The essentials of bandaging /

by Berkeley Hill

THE TRUNK.

To bandage the Breast.

Apparatus.—1. A roller 3 inches wide and 8 yards long.

The roller is first carried once round the body below the breast, beginning in front and passing towards the sound side. When the bandage is fixed, the roller ascends over the lower part of the diseased breast, to the opposite shoulder, and comes back by the arm-pit to the horizontal turn; it is then passed round the chest to fix the oblique turn. Having done this, it again is carried up over the breast and shoulder, and round the body in alternate turns until the breast is fully compressed, each turn over the breast being carried higher than the preceding one, and each turn round the body overlapping the oblique turn to keep it in place (see fig. 7).

Fig. 7.—Bandage for a Breast.

To bandage both Breasts.—This is readily done by first bandaging one breast and then, carrying the roller over the shoulder of the side already bandaged, bringing it across the sternum and under the second breast on to the horizontal turns, which it follows alternately with the oblique ones, as was done in bandaging the first breast. The only difference is, that in compressing the first breast the bandage was passed obliquely upwards, for the second it is carried obliquely downwards over the breast.

Spica Bandage.

Apparatus.—1. A roller or 2½ or 3 inches wide.

2. Some pins.

Fig. 8.—Spica for the Groin.

Lay the end on the groin to be bandaged, carry the roller between the great trochanter and the crista ilii round the pelvis to the other side, passing there also between the crista ilii and trochanter; next take the roller downwards in front of the pubes to the injured groin, then outwards round the thigh below the trochanter to the gluteal fold, and pass it up between the thighs to the groin, where the figure of 8 is completed. A second and a third are to be passed in the same way, carrying them exactly one over the other, round the body and below the buttock (see fig. 8); at the groin they should overlap, each lying a little above the preceding turn. A pin, when the necessary number of turns is completed, fastens down the end.

Hernia Spica.—The spica bandage is usually required to keep dressings and compresses in place over wounds after operation for strangulated hernia, sinuses, &c., in the groin; when the figure of 8 has been put on the first time it may be cut across in front; and, the dressings being changed, the ends may be fastened together by pins. If additional strips are laid across and fastened to the figure of 8 underneath, the required pressure is obtained, and much tedious lifting of the patient is saved (see fig. 9.)

Fig. 9.—Hernia Spica.

Body bandage for tapping the Belly in Ascites.—This is made of two thicknesses of stout flannel, 2 feet wide in the middle, where it forms a continuous sheet for 18 inches, but beyond that it is split into 3 tails, 6 inches wide and 3 feet long. In the middle line, 4 inches below the centre, is a round hole 2 inches across, through which the surgeon reaches the skin to insert the trocar.

When in use, the middle of the bandage is placed in front with the hole in the mesial line of the body, and midway between the umbilicus and pubes; the ends of the right side are passed behind the back to the left, interlacing with those from the left side. When all is ready, an assistant standing on each side of the bed pulls steadily on the ends to keep up continuous pressure on the abdominal viscera as the fluid escapes. After the fluid is evacuated the ends are wound firmly round the body in front, while the puncture in the wall of the belly is closed by a fold of lint attached with a strip of plaster.

The T Bandage is used to apply dressings, compresses, &c., to the anus or perinæum. A roller 3 inches wide is fastened by a couple of turns round the pelvis, and then fixed by a pin at the middle line in front. From this point the roller is carried tightly over the dressings to the corresponding point behind, and returned once or twice more until sufficient pressure is gained, when it is fastened off.

The Strait Jacket is made of jean or stout canvas. It is cut long enough to reach below the waist, around which a strong tape is carried to be drawn tight and tied after the jacket is put on. The sleeves are several inches longer than the arms, and their ends can be drawn close by a tape which runs in the gathers; a similar tape confines the garment round the neck, and it is tied behind by tapes down the sides. When the jacket is to be put on a patient it is first turned inside out, then one of the nurses or assistants thrusts his own arms through the sleeves, and facing the patient, invites him to shake hands; having thus obtained possession of the patient’s hands he holds them fast while a second assistant, standing behind the patient, pulls the jacket off the first assistant on to the patient, whose hands are thus drawn through the sleeves before he perceives the object of the manœuvre; the jacket is next tied round the neck and behind, the tapes of the sleeves are carried round the body, drawn tight till the arms are folded across the chest, and fastened to the bed on each side, or tied round the body.

Manacles for Delirious Patients.—Instead of the strait jacket a double leathern muff is now generally used to restrain unruly patients. It irritates them less, and is far more easily applied.

Fig. 10.—Manacles for confining the arms of delirious patients.

In wearing it the arms are crossed in front, and a strap drawn tight round both wrists. Each hand is thrust into a stout leathern glove, or muff, connected with the wrist-strap, and capable of being tightened over the fingers by a strap and buckle across the glove.

To suspend the Testicles.—Suspensories are made specially for this purpose. The best are fastened round the neck by a loop of elastic tape, but a very efficient one can be improvised with a pocket handkerchief and a piece of bandage. The bandage is tied tightly round the hips for a girdle, the handkerchief is folded three-corner wise, and its longest side slipped behind the testes, the ends being passed over the girdle (see fig. 11), and tied again behind the scrotum. The loose apex of the handkerchief is drawn up in front over the girdle and pinned to it, which is all that is required (see fig. 12).

Fig. 11.—Shawl Suspensory for the Testes, in the first stage of application.

Fig. 12.—Suspensory for Testes completed.

When the patient is recumbent, the testes may be supported by a strip of diachylon plaster 2 feet long and 4 inches wide, passed across from hip to hip underneath the scrotum and testes, which lie supported on a shelf.

Another way of raising the testes is to place a soft pincushion between the thighs, and allow the swollen gland to rest on the cushion.