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Applying a thermal insulating bandage. Lesson-seminar: "Desmurgy

It is used for extensive frostbite of the extremities to protect against the effects of cold.

Execution order:

1.A thick bandage (cotton-gauze) is applied to the limb. The bandage should only cover the area where the skin is noticeably pale.

2. The limb is wrapped in non-air-permeable fabric (cellophane, oilcloth).

3. On top of the film, the limb is wrapped in a thick bandage (cotton-gauze, wool, etc.).

4. Transport immobilization with tires or improvised material (planks, a piece of plywood, thick cardboard).

Manipulation No. 21

Prepare equipment for determining Rhesus status using the express method

Equipment:

1.Universal anti-Rhesus reagent.

2. Tested blood.

3. Conical test tube.

4.Saline solution.

Execution order:

1. Drop one drop of the universal anti-Rhesus reagent into a test tube.

2.Add one drop of test blood.

3.Mix and leave in a horizontal position for 3 minutes.

4.Add 3 ml. physical Solution, mix.

5.Looking at the light for the presence of clumps of glued red blood cells in the solution indicates that the blood is positive, the absence of agglutination, that Rh is negative

Manipulation No. 22

Determination of blood group using standard sera

Equipment:

1. Standard sera of groups O(I), A(II), AB(IV) of two different series.

2.White porcelain or enamel marked plates with holes.

3.Isotonic sodium chloride solution.

4.Needles, pipettes, glass rods with rounded ends (or glass slides).

5. Balls, alcohol, rubber gloves.

Execution order:

The study is carried out at room temperature.

1. Under the appropriate designations, standard sera of groups I, II, III are applied to the plate in a volume of 0.1 ml (one large drop about 1 cm in diameter), of two different series (6 drops in total).

2.A large drop of blood is placed in a separate well next to the serum.

3.Next, from this drop of blood into the serum with a dry glass rod (or the corner of a glass slide), add a 10 times smaller volume of the blood being determined (0.01 ml) and mix. Stirring with one end of the stick (one corner of the slide) in two wells is not allowed.

4.After mixing, shake the plates periodically for 5 minutes.

5.Then add 1 drop of isotonic sodium chloride solution to all drops.

6. Periodically shake the plates for another 5 minutes.

7.Reading the results.

The results of reactions in drops with paired serums should be the same.

O (I) – agglutination is absent in all sera.

A (II) – presence of agglutination in serum O (I) and B (III)

B (III) – presence of agglutination in serum O (I) and A (II)

AB (IV) – the presence of agglutination in all three sera.

8. The presence of agglutination in all sera indicates that the blood belongs to the AB (IV) group and requires an additional test with AB (IV) group serum. There should be no agglutination during this reaction.

Manipulation No. 23

Independent work No. 2

To check the quality of gypsum, a number of tests are used:

· Take equal portions of gypsum and water at room temperature and mix. The mass should freeze and harden after 6-7 minutes. The resulting plate should break, not crumble;

· take the plaster into your fist and squeeze tightly; if it is of high quality, then after unclenching the fist it will crumble, low-quality plaster will lie on the palm in the form of a lump with fingerprints;

· gypsum mixed with water should not smell like rotten eggs.

To ensure that the gypsum does not lose its properties, it should be stored in a dry place in a tightly closed box. Sometimes it is desirable to slow down the hardening of the gypsum, then it is mixed with cold rather than warm water or after that starch paste is added. To speed up the hardening of gypsum, it is mixed with warm water (30-35°C). After applying it, you can use a hair dryer or dry air bath. The advantage of a plaster cast is that it creates immobilization, provides maximum rest to the wound, protects it from secondary infection, and protects the granulating wound from trauma. Excess wound discharge is well absorbed into the plaster cast, since plaster is highly hygroscopic. All this provides favorable conditions for the healing of wounds and fractures.

Classification of dressings

By type of dressing material: 1. Soft dressings:

· adhesive;

· adhesive;

· kerchiefs;

· bandage;

· sling-shaped;

· T-shaped.

2. Hard bandages:

· hard (transport and medical splints, extension devices, orthopedic devices, prostheses, splints and corsets);

· hardening (gypsum, zinc-gelatin, starch, dressings made of polymer materials).

According to the method of securing the dressing material:

1. Bandage-free dressings:

· cleolic;

· collodion;

· adhesive;

· kerchief;

· sling-shaped;

· T-shaped.

