Slings are used :
1. To afford support or rest to an upper limb.
2. To prevent the weight of an upper limb pulling on or moving the chest, shoulder or neck.
TYPES OF SLING
Arm Sling : This helps to support the forearm and hand in cases of fractured ribs, wounds and injuries of upper limb and fracture of forearms when splints are being used.
Application of an Arm Sling : Face the casualty and put one end of a spread out triangular sheet or bandage over his shoulder on the sound side with the point towards the injured side. Pass it around his neck so that it appears over the shoulder of the injured side and let the other end hang down in front of the chest. Carry the point behind the elbow of the injured limb and place the forearm over the middle of the bandage so that it is at right angles of the upper arm; then carry the second end up to the first and tie them in the hollow just above the collar bone. Tuck the bandage into the back of the elbow, bring the point forward and secure it with a safety pin to the front of the bandage.
The base of the bandage should be at the root of the little finger so that all the finger nails are exposed. A bluish tinge of the finger nail indicates that their is a dangerous constriction interfering with the circulation in the upper limb.
Collar and Cuff Sling :
It helps to support the wrist by clove hitch bandage. To apply a collar and cuff sling bend the casualty’s elbow and lay his forearm across the chest with his fingers touching his opposite shoulder. Pass a “clove hitch” around his wrist and tie the ends of the bandage in the hollow just above the collar bone on the injured side.
A “clove hitch” is made by taking a narrow bandage and making a loop. Make a second loop and lay it on top of first, then lay the top loop behind the first without turning.
It helps to keep the hand well raised and is applied in cases of fractured collar bone. Place the casualty’s forearm across his chest so that his fingers point towards the shoulder and the centre of the palm rests on the breast-bone. Lay an open bandage over the forearm with one end over the hand and the point well below the elbow. Steady the limb and tuck the base of the bandage well under the hand and forearm so that the lower end may be brought under the bent elbow and then upwards across the back to the uninjured shoulder, where it is tied in the hollow above the collar bone. The loose point of the bandage is then tucked well in between the forearm and bandaged in front and the fold thus formed is turned backwards over the lower part of the upper arm and pinned.
Slings may be improvised in many ways; for e.g., by pinning the sleeve to the clothing; by turning up and pinning the lower edge of the coat; by passing the hand inside the buttoned coat, jacket or waistcoat. Scarves, ties, belts or tights etc. can also be used as slings.
Roller bandages are made of various materials like cotton or linen with loose mesh and are of various lengths and widths according to the use to which they are put. They are used in hospitals and first-aid posts.
Use of Roller Bandage
• To keep dressing in position.
• To apply pressure to control bleeding.
• To support a sprain.
Part bandaged Width of bandage
Fingers 1 inch (2.5 cm)
Hand 2 inches (5 cm)
Head and Arm 2-2 1/2 inches
Leg 3-3 1/2 inches
Trunk 4-6 inches
Basics of application :
1. Face the casualty.
2. The roller bandage should be rolled tightly and evenly.
3. When partly unrolled, the roll is called the head (or drum) and the unrolled part the free end (or tail).
4. Hold the head of the bandage in the right hand when bandaging a left limb or vice versa.
5. Apply the outer side of the free end to the part and where possible lock it in position by a superimposed turn.
6. Bandage firmly from below upwards and from within outwards over the front of the limb.
7. Apply each layer of the bandage so that it covers two-third of the preceding one.
8. See that the bandage is neither too tight nor too slack.
9. Secure the bandage by a safety pin or other suitable method such as adhesive strapping.
The rolled part is called Head and the unrolled portion is called Tail.
There are four major methods of application of roller bandage : Simple Spiral : This can be used when the part to be bandaged is of uniform thickness as, for instance, the finger or wrist and a short portion of the forearm above it. The bandage is rolled in a spiral direction.
Reverse Spiral : This is done by a number of spiral turns in which the bandage is reversed downwards upon itself at each circuit of the limb. This is used in bandaging parts of the limbs, where, owing to their varying thickness, it is impossible to make a simple spiral lie properly, like the leg, forarm etc.
Figure of Eight : It is applied by passing the bandage obliquely round the limb, alternately upwards and downwards, the loops resembling the figure 8. It is used for bandaging at or in the neighbourhood of a joint such as knee or elbow. It can also be used instead of a reverse spiral for a limb.
Spica : This is a modified figure of 8 used for bandaging the hip, shoulder, groin or thumb.
BANDAGING SPECIAL BODY PARTS
1. Hand Bandage : Fix the bandage by a turn around the wrist, with the palm held downwards, and carry the roll obliquely over the back of the hand to the side of the little finger. Carry the bandage round the palm encircling the fingers with one horizontal turn, so that the lower border of the bandage just reaches the root of the nail of the little finger. Carry the bandage once more round the palm and then return obliquely to the wrist. The figure of 8 turns around the wrist and hand are repeated until the hand is covered and the bandage is then finished with a spiral turn round the wrist.
2. Elbow bandage : Bend the elbow at right angles. Lay the outer side of the bandage on the inner side of the joint and take one straight turn, carrying the bandage over the elbow tip and round the limb at the elbow level. The second turn is made to encircle the arm, and the third to cover the forearm, each of the turns made to cover the margins of first turn. Continue the turns alternately below and above the first turn.
3. Finger bandage : With the palm downward fix a one-inch bandage by two circular turns round the wrist, leaving the end free for tying off afterwards. Carry the bandage obliquely over the back of the hand to the base of finger to be bandaged, taking the fingers in order starting from the little finger side. Take one spiral turn to the base of finger nail and then cover the finger by simple spiral turns. Now carry the bandage across the back of the hand to the wrist and complete it with one straight turn round the wrist. Secure the bandage by a safety pin or by tying the two ends of the bandage together. If more than one finger is to be bandaged, take a turn round the wrist between each two fingers, and continue as above until the bandage is complete.
4. Shoulder bandage : Place a small pad of cotton wool under each armpit. Take a 3-4 inch bandage and fix it with two spiral turns round the upper part of the arm. Make 2 or 3 reverse spiral turns round the upper arm until the bandage reaches spiral turns round the upper arm until the bandage reaches the point of the shoulder, then carry the bandage over the shoulder, across the back and under the opposite armpit. Bring it back across the chest a arm, round under the armpit and over the shoulder again, cover two-thirds of the previous turn. This forms a figure of 8 round I arm and the body, and the turns are repeated until the WIK shoulder is covered.
To check circulation after bandage
Sometimes with tight bandage, circulation is obstructed down below and the casualty experiences tingling or lack of feeling in his or her fingers or toes. Casualty may be unable to move his or her fingers or toes, toe nail beds may be pale or blue and become cold. Hence, the circulation is to be checked.
(1) In case of upper limbs, the radial pulse in hand is to be checked. If no pulse the bandage is too tight.
(2) In case of lower limb, the pulse of the feet at the ankle joint on the inside of the leg to be felt. If no pulse the bandage is too tight.