HEAT & COLD

APPLICATIONS
HEAT APPLICATION - indications
Promotes circulation to an injured area; promotes
healing
Aids in removing debris from infected wound
Relieves muscle spasm
Relieves pain (muscular relaxation)
Overcomes feelings of chilliness
Raises body temp
COLD APPLICATION - indications
Limits accumulation of edema
Controls bleeding
Relieves pain
Produces an anesthetic effect
Reduces body temp
RULE OF THUMB:
Use cold application immediately after injury

Use heat to promote comfort and to improve

circulation, later

HEAT = VASODILATION
COLD = VASOCONSTRICTION
THE EFFECTS… (HEAT & COLD)

Local

Systemic
Effects of Heat
Local Systemic

 Inc. bld flow, O2, nutri, Increased C/O

antibodies, WBCs Increased pulmonary
 Aches, pains, comfort, relief ventilation
 Accelerates inflammatory Decreased BP
process
 Soft tissue healing, inc.
suppuration
 Joint stiffness (arthritis,
contractures, LBP, open
wounds needing debridement)

 DA: edema
Effects of Cold
Local Systemic
 Reduces bld flow, O2, Increased BP
metabolites, wastes Shivering
 Lowers temp
 Pallor, coolness
 Controls bleeding
 Sports injuries

 DA: impaired circulation, cell

deprivation, damage to
tissues
NURSING PRECAUTIONS
 Neurosensory
impairment
 Impaired mental status
 Impaired circulation
 Surgery
 Open wounds
 VARIABLES AFFECTING
Tolerance to Heat and Cold

BODY PART
SIZE OF THE EXPOSED
BODY PART
INDIVIDUAL TOLERANCE
LENGTH OF EXPOSURE
INTACTNESS OF SKIN
 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 II. Moist
 HWB  Compresses
 Aquathermia Pad  Packs
 Hot & Cold Packs  Soaks
 Heat Cradle / heat  Sitz bath
Lamp  Sponge Bath
 Ice Bag/collar
 Hypo/hyperthermia
blankets
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