What is the pressure immobilization technique for venomous bites. How effective is it for different types of envenomation. Why is its use controversial for North American snakebites. What are the key considerations in applying this first aid method.

The Pressure Immobilization Technique: An Overview

The pressure immobilization bandage (PIB) technique, also known as pressure immobilization with bandaging (PIB), is a first aid method developed for managing certain types of venomous bites and stings. This technique involves applying a firm bandage over the bite site and immobilizing the affected limb to slow the spread of venom through the lymphatic system.

How does the pressure immobilization technique work? The method aims to create enough pressure to impede lymph flow without restricting arterial or venous blood flow. Typically, this involves wrapping an elastic bandage around the entire length of the bitten limb, starting from the bite site and moving towards the body. The pressure should be firm but not tight enough to cut off circulation.

Recommended Pressure Levels

• Upper extremity: 40-70 mm Hg
• Lower extremity: 55-70 mm Hg

A practical guideline for correct pressure is that the bandage should be comfortably tight and snug, allowing a finger to be slipped underneath it. Following bandaging, the affected limb should be immobilized using a splint or sling to further reduce movement and slow venom spread.

The Origins and Intended Applications of PIB

Where did the pressure immobilization technique originate? The method was initially developed in Australia in the 1970s, primarily for dealing with bites from highly neurotoxic snakes such as the taipan and tiger snake. These snakes produce venoms that primarily affect the nervous system, and delaying venom absorption can be crucial in preventing rapid onset of life-threatening symptoms.

For which types of envenomations was PIB originally designed? The technique was intended for use with:

1. Neurotoxic snake bites (e.g., Australian elapids)
2. Box jellyfish stings
3. Blue-ringed octopus bites

These envenomations share the characteristic of producing primarily neurotoxic effects, where delaying systemic venom absorption can potentially prevent or delay the onset of severe symptoms like respiratory paralysis.

Controversy Surrounding PIB Use for North American Snakebites

Why has the recommendation of PIB for North American snakebites caused concern among toxicologists? The crux of the controversy lies in the significant differences between the venoms of Australian elapids and North American pit vipers (Crotalinae subfamily).

What are the key differences in venom composition and effects?

• Australian elapids: Primarily neurotoxic effects
• North American pit vipers: Primarily cytotoxic and hemotoxic effects

The venom of North American pit vipers tends to cause local tissue damage, swelling, and coagulation disorders rather than the rapid neurotoxic effects seen with Australian elapids. This fundamental difference raises questions about the appropriateness and potential risks of applying PIB in North American snakebite scenarios.

Potential Risks of PIB in North American Snakebites

What are the concerns about using PIB for pit viper bites?

1. Concentration of cytotoxic venom components in local tissues, potentially exacerbating tissue damage
2. Masking the progression of local symptoms, which are important clinical indicators
3. Delaying or complicating assessment and treatment upon arrival at a medical facility
4. Risk of improper application leading to tourniqueting effects

These potential risks have led many toxicologists to advise against the routine use of PIB for North American pit viper bites.

The Science Behind PIB: Efficacy and Limitations

What scientific evidence supports the use of PIB? Several studies have demonstrated the effectiveness of properly applied PIB in delaying venom absorption and spread:

• Animal studies showing reduced venom absorption with PIB application
• Human volunteer studies using mock venom (radiolabeled tracer)
• Clinical case reports of successful use in Australian elapid bites

However, it’s crucial to note that most of this evidence pertains to neurotoxic venoms, particularly those of Australian elapids.

What are the limitations of the current evidence for PIB?

1. Limited data on efficacy for non-neurotoxic venoms
2. Lack of large-scale clinical trials in real-world settings
3. Variability in application techniques and pressure levels
4. Difficulty in maintaining proper immobilization in field conditions

These limitations highlight the need for caution when extrapolating PIB recommendations to different types of envenomations or geographic regions.

Current Guidelines and Recommendations

How do current guidelines address the use of PIB? The recommendations vary depending on the organization and geographic focus:

American Heart Association (AHA) and American Red Cross (ARC)

The 2010 AHA/ARC guidelines included a recommendation for PIB use in snakebites, stating:

“Applying [PIB] with a pressure between 40 and 70 mm Hg in the upper extremity and between 55 and 70 mm Hg in the lower extremity around the entire length of the bitten extremity is an effective and safe way to slow the dissemination of venom by slowing lymph flow (Class IIa, LOE C).”

