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Hotandcoldapplication 180409164902
Hotandcoldapplication 180409164902
Hot Application
Hot application is the application of a hot agent, warmer than skin either in a moist or dry from
on the surface of the body;
Purpose:-
Cold application
Cold application is the application of a cold agent cooler than skin either in a moist or dry form,
on the surface of the skin.
Purpose
Temperature Fahrenheit
Very Cold 32 to 55 F
Cold 55 to 65 F
Cool 65 to 80 F
Neutral 80 to 92F
Warm 92 to 98 F
Hot 98 to 104F
Conduction: Contact
Convection: movement
Evaporation: through liquid-gas transfer
Radiation: electromagnetic waves
Conversion: transfer from one energy type to another
THERAPEUTIC APPLICATION
Heating Agents ◦ Transfer heat to patient’s body, between various tissue / fluids
Cooling Agents ◦ Transfer heat away from patient’s body.
Peripheral vasodilatation
Increased capillary permeability
Increased oxygen consumption
Increased local metabolism
Decreased blood viscosity
Decreased muscle tone
Increased blood flow
Increase Lymph flow
Increase motility of leucocytes
Peripheral Vasoconstriction
Decreased capillary permeability
Decreased oxygen consumption
Decreased local metabolism
Increased blood viscosity
Decreased muscle tone
Decreased blood flow
Decreased lymph flow
Decreased motility of leucocytes
Maximum vasoconstriction occurs when the skin temperature reaches 150 or in about 30
minutes to one hour.
Vasodilatation begins as a
Recovery time of one hour is best before reapplication.
Body part: 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: 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: The larger the area exposed to heat and cold, the lower the
tolerance to temperature changes.
Damage to body surface area: Injured skin areas are more sensitive than intact areas to
temperature variations.
Individual tolerance: 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: Thinner skin layers in children and elderly people increase the risk for burns from
the heat and cold applications.
Hot application
Malignancies
Impaired kidney, heart & lung functions
Acutely inflammed areas
On clients with paralysis
Open wounds
Edema associated with venous or lymphatic diseases
Headache
Client with metabolic disorders
Very young & very old client
Client with very high temperature
Pain
Burns
Maceration (with moist heat)
Redness of the skin
Edema
Pallor (secondary effect)
Hyperthermia
Therapeutic effect of hot application
1.Hemodynamic
Increase circulation 1.5-2x normal
Increased metabolism (contraindicated in 2-3 days post injury)
Increased inflammation, phagocytosis, & wound healing
Decreased pain (analgesia); not as effective as cryotherapy for acute pain
Decreased muscle spasm
Decreased tissue stiffness (fluids less viscous and collagen releases
Depth of effects are not as great as with cold
Vascular changes are confined to skin (1cm)
2. . Neuromuscular
Increase sensory nerve conduction
Analgesic effects both distal and proximal to area treated This is why non-acute back
patients use heat instead of ice
Reducing muscle spasm
Inhibits muscle contraction
General instruction :-
Assess the condition of the client prior to, during & after the application of the heat &
cold application.
Check vital signs.
Maintain correct temp. for the entire duration of the application.
Never use any equipment unless understand its operation completely.
There must be a recovery period between the application.
Expose the client only requires part..
Don’t allow the client to adjust temp. control
Never ignore the complaints of a client
Make sure that the client is in a position to remove the application if it is causing him
discomfort or advice patient to call for help.
Call bell must be in reach to children.
Never leave client even for short period
Squeeze off water from moist heat applications to prevent scalding.
Apply thin layer of petroleum jelly or oil to skin prior to the application of moist heat
application. It will reduces soaking of the skin & therefore maceration.
Don’t use electrical appliances close to the open oxygen.
If any sign of complication recognized stop procedure immediately.
After procedure, dry the body area gently by patting not by rubbing to remove the
moisture.
Hot water bag to be fill two-thirds to half full with warm water and remove air at the top
so the bag is easier to mold over the body part.
Dry the outside of the bag & test for leakage by holding the bag upside down.
Cover bag with a towel or pillowcase (never apply directly on the skin surface)
Keep bag in place for 20–30 minutes and then remove.
Do not allow the client to lie on the hot water bag.
Cold application
Relieves pain
Prevent gangrene
Prevent edema & reduce inflammation
Control hemorrhage
Control the growth of bacteria
Reduces the body temperature
Anaesthetize an area
1. Hemodynamic Effects
Immediate vasoconstriction
Hunting Response
Response to pain associated with extreme cold
Raynaud's Phenomenon
A vascular reaction to cold application or stress that results in a white, red, or blue
discoloration of the extremities. This happens because the blood vessels under the
skin tighten. When blood does not reach parts of the body, these areas may turn
blue and feel cold.
2. Neuromuscular Efects
Decreased muscle spasm by decreasing muscle spindle activity.
Intramuscular fibers (muscle spindle) runs parallel to fibers of the muscle.
Muscle contraction causes spindle contraction so it remains sensitive. The lower
the temperature, the lower the spindle activity.
3. Decreased Nerve Conduction Velocity
Decreased NCV of sensory and motor nerves occurs ◦
Greatest effect in myelinated, small fibers pain transmitters
Least effect in unmyelinated, large fibers
4. Increased Pain Threshold
5. Metabolic Effects:-
The decrease in metabolism allows them to live without as much oxygen. ◦
Normal body temperature is 37 ° C. ◦ Increase above 45° C (113° F) proteins
denature
6. Inflammation Control
Decreases chemical reactions secondary to acute inflammatory response
Decreased blood flow secondary to vasoconstriction, increased viscosity
7. Edema Control
Decreases intravascular fluid pressure via decreasing blood flow, increased viscosity
Most effective if applied immediately, in conjunction with elevation and compression.
Complication :-
Tissue Death
Frost Bite
Nerve damage :- Unwanted vasodilation due to prolonged vasoconstriction, ischemia,
thromboses in smaller vessels.
Freezing of tissues :- damage at 39 degrees F
To avoid, duration limited to under 45 minutes and tissue temperature above 39
degrees F
When goal is vasoconstriction, treatment limited to 10-15 minutes.
General instruction:-