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  • Heat and Cold Application

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    Bern Nerquit
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    Heat and cold are applied locally and systemically for therapeutic effects. Hot applications promote healing and reduce swelling through vasodilation and increased blood flow. Cold applications relieve pain and control bleeding through vasoconstriction. Proper application of heat or cold follows guidelines for temperature, duration, area of the body, and consideration of any injuries or conditions. The RICES method counters injury by promoting rest, applying ice, compressing the area, elevating it, and providing stabilization.

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    Heat and cold are applied locally and systemically for therapeutic effects. Hot applications promote healing and reduce swelling through vasodilation and increased blood flow. Cold applications relieve pain and control bleeding through vasoconstriction. Proper application of heat or cold follows guidelines for temperature, duration, area of the body, and consideration of any injuries or conditions. The RICES method counters injury by promoting rest, applying ice, compressing the area, elevating it, and providing stabilization.

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    164 views5 pages

    Heat and Cold Application

    Uploaded by

    Bern Nerquit
    Heat and cold are applied locally and systemically for therapeutic effects. Hot applications promote healing and reduce swelling through vasodilation and increased blood flow. Cold applications relieve pain and control bleeding through vasoconstriction. Proper application of heat or cold follows guidelines for temperature, duration, area of the body, and consideration of any injuries or conditions. The RICES method counters injury by promoting rest, applying ice, compressing the area, elevating it, and providing stabilization.

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    of 5

    Heat and Cold Application – HA 2.5.

    20

    - Hat and cold are applied to the body for local and systemic effects
    - Hot application is the application of a hot agent, warmer than skin either in a moist or dry
    form on the surface of the body

    Purpose

    - Promote healing and comfort


    - Reduce tissue swelling

    Therapeutic Application

    i. Heating Agents – transfer heat to patient’s body between various tissue/fluids


    ii. Cooling agents – transfer heat away from patient’s body

    CLASSIFICATION OF HOT APPLICATION

    Local
    Dry Heat Moist Heat
    - Hot water bottles - Warm soaks (local baths)
    - Chemical heating bottles - Hot fomentations (compresses)
    - Infrared rays - Poultices (cataplasm)
    - Ultraviolet rays - Stupes (medical fomentation)
    - Short wave diathermy - Paraffin baths
    - Heating lamps - Sitz bath
    - Electric cradles - Aquathermia pad
    - Electric heating pads
    Systemic
    Dry Heat Moist Heat
    - Sun bath - Steam baths
    - Electric cradles - Hot packs
    - Blanket bed - Whirlpool bath (full immersion bath)

    TEMPERATURE FOR HOT AND COLD APPLICATIONS

    Description Temperature Application


    Very cold Below 15 Ice bag
    Cold 15-18 Cold packs
    Cool 18-27 Cold compresses
    Tepid 27-37 Alcohol sponge bath
    Warm 37-40 Warm bath
    Hot 40-46 Hot soak, hot compresses
    Very hot Above 46 Hot water bag for adult
    Body’s Physiologic Response to Heat and Cold

    i. Local Effects of Heat


    o Vasodilation and increase blood flow to affected area bringing (oxygen, nutrients,
    antibodies, and leukocytes)
    o Promotes soft tissue healing
    o Used for client with joint stiffness and low back pain
    o Sedatice effect
    o Increase inflammation
    o Relieves pain, relaxes muscles, promotes healing, reduces tissue swelling, decreases
    joint stiffness
    ii. Systemic Effect of Heat
    1. Heat Applied on large body area
    2. Excessive peripheral vasodilation
    3. Drop in blood pressure
    4. Fainting attack
    iii. Disadvantage of Hot Application
    1. Increase capillary permeability
    2. Extracellular fluid and substance on plasma to pass through capillary walls
    3. Edema
    iv. Important Points
    o Heat packs can be dry or moist. Dry heat can be applied for up to 8 hours while
    moist heat can be applied for 2 hours. Moist heat is believed to act more quickly
    o Heat should normally be applied to the area for 20 minutes up to 3 times a day
    unless otherwise indicated
    o Single use wraps, dry wraps and patches can sometimes be used continually for up
    to 8 hours
    v. Useful uses for Heat
    o Osteoarthritis
    o Strains and sprains
    o Tendonitis, or chronic irritation and stiffness in the tendons
    o Warming up stiff muscles or tissue before activity
    o Relieving pain or spasms relating to or back injury, including the lower back
    vi. Therapeutic Uses of Local Heat Applications
    o Decreases pain
    o Decreases muscle pain promotes healing
    o Promotes suppuration
    o Relieves deep congestion
    o Softens the exudates
    o Provide warmth
    o Stimulates peristalsis
    vii. Contraindications to the use of Heat
    o The first 24 hours after traumatic injury (heat increase bleeding and swelling)
    o Active haemorrhage (heat causes vasodilation and increase bleeding)
    o Non inflammatory edema (heat causes vasodilation and increase bleeding)
    o Skin disorder (heat can burn or cause further damage to the skin)
    o Localized malignant tumor (heat increases cell growth and accelerate metastases)
    o Client’s with paralysis, open wound, metabolic disorders
    viii. Complications of Hot Application
    o Pains, burns, edema
    o Maceration/ softening (with moist heat)
    o Redness of skin
    o Pallor (secondary effect)
    o Hyperthermia