2. Bandages:

· circular or circular;

· spiral;

· creeping;

· intersecting (cruciform or eight-shaped);

· spicate;

· turtle (converging and diverging);

· returning;

· tubular (mesh) bandages.

By purpose:

· protective (aseptic dressing)- sterile dry gauze to cover the wound and protect it from infection;

· medicinal- a sterile gauze pad moistened with a medicinal substance and fixed to the wound with a bandage or other method for therapeutic purposes;

· hemostatic (pressure)- a tight bandage (Fig. 8.4) is used to stop bleeding from a wound (Fig. 8.3);

· immobilizing transport(Fig. 8.5, 8.6) or medicinal(Fig. 8.7) - an immobilizing soft or hard bandage that ensures immobility of the limb during fractures, joint damage, extensive soft tissue damage and suppurative processes on the limb;



· transport bandage with traction(Fig. 8.8) or medicinal(Fig. 8.9) is used for fractures in order to keep bone fragments in the correct position when they are displaced, as well as to prevent contractures in extensive third-degree burns;

· corrective bandage- correcting deformity (plaster corset for curvature of the spine) (Fig. 8.10);

· contour bandage- a bandage that follows the contours of the body on which it is applied is used in the treatment of burns and extensive wounds of the extremities, and for hernias of the abdominal wall (Fig. 8.11).

There are contour dressings according to Lukyanov and according to Mashtafarov. Contour bandages are prepared from a piece of material that can cover the entire area of ​​the wound (burn) and secure the dressing material. Contour bandage according to Lukyanov(Fig. 8.12) - These are three- and four-cornered pieces of material of various sizes, to which ribbons or straps are sewn for tying or securing with safety pins. Lukyanov’s contour bandages also include corsets and jockstraps (Fig. 8.13). Contour, or economical, bandages according to Mashtafarov They are always cut out individually from rags or large pieces of gauze (2-4 layers). The pieces have the shape of an irregular oval, the central part of which is placed on the wound area, and longitudinal cuts are made along the periphery, due to which the material takes the form of an irregularly shaped star with rays of different lengths. These “rays” - stretch marks are used as ties and tightly fix the dressing material to the surface of the body. Mashtafarov's bandages are applied to the axillary region, mammary gland, back (Fig. 8.15), abdomen, buttocks (Fig. 8.14), chest, heel, knee, thigh, lower leg (Fig. 8.16).

· Occlusive or sealing dressing(Fig. 8.17) is applied for penetrating wounds of the chest. With such a wound, a “sucking wound” is formed, which sucks in air as you inhale and expels it as you exhale. This condition is called open pneumothorax. It is life-threatening, since the air sucked in through the wound compresses the lung, turns it off from the act of breathing and, pushing back the heart, significantly complicates its work. Such a wound needs to be closed as quickly as possible. To do this, airtight materials are placed on the wound while exhaling (the outer shell of the IPP, oilcloth, polyethylene, compress paper, adhesive plaster like a tile, etc.).

· Individual dressing package (IPP)(Fig. 8.18) consists of sterile cotton-gauze pads (bandages) and bandages, which are in parchment paper, in a rubberized cover and a fabric shell (Fig. 8.18, a). Cotton-gauze pads are impregnated with antiseptics or antibiotics to prevent infection.

· When opening (Fig. 8.18, b) the fabric shell, remove the pin from the cover and, unfolding the parchment paper, take out the pads (Fig. 8.18, c) so as not to touch the surface applied to the wound with your hands. The pads are secured to the wound (Fig. 8.18, d) with turns of gauze bandage. The end of the bandage is secured with a pin.

· Compress bandage(Fig. 8.19) is used to treat inflammatory diseases of the skin and subcutaneous tissue in the infiltration stage. Do not apply a compress to damaged skin (wounds, abrasions) or for pustular skin diseases (boils, carbuncles). The dressing is applied in the form of a “layered cake”: a gauze cloth moistened with alcohol (diluted in a ratio of 1:2) or Vishnevsky ointment is placed on the infiltrated area, covered with polyethylene or compress paper on top, then with gray compress cotton wool. In this case, each subsequent layer of the dressing should overlap the previous one by 2 cm around the perimeter, which ensures a long-term greenhouse effect and, as a result, warming of the underlying tissues (resorption of the infiltrate or its maturation). The bandage is secured with a gauze bandage. The compress must be kept for 6-8 hours. To prevent rapid cooling of the skin after removing the compress, apply a dry bandage to this area. Compression bandage(Fig. 8.20) (elastic fabric bandage) is used: - for diseases of the veins of the lower extremities; - for lymphostasis; - for the prevention of thromboembolism (intra- and postoperative); - for long-term compression syndrome of the limbs (during first aid and transportation); - in sports medicine. The bandage begins with a fastening round in the area of ​​the ankle joint in the form of a figure eight, then with uniform elastic tension it rises up the shin like a spiral bandage (maybe with bends) to the upper third of the thigh, where the end of the bandage is secured with a pin.

