Deo bandage, overlay technique in pictures. Deso bandage: types, indications, wearing technique Applying a soft deso bandage

21.06.2020

The main purpose of the bandage is to fix the limbs in case of injuries and dislocations... Let us consider how to apply a Dezo bandage and analyze the key mistakes made by healthcare workers, due to which the bandage does not fulfill its therapeutic functions.

Indications for use

A dezo bandage, the scheme of which is discussed below, is applied to patients when it is necessary to immobilize the arm - in case of fractures and injuries of the upper limbs. The application of this bandage is recommended by GOST R 52623.2-2015 for fractures humerus... Desmurgy considers Dezo as part of the first medical aid, as an auxiliary immobilization after operations, as well as during the transportation of patients.

The indications for the use of the bandage are:

Dislocations of the shoulder.
Fractures of the humerus.
Clavicle fractures.
Various conditions after shoulder dislocation.

With the help of the Deso bandage, the limb is fixed to the body, but the shoulder joint is not retracted. If the Desot method is used for long-term immobilization of a limb, for example, with a fracture of the clavicle, it is necessary to apply additional elements in order to take the shoulder back.

For what cases the Dezo bandage is not suitable:

with fractures open type;
with complex fractures with fragmentation of bones.

In this case, the bandage can aggravate the patient's condition - displace bone fragments, provoke the destruction of soft tissues by fragments, etc.

In many cases, a Deso dressing is not needed - there are Dezo dressings that are ready to use. However, in urgent cases, when a ready-made dressing is not available, ordinary gauze bandages are used.

There are two important things about dressing:

bandaging on the left hand begins from left to right;
on the right hand, a bandage is applied from the right to the left.

Desmurgy: Deso

Desmurgy is a section of medical knowledge about the properties and types of dressings, including how to apply medical dressings to different parts of the body. In desmurgy, recommendations are given on how to correctly apply certain dressing schemes. For Dezo dressings, the scheme also focuses on general principles desmurgy.

Therefore, nurses should be guided in desmurgy, because bandaging is one of their immediate functions. This will allow the nurse to quickly and correctly apply the dressing correctly, even in an emergency and in times of pressure.

The Dezo bandage got its name from the inventor of the bandage bandage, which is used to immobilize the limbs, Pierre Dezo.

Today, this type of dressing is used everywhere in healthcare facilities, so healthcare providers need to know how to apply the Deso dressing step by step and be able to apply this knowledge step by step.

How to apply a bandage step by step

Bandaging includes three stages - preparatory, main and final.

1. Preparatory stage:

tell the patient about the essence of the manipulation, get his consent to perform it;
the patient is asked to take a sitting position;
a nurse treats hands with antiseptic, puts on a mask and gloves.

2. The main stage:

the limb, on which the Deso bandage scheme will be applied, is given a mid-physiological position;
a cotton-gauze roller is placed in the armpit of the injured arm;
the health worker makes two circular fixing rounds of bandage on the chest, injured limb in the region of the middle third of the shoulder, back and under the axillary. The direction of the bandage is from the healthy side to the damaged one;
the second round is carried out from the healthy armpit to the shoulder girdle of the injured side, then down along the back surface of the shoulder under the elbow;
the third round - the bandage goes around the elbow joint. Then the hand and forearm are fixed, the bandage is slanted upward into the armpit of the healthy side, and is brought out along the back onto the sore forearm;
the fourth round - the bandage is carried out vertically downward in front of the shoulder, bends around the elbow joint. After that, the bandage is directed to the posterior surface of the chest in the armpit of the healthy side;
then all four circles are repeated at least 3 times;
the bandage is completed with a fixing tour - the bandage is directed around the chest, the bandage is fixed in the front of the chest;
pins are used to fix the crossing points of the tour, they can also be stitched.

3. Final stage:

disinfect the outer surfaces of products medical purpose;
take off gloves, place them in a disinfection container, treat and dry your hands;
fill out medical documents;
disinfect used materials, products, etc.