However, this recommendation has been criticized for potentially overstating the evidence and not adequately distinguishing between different types of envenomations.

Position Statement on PIB for North American Crotalinae Envenomation

In response to the AHA/ARC guidelines, a joint position statement was issued by several toxicology organizations, including:

• American College of Medical Toxicology
• American Academy of Clinical Toxicology
• American Association of Poison Control Centers
• International Society on Toxinology
• European Association of Poison Centres and Clinical Toxicologists
• Asia Pacific Association of Medical Toxicology

This statement concludes that PIB cannot be recommended as pre-hospital care for North American pit viper bites, where non-neurotoxic envenomation is the norm.

Key Considerations in Applying PIB

What factors should be considered when evaluating the use of PIB in a given scenario?

1. Certainty regarding the species of snake involved
2. Expected time to arrival at a facility providing definitive care
3. Ability of lay individuals to distinguish between different envenomation scenarios
4. Likelihood of correct application and maintenance of PIB
5. Potential risks and benefits specific to the type of venom involved

These considerations highlight the complexity of applying a single first aid technique across diverse envenomation scenarios and geographic regions.

The Future of Snakebite First Aid: Balancing Evidence and Practicality

How should new recommendations in snakebite management be developed and implemented? The history of snakebite first aid is replete with once-popular techniques that were later abandoned due to lack of efficacy or evidence of harm. Examples include:

• Tourniquets
• Cryotherapy
• Incision and suction
• Electrotherapy
• Routine fasciotomy

This historical perspective underscores the importance of rigorous scientific evaluation before widely implementing new first aid techniques.

What steps are necessary to establish best practices in snakebite first aid?

1. Conduct large-scale clinical trials in relevant geographic areas
2. Evaluate both efficacy and potential risks of new techniques
3. Consider practical aspects of implementation by lay responders
4. Develop clear, context-specific guidelines that account for regional differences in venomous species
5. Provide comprehensive education and training for both medical professionals and the general public

By taking a cautious, evidence-based approach, the medical community can work towards developing first aid recommendations that are both effective and appropriate for specific envenomation scenarios.

The Role of Public Education in Snakebite Prevention and Management

How can public education contribute to better outcomes in snakebite cases? Effective public education programs can play a crucial role in both preventing snakebites and improving first aid responses. Key components of such programs might include:

Snake Identification and Avoidance

Teaching the public to identify venomous species in their area and understand snake behavior can significantly reduce the risk of bites. This education should emphasize:

• Recognizing common venomous species
• Understanding snake habitats and active seasons
• Proper behavior when encountering snakes in the wild
• Safe practices for outdoor activities in snake-prone areas

By fostering respect for snakes and promoting safe practices, many bites can be prevented altogether.

Appropriate First Aid Responses

What should the public be taught about snakebite first aid? Clear, region-specific guidelines should be provided, focusing on:

1. Keeping the victim calm and still to slow venom spread
2. Removing constricting items like jewelry or tight clothing
3. Positioning the affected limb below heart level
4. Seeking immediate medical attention
5. Avoiding harmful traditional remedies or outdated first aid techniques

In areas where PIB is recommended for certain types of bites, proper application techniques should be taught, along with clear guidance on when and when not to use this method.

Importance of Prompt Medical Care

Why is emphasizing the need for rapid medical attention crucial? Public education should stress that definitive treatment for venomous bites requires antivenom and supportive care in a medical facility. Key points to communicate include:

• The time-sensitive nature of antivenom administration
• The limitations of first aid in treating envenomation
• The potential dangers of delaying medical care while attempting home remedies
• The importance of providing accurate information about the snake and circumstances of the bite to medical personnel

By promoting rapid access to medical care, outcomes can be significantly improved for snakebite victims.

Technological Innovations in Snakebite Management

How is technology advancing the field of snakebite treatment and prevention? Several innovative approaches are being developed to address various aspects of snakebite management:

Venom Detection Kits

What are venom detection kits and how do they work? These portable devices aim to rapidly identify the type of venom present in a bite, potentially allowing for more targeted and timely treatment. Key features include:

• Use of immunoassay technology to detect venom-specific proteins
• Rapid results, often within minutes
• Potential to guide antivenom selection in areas with multiple venomous species

While promising, these kits are still in development and require further validation before widespread clinical use.

