Heat and cold applications can provide therapeutic benefits through physiological responses. Heat therapy increases blood flow and the delivery of nutrients while decreasing pain. Cold therapy decreases blood flow and inflammation while reducing pain. The duration, area, and patient condition impact the safe and effective use of heat and cold to facilitate healing. Proper documentation is required for legal purposes.

1. Therapeutic Effects of Heat and Cold Applications Facilitates removal of waste & toxins. Produces a local warming effect. Increases absorption of fluid by capillaries & promotes removal of excess fluid from interstitial spaces, Increases capillary permeability Increases delivery of oxygen & nutrients, leukocytes, antibodies to facilitate the inflammatory process. Decreases blood viscosity Increases tissue metabolism Improve blood flow Promote vasodilation