Israeli Bandages

Before the Israeli emergency bandage was invented in 1998, wounded soldiers were told to find a rock and wrap it on top of hemorrhaging wounds in order to hold direct pressure.

Although that time was less than 20 years ago, technology has come a long way since then. The emergency bandage’s banana-shaped, plastic pressure bar now does the work of the rock and comes conveniently attached.

These bandages, like so many first aid items, were developed for use in the U.S. military to quickly stop bleeding in emergency situations by putting focused pressure on uncontrollable wounds. They've been actively used in combat by the military since Operation Iraqi Freedom in 2003.

Index:

When you buy the Israeli bandage it comes individually wrapped in a sterile, vacuum-sealed package, but if it’s your first time using one open it up and try it out.

How to stop bleeding with a israeli trauma bandage

Don’t worry about needing to buy a new bandage once you break the seal; although it’s no longer considered sterile you won’t increase the risk of infection as long as the bandages are kept clean[1].

Israeli battle dressing to control hemorrhage

As the bandage is unrolled there is a white string that’s been threaded through the wrap material. This will prevent the elastic wrap from unrolling and falling into dirt or potential contaminants if you accidentally drop the roll. The string will pull through as you wrap the bandage and will fall out at the end.

The bandages are non-reusable because there’s no good way to clean blood out of the absorption pad, so you may want to keep a second one in your house as backup.

Package of an emergency bandage

The package is vacuum-sealed, but I’ve found that there’s a lot of extra plastic hanging off either end that takes up valuable space in a small, portable first aid kit. I cut off both ends of the plastic, so that the wrapping is shaped like a tube that’s the same length as the bandage is wide. Just make sure you don’t cut the instructions off the package.

The rolled up bandage fits snugly inside the package with no wasted space.

How to Use an Israeli Bandage:

On Limbs:

Learn how to apply an emergency bandage with our infographic. Remember that you can download or share our infographic, just remember to reference our site or link this article in your website.

Place the white absorption pad on the wound, holding pressure with your hand to stop the bleeding if possible. Use your other hand to wrap the elastic roll around the limb or body. Slip the elastic bandage through the slot in the banana-shaped plastic pressure bar, and pull it tight. Then pull the elastic bandage back, forcing the pressure bar to lie flat on the pad. Continue to wrap the rest of the elastic bandage tightly around the patient and over the pressure bar making sure to cover the entire absorption pad so that no dirt or debris can slip in. For added pressure, twist the elastic bandage once every time you go over the pressure bar. Secure the hooking ends of the closure bar to the elastic bandage wrap. If bleeding still hasn’t been controlled, take the closure bar and slip it under the last 1 or 2 bandage wraps. Twist the closure bar like a tourniquet windlass to increase the pressure on the wound as shown here. When the bleeding is controlled, hook the closure bar to the bandage to secure it in place.

With this method I wasn’t quite able to get the same pressure as with a tourniquet because the plastic closure bar looked like it was going to break. With a slightly longer, sturdier windlass an israeli bandage could be used as an improvised tourniquet.

If you’re applying the israeli bandage to your own arm, there is an easy way to wrap the bandage 1-handed. At the very end of the wrap next to the absorption pad there is an arm loop. Slide the injured arm through the loop, over the wound and continue to wrap as normal.

On the Chest:

The technique for wrapping the chest is similar to that for the limbs with several potential differences.

When dealing with deep cuts or punctures in the chest, most external bleeding will not be life threatening, and internal bleeding requires emergency hospital care. The main, easily-treatable cause of death related to chest wounds is a punctured lung. This can be treated with a chest seal or occlusive dressing that prevents air flow into the chest cavity through the wound.

While commercial chest seals are available, if you find yourself without one an israeli bandage can be used in its place. Cut open the plastic packaging of the bandage and place it on the absorption pad making sure that the sterile side of the packaging is facing the wound. Wrap the bandage the same way you’d wrap a limb. Be careful that the package lies smooth over the wound with no creases or folds; this should be an airtight seal.

See our article on chest seals and occlusive dressings for more information on sucking chest wounds.

On the Abdomen:

Abdominal wounds don’t need a lot of pressure because there’s no bone to put pressure against.

The absorption pad should be placed over the wound and wrapped like the chest or a limb, but don’t pull the bandage as tight. The purpose of an abdominal dressing is to keep the wound sterile and prevent infection. If possible, moisten the absorption pad before applying. A dry pad will stick to the wound as the blood clots causing it to reopen when the bandage is removed.

