Dressing Specific Anatomical Sites

Question 1

Introduction

Answer 1

Dressing and bandaging wounds is not the same for every part of the body. This section describes the various factors that need to be considered for a given body region

Question 2

Scalp Dressings

Answer 2

Scalp injs tend to bleed profusely owing to their rich blood supply
When bleeding is present, application of direct pressure is often effective due to the rigid skull

Be careful to accurately determine the extent of the injury, and if there is a skull fracture or open brain inj
When skull has been fractured, apply pressure to the areas around the break

Use a bulky dressing that assists in topping blood loss and helps prevent excessive direct pressure on the potential open brain injury

The shape of the skull is a consideration when dressing wounds that involve the scalp. Improperly applied dressings can easily slide up or down the scalp, becoming ineffective. In addition hair may interfere with securing dressing

Question 3

Facial Dressings

Answer 3

Facial injs tend to cause significant anxiety for pts and family.
While tending to the clinical needs, take the time to reassure the pt.
Application of direct pressure is an effective means to control bleeding from soft-tissue disruption along the face

If an avulsed piece of tissue is present, attempt to place the piece in it normal anatomical location
Note. that facial bleeding tends to be quite heavy owing to the rich blood supply in this area

Assess the pt for the presence of, or potential for, airway compromise early in your assess
Blood pouring drainage. do not allow a gruesome facial injury to distract you from attending to life threats

Question 4

Ear or Mastoid Dressings

Answer 4

Trauma to the ear is commonly external, although internal inj is a possibility
Never place a dressing in the ear canal, but loosely apply it along the entire length of the external ear.
Gauze sponges work well to aid in stopping blood loss
If blood is flowing from the ear canal, DO NOT attempt to control it directly
CSF may be leaking and haling the blood flow may increase pressure within the skull.
Place a bulky dressing to the external ear and transport the pt rapidly

Question 5

Neck Dressing

Answer 5

Important anatomical structures in the neck include large blood vessels, the airway, and the cervical spine

There is little room for error when trauma is present in this area. A minor neck laceration can lead to an air embolism, a small puncture can penetrate the spinal canal and an open wound or hematoma can disrupt the airway. Pay close attention to the clinical signs that accompany external trauma

Open injuries to the neck require use of an occlusive dressing to prevent the drawing of air into the circulatory system. Apply dressings carefully so that they do not occlude major vessels or interfere w/ the movement of air through the trachea

Question 6

Shoulder Dressings

Answer 6

The shoulder is relatively easy to dress and bandage. Apply direct pressure to control external hemorrhage in this region. If immobilization is indicated, a sling and swath will prevent motion of the shoulder girdle

Question 7

Thorax Dressings

Answer 7

Injuries to the torso require vigilant assessment for underlying internal trauma.
A seemingly innocuous entrance wound may be the only indication that a gunshot injury is present.
Cover open wounds w/ an occlusive dressing that is taped on three sides

Assessment of breath sounds become a high priority when you find an open chest wound b/c pneumothorax or hemothorax may develop from penetrating trauma.
continually reassess a pt w/ thoracic soft-tissue injs

The best choice for securing a thorax dressing is medical tape. Circumferentially wrapping the torso may interfere with ventilation and should be avoided

Question 8

Groin and Hip Dressings

Answer 8

Soft-tissue injs to the groin and hip do not present a significant challenge to paramedics.
Typically, application of a dressing and bandage in combination w/ direct pressure will control blood loss in this region.
Injs to the genitalia are best managed by a paramedic of the same sex whenever possible.

In many cases, it is possible to provide the pt w/ a dressing to allow self-directed care.
This makes an uncomfortable scenario easier for the pt and paramedic.
If proper care cannot be accomplished by working directly w/ the pt, you must excessidingly professional and respect the pt’s modesty in all but the most serious cases

Question 9

Hand, Wrist and Finger Dressings

Answer 9

The hands, wrist and fingers are among the easiest sites to properly dress and bandage. A dressing is applied over any open wound, and bandage material is wrapped completely around the affected area
When possible the hand should be placed in the position of function
This is accomplished by placing a roll of gauze or similar material in pts hand
The hand and wrist can be easily immobilized

Question 10

Elbow and Knee Dressings

Answer 10

Joints are not difficult to dress and bandage but movement may cause dressings to shift.
It is good practice to provide immobilization of the elbow or knee when a larger wound is present.
Even smaller wounds may be difficult to manage b/c of skin tension and movement of the limb.
When either of these joints are injured, it becomes very important to assess distal neurovascular status
Elbow injs have a higher risk for neurovascular compromise because of the limited space available for blood vessels and nerves

Question 11

Ankle and Foot Dressings

Answer 11

The ankle and foot are simple to dress and bandage. control of bleeding is accomplished by direct pressure and may be augmented by elevation and pressure points in cases involving significant bleeding
Avoid tight bandage that interfere w/ circulation or sensation
Always assess distal neurovascular function before and after caring for the wound