Smartphone Apps for Snake Identification

How can smartphone technology assist in snakebite scenarios? Several apps have been developed to help users identify snakes and access region-specific first aid information:

1. Photo-based identification using AI algorithms
2. Geolocation features to provide information on local venomous species
3. Access to emergency contact information and nearest medical facilities
4. First aid guidelines tailored to specific types of envenomation

These apps can be valuable educational tools and may assist in emergency situations, but should not replace professional medical advice.

Advanced Antivenom Development

What new approaches are being explored in antivenom production? Traditional antivenom production involves immunizing animals (typically horses) with venom, but new technologies are being investigated:

• Recombinant antibody technologies to produce more specific and consistent antivenoms
• Nanoparticle-based approaches to neutralize venom components
• Development of broad-spectrum antivenoms effective against multiple species
• Exploration of plant-based compounds with anti-venom properties

These advancements aim to produce safer, more effective, and potentially more affordable antivenom treatments.

Global Perspectives on Snakebite Envenomation

How does the global burden of snakebite envenomation vary across regions? Snakebite is a significant public health issue, particularly in tropical and subtropical regions. The World Health Organization (WHO) estimates that:

• Up to 5.4 million people are bitten by snakes each year
• 1.8 to 2.7 million cases of envenoming occur
• 81,000 to 138,000 deaths result from snakebites annually

However, the impact and challenges of snakebite envenomation differ significantly between regions.

Regional Variations in Snakebite Epidemiology

What factors contribute to regional differences in snakebite incidence and outcomes?

1. Distribution of venomous snake species
2. Human population density and agricultural practices
3. Access to healthcare and antivenom availability
4. Cultural beliefs and traditional practices
5. Effectiveness of public health interventions

Understanding these regional variations is crucial for developing targeted strategies to reduce snakebite morbidity and mortality.

The WHO Snakebite Envenoming Strategy

How is the global health community addressing the snakebite challenge? In 2019, the WHO launched a strategy to reduce snakebite-induced death and disability by 50% before 2030. Key components of this strategy include:

• Improving production, quality control, and regulation of antivenoms
• Ensuring affordable and timely access to safe, effective treatments
• Strengthening health systems to deliver better snakebite management
• Empowering communities through education and prevention programs
• Increasing partnerships, coordination, and resources for snakebite control

This global initiative recognizes snakebite envenoming as a neglected tropical disease and aims to mobilize resources to address this often-overlooked health crisis.

As we continue to advance our understanding of snakebite management, it’s clear that a multifaceted approach is necessary. This includes ongoing research into first aid techniques like pressure immobilization, development of new treatments and technologies, and comprehensive public health strategies tailored to regional needs. By combining scientific rigor with practical considerations and global cooperation, we can work towards significantly reducing the burden of snakebite envenomation worldwide.

Commentary: Pressure Bandaging for North American Snake Bite? No!

J Med Toxicol. 2011 Dec; 7(4): 324–326.

Published online 2011 Nov 8. doi: 10.1007/s13181-011-0188-9

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Author information Copyright and License information Disclaimer

This issue of The Journal of Medical Toxicology includes a position statement regarding the use of pressure immobilization for the pre-hospital treatment of North American Crotalinae envenomation. This commentary discusses the background behind the creation of the position statement and explores the issues involved in applying science to real-world public health recommendations and practice.

Keywords: Pressure immobilization, Crotalinae, Envenomation

This issue of The Journal of Medical Toxicology includes a position statement regarding the use of pressure immobilization for the pre-hospital treatment of North American Crotalinae envenomation [1]. It has been jointly endorsed by the American College of Medical Toxicology, the American Academy of Clinical Toxicology, the American Association of Poison Control Centers, the International Society on Toxinology, the European Association of Poison Centres and Clinical Toxicologists, and the Asia Pacific Association of Medical Toxicology, and concludes that pressure bandage with immobilization (PBI) cannot be recommended as pre-hospital care in areas such as North America, where non-neurotoxic snakebite is the norm.

This position statement was formulated because of concern about recently published first aid guidelines of the American Heart Association (AHA) and American Red Cross (ARC) [2]. Those guidelines, designed to be applied by bystanders or the victim, included the following:

“Applying [PBI] with a pressure between 40 and 70 mm Hg in the upper extremity and between 55 and 70 mm Hg in the lower extremity around the entire length of the bitten extremity is an effective and safe way to slow the dissemination of venom by slowing lymph flow (Class IIa, LOE C). For practical purposes pressure is sufficient if the bandage is comfortably tight and snug but allows a finger to be slipped under it. Initially it was theorized that slowing lymphatic flow by external pressure would only benefit victims bitten by snakes producing neurotoxic venom, but the effectiveness of pressure immobilization has also been demonstrated for bites by non-neurotoxic American snakes….”

