Bandages and Binders - Lecture notes week 12 PDF

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Bandages and Binders - Lecture notes week 12...

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Bandages and Binders Relate the purposes of bandages and binders to client care and injury prevention

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Pressure Immobilization o Of joint pain Support o A limb/Joint/wound/Incision Prevent edema Secure splint Compression Shape stump Secure dressing Hold a cold/warm pack in place

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Before applying anything

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Check doctor’s order Verify allergies Obtain proper measurement of area Knowledgeable of proper application instructions Do not delegate application to a UAP

Explain the principles used in the application of bandages and binders 

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Inspect skin o Thoroughly inspect o Inspect circulatory status Potential for infection Potential for skin breakdown o Inspect and palpate o Swelling o Inspect wound o Note drainage o Change dressing if needed o Assess  Pain  ADL status Adequate blood flow

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o Perform a peripheral neurovascular assessment or PNA (peripheral neurovascular assessment) o Observe for: color of extremities o Motion or mobility o Sensation/sensitivity o Edema/ Swelling o Temperature of skin Equal tension and lapping o Bandages/binders Placement of pins and knots o Avoid placing over a bony prominence to avoid pressure and skin breakdown o Report any  Coolness  Cyanosis  Numbness  Tingling  This is an indication of blood flow restriction Adequate ventilation o After bandage placement o Reassess in 30 min. o Neurovascular check (PNA) o In alteration:  Move bandage immediately  Assess limb  Notify provider  document

Select bandage material for variety of uses Types of bandage material  Gauze o Porous/inexpensive/conforms to body o Medication can be added in addition o Very common o Can be thin or bulky  Elastic knits o Support/pressure/compression o Ex: ACE bandages/TED hose o May need fasteners to secure o Some have Velcro o Disposable elastic support (coband) o Provides compression/support o Less likely to loosen or slip out of place

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o Thin/breathable material o Can be cut to desired length o Caution:  Can be wrapped too tight causing pressure and decreased circulation Elastic webbing o Assist in securing bandages/IV sites/ tubing o Flexible o Can be reused if not soiled o Can be cut to fit area Flannel/ Muslin

Soft material Usually made of cotton Can be torn to fit area with ease Provides protection Used often as padding between primary dressing and compression wrap  EX. Cast padding o Closure types  Velcro  Hooks  Clips  Tape  Self-adhearing Purpose of choosing each type o o o o o

Demonstrate the 5 basic turns in banding  Circular o Used when wrapping with continuous application in the same place o Stabilizes ankles/wrists/fingers/toes o Each turn overlaps the other o Provides even pressure applicator o Secure with tape or clips 

Spiral o Promotes venous return o Effective when a bandage needs to be applied around an arm, leg, or wrist o May be used to hold dressing in place o Wrapping limp in ascending path  Partially covering previous wrapping while moving up the limb

o Two circular turns, then wrap with a 30-degree angle until covered, finish with two circular turns o Secure with tape of clips 

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Spiral- reverse o May hold better on arms. Legs, thighs (extremities that are wider at one end than the other-cone shape) than spiral alone o Promotes venous return o Holds dressing in place o Similar to spiral, except the bandage is folded back (distally) halfway through each pass o The appearance of a basket weave is produced o Begins as a spiral bandage, two circular turns, one 30 degree turn hold it and turn it back on itself at 30 degree turn o Continue until covered o End with two circular tuns, tape, or clips Figure eight o Stabilizes joints, such as wrist or ankle, and helps maintain immobilization o Overlapping application, alternating with ascending and descending wrapping, with each pass of the bandage crossing over previous wrapping as in a figure eight o Two circular turns, then a figure 8 pattern which goes above and below the joint

o Make sure the turns overlap and the same location o End with two circular turns, tape, or clips Recurrent o Binds amputation stump in preparation for prosthesis fitting o Holds dressings on the head o Anchored at the top with several spiral wraps, then back and forth across the end of the extremity or head Finish with spiral reverse or figure eight

Select the appropriate binder for a variety of alterations in function

List reasons for selecting a specific type of binder Types of binders  T -binder o Named for their t shape o Wrap around the waist and pass over the perineal area o Used to maintain correct positioning of perineal/rectal  Bandages o Also used with support dressings o Single width for female o double width for male o place band at natural waistline  tails: from behind and up  Perineal  Sling: or cloth binder o Used to support upper extremities o Commercial sling o Triangular cloth o Arm should be flexed o Square knot  Straight o An abdominal binder is a wide o flat piece of fabric that is secured around the trunk of the client’s body to support the abdomen or dressings on the abdomen o Most frequently, the binder is secured with Velcro

The abdominal binder is most often used after abdominal surgery to hold large dressings in place § Abdominal  To measure length of binder: begin at umbilicus and encircle the abdomen  To measure the width of binder: distance from the costal margin to the top of the iliac crest  Place center of binder to back, roll pt side to side to position properly, secure from bottom up, reassess every 2-3 hours Reasons why each type is used Demonstrate application of bandages and binders  Correct size is utilized  Clean and dry 

 Apply distal to proximal  Pad if needed  Toes and fingers exposed  Adequate circulation is maintained  Change soiled dressings PRN  Perform hand hygiene  Ensure correct size  Place over dry area  Place body part in natural position  Pad area to prevent friction  Fasten from the bottom up  Change when soiled-may be washed with soap/H2O List reasons for selecting a specific type of binder Types of binders  Perineal  Sling  Straight Demonstrate application of bandages and binders Video demonstration

Design a teaching plan for a client needing bandages or binders 

Demonstration o return demonstration o Remove for bathing o Proper washing techniques o Remove and report if:  Difficulty breathing  skin redness or irritation  skin discoloration  numbness or tingling  Bandages and binders:  Lifespan considerations  Pre-school/school aged children  Allow child to assist with holding and wrapping

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Demonstrate procedure on a doll o Teach caregivers during application

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Elderly o Additional support of joint o Increased risk for skin breakdown...