Learn How to Properly Apply a Bandage Wrap

Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York.

A compression bandage is a type of stretchy bandage that is wrapped around a body part to place pressure on it. It is commonly used in first aid as part of a therapy known as RICE (rest, ice, compression, and elevation), and helps to reduce pain and swelling by restricting blood flow.

These bandage wraps are typically used to treat sprains and strains. But, they can also help to keep a body part stabilized, such as when there has been a rib fracture. The bandages may also be used to prevent or treat the build-up of fluid in the lower legs, known as edema.

This article will discuss how to use compression bandages correctly so that they don't cut off circulation, and other mistakes to avoid. It also presents treatment alternatives to use when a bandage wrap isn't the right approach.

Compression bandages can be anywhere from 2 inches to 6 inches in width. As a general rule, the wider the bandage is, the less likely it will cut off circulation. It is important, therefore, to select the right size for the body part.

If the bandage wrap is cutting off circulation, you may feel swelling, numbness and tingling at or below the site. The skin color also may appear bluish or purple-red. You'll need to loosen the wrap to restore circulation.

Always choose the right-sized bandage for the body part. A too-narrow bandage can cut off circulation, while a bandage that's too wide may not provide enough compression.

When using a compression bandage, you need to apply the right amount of pressure to prevent swelling and help stabilize the injury. This can be tricky since body parts and the blood vessels that supply them differ in size and shape. Wrapping a thigh is one thing; wrapping a complex joint like an ankle or wrist is another.

The bandage should be tight enough to feel snug but not so tight as to cause pain, discomfort, numbness, tingling, or cold or blue fingers or toes. These are signs that the bandage is too tight and needs loosening.

To use a compression bandage on a leg or arm:

To use a compression bandage on an ankle:

To use a compression bandage on a wrist:

Don't be afraid to ask for help if you don't know how to use a compression bandage. If in doubt, call your healthcare provider or ask your pharmacist to show you how to use one.

Compression bandages do a good job of keeping the swelling down. However, there's a limit to how long you should compress an injury. At some point, blood flow needs to increase to encourage healing.

To improve healing and prevent injury, there are some dos and don'ts you should follow:

Use a compression bandage for only the first 24 to 48 hours after an injury.

Combine rest and elevation with compression whenever possible.

Remove the bandage at least twice daily for a few minutes before placing it back again.

Ask your healthcare provider if you should sleep with a compression bandage on. If so, loosen it a little bit before bed.

Don't apply ice and compression at the same time. This can cause frostbite.

Don't wrap elastic bandages too tightly. This can cut off circulation.

Don't use a compression bandage to prevent reinjury. The bandages can help stabilize joints, but they neither support nor protect them.

Never use limp bandages. Washing the bandage can help restore some of the elasticity. Buy new ones if needed.

Compression bandages are extremely useful but not appropriate for all situations. There are several alternatives that may be better suited for certain injuries or medical conditions.

For longer-term use, compression wraps may be recommended instead of compression bandages. These are wider pieces of elastic material usually secured with velcro. They are designed for larger body parts, such as the chest or thigh, and provide stable, even compression.

There are also tube-like elastic sleeves and compression socks, also designed for longer use.

Self-adherent compression bandages, such as Coban or Dynarex, are bandages that behave like tape but do not stick to the skin. They can be torn to specific lengths and come in widths ranging from a half-inch to 4 inches.

Self-adherent compression wraps (self-adhesive bandages) are regularly used in athletics or following a blood draw to provide compression. They can even be used as a tourniquet.

Gauze wraps are not as springy as an elastic bandage. They aren't used as much for compression these days because they tend to slip and lose their shape quickly. These are better suited to control bleeding or dress open wounds.

A bandage wrap is appropriate for initial treatment of some injuries, but not all of them. If an injury causes extreme pain, a visible deformity, a locked joint, severe bruising or swelling, or the inability to stand or walk, see a healthcare provider.

A compression bandage is a long strip of stretchable cloth that you wrap around a sprain or strain to apply gentle pressure. By restricting blood flow, swelling and inflammation can be reduced. This not only promotes healing but helps to make the injury feel better.

It is important to use a compression bandage correctly. This includes choosing the right size and wrapping the body part snugly to apply pressure without cutting off circulation. A compression bandage generally should be used for only 24 to 48 hours after an injury.

A sprained wrist or ankle is a common injury, so having a compression bandage in your first aid kit is important. But compression bandages are not intended as a substitute for medical care. Be sure to contact a healthcare provider about your injury.

Urbanek T, Jusko M, Kuczmik WB. Compression therapy for leg oedema in patients with heart failure. ESC Heart Fail. 2020 Oct;7(5):2012–20. doi:10.1002/ehf2.12848

American Red Cross. American Red Cross first aid/CPR/AED participant's manual.

American Academy of Orthopaedic Surgeons. Ankle sprains: what's normal and what's not.

Hansrani V, Khanbhai M, Bhandari S, Pillai A, McCollum CN. The role of compression in the management of soft tissue ankle injuries: A systematic review. Eur J Orthop Surg Traumatol. 2015 Aug;25(6):987-95. doi:10.1007/s00590-015-1607-4

By Rod Brouhard, EMT-P Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

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