Medical Bandages: Uses and Best Practices

• A medical bandage speeds up the healing process when placed on a wound.
• Medical bandages are used in first aid to prevent bleeding, help blood clot, prevent wound infections, and relieve pain.

Uses of Medical Bandages

• Protecting wounds from contamination and infection
• Stopping bleeding
• Preserving infected organs or tissues
• Reducing pain
• Cleanliness is essential when bandaging a wound
• Ambulance officers can use complex bandaging methods when cleanliness is ensured.
• Injured persons should have their wounds bandaged before hospital transfer.
• Contaminated wounds should be treated as soon as possible.
• Delaying care is likely for many reasons, including medical staff preoccupation.
• Choosing the right wound dressing ensures quick healing and protects against potential complications and infections.
• Universal sterile dressing and adhesive tape are sufficient to secure all types of dressings.
• The best wound dressing stays on the wound for the longest possible time.
• Changing a wound dressing too often increases the chance of infection.

Types of Medical Dressings

Gauze Dressings

• Used for all types of wounds
• Made of cotton
• Easy to use, highly permeable, and provides ventilation
• Provides ventilation to the wound
• Inexpensive
• Protects the affected area from shocks and relieves pain
• Gauze can stick to wounds, causing tissue damage and bleeding
• Moisten with water or saline before application
• Used on inflamed wounds, wounds that secrete, and wounds requiring frequent dressing changes

Transparent Film Dressings

• Made of polyurethane
• Used for wounds requiring continuous monitoring
• Wounds remain visible as they do not cover the wound site
• Allows oxygen and moisture to pass through
• Can stay on the wound for a week without needing to be changed
• Should not be used on inflamed or severely bleeding wounds
• May cause complications due to occlusive properties
• May stick to some wounds

Foam Dressings

• Used for wounds that secrete medium to high amounts of secretions
• Consist of a layer covered with gel or polyurethane
• Highly absorbent and permeable to vapor and water
• Do not need to be changed frequently
• Should not be used on dry wounds or severe burns
• Used on diabetic feet, minor burns, and bedsores

Hydrocolloid Dressings

• Transparent and highly absorbent
• Consist of an adhesive or foam layer containing materials that form a barrier against urine, feces, and pollutants
• Impermeable to water and air
• Used on burns, bedsores, and venous ulcers
• Not used on infected wounds

Hydrogel Dressings

• Moisturize the wound, allowing cells to grow and speed up healing
• Composed mainly of water
• Forms a layer that protects against shocks and relieves pain
• Another dressing is needed to fix it in place since it is non-sticky
• Used for dry wounds, wounds containing dead tissue, and second-degree burns
• Not used on inflamed wounds

Alginate Dressings

• Composed of algae
• Used on wounds that secrete large amounts of secretions due to high absorption capacity
• Need to be changed frequently which may cause bacterial infection and dryness

Collagen Dressings

• Often used in chronic wounds

Instructions for Applying Bandages

• The bandage must be firm and stable
• Stability ensured by gauze rolls, triangular bandages, adhesive tapes, and elastic bandages
• Elastic bandages should be stretchable to conform to the injured limb's shape
• Use a little adhesive tape to keep bandages in place
• Ensure bandages dont restrict blood circulation
• Pressure bandages, when properly applied, do not obstruct blood circulation
• Some commercial elastic bandages are dangerous

Additional Bandage Information

• Triangular bandages secure the bandage
• May not provide the same parallel pressure as gauze rolls
• Adhesive tape secures the bandage best in closed bandages
• Adhesive tape secures absorbent chest and abdominal wounds

Wound Dressing Method for Minor Wounds

• Wash the wound well to remove any dirt
• Apply pressure to control bleeding
• Wrap the wound with a suitable wound dressing
• Use ice compresses to relieve pain and swelling
• Seek medical advice for deep or extensive wounds
• Get a tetanus vaccination if not vaccinated within five years

How to Change Wound Dressing at Home

• Wash your hands thoroughly
• Remove the old bandage slowly to prevent skin tearing
• Apply antibiotic ointments to prevent infection and adhesion
• Use moisturizing ointments to speed up wound healing

Injection Techniques

• Intramuscular: 90° angle
• Subcutaneous: 45° angle (but now often 90° with shorter needles for insulin)
• Intravenous: 25° angle
• Intradermal: 10-15° angle

Objectives

• Getting introduced to the main injection routes and the advantages of each type.
• Know and practice the common injection techniques.
• List the precautions required while giving an injection.

General Practical Aspects of Injection

• Check expiry dates of all items, including the drug
• Make sure the vial or ampoule contains the right drug and strength
• Maintain sterility throughout preparation
• Wash hands and disinfect injection site
• Ensure no air bubbles are in the syringe
• Use extra care when the needle's protective cover is removed
• Avoid touching anything with the unprotected needle
• Be careful not to prick yourself or others after the injection
• Dispose of contaminated waste safely

Main Parts of a Syringe

• Needle
• Bevel
• Barrel
• Plunger
• Cap

Four Main Considerations Regarding Injections

• Route of administration
• Injection site
• Technique
• Required equipment

Common Injection Routes

Subcutaneous Injection (SC)

• Used for slow, sustained absorption of medication
• Inject up to 1-2 ml
• For insulin injections needing slow, steady release
• Relatively pain-free
• Suitable for frequent injections
• Best sites are ...

Subcutaneous Injection Technique

• Pinch a skin fold to lift adipose tissue away from underlying muscle
• Traditionally given at a 45-degree angle
• Now recommended at a 90-degree angle with shorter insulin needles

Intradermal Injection (ID)

• Provides a local rather than systemic effect
• Used for diagnostic purposes like allergy or tuberculin testing, or local anesthetics
• Insert needle at a 10-15 degree angle, bevel up, just under the epidermis
• When a wheal appears on the skin surface stop
• Inject up to 0.5 mL
• Sites are similar to subcutaneous injections + inner forearm

Intramuscular Injection (IM)

• Delivers medication into well-perfused muscle
• Provides rapid systemic action and absorbing relatively large doses
• Five sites for IM injections:
  • Deltoid muscle
  • Dorsogluteal (gluteus maximus)
  • Ventrogluteal (gluteus medius)
  • Vastus lateralis
  • Rectus femoris

IM Technique

• Quickly pierce disinfected skin at a 90-degree angle and enter muscle
• Slowly inject medication at a constant rate until all medication has been delivered
• Withdraw needle and syringe quickly to minimize discomfort
• Clean area and check for bleeding

Intravenous Injection (IV)

• Inject directly into a vein

  • Purpose:
    • Giving a single medication dose
    • Cannulation for IV infusion of blood, medication, or a fluid solution
    • Withdrawing blood for analysis

IV Technique

• More complicated and dangerous than other injection types
• Choose a prominent vein
• Clean injection site with alcohol
• Feel the vein (spongy) with fingers
• Wrap tourniquet around the arm just above injection site
• Insert needle at a 45° angle into the vein, bevel up
• Pull back plunger slightly to test for blood
• Remove the tourniquet
• Slowly push the plunger and administer the medication
• Pull out needle and apply pressure with clean gauze and band-aid

Uncommon Injection Routes

• Intra-cardial injection
• Intra-articular injection
• Intra-spinal injection
• Intra-pleural injection