Even though the AHA/ARC recommendation is weak (Class II: “conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment.” Class IIa: “weight of evidence/opinion is in favor of usefulness/efficacy”; level of evidence C: “recommendation based on expert opinion, case studies, or standards of care.”) [3] and meant to apply to snakebites worldwide, we are concerned that the recommendations will be applied to North American Crotalinae envenomations. We are also concerned that this guideline was graded above the level of current evidence and that the subtleties of the recommendation grading system are very likely to be underappreciated by most.

The pre-hospital use of PBI in North American snakebite would be a major change in how such cases are managed. The history of snakebite first aid and emergency care is full of concepts that, despite initial theoretical appeal and/or anecdotal evidence, ultimately proved to be harmful. Once-common practices, such as tourniquets, cryotherapy, incision, suction, electrotherapy, and fasciotomy, have been eliminated as their effectiveness was refuted, and more importantly, evidence of harm emerged [4–9]. With this perspective, the introduction of a new practice must be based on the scientific demonstration of efficacy and safety.

The application of science to real-world scenarios can be complex. The aim of PBI is to sequester venom in the limb, delaying its arrival into the central circulation and thereby delaying or even preventing the onset of the potential systemic consequences of envenomation [10]. Apart from directly measuring the clinical efficacy of PBI for various endpoints, together with risks of harm of properly applied PBI, it is important to consider context-specific considerations. Key questions are: (1) the certainty regarding the kind of snake involved, (2) the expected time to arrival at a place where definitive therapy can be provided, (3) whether lay individuals are able to distinguish between scenarios with different management considerations, and (4) the likelihood that PBI will be applied correctly or incorrectly and that immobilization can be realistically maintained.

In addition to these concerns, the larger questions include when, how, and on what basis should a new recommendation in the management of snakebite be put forward? Moreover, when universal benefit may not result, should first aid training be guided by utilitarian endpoints in which many patients might benefit by an intervention that harms some, or even worse, harms many patients and benefits few?

When evaluating the application of PBI to Crotalinae envenomations, the science is incomplete. Randomized, prospective, controlled, studies of PBI in human Crotalinae envenomations have not been performed. Our current state of knowledge comes primarily from animal models and a few studies in neurotoxic snakebite, where local tissue injury is not the major concern. This is an entirely different clinical problem to that posed by Crotalinae envenomations, where local tissue injury predominates. Furthermore, extrapolating from animal models to humans can be problematic, especially when animal studies have used fatality from systemic effects—rather than tissue injury—as a primary end-point. The data on tissue injury in animal studies is limited, but a porcine study demonstrated that tissue pressures in a range that would, in other contexts, result in the consideration of fasciotomy, and which might result in ischemic injury, can occur from PBI [11]. Recent studies in humans have demonstrated that both trained and lay individuals applied PBI that resulted in either ineffective or tissue pressures in the same range [12–14]. Finally, the porcine study of Crotalinae envenomation used in support of the AHA/ARC guidelines [2] actually drew the opposite conclusion, stating: “On the basis of our findings, we cannot recommend pressure immobilization widely for viper envenomation…” [11].

Thus the existing science points away from adoption of PBI in Crotalinae envenomation rather than towards it. Given that 98% of North American venomous snakebites are by Crotalinae, that fewer than 0.2% of those victims die, and that virtually all have soft-tissue injury, the key question is whether deploying pressure immobilization as a first aid strategy in this context will lead to a large number of people with increased and/or permanent limb injury while saving virtually no lives [15, 16]. Clearly, more work needs to be done. But our interpretation of the current state of knowledge is that the potential for harm of PBI in the vast majority of Crotalinae envenomations outweighs the potential benefits.

In the context of limited evidence, it is understandable that learned and well-intentioned individuals may disagree. This makes the consensus of toxicologists and envenomation specialists worldwide in opposition to the use of PBI in the prehospital setting all the more striking. The six organizations that endorse the position statement represent the mainstream medical opinion among experts on four continents. There is currently strong consensus that this technique should not be promulgated or taught in areas where non-neurotoxic snakebite predominates. Thus, in North American Crotalinae snakebite, the evidence for PBI would be more properly graded as Class III: “conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful [3].”