· Thermal insulating(Fig. 8.21) bandage(dry cotton-gauze with a thick layer of cotton wool) is used for frostbite in order to warm and protect the damaged part of the body from cold (vasodilation - improvement of microcirculation and endogenous warming of the affected tissues).

Rice. 8.3. Bleeding from the wound.

Rice. 8.4. Hemostatic dressing.

Rice. 8.5. Transport immobilization of the lower limb with a Kramer splint.

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The use of gingival dressings in periodontology is possible at the stages of etiotropic and restorative (surgical) treatment. When carrying out etiotropic local therapy with some prolonged gel and ointment forms, the dressings perform an isolating function, ensuring their long-term retention in the periodontal pocket. They prevent the dissolution or dilution of the concentration and washout of drugs by oral fluid.

The use of a gingival dressing after surgical treatment provides:

1. Protection of the postoperative wound from the external environment.

2. Minimizing postoperative wound infection.

3. Control of postoperative bleeding.

4. Closer adherence of the mucosal flap to the underlying bone tissue, especially in cases where the flap is displaced apically.

5. Creating better conditions for healing by protecting the surface of the postoperative wound from injury during chewing and accumulation of plaque.

6. Reducing pain during eating, talking, and tongue movements.

7. Creating more comfortable conditions for the patient in the postoperative period.

To achieve these goals, the gingival dressing must meet the following requirements:

Be soft and flexible so that it can be conveniently placed on the dental arch and alveolar process and easily adapted to its surface.
. Have a short curing time.
. After hardening, it does not deform, is firmly fixed on the gum, does not move or break.
. After hardening, have a smooth surface to prevent mechanical irritation of the mucous membrane of the lips and cheeks.
. Be biocompatible with oral tissues and do not contain substances that provoke an allergic reaction in a particular patient.
. Be resistant to oral fluid, have a weak pleasant taste or be tasteless and odorless.
. Have an antimicrobial effect to ensure control of dental plaque in the postoperative period.

In periodontology, 2 types of gingival dressings are used:

1. Eugenol-containing.
2. Eugenol-free.

Eugenol-containing gum dressings have been used since 1923. They are based on zinc oxide and eugenol, mixed into a plastic homogeneous mass. The powder for preparing the dressing contains magnesium dioxide, rosin, which gives the dressing strength, tannic acid (bacteriostatic, astringent effect), cellulose fibers (stability in oral fluid, strength) and zinc acetate (hardening catalyst). In addition to clove oil, the liquid contains thymol, color additives and fruit oil (apricot, peach, lemon, etc.) to soften the irritating effect of clove oil and as a fragrance. In addition, these oils increase the plasticity of the dressing. They can be prepared ahead of time according to the recipe and stored in the refrigerator, wrapped in wax paper.

The side effects inherent in eugenol-containing dressings (burning sensation, increased sensitivity of periodontal tissues, possible development of allergic reactions to the ingredients) have forced many doctors to abandon their use and give preference to gingival dressings that do not contain eugenol, the main components of which are fatty acids and metal oxides. These are, as a rule, official, ready-made forms. One of the most commonly used dressings is Soe-Rak, which is prepared by mixing the contents of two tubes to the desired color. One of them contains zinc oxide, oil (as a plasticizer), resin (to improve adhesion to the gums) and a fungicide. The second tube contains coconut fatty acid, resin and chlorthymol, which provides the dressing with antimicrobial properties.

Ready-made forms of gum dressings include Uosorask, Reprask. The latter contains amyl acetate, butyl flathal, zinc oxide, zinc sulfate, and filler. Another option for eugenol-free dressings is cyanoacrylate dressings. They are a gel, liquid or aerosol, which are applied immediately to the postoperative wound, which has previously been well dried, and harden within 5-10 seconds.

Such dressings adhere well to any surface (smooth, rough, uneven) and last from two to seven days. Some manufacturers add antimicrobial drugs (chlorhexidine, nitrofurans) or antibiotics (oxytetracycline, neomycin) to cyanoacrylate dressings; however, in order to avoid unforeseen complications, it is necessary to carefully collect an allergy history before using them. In order to relieve or prevent dental hypersensitivity, it is recommended to include fluoride varnishes in the dressings immediately before application.

