Skill 58

Pressure Bandages (Applying)

A pressure bandage is a temporary treatment to control excessive, sudden, unanticipated bleeding. Hemorrhage may occur during surgical intervention (e.g., cardiac catheterization, arterial puncture, organ biopsy) or after surgery or be a life-threatening occurrence related to accidental trauma (e.g., stabbing, suicide attempt). Pressure dressings are essential to stopping the flow of blood and promoting clotting at the site until definitive action can be taken to stop the source.

Given the emergent nature of an acute bleeding episode, the aseptic techniques considered essential in most dressing applications are secondary to halting the bleeding. A pressure dressing applied in an emergency is usually temporary; the wound can be cleaned and the dressing changed once the bleeding has been controlled.

Delegation and Collaboration

The skill of applying a pressure dressing in an emergency situation cannot be delegated to nursing assistive personnel (NAP). If application requires more than one person, the NAP can assist. The nurse directs the NAP to:

▪ Observe the pressure dressing during care activities to make sure that it remains in place and that there is no visible bleeding from the site.

▪ Observe underneath the patient for bleeding after the dressing has been applied.