HOT & COLD APPLICATION

HEAT & COLD APPLICATION

Objectives:

After 4 hours of varied classroom activities the level II students will be able to:

1. define the following terms:

1.1 Hot Application 1.11 Aquathermia Pads

1.2 Cold Application 1.12 Electrical treating Pads

1.3 Aquathermia 1.13 Radiation

1.4 Cold chemical packs 1.14 Connection

1.5 Heat cradle 1.15 Conduction

1.6 Heat lamp

1.7 Ice bag

1.8 Ice collar

1.9 Counterirritants

1.10 Ice Gloves

2. state the importance of heat and cold application

3. give the indications and the contraindications of heat and cold application

4. identify the three (3) processes of heat transfer

5. cite factors affecting heat and cold application

6. enumerate the different methods of heat and cold transfer

7. discuss the physiological effects of heat and cold applications

8. list guidelines in heat and cold application

9. explain the scientific principles involved of heat and cold application

10. enumerate nursing responsibilities before during and after of heat and cold

application

1. Definition of terms

1.1 Heat application - applying of heat to the painful area of the body part to reduce pain.

1.2 Cold application - applying of cold to the painful area of the body part to reduce pain.

1.3 Aquathermia - water flow to treat with warm water.

1.4 Cold chemical packs - contain chemicals that released by stricking, kneading, or squeezing the packs which are used for the therapeutic program.

1.5 Heat cradle - is made of metal bands which have been soldered and shaped in the form of a “half moon”. It is used to apply dry heat to the extremities and affords a good way to help circulation in an extremity

1.6 Heat lamp - is an incandescent light bulb that is used for the principal purpose of creating heat rather than visible light.

1.7 Ice bag - is usually made of rubber or plastic and often has a cloth covering.

1.8 Ice collar - is a specialized type of ice bag, smaller than most ice bags and is used for the neck or the small areas of the body.

1.9 Counterirritants - are drugs which produce vasodilation in l ocal cutaneous tissues.

- an agent that induces local information in underlying or adjacent tissues.

1.10 Ice gloves - is used to protect the hands from extreme cold.

1.11 Aquathermic Pads - also known as aquamatic pad (K- Pad), is a rubber pad constructed with tubes containing water which is heated and maintained at a constant preset temperature by an electric control unit.

1.12 Electrical treating pads - is a method for application of dry heat locally. It is easy to use provides a constant and even heat, and is relatively safe if proper used.

1.13 Radiation - is the transfer of heat form the surface of one object to the surface of another without contact between the two objects, mostly in the form of infrared rays.

1.14 Convection - is the dispersion of heat by movement of liquid or gas

- transfer of heat by movement of liquid of gas

1.15 Conduction - is the transfer of heat from one molecule to a molecule of lower temperature with contact between molecules.

Importance of Heat and Cold Application

ü To relieve spasm

ü To soften exudates

ü To hasten healing

ü To warm a part of the body

ü To increase peristalsis

ü For comfort and relieve

Indications and Contraindications of Heat and Cold Application

INDICATIONS OF HEAT APPLICATION

• For the relief of swelling
• For the healing of wounds and removal of toxin
• Improves elimination of waste
• For increase body temperature
• For warmth, comfort and relief fatigue.

INDICATIONS OF COLD APPLICATION

• Relief of pain
• Controlling hemorrhage
• Reducing fever
• For comfort

CONTRAINDICATIONS OF HEAT APPLICATION

• Non-inflammatory edema
• Acutely inflamed areas
• Localized malignant tumor
• Skin Disorder causing redness of blisters
• Cutaneous injuries

CONTRAINDICATIONS OF COLD APPLICATION

• Open wounds
• Impaired circulation
• Allergy of hypersensitivity
• Lowered body temperature, shivering
• Presence of neuropathy

Precautions for the Uses of Heat and Cold Application

Ø Sensory Impairment

§ Persons with sensory impairments are unable to perceive that heat is damaging the tissues and are at risk for burns or they are unable to perceive discomfort from cold and are unable to prevent tissue injury.

Ø Impaired Mental Status

§ Confused persons and persons with an altered level of consciousness lack full awareness and are unable to cooperate during the application, making such a therapy unsafe for them.