Technique for applying gingival dressings

Before application, good hemostasis of the wound is carried out, it is cleaned with a 1.5-3% solution of hydrogen peroxide, dried with warm air, and isolated from saliva. A two-component dressing is prepared by mixing on a plate according to the instructions. The finished form is taken from the packaging with a sterile spatula and rolled into a roller.

Application of the prepared bandage begins with the tooth distal to the wound on the vestibular surface of the gum.

It should cover the gingival margin by no more than "/3 ​​of the height of the crown and attached gum. Using a cotton ball, the bandage is slightly pushed into the gingival embrasure space, without filling the gingival or periodontal pocket. Its modeling is completed either by light pressure with a finger (with a glove) , lubricated with a thin layer of petroleum jelly to prevent sticking, or with the lip (cheek). In the same way, the gingival margin from the lingual (palatal) surface should not be applied in excess, as it may move, irritate the bandage, or cause a gag reflex; should not interfere with occlusion. Hardening occurs in 20-30 minutes.

The optimal period of presence of a gingival dressing after surgical treatment is up to 7 days. If necessary, it can be increased. However, in this case, the bandage should be removed, the wound should be examined and treated with antiseptic. To isolate medications in the periodontal pocket, a gingival bandage is applied for 2-3 hours to 24 hours. This depends on the dosage form of the medication introduced into the pocket and its duration of action.

If the bandage is deformed or broken, then after anesthesia and antiseptic treatment of the gums, it can be reapplied or “repaired.”

Polishing the root surface in the postoperative period is indicated no earlier than a week after removing the bandage. It is recommended to use soft rubber cups, fine strips and thin abrasive pastes.

Hygienic manipulations in the oral cavity by the patient themselves should be carried out carefully so as not to damage the bandage. Additional administration of antimicrobial rinses is recommended.

Protective gingival dressings are used mainly after curettage, gingivectomy, mucogingival and osteomucogingival operations. Protective gingival dressings are used after curettage, gingivectomy, some mucogingival operations using free cheap grafts, as well as in osteomucogingival surgery.

A. S. Artyushkevich
Periodontal diseases

1. Apply a piece of soft cloth, folded several times, to the affected area.

2. Cover this layer with oilcloth or wax paper of such a size that it completely covers the wetted fabric.

3. Place a layer of cotton wool on an even larger area on the oilcloth. You can use a baize, flannel, or woolen scarf.

4. Secure all three layers with several turns of the bandage.

If the bandage was applied correctly, then after its removal the fabric remains moist and warm.

BASIC CONCEPTS ABOUT ELECTRICAL INJURY AND ELECTRIC BURNS

Electrical trauma and burns from exposure to electric current or lightning have their own characteristics and, under certain conditions, can cause instant death of the victim even before assistance is provided.

Electrical injury- this is an electric shock or lightning discharge, accompanied by profound changes in the central nervous system, respiratory and cardiovascular systems in combination with local damage.

There are low voltage injuries and high voltage injuries. Low voltage currents are commonly used in household electrical appliances. More often, children who have access to sockets, switches, and wiring suffer from them. The general effect of low voltage current is a convulsive contraction of the muscles, as a result of which the victim is unable to free himself from the source of voltage. Loss of consciousness, disturbances in cardiac activity and breathing may occur. There are known cases of death from low voltage currents.

As a rule, hands are exposed to local action of low voltage current. The skin on the hands is often moist, as a result of which it becomes a good conductor of electricity. The current penetrates deep into tissues and destroys them. Usually this results in deep burns of III-IV degree. As a result of such a burn, you can lose your fingers.

High-voltage burns are the most life-threatening. As a result of the general action of high voltage currents, death can occur instantly or even several hours after the current stops. Victims often lose limbs due to local exposure to high voltage. Such injuries occur during contact with wires carrying technical high voltage current, when entering transformer booths, during excavation work in the area of ​​high voltage cables and in other places specially marked with a “high voltage” sign.



The effect of current on the human body is presented in table. 10.

Table 10

The specific effect of current on the body and its consequences

Effect of current

Cell protein coagulation: tissue necrosis Thermal injury: burns, charring

Tissue separation: separation of body parts and limbs

Excitation of skeletal and smooth muscles: pain, convulsions, spasm of respiratory muscles, spasm of arterioles, tissue hypoxia, respiratory and cardiac arrest

The immediate cause of death on the spot is most often: central respiratory arrest due to the effect of current on brain structures; peripheral respiratory arrest due to spasm of the respiratory muscles; fibrillation (random contractions) of the ventricles of the heart.

