Bandage

“ In bandaging a leg both above and below the knee, the bandage must be put on with a view to the necessary bending of the knee in walking and sitting, if the patient is expected to use the leg.
8. Never apply a wet bandage, as you cannot judge of just how much pressure will be exerted when the bandage dries, because of the shrinkage of cloth with drying; much greater in some cloth than in others.
Kinds of roller bandages:
1. Circular for parts uniform in size, as the body.
2. Spiral for conical surfaces, as fingers or toes. ”

“ Several more strips he tied together, and then wound the long bandage around his shoulder and pulled. The pain brought him close to a swoon, but when his senses cleared he found that the flow from his wounds had eased. ”

“ A bruise that is followed quickly by a soft bluish tumor or swelling indicates the rupture of a vein, and it should not be punctured or pricked, but should be allowed to disappear by absorption; a bandage making moderate pressure will hasten this process; and here let me say that any bandage should be applied from the extremity to the point where it is needed, that is, from the hand or foot to the parts on arm or leg where the bandage is needed. This is to prevent swelling of the parts below, as the circulation in the veins is impeded by any bandage between them and the heart. ”

“ Tear the lint into strips and wrap it round the joint; then strap the part firmly from below upwards over the lint with strips of diachylon plaster, each overlapping the preceding. Lastly, envelope the joint in a thin layer of cotton wool, and roll a bandage soaked in starch over all. If the patient wears no other kind of splint the bandage may be strengthened by laying a piece of millboard well softened in boiling water along each [Pg 29] side of the joint before the starch bandage is applied. ”

“ When the hand is covered by these figures of 8 the bandage is passed up the forearm by reverses placed over the extensor muscles till the elbow is nearly reached. Before going further a dossil of cotton wool is placed in the bend of the elbow, and on the inner condyle; the joint is bent to the degree that will be required by the splint, and the patient told to grasp some part of his dress, or the sleeve of the other arm, that he may not unconsciously extend the joint again while the bandage is being rolled round it. ”

“ The rubber bandage, properly applied, should not cause any uncomfortable feeling and there should be absolutely no pain present. At all times one must be able to feel the pulse below the site of the bandage. If the bandage is applied too tight, the skin of the limb looks grayish-blue and there appear whitish, or vermilion colored spots, which grow larger and larger, as long as the too tightly drawn bandage is on. ”

“ Fig. 15.—Bandage covering the elbow. The first turn over the point of the elbow is shown by the dotted lines.
Fig. 16.—Spica Bandage for the shoulder.
The arm is covered by spirals and reverses till the armpit is reached. Before bandaging the shoulder the armpit is protected by cotton wool or a double fold of soft blanket; the roller is then carried in front of and over the shoulder, across the back to the opposite axilla, where also some wool should be placed, then across the chest to the top of the shoulder again, and under the armpit to the front (see fig. 16) . ”

“ Let patient lie flat and swallow small pieces of ice, and also take one-quarter teaspoonful of table salt in half a glass of cold water.
BRUISE.
First Aid Rule 1.—Bandage from tips of fingers, or from toes, making same pressure with bandage all the way up as you do over the injury.
Rule 2.—Apply heat through the bandage, over the injury, with hot-water bottles.
Cause, Etc.—A bruise is a hidden wound; the skin is not broken. It is an injury caused by a blunt body so that, while the tougher skin remains intact, the parts beneath are torn and crushed to a greater or lesser extent. ”

“ We need only mention here a few simple bandages that could be applied by a non-professional nurse. Every one should know how to roll a bandage. The great knack of rolling it is to get it perfectly tight and even. The first few turns can be taken round a knitting needle, which should then be withdrawn. Nursing Illustration No. 1, figs, 1 and 2, show clearly how to do this.
In cases of broken bones send at once for the doctor, but pending his arrival do not move the patient unless splints have been applied to the injured part. ”

