearm.
| Steps in procedure | Rationale | |
| 1 | Make two circular turns to anchor the bandage and bring the bandage upward at about a 30° angle. | |
| 2 | Place the thumb of the free hand on the upper edge of the bandage. | The thumb will hold the bandage while it is folded on itself. |
| 3 | Unroll the bandage around about 15 cm (6 inches) then turn the hand so that the bandage falls over itself. | |
| 4 | Continue the bandage around the limb, overlapping each previous turn by two-thirds the width of the bandage, make each bandage turn at the same position on the limb so that the turns of the bandage will be aligned. | |
| 5 | End the bandage with two circular turns and secure. |
4) Spica
The Spica is a form of figure-of-eight in which one turn is very much larger than the other. It is used for joints at right angles to the body, e.g., shoulder, groin, and thumb.
| Steps in procedure | Rationale | |
| 1 | Bend the elbow at right angles. | |
| 2 | Lay the outer side of the bandage on the inner side of the joint and take two straight turns carrying the bandage over the elbow tip and around the elbow. | Two turns are taken to fix the bandage to the body part. |
| 3 | Make a second turn to encircle forearm and the upper arm. | |
| 4 | Ensure the first turn is covered one-third of the width of the bandage below and above. | |
| 5 | Continue bandaging, covering one-third of the previous turn until the entire dressing is secured. | By covering one-third below and above, remaining one-third is exposed. |
| 6 | Complete bandaging by taking two circular turns above and secure it with safety pin or tape. |
5) Knee Bandage
| Steps in procedure | Rationale | |
| 1 | Flex the knee and lay the outer side of the bandage against the inner side of the knee (medial). | |
| 2 | Take two straight/circular turns over the knee cap. | This makes the bandage to go around the knee and secures it firmly. |
| 3 | Take a turn below and above covering one-third of the previous turn. | Ensures that the margins of the bandage covering the knee cap are covered. |
| 4 | Continue the turns below and above the joint until the whole knee is covered. | |
| 5 | Secure the bandage by completing with two circular turns around the thigh. | |
| 6 | Fix the end with adhesive tape or safety pin. |
6) Capeline (Head) Bandage
This bandage is sometimes used when the whole scalp is to be covered. A double-headed roller bandage is used.
| Steps in procedure | Rationale | |
| 1. | Position the patient to sit on a stool or chair and stand behind the patient. | This position will be convenient to apply the head bandage. |
| 2. | Place the center of the outer surface of the bandage in the center of the forehead, the lower border of the bandage lying just above the eyebrows. | |
| 3. | Bring the head of the bandage around over the temples and above the ears to the nape of the neck when the ends are crossed. | Ensures that the ear ls not covered. |
| 4. | Bring the upper bandage around the head and the other head of bandage over the center of the top of the scalp and then to the root of the nose. | |
| 5. | Bring the bandage which circles the victim’s head over the forehead, covering and fixing the bandage which crosses the scalp. This bandage is then brought back over the scalp. | |
| 6. | Ensure that each turn of the bandage covers two thirds of the previous turn. | Adheres snugly to the body part (head) and also stays firm. |
| 7. | Cross it again at the back and fix using the encircling bandage and tun back over the scalp to the opposite side at the central line, now covering the other margin of its original turn. | |
| 8. | Repeat the backward and forward turns to alternate side of the center, each one being in turn fixed by the encircling bandage until the whole scalp is covered. | |
| 9. | End the bandaging by taking two circular turns round the head. | This will secure the turns of the bandage. |
| 10. | Secure it with adhesive tape or safety pin over the forehead. |
7) Ear Bandage
This bandage is used to secure the dressing of the ear.
| 1 | Lay the outer surface of the bandage against the forehead and carry the bandage round the head in two circular turns, bandaging away from the injured ear. |
| 2 | Carry the bandage round the back of the head on the unaffected side and then down the nape of the neck. |
| 3 | Repeat the turns each turn being slightly higher than the previous one. |
| 4 | Bring the bandage slightly lower as it covers the hair. |
| 5 | Continue the turns until the whole ear on the affected side is covered and complete the bandage by two straight/circular turns around the forehead. |
| 6 | Secure it with adhesive tape or safety pin, where all the turns cross one another. |
Special considerations
The bandage can also be taken around the forehead with each turn covering the dressing, but this makes a heavy bulk around the head which may not be really necessary.
8) Eye bandage
| 1 | Lay outer surface of the bandage against the forehead and take circular turns around the head bandaging away from the injured eye. |
| 2 | Carry the bandage, round the head until it reaches the eye on the affected side. |
| 3 | Take it obliquely to the back of the head, under the prominence on the back of the skull and from there bring it upward beneath the eye of the affected side. |
| 4 | Take it further over the pad of the eye to a circular turn and continue over the head to the starting point. |
| 5 | Repeat this turn 2 or 3 times until the dressing is covered. |
| 6 | Finish with the safety pin just above the unaffected eye. |
9) Jaw bandage
A narrow strip of material about 3 feet long or a narrow fold of triangular bandage can be used for a jaw bandage.