In response to criticisms from members of the clinical toxicology community, the AHA and the ARC have acknowledged that their guideline regarding snakebite does not define the snake groups, geographic locations, and individual circumstances in which PBI might be applicable and also that the data regarding PBI in Crotalinae envenomation are limited and insufficient to deem PBI safe and effective. They are planning to clarify the guideline. For future guidelines, content experts from the position-statement-sponsoring organizations will be invited to assist in the writing (Rose Marie Robertson, personal communication 2011). We applaud the AHA and ARC for their evidence-based approach and their ongoing process of review and clarification.

We agree with the conclusions of the position statement: “The use of pressure immobilization for the pre-hospital treatment of North American Crotalinae envenomation is not recommended [1].”

In the absence of definitive data on much of the pre-hospital management of Crotalinae snakebite, the following recommendations are based on the best available evidence, as well as expert consensus [17, 18]:

1. Get a safe distance away from the snake.

2. Remove jewelry and loosen tight-fitting clothing.

3. Loosely splint or otherwise immobilize the extremity in a functional position.

4. As a default action, maintain the bitten extremity in a neutral position with regard to the heart. Other potential actions should be guided by an experienced clinician.

5. Get to a hospital, preferably transported by an EMS provider. In general, supine positioning will prepare providers in managing possible effects such as hypotension and/or vomiting.

6. Avoid useless and/or potentially harmful interventions, such as tourniquets, incision, suction, cryotherapy, or electric shock.

Steven A. Seifert, Email: ude.mnu.dulas@trefiess.

Julian White, Email: [email protected].

Bart J. Currie, Email: ua.ude.seiznem@trab.

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Pressure Immobilisation First Aid : School of Biomedical Sciences

Bites to the lower limb

1. Move the victim away from the snake. Calm and reassure them. Jewelry such as toe rings and ankle bracelets should be removed before the bandage is applied.

Regardless of where on the limb the bite has occurred, commence bandaging from just above the toes (leave these uncovered so that blood flow to the nail beds can be monitored).

Crepe bandages are ideal, but any flexible material may be used. Clothing, towels etc may be torn into strips.  Panty hose have been successfully used.

Do not take off clothing, as the movement of doing so will promote the movement of venom into the blood stream. Keep the bitten limb, and the patient, still.

Bandage upwards from the lower portion of the bitten limb. Even though a little venom may be squeezed upwards, the bandage will be more comfortable, and therefore can be left in place for longer if required.

2. The bandage should be as tight as you would apply to a sprained ankle.

3. Extend the bandage as high as possible up the limb.

4. Apply a splint to the leg. Any rigid object may be used as a splint.  e.g. spade, piece of wood or tree branch, rolled up newspapers etc.

5. Bind it firmly to as much of the leg as possible.

Keep the patient still. Lie the patient down to prevent walking or moving around.

Bites to the hand or forearm

Bandage as much of the arm as possible, starting at the fingers.

Use a splint to the elbow.

Keep the patient still. Lie the patient down to prevent walking or moving around.

Note: We do not recommend that the arm be bent at the elbow and placed in a sling as this can create a tourniquet effect at the elbow.

Bites to the trunk

If possible apply firm pressure over the bitten area. Do no restrict chest movement. Keep the patient still.

Bites to the head or neck

No first aid for bitten area. Keep the patient still.

Summary

1. Research stresses the importance of keeping the patient still. This includes all the limbs. Bring transport to the patient if possible.
2. DO NOT cut or incise the bitten area.
3. DO NOT apply an arterial tourniquet. (Arterial tourniquets, which cut off the circulation to the limb, are potentially dangerous, and are no longer recommended for any type of bite or sting in Australia.)
4. DO NOT wash the bitten area or suck the bite. The type of snake involved may be identified by the detection of venom on the skin. No attempt should be made to catch or kill the snake.
5. Note: Even if the bitten or stung person is ill when first seen, the application of pressure-immobilisation first aid may prevent further absorption of venom from the bite or sting site during transport to hospital.
6. If the bandages and splint have been applied correctly, they will be comfortable and may be left on for several hours. They should not be taken off until the patient has reached medical care.
7. The treating doctor will decide when to remove the bandages. If a significant amount of venom has been injected, it may move into the blood stream very quickly when the bandages are removed. They should be left in position until appropriate antivenom and resuscitation equipment have been assembled.
8. Bandages may be quickly reapplied if clinical deterioration occurs, and left on until antivenom therapy has been effective.
9. Hospital Staff 
   Please note that first aid measures are usually removed soon after the patient is admitted. Do not leave on for hours.