Long-term causes of death can be: electric shock, which develops against the background of suppression of brain functions, leading to disruption of the functioning of organs and systems of the body; late disturbances of cardiac activity that occur against the background of myocardial hypoxia due to spasm of the coronary arteries (infarction-like changes).

The severity of electrical injury can be:

light, when convulsions are observed without loss of consciousness and without disturbances in breathing and cardiac activity;

moderate severity, when, against the background of convulsions, there is a loss of consciousness, but without disturbances in breathing or cardiac activity;

heavy, when, against the background of convulsions and loss of consciousness, respiratory and cardiac disturbances are noted;

extremely heavy when, under the influence of current, a state of clinical death instantly develops.

For any severity of electrical injury, the victim must be hospitalized for observation due to the possible development of long-term life-threatening complications.



The survival of the victim is also influenced by the current loops, that is, the path along which it passes through the body. It is especially dangerous when current loops affect vital organs. The current entry and exit points are called current marks. P6| It can be used to approximately judge the path of the current loop. For example, if the entry mark is located on the upper limb, and the exit mark is on the foot, it means that the current has gone into the ground, passing through the entire body of the victim. In such a situation, its direct effect on the heart muscle cannot be ruled out.

What is bandaging (bandaging technique)? Who should study desmurgy? You will find answers to these and other questions in the article.

A bandage is a hard or soft device that fixes dressing materials (sometimes containing medicinal and other substances) on the surface of the body. He studies bandages, methods of applying them, as well as the rules of healing wounds in the medical section of desmurgy.

Classification

How are bandages applied? What is the overlay technique? By purpose they are distinguished:

  • hemostatic (pressure) bandages - stop bleeding by creating a certain pressure on the desired area of ​​the body;
  • protective (aseptic) - prevent wound infection;
  • medicinal (usually partially impregnated with the mixture) - provide prolonged access of the medication to the wound;
  • stretching bandages - straighten broken bones, for example tibia;
  • immobilizing - immobilize a limb, mainly for fractures;
  • bandages that eliminate deformities - corrective;
  • sealing wounds (occlusive), for example, in case of chest injuries, are needed so that the victim can breathe.

The following types of dressings exist:

  • hard - using hard materials (Kramer splint and others);
  • soft - using soft raw materials (bandage, cotton wool, gauze and others);
  • hardening - plaster bandages.

"Dezo"

What is the Deso bandage used for? The technique of applying it is simple. It is used to fix the upper limbs during shoulder dislocations and fractures. To make this bandage you need the following tools:

  • pin;
  • bandage (width 20 cm).

It should be noted that the right hand is bandaged from left to right, and the left hand in the reverse order.

So, let's find out how the Deso bandage is made. The technique for applying it is as follows:

  1. Make the patient sit facing you, reassure him, and explain the course of the upcoming actions.
  2. Place a roller wrapped in gauze into the armpit.
  3. Bend your forearm at an angle of 90° at the elbow joint.
  4. Press your forearm to your chest.
  5. Perform a couple of fastening rounds of the bandage on the chest, the injured arm in the shoulder area, the back and the armpit on the side of the working arm.
  6. Place the bandage through the armpit of the able-bodied side along the frontal thoracic surface obliquely onto the shoulder girdle of the painful area.
  7. Go down the back of your injured shoulder, under your elbow.
  8. Bend the elbow joint and, holding the forearm, direct the bandage obliquely into the armpit of the healthy side.
  9. Move the bandage from your armpit down your back to your sore forearm.
  10. Move the bandage from the shoulder girdle along the frontal plane of the painful shoulder under the elbow and around the forearm.
  11. Direct the dressing down the back into the armpit of the healthy side.
  12. Repeat the rounds of the bandage until the shoulder is thoroughly fixed.
  13. Complete the bandage with a couple of fastening rounds on the chest, sore arm in the shoulder area, and back.
  14. Pin the end of the sling with a pin.

By the way, if the bandage is applied for a long time, the bandage needs to be stitched.

Sling-bonnet

Do you know what a headband is? The technique of applying it is easy to remember. This bandage can simultaneously perform the functions of fixation, stop bleeding, secure medications and prevent infection from entering the damaged surface. In fact, it is universal.

