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4 Hot and Cold Application
4 Hot and Cold Application
Objectives:
The students will be able to
• Identify the physiologic effect of Heat and Cold Applications
• Enumerate the indications and Contraindications of Heat and Cold Therapy
• Identify the different methods of heat and cold therapy
Introduction
• In our life we encounter different injuries caused by accidents one of which is suffering from sprain or strain.
The hot and cold applications are essential to manage these ailments. Hence, it is important to identify the
indications and contraindication of these applications to promote comfort to our clients.
Systemic effect
• HEAT
- Heat may cause excessive peripheral vasodilation, which produces a drop in blood pressure. A significant
drop in blood pressure can cause fainting.
• COLD
- Extensive cold applications and vasoconstriction, a client’s blood pressure can increase.
- Shivering, a generalized effect of prolonged cold
Thermal Tolerance
Conditions that necessitate precautions in the use of heat and cold:
• Neurosensory impairment
• Impaired mental status
• Impaired circulation
• Immediately after injury and surgery
• Open wound
Rebound Phenomenon
• Occurs at the time the maximum therapeutic effect of the hot or cold application is achieved and the opposite
effect begins. (20-30mins- 30-45mins) or cold application (15 C) is achieved and the opposite effect begins
• Safety Alert: An understanding of the rebound phenomenon is essential for the nurse and client. Thermal
applications must be halted before the rebound phenomenon begins.
Cold applications
• Open wounds
• Impaired circulation
• Allergy or hypersensitivity to cold
Heat Applications
Conditions contraindicating the use of heat:
• The first 24 hours after traumatic injury. Heat increases bleeding and swelling.
- Active hemorrhage
- Noninflammatory edema
- Skin disorder that causes redness or blisters
Procedures:
1. Place the hot water bag flat, Fill the bag with hot water about a half to two thirds full
2. Place the hot water bag flat gradually and expel the remaining air
3. Turn the stopper until it is tight
4. Dry the bag and hold it upside down to check for its leaks
5. Wrap the bag in a cloth cover and tighten its ties
6. Place the bag on the body site of the client as appropriate
AQUATHERMIA PAD
• Also referred to as a K-pad
• It is constructed with tubes containing water. The pad is attached by tubing to an electrically powered control
unit that has an opening for water and a temperature gauge.
• Some aquathermia pads have an absorbent surface through which moist heat can be applied. The other
surface of the pad is waterproof. These pads are disposable.
Procedure:
1. Fill the reservoir of the unit two-thirds full of water
2. Set the desired temperature. Check the manufacturer’s instructions. Most units are set at 40°C (104°F) for
adults.
3. Cover the pad and plug in the unit. Check for any leaks or malfunctions of the pad before use.
4. Apply the pad to the body part
5. Use tape or gauze ties to hold the pad in place. Never use safety pins.
6. If unusual redness or pain occurs, discontinue the treatment, and report the client’s reaction.
Key points:
• For unconscious clients, elders, infants, and clients who haven't regain consciousness after anaesthesia, the
safe water temperature should be 50℃ in order to avoid burns.
• For the client with impaired sensation, a large towel should be put over the bag with a cloth cover or a blanket
is used to wrap the bag.
• Remove the bag no more than 30 minutes after application if the purpose is to give treatment.
HOT LAMPS
• to reduce inflammation
• to relieve spasm and pain
• to promote scar and granulation tissue formation
Equipment:
• tray • small rubber drawsheet
• sterile dressing transfer forceps • sterile drape
• dressings • cotton mat
• sterile petrolatum • electrical stove
• sterile cotton swab • thermometer
• sterile gauze • boiler (hot water (50~60℃)
• plastic sheet • hot water bag (if necessary)
Procedures
1. Spread light coat of sterile petrolatum over skin surface to be treated.
2. Cover a sterile gauze on it.
3. Put dressings into the hot water (50~60℃)
4. Then cover it with a plastic sheet and cotton mat.
5. Take out dressings with sterile transfer forceps and wring excess water. Apply the dressing onto the area to
be treated.
Key points:
• Change dressings every 3 to 5 minutes and observe skin condition.
• If continuous compresses are ordered, it can be applied 15 to 20 minutes.
Equipment
• sterile sitz bath tub • sterile gauzes
• sitz bath chair • thermometer
• hot water bottle • large bath blanket
• sitz bath solution
Procedures
1. Place the sitz bath tub in a special chair. Pour the hot water (40~45℃) into the tub until a half full. Then make
prescribed solution.
2. Allow the client to have sitz bath for 15 to 20 minutes and maintain a constant temperature by adding warm
water.
3. Observe the client for pulse, respiration and facial color. (light-headed or nauseated)
4. After the sitz bath, assist the client out of the tub.
Key points:
• The bath tub and medication fluid should be sterile if there is wound.
• It' s not preferred for the female client:
- during mens
- in the latter period of pregnancy / less than 2 weeks after delivery
- having vaginal bleeding having acute inflammation in pelvic cavity
HOT SOAKS
• 43~46℃
• 30min
• Dry cold
- ice bag, ice cap or ice collar
- chemical cold pack
• Moist cold
- cold compress
- cold soaks
- cooling sponge bath
o alcohol sponge bath tepid sponge bath
Preparation
• Assessment
- the client's physical condition
- The client's level of sensation
• Equipment
• Explanation
- The client understands the purpose of the therapy and precautions taken during treatment.
USE OF ICE BAGS
• to reduce body temperature.
• to reduce hemorrhage, swelling and pain after sprains, head injuries and dental surgeries
Equipment
• ice bag
• cloth cover
• towel
• basin
Equipment
• ice cap • Sponges
• drawsheet • rectal thermometer
• bucket • ice
• sterile drape • basin
• small pillow
HYPOTHERMIA BLANKETS
• This appliance is made based on the principle of semiconductor refrigeration. There is a circulating exchange
between the cooled distilled water in the water tank and that in the hypothermia blanket via main machine.
This process facilitates the heat loss of the skin in contact with the blanket, and then the body temperature is
lowered.
• tepid water sponge bath 32~34℃
• alcohol sponge bath 25~35% ; 30℃