Page 623 - WSAVA2018
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Bandage Assessment
When the bandasge has been placed, regardless of the type or area, it should be assessed using the following questions:
· Is the bandage achieving its aim?
(Immobilising the correct joint, not slipping, in correct position)
· Is the bandage comfortable?
(Check that the bandage is not too tight or causing discomfort to the patient – no chewing or interference from patient)
· Is the bandage suitable?
(The bandage is not interfering with the other general movement of the patient).
Bandage Care
· Check for:
· Odour
· Discharge
· Wetness
· The bandage should be removed and the source investigated
· Contamination / dirt
· Check above and below the bandage for:
· Skin inflammation / redness
· Oedema
· Heat or coldness
It is vital that the bandage is kept clean and does not become soiled or wet from environmental factors (urine, faeces, wet ground etc). If soiling occurs the bandage must be changed.
If a limb is bandaged, the bandage can be protected from the environment (e.g. when toileting outside) by placing a protective covering over it. For example, a clean dry used drip bag can have the bottom cut from it and tied over bandage or use a plastic bag in a similar manner.
Your Singapore, the Tropical Garden City
B.D. Wright1
1Veterinary Anesthesiologist — Integrative Pain Management Specialist,
A thorough review of pain physiology MARKEDLY lubricates the conversation around the mechanisms of analgesia- both pharmacologic and non-phamacologic.
In this SHORT lecture on the topic we will quickly cover the major contributors of pain physiology, and how treatments address these sub-categories in the generation (or treatment) of pain.
Periphery: The triad of elements making up nerve ending are all modifiable.
Nerve endings in the periphery are blocked with a laundry list of sodium channel blockers (lidocaine, bupivacaine, etc) that block a particular subtype of sodium channels known as tetrodo-toxin sensitive channels. These drugs are relatively indiscriminate about which types of nerves that are blocked (bupivacaine and ropivacaine may slightly favor sensory), although the kinetics of drug penetration tends to favor blockade of thinner, less myelinated and less deeply bundled nerves. Sensory fibers carrying pain, heat and touch sensations are readily altered while thick, myelinated motor fibers are slower to affect.
As with the local anesthetics, a wide variety of nerve endings are present in the periphery and not only pain fibers are affected by interventions. Stimulating heat or cold-sensing receptors, touch sensing receptors, etc sends competing signals to the dorsal horn of the spinal cord. These stimuli decrease the amount of afferent stimuli reaching being received. This is one method
by which heat, cold, touch, massage, and acupuncture play a role at the nerve endings. This particular
aspect of descending inhibition was targeting by early pain pioneers Melzak and Wall in their ‘gate theory’. Thermotherapy (ice/cold) also chemically inhibit pain signals through their effect on TrP channels in peripheral sensory nerves.
Finally, the mast cells and capillaries are critical. Local release of inflammatory mediators set an avalanche of events into action. Interventions at this level include peripherally acting anti-inflammatories such as non- steroidal drugs (NSAIDs) and steroids. A large laundry
list of nutritional supplements act as anti-oxidants and have some effect and reducing inflammation (Boswellia, Curcumin, etc) Cooling, photodynamic treatments such as low-level laser therapy and acupuncture also are likely to have direct affects on both decreasing inflammation
 Tertiary Layer
thick, cotton based material with an adhesive side
  material containing latex that ‘sticks’ to itself but not to the skin or hair
   Once a bandage has been applied and assessed it should be frequently checked until removal, this includes:
· Ensure the bandage is not too tight
· Check that it is not casusing the patient
discomfort / pain
· Check in correct position (not slipped)

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