Applying gypsies longets from self-made gypseous preparation

On an able-bodied extremity by means of a gauze stria measure length of a field on which will overlap gypseous лонгет and abandon it on an effective area. On a surface of a table develop gauze bandage on length of the measured strip of bandage. This piece of bandage pour a gypseous powder with which smooth and rub in bandage a rib of a palm of the left-hand hand. Atop of the imbued gypseous bandage impose a following stratum of gauze bandage with which similarly imbue with a gypsum. Thus control breadth longet. Longet do from 5-12 stratums of the bandage imbued by a gypsum. The made preparation лонгеты compound leaky from the ends up to the middle. Take gypseous preparation from two legs two hand for the ends, dip it into a basin with water. Bandage hold in water until eduction of air traps will be stopped. After the bandage has completely exuded with water, its two hands take out from water and easy pressing to the middle wring out. The expressed gypseous bandage, put on an effective area of a table, develop heads and some times smooth with a right hand that it was formed smooth, identical depth a surface. Prepared gypseous longet take for the ends, put to a part, which immobilization. Give extremities of a physiologic standing. Smooth an exterior surface of a plaster bandage. Edges smooth down, bend outside and do its spherical. A plaster bandage lay gauze bandage.

Applying of a circular plaster bandage

After take out bandage from water the free end of bandage take in the left-hand, and a head - in right and start to bandage. At bandaging a right hand all time unrolls bandage, and left-hand - smoothes it. It is necessary to coat with each following round previous on 2/3. In those places where diverticulums are formed, them, undercut with scissors, press to a surface which bandage and smooth. All stratums of the imposed bandage should be bridged in a single whole, the bandage should respond a configuration of this surface precisely. During bandaging an extremity give a physiologic standing. At applying a circular plaster bandage ends of dactyls, as a rule, abandon open to track on a state of an extremity. A plaster bandage lay gauze bandage.

Putting off of plaster bandages

For putting off of plaster bandages the special toolkit is used: scissors for a gypsum, a power saw, Volf's forceps, an expander. During a cast removal immobilization the part of a body should remain immobile. The gypsum is taken out gradually with participation of the patient.

VII. System of educational assignments for checkout of a final level of knowledge

Situational problems for checkout of a terminating level of knowledge.

1. To the patient, 77 years, operation - ablation of the left-hand inferior extremity in occasion of the wet gangrene day ago has been executed. A state of the patient serious. Self-maintainedly move she cannot. At survey the dermahemia in fields of angles of both scapulas a field of a sacrococcygeal articulation is taped. What complication can educe at the yielded patient? What it is necessary to do in such situation?

The answer: At the patient decubituses can educe; it is necessary to wipe the specified fields of 40 % a solution of ethanol, to spend a complex of actions on prophylaxis of a decubitus.

2. After a road accident of the patient, 33 years, complain of a pain in a right half of basin. At survey - exponents of a hemodynamic are stable, asymmetry of a basin is not present, the expressed tumescence and a hemorrhage in right inguinal field. Select an optimum expedient of transportation of the patient in a medical institution.

The answer: it is necessary for Patient to execute anesthesia by means of analgetics or narcotic drugs. Then to the patient to make orthopedic laying on a firm surface with the substituted platen under popliteal spaces.

3. The patient, 35 years, has fallen from height of 2,5 meters to the left-hand and a leg. The left-hand brachium and a femur in a medial third is distort ed. In these segments pathological mobility and an osteal crepitation is scored. The occluded fractures of a femur and a brachium are diagnosed. What transport immobilization the most expedient in that case?

The answer: The Patient requires injection of narcotic materials. Then it is necessary to impose splint Diteriksa on the left-hand inferior extremity and Kramer's splint on the left upper extremity.

4. The patient of 6 weeks was treated in occasion of epicondylic fracture of a right femur. To the patient the skeletal extension which at it was during these 6 weeks is taken out. The subsequent treatment will transit with application of an immobilization plaster bandage. What plaster bandage is necessary for using at the patient?

The answer: the plaster bandage (from the extremities{ends} of dactyls to the inferior ribs) Overlaps coxitic.

5. The person of 35 years was converted in a fracture clinic with complaints to a pain in a medial third of right anticnemion from an exterior surface which has arisen after shock by a wooden rod. In the field of an anticnemion the edema, a sharp pain is defined at a palpation on an exterior surface in a medial third of anticnemion, the crepitation in the same place is felt. On a X-ray pattern of a right anticnemion fracture of a fibular bone in a medial third with inappreciable shift of spalls under an angle is certain. What expedient of an immobilization is necessary for applying at this patient?

The answer: At the isolated fracture of a fibular bone impose a plaster bandage „circular” for 4-5 weeks.

6. The woman of 43 years has been delivered in a reception of the central regional hospital by a brigade of first aid with complaints to the strong pain in a field of the left-shin anticnemion, impossibility to become to the left foot. A trauma has gained during slope from a ladder. In a medial third of left-hand anticnemion the edema is scored, at a palpation - the strong pain. The load on all extremity causes the appreciable intensifying hurt. On a X-ray pattern of the left-hand anticnemion skew fracture in a medial third of tibial bone without shift of osteal spalls is certain. What expedient of an immobilization is necessary for applying at this patient?

The answer: At the isolated fracture of a tibial bone it is necessary to impose for 6 weeks a circular bandage from the ends of dactyls of stack to the middle of a femur.

7. The man of 27 years complain of a pain in a mandible. At survey pathological mobility and a crepitation in a field of both branches of a mandible is scored. The ambulance surgeon the diagnosed double fracture of a mandible with shift of spalls. In what first aid to the patient will consist?

The answer: It is necessary to impose the special splint which consists of the soft and standard rigid mental splint, to inlet anesthetizing drugs, to transport the patient in unit of maxillofacial surgery.

8. To the patient of 63 years the executed operation - ablation of a right inferior extremity at a level of a medial third of femur. Operation has been made in occasion of a gangrene of right stack which has arisen on a phon of an obliterating atherosclerosis of receptacles of the inferior extremities. What bandage is necessary for imposing on a stump to anchor a dressing material on a postoperative wound?

The answer: It is necessary to impose returnable a bandage with fixativing round around of a trunk.

9. To the woman of 37 years the regional resection of a nail plate of 1-st dactyl of the left-hand stack in occasion of ingrown a fingernail has been executed. What it is necessary to bandage after operation?

The answer: with an antiseptic which put to a wound of 1-st dactyl, it is necessary to anchor the Napkin a spiral bandage, and to fix circular rounds above ossicles.

10. To the boy of 12 years operation on excision of a foreign body (a spall of a needle) in a field of the left heel has been executed. What it is necessary to apply a bandage to bracing a napkin with an antiseptic?

The answer: It is necessary to apply missing turtle a bandage.

11. To the patient the executed operation a cholecystectomia through upper - median laparatomic a slit. What you suggest to apply a bandage at this patient after sew an operational wound on an abdominal wall?

The answer: It is possible to apply one of species of a glue bandage. The most spread from them is glue the bandage.

12. Combustion II-III is diagnosed for the suffered woman of 33 years-IV degrees of all right brush. The executed surgical treatment of the burn surface, the imposed bandage with jodopyron. How it is possible to anchor a dressing material on a brush?

The answer: the Dressing material on a brush in this case can be anchored a returnable bandage on a brush.

13. To the patient of 45 years there was executed a diaplasis of a dislocation of a right brachium. What it is necessary to apply at him a bandage to an immobilization of a right upper extremity for the term of 3-4 weeks?

The answer: It is necessary to apply bandage Desoult’s with which supplement with rounds from gypseous bandage.