Lecture 13: Bandaging & Bandaging Tech - SA (Exam 2) Flashcards
1
Q
What are the goals of a bandage
A
- Protects wounds
- Speed wound healing
2
Q
What can happen if there are complications w/ a bandage
A
- Result in limb amputation
- Kill the px
3
Q
List the good things a bandage can do
A
- Provide wound cleanliness
- Control wound environment
- Reduce edema & hemorrhage
- Eliminate dead space
- Immobilize injured tissue
- Min scar tissue
- Make the px more comfy
4
Q
List complications w/ bandages
A
- Patient discomfort
- Px mutilation of bandage & wound
- Bacterial colonization of wound
- Ischemic injury
- Damage to healing tissues
- Become a GI foreign body obstruction
5
Q
What are indications for bandages
A
- Used below the elbow & stifle
- Treating injuries to reduce pain, swelling, & local tissue damage
- Protecting wounds or devices
- For transport
6
Q
Describe the soft padded bandage (Modified robert jones)
A
- Immobilizes limb
- decreases/ limits soft tissue swelling
- Absorbs wound exudate
- Add splint material
- Fracture must be below the elbow/stifle
7
Q
What are the three layers of a bandage
A
- Primary (contact layer)
- Secondary (Intermediate layer)
- Tertiary (out layer)
8
Q
What is the functions of the primary layer
A
- Debrides tissue
- Delivers medication
- Transfers wound exudate
- Forms an occlusive seal
- Min pain
- Prevents excessive loss of body fluids
9
Q
What are the functions of the secondary layer
A
- Absorbs & stores deleterious agents
- Retards bacterial growth
- Pads wound from trauma
- Splints wound to prevent movement
- Holds primary bandage layer in place
10
Q
What are the fxns of the tertiary layer
A
- Holds other bandage layers in place
- Protects against external bacterial colonization
- Cosmesis
11
Q
What are the types of primary layers
A
- Adherent
- Nonadherent
- Occlusive
- Semi-occlusive
12
Q
What needs to be considered when selecting a primary layer
A
- Phase of wound healing
- Amount of exudate
- Wound location & depth
- Presence or absence of eschar
- Amount of necrosis or infection
13
Q
Describe Adherent primary layers
A
- Used when wound debridement required
- May be wet or dry
14
Q
Describe nonadherent primary layers
A
- During repair phase or if no necrotic debris
- Retains moisture to promote epithelialization & prevent dehydration
- Drains excess fluid & prevents maceration
15
Q
Describe occlusive primary layer
A
- Impermeable to aire
- Use on nonexudative wounds to keep moist
- Speeds rate & quality of healing compared to dressings allowing desiccation
- Use in partial thickness wounds w/o necrosis or infection
16
Q
Describe semi-occlusive primary layer
A
- Allows air to penetrate
- Allows exudate to escape
- Most commonly used primary layer
17
Q
List the steps of applying a soft padded bandage
A
- Assemble bandage materials & supplies
- Tape stirrups
- primary layer
- Secondary layer
- Tertiary layer
- Labeling
18
Q
How are tape stirrups applied
A
- Distal 1/3 of limb
- On the medial & lateral or dorsal & plant/palmar sides
- Tabbed ends or tongue depressor to help w/ seperation
19
Q
What is a tip for the modified robert jones bandage
A
place cotton btw/ the toes to decrease moisture build-up, increases px comfort, & don’t forget the dewclaw
20
Q
Describe applying the primary layer
A
- Contact layer
- nonadherent
- +/- meds
- usually sterile
- Wicking
21
Q
Describe applying secondary layers
A
- Intermediate layer
- Absorbent
- Supportive
- +/- rigid support
- Applied from the toes up, 50% overlap, & firm even pressure
- Separate the tape stirrups
- Rotate the stirrups proximally while twisting 180 degrees
- Secure stirrups to the underlying wrap (this prevents distal slipping)
22
Q
Describe applying tertiary layer
A
- Outer layer
- applied - toes up, 50% overlap, & firm even pressure
- This is what the clients see
23
Q
Describe applying a walking pad
A
- Elastikon or durable material
- Very adhesive
- Water resistant
- Applied w/o much pressure since the elastic properties might lead to swelling
- Can use a Koozie
24
Q
What need to be on the label of the bandages
A
- Date
- Initials
- Reminders
- Warnings
25
What adherent bandage layers are no longer recommended
* Wet to dry
* Dry to dry
26
T/F: nonadherent bandage types or recommended for all stages of wound healing
True
27
What bandage type is most often used in vet me
Semi occlusive
