UNIT-VII HEAT AND COLD APPLICATIONS

1. UNIT-VIIHEAT AND COLD APPLICATIONS PRESENTED BY: Mrs. PRASHMA

2. LEARNING OBJECTIVES • To define hot application • To list out the purposes of hot application • To explain the classification of hot applications • To discuss the physiological effects of hot applications • To enumerate the contraindications for hot applications • To explain the complications of hot applications • To discuss the principles of hot applications • To demonstrate the procedure

3. INTRODUCTION Heat and cold are applied to the body for local and systemic effects.This involves use of heat in therapy such as for pain relief and health. It can take the form of a hot water bottle,  packs, whirlpool baths, and others.

4. HEAT AND COLD APPLICATION Hot application DEFINITION : Hot application means the application of an agent Warmer than the skin. Heat is applied in either a moist or dry form.

5. PURPOSES OF HOT APPLICATION: • To provide comfort • To promote circulation • To relax the muscles • To promote healing • To stimulate peristalsis • To soften the exudates • To decrease joint stiffness • To relieve bladder distension • To decrease pain • To counteract sudden drop in temperature

8. CLASSIFICATION OF HOT APPLICATION:

11. PHYSIOLOGICAL EFFECTS OF HOT APPLICATION: • Peripheral vasodilations • Increased capillary permeability • Increased local metabolism • Increased oxygen consumption • Lymph flow increased • Motility of leukocytes is increased • Muscle tone is increased

12. SSECONDARY EFFECT OF HOT APPLICATION: • The primary effect of hot application may last only for 20-40 minutes . • After this time, the heat application must be discontinued and recovery time of one hour is allowed, otherwise secondary effects (vasoconstriction) will take place.

14. PRINCIPLES OF HOT APPLICATION • Heat causes dilatation of blood vessels and increases the blood supply to the area • Heat stimulates metabolism and the growth of the new cells and tissues • The end organs of the sensory nerves in the skin convey the sensation of heat ; the sensations arte interpreted in the brain • Water is good conductor of heat • The flow of heat is from the hotter area to the less hot area • Presence of steam increases the temperature of the hot applications • The temperature tolerance varies with individuals and according to the site and area covered • Friction produces heat

15. COMPLICATIONS OF HOT APPLICATIONS • Pain • Burns • Maceration(moist heat) • Redness of the skin • Edema • Hyperthermia • Pallor (secondary effect)

16. GENERAL INSTRUCTIONS • Protect damaged skin layers exposed which sensitive to temperature variations. • Check a patient frequently during hot applications, the condition of the skin indicates whether tissue injury is occurring • Do not allow a patient to adjust temperature settings • Never position a patient in such a way that he cannot move away from the temperature source. This avoids the risk of injuries from temperature exposure

18. HOT WATER BAG • Hot water bag is common method of applying local dry heat • Hot water bag application is defined as process of applying dry heat by means of a rubber bag on specific part of body PURPOSES: • To provide comfort and warmth • To stimulate circulation • To relieve pain • To relax muscles • To promote healing • To relieve congestion and inflammation • To relieve bladder distension

19. PRELIMINARY ASSESSMENT Check : • Doctors order for any specific instructions • General condition of the patient • Type of application to be used, duration and frequency of treatment • Inspect the part for any lesions • Presence of any contraindications for the application of heat • Self-care ability to follow instruction • Articles available in the unit

20. PREPARATION OF THE PATIENT AND ENVIRONMENT • Explain the procedure to the patient • Provide privacy if needed • Expose only the part that needs treatment • Place in a comfortable position • Arrange the articles at the bedside EQUIPMENT : • Hot water bag with water • Jugs-2 • Duster -1 • Towel-1 • Vaseline or oil • Bath thermometer

21. PROCEDURE • Wash hands • Check hot water bag for any leakage • Check the temperature of water with a bath thermometer • The temperature should be 105-115 F for children and 115-125 F for adults • Keep the bag on flat surface • Pour hot water into bag until 2/3 rd full • Expel excess air by permitting water to come to mouth of bag and then close • Hold bag upside down to check for leakage

22. PROCEDURE • Wipe outside with duster put into flannel cover and apply to part • Expose only the part that needs treatment and apply it. Apply the hot water bag over area and cover it with the towel or sheet • Provide warmth by covering all non-treatment areas with bath blanket or bed covers • Remove bag after about 20-30 minutes

