How to Make a Pressure Dressing (and Not Lose a Limb)

by James Hubbard, M.D., M.P.H.

Pressure dressing, pressure bandage, compression dressing, compression bandage, they’re all the same thing to me. They’re bandages that press down on—compress—a wound. Most of the time this is to stop a wound from bleeding. (If you’ve applied pressure for about 10 minutes and it’s still bleeding, it might be time for a pressure bandage.)

So what’s the big deal about using one? The big deal is if you put any bandage too tight around an extremity, or the extremity swells and the bandage has no give, you’ve got a tourniquet. You’ve cut off blood supply coming from the arteries, and the tissue distal (farthest from the heart) to the dressing is going to die.

So how to you make a pressure dressing correctly? Think bulk.

• Add extra layers of gauze or bunch up some clean cloth. When you tape the dressing down, the bulk will press down on the wound, but it will also have some give so it doesn’t cut off circulation.
  
• Tape it down firmly—about one-half or two-thirds around if it’s an extremity. Don’t cut off the circulation by wrapping tape all the way around an extremity. You could, however, use an elastic bandage instead of tape. Wrap it firm but not too tight. You should be able to stick a couple of fingers under the wrap.
• If the hand or foot starts to get discolored, cold, or tingly, loosen the compression bandage immediately. Until you can readjust it, you can press on the bandage with your hand to stop the bleeding.