28
When should a tie over bandage be used
When the wound is in an area inaccessible by standard bandaging tech
29
What is this
Tie over bandage
30
Describe a tie over bandage
* Apply several sutures or skin staples w/ loose loops around the periphery of the wound
* Apply primary & secondary bandage layers
* Hold tertiary layer by lacing umbilical tape or heavy suture through loose skin sutures or staples
31
When are pressure relief bandages used
* Usually over bony prominence
* To treat/prevent pressure sores
32
What does pressure bandage do
* Facilitates control of minor hemorrhage, edema, & excess granulation ( direct application of corticosteroid ointment to the wound helps control excess granulation tissue)
* Them more convex the surface the greater the pressure exerted by the dressing on tissue
33
When to use adherent bandages & why
* Wound surface has necrotic tissue, foreign matter, or viscous exuate
* Necrotic tissue & foreign material adhere to gauze & are removed w/ the bandage
34
When to use dry adherent bandages
* When wound surface has loose necrotic tissue & foreign material
* When wound has large quantity of low viscosity exudate that doesn't aggregate
35
What does the robert jones bandage do
* Immobilize
* Decreases/limits soft tissue swelling
* Absorbs wound exudate
36
Describe the robert jones bandage
* Very large/thick bandage
* Uses rolled/sheet cotton
* Wrapped w/ more compression
37
How should proximal extremity lesions be bandaged
Continue the bandage up the leg, around the chest or abdomen, & btw/ the legs to create spica type bandage
38
How should a paw bandage be place
* Placed like the leg except the digits are covered
* After placing the stirrups & contact layer reflect the casting pad over digits from dorsal to ventral then ventral to dorsal
* Wrap padding around the distal limb
* Conform bandage to limb w/ elastic gauze
* Secure bandage w/ elastic tape in similar fashion
39
Name a traction splint and the cons
* Schroeder-Thomas splint
* Labor intensive
* Soft tissue complications
* Lacks predictability
40
What is a spica splint used for
Immobilization of the shoulder
41
What is the ehmer sling
* "Ehmer Femur"
* To prevent pelvic limb weight bearing
* Post hip reduction or acetabular fractures
42
What is a velpeau sling
* "Velpeau elbow"
* To prevent forelimb weight bearing
* After shoulder/forelimb procedures
43
When to casts for fractures
* Stable min displaced fractures
* Young rapidly healing animals
* Only injuries distal to the elbow/stifle
* Unable to repair w/ surgical tech
* Discuss expense w/ owner
* Swelling reduced prior to cast
* Green stick may not need sedation
* Displaced fractures = general anesthesia
* Check @ least every 2 W
44
T/F: Cast open fractures
False
45
When should you radiograph during casting & what should be seen on the Xray
* After casting
* Must have >50% of fracture ends (in ea of 2 radiographic views)
46
What limb position should the cast be placed
* Standing position
* Encourages use when walking
* Limits muscle atrophy & joint stiffness
* Shortens recovery period after removal
47
What are common complications
* Slipping/loosening
* Water or urine soaked
* Joint stiffness & muscle atrophy
* pressure sores
* More padding = less well immobilized
48
What about checking & changing
* Require high degree of client compliance
* Discharge should include verbal, written, & visual instructions for clients
* Check freq
49
What does changing frequency depend on
* Age
* Activity
* Cleanliness
* Associated wounds
* Swelling
50
What should be assessed when checking bandages
* Clean
* Dry
* Comfort (chewing? Lameness increase?)
51
When should a bandage be removed
* Signs of oder
* Swelling
* Toe temperature (compared to other foot)
* Nail bed cyanosis
52
What are some rules to remember when bandaging
* Sedation or anesthesia may be req
* Leave middle 2 toes (claws) exposed when possible
* Bandages start @ toes & go up limb to avoid swelling
* Keep limb in physiologic position (Not standing & do not apply w/ limb in full extension)
* Overlap 1/3 to 1/2 the width of you wrap
* Apply firm even pressuring application (proportional to amount of padding & size of px)
* Owner compliance
* No single dressing produces optimum microenvironment for all wounds or all stages of wound healing of a single wound
* Identify underlying structures
