BICOL UNIVERSITY POLANGUI CAMPUS

Level I CIs

HEAT & COLD APPLICATIONS

HEAT APPLICATION - indicationsPromotes circulation to an injured area;

promotes healingAids in removing debris from infected woundRelieves muscle spasmRelieves pain (muscular relaxation)Overcomes feelings of chillinessRaises body temp

COLD APPLICATION - indicationsLimits accumulation of edemaControls bleedingRelieves painProduces an anesthetic effectReduces body temp

RULE OF THUMB:Use cold application immediately after injury

Use heat to promote comfort and to improve circulation, later

HEAT = VASODILATIONCOLD = VASOCONSTRICTION

THE EFFECTS… (HEAT & COLD)

Local

Systemic

Effects of Heat Local Systemic

Inc. bld flow, O2, nutri, antibodies, WBCs

Aches, pains, comfort, relief

Accelerates inflammatory process

Soft tissue healing, inc. suppuration

Joint stiffness (arthritis, contractures, LBP, open wounds needing debridement)

DA: edema

Increased C/OIncreased pulmonary

ventilationDecreased BP

Effects of Cold Local Systemic

Reduces bld flow, O2, metabolites, wastes

Lowers tempPallor, coolnessControls bleedingSports injuries

DA: impaired circulation, cell deprivation, damage to tissues

Increased BPShivering

NURSING PRECAUTIONS

Neurosensory impairment

Impaired mental status

Impaired circulation Surgery Open wounds

BODY PARTSIZE OF THE EXPOSED

BODY PARTINDIVIDUAL TOLERANCE

LENGTH OF EXPOSUREINTACTNESS OF SKIN

VARIABLES AFFECTINGTolerance to Heat and Cold

Pointers

The selection of temperature depends on factors (i.e. duration of application, pt’s condition, skin condition and sensitivity)

Maximum safe limits of both can be tolerated without discomfort or tissue damage

H & C receptors adapt to temp changes

Pointers

Infants & children do not tolerate H&C well. Use appropriate temp per age group.

For emergency use: use a bag of frozen vegetables.

HWB/Ice caps should not be placed directly over client’s skin.

Check for any untoward changes time-to-time!

TEMPERATURES FOR H & C Applications

Description Temperature Application

Very cold < 15 C Ice bags

Cold 15 – 18 C Cold pack

Cool 18 – 27 C Cold compress

TEPID 27 – 37 C TSB

Warm 37 – 40 C Warm bath

Hot 40 – 46 C Hot soak, irrigations, HC

Very hot > 46 C HWB

Methods of Heat & Cold Application

I. Dry HWB Aquathermia Pad Hot & Cold Packs Heat Cradle / heat

Lamp Ice Bag/collar Hypo/

hyperthermia blankets

II. Moist Compresses Packs Soaks Sitz bath Sponge Bath

NURSING INTERVENTIONS - HWB Measure TEMP: N adult : 52C,

Debilitated / Unconscious adult : 40.5 – 46C, < 2y/o: 40.5 -46C.

Fill 2/3 full. Place on a flat surface. Expel air, secure cap. Hold upside

down. Wrap. Apply 20-30mins. Assess area time-

to-time.

NURSING INTERVENTIONS – Ice cap Fill ice cap up to 2/3 full. Pour water over the cubes. Twist the

top and cap. Check for leaks. Wrap. Apply 20-30 min/area. Assess skin time-to-time.

NURSING INTERVENTIONS – TSB

Check ct’s V/S. Protect ct’s bed. Warm the room. Drape ct. Prepare ice caps, HWB, water. Add ice chips to the water gradually. Sponge: face, arms, legs (3-5mins). Slowly and

gently. Back, buttocks (10mins). Leave each area wet, cover with damp towel. Place ice caps (forehead); HWB (feet). Continue up to 25 - 30 mins. Pat dry. Check temp at 15 mins; and after 30 – 60 mins.

MAJOR COMPLICATION

REBOUND PHENOMENON Turns out to be the opposite effect Heat VD VC; Cold VC VD Occurs at the time the maximum therapeutic

effect of the hot or cold application is achieved and the opposite effect begins

NURSING IMPLICATION???

Thank you…

END