DEMONSTRATION ON HOT & COLD APPLICATION

INTRODUCTION: -

Applications of heat and cold are commonly used in the hospital and homes as therapeutic measures. in
the hospitals, these measures are carried out at the direction of the physician. heat and cold applications
also serve as comfort measures. applications of heat and cold are also used in the course of physical
medicine as part of a rehabilitation programme such as paraffin bath, whirlpool bath etc.

EFFECT OF HOT AND COLD APPLICATION:-

 Physiological changes due to application of heat:-

❖ Vasodilatation: Increased capillary permeability, increased local metabolism, increased oxygen

requirement.

❖ Decreased blood viscosity, increased blood flow, increased lymph flow, increased motility of
leukocytes, reduce muscle tension.

 Physiological changes due to application of cold:

❖ Vasoconstriction: Decreased capillary permeability, decreased local metabolism, decreased

oxygen requirement.

❖ Increased blood viscosity, decreased blood flow, decreased lymph flow, decreased mobility of
leukocytes, decreased muscle tension.

 Secondary effect from heat application:-

If the heat is applied for one hour or more vasodilatation will be always followed by
vasoconstriction due to the reflex action as the body attempts to control excessive heat loss from the
area. continuous exposure to heat also damages the epithelial cells, localized tenderness and even
blistering.

 Secondary effects from cold application:-

If the cold application is prolonged, it results in reflex vasodilatation to prevent tissue ischemia, which
occurs due to inability to receive an adequate flow of blood and nutrients in the cells, Initially, the skin
appears reddened, followed by bluish purple with numbness and a burning type of pain.

Principles of applications of heat and cold therapy:-

 Heat is a form of energy resulting from the internal vibration of the molecules of which body is
composed.
  Heat is always passed from a hotter body to a cooler one.

 Heat is distributed throughout the body and by direct conduction throughout the tissue.

 Heat is lost from the body chiefly through conduction, convection, radiation, and evaporation.

 The amount of blood that circulates close to the surface of the skin in influenced by the dilatation
and constriction of the peripheral arterioles.

 Application of heat and cold influences dilatation of and constriction of peripheral blood vessels.

 Moisture conducts heat better than air.

 The length of time of exposure to extremes in temperature affects the body’s tolerance to the
temperature.

General instructions for application of heat and cold therapy:-

❖ Assess the condition of the patient prior to, during and after the application of the heat and cold
therapy.

❖ Maintain the correct temperature for the entire duration of the application.

❖ Never use any equipment unless you know its operation completely.

❖ Expose the patient only to a safe tissues.

❖ Never ignore the complaints of a patient, however small they appear to be.

❖ Application of heat and cold must be very carefully used when the patient is unconscious,
anaesthetised or unable to respond to pain.

❖ Any sigh of complications should be recognised early, stop the procedure and report immediately.

❖ During hot and cold application, protect the patient from getting chills. A shivering can raise the
temperature. it also allows a patient to catch a cold.

❖ In hyperpyrexia, the temperature of the body should be brought down gradually and steadily.
sudden cooling is dangerous to the patient.

Application of heat:-
Definition:- Application of heat means the use of an agent warmer then the skin, which may be applied in
either a moist or a dry form. it can be applied to produce a local or system effect or both.

Purpose:-
➢ To promote circulation

➢ To relieve congestion and reduce oedema or inflammation

 ➢ To increase suppuration

➢ To promote tissue relaxation

➢ to relieve pain

➢ To soften the exudates

➢ To provide warmth and comfort

➢ To stimulate peristalsis

➢ To dry casts, moist wounds and burns

Articles required are

ARTICLES RATIONALE
A tray containing:
• A hot water bag with • To provide treatment
cover/ towel- 1

• Jugs- 2 • One to keep hot water

• one to keep cold water

• Duster- 1 • To wipe outside of the

bottle

• Lotion thermometer • To check the

temperature

• Vaseline / oil • To apply on the skin

• A kidney tray and paper • To receive the waste.

bag

Steps of procedure:-
STEPS RATIONALES
• Wash hands • To prevent cross- infection pathogens can
transfer from source to the new host.

• To maintain privacy it helps in giving

• Screen the patient relaxation and comfort to the patient.

• To economise time, energy and material

and organisation facilities performance of
• Collect the supplies from the the task.
treatment room.

• To prepare application within the

• Mix hot and cold water and check acceptable range.
the temperature (the temperature
of the water should be 120-149◦F or
49-65◦C ) or keep the boiling water
till the steam disappears.
• Pour some water into the hot water
bottle and empty it. • To warm the hot water bottle so that
very little heat is lost warm the rubber
through conduction and convection.

• Pour water to fill the 1/2 - 2/3 of the • To avoid unnecessary weight on body
capacity of hot water bottle. part especially if applied on abdomen and
allows to mould over the body area to
provide even heat.

• Expel the air by placing the bag over

a flat surface. cork it tightly. • Air in the bag will interfere with the
conduction of heat and it will not to be
easily moulded to the patient’s body.
• Dry the outside of the bottle and • To prevent scalding of the patient to
hold the bottle upside down for ensure that the bottle is not leaking.
checking leakage.