How is it applied? If the patient is conscious, one person can bandage him. If the victim has lost consciousness, in order to make a high-quality bandage, the medical worker must involve an assistant.

Cut a meter-long tape from the head of the bandage and place it in the middle on the parietal area. The ends should hang freely, like the ties of a baby's cap. During the procedure, they must be held by the victim himself or a medical assistant.

Make a couple of securing rounds around the entire skull. Then lay out the cap itself. After the blocking round, reach the area of ​​the tie, wrap the head of the bandage around it and bring it to the back of the head to the second strap. There, too, wrap a bandage around it and apply it to the cranial area from the forehead.

The movements should be repeated, and each next round should overlap the previous one by about a third. With the help of such moves, the entire scalp area is completely covered with dressing tissue. It turns out to be a gauze cap, similar to a cap. The bandage is fixed like this: tear the end of the bandage, secure it with a knot and tie it under the tie. Then tie the straps together.

Do you know that a cap bandage can stop bleeding? The application technique in this case is somewhat different. Trim the hair in the area of ​​the injury and check it for foreign matter. If possible, disinfect the wound or its edges. It must be remembered that an antiseptic (mainly alcohol) can contribute to the appearance of painful shock. Therefore, carry out the procedure carefully. Then apply a clean gauze napkin in two layers to the open wound, followed by a squeezing pad from a bandage bag. Next, apply the bandage according to the above algorithm.

If you don't have a specific pad on hand, use a dressing bag or tightly rolled things, preferably clean. The pressure pad should completely cover the wound, overlap the edges and not deform. Otherwise, it will push through the edges of the wound and increase its size.

During breakfast, lunch and dinner, the straps of the headband can be relaxed. It is not recommended to untie them while sleeping, as the sling may move out.

Bleeding

What is the technique for applying a pressure bandage? This type is used primarily to stop minor bleeding and reduce extravasation in joints and periarticular soft tissues. Apply a gauze-cotton pad to the wound and secure it tightly with a bandage without squeezing the blood vessels. Sometimes health care providers use elastic compression bandages for ligament damage or venous insufficiency.

It is known that bleeding can be capillary (blood discharge over a large surface of the body), arterial and venous. Arterial blood gushes out and has a scarlet color, and venous blood pours out in an even stream, dark.

What is the technique for applying a pressure bandage in these circumstances? For minor external bleeding from a vein or capillaries, apply a compressive sling without squeezing the limb. This method will not help if there is severe mixed or arterial bleeding. Pinch the artery with your finger above the wound (identify the point by pulsation) while an assistant prepares a tourniquet. Place a note under the tourniquet indicating the time it will be applied.

Finger injuries

How is the “Glove” bandage created? The technique of applying it is quite simple. This sling is used for wounds of the fingers. To apply it, you need to have a needle and syringe, a narrow bandage (4-6 cm), balls, a tray, gloves, an antiseptic and an analgesic.

Make the patient sit down and face him (monitor his condition). Numb the area to be bandaged. Perform 2-3 circular rounds around the wrist, and then direct the bandage obliquely along the dorsal surface of the hand to the nail of the thumb of the right hand, and of the left hand to the nail phalanx of the little finger (do not cover ½ of the nail phalanx with the bandage to observe the condition of the limb).

Then close it with spiral turns from the nail to the base of the finger, and cross the bandage on the back surface and direct it to the wrist (from left to right). Perform a tightening tour around the wrist. Bandage the remaining fingers in the same way. Complete the bandage with circular rounds and tie. It should be noted that the “Knight’s Glove” bandage can be supplemented with a scarf.

Spica type

Many people are unfamiliar with the technique of applying a spica bandage. As a rule, it is used to fix the shoulder joint in case of pathology of the shoulder and axilla. You should have on hand a bandage (12-16 cm wide), a sterile napkin, scissors, a kidney-shaped basin, a pin, and tweezers.

Here you need to perform actions in the following sequence:

  • Turn to face the patient.
  • Draw two securing circles around the shoulder on the affected side.
  • The third round is carried out obliquely from the armpit to the back along the front of the shoulder.
  • The fourth round continues the third.
  • With the fifth circle, cover the shoulder circularly (outer, inner surfaces, front and back) and bring it to the back, crossing it with the fourth round.

"Mitten"

Why is the “Mitten” bandage necessary? The technique of applying it is completely simple. It is used for injuries and burns of the hand, frostbite. To make this sling, you need to prepare a needle and syringe, napkins, bandage (8-10 cm wide), tray, analgesic, balls, antiseptic and gloves.

