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What are the dressing methods for the wounded?

Bandage is one of the important first aid measures for post-earthquake trauma patients. Timely and correct dressing can achieve the purposes of compression and hemostasis, reducing infection, protecting wounds, relieving pain, and fixing dressings and splints. On the contrary, the wrong dressing will lead to increased bleeding, aggravated infection, new injuries, sequelae and other adverse consequences.

When dressing a wound, you should know whether there is any internal injury. At the scene of trauma first aid, we can't just dress the superficial wounds and ignore other internal injuries.

It's also a wound on the limb. Whether there is a fracture or not, the dressing method is different. When there is a fracture, the correct fixation of the fracture site should be considered when dressing. It's also a physical wound. If internal organs are found to be damaged, such as liver rupture, intra-abdominal bleeding, hemothorax, etc. Priority should be given to the treatment of internal organs injury, and time should not be delayed when dressing body surface wounds; The same head trauma, such as craniocerebral injury, is not simply bandaged to stop bleeding, but also needs monitoring. For the wounded who are shot in the head, even if they feel good, they need to be observed for 24 hours. If there is head swelling, headache aggravation, or even nausea and vomiting, it means that there is intracranial injury and it needs urgent treatment.

Therefore, before dressing the obviously visible wound of the injured, it is necessary to know whether there is any injury in other parts, especially whether there is hidden visceral injury. In the case of bleeding, the application of wound dressing must be based on hemostasis. If the bleeding is not stopped in time, it may cause serious blood loss, shock and even life-threatening. In view of the different situations of arterial bleeding and venous bleeding, temporary measures such as finger pressure hemostasis and tourniquet hemostasis were taken to temporarily stop bleeding, and then they were sent to the medical point or waited for rescuers to come for treatment.

Bandages and triangular towels are the most common dressing materials. If there is no special bandage and triangular towel, clothes, sheets and towels can be torn into strips instead of bandages, or clothes and sheets can be cut into triangular towels. Bandage is generally used to fix limbs and joints, or to fix dressings, splints, etc. Triangular bandage dressing is mainly used for dressing and suspending injured limbs.

Bandage dressing methods include ring method, spiral method, spiral reverse folding method, snake method, eight-character method, return method and so on.

1. ring method: usually used to wrap the wrist and parts with roughly equal thickness, such as chest and abdomen. Wrap the bandage in a circular overlapping way, with the first circle slightly inclined, and the second and third circles annularly press the first circle, cut two strips of cloth at the end of the bandage, and tie the knot after winding the limb.

2. Spiral method: suitable for forearm, finger, trunk and other places. It is mostly used to wrap limbs with roughly equal thickness and large area injury. Make the bandage spiral upwards, and press it at 1/2 of the previous one in each turn.

3. Spiral reverse folding method: mostly used in forearm and thigh. From bottom to top, do spiral winding first. When it becomes thicker, fold the bandage backwards in each turn to cover 1/3~2/3 of the previous turn.

4. Serpentine method: mostly used for fixing between splints. After winding the bandage in a circle for several times, it is wound obliquely at regular intervals and then tied in a circle at the end.

5. "8-character" method: it is mostly used for dressing shoulders, ilium, knees and condyles. This dressing method is to wrap the bandage up once and then down once. Each lap spans the previous lap and is covered at 1/2 of the previous lap.

6. Return method: This method is mostly used for head and broken limbs. Fold the bandage back and forth many times. The first turn usually starts from the middle, and then each turn is wound from left to right until it is completely wound. The folded ends are wrapped and fixed by circular winding.

Triangle towel mainly adopts different dressing methods according to different dressing parts.

1. Face dressing method: tie a knot at the top corner of the triangle, then put the top corner on the top of the head, wrap the face in the center of the triangle, cut holes at the ears, eyes, nose and mouth, pull the left and right bottom corners to the back of the neck to cross, and then tie a knot around the forehead.

2. Head dressing method: put the midpoint of the bottom edge of the triangle towel on the forehead, wrap the two bottom corners around the back of the head, wrap the ears around the forehead after crossing, and tie the knot tightly. Finally, embed the top corner into the bottom edge, fold it up and tie it.

3. Abdominal dressing method: put the bottom edge of the triangle towel horizontally on the upper abdomen, pull the two bottom corners to the back and tie a knot near the waist, with the top corner facing down, connect a small belt at the top corner, pull the top corner from between the legs to the hip and tie it with the bottom corner tied at the waist.

4. Hand bandaging method: put the palm in the center of the triangle towel and cover the vertex angle on the back of the hand. The two bottom corners are intertwined on the back of the hand, and the top corner is folded back at the intersection, and then the two bottom corners are intertwined on the wrist to press the top corner to tie a knot.

5. Foot dressing method: put the foot in the center of the triangle towel, lift the top corner and fold it back to cover the instep, lift one bottom corner and fold it to the other side of the foot, tie it around the ankle with the top corner, and then lift the other bottom corner and tie it around the ankle.

In addition to mastering the dressing methods of bandages and triangular towels, it is of great practical significance to know the dressing methods and taboos of some special wounds for saving the lives of the wounded after the earthquake and preventing wound infection and limb necrosis caused by wrong dressing.

When dressing abdominal trauma, you can wet the patient's lips and tongue with a wet cloth, which will make the patient feel much better. If the intestines of the wounded flow out of the abdominal cavity, protect them and keep them moist. Don't try to reset, it will bring trouble to the operation after rescue. If the internal organs are not exposed, the wound should be cleaned and bandaged. When the abdominal organs overflow, the wounded should take the supine position, bend the lower limbs and relax the abdomen to reduce the pressure in the abdominal cavity. Cover the fallen viscera with a clean dressing, then wrap the fallen viscera with a thick dressing or a wide belt (or a clean bowl), and then wrap it.

If an open pneumothorax is formed due to chest injury and perforation, the chest will expand when inhaling, and air will enter the wound, causing lung failure, which is one of the biggest dangers of chest injury. At this time, the wound should be covered with the palm of your hand in time to prevent air from entering when inhaling, and the chest wall wound should be closed as soon as possible to turn the open pneumothorax into a closed pneumothorax. Let the wounded lie on his back with his head and shoulders tilted to the injured side. Use multiple layers of gauze or cotton as a pad, and bandage it under pressure; Or block the wound with plastic cloth or aluminum foil and wrap it with a triangular towel.

Head injury may damage the brain, and the wound may also affect normal breathing and diet. To ensure that the root of the tongue will not touch the throat and make breathing smooth, it is necessary to pull out the fallen dentures or broken teeth to control bleeding. Sober patients can sit and lie down. Coma patients must lie on their side according to their recovery posture without damage to their neck and spine. If the brain tissue bulges, it should be covered with sterile gauze, then folded into a circle with gauze and placed around the brain tissue (it can also be buckled with a clean porcelain bowl), and gently wrapped and fixed with a triangular towel or bandage.

In addition, special attention should be paid to dressing wounds, and clean and pollution-free cloth should be used to dress them; The action should be quick and accurate, and it should not aggravate the pain, bleeding or wound pollution of the wounded; Dressing should not be too tight or too loose, too tight will affect blood circulation, too loose will make dressing fall off or move; When the limbs are bandaged, it is best to expose the finger (toe) end to the outside so as to observe the blood circulation; When bandaging with a triangular scarf, the angle should be tightened, the bandaging should be firm, and the knot should be firm; Don't tie a knot in the wound or back to avoid aggravating the pain.