Errors

In the event that, when applying the Dezo bandage, the scheme of the health workers is violated, this can lead to the following consequences:

1. The hand is fixed in the wrong position. The ends of the fractured bone are displaced, the fixation is generally poor and insufficient.
2. The bandage is too tight. In this case pain at the site of the fracture are intensified, because normal blood circulation in the tissues is disrupted.
3. The bandage is not tight enough. In this case, the bandage will constantly slide off the shoulder, the arm moves freely, there is no immobilization. Such a bandage will not achieve the desired treatment results.
4. The bandage was applied to the injury site with uneven pressure. In those places where the dressing is too tight, the tissues are squeezed, and in those where the dressing is not tight enough, the dressing functions are not performed.
5. Wrong dressing material selected. In the event that there are no bandages of the required size in the medical kit, the paramedics use the materials at hand - tissue cuts, sheets, duvet covers, etc. This is a big mistake - such a bandage will not be able to perform the function of immobilizing a limb, moreover, it can harm it.

If there is no suitable material, the best solution is to leave the hand in the position in which it was after the injury and wait for the arrival of paramedics who will perform all the necessary actions before the surgeon examines the injury.

Attention! the information on the site is not a medical diagnosis, or a guide to action and is for informational purposes only.

Algorithm 29

Dezo's bandage.

INstop word: “I provide the first medical assistance, at the scene of the victim with a dislocation of the right clavicle. Anesthesia has already been carried out. My task is to carry out transport immobilization of the right clavicle with the help of the "Dezo" bandage. "

Equipment: bandages, scissors. To carry out the manipulation, an assistant will be needed in the role of the patient.

Obtaining the consent of the patient: "Hello! My name is Name Patronymic. I am a nurse. In order to ensure the immobility of the damaged area during transportation, it is necessary to apply a bandage. Do you agree? Sit comfortably. The body must be motionless. If my actions cause you pain, please let me know. Okay?"

Manipulation technique:

Take a wide bandage;

place a cotton pad in your armpit;

bend your arm at the elbow and bring it to your chest;

strap your shoulder to chest in a circular way, starting from the "healthy side" (1st round);

direct the bandage from the healthy armpit to the shoulder girdle of the "sick" side, obliquely upward;

throw it over the shoulder girdle back and lower it down to the elbow joint (2nd round);

go around the elbow joint, supporting the forearm and hand, direct the bandage obliquely upward into the armpit of the "healthy side";

lead it to the back of the chest (3rd round);

direct the bandage obliquely up the back to the sore shoulder girdle;

throw it over it and slide down to the elbow joint;

go around the hand in the upper third of the forearm and direct the bandage to the back of the chest (4th round);

direct the bandage inthe armpit of the "healthy side" on the back;

repeat four rounds several times until the arm is fully fixed;

secure the bandage in one of the ways.

Completion: "All. The bandage is now complete. An ambulance will come and I will accompany you to the hospital. If you feel worse, please let me know. Okay?"

General rules for the imposition of soft bandages

The bandaged part must be accessible (at the chest level of the bandage)

The patient is placed in a comfortable position

The bandaged part must be motionless

The limbs are given a functionally advantageous position

Muscles should be as relaxed as possible.

You should stand so that you can see the bandaged part and the face of the bandaged.

Periodically (at least 3 times) the patient should be asked the question: "How do you feel?"

Bandaging technique

The bandage should be of the appropriate size (head, limbs -10 cm; fingers - 5 cm; trunk - 10-14 cm)

Bandaging is carried out from the periphery to the center, from the lower sections to the upper ones.

The head of the bandage is taken in the right hand and the end in the left, without preliminary rolling.

Bandaging begins with a fixing circular round

The head of the bandage rolls without tearing along the bandaged surface, stretches evenly, each subsequent round (spiral bandage) should cover the previous one by half.

