Elastic Bandage Application
Elastic bandages exert gentle, even pressure on a body part. By supporting blood vessels, these rolled bandages promote venous return and prevent pooling of blood in the legs. They’re typically used in place of antiembolism stockings to prevent thrombophlebitis and pulmonary embolism in postoperative or bedridden patients who can’t stimulate venous return by muscle activity.
Elastic bandages also minimize joint swelling after trauma to the musculoskeletal system. Used with a splint, they immobilize a fracture during healing. They can provide hemostatic pressure and anchor dressings over a fresh wound or after surgical procedures such as vein stripping.
Equipment
Elastic bandage of appropriate width ▪ tape, pins, or self-closures ▪ gauze pads or absorbent cotton ▪ Optional: gloves.
Bandages usually come in 2″ to 6″ (5- to 15-cm) widths and 4′ and 6′ (1.2- and 1.8-m) lengths. The 3″ (7.6-cm) width is adaptable to most applications. An elastic bandage with self-closures is also available.
Preparation of Equipment
Select a bandage that wraps the affected body part completely but isn’t excessively long. Generally, use a narrower bandage for wrapping the foot, lower leg, hand, or arm and a wider bandage for the thigh or trunk. The bandage should be clean and rolled before application.
Implementation
Verify the doctor’s order.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
Examine the area to be wrapped for lesions or skin breakdown. If these conditions are present, consult the doctor before applying the elastic bandage.
Explain the procedure to the patient, provide privacy, and answer any questions to decrease anxiety and increase cooperation.
Position the patient with the body part to be bandaged in normal functioning position to promote circulation and prevent deformity and discomfort.
Avoid applying a bandage to a dependent extremity. If you’re wrapping an extremity, elevate it for 15 to 30 minutes before application to facilitate venous return.
Apply the bandage so that two skin surfaces don’t remain in contact when wrapped. Place gauze pads or absorbent cotton as needed between skin surfaces, such as between toes and fingers and under breasts and arms, to prevent skin irritation.
Hold the bandage with the roll facing upward in one hand and the free end of the bandage in the other hand. Hold the bandage roll close to the part being bandaged to ensure even tension and pressure.
Unroll the bandage as you wrap the body part in a spiral or spiral-reverse method. Never unroll the entire bandage before wrapping because this could produce uneven pressure, which interferes with blood circulation and cell nourishment.
Overlap each layer of bandage by one-half to two-thirds the width of the strip. (See Bandaging techniques, page 246.)
Begin wrapping an extremity at the most distal part and work proximally to promote venous return. Wrap firmly but not too tightly. As you wrap, ask the patient to tell you if the bandage feels comfortable. If he complains of tingling, itching, numbness, or pain, loosen the bandage.
When wrapping an extremity, anchor the bandage initially by circling the body part twice. To prevent the bandage from slipping out of place on the foot, wrap it in a figure eight around the foot, the ankle, and then the foot again before continuing. The same technique works on any joint, such as the knee, wrist, or elbow. Include the heel when wrapping the foot, but never wrap the toes (or fingers) unless absolutely necessary because the distal extremities are used to detect impaired circulation.
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