Bandaging Techniques

Why This Matters

Bandaging isn't just about wrapping injuries—it's about understanding why different techniques exist and when to use each one. You're being tested on your ability to match the right bandaging method to the injury type, body location, and treatment goal. Whether you're controlling hemorrhage, immobilizing a fracture, or protecting a wound from contamination, the technique you choose directly impacts patient outcomes.

The key principles here are pressure management, circulation preservation, and anatomical adaptation. Every bandaging decision balances support against restriction, compression against blood flow. Don't just memorize the steps—know what problem each technique solves and why it works better than alternatives for specific situations.

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Bleeding Control Techniques

When hemorrhage is the primary concern, bandaging shifts from support to active pressure application. The goal is to compress blood vessels while maintaining tissue viability downstream.

Pressure Bandaging for Bleeding Control

• Direct, sustained pressure is the gold standard—apply firmly over a sterile dressing and maintain for 5-10 minutes without peeking
• Elevation complements compression by reducing hydrostatic pressure to the wound site
• Escalation protocol—if bleeding soaks through, add more material on top rather than removing the original dressing; seek immediate medical help if bleeding persists

Occlusive Dressing for Chest Wounds

• Three-sided seal is critical—tape on three sides only, leaving one edge open to create a flutter valve effect
• Prevents tension pneumothorax by allowing trapped air to escape during exhalation while blocking air entry during inhalation
• Use airtight material such as plastic wrap or specialized chest seals; monitor constantly for respiratory distress

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Joint Stabilization Techniques

Joints present unique challenges because they require support without complete immobilization. The figure-eight pattern follows anatomical contours to provide stability while preserving functional range.

Figure-Eight Bandaging

• Crosses over the joint in an X-pattern, anchoring above and below while reinforcing the joint center
• Ideal for ankles, knees, elbows, and wrists—anywhere two bones meet and movement occurs
• Balances stability with mobility—snug enough to support, loose enough to allow circulation; always check distal pulses

Sling and Swathe Technique

• Two-component system—the sling cradles and elevates the arm while the swathe binds it securely to the torso
• Immobilizes shoulder and upper arm injuries by eliminating movement at multiple joints simultaneously
• Comfort check is essential—ensure the sling doesn't compress the neck and the swathe allows chest expansion for breathing

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Cylindrical Limb Wrapping

Arms and legs are essentially cylinders, and bandaging them requires techniques that provide uniform compression along the entire length. The key principle is distal-to-proximal application—always start farthest from the heart and work toward it.

Roller Bandage Application

• Distal-to-proximal direction prevents blood pooling and promotes venous return toward the heart
• Even tension throughout is critical—too tight causes ischemia, too loose allows slippage and inadequate support
• Foundation technique for most limb injuries; clean, dry bandage prevents infection and maintains adhesion

Spiral Bandaging

• 50% overlap rule—each turn covers half of the previous layer, creating uniform double-thickness coverage
• Best for uniform cylindrical areas like forearms, calves, and thighs where diameter stays relatively constant
• Adjustable compression—increase tension for support, decrease for simple dressing retention

Circular Bandaging

• Anchor technique used to start and finish other bandaging methods
• Complete overlap with each turn—best for small areas or as a base layer before transitioning to spiral or figure-eight
• Quick wound coverage for minor injuries; each layer reinforces the last for secure dressing retention

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Anatomically Adaptive Techniques

Some body parts don't fit neat categories—they require bandages that conform to irregular shapes while accounting for sensitivity and function.

Triangular Bandage Techniques

• Maximum versatility—can become a sling, a head covering, a tourniquet pad, or a securing tie depending on how it's folded
• Cravat fold (folded into a strip) works for binding; open triangle works for slings and large coverage areas
• Emergency improvisation—any large cloth can substitute in a pinch, making this technique essential for field situations

Head Bandaging

• Recurrent technique works best—passes run front-to-back over the crown, secured by circular turns around the circumference
• Avoid excessive pressure on skull injuries; the goal is wound protection, not compression
• Secure without slipping—the head's shape makes bandages prone to movement; use clips or tape, and monitor for swelling

Hand and Foot Bandaging

• Figure-eight around digits allows individual finger or toe wrapping while maintaining circulation
• Anchor at wrist or ankle before extending to digits; this prevents the bandage from sliding off
• Circulation checks are mandatory—check color, temperature, and capillary refill in fingertips and toes after application

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Quick Reference Table

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Self-Check Questions

1. Which two bandaging techniques both use a figure-eight pattern, and how do their purposes differ?

2. You're treating a patient with a deep laceration on the forearm. In what direction should you apply the roller bandage, and why does this direction matter physiologically?

3. Compare and contrast pressure bandaging for a limb wound versus an occlusive dressing for a chest wound—what principle do they share, and what makes their application fundamentally different?

4. A patient has an ankle sprain and a fractured humerus. Which bandaging technique would you use for each injury, and what determines your choice?

5. If an exam question describes a sucking chest wound with progressive respiratory distress after dressing application, what likely went wrong with the bandaging technique, and how should it have been applied?