Chapter 9 Dressings, Bandaging, and Immobilization Techniques

1. Chapter 9Dressings, Bandaging, and Immobilization Techniques EMR 9-1

2. Introduction • The EMR must be familiar with different types of dressings, bandages, and immobilization techniques to properly care for patients with wounds and fractures • This chapter discusses types of dressings, application of dressings, bandaging materials, and immobilization devices used by Emergency Medical Responders (EMRs) EMR 9-2

3. Learning Objective 1 Identify Different Types of Dressings • DRESSINGS • Sterile, absorbent materials placed directly over a wound • Protect open wound from further injury and contamination • Gauze dressings • Cont. EMR 9-3

4. Learning Objective 1 Identify Different Types of Dressings DRESSINGS • Trauma dressings • Universal dressings • Occlusive dressings • Non-adherent dressings • Hemostatic dressings • Improvisational dressings EMR 9-4

5. Learning Objective 2 Bandage Types and Methods for Using Bandages • BANDAGES • Generally made of strips of cloth • Hold dressings securely in place • Provide pressure • Protect the wound • Roller bandages • Cont. EMR 9-5

6. Learning Objective 2 Bandage Types and Methods for Using Bandages • BANDAGES • Elastic bandages • Military compresses • Triangular bandages • Tourniquets • Improvisational bandages EMR 9-6

7. Learning Objective 2 Bandage Types and Methods for Using Bandages • METHODS OF BANDAGING • EMR must be familiar with various methods • Recurrent bandage • Spiral bandage • Figure-of-eight bandage EMR 9-7

8. Learning Objective 2 Bandage Types and Methods for Using Bandages ADDITIONAL BANDAGING APPLICATIONS • Type and location of wound dictate bandage choice • Neck wounds • Eviscerations • Straddleinjuries Cont. EMR 9-8

9. Learning Objective 2 Bandage Types and Methods for Using Bandages • ADDITIONAL BANDAGING APPLICATIONS • Impaled objects • Avulsions or amputations • Eye injuries • Head injuries • Shoulder and hip injuries EMR 9-9

10. Learning Objective 2 Bandage Types and Methods for Using Bandages • BASICS OF DRESSING AND BANDAGING • Always use PPE • Keep dressings as sterile or clean as possible • Control bleeding by using pressure • Cover the entire surface of a wound with a dressing • Cover area above and below dressing with a bandage • Cont. EMR 9-10

11. Learning Objective 2 Bandage Types and Methods for Using Bandages • BASICS OF DRESSING AND BANDAGING • Anchor initial turn of a roller or elastic bandage • For additional security, use twists • Secure the end of the roller or elastic bandage • Do not wrap bandage too tightly • If tourniquet is applied, seek rapid transport; note time EMR 9-11

12. Learning Objective 3 Basics for Using Splinting Devices • SPLINTING • Classifications • Slings and swathes • Flexible splints • Rigid splints • Pneumatic splints • Traction splints • Cont. EMR 9-12

13. Learning Objective 3 Basics for Using Splinting Devices • SPLINTING • Improvised splinting techniques • T-shirt • Belt • Magazine, book, or newspaper • Blanket, sleeping bag, or ground mat • Bedroll or pillow EMR 9-13

14. Learning Objective 4 Steps in Properly Splinting Extremities • BASICS OF SPLINTING • Wear PPE • Expose the area • Control bleeding • Stabilize above and below fracture site • Assess for CMS before and after splinting • Cont. EMR 9-14

15. Learning Objective 4 Steps in Properly Splinting Extremities BASICS OF SPLINTING • Loosen splint if change in sensation • Loosen splint if decrease in pulse • If no pulse, gentle traction and slight rotation • If no pulse, package and transport • If possible, place in natural position Cont. EMR 9-15

16. Learning Objective 4 Steps in Properly Splinting Extremities BASICS OF SPLINTING • Foot bent at 90-degree angle • Hand with a grip • No weight put on injured limb • Elevate above heart and apply cold packs • Pad gaps in splint • No cravats or straps over injury site EMR 9-16

17. Learning Objective 5 Methods for Immobilizing Patients • FULL BODY IMMOBILIZATION • Backboard provides spinal immobilization • Apply cervical immobilization device • The EMR must be adept • Maintain neutral inline alignment • Place according to manufacturer specifications EMR 9-17

18. Learning Objective 5 Methods for Immobilizing Patients • SHORT BACKBOARD • Short spinal immobilization devices (SSIDs) • Cervical or other spinal injury • Used for a patient in a sitting position • Temporarily stabilizes during transfer to long backboard EMR 9-18

19. Learning Objective 5 Methods for Immobilizing Patients LONG BACKBOARD • Used for full-body immobilization • Nose, navel, and toes in a straight line • Modified logroll • Seven-person lift • CMS checked before and after move EMR 9-19

20. Learning Objective 5 Methods for Immobilizing Patients • RAPID EXTRACTION • EMR must make decision quickly • Requires manual stabilization of the spine • Time permitting, move SSID to long backboard • Time does not permit, perform rapid extraction • Check CMS before and after move EMR 9-20

21. Learning Objective 5 Methods for Immobilizing Patients PEDIATRIC CHALLENGES • Child’s head is larger in relation to the body • Neutral inline alignment may be compromised • To maintain correct jaw angle • Use pediatric longboard EMR 9-21

22. Learning Objective 5 Methods for Immobilizing Patients • HELMET CHALLENGES • Special safety precautions to be considered • If helmet on, secure to backboard • Place extra padding under shoulders • If airway and breathing compromised, must remove helmet carefully EMR 9-22

23. Summary • The EMR must understand the basics for applying various types of dressings, bandages, splints, and spinal immobilization devices • Practicing and mastering the skill sets in each area will prevent further injury to the patient EMR 9-23