开放性伤口的止血包扎(Hemostaticbandageforopenwound)

开放性伤口的止血包扎（Hemostatic bandage for open
wound）
开放性伤口的止血包扎(Hemostatic bandage for open wound)
Hemostatic bandage for open wound
[indications]
It is suitable for emergency hemostasis and bandaging under various kinds of bleeding, especially for emergency treatment of massive hemorrhage. It can stop bleeding, protect wound, fix dressing, reduce pollution, fix fracture and joint, reduce pain.
Preoperative preparation
1. understand and familiar with the patient's condition. Explain the disease with the patient or family member, do well the explanation work, and strive for the coordination of sober patients.
2. disinfection supplies, sterile gauze, cotton pad, bandage, triangular towel, tourniquet, etc., can also be clean towels, handkerchiefs, cloth, clothing and other alternatives.
[operation steps]
Hemostatic method:
L. compression bandaging method is the most commonly used emergency hemostasis method. Cover the wound with dressing and bandage it with bandage.
2. blocking hemostasis with sterilized gauze, cotton pad and
other dressings blocked in the wound, and then bandage, triangular bandage or four bandage pressure bandage, tightness to achieve hemostasis is appropriate. Commonly used in the neck, buttocks and other deep wounds.
3. pressing the finger to stop bleeding, pressing the upper end of the blood vessel with finger, that is, near the end of the heart, to make the blood vessel closed and block the blood flow to achieve the purpose of hemostasis. Emergency treatment of arterial bleeding in head, face, neck and extremities.
The 4. buckling padded arm or leg of the hemostasis of bleeding, can be placed in the cotton yarn pad, towel or clothes or other items in the popliteal fossa, buckling joint, with a sling or tape as figure 8 fixed. Pay attention to fracture or joint dislocation can not be used, and at the same time, so that the pain of the wounded is greater, should not be preferred.
5. tourniquet hemostasis method is suitable for limbs big vessel rupture or other first aid hemostasis invalid. Including: Rubber tourniquet method: used tourniquet or length of LM rubber tube, first in the position of the tourniquet pad a layer of cloth or clothing, and then to the left finger, index finger, middle finger to the other end of the lead hemostasis, hand wound limb tourniquet wrapped around 2 to 3 ring, and a rubber tube end pressure in the tightly wound rubber tube fixed; the bear hemostasis: first aid available cloth, rope, sling or towel instead of rubber tube, the first pad pad, the pad body belt in a
circle around the knot, wearing a short rod in a knot, rotate the short rod of the belt tightening, not to bleed so far, the short rod is fixed on the body.
Bandaging method:
1. bandaging method is mainly used for dressing and dressing and splint fixation of limbs, hands and feet wounds. Including: Circular bandage - mainly used for the wrist and neck; figure 8 - bandaging method used for dressing near the joint; spiral bandaging method - mainly used for upper limb and thigh; herringbone bandage - for the forearm and lower leg.
2. bandage bandage method according to different parts of the wound, using different bandage bandage method, there are common:
(1) the head wound by capeline method, the triangle edge folding width of about 3cm, the median on the brow upper, top to bottom pull occipital, through ear backwards in the occipital cross and pinned angle by ear, round to ebula knot, upward folding angle to the bottom or with pins.
(2) the top of the head, facial or occipital wounds: the triangle vertices on the forehead knotted, the knot on the midpoint of occipital horns, the tight wrap around to the jaw, occipital tubercle knot, called hood type bandage.
(3) a wide range of facial mask: the wound dressing method, the triangle vertices knot, placed on the jaw, put on the bottom cover face, tighten the two corner to the occipital cross, then raozhi forehead
knotted, bandaged according to the injury in the eyes, nose and mouth cut hole.
(4) head, eye, ear trauma: use head eye bandaging method. The
triangle in the bottom knot on the bridge of the nose, two are pulled to the ear, occiput posterior cross raozhi forehead knotted, reflexed upward fixed angle.
(5) unilateral eyeball injury: unilateral bandaging was used. Fold the triangle towel into 4 finger wide bands, cover the upper 1/3 of the band, lower the 2/3 from the ear to the occiput, and then pass it up to the forehead,
Press the other end, and finally tie the wound around the ear, and
tie the pillow to the healthy mouth.
(6) binocular injury; double bandaging method. First, the middle
part of the belt is pressed down, and the lower end is from the ear to the pillow, and then the upper end is pressed from the upper ear to the forehead, and the upper end is bent downward to press the other eye, and then to the back of the ear, the pillow, and the knot on the opposite side of the mouth. (7) wounds of the lower jaw, ear, forehead or temporal region: the lower tie type bandaging method. The towel is extended through the ear or the temporal part, and the long end is connected with the top, then the temporal part and the short end are crossed, and the two end is wrapped around the head and knotted in the opposite side of the temporal region.