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Imposition of a plaster bandage from 2,000 rubles in Rostov-on-Don

A medical bandage can be an effective treatment tool in the hands of an experienced qualified doctor. The duration of the recovery period after a surgical operation or injury directly depends on the correct application of the bandage. Specialists of the Rostov medical center “Best-Clinic” are fluent in the techniques of applying dressings of all types and apply their experience in helping our patients.

Why dressings are applied

Dressings are necessary to achieve the following goals:

• protection of the wound surface from external factors and infection
• pressurizing internal organs to stop internal bleeding
• retention of drugs on the surface of the wound
• immobilization of the site of dislocation or fracture

The purposes pursued when applying dressings can be very different, so there are many varieties of medical dressings that differ from each other in the application technique and dressing materials used. Also, dressing is carried out not only for injuries of the limbs, but also after surgical procedures, for example, during operations on the face.

Types of dressings

Different types of dressings are used in modern medicine:

• Pressure

A medical pressure bandage is commonly called a tourniquet and is applied when venous or capillary bleeding occurs. It is also effective when used to stop bleeding from large arteries. It is important to know that a pressure bandage should not be left on the body for a long period of time (in the cold season, the tourniquet must be removed after two hours from the moment of application, and in the warm season – after one hour).

• Occlusal (preventing air and moisture exposure to the wound)

This type of bandage has a powerful therapeutic effect, as it accelerates the formation of epithelium on the surface of the wound, protects the wound from external factors and improves the granulation process. Occlusive dressings are applied during the treatment of dermatological diseases, and are also often used in military field surgery.

• Medicinal (ensuring the supply of medicinal substances to the wound)

When such dressings are applied, the material used is impregnated with the drug. Thus, a long-term access of the drug to the wound surface is achieved. Naturally, the drug bandage can be on the body for a strictly defined time, after which it is necessary to perform a dressing.

• Retainers

Retaining bandages are widely used in sports medicine. Medical dressings of this variety are applied to athletes to ensure the fixation of the joints in case of instability resulting from sports injuries. Retaining dressings are made of modern elastic materials, making their use as comfortable as possible for patients.

• Compression

Bandages of this variety are very effective in the treatment of diseases of the veins of the legs. After applying the bandage, the patient should experience the feeling of a tight-fitting boot, while the toes should not go numb. Compression bandages are applied using special elastic bandages.

• Immobilization (immobilization)

Immobilization dressings are also called transport dressings because they are applied to patients to ensure immobility at the time of transport of the patient. They are applied for joint injuries, fractures, suppurative processes of the limbs and soft tissue injuries, characterized by a large area.

• Aseptic

The main function of an aseptic medical dressing is to prevent infection from entering the wound surface. To apply a dressing of this type, a sterile gauze napkin is used, used in several layers, and cotton wool. Also, an aseptic dressing helps to dry the wound.

• Corrective (providing correction of deformities)

These dressings are applied with an elastic or mesh-tubular bandage, wadding and cotton fabric. Corrective dressings allow you to eliminate congenital or acquired body deformities.

Dressings can be applied using different types of materials. They are thus divided into three categories:

• Splints (hard bandages)

When applying a splint, it is necessary to lay the areas of bony protrusions with a soft material so that abrasions and bedsores do not form under the dressing.

• Soft
• Hardening (starch and gypsum)

Plaster casts are most often used in the treatment of fractures and are an effective means of immobilization. They are very durable and allow the patient to perform an X-ray examination without removing the dressing.

The comfort of the patient and the therapeutic effect of dressings directly depends on the quality of the consumables used in the application.

What is an application kit

This term refers to a collection of medical consumables needed to make various types of dressings that are applied for first aid purposes.

Before surgery

After surgery

Located in Rostov-on-Don, the Best Clinic medical center is fully equipped with modern dressing materials that allow patients to receive high-quality medical care at affordable prices.

Attention! Please check the prices before visiting a specialist!

