THE HEAD.
Bandages for the Head.—A roller is commonly applied in three different ways to the head. 1st. For keeping simple dressings in place.
Apparatus.—1. A roller 2 inches wide, and of the usual length.
2. Some pins.
A turn is first carried round the head, over the brows and below the occipital protuberance, and fastened by a pin; this being done, the roller is carried across the dressing, and getting into the line of the first turn, is passed round the head again, then across the dressing, and round the head by horizontal and oblique turns alternately, the former to fix the latter, and prevent their slipping off the dressing (see fig. 2). In the figure the oblique turns have been doubled, and would fix dressings on each side of the head.
Fig. 2.—Bandage for retaining dressings in position, showing two sets of oblique turns.
Knotted Bandage.—This is used when pressure on the superficial temporal artery is required.
Apparatus.—1. A roller 8 yards long, 2 inches wide, one-third being rolled into one head, the rest into another head.
2. Some lint.
3. A piece of a wine cork one-third of an inch thick.
4. Needle, thread, and pins.
The cork is folded in a double thickness of lint; over this are placed six or eight more folds of lint of gradually increasing size, and the whole are kept in shape by a stitch passed through them and through the cork. This forms a graduated compress, and is then laid on the wound small end downwards.
One head of the roller is taken in each hand, its middle laid over the compress on the injured temple, say the right; the ends are carried round the head, one just above the eyebrows to the left temple, and the other backwards below the occipital protuberance, to the same point; the ends are then crossed and changed from one hand to the other to be brought to the wounded temple. Here they are again tightly crossed, one end being carried under the chin and by the left side to the vertex, there meeting the other end, which has passed over the head, in the opposite direction (see fig. 3); at the right temple the ends are again crossed or “knotted,” but this time they are passed horizontally round the head. Having done this the ends are pinned and cut off, or if necessary the knots repeated before fastening; the first pair, if tightly drawn, usually suffice as well as several.
Fig. 3.—Knotted Bandage.
The Capelline Bandage is rarely required, but is used when the restlessness of the patient renders it difficult to keep dressings or ice-bags in place.
Apparatus.—1. A double-headed roller, 2 inches wide and 12 yards long.
2. Some pins.
Fig. 4.—Capelline Bandage.
The middle of the roller is laid against the forehead just above the brows, and the ends passed behind the occiput, where they are crossed, and while one continues the circular turns round the head, the other head of the bandage is brought over the top along the middle to the front, passing under the encircling turn, which fixes it. It is then carried back to the occiput, on one side of the first transverse band, when again fixed behind by the circular band it is brought forward on the opposite side of the first, and fixed in front. This arrangement is repeated until the head is covered in a closely fitting cap (see fig. 4).
In beginning this bandage, it is necessary to keep the first circle low down, close to the brows in front, and below the occipital protuberance behind, or the cap will not fit firmly over the skull.
A Shawl Cap is readily improvised with a silk or cambric handkerchief folded diagonally into a triangle; the base of the triangle is then carried over the brow, the apex let fall behind the occiput, where the ends cross, and catching in the apex, come round to the front to be tied on the forehead.
Fig. 5.—Shawl Cap.
The Four-tail Bandage.—Instead of applying the handkerchief in the manner just described, it may be split from each end to within six inches of the middle, and so converted into a broad four-tail bandage; the middle is laid on the top of the head, the hinder ends tied under the chin, and the forward ones behind the nape of the neck (see fig. 6). Or a piece of calico, 1½ yards long and 4 or 6 inches wide, is split from each end 3 inches short of the centre—one pair of tails being rather wider than the other. If used on the face, the middle is put against the point of the chin, the two narrow tails are carried backwards to the nape, crossed, and pinned together on the forehead above the brows. The two broader tails are carried upwards in front of the ears, where they turn round the two narrow tails, to be either tied or pinned at the vertex. Four-tail bandages are used elsewhere, as in the axilla, to keep poultices in place, &c.
Fig. 6.—Four-tail Bandage.
To retain Ice Bladders on the Head.—This is done by folding a thin napkin over the bladder, which is then laid against the head or part to be kept cool, and the ends of the napkin are pinned tightly down to the pillow at each side. In this way the bag cannot slip, and its weight is at the same time prevented from pressing on the head.
To compress the Jugular Vein after bleeding.—After venæsection of the external jugular vein it is requisite to keep a compress of lint on the wound. This is done by fastening the bandage on the neck with two simple turns, then carrying it in a figure of 8 round the neck, over the compress and under the axilla of the opposite side, then round the neck again; if the figure of 8 is passed pretty firmly, sufficient pressure is made in this way without interfering with the circulation through the vessels, and the turns round the neck of course must not be tight.