In this case, you need to follow these steps:

  • Have the patient sit down and face him to monitor his condition.
  • Pain relief.
  • Perform 2-3 circular securing turns in the wrist area.
  • Bend the bandage 90° on the dorsum of the hand.
  • Run the bandage along the back of the hand to the tops of the fingers, and then move to the palmar surface and reach the wrist.
  • Repeat step three three to four times, covering four fingers in unison.
  • Using a circular motion in the wrist area, secure the previous turns, bending the bandage 90° in advance.
  • Guide the bandage along the back to the tops of the fingers, wrapping it in spiral-shaped strokes, following to the base of the fingers.
  • Return the bandage to your wrist through the back of your hand. Secure the previous turns with a circular tour.
  • Apply a spica bandage to your thumb.
  • Complete the sling with circular turns around the wrist and tie.

By the way, to prevent your fingers from sticking together, you need to put gauze scarves between them. The “mitten” can be supplemented with a scarf sling to immobilize the limb.

Head bandaging

What is the technique of applying a headband? We discussed the cap sling above. It is known that several types of bandages that have different purposes are used to bandage the skull:

  • "Hippocrates' cap." To apply this sling, use two bandages or a bandage with two heads. Take the head of the bandage in your right hand, make circular turns and fasten the bandage rounds, which, diverging or converging, should gradually cover the cranial vault.
  • When bandaging the right eye, the bandage is moved from left to right, and the left one in the opposite direction. Fix the bandage around the head in a circular motion, then lower it to the back of the head and pass under the ear from the bandaged area obliquely and upward, covering the damaged eye with it. The curved move is grabbed in a circular manner, then an oblique move is made again, but slightly higher than the previous one. Alternating oblique and circular turns, they envelop the entire eye area.
  • Bandage for two eyes. The first fixing circular round is performed, and the next one is moved down along the crown and forehead. Then a curved coil is made from top to bottom, enveloping the left eye. Next, the bandage is moved around the back of the head and again a curved move is made from bottom to top, covering the right eye. As a result, all subsequent turns of the bandage intersect in the area of ​​the bridge of the nose, imperceptibly enveloping both eyes and going down. At the end of bandaging, the sling is strengthened with a horizontal circular tour.
  • The Neapolitan sling begins with ring turns around the head. Next, the bandage is lowered from the affected side to the area of ​​the ear and mastoid process.
  • The Bridle sling is mainly applied to cover the chin area. First, a fixing circular tour is performed. The second turn is led obliquely to the area of ​​the back of the head on the neck and under the jaw is transformed into a vertical position. Moving the bandage in front of the ears, make a couple of turns around the head, and then from under the chin they bring it obliquely to the back of the head or along the other side and, turning it into horizontal turns, secure the bandage. In order to completely close the lower jaw after securing horizontal moves, you need to lower the head of the bandage crookedly down the back of the head and move to the neck along the front area of ​​the chin. Next, going around the neck, you need to return. Then, lowering the turn of the bandage slightly below the chin, it is raised vertically, securing the bandage around the head.

Occlusal view

The technique of applying an occlusive dressing is known only to healthcare workers. Let's consider it in as much detail as possible. Occlusive dressings provide airtight isolation of the injured area of ​​the body, preventing its contact with air and water. To make such a device, you need to place a water- and air-tight material, for example, rubberized fabric or synthetic film, on the wound and the adjacent area of ​​skin with a radius of 5-10 cm, and secure it with a regular bandage. Instead of a bandage, you can use wide strips of adhesive tape.

It is known that modern and reliable application of an occlusive sling is especially important when the patient has a penetrating chest wound and pneumothorax has developed.

Each person should review the application of bandages. The technique for applying a sealing (occlusive) bandage is as follows:

  1. If the wound is small, prepare 1% iodanate, a tuff and a personal dressing bag. Sit the victim down and treat the skin around the injury with an antiseptic. Then place the rubber sheath of the private set on the wound with the sterile side, and place cotton-gauze bags on top of it. Next, you need to secure it all with a spica bandage (if the injury is at the level of the shoulder joint) or a spiral bandage on the chest (if the injury is below the level of the shoulder joint).
  2. If the wound is extensive, prepare 1% iodanate, tuffer, Vaseline, sterile wipes, a wide bandage, oilcloth and a gauze-cotton swab. Place the victim in a semi-sitting position and treat the skin around the wound with an antiseptic. Then apply a sterile napkin to the injury and lubricate the skin around it with Vaseline. Next, apply the oilcloth so that its edges protrude 10 cm beyond the wound. Then apply a gauze-cotton swab, covering the film by 10 cm, and secure with a bandage on the chest or a spica-shaped sling.

