Local Application of Cold and Heat

Application of Cold
• Has systemic and local effect
• Can be applied to the body in two ways
1. Moist
2. Dry

Purpose: (Indication)
• To reduce body to during high fever and hyper pyrexia or sun stroke
• To relieve local pain
• To reduce subcutaneous bleeding e.g. in sprain and contusion
• To control bleeding e.g. epistaxis
• To relieve headache
• To provide comfort to a patient in extreme hot weather if desired

1. Moist Cold
• Cold compress
• A cloth (padded gauze) is immersed in cold water and applied in area where we get large superficial vessels E.g. axilla and groin
• Change the cloth when it becomes warm
• Applied for 15-20 min

2. Dry Cold (Ice Bag)
• Ice kept in a bag
• Covered with cloth and applied on an area
• Temperature <150 C

Application of Heat
Purpose
• To relieve stasis of blood
• To increase absorption of inflammatory products
• To relieve stiffness of muscle and muscle pain
• To relieve pain and swelling of a localized inflammation boil or carbuncle – sometimes increases edema, increases capillary permeability
• To increase blood circulation
• To promote suppuration
• To relieve distention and congestion
• To provide warmth to the body

Methods
1. Dry Heat
• Using hot water bottle (bags)
• After contact of the body with moisture of water vapors temperature >46 oC
• 52 oC for normal adults
• 40.5 – 46oC for debilitated or unconscious patient’s and child < 2 yrs
• 2/3 of the bag should be filled with water
• Expel the remaining air and secure the top
• Dry the bag and hold it upside down to test for leakage
• Wrap it in a towel or cover and place it on the body part
• Maximum effect occurs in 20-30 min
• Remove after 30-45 minutes

2. Moist Heat
1. Hot compress: a wash cloth immersed in hot water of temperature 40-46oc and change the site of washcloth frequently
Complication
• Paralysis
• Numbness
• Loss of sensation – fear of burn

2. Sitz bath
Sitz Bath (hit bath)
It is used to sock the client's pelvic area
• A clients sits in a special tub or a bowel
• The area from the mid things to the iliac crests or umbilicus - increases circulation to the perineum (when the legs are also immersed blood circulation to the perineum or pelvic area decrease)
• Temperature of water – 40-43 oc (105-110 o F) – unless the patient is unable to tolerate the temperature

Purpose:
• To relieve pain in post operative rectal condition
• Smoothen irritated skin (perineum)
• Facilitates wound healing (after episiotomy)
• To release the bladder in case of urinary retention

If it is going to be given in the tub – fill ½ the tube with water and add the ordered medication In a bowel – fill 2/3 of it with water – add the ordered medication and dilute The medication to Rx the perineum in KMNO4 sol. 250 mg KMNO4 in 500 ml of water The duration of the bath is generally 15-20 minutes (20-25)
depending on the client’s health. Help the client to dry. NB. Great care has to be taken to prevent heat/cold burns when applying heat or cold especially to elderly.

Study questions:
1. Mention the two purposes of the heat application.
2. Describe the mechanism of action of heat application to effect its purposes.
3. What is tepid sponge?
4. What is the common medicine used in sitiz bath?
5. What is the average duration of time the patient is soaked in sitiz bath?