To bandage or not to bandage...

[JJR512]

...That is the question.

My partner at my commercial ambulance company job (a county FF/EMT, retired after 20 years) told me that if I put together my own BLS bag and happen to witness or come upon an accident, or any other situation where I am the first on scene where someone is bleeding, that I should not bandage the wound because the official responding medic would need to see it to properly describe it in his report to the hospital. My partner said that if I bandaged the wound, the official responders would need to remove my bandage to see it (unless they were lazy).

Is this correct?

My final thought was that if a person is having "dense bleeding", and their airway and breathing are fine, and 911 has been called, I should attend to that before the person bleeds out and dies.

 

[Ridryder911]

Depends on the situation. If it is a real severe bleed and is bandaged well that has bleeding under control, I can document that the wound was bandaged prior to arrival and not assessed to disrupt clotting.

If it is a simple wound (which most is) I will remove and examine it, so I can inform it is needs to be sutured or not.

One will find that most wounds are simply covered up to prevent debris from entering it, seldom many bleed after the initial laceration, rather ooze. Very rarely I find that I have to place bandages and dressing on wounds.

R/r 911

 

[bstone]

I have often had elderly PTs who have fallen and hit their head in their NH room. By the time we get there the bleeding has stopped, but we still clean and bandage the wound. When we get to the ER, the nurses remove the bandage to inspect it. Sometimes the nurses at the NH have already bandaged it, but our protocols say we need to visualize the wound.

So, potentially the PT gets 3 dressings of the wound. Kinda redundant.

 

[JJR512]

If it is a simple wound (which most is) I will remove and examine it, so I can inform it is needs to be sutured or not.

Is the ability to assess if a wound needs to be sutured or not something that is taught at a higher skill level than EMT-B, or is that just something that even an EMT-B can learn with experience?

I was taught that bandages are not removed in the field so as to not disrupt the clotting, as you mentioned, and that the ED staff would remove the bandage if necessary. I take this to mean by extension that if an officially dispatched EMT-whatever arrives on scene to find that a bystander EMT has already bandaged something, and it appears under control, the responder should leave it alone, document that the bystander bandaged the wound and the bystander's description and present that to the receiving ED staff and let them deal with it. (Of course, if it's not under control, then additional bandaging should be applied over the existing bandage, according to what I was taught.)

But I have no field experience, although I do know that what's done in the field isn't always exactly like what's taught in the classroom. That's why I'm asking these questions...

I still think that, as an EMT-B, if I'm a bystander to a situation, and I have the supplies (including gloves!) with me, and there's nothing more serious to deal with, I would bandage a wound. Unless a bunch of people tell me not to...

 

[reaper]

I normal take it off. I have had to many times when FR's tell me the pt's head is falling off, only to find a small Lac.

Like rid said, I rarely bandage, unless it's uncontroled bleeding.