An occlusive dressing can be used in conjunction with an israeli bandage to increase the covered area for large wounds.

On the Head:

Pressure bandages can even be used on the head, but you'll need to employ a creative wrapping technique to secure it. With cuts on the scalp the bandage will tend to slip upwards along the curve of the head, so wrap it down under the chin once to keep it in place. Loop the israeli bandage roll behind the top end of the pressure bar to change the wrapping direction as shown in the video here.

On the Neck:

Injuries to the neck can affect 3 major things; the airway, the blood vessels, or the cervical spine. When using a pressure bandage on neck wounds the airway needs to be kept open. Since the major blood vessels in your neck run along either side of the trachea, we're mostly worried about major bleeding from cuts to the side of the neck as opposed to the front or back.

The goal is to put pressure on the blood vessels while still allowing the patient to breathe. To do so, place the absorption pad on the wounded side of the neck and wrap the israeli bandage down under the opposite armpit as shown in the video.

For cervical spine injuries see SAM splints.

To Secure a Splint:

When dealing with a fractured limb, pressure bandages can be used in conjunction with a SAM splint to make an extremely robust splint.

After molding the SAM splint around the fractured limb, wrap the emergency bandage around the limb and the splint in the usual way. With each loop of the elastic wrap move along the length of the splint, so that most or all of the limb is held tight to the SAM splint.

Specialized Types of Israeli Bandage:

Although the basic bandage will work for almost all applications, there are 2 other types of israeli bandages used to treat large wounds or wounds with an entry and exit hole.

Extra Large Emergency Bandage

On the Abdomen

  • This product has a 12x12in (30x30cm) absorption pad with an 8in (20cm) elastic wrap. There is a thin sheet of plastic covering the pad. This prevents abdominal wounds from drying out, protects sensitive tissue from sticking to the absorption pad, and helps seal the wound against outside contaminants.
  • The application method is much the same as the basic israeli bandage, but there are several distinct differences. On this model the pressure bar is not in the center of the absorption pad because the pressure bar serves a different purpose for large wounds like burns or road rash. These won’t benefit from focused high pressure since any bleeding will be spread out over a large area. Instead, the first priority is protecting the cleanliness.
  • Normally, your skin acts as a barrier between you and the outside world; when cut, bleeding helps prevent infection by pushing dirt and debris out of the body, but with wounds covering a large area the skin is either damaged or removed and you’ve lost that barrier. To prevent infection make sure all sides of the absorption pad are covered by the elastic wrap so no dirt can slip in the sides. The other reason the pressure bar is located on the far side of the pad is for torso wounds. The placement lets you cover more of the pad with elastic wrap by saving a revolution of the wrap around the body.

On Amputations

  • When using the large bandage for limb amputations, pull off the plastic cover sheet, and wrap the pad over the stump of the amputated limb to create a protective cup. Wrap the elastic around the limb above the amputation. Do not put pressure directly on the end of the amputation site; instead, the pressure bar goes on the limb above the amputation. Wrap like normal until the last few revolutions. To make the bandage like a tourniquet twist the elastic for the last several revolutions as you wrap so that it’s a round narrow band instead of a wide and flat sheet. Slip the plastic closure hook under the wrap and twist until the bleeding stops.
  • If you have it, a tourniquet is more suited for this application.

Entry/Exit Bandage

The entry/exit bandage is the same as the normal israeli bandage, but it has a second pad for wounds like gunshots that have both an entry and exit wound. Make sure to put the pressure bar on the larger wound, and the secondary absorption pad on the smaller wound.

Tips:

  1. Before using the israeli emergency bandage to stop bleeding, pack the wound with hemostatic gauze. This will cause the blood to clot faster and put more pressure on the wound.
  2. If you use hemostatic gauze, stick the wrapper into the bandage wraps, so the doctor knows what treatment you used.
  3. When unrolling the bandage try not to touch the white sterile absorption pad to keep it as clean as possible before applying it to the wound.
  4. When using a normal israeli bandage on burns or other large area wounds, coat the absorption pad with B&W Ointment to help prevent infection and seal the area.

Summary:

  • Treats major bleeding
  • Comes vacuum sealed and sterile
  • Single use/non-reusable
  • Use with hemostatic gauze for best performance

Additional Resources:

  1. Different Procedures for the Emergency Bandage

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About Peter Oldani - Author of Inside First Aid

About the author

Peter Oldani graduated college with a B.S. in biomedical engineering, worked as an EMT to gain hands on experience in emergency medicine and completed active shooter training as part of New York State’s initiative to prepare civilian organizations for disaster response.