Bandaging and

Splinting
 Bandaging and Splinting
 Introduction
Bandaging is both science & an art. The proper
bandage properly applied can aid in the recovery
of a client but a carelessly or improperly applied
bandage can cause discomfort to the client; in
many instances it may expose the wound to
danger of infection; it may even imperil the life of
the client. Therefore, it is essential that nurses
should become familiar with the various bandages
and able to apply them properly. The technique of
bandaging can be mastered by constant practice.
Bandaging and Splinting
 Objective:

At the end of this lecture

demonstration the student will be
able to perform correct bandaging
and splinting technique using
triangular and roller/elastic
bandage.
Purposes of Bandaging
1. Holds a dressing in place over an
open wound.
2. Provides support to immobilizes an
injured body part.
3. Provides direct pressure over a
dressing on body part that has a
bleeding wound for control of
hemorrhage.
4. Secures splint to an injured part of
the body.
5. Reduce or prevent edema.
Bandaging and Splinting
 Purposes:
1. Holds a dressing over a wound.
2. Creates pressure over a body part. (ex. An
elastic pressure bandage applied over an
arterial puncture site)
3. Immobilizes a body part (an elastic
bandage applied around a sprained ankle)
4. Provides direct pressure over bleeding
wound for control of hemorrhage.
5. Secures splint to an injured part of the
body.
Principles in Bandage Application
1. Apply bandage snugly-NOT too
tight to restrict blood circulation
nor too LOOSE that will allow the
dressing to slip. Always check the
extremity’s pulse. If pulse cannot
be felt, loosen the bandage.
2. Tie and untie bandages using a
square knot.
Principles in Bandage Application

3. Do NOT apply a bandage directly

over a wound. Put a sterile
dressing ON first.
4. Don’t leave loose ends. They
might get caught. All knots
should be tucked in.
Principles in Bandage Application
5. Don’t cover fingers or toes
unless they are injured. They need
to be observed for color changes
that would indicate impaired
circulation.
6. Assess extremity for circulation
after first 20 minutes and then
every 2 hours.
Principles in Bandage Application
7. Ensure that the bandage is
wrinkle free. Partial occlusion of
the vessels can occur within 20
minutes after application.
8. Do not start a roller bandage
above the wound, instead start
below the wound and work
upward.
Principles in Bandage Application
9. Do not apply a circular bandage
around a victim’s neck –
strangulation may occur.
Types of Bandages

3 General types of bandages;

1. Triangular bandages
2. Roller bandages
3. Tailed bandages
Triangular and Cravat Bandages
 Uses of Triangular Bandage;
1. Used for the temporary or
permanent bandaging of
wounds.
2. Immobilization of fractures and
dislocations.
3. Used as a sling for the support
of an injured part of the body.
Triangular and Cravat Bandages
 The long side of the triangular is
called the “base”.
 The point opposite the base is called

the “apex”.
 The points at each end of the base are

called the “ends” or “extremities”.

APEX

ENDS ENDS

BASE
Triangular and Cravat Bandages
 This bandage may be used either
as a triangle or as cravat.
 The Cravat being made from the

triangle by bringing the apex to

the base and folding it upon itself
a sufficient number of times to
obtain the desired width.
Triangular and Cravat Bandages
Bandage Application
A. Open Phase
1. Head bandage
2. Face and back of the head
3. Anterior / Posterior Chest
bandage
4. Arm Sling
5. Underarm Sling
6. Foot/Hand bandage
Head Bandage (topside)
 The triangle of forehead or scalp (fronto-
occipital) is used to hold dressings on the
forehead or scalp.
Head Bandage (topside)
a. Place middle of
base of the triangle
so that edge is just
above the
eyebrows and bring
apex backward,
allowing it to drop
over back of head
(occiput). Bring
ends of triangle
backward above
ears.
Head Bandage (topside)
b. Cross ends
over apex at
occiput,
carry ends
around
forehead
and tie
them in a
square
knot.
Head Bandage (topside)
c. Turn up
apex of
bandage
toward top
of head.
Tuck in
behind
crossed
part of
bandage.
Face and Back of Head
Anterior/Posterior Chest Bandage
 This bandage is used to hold dressings on
burns or wounds of chest or back.
Anterior/Posterior Chest Bandage
a. Drop apex of
triangle over
shoulder on injured
side. Bring bandage
down over chest (or
back) to cover
dressing, so that
middle of base of
bandage is directly
below injury. Turn
up a cuff at base.
Anterior/Posterior Chest Bandage