• Cover the bag with a hot water

bottle cover or other protector and • Protects skin from direct contact with the
apply the hot water bottle to the rubber.
prescribed area.
 • Keep the bottle in the place for
about 20-30 min, change its position • Maximum therapeutic effects from
as necessary. application of heat occur within 20-30
• Inspect the area occasionally for min.
redness pain and swelling.
• Extended use of heat cause tissue
congestion and vaso- constriction.
inspection and changing the position
prevent burns.

After care of the patient and articles:-

 Remove the hot water bag when treatment is over.

 Inspect the area for redness; if redness is present apply Vaseline or oil.

 Note the patient response and make him comfortable.

 Take all the articles to utility room and remove the cover of the bag. empty the bag and wash its
outside with soap and water.

 Dry the bag by hanging upside down. when dried, fill it with some air, cork it and store it in a
proper place.

 Wash the cover of the bag, dry it and put it in a proper place.

 Wash hands.

 Record the procedure with date, time, the area to which it is applied, the purpose of application
and reaction, if any.

 Observe the patient with for its therapeutic effectiveness.

Application of cold:-
Application of cold means using an agent on the skin that is cooler than the skin. the application is either
moist or dry. it can be applied to procedure a local or systemic effect or both.

Purpose:-
➢ To reduce inflammation.

➢ To relief pain.
 ➢ To prevent oedema, and reduce inflammation.

➢ To control haemorrhage.

➢ To decrease metabolism and thus prevent gangrene.

➢ To reduce body temperature.

➢ To anaesthetise an area for a short period.

➢ To inhibit bacterial growth and prevent suppuration.

Objectives:-
 To relieve pain, burning or irritation.

 To control bleeding.

 To prevent gangrene by decreasing the tissue metabolism.

 To prevent or reduce inflammation and oedema.

 To inhibit the bacterial growth and prevent suppuration.

 To reduce the body temperature.

 To anaesthetize an area for a short period.

Ice bag and ice collar:-

 The ice bag or ice cap and ice collar are commonly used for applying dry cold to the body.

 An ice collar is a long narrow rubber or plastic bag, which fits around the neck. the bags are
usually made with an opening through which small pieces of ice are inserted.
Articles required
Articles Rationales
• A big bowl • To keep ice cubes
• An ice bag with cover • To provide cold application
• A mackintosh with a towel • To protect the bed
• A roll of tape or bandage • To secure the bag
• A small container with salt • To sprinkle on ice
• A small spoon • To take ice pieces from the bowl
• A duster • To wipe the bag after filling
• Small ice cubes • To fill in the bag
• A kidney tray and a paper bag • To discard wastes
Steps of procedure:-
Steps Rationales
• Break the ice into small pieces. • For easy insertion of ice bags, makes it
easier to mould the bag to a body part.
Leave the pieces in a bowl for a while to
smoothen the sharp edges.
• Sprinkle sodium chloride. • Salt lower the melting point and
prevents the ice from melting.
• Check the ice bag for leakage by
pouring into it. • To ensure that the bag is in a good
working condition.
• Empty the bag and fill it about 1/3
with ice. • To make the bag light.

• Keep the bag on a flat surface and

squeeze out the air. • Air is removed in order that the ice bag
can be moulded to the patient’s body.
• Screw the cap well and wipe it. invert
and check for any leakage. • To ensure that the bag is not leaking.
dries the excess moisture.
• Put on a flannel cover.
• The cover retains cold for more gradual
application and it absorbs the water
formed by atmospheric condensation.

• Explain the procedure to the patient. • To gain more cooperation.

• Spread the mackintosh and the towel • To protect the pillow.
over the pillow. apply the ice cap on
the area ordered. • To prevent the effect of prolonged
• The ice bag is applied for about half an exposure to cold. to prevent the
hour and then it is discontinued for at secondary effect.
least an hour for the recovery period.
• Chart the treatment and its effect. • Recording is important for any
• Wash the ice bag with soap and water procedure.
and dry it.
• Dry and then powder between the • For re-use.
layers of the rubber and store after
filling it with air. • To store it properly.
After care of the patient and articles:-
➢ Remove the ice bag when treatment is over.

➢ Note the patient response and make him comfortable.

➢ Take all the articles to utility room and remove the cover of the bag. Empty the bag and wash its
outside with soap and water.

➢ Dry the bag by hanging upside down. when dried, fill it with some air, cork it and store it in a
proper place.

➢ Wash the cover of the bag, dry it and put it in a proper place.

➢ Wash hands.

➢ Record the procedure with date, time, the area to which it is applied, the purpose of application
and reaction, if any.

➢ Observe the patient with for its therapeutic effectiveness.

Conclusion:-
Heat and cold applications serve as comfort measures. applications of heat and cold are also used in the
course of physical medicine as part of a rehabilitation programme such as paraffin bath, whirlpool bath
etc.

Bibliography:-
 Nancy. SR, Textbook of principles and practice of nursing, Senior nursing arts procedures, 6 th
edition 2007, published by N.R Publishing house, page no. 461-471, 484-485.

 S. Marguerite, Ambrose, textbook of Nursing procedure, 3rd edition, Page no. 168-169, 170-172.

 Thresyamma. CP, textbook of Fundamental of nursing procedure manual for general nursing and
midwifery course, 1st edition 2006, published by jaypee brothers, page no. 398-408.

 TNAI, textbook of fundamental of nursing a procedure manual, 1st edition 2007, published by
secretary general behalf of TNAI, page no. 410-435.