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Applying an Abdominal Binder

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olivia dickerson

on 27 February 2014

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Transcript of Applying an Abdominal Binder

62
ECG
bpm
Thank You!
Don't Forget !

When performing this procedure, remember to always identify the patient according to agency policy and be attentive to standard precautions, hand hygiene, patient safety and privacy, body mechanics, and documentation.
Make sure you choose a binder of the correct type and size for the intended purpose.

1. Choose a binder

2. Wash hands. Don gloves.

3. Thoroughly clean and dry the abdomen part that’s being covered.

4. Place the body part in its natural comfortable position, whenever possible.
5. Pad between skin surface and over bony prominences.

6. Fasten from the bottom up, especially for abdominal binders.

7. Change binders whenever it’s soiled or wet.

8. Measure the patient for the binder:

a. Place the patient in supine position.
b. With a measuring tape, encircle the abdomen at the level of the umbilicus. This is the length of the binder.
c. Measure the distance from the costal margin to the top of the iliac crests. This is the width of the binder.
d. Dispose of gloves and measuring tape, and wash your hands.
e. Obtain the abdominal binder based on these measurements.
f. Pad any pressure areas or skin abrasions.

Evaluation

Evaluate whether the patient’s physical condition has changed since using the binder.
Assess circulation to be sure the binder is not secured too tightly. Check color, warmth, tingling, sensation, and capillary refill.
Assess the depth of breathing to make sure the binder is not restricting ventilation.
Check the skin under the binder to be sure there are no areas of irritation, pressure, or skin abrasion.
Assess incisions or wounds under the binder to be sure they are not bleeding and healing properly.
Monitor comfort regularly
Assess the client’s ability to perform Activities of Daily Living while wearing the binder

Procedure Steps:
Presented by Olivia Dickerson
Applying an Abdominal Binder
What is an abdominal binder?
An abdominal binder is used to provide support to the abdomen. It is often ordered when there is an open abdominal wound that is healing by secondary intention. The binder decreases the risk of dehiscence. Abdominal binders may be straight or multitailed.

Abdominal binder
Clean nonsterile gloves
Measuring tape

Equipment:

The procedure itself may be delegated to an NAP. Assessment of the incision line or wound is a licensed professional’s responsibility and should not be delegated.

Delegation:

Assess the condition of the wound (if one is present). Note the amount and type of drainage. A wound must be dressed before it is bandaged; if there is a significant amount of exudate, you will need to apply a secondary dressing.
Assess for pain and check the circulation of the underlying body parts before and after applying the binder. Look for cool, pale, or cyanotic skin, tingling, and numbness.
Determine whether the client or the family has the skills to reapply the binder when necessary.

Pre-Procedure Assessments:
12. With your dominant hand, grasp the end of the binder on the side furthest from you, and steadily pull toward the center of the patient’s abdomen. With your nondominant hand, grasp the end of the binder closest to you, and pull toward the center. Overlap the ends of the binder so that the hook and loop fasteners or Velcro meet.



13. Make sure the binder is positioned properly to provide support but not compromise circulation or impair breathing.
14. Remove the abdominal binder every two hours, and assess the underlying skin and dressings. Change wound dressings if they are soiled, or as prescribed.
Last Step !

*Many agencies use specialized wound care flowsheets.


Documentation
Document appearance and location of the wound or incision under the binder, type and amount of exudates, and odor, if present, after cleansing
Document the patient’s level of pain before and after the procedure. If the patient was medicated for pain, document the drug and dose used, time given, and patient response.
Document the type of binder used (Abdominal)
Document Date and time the binder was applied and removed
Document any change in the appearance of the wound or skin in contact with the binder.
Document education provided to the patient.

Teach the client and/or caregiver how to apply the binder in the proper position, snugly but not too tightly.

Home Care
Teach the family to inspect the site under the binder to be sure the skin is not pinched or with other points of pressure. This is especially crucial for older adults.

Clean binders in warm, soapy water when soiled. Use a mesh laundry bag to keep the Velcro straps from catching other clothing in the washer. Air dry thoroughly.

Patients should have two binders at home, one to wear while the other is laundered. Apply and remove binder to promote comfort and ensure good circulation.
The article was about reviewing the evidence for the use of an abdominal binder on breathing, speech and cardiovascular function in people who have suffered a spinal cord injury.
The size of effect of an abdominal binder on outcomes was calculated into data that was reported.
This review found some evidence that the use of an abdominal binder improves vital capacity (VC), but decreases functional residual capacity (FRC) when assuming the sitting or tilted position in people who have suffered SCI.
Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis.
Nursing Journal:
Reference List
Wadsworth, B. M., Haines, T. P., Cornwell, P. L., & Paratz, J. D. (2008). Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis. Spinal Cord, 47(4), 274-285.
Wilkinson, J. M., & Leuven, K. (2007). 34. Fundamentals of nursing: theory, concepts & applications (pp. 803-805). Philadelphia: F.A. Davis Co..
11. Assist the patient to turn to the other side as you unroll the binder from underneath him.
10. Make sure the binder doesn’t slip upward or downward.
9. Assist the patient to roll to one side. Roll one end of the binder to the center mark. Place the rolled section of the abdominal binder underneath the patient. Position the binder appropriately between the costal margin and iliac crest.
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