Ø Impaired Circulation

§ Persons with peripheral vascular disease, diabetes, congestive heart failure lack the normal ability to dissipate heat via the blood circulation, which put them at risk for tissue damage.

Ø Low Heat Tolerance

§ Infants, children, and older clients tolerate temperature changed poorly. Precautions are needed to prevent burning.

Ø Open Wounds

• Tissues and an open wound are more sensitive to heat and cold.

The (3) Processes of Heat Transfer

1. Conductive Heat

§ Provided by direct application of heat or immersion in heated bath water

· Ex. Hot water bag, disposable hot and cold pack, aquathermic pad, and warm compress.

§ Heat is transferred directly to the skin and then to the underlying tissues

§ Relatively superficial

2. Conversive or Radiant Heat

§ Provided by a heat lamp

· Ex. Standard lamp, heat lamp, and heat cradle

3. Convective Heat

§ Easily applied by heating the surrounding air

§ Transfer of heat by conduction in a moving medium, such as fluid.

Factors Affecting Heat and Cold Application

1. The intensity of the temperature

2. Prior skin temperature

3. Rapidity of temperature

4. Duration of the application

5. Environmental temperature

6. Differences in temperature toleration level

7. Traumatic damage

8. Amount of body surface area

9. Generalized systematic responses

10. Age of patient

Methods of Heat Application and Cold Application

Heat Application

Ø Use of Hot Water Bag (bottle) 40° - 46° C/37 – 40°

Ø The Disposable Hot Pack 101° - 114° F

Ø The Aquamatic Pad (K-Pad) 40.5° C

Ø The Electric Heating Pad

Ø The Heat Cradle

Ø The Hip or Sitz Bath 40 – 43 °

Ø Warm Soak

Ø Heat Lamp

Cold Application

Ø The Ice Bag (Ice Collar) below 15° C

Ø Disposable Cold Pack

Ø Cold Compress

Ø Cold Soaks

Ø Alcohol or cold sponge bath

Physiological Effects of Heat Application and Cold Application

Ø Heat Application

1. Heat raises the temperature of the skin and underlying tissues, causing vasodilation.

2. Heat and vasodilation increase local cellular metabolism

3. Heat increases capillary permeability

4. Heat accelerates the inflammatory process by increasing both the action of phagocytic

cells that ingest microorganisms and other foreign material and the removal of the

waste products of infection.

5. Heat promotes muscle relaxation

6. Heat also makes the connective tissue more flexible

7. Heat to the abdomen decreases peristalsis

8. Heat relieves pain

Ø Cold Application

1. Cold decreases capillary permeability

2. Cold, like heat can reduced muscle spasm

3. Cold alters tissue sensitivity

4. Cold relieves pain, particularly which associated with muscle spasm

5. Prolonged exposure to cold results in impaired circulation

Guidelines in Heat and Cold Application

• Determine the client’s ability to tolerate the therapy

• Identify conditions that might constrain treatment.

(e.g., bleeding, circulatory impairment)

• Explain the application to the client

• Assess the skin area to which the heat or cold will be applied

• Ask the client to report any discomfort

• Examine the area to which the heat or cold was applied.

The Scientific Principles Involved of Heat and Cold Application

1. Anatomy and Physiology

v our blood vessels react to the application of Heat and Cold. Heat applications improves blood flow to an injured part.

2. Physics

v conduction, convention and radiation may transfer heat from one place to another.

3. Chemistry

v commercially prepared hot packs are activated by striking, kneading or squeezing the pack wherein chemicals are mixed and released heat.

4. Microbiology

v hand hygiene should be observed.

5. Sociology

v people differ on their degree of heat and cold toleration.

6. Psychology

v application of heat or cold on the skin gives therapeutic effects to the patient.

7. Safety and Security

v nurse must know the recommended temperatures in applying the heat and cold application to the client

Nursing Responsibilities

BEFORE:

• Refer the physician’s order
• Perform medical handwashing
• Ensure proper operation of equipment
• Explain steps of procedure and purpose to client

DURING:

• Ensure privacy
• Assist client in assuming comfortable position

AFTER:

• After the application, gather the materials used, dispose these appropriately and do after care.
• Perform medical handwashing
• Record the application compress, observations, solutions used, appearance of wound and any exudates, any statement of discomfort from the patient.