“ N. B.—In case of wounds from powder, or punctured wounds, as from rusty nail, see a doctor who will treat patient with anti-tetanic serum.
Read the chapters concerning bandages: Chapters XIII and XVI.
Bandages are used: 1. To hold dressings in place. 2. To support the parts. 3. To hold splints in place.
Never use wet bandages—they shrink in drying.
Never put a tight bandage over a wet compress; use a loose triangular bandage. ”

“ When the plaster is quite set the bone is immoveable and may be carried about without risk of displacement. In deciding what joints should be included in the bandage, the same rules obtain in this as for the starch bandage; no more joints should be rendered immoveable than are necessary to obtain command of the broken bone; when the fracture is near a joint, that must be confined to prevent the bones being moved with the movements of the joint ”

“ Around this, the shoulder, and the other armpit, a bandage is to be put on in the form of the Greek letter Χ, so that the decussation may take place above the affected shoulder; and the arm is to be bound to the sides; and the elbow and hand are to be slung by the neck, so that the limb may not fall out again while the dislocation is recent. After the seventh day or later, having loosed the bandages, we must have recourse to moderate friction, so that the body being rendered firmer, the joint may become less liable to luxations. ”

“ Send for doctor at once. Much harm is done by unskilled handling. Do not move patient unless absolutely necessary.
If a compound fracture, apply iodine. Bandage a sterile gauze compress loosely over wound, tie a cloth tightly around limb, between wound and body. See “Hemorrhage” in this list.
Using extreme gentleness, place limb in comfortable position on a pillow or pad, and tie fast with strips of muslin or bandages.
If impossible to get doctor for a long time, and patient must be moved, use extreme carefulness, and tie limb to padded splints with bandages. ”

“ If sole leather or pasteboard be used instead of gutta-percha, they must be prepared in the same way, but allowed to remain on the chin twenty-four hours that they may set before the final trimming and adjustment.
Step 3. A bandage, 4 inches wide and 11⁄2 yard long, and slit from each end to about 2 inches from the centre, is then applied to the splint, and a small pad of folded flannel should be placed at the nape of the neck to protect the skin from the crossed bandage. When all is ready, the two upper ends are carried behind the neck, crossed, drawn tight, and tied or pinned on the forehead ”

“ The art of putting on a roller bandage is an important one for a nurse to acquire, and I may here give a few 261general principles though no exact directions can be given. In applying a bandage care must be taken that it is put on tight enough to fulfil the object in view, without running any risk of stopping the circulation. A bandage must lie smoothly, without wrinkles, and making an even pressure. ”

“ A broad bandage is applied round the pelvis over the groin, and down the thigh, investing all that part of the limb left uncovered by the previous bandaging. A broad band, like a riding belt, is fastened round the pelvis, so as to bind the splint to the trunk, and thereby keep the broken surfaces of the bone in contact. ”

“ Under any circumstances this is exceedingly irksome to the patient, but is least so if two silk handkerchiefs be substituted for the bandage, one being passed round each shoulder and the ends of both braced tightly together behind the back. The wedge-shaped pad may be dispensed with if the shoulders are braced back, but the elbow must still be raised and drawn to the side.
The American surgeons have a very good plan for attaching the sling to the sound shoulder. ”

“ To the wound itself a cerate mixed with pitch is to be applied, a thin folded compress is to be bound upon it, and the parts around are to be anointed with white cerate. The cloths for bandages and the other things should be torn broader than in cases in which there is no wound, and the first turn of the bandage should be a good deal broader than the wound. For a narrower bandage than the wound binds the wound like a girdle, which is not proper, or the first turn should comprehend the whole wound, and the bandaging should extend beyond it on both sides. ”

“ Have the bandage an inch or two wide and about a yard long, and a compress of one or two small pieces of linen, folded two inches square, to lay over the puncture when the bleeding is stopped. Care must be taken not to cut too deep, or over a tendon or artery. Though great advantage may be had by bleeding in the beginning of some inflammatory fevers, in apoplexy, and after severe injuries, &c., it should not be attempted by persons not skilled in anatomy. ”

