Splinting and Bandaging

Splinting and bandaging are two other critical first aid skills that you can hardly do without as a first aider. The materials are part of the kit or box used in first aid. To achieve the objectives of this course and the entire programme, acquisition of this skills are very important. Previous unit gave you practical guidelines to protect you from blood borne pathogens. This site has been designed to present discussions and demonstrations on splinting and bandaging.

1. Discuss the value of splinting and bandaging.

2. Demonstrate the application of a splint.

3. Highlight the two principles of splinting.

4. Demonstrate the application of a bandage.

Splinting

Fractures have been mentioned as one of the emergencies or accidents in sports. To prevent any further damage to the tissues, any suspected fracture, dislocation or severe sprain should be splinted before moving the athlete. Therefore, you must possess a good skill and knowledge of splinting to be a good sports injury or accident first aider. Nowadays, you do not need to improvise to do splinting as there are many commercial splints. Remember, it is part of your first aid kit or box content. However, when commercial splints are not available, you can still splint using rigid or bulky material that are well padded, boards, cardboard, bats, magazines, blankets or pillows.

There are two major concepts of splinting that describe the principles of good splinting. They are:

1. To splint from one joint above the fracture to one joint below the fracture.

2. To splint where the athlete lies. Under normal condition, do not try to move the athlete until he has been splinted.

Function of Splints

What are splints used for? To immobilize injured parts of the body and any other parts which movement can cause further damage.

The objective of first aid is to protect the injured athlete from further harm or injury. Bearing this in mind, the following points will help you when splinting an injured athlete:

1. Splint the athlete in the condition you found him. Do not move him unless you have splinted him or the athlete is in danger or requires repositioning for CPR or control of severe bleeding.

2. Immediately, call emergency medical personnel and let them do the splinting of the following:

• Large joint dislocation

• Injuries where bones create a clearly seen deformity

• Fracture of the spine, pelvis, hip, shoulder, knee.

• Compound fracture

• Displaced rib fracture

• Any musculoskeletal injury that results in loss of circulation, numbness or loss of function.

3. If it will take more than 20 minutes to get the called medical assistance, splint the injury in the position you found the athlete. However, if spine fracture is involved, simply stabilize the head and prevent the athlete from moving until help arrives.

4. If the bones end is exposed, cover it with sterilized gauze.

5. If the fracture is close to a joint or there is severe sprain, immobilize the bones superior and inferior to the joints.

6. Secure splint with ties or an elastic rap. Do not place ties directly on the injury but above and below it.

Check the skin colour, temperature and sensation of the fingers or toes periodically depending on where the splint is applied. This necessary and regular check helps to monitor blood supply to the distal parts of the limbs and should continue until the athlete arrives at a medical facility.

Bandaging

This is another method of stabilizing injured body parts. It is also used in dressing a wound. Have you ever had a wound that was dressed? If yes, how was the dressing done? Dressing is a sterile material, usually guaze, used to cover a wound, to control bleeding and prevent contamination. When a dressing is applied, a bandage is used to hold it in place.

A bandage can be a folded neckband (cravat), strips of cloth or commercially made elastic adhesive tape that can be applied directly to the skin and it will hold the dressing well, even when it is near a moving joint.

Has bandage ever been applied on any part of your body or on someone very close to you? What was it used for?

Uses of Bandage

Bandage is used in:

1. Providing compression to minimize swelling in the initial management of injury;

2. Reducing the chances of injury occurring and

3. Providing additional support to an injured part of the body.

Generally, bandages consist of gauze, cotton cloth and elastic wrapping. Gauze comes in three forms:

1. A roller bandage used in holding dressing and compression in place;

2. A padding used in the prevention of blisters, and

3. A sterile pad for wounds, (Prentice, 2006).

Cotton cloths are used for ankle wraps and for triangular bandages and cravat or neckband. There are also elastic bandages which have become very common and as such deserve a special discussion here.

Fig. shows different sizes of roller elastic bandage.

Elastic bandages

This is the most common of all the bandages mentioned. It possesses a characteristic called extensibility, which allows it to conform to most parts of the body. They are said to be active bandages, because, they do not restrict the movements of the athlete. They come in different sizes. The size you will use will depend on the body part involved. The following are popular sizes and where they are used:

1. For hand, finger, toe and head, use 5cm (width) by 5.5m (length)

2. For the extremities (upper and lower limbs), used 7.5cm (width) by 9m (length);

3. For the thigh, grown and trunk, use 10cm or 15cm (width) by 9m (length).

Now you have known the various` dimensions of elastic bandage, check the ones in your first aid kit or box, note their sizes and indicate where they can be used.

When you select a bandage to be used, be sure it is a single piece, that is, it will not have any wrinkles, seams and any other imperfections, as these may irritate the skin.

Consider the following points when using the bandage you roll:

1. Wrap the body part in the position that has maximum muscular contraction. This ensures unhindered movement and circulation.

2. Make the wrap firm but not too tight. This is ensured by using many turns with moderate tension.

3. The over laying turn or wrap should overlap more than half of the underlying turn or wrap. When a bandage is applied to the limbs, regularly examine the fingers and toes to make sure that circulation are not hindered. A very cold finger or toe indicates poor or no circulation as a result of excessively tight bandage.

Application of Bandage

The most common place to apply bandage are the limbs. The following suggestions will help you in the application of bandage:

(1) Start at the smallest circumference. For instance, wrist to elbow or ankle to knee.

(2) Place the loose end of the bandage in front of the wrist or ankle and hold this position with one hand.

(3) Move the roll backward, under and completely around the limb and back to the starting point.

(4) Keep forming turns until you have made the bandage firm.

After applying the roller bandage, use a locking technique to hold it in place. The most common techniques are tying and pinning. You can also apply adhesive tape over many overlying wraps or turns. Now you have applied the bandage. It remains there until it has fully accomplished its purpose. Then, it can be removed.

There are two popular methods of removing wrapped bandage –

1. Unwrapping the bandage – This involves carefully reversing the wrapping procedures.

2. Cutting the bandage – This involves using scissors to cut the bandage. You should be very careful not to cut the skin or cause additional injuries to the athlete.