PHYSIOLOGIC EFFECTS OF HEAT AND COLD

HOT
Vasodilation
Increase capillary permeability
Increase capillary permeability
Relaxes muscle
Increase inflammation; increase blood flow to
an area, bringing phagocytes
Decrease pain by relaxing muscle
Sedative effect
Reduces joint stiffness by decreasing viscosity
of synovial fluid
COLD
Vasoconstriction
Decrease capillary permeability
Decrease capillary permeability
Relaxes muscle by decreasing muscle
contractility
Slows bacterial growth, decrease inflammation
Decrease pain by numbing the area, slowing
the flow of pain impulses, and by increasing
pain threshold
Local anesthetic effect
Decrease bleeding

VARIABLES AFFECTING PHYSIOLOGIC TOLERANCE TO HEAT AND COLD

1. Body part
2. Size of exposed body part
3. Individual tolerance
4. Length of exposure
5. Intactness of skin

CONDITIONS NECESSITATE PRECAUTION FOR THE USE OF HOT AND COLD

1. NEUROSENSORY IMPAIRMENT
2. Impaired Mental Status
3. Impaired circulation
4. Immediately after injury or surgery
5. Open wounds

REBOUND PHENOMENA- occurs at the time the maximum therapeutic effect of the hot or cold
application is achieved
And the opposite effect of the hot or cold application is achieved and the opposite effect begins.

APPLYING HEAT
>Can be applied both dry and moist method.

A. DRY HEAT
1. Hot water bag or Bottles- inexpensive
-Disadvantages: may leak, and often the weight of the bag or bottle
on patients body part can be uncomfortable.
2. Electric Heating pads- can be used to apply dry heat locally
-Easy to apply and is more safe to use.
Recommendations: -Avoid using pins to secure a heating pad
-place a covering over the pad, preferably one that is moisture proof.
-Place a heating pad anteriorly or laterally to, not under the body part.
-Use a heating pad with a selector switch that cannot be turned up
beyond a safe temperature.
-Assess the skin at regular intervals
3. Aquathermia pads-is a pad constructed with tube containing water.
-the pad is attached by tubing to an electrically powered control unit
that has an opening for water and temperature gauge.
-health problems: back pain, muscle spasms, thrombophlebitis and
mild inflammation.
4. Heat cradle- is a metal frame with a row of 25 watt light bulb.
-the cradle is placed over the client and usually covered with bath blanket or sheet.

-assessed patient every 10minutes.

 -Heat is provided through radiation.
5. Heat lamp- is gooseneck lamp with a 60 watt bulb.
-The lamp is placed 45 to 60 cm (18-24 ich) from the area to be heated.
-Lamp provides heat by radiation.

B. MOIST HEAT
1. STERILE WARM MOIST COMPRESS
-are used on wounds to promote circulation and wound healing and to reduce
edema.
2. SITZ BATH- are method of applying tepid or hot water to the pelvic or rectal area by
sitting in a tub, special chair, or basin filled with sufficient water to reach umbilicus.
3. Warm soaks-the immersion of a body area into warm water or medicated solution.
PURPOSE: -to increase blood supply to a locally infected area.
-to aid in cleaning large and sloughing wounds

APPLYING COLD
-Cold is applied by both dry and moist method

A. DRY COLD
1. ICE BAGS- easy to apply and inexpensive.
-the same advantage with hot water bags.
-apply ice bag for 30minutes and remove it for 1 hour before reapplying it.
2. COLD PACKS- this is commercially prepared.
-these bag are sealed containers filled with a chemical or non toxic
substance.
3. HYPOTHERMIA BLANKET- Used to lower down body temperature.
-this apparatus has coils through which refrigerated solution circulates.
4. MOIST COLD – a.ka cold compress
-applicable for eye injury, headache, tooth extraction and hemmorhoids.
- immerse the material used for the application in a clean basin that contain
pieces of ice and a small amount of water.
-wring the compress thoroughly before applying it to avoid dripping.
-apply for 20minutes and repeat application every 2to3 hours as ordered.

BINDER APPLICATION
ASSESSMENT: - Inspect and palpate the area for swelling.
-inspect for the presence of and status of wounds.
-Note the presence of drainage.
-Inspect and palpate for adequacy of circulation.
-Ask the client from alternate sent about any pain experienced
-Assess the patient for the ability to reapply binder.
-Assess level ADL of patient

TYPES OF BINDER
1. STRAIGHT ABDOMINAL BINDER
- With the client in a supine position, place the abdominal binder smoothly under the
client, with the upper border of the binder at the waist and the lower border at the level of the
gluteal fold.

2. SCULTETUS BINDER
-Bring the tails over to the center from alternate side.
-Secure it with safety pin or Velcro
-Lace the tails from top down. This provide downward pressure to the uterus.