Bends are made on the cone-shaped sections

Recurrent movements, abrupt movements, as well as "fitting" movements should be avoided

At the end of the application of the bandage, the end of the bandage is fixed with a knot, a pin, glue, adhesive tape, tubular bandage, stitching. Fastening cannot be carried out over the wound. Criteria for the correctness of the applied dressing:

The bandage must perform its function

The bandage must be firmly attached

The bandage shouldn't hurt

The dressing should not interfere with blood circulation

The dressing should have an aesthetic appearance.

Possible mistakes:

Gross mistakes:

Violation of the rules of bandaging points: 2; 3; four; 6.

Violation of the bandaging technique, points: 2; 8

The dressing does not meet the criteria for correctness, points: 1; 2; 3; four.

Not blunders:

Errors during positioning of the dressing among other interventions.

Not the ability to justify the need to bandage the patient.

Violation of the course of manipulation.

Criteria for evaluation:

Passed - no blunders, no more than two blunders.

Didn't pass - the presence of at least one gross error, more than two not gross errors.

If an error is found, the teacher may ask you to repeat the corresponding stage of the manipulation, if the error is corrected - passed, not corrected - did not pass.

Dezo's bandage immobilizes the upper limb. Fixes the shoulder and the forearm bent at the elbow to the body, creates physiological traction. Covers all the necessary musculoskeletal system. Helps relieve stress. It prevents displacement, which reduces the risk of complications and speeds up recovery from injuries.

It is named after the inventor Pierre Desot, one of the best French surgeons of the 18th century. Now it is used in an improved form - the application technique and the materials used have changed, due to which the effectiveness of treatment has increased.

Indications

The Desot bandage is necessary to immobilize the hand from the shoulder to the digital phalanges when:

dislocation of the shoulder and for the prevention of relapse;
fracture of the humerus;
fracture of the clavicle;
fracture of the scapula;
damage to the ligaments;
paralysis of the upper limbs;
arthritis, periarthritis and arthrosis;
secondary myositis, neuritis, paresis and plexitis;
during the recovery period after operations on upper limb and wearing plaster.

It can be used for simple fractures - when there is no risk of displacement and damage to soft tissues by bone fragments. Sometimes it is prescribed for bruises and cuts in the hands.

Types of dressings Dezo

Dezo bandages

The classic Dezo bandage is bandage. It covers the sore shoulder and torso in several rounds of the bandage, bends around the back and elbow from below, rises obliquely upward, under the healthy armpit, spreads over the sore shoulder and falls again. Fastened with pins or plaster. If you have to wear it for a long time, the bandage tours are stitched so that they do not slip and stretch less. Sometimes the Dezo bandage is made in plaster.

Disadvantages of Dezo bandage

Too tight a bandage interferes with blood circulation and causes pain. Too weak - does not fulfill its functions. Improper fixation can lead to improper bone fusion. In addition, the bandage requires systematic care. If it becomes dirty or displaced, replacement is required: you need to remove the old bandage and apply a new one, without strictly changing the position of the sore arm.

Ready-made dressings Deso

Deso ready-made dressings are easier to use, more comfortable for patients and doctors. They are bandages - connected in a single structure and. Made of hypoallergenic materials that allow air to pass through, they do not cause irritation, they provide full circulation. Attached with Velcro. They do not require precise selection - they are produced in universal standard sizes, individually adjustable.

Rules for wearing a Dezo bandage

How to choose and wear correctly?

A ready-made Deso-type bandage on the shoulder joint is worn over underwear according to the principle of a T-shirt. The sore arm is bent at a right angle, the forearm is parallel to the floor. Above the elbow, the product is attached to the body horizontally with a belt. The device should not dangle or squeeze.

A traumatologist or orthopedic surgeon selects a suitable size. He also puts on a bandage for the first time on the patient and teaches the necessary technique.

How much to wear and how to sleep?

