(2) Wrap one of the tails around the injured body part with your free hand.
As you wrap, cover one of the exposed sides of the dressing with the bandage. (The
bandage can usually be wrapped around a limb more than once.) Bring the tail back
over the dressing (figure 5-9 D). The second tail is held in the palm of the hand holding
the dressing in place.
(3) Wrap the other tail around the injured body part in the opposite direction.
As you wrap, cover the remaining exposed side of the dressing with the bandage. Bring
the tail back to the dressing.
Using the tails to seal the exposed edges of the dressing will prevent foreign
material from getting under the dressing and contaminating the wound.
(4) Tie the tails into a nonslip knot over the outer edge of the dressing
(figure 5-9 E). The tails should be tied firm enough to prevent the dressing from
slipping, but loose enough to insert two fingers between the knot and the dressing.
d. Check Circulation. After the knot is tied, check the blood circulation below
(distal to) the bandage. If the skin below the bandage becomes cool to the touch,
bluish, or numb, the bandage may be too tight and interfering with circulation. Also
check to see if you can detect a pulse below the bandage. If blood circulation is
impaired, loosen and retie the tails; then check the circulation again. If circulation is not
restored, evacuate the casualty as soon as possible. Medical treatment may be needed
to save the limb.
e. Apply Manual Pressure. If practical, apply direct pressure over the dressing
with your hand (figure 5-9 F). This pressure will help to compress the damaged blood
vessels and control the bleeding. Maintain this pressure for 5 to 10 minutes.
If the casualty is conscious and can follow instructions, you can have him
apply the manual pressure himself.
f. Elevate the Injured Limb. Elevate the injured limb above the level of the
casualty's heart to decrease the bleeding. An injured leg can be raised by placing the
foot and ankle on a stable object such as a pack, log, or rock (figure 5-9 G ). An injured
forearm can be elevated by placing the forearm on the casualty's chest if he is lying on
his back or by having the casualty place his arm on top of his head if he is sitting.
Elevating the injured limb and applying manual pressure should be done at the same
time when no fracture is involved.
Examine the injured extremity for fractures (visible broken bone,
deformity of the limb, etc.) before elevating the limb. If a fracture is
suspected, do not elevate the wound until the limb has been properly