Gypsum variety

It is difficult to fully understand bandaging. The overlay technique, of course, is useful to everyone. It is known that there are complete plaster casts and incomplete ones. The latter include a crib and a splint.

These slings can be unlined or with a cotton-gauze lining. The former are used in the treatment of fractures, and the latter in orthopedic practice. So, the technique of applying plaster casts is performed as follows:

  • Before applying the bandage, sit or lie down the patient so that he does not experience any discomfort when bandaging.
  • For the limb or body part being fixed, use special stands or racks to give it the position in which it will be after the procedure is completed. Cover all bone protrusions with gauze and cotton pads to prevent bedsores.
  • Guide the plaster bandage in a spiral, bandage without tension, rolling it over the body. Do not tear the head of the bandage from the surface to be bandaged to prevent wrinkles from appearing. Smooth each layer with your palm and model it according to the contours of the body. With this technique, the bandage becomes monolithic.
  • Above the fracture zone, on the folds, strengthen the bandage, which can include 6-12 layers, with additional rounds of bandage.
  • During bandaging, it is forbidden to change the position of the limb, as this leads to the appearance of folds, and they will compress the vessels and a bedsore will appear.
  • During the procedure, support the limb with your entire palm, not your fingers, to prevent indentations in the bandage.
  • While applying the cast, monitor the patient's pain and facial expression.
  • Always leave the fingers of the lower and upper limbs open so that blood circulation can be judged by their appearance. If your fingers are cold to the touch, turn blue and swell, then venous congestion has occurred. In this case, the bandage needs to be cut and possibly replaced. If the patient complains of terrible pain, and the fingers become cold and white, then the arteries are compressed. Therefore, immediately cut the bandage lengthwise, separate the edges and temporarily secure it with a soft bandage until a new bandage is applied.
  • Finally, the edges of the bandage are trimmed, folded outward, and the resulting roll is smoothed with a mixture of plaster. Then cover with a layer of gauze and coat with the paste again.
  • Finally, write on the bandage the date it was applied.

It is known that it is forbidden to cover a wet bandage with a sheet until it dries. It will dry out on the third day.

Rules

Therefore, we know the technique of applying bandages. Among other things, you need to follow some bandaging rules:

  • always face the patient;
  • start bandaging with a securing bandage;
  • Apply the bandage from bottom to top (from the periphery to the center), from left to right, minus special dressings;
  • with each subsequent turn of the bandage, overlap the previous one by half or 2/3;
  • bandage with both hands;
  • when applying a bandage to cone-shaped parts of the body (shin, thigh, forearm), for a better fit, twist it every couple of turns of the bandage.

Soft types

The technique of applying soft bandages is known to many. These slings are divided into the following types: bandage, adhesive (colloid, adhesive plaster, cleol) and kerchief. They are created like this.

Adhesive dressings are used mainly for minor injuries and on the wound area, regardless of its location. If hair grows in the area, it is shaved off beforehand.

To make an adhesive plaster bandage, you need a dressing material applied to the wound and attached with a couple of strips of adhesive plaster to healthy areas of the skin. Unfortunately, this design has an unreliable fixation (especially when wet), and maceration of the skin under it may occur.

Cleol is the name given to resin - pine resin dissolved in a mixture of ether and alcohol. Cover the wound with a bandage, lubricate the skin around it with the medicine and let it dry a little. Cover the bandage and skin areas treated with cleol with gauze. Press the edges of the napkin tightly to the skin, and trim off any excess gauze that has not adhered to it with scissors. What disadvantages does this bandage have? It does not stick firmly enough, and the skin becomes contaminated with dried cleol.

The collodium dressing differs from the previous one in that the gauze is glued to the skin with collodion - a mixture of ether, alcohol and nitrocellulose.

Requirements

We reviewed the types and techniques of applying bandages. We have studied a broad topic. Of course, you now know how to help a person who has been injured. To bandage the toes and hands, narrow bandages (3-5-7 cm) are used; for the head, forearms, hands, and lower legs - medium (10-12 cm), for the mammary gland, thighs, and chest - wide (14-18 cm).

If the bandage is applied correctly, it does not interfere with the patient, is neat, covers the injury, does not interfere with lymph and blood circulation, and adheres firmly to the body.