The duration of wearing the Dezo bandage depends on the nature of the injury. With a dislocated shoulder, it is worn from a week to a month. Younger, more active patients require longer immobilization to prevent secondary trauma. With uncomplicated closed fractures shoulder or collarbone product is worn for about a month.

How much to wear during the day and whether it is possible to take off at night, the doctor indicates. When worn around the clock, the most common option is to sleep on your back.

How to care?

Deso's ready-to-wear shoulder bandages are available in non-marking colors, so they do not require special care while they are being worn. After the end of the treatment, the product is washed at a temperature of 30 ° C in manual mode without spinning. Dried naturally.

Indications for the Desot dressing: immobilization of the upper limb to the chest in case of clavicle fractures, as well as after reduction of shoulder dislocation.
When applying a bandage, the upper limb is given a physiological position.

First, the shoulder is fixed to the body, then the wrist joint is held, and finally the elbow joint of the injured side. The joints of the healthy upper limb remain free, and the patient can make any movements with the healthy hand.
Equipment: bandage 20 cm wide, cotton-gauze roll, scissors, pin or adhesive plaster.
Note: The fixing round of the bandage is always carried out to the sore arm around the torso, pressing the shoulder tightly against the chest. When a bandage is applied to the left hand, the bandage moves from left to right, and when bandaging the right hand - from right to left, the arm is given a bent position in the elbow joint at a right angle, the elbow is pulled back a little, and the shoulder is raised up during the bandaging process.

1.The Deso bandage is applied after preliminary insertion of a cotton wool roll wrapped in gauze into the armpit. After that, carefully bend the injured limb at the elbow joint, bring and press to the chest.

2. Make two fixing rounds of the bandage along the chest, sore arm in the shoulder area, back and armpit from the side of the healthy limb.

3. Lead the bandage through the armpit of the healthy side along the front surface of the chest obliquely on the shoulder girdle of the affected side.

4. Lower the bandage down the back of the sore shoulder under the elbow.

5. Bend the elbow joint and, supporting the forearm, direct the bandage obliquely into the armpit of the healthy side. Lead the bandage from the armpit along the back to the sore shoulder girdle.

6. Lead the bandage from the shoulder girdle along the front surface of the sore shoulder under the elbow and go around the forearm. Direct the bandage down the back into the armpit of the healthy side. Repeat the rounds of the bandage until the shoulder is fully fixed.

7. Finish the bandage with two fixing rounds on the chest, sore arm in the shoulder, back. Pin the end of the bandage with a pin. If a bandage is applied long time, bandage tours should be stitched.

This bandage is applied to fix the upper limb in case of shoulder fractures and dislocations.

Necessary tools

bandage 20 cm wide
pin

Note. The right hand is bandaged from left to right, the left - from right to left.

Sequencing

1. Sit down the patient facing him, calm him down, explain the course of the upcoming manipulation.
2. Place a cotton wool roll wrapped in gauze into the armpit.
3. Bend the forearm at the elbow joint at a right angle.
4. Press your forearm to your chest.
5. Make two fixing rounds of bandage along the chest, sore arm in the shoulder area, back and armpit from the side of the healthy limb.
6. Lead the bandage through the armpit of the healthy side along the front surface of the chest obliquely on the shoulder girdle of the affected side.
7. Go down the back of the sore shoulder under the elbow.
8. Bend around the elbow joint and, supporting the forearm, direct the bandage obliquely into the armpit of the healthy side.
9. Lead the bandage from the armpit along the back to the sore forearm.
10. Lead the bandage from the shoulder girdle along the front surface of the sore shoulder under the elbow and go around
forearm.
11. Direct the bandage along the back into the armpit of the healthy side.
12. Repeat the rounds of the bandage until the shoulder is fully fixed.
13. Finish the bandage with two reinforcing rounds along the chest, sore arm in the shoulder, back.
14. Pin the end of the bandage with a pin.

Note. If the bandage is applied for a long time, the tours of the bandage should be stitched.