“ The application of a broad flannel bandage, so as to restrain the motions of the chest, and to cause the sufferer to breathe by the diaphragm, has been recommended from the earliest periods of surgery; but many persons with injured or broken ribs cannot bear the pressure of a bandage, while others derive much ease from its use. A tight bandage generally disagrees when the injury has been sustained at the lower part of the chest, and is more frequently useful when the fracture is above the fifth or sixth rib. ”

“ Where arteries are evidently bleeding—which may be inferred from the spurting character of the hemorrhage—a tight bandage above the seat of the wound, if on one of the extremities, will often be followed by a cessation of the bleeding, and where only small vessels are cut, a bandage tightly applied over the wound itself may accomplish a similar result. ”

“ A loose bandage, injudiciously used in a case where a tight or a moderately firm bandage should have been used, would cause the medicine to fall off from the lint and give rise to the consequent friction and laceration of the edges of the ulcer. Similarly, a moderately firm and steady bandage (Sama-Vandha) fastened in a case where a light or loose bandage should have been used, would fail to produce any effect. A proper bandage would lead to the subsidence of pain, and the softening of the edges of the ulcer, thus bringing about a purification of the local blood. ”

“ Nothing will be found to serve the purpose of supporting the parts so well as a properly adjusted bandage, which is useful in every instance, and sure to stay on if sewed here and there to the fleece. The bandage should never be omitted where the wound has any tendency to gape, as too great a strain upon the stitches cannot but lead to delay in the healing process. In bandaging a limb or part of a limb, commence always at the foot, and proceed upwards; in other parts of the body begin where you find it most convenient. ”

“ TO STOP BLEEDING.—Place a pad of clean cloth on the wound and bandage firmly. Raise the part affected. If raising the limbs or applying the pad does not control the bleeding, compress with your two thumbs over bone and as near the wound as possible. Give no stimulants as long as bleeding remains uncontrolled. ”

“ Metrical Texts:—A smashed, lacerated, fractured, dislocated, displaced bone, or a vein or a ligament similarly jeopardised, may be soon healed or set right with the help of a surgical bandage. The patient is enabled by such a means to lie down, or stand up or move about with ease. And an increased facility of rest or movement leads to speedy healing. ”

“ The work they had done gave them a certain amount of cover, at least for the vital parts of head and shoulders, but in the next half-hour there were many casualties, and man after man worked on with blood oozing through the hastily-applied bandage of a first field-dressing or crawled in under the scanty parapet and crouched there helplessly. ”

“ Persons suffering from cold feet, on going to bed at night may use the bandage as follows: first bring heat to the feet by exercise or friction; then put a bandage into cold water, wring it out well, envelope the feet in it, and over that place a thick dry bandage. ”

“ But sometimes the discharge of blood is so great, that if it be not stopt, the patient may die even before a surgeon, though at no great distance, can arrive. In this case, something must be done by those who are present. If the wound be in any of the limbs, the bleeding may generally be stopt by applying a tight ligature or bandage round the member a little above the wound. ”

“ The patient then being placed on a high seat, we are to direct him to lay his hand prone upon an even table, and the fractured pieces being stretched by an assistant, we arrange them with two fingers, that is to say, the thumb and the index-finger. A tight bandage is to be used at the time that inflammation prevails, for, owing to the porous nature of the bones, a redundance of callus is formed. ”

“ Application of the bandages.—Previously to applying the bandages, a coat of varnish is given to the whole body, with the exception of the face, and immediately upon this varnish are placed layers of lead; it is then only, that methodical bandages are made to cover all the parts, from the fingers and toes to the head; each turn of bandage was fixed by a point of suture, then covered again with another layer of varnish, with new plates of lead, and finally, with a new bandage applied with the same care as the first. ”