(8) shoulder wounds: bandage with shoulder triangle bandage, swallow tailed bandage or sleeve shoulder bandaging. Dovetail type bandage: the triangle folded dovetail type on the injured side, back angle is
slightly larger than the forward angle, two corner armpit in the injured side knot, two dovetail angle cross
to the contralateral to the neck, armpit knot.
(9): forearm sling sling suitable for forearm trauma or fracture, large span forearm methods: triangle flat on the chest, angle in
parallel with the injured limb elbow flexion, the injured limb, filed a triangle bottom ends on the back of the neck tie, top to the chest outside the fold, with pins. The forearm sling is suitable for small clavicle, humerus fracture, shoulder joint injury and arm injury, methods: the triangle folded ribbon, placed in the center of l/3 in the injured side of the forearm, ends in the neck tie, will be suspended in front of forearm.
(10) chest and back wounds: including single chest bandaging method, chest back swallow tailed bandage method, chest and back double dovetail bandage method.
(11) abdominal wounds, including abdominal pocket bandaging and abdominal swallow tailed bandaging.
(12) buttock wound: single buttock bandaging method. Two a triangle,
a triangle cover hip injury, upward angle, bottom folded into two finger width in the thigh around the end; another is folded into a triangle
strip on the triangle vertices around the waist, a week end, finally the triangle vertices back with pins.
(13) limb bandaging: fold the triangle towel into a proper width and wrap it around the wound.
(14) bandage of hand (foot) triangle bandage: put hands or feet
on the triangle towel, vertical with the bottom, reverse the
triangle scarf vertex angle to hand or foot back, bottom winding knot.
3. four bandage method is mainly used for the nose, mandible, forehead and posterior head trauma.
4. sheets, clothes wrapped towels fly with operation.
5. special injury bandaging
(1) open craniocerebral injury: the bowl clean the wound, or
dressing or other clean cloth made bigger than the wound ring, put around the wound, and then bandage, lest when wrapping the fracture in the skull, while protecting the brain swelling.
(2) open pneumothorax: such as chest trauma with pneumothorax, small wounds with tight bandage, blocking the gas from the wound. It can be covered with thick dressing or plastic cloth first, then bandaged with gauze pad or towel pad. If the wound is larger or the chest wall defect is more, it can be packed and compressed with gourd shaped gauze. First, a pair of Vaseline gauze was used to fill the chest cavity through the wound, then the central part was filled with dry gauze, and the dressing was used. The adhesive plaster was used to press and fix.
(3) rib fracture: chest trauma with multiple rib fractures, clothing, pillows and other pressure bandaging injury side, in order to curb the chest wall floating, if necessary, the wounded side lying on the injured side. The single rib fracture with a wide tape fixed: 3 ~ 4 with tape, each 7 ~ 8cm wide and 2/3
for chest circumference length, maximum expiratory fixed on the patient, from the contralateral shoulder forward to contralateral midclavicular line, on tape overlap 2~3cm.
(4) open fracture and bone end exposure: the exposed fracture ends should not be accepted when bandaging.
(5) abdominal trauma and visceral prolapse: prolapsed organs can not accept, when wrapping the buckling legs, relax muscles, will emerge with a large internal sterile gauze cover, and then a clean bowl, spoon, concave shape buckle,
Or with gauze, cloth roll, towel and so on, make a circle shape, in order to protect the internal organs, and then bandage fixed.
[notes]
1. quickly expose the wound and check, take first aid measures.
2. patients with proper conditions should be treated properly, such
as cleaning oil around the wound, local disinfection, etc..
3. the use of tourniquet must be wrapped in the proximal end of the wound; local administration of cloth or unlined skin protection; should raise the limb for 2 to 3 minutes before tourniquet in venous blood, in order to increase the centripetal flow; must be marked every tourniquet
time, and every 45 to 60 minutes to relax tourniquet time, every time to relax the tourniquet time was 3 to 5 minutes before the release of the tourniquet application hand compression artery proximal
to the tourniquet; elastic should be appropriate, to stop bleeding, the distal touch pulse as well.
4. bandage materials, especially the gauze covering the wound should be strictly sterile, no sterile dressing, as far as possible the use of relatively clean materials, such as clean towels, cloth and so on.
5. the bandage can not be too tight or too loose, knot or fixed
parts should be in the outer side of the body or front.。