HEAT AND COLD

APPLICATION
WELLA GRACE A. GO, RN, RM
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 HEAT AND COLD APPLICATION
Physiologic Effects of heat and cold application
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Heat Application
■ Opens up blood vessels, which increases
blood flow and supplies oxygen and nutrients
to reduce pain in joints and relax sore
muscles, ligaments, and tendons
■ The warmth also decreases muscle spasms
and can increase range of motion
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■ Applying superficial heat to your body can
improve the flexibility of tendons and
ligaments, reduce muscle spasms, and
alleviate pain
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Heat application serves to:
■ Relieve local pain, stiffness, or aching,
particularly of muscles and joints
■ Assist in wound healing
■ Reduce inflammation and infection
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■ Make the chilly client more comfortable
■ Raise body temperature to help maintain
normal body temperature
■ Promote drainage (draw infected material
out of wounds)
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Warm Sitz Bath
■ A sitz bath is a warm, shallow
bath that cleanses the perineum,
which is the space between
the rectum and the vulva or
scrotum.
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■ A sitz bath can be used for everyday personal
hygiene. It can also provide relief from pain or
itching in the genital area. Water temperature
should be from 43 – 46°C and duration of the
bath is usually 15 – 30 minutes.
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Indications:
■ You recently had surgery on the vulva or vagina
■ You’ve recently given birth
■ You recently had hemorrhoids surgically
removed
■ You have discomfort from hemorrhoids
■ You have discomfort with bowel movements
(e.g. anal fissure)
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Contraindications:
■ Pregnancy
■ Menstruation
■ Renal inflammation
■ Increased irritability of the genital organ
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Tepid Sponge Bath
■ A tepid sponge bath is just washing up with a wash
cloth and a certain temperature of water of about
27 – 37°C.
Indications:
■ Treatment for reducing the
elevated temperature.
■ Bath as a regular, cleansing act.
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Contraindications to the use of heat:
■ The first 24 hours after traumatic injury (heat
increase bleeding and swelling)
■ Active hemorrhage (heat causes
vasodilatation and increase bleeding)
■ Non inflammatory edema (heat increases
capillary permeability and edema)
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■ Skin disorder (heat can burn or cause further
damage to the skin)
■ Localized malignant tumor (heat increase cell
growth and accelerate metastases)
■ Very young and very old client
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Complications:
■ Pain
■ Burns
■ Redness of the skin
■ Edema
■ Pallor (secondary effect)
■ Hyperthermia
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Cold Application
■ Slows down blood flow to an injury, thereby
reducing pain and swelling.
■ Cold therapy slows circulation, reducing
inflammation, muscle spasm, and pain. It
should be used if the area is swollen or
bruised.
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Cold Application serves to:
■ Lower the temperature of the skin and underlying
tissue
■ Vasoconstrict
■ Decrease capillary permeability
■ Slow bacterial growth
■ Decrease inflammation
■ Local anesthetic effect
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Contraindications to the use of cold:
■ Open wound (cold can increase tissue
damage by decreasing blood flow to an
open wound)
■ Impaired circulation (cold can further
impair nourishment of the tissue)
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■ Allergy and hypersensitive to cold
application
■ Some people react by decrease BP
■ Inflammatory response (swelling, joint
pain)
■ Raynaud’s phenomenon
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Complications:
■ Pain
■ Blisters and skin breakdown
■ Gray or bluish discoloration
■ Thrombus formation
■ Redness (secondary effect)
■ Hypothermia
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Midwife Interventions:
■ Assess the condition of the client prior to,
during and after the application of the heat
and cold therapy.
■ Check vital signs including the neuro-
sensorium of the patient.
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■ Use heat and cold application between 20 –
30 minutes only. If heat application exceeds
beyond 30 minutes, the tissues may congest
causing blood vessels to constrict, likewise, if
cold application exceeds beyond 30 minutes,
then vasodilation begins as a protective device
to prevent the body tissue from freezing. Note:
Stop before rebound effect begins!
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■ As midwife in – charge during heat application,
check the temperature first with your elbow to
prevent burns. Also, do not place hot packs directly
to the skin as this may cause burns as well.
■ Never leave the patient during the application
especially if they are too young or too old to ensure
safety.
■ Check also the temperature of the surrounding as
this may affect the result of the application.
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■ Maintain correct temperature for the entire
duration of the application. DO NOT exceed the
normal requirement to prevent damage of
tissues.