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Receiving the patient

Greet the patient & introduce yourself.
Develop a good rapport with the patient.
Provide them a comfortable position to sit/laydown
Case sheet reading/History Taking

Name Identification of the patient

Age Modulation of treatment (Adult/Old )
Sex Provide privacy (Male/Female)
Occupation Correlate the symptoms/signs of the patient for ergonomic advice if
Chief Complaints Generation of problem list & Setting goals (Short & long term) for
the treatment
Side Right or Left side of the involvement.
Site Specific area/region to be treated (Anterior/Posterior/Medial/Lateral)
Duration of the condition Acute/Sub-acute/Chronic (Treatment planning & Setting)
Diagnosis Condition of the patient
Verify the absence of General contraindications
Late stages of Diabetes Mellitus
Severe renal and cardiac problems
Cardiac pacemakers
Severe Hypotension and hypertension
Infective conditions like TB
Over the abdomen/lower back during pregnancy
Metal Implants
Mentally retarded patients/
Mentally upset patients
Ask about previous treatments & check the treatment notes

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Explanation regarding the need for the treatment to the patient

Explain the therapeutic benefits of heat therapy

Collection of essential Materials

Hot packs of correct size and shape for the area to be treated.
Adequate pillows, towels, bed sheets.
Two test tubes for hot & cold discrimination test
All the collected materials should be placed near to the treatment couch.

Testing of equipment & Self Demonstration

Explanation to the patient about the treatment, its effects and the sensation he/she feels
during the treatment so as to gain the self-confidence & cooperation of the patient for the
Check for mains output by using the tester, look for any frayed part of power cords
Hydrocollator unit should be working at least 1 hour prior to the application in
thermostatically controlled temperature between 70C and 80C.
Hydrocollator unit can be left on continuously as long as there is enough water in the
Positioning of the patient

Place patient in a well-supported, comfortable & relaxed position.

Use adequate pillows, towels & bed sheets.
Expose the body part to be treated, have patient remove all jewelry from the area.
Drape the untreated part of the patient to preserve modesty, protect clothing, but allow
easy accesses to the body part to be treated.

Preparation of the part to be treated

If there is any oil/cream/gel/dust clean the area with water & soap.
Make sure the treatment part is dry.
Make sure there are no local contraindications present for the treatment.

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Open wounds
Local skin infections
Localized haemorrhagic spots

Check integrity of local sensation by hot & cold discrimination test.

Instructions & Warning to the patient
Instruct the patient NOT TO move the treatment part, NOT TO touch the power cord &
the generator, NOT TO sleep during the treatment.
Inform the patient that he/she should feel only warmth; if it becomes hot the patient
should immediately report to the patient.
Warn the patient if he/she sleeps/not reporting the feeling of warmth during the
treatment; there is a chance of getting blister/burns over the treatment area.
Technique/Methods of application of Treatment

Remove the pack from the unit & place it on the towel.
Fold another towel into 4 6 layers & place it over the pack.
Wrap the whole pack up with the bottom towel.
The temperature of the wrapped pack should not exceed 44C
Set appropriate treatment time for the patient condition. (20 30 min)
Monitor the initial response from the patient to treatment during the first 5 to 10 min
Periodically ask patient if feeling of warmth is too vigorous or comfortable.
Periodically remove the towel and check the skin for mottling
Ask the patient for feedback & by visually inspecting the skin every 5 minutes.
If patient report of excess heat adjusts with more layers of towelling.
If the patient is reporting of not enough heat adjust towel layers ( reduce number of
layers) in next session of treatment
During the treatment maintain the position of hot pack

Termination of the treatment & checking the patients for any adverse reactions
Remove hot pack and remove the materials used for draping from the patient.
Inspect the treatment area for any adverse reactions like blisters/burns/rashes etc.
Ask the patient to maintain the same position for few minutes (In order to avoid postural
hypotension if you are choosing supine/prone position) & then to sit/stand.
Help him/her with the dressing if required.
Winding up
Keep all the collected materials to its original place
Documentation / Recording
Record the side, site, duration & condition of the patient.

Sreeraj S R

Number of towel layers used

Treatment time.
Any adverse reactions if any.
Ask the patient response/feeling towards the treatment area.

Follow up
Fix up the next appointment with the patient

Sreeraj S R