| 1 | Place the bandage under the chin with one end longer. |
| 2 | Carry the longer end in front of the ear to the top of head and up to the opposite ear. |
| 3 | Take the shorter end above the ear. |
| 4 | Tie the ends above the ear. |
10) Shoulder (Spica)
| 1 | Place a small pad of cotton wool in the affected axilla. |
| 2 | Take 3 – 4 inch bandage and fix it with spiral turns round the upper part of the arm. |
| 3 | Take 2 or 3 reverse spiral turns round the upper arm until the bandage reaches the point of the shoulder. |
| 4 | Carry the bandage over the shoulder across the back and under the opposite armpit. |
| 5 | Bring it across the chest and arm round under the armpit and over the shoulder again, covering two-thirds of previous turn. |
| 6 | Repeat the turns until the whole shoulder covered. |
| 7 | Secure the bandage using a pin over the injured shoulder. |
10) Thumb (Spica)
| 1 | Place the hand so that the back of the thumb is uppermost. (dorsal side of the thumb above). |
| 2 | Take two circular turns round the wrist and carry the bandage over the back of the thumb. |
| 3 | Encircle the thumb with one or two straight turns so that the lower border of the bandage is level with the root of the nail. |
| 4 | Carry the bandage back over the back of the hand, round the wrist, and repeat the figure-of-eight turns round the thumb. |
| 5 | Ensure the body of the thumb is completely covered. |
| 6 | Complete the bandage with two straight turns, round the wrist and secure it with the pin or adhesive tape. |
11) Finger bandage (without covering the fingertip)
| 1 | With the hand pronated fix, the bandage by two circular turns round the wrist. |
| 2 | Carry the bandage obliquely over the back of the hand to the base of the finger to be bandaged. |
| 3 | Take the head of roll to the fingers in order and start from the side of little finger. |
| 4 | Take one spiral turn to the base of the finger and then cover the finger by simple spiral turns. |
| 5 | Then carry the bandage across the back of the hand to the wrist and complete it with two straight turns round the wrist. |
| 6 | Secure the bandage by safety pin or adhesive tape. |
| 7 | If more than one finger is to be bandaged, take a tum round the wrist between each two fingers and continue as above until the bandage is complete. |
12) Finger bandage (To cover the fingertip)
| 1 | Repeat steps 1-3 as mentioned in the above procedure. |
| 2 | Take the bandage straight up to the back of the finger and over the middle of the tip and down the front to the level of the second joint. |
| 3 | Hold the turns at the back and in front and with the fingers of the other hand, make two more turns over the tip of the finger one on either side of the first turn. |
| 4 | fix the loop with the straight circular turn as near to the tip as possible and then cover the finger by simple spiral turn. |
| 5 | Take simple spiral turns from medial to lateral aspect of the finger. |
| 6 | Take two straight turns around the wrist and complete as before or continue to next finger. |
13) Spic hip
| 1 | Plac the outside of the bandage on the inner side of the. thigh about 6 inches below the groin. |
| 2 | Carry the bandage horizontally round the limb and make 3 or 4 ascending reverse spiral turns round the thigh. |
| 3 | Carry the bandage from medial to lateral aspect up toward the hip and to the back passing over the prominence of the hip bone on the opposite side |
| 4 | Bring the bandage down, over the abdomen to the outer side of the thigh and repeat the figure of eight round the body and the thigh until the hip is covered. |
14) Spica of groin bandage
| 1 | Place the outside of the bondage on the inner side of the thigh |
| 2 | Carry the bandage horizontally round the lint in two circular tums |
| 3 | Carry the bandage from medical to lateral aspect up toward the hip and to the back passing over the prominence of the hip bone on the opposite side. |
| 4 | Bring the bandage down, over the abdomen to the outer side of the thigh and repeat the figure of eight round the body and the thigh covering the two-thirds of previous turn, until the groin covered. |
| 5 | The crossings are made over the front of the groin. |
| 6 | Secure the bandage on the unaffected side over the abdomen, with a safety pin or an adhesive tape. |
15) Double spica of groin bandage
| 1 | Lay the outer surface of the bandage over the right groin and pass the bandage round the thigh, carrying it up over the front of the right groin to the left hip. |
| 2 | Carry the bandage round the back and right hip and over the lower part of the abdomen to the outer side of the thigh. |
| 3 | Pass the bandage under the thigh up to left groin and round the back and right hip and down again to the inner side of the right thigh |
| 4 | Repeat these turns on either side until both groins are covered. Each turn being slightly higher and covering two-thirds of the previous one |
| 5 | Secure the bandage over the abdomen by safety pin or adhesive tape. |
16) Stump bandage
| 1 | Use a 4-inch bandage. Make two circular turns round the limb above the stump. |
| 2 | Place the end in the center of the upper side of the limb and carry the bandage over the center of the stump to the same level behind. |
| 3 | Hold the turns at the back and in front with the thumb and fingers of the other hand. |
| 4 | Repeat the recurrent tums over the end of the stump first and on the stump, on the left and on the right side of the original turns until the whole dressing is covered. |
| 5 | Fix the loops with straight turns round the stump and cover the dressing completely. |
| 6 | Secure it with a safety pin or adhesive tape. |
17) Foot and ankle bandage
| 1 | Make two circular turns round the ankle to fix the bandage. |
| 2 | Take an oblique turn across the foot to the root of little toe. |
| 3 | Make one horizontal tum round the foot at this level and then carry the bandage back over the foot and take a turn round the ankle just above the heel |
| 4 | Repeat this figure-of-eight turns round the foot and ankle each turn overlapping the previous one by two-thirds of its width |
| 5 | Secure the bandage with two circular turns around the ankle with pin or tape. |
18) Heel bandage
| 1 | Keep the foot at right angles. |
| 2 | Start two circular turns on center of the heel, carry it round the foot below the tip of the heel is well covered. |
| 3 | Bring the bandage over the ankle around the leg, below and then above the previous turn covering one-third on either side. |
| 4 | Repeat the turns by covering two-thirds of the previous turn. |
| 5 | Complete it by two circular turns above the ankle and secure it with pain or adhesive tape. |
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
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