1. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 33 Heat and Cold Applications

2. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2  Heat and cold applications: Promote healing and comfort Promote healing and comfort Reduce tissue swelling Reduce tissue swelling  Heat and cold have opposite effects on body function.  You must understand the purposes, effects, and complications of heat and cold applications.

3. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3  Doctors order heat and cold applications.  Before you apply heat or cold applications, make sure that: Your state allows you to perform the procedure Your state allows you to perform the procedure The procedure is in your job description The procedure is in your job description You have the necessary training You have the necessary training You know how to use the equipment You know how to use the equipment You review the procedure with a nurse You review the procedure with a nurse A nurse is available to answer questions and to supervise you A nurse is available to answer questions and to supervise you

4. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4  HEAT APPLICATIONS  Heat does the following: Relieves pain Relieves pain Relaxes muscles Relaxes muscles Promotes healing Promotes healing Reduces tissue swelling Reduces tissue swelling Decreases joint stiffness Decreases joint stiffness  When heat is applied to the skin: Blood vessels in the area dilate. Blood vessels in the area dilate. Blood flow increases. Blood flow increases. Tissues have more oxygen and nutrients for healing. Tissues have more oxygen and nutrients for healing. Excess fluid is removed from the area faster. Excess fluid is removed from the area faster. The skin is red and warm. The skin is red and warm.

5. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5  Complications High temperatures can cause burns. High temperatures can cause burns. When heat is applied too long: When heat is applied too long:  Blood vessels constrict.  Tissues receive less blood.  Tissue damage occurs and the skin is pale.  Persons at risk for complications include: Older and fair-skinned persons Older and fair-skinned persons Persons with problems sensing heat and pain Persons with problems sensing heat and pain Persons with metal implants Persons with metal implants Pregnant women Pregnant women

6. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6  Moist heat applications With a moist heat application, water is in contact with the skin. With a moist heat application, water is in contact with the skin. Moist heat has greater and faster effects than dry heat. Moist heat has greater and faster effects than dry heat. Heat penetrates deeper with a moist application. Heat penetrates deeper with a moist application.  To prevent injury, moist heat applications have lower temperatures than dry heat applications. Types of moist heat applications Types of moist heat applications  A hot compress is a soft pad applied over a body area.  A hot soak involves putting a body part into water.  A sitz bath involves immersing the perineal and rectal areas in warm water.  A pack involves wrapping a body part with a wet or dry application.

7. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 7  Dry heat applications Water is not in contact with the skin. Water is not in contact with the skin. The application stays at the desired temperature longer. The application stays at the desired temperature longer. Dry heat does not penetrate as deeply as moist heat. Dry heat does not penetrate as deeply as moist heat. Dry heat needs higher temperatures to achieve the desired effect. Dry heat needs higher temperatures to achieve the desired effect.  Burns are a risk. Some hot packs and the aquathermia pad (Aqua-K, K- Pad) are dry heat applications. Some hot packs and the aquathermia pad (Aqua-K, K- Pad) are dry heat applications.

8. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8  COLD APPLICATIONS  Cold applications are used to: Treat sprains and fractures Treat sprains and fractures Reduce pain, prevent swelling, and decrease circulation and bleeding Reduce pain, prevent swelling, and decrease circulation and bleeding Cool the body when fever is present Cool the body when fever is present  Cold has the opposite effect of heat.  When cold is applied to the skin, blood vessels constrict.  Cold applications are useful right after an injury.

9. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9  Complications include: Pain Pain Burns and blisters Burns and blisters  From intense cold  When dry cold is in direct contact with the skin Poor circulation Poor circulation When cold is applied for a long time, blood vessels dilate. When cold is applied for a long time, blood vessels dilate.  Persons at risk for complications include: Older and fair-skinned persons Older and fair-skinned persons Persons with sensory impairments Persons with sensory impairments

10. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10  Moist cold applications: Penetrate deeper than dry ones Penetrate deeper than dry ones Are not as cold as dry applications Are not as cold as dry applications  The cold compress is a moist cold application.  Dry cold applications include ice bags, ice collars, and ice gloves.  Cold packs can be moist or dry applications.

11. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11  APPLYING HEAT AND COLD  Protect the person from injury.  COOLING AND WARMING BLANKET  Hyperthermia is a body temperature that is much higher than the person’s normal range. Causes include: Causes include:  Hot weather (heat stroke)  Illness  Dehydration  Not being able to perspire Lowering the person’s body temperature is necessary. Lowering the person’s body temperature is necessary.

12. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12  Hypothermia is a very low body temperature. Cold weather is a common cause. Cold weather is a common cause. The person is warmed to prevent death. The person is warmed to prevent death.  A cooling and warming blanket may be used to treat hyperthermia and hypothermia. When used for cooling, the device is called a hypothermia blanket. When used for cooling, the device is called a hypothermia blanket. When used for warming, it is called a hyperthermia blanket. When used for warming, it is called a hyperthermia blanket.