Prices for applying a bandage

Service name

Price, rub

Applying fixing plaster bandages – hand

2,000

Applying fixing plaster bandages – elbow joint

3000

Imposition of fixation plaster cast – shoulder joint

4000

Imposition of fixation plaster bandages – knee joint

4,500

Imposition of fixation plaster bandages – ankle joint

2,000

Assistance in case of injury (during the period of ice) displacement of the ends of the bones in the joints relative to each other with a violation joint bag. It most often occurs in the shoulder, less often in the hip, ankle and elbow joints as a result of an unsuccessful fall or bruise.

It is characterized by severe pain, immobility of the joint, a change in its shape.

A dislocation cannot be reduced by oneself, as this will only increase the suffering of the victim and aggravate the injury. In case of dislocation of the shoulder joint, the hand is placed on a scarf or tightly bandaged to the body.

Sprains and ruptures of the ligaments of the joints occur as a result of sudden and rapid movements that exceed the physiological mobility of the joints. The most commonly affected are the ankle, wrist, and knee joints. There is a sharp pain in the joint during movement, swelling, bruising when the ligaments are torn.

First aid consists of tight bandaging by applying a pressure bandage, a compress (cold) and resting the limb. Bruises are among the most common injuries in emergency situations and at home.

Bruises is damage to tissues and organs without breaking the integrity of the skin and bones. The degree of damage depends on the impact force of the area of ​​the damaged surface and part of the body, its significance for the body. It is natural to imagine that a blow to the finger with a hammer is less dangerous than the same blow to the head.

The main signs of bruises include pain, swelling and bruising at the site of contact with the injuring object. The choice of first aid methods depends on the location and severity of the injury. Complete rest is created for the bruised limb, an elevated position is given, a tight pressure bandage is applied to the site of the bruise, a cold compress or an ice pack can be put.

A contusion of the head is very serious in its consequences, as it can be accompanied by concussion and contusion of the brain.

Signs of a concussion include loss of consciousness at the scene, possible nausea and vomiting, slow pulse.

The victim is given complete rest, a cold compress, ice in a bubble on the head. With all possible precautions, the patient should be sent to a medical institution as soon as possible. For transportation, it is placed with its back on a shield, and its head on a soft pillow. To fix the neck and head, a soft fabric collar is applied to the neck.

From a pathoanatomical and clinical point of view, a fracture is a set of bone injuries with a violation of its integrity and simultaneous damage to the surrounding soft tissues. The degree and nature of damage can be very diverse. The treatment of bone fractures aims to save the life of the victim, prevent possible complications and, in the shortest possible time, restore the integrity of the bone, the function of the limb and the patient’s ability to work.

Treatment should begin at the scene. Success largely depends on the timely and correct provision of first aid (at the scene and on the way to evacuation to a medical institution).

Temporary immobilization of the limb must be carried out immediately. Poor immobilization or transportation without prior good immobilization of the limb can cause a number of complications (additional trauma to the skin, muscles, blood vessels and nerves) and cause increased bleeding, pain, shock, embolism and spread of infection. When immobilizing a broken limb with splints, two joints are necessarily immobilized – one above and the other below the fracture.

Means of fixing the damaged area of ​​the body, used when delivering the patient to a medical institution, is called transport immobilization. It is the most important link in providing first aid to the victim. Immobilization eliminates the mobility of bone fragments and secondary injury to the neurovascular bundles, spinal cord, internal organs, skin, reduces pain, and helps prevent shock and fat embolism. The absence of transport immobilization or its incorrect use can adversely affect the course and outcome of a traumatic disease.

Basic requirements for transport immobilization:

1. Maximum immobilization of the damaged area of ​​the body. In case of fractures, it is imperative to fix the joints lying above and below the injury site. The exceptions are fractures of the radius in a typical location and fractures of the ankles.
2. Fixation dressings must not cause tissue compression. To avoid bedsores and circulatory disorders, the protruding points of the body are covered with soft pads, and constrictions are eliminated.
3. Immobility of limbs is performed in a functionally advantageous position.

Transport immobilization is carried out with soft tissue bandages, splints.

Can be used as an independent fixing method or as an addition to another. Cloth dressings are most often used for fractures and dislocations of the clavicle, fractures of the scapula, injuries of the cervical spine. In cases where there are no other means for fixation, the listed bandages, as well as scarves, can be used to immobilize fractures of the upper and even lower limbs – bandaging the injured leg to a healthy one. In addition, soft tissue bandages always complement all other methods of transport immobilization.

The most acceptable and commonly used method of fixation during the transportation of casualties.