    CLASSIFICATION OF COLD APPLICATION

    Local
    Dry Cold Moist Cold
    - Ice bag - Ice to suck
    - Ice collar - Cold compress
    - Ice pack (poultice) - Evaporating lotion
    - Ice cradle
    - Chemical cold packs
    Systemic
    Dry Cold Moist Cold
    - Hypothermia - Cold sponging
    - Cold bath
    - Cold pack

    i. Local effects of Cold


    o Lowers the temperature of the skin and underlying tissues
    o Vasoconstriction
    o Decrease capillary permeability
    o Slow bacterial growth
    o Decrease inflammation
    o Local anaesthetic effect
    ii. Systemic Effects of Cold
    1. Excessive cold applications
    2. Vasodilation
    3. Increase blood pressure
    4. Prolonged cold
    5. Shivering
    iii. Therapeutic effects of Cold Application
    o Relieves pain
    o Prevents gangrene
    o Prevent edema and reduce inflammation
    o Control haemorrhage
    o Control growth of bacteria
    o Reduces body temperature
    o Anaesthetic effect on the area
    iv. Contraindications to the use of Cold
    o Open wound (cold can increase tissue damage by decreasing blood flow to an open
    wound)
    o Impaired circulation (cold can further impair nourishment of the tissue)
    o Allergy and hypersensitive to cold application
    o Some people react by decrease blood pressure
    o Inflammatory response (swelling, joint pain)
    v. Complications of Cold Applications
    o Pain
    o Blisters and skin breakdown
    o Maceration (with moist cold)
    o Grey or bluish discoloration
    o Thrombus formation
    o Redness (secondary effect)
    o Hypothermia

    RICES

    - Serves to counteract the body’s initial response to injury

    Rest : limits scope of original injury by preventing further trauma

    Ice: can decrease cell metabolism, reducing the amount of secondary hypoxic injury by enabling
    tissues to live on limited oxygen and secondarily reduces pain (crushed ice is the ideal form of cold
    application during initial injury because it produces the most rapid temperature decrease

    Compression: decrease the pressure gradient between blood vessels and tissue and discourages
    further leakage from capillaries

    TYPES:

    1. Circumferential – provides even pressure


    2. Collateral – pressure on 2 sides (aircast)
    3. Focal – u-shaped horseshoe pads

    Elevation : decreases the hydrostatic pressure within the capillary beds to encourage absorption of
    edema by Lymphatic system

    Stabilization : limits muscle spasm and neutral inhibition related to guarding the injured area (early
    stabilization eases the pain- pain cycle by letting muscles relax)

    REBOUND PHENOMENON: Heat

    - No the opposite effect is occurring because of vascular constriction


    - Recovery time of one hour is advised before reapplication

    REBOUND PHENOMENON: Colds

    - Maximum vasoconstriction occurs when the skin temperature reaches 15 deg or in about 30
    minutes to one hour
    - Vasodilation begins as a protective device to prevent the body tissue from freezing
    - Recovery time of one hour is best before reapplication
    FACTORS AFFECTIONG HEAT AND COLD TOLERANCE

     Body Part
    o Certain areas of the skin have a sensitivity to temperature variations. The inner
    aspect of the wrist and forearm, the neck, and the perineal area are temperature-
    sensitive, while the back of the hand and the foot are not as sensitive
     Duration of Application
    o Therapeutic benefits of heat and cold applications are achieved with short periods of
    exposure to temperature variations. Tolerance increases as the length of exposure
    increases
     Area of body exposed
    o The larger the area exposed to heat and cold, the lower the tolerance to
    temperature changes
     Damage to body surface area
    o Injured skin areas are more sensitive than intact areas to temperature variations
     Individual tolerance
    o Tolerance to temperature variations is affected by age and physical condition. The
    young and the aged are especially susceptible to heat and cold. Neurosensory
    impairments may interfere with the reception and perception of stimuli, increasing
    the risk of injury
     Age
    o Thinner skin layers in children and elderly people increase the risk for burns from
    the heat and cold applications. Older adults have a decreased sensitivity

    Methods of Applying Heat and Cold

     Hot water bag (bottle)


    o More common source of dry heat
    o Inexpensive
    o Improper use leads to burning
     Hot and cold packs
    o Commercially prepared hot and cold packs provide heat or cold for a designated
    time

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