Use of Cold†

Local Effects
Vasoconstriction, which decreases oxygen to area
Decreased metabolism and thus decreased oxygen needs
Decreased fluid in area and thus decreased swelling
Decreased pain through numbness
Impaired circulation and increased cell death caused by lack of oxygen
Indications
Sprains
Fractures
Swelling
Bleeding
Contraindications
Open wounds because of decreased chance of healing
Impaired circulation because of increased chance of injury
Sensory-impaired patients because of increased chance of injury
Confused patients because of increased chance of injury

Positioning
Dorsal lithotomy Patient lies on back with legs well apart. Knees are bent;
stirrups are often used. Position is used to examine the bladder, vagina,
rectum, or perineum.
Dorsal recumbent Patient lies on back with legs slightly apart. Knees are
slightly bent with the soles of the feet flat on the bed.
Fowler’s Patient is partly sitting with knees slightly bent. The head of the
bed can be at semi-Fowler’s (45 degrees) or high Fowler’s (90 degrees).
Knee-chest Patient rests on knees and chest with head turned to the side.
Position is used to examine the rectum or vagina.
Left lateral Patient lies on left side with hips closer to the edge of the bed.
Left Sims’ Patient lies on left side with right knee bent against abdomen.
Used in rectal examinations and giving enemas.
Prone Patient lies on abdomen with arms at sides.
Reverse Trendelenburg Patient lies on back with legs together. Bed is
straight with head of bed higher than the foot.
Side lying Patient’s head is in straight line with spine. Use pillows to support
head, arms, and upper leg.
Supine (horizontal recumbent) Patient lies on back with legs together and
extended.
Trendelenburg Patient lies on back with legs together. Bed is straight with
head of bed lower than the foot. Used in pelvic surgery.