b. Carry ends
around and tie
in a square
knot, leaving
one end longer
than the other.
Anterior/Posterior Chest Bandage

c. Bring apex
down and tie to
long end of
first knot.
Arm Sling

The triangular arm sling (brachio-

cervical triangle) is used for the
support of fractures or injuries of
hand, wrist and forearm. There
are 2 versions of sling.
Arm Sling
Arm Sling (A- Version)
 In this method of applying the sling, the
forearm is supported from both shoulders by
the sling.
Arm Sling (A- Version)
1. Bend arm at elbow so
that little finger is
about a handbreadth
above level of elbow.
2. Place one end of
triangle over shoulder
on injured side & let
bandage hang down
over chest with base
toward hand & apex
toward elbow.
Arm Sling (A- Version)

3. Slip bandage
between body and
arm.
4. Carry lower end
up over shoulder
on uninjured side.
Arm Sling (A- Version)
5. Tie the 2 ends by square
knot at the neck. Knot
should be on either side of
neck not in the middle
where it could cause
discomfort when client is
lying on back.
6. Draw apex of bandage
toward elbow until snug,
bring it around to front &
tuck.
Arm Sling (B- Version)
 If it is desirable to support the forearm
without pressure on the collarbone or
shoulder of the injured side, the following
steps should be taken.
Arm Sling (B- Version)
1. Bend arm at elbow
so that the little
finger is about a
handbreadth
above level of
elbow.
2. Drape upper end
of triangle over
uninjured
shoulder.
Arm Sling (B- Version)
3. Slip bandage
between body and
arm.
4. Carry lower end
up over flexed
forearm (ends of
fingers should
extend slightly
beyond base of
triangle).
Arm Sling (B- Version)
5. Slide lower end of
bandage under
injured shoulder
between arm & body
& secure the two
ends with a square
knot.
6. Draw apex toward
elbow until snug &
tuck.
Foot Bandage
 Usedto hold dressings of
considerable size on the foot.
Foot Bandage
a. Center foot
upon
bandage at
right
angles to
base with
heel well
forward of
base.
Foot Bandage
b. Carry apex of
triangle over
toes to ankle &
tuck excess
fullness of
bandage into
small pleats on
each side of
foot.
Foot Bandage
c. Cross
each half
of bandage
toward
opposite
side of
ankle.
Foot Bandage

d. Bring
ends of
triangle
around
ankle.
Foot Bandage

e. Tie ends
in square
knot.
Hand Bandage
 Usedto hold dressings of
considerable size on the hand.
Hand Bandage
a. Place
middle of
base of
triangle
well up on
palmar
surface of
wrist.
Hand Bandage
b. Carry apex
around ends of
fingers. Cover
back (dorsum)
of hand to
wrist & tuck
excess fullness
of bandage
into small
pleats on each
side of hand.
Hand Bandage

c. Cross each
half of
bandage
toward
opposite
side of
wrist.
Hand Bandage

d. Bring
ends of
triangle
around
wrist.
Hand Bandage

e. Tie ends
in square
knot.
Bandage Application
B. Cravat Phase
1. Forehead bandage
2. Eye bandage
3. Cheek/Ear/Jaw bandage
4. Shoulder/Hip bandage
5. Elbow/Knee bandage
6. Palm bandage
7. Palm Pressure bandage
8. Sprained Ankle (Shoe on/off)
Forehead
Cravat Bandage of Eye
 Usedto hold a dressing over the eye.
Two cravats are required.
Cravat Bandage of Eye
a. Lay center
of first
cravat over
top of head
with the
front end
falling over
uninjured
eye.
Cravat Bandage of Eye
b. Bring
second
cravat
around
head, over
eyes & over
loose ends
of first
cravat. Tie
in front.
 Cravat Bandage of Eye
 c.Bring ends of first cravat back over top
of head, tying there & pulling second
cravat up & away from uninjured eye.
Cravat of Head or Ear
 The purpose of this bandage is to apply
pressure to control hemorrhage from wounds
of scalp or to hold dressings on wounds of
ear or lower scalp.
Cravat of Head or Ear

a. Place
middle
of cravat
over
dressing
.
Cravat of Head or Ear

b. Pass each
end
completely
around
head.
Cravat of Head or Ear

c. Tie in
square
knot.
Cravat of Jaw
 The cravat of jaw (mento-vertico-occipital
cravat) is used to hold dressings on the chin,
cheeks & scalp & as a temporary support to
immobilize a fractured or dislocated jaw.
Cravat of Jaw
a. After making a
triangular
bandage into a
cravat of proper
width, place it
under the chin &
carry ends
upward with one
end longer than
the other.
Cravat of Jaw
b.Bring
longer end
over top of
head. Cross
both ends
on side of
head. (Ends
should now
be of equal
length.)
Cravat of Jaw
c. Pass ends
around head in
opposite
directions & tie
with square
knot on other
side of head
on primary
turn of cravat.
Shoulder Bandage

The triangle of the shoulder is

used to hold dressings on wounds
of the shoulder. Two bandages
are required, one a triangle & the
other a cravat, roller bandage or
belt.
Shoulder Bandage
Shoulder Bandage
a. Place center of cravat, &
roller bandage at base
of neck on injured
side & fasten just
forward of opposite
armpit.
b. Slide apex of open
triangle under cravat
at base of neck &
place over dressing on
injured shoulder &
upper arm. Turn up
cuff at base.
Shoulder Bandage

c. Bring ends
around arm
and tie.
Shoulder Bandage

d. Secure apex
to cravat at
neck by
tucking in.
Shoulder –Armpit Cravat
The shoulder-armpit cravat (bis-
axillary) is used to hold dressings in
the armpit (axilla) or on the shoulder.
Shoulder –Armpit Cravat

a. Place cravat
over dressing
in armpit so
the front end
is longer
than the
back. Carry
the ends
upward.
Shoulder –Armpit Cravat

b. Bring ends
across each
other over
top of
shoulder.
Shoulder –Armpit Cravat

c. Cross ends
over back &
chest to
opposite
armpit. Tie
ends just in
front of
uninjured
armpit.
Hip Bandage
The triangle of the hip is used to hold
dressings on the buttock or hip. It
requires 2 bandages, one a triangle &
the other a cravat, or roller bandage.
Hip Bandage

a. Fasten
cravat,
roller
bandage
around
waist.
Hip Bandage
b. Place base of
triangle below
buttock (gluteo-
femoral fold), &
slide apex under
cravat at waist.
Fold base
upward to form
cuff & carry ends
of base around
thigh.
Hip Bandage

c. Tie ends of
base with
square knot.
Fasten apex
to waist
cravat by
tucking
under.
Cravat of Elbow
The cravat of the elbow is used to
hold dressings around the elbow.
Cravat of Elbow
a. Bend arm at
elbow and
place center
of cravat at
point of
elbow
(olecranon).
Cravat of Elbow
b. Bring ends
up and cross
each other in
overlapping
spiral turns.
Continue one
end up arm
and the other
end down
forearm.
Cravat of Elbow
c. Bring
ends to
front of
elbow
(antecubital
fossa) and
tie.
Cravat of Knee
The cravat of knee is used to hold
dressings around the knee.
Cravat of Knee
a. Place
center of
cravat over
kneecap & let
ends hang
down each
side of knee.
Cravat of Knee
b. Cross ends
underneath &
continue several
overlapping
descending
turns down calf
& several
overlapping
ascending turns
up thigh.
Cravat of Knee

c. Bring
ends
together &
tie under
knee.
Cravat of Palm of Hands/Palm Pressure
 Usedto hold dressings on the palm of
the hands.
Cravat of Palm of Hands/Palm Pressure

a. Lay center of
cravat over
center of palm
of hands with
ends hanging
down each
side.
Cravat of Palm of Hands/Palm Pressure

b.Bring the
thumb end
across back of
hands, over
palm &
through hollow
between
thumb & palm.
Cravat of Palm of Hands/Palm Pressure

c. Bring the
other end
across back of
hand toward
base of thumb
& obliquely
across palm to
base of little
finger.
Cravat of Palm of Hands/Palm Pressure

d. Cross both
ends at back
of hand.
Cravat of Palm of Hands/Palm Pressure

e. Continue
procedure,
ends crossing
first at back
of hand and
then over
palm.
Cravat of Palm of Hands/Palm Pressure

f. Tie in
square knot
at wrist.
Cravat of Leg
 Used to hold dressings on the leg.
Cravat of Leg

a. Place center
of cravat over
dressing.
Cravat of Leg
b. Begin ascending
turns with upper
end & descending
turns with lower
end, with each
turn covering two-
thirds of preceding
turn until dressing
is covered.
Cravat of Leg

c. Terminate
by tying both
ends in
square knot.
Sprained Ankle (shoe on/off)
Used for holding sprained ankle.
Sprained Ankle (shoe on/off)

a. Place center
of cravat
under arch of
shoe.
Sprained Ankle (shoe on/off)

b. Carry both
ends back of
foot,
crossing at
back of
ankle.
Sprained Ankle (shoe on/off)
c. Carry ends to
front of foot,
cross each end
in front of ankle
& carry ends
under bandage
at each side of
ankle. Take up
slack.
Sprained Ankle (shoe on/off)

d. Bring ends
to front.
Sprained Ankle (shoe on/off)

e. Tie
securely.
Roller Bandage
Purposes :
1. To hold dressings in place.
2. To support an injured part.
3. To provide pressure for control
of hemorrhage.
4. To secure a splint to an injured
part in order to immobilize it.
Roller Bandage
 The width & length depends upon the
part to be bandaged.
1. The sizes most frequently used are 2
inches wide & 6 yards long used for
hand, finger, toe & head bandage.
2. 3 inches wide & 10 yards long are
used for extremities.
3. 4 inches wide & 10 yards long are
used for thigh, groin & trunk.
Roller Bandage
Applying the Roller Bandage
When a roller bandage is to be applied to a
part, the roll should be held in the right hand
so that the loose end is on the bottom. The
outside surface of the loose end is next applied
to the part & held there with the left hand. The
roll is then passed around the part by the right
hand, which controls the tension & direction of
the bandage. 2 or 3 of the initial turns of a
roller bandage should overlie each other to
secure the bandage. In applying the bandage,
it is often necessary to transfer the roll from
one hand to the other.
Applying Roller Bandage
 Principles:
1. In bandaging an arm or leg, the entire
extremity (except fingers or toes) should
be covered to maintain uniform pressure.
The fingers or toes should be left
exposed so the circulation in these parts
can be checked.
2. An extremity should be bandaged in its
final position since bending will change
the pressure of parts of the bandage.
Applying the Roller Bandage
 Principles:

3. It is safer to use a large number of

turns rather than a few too firmly
applied turns to secure splints or
dressings. This is particularly important
in applying a wet bandage or one that
may become wet while securing a wet
dressing. A wet bandage will be unduly
tightened when it dries if allowance has
not been made for shrinkage.
Applying the Roller Bandage
 Principles:

4. Bandage turns should overlap to

completely cover the skin since any
uncovered skin may be pinched
between the turns. To prevent
chafing and irritation when two
parts are bandaged together , skin
surfaces should be separated by
absorbent material.
Bandaging Techniques
1. Circular Bandage
2. Spiral Bandage
3. Spiral – Reverse
4. Figure of Eight
5. Recurrent
Bandaging Technique
Circular Bandage – used to cover
cylindrical parts & to anchor bandages.
Each turn encircles the previous one,
covering it completely.
Bandaging Technique
Spiral Bandage – used to wrap a long,
straight body part or one of increasing
circumference. Each turn partially overlaps
the previous one.
Bandaging Technique
Spiral-Reverse – used to accommodate the
increasing circumference of a body part.
Anchor the bandage & then reverse direction
halfway through each spiral turn.
Spiral-Reverse
a. Anchor at
wrist with
primary turns in
usual way,
bring bandage
obliquely up
forearm to just
below elbow &
make a circular
turn.
Spiral-Reverse
b. Bring obliquely
downward to wrist
& circle wrist.
(These turns hold
the dressing while
the spiral reverse
is being applied.)
then start the
bandage obliquely
upward again.
Spiral-Reverse

c. Instead of
continuing
upward,
fold
bandage
back & hold
fold with
thumb.
Spiral-Reverse
d. Continue
around arm &
repeat procedure
until arm is
covered. Each turn
must overlie
about 2/3 of
preceding turn &
reverses must be
in a straight line.
Spiral-Reverse

e. Terminate
with circular
turns below
elbow &
secure.
Bandaging Technique
 Figure of Eight of Elbow– used to hold
dressing in the triangular hollow in front of a
joint. Anchor below the joint & then use
alternating ascending & descending turns to
form a figure of eight.
Figure of Eight
a. Anchor with
circular turn
above elbow &
carry bandage
obliquely
downward
over hollow of
joint.
Figure of Eight
b. Circle forearm
below elbow to
anchor, bring
obliquely
upward over
hollow of elbow
& pass around
upper arm at
primary circle.
Figure of Eight
c. Repeat
procedure with
oblique turns
progressing up
forearm, each
turn
overlapping
preceding turn
by 2/3.
Figure of Eight

d. Terminate
at starting
point &
secure.
Figure of Eight of Forearm
 Figure of eight of
forearm – used
to retain
dressings or
secure splints on
the forearm. This
may start as a
continuation of
figure of eight of
hand or with
primary circular
turns of wrist.
Figure of Eight of Forearm

a. Carry
spirally
upward
around
forearm.
Figure of Eight of Forearm

b. Apply
circular turn
just below
elbow.
Figure of Eight of Forearm

c. Then carry
spirally
downward
around
forearm
forming X with
upward turn.
Figure of Eight of Forearm

d. Repeat
procedure,
each turn
overlapping
one-half or
two-thirds of
preceding turn.
Figure of Eight of Forearm

e. When
forearm is
covered,
terminate
below elbow &
secure.
Bandaging Technique
 Recurrent with Spiral Turns – use for a stump,
a hand or the scalp. This technique includes a
combination of recurrent & spiral turns.
Recurrent with Spiral Turns
a. Anchor bandage
with several turns
around the head,
terminating behind
head. At this point
fold bandage
upward with
assistant holding
fold in place with 2
fingers.
Recurrent with Spiral Turns
b. Continue
bandage over top
of head to center
of forehead. Fold
bandage back at
this point & hold it
there with free
hand. Carry
bandage back to
point held by
assistant at rear of
head.
Recurrent with Spiral Turns
c. Continue
procedure until
entire head is
covered, turns
alternating to the
left & right the
center line & each
turn overlying the
outer half of the
preceding turn.
Recurrent with Spiral Turns
d. Apply
several circular
turns around
head, covering
the ends of the
initial turns &
secure.
Splinting
 Purposes:

To immobilize fractures,
dislocations or subluxations.
General Principles of Splinting
1. All fractures of long bones
should be splinted “where they
lie” before movement or
transportation of any kind is
attempted.
2. In applying a splint, the joint
above the fracture & the joint
below the fracture should be
immobilized.
General Principles of Splinting

3. The splint should be so applied

that it does not interfere with the
circulation of the splinted part.
4. The splint should be padded to
prevent injury to the limb or
discomfort to the client.
General Principles of Splinting
5. Traction is required for most
fractures of long bones to overcome
muscle contraction & associated
shortening. Traction overcomes muscle
contraction & lessens shortening & thus
regains or maintain normal length of
the bone.
6. Splints may be improvised from
boards or sticks, rolled magazines or
newspapers, etc.
Splinting of fractures of Upper Extremities
Splinting of fractures of Upper Extremities
Splinting of fractures of Upper Extremities
Splinting of fractures of Upper Extremities
Splints & Slings for Upper Extremities
Slings
 Purposes:

1. To support and
immobilize an
injured arm,
wrist or hand.
2. To support the
weight of a
splint or hold
dressings in
place.
Slings
Tailed Bandages
Double T-bandage

T-bandage

Four – Tailed bandage

Many-tailed bandage
 Types of Tailed Bandage
1. T-bandage – is a T-shaped bandage
consisting of a vertical strip of material
sewn or pinned to the center of a
horizontal strip. This may be used as a
scalp, ear, eye or perineum bandage.
T-bandage
Types of Tailed Bandage
2. Double T-bandage – may be made by
sewing 2 vertical strips of material to the
center of a horizontal strip and about 4
inches apart. This may be used to hold
dressings on the chest, back or
perineum.
Double T-bandage
Types of Tailed Bandage
3. Four-tailed bandage – is a piece of
material 4-6 inches wide and about 30
inches long with each end cut about 12 0r
14 inches down its middle, leaving the
center piece about 12 or 14 inches in
length. This is used to hold dressings on
the jaw, nose, forehead and back of the
head.
Four-tailed bandage
Types of Tailed Bandage
4. Many-tailed bandage is similar in
construction to the four-tailed bandage
except that the ends are cut into the
desired number of tails about 16 inches
in length and the uncut portion is about
20 inches in length.
Thank you !!!!
Ready for a Quiz!!!
1-5 Give 5 Principles to
be observed in
bandage application.
6. What type of
triangular bandage is
used to hold dressings
on the forehead or
scalp?
7. What type of
triangular bandage is
used to hold dressings
on burns or wounds of
the chest and back?
8. What type of triangular
bandage is used to
support fractures or
injuries of hand, wrist
and forearm?
9. What type of cravat
bandage is used to
support in order to
immobilize a fractured
jaw?
10. What type of
bandage is used to
hold dressings on the
buttocks or hip?
11 -12. What are the 2
bandages used in
answer # 10 to hold
the dressings?
13. What bandage
technique wherein
each turn encircles the
previous one?
14. What bandage
technique wherein
each turn partially
overlaps the previous
one?
15. What do you call
the TIE that terminates
the bandage
application?
ANSWERS
 1-5Give 5 Principles to be
observed in bandage application.
ANSWERS:
1. Apply bandage snugly-NOT too tight
to restrict blood circulation nor too
LOOSE that will allow the dressing to
slip. Always check the extremity’s
pulse. If pulse cannot be felt, loosen
the bandage.
2. Tie and untie bandages using a
square knot.
ANSWERS in # 1-5
3. Do NOT apply a bandage directly over a
wound. Put a sterile dressing ON first.
4. Don’t leave loose ends. They might get
caught. All knots should be tucked in.
5. Don’t cover fingers or toes unless they
are injured. They need to be observed
for color changes that would indicate
impaired circulation.
6. Assess extremity for circulation after
first 20 minutes and then every 2 hours.
ANSWERS in # 1-5
7. Ensure that the bandage is wrinkle free.
Partial occlusion of the vessels can occur
within 20 minutes after application.
8. Do not start a roller bandage above the
wound, instead start below the wound
and work upward.
9. Do not apply a circular bandage around
a victim’s neck – strangulation may
occur.
 6.
What type of triangular
bandage that is used to hold
dressings on the forehead or
scalp?

ANSWER:
 Head bandage or Triangle of

forehead or scalp
 7.What type of triangular
bandage that is used to hold
dressings on burns or wounds
of the chest and back?

ANSWER:
 Anterior/Posterior chest

bandage
 8.
What type of triangular
bandage that is used to
support fractures or injuries of
hand, wrist and forearm?

ANSWER:
 Triangular Arm sling
 9.What type of cravat bandage
is used to support the jaw
when get fracture in order to
immobilize it?

ANSWER:
 Cravat of Jaw
 10.What type of bandage is
used to hold dressings on the
buttocks or hip?

ANSWER:
 Hip bandage
 11-12. What are the 2
bandages used in answer # 10
to hold the dressings?

ANSWER:
 11. 1 Triangle
 12. 1 Cravat
 13.What bandage technique
wherein each turn encircles
the previous one?

ANSWER:
 Circular bandage
 14.What bandage technique
wherein each turn partially
overlaps the previous one?

ANSWER:
 Spiral bandage
 15.What do you call the TIE
that terminates the bandage
application?

ANSWER:
 Square Knot