23. AFTER CARE • Dry the area, if moist with perspiration • Inspect the part for redness • Position the patient comfortably on the bed • Cover the patient with sheets and remove the drapes if any • Empty the bag and hang upside down • Replace the articles after cleaning • Wash hands • Record the procedure in nurse's record sheet

25. GENERAL INSTRUCTIONS • The water should not be hot enough to burn the patient • The temperature of the water should be between 105-115 F for children and 115-125F for adult • Air should be expelled out from the hot water bag, because air in the bag will interfere with the conduction of heat • In case of unconscious patient, patient in shock or as infant that hot water bag should be placed outside the blanket covering the patient

26. GENERAL INSTRUCTIONS • Assess the condition of the patient prior to, during and after the application of the heat, watch for the vital signs • Maintain the correct temperature for entire duration of the application • Check the position of hot water bag frequently when the patient is very sick or unconscious

27. CONTRAINDICATIONS • Open wound • Hypertension • Metabolic disorders • Impaired kidney, heart and lung functions • Acute inflammations

28. INFRARED THERAPY Infrared radiation is long visible rays of spectrum used therapeutically for production of heat in tissues. PURPOSES • To promote comfort • To soften connective tissues • To promote healing of bedsores • To improve circulation • To relieve spasm and pain • To promote suppuration • To relieve congestion in internal organs

29. INFRARED THERAPY GENERAL INSTRUCTIONS • The patient and the therapist must wear protective goggles during the procedure • Instruct the patient not to touch the lamp, nor to move close to it during procedure • Advice the patient not to touch lamp • Warn the patient that lamp would become hot after few minutes • Advisable for nurse to stand or stay with patient throughout treatment • Patient and nurse to avoid facing lamp • Keep the patient’s skin clean and dry before using infrared lamp • It helps in the pigmentation of skin, production of vitamin D and bactericidal activity

30. INFRARED THERAPY GENERAL INSTRUCTIONS (conti…) • The duration of treatment is usually 20 minutes PRELIMINARY ASSESSMENT Check • Doctors order for any specific instruction • General condition and diagnosis of the patient • Self-care ability to follow instructions • Type and duration of the treatment • Articles available in the unit

31. INFRARED THERAPY PREPARATION OF THE PATIENT AND ENVIRONMENT: • Explain the procedure to the patient • Provide privacy if needed • Position the patient according to the treatment • Expose only the needed part EQUIPMENT : • Infra red lamp • Inch tape • Top sheet • goggles

32. INFRARED THERAPY PROCEDURE: • Wash hands • Expose area to which heat is to be applied • Drape patient appropriately to avoid exposures • Put on goggles to protect patient’s eyes • Place lamp at a distance 45-55cm (18 inches) • After 5 minutes commencement of treatment AFTER CARE: • Check the condition of patient’s skin for burns, redness and discomfort • Position the patient comfortably on the bed • Replace the articles • Wash hands • Record the procedure in nurse’s record sheet

35. INFRARED THERAPY

37. HOT FOMENTATION Hot fomentation is defined as a process of applying moist heat to localized part of body. PURPOSES : • To relieve pain and congestion • To relieve inflammation • To relieve retention of urine • To relieve intestinal and renal colic • To stimulate nerve ending to stimulate peristalsis • To provide comfort and warmth • To relax muscles • To promote suppuration • To apply sterile compress on wounds

39. PERSONS AT RISK • Fair skin • People with problems sensing pain • Persons with metal • Very young • Elderly o Changes in skin with aging Changes in skin with aging o Those with dementia might miss pain

45. SITZ BATH

46. SUMMARY Today we discussed about meaning of hot application, purposes, contraindications, physiological effects, complications and procedure.

47. CONCLUSION Heat can relieve the stiffness in joints in different cases. Shortwave and Microwave heat application may reduce muscle spasms, and selective heating with microwaves can accelerate absorption of hematomas. This will, in turn, allow the stiff muscle to stretch.

48. EVALUATION MCQ’s 1 . Hot application on blood vessels produce • Vasoconstriction • Vasodialation • Depression of vital signs • Increased viscosity of blood 2. The temperature of the water used for Sitz bath include • 115 F-120F • 110F-115F • 120F-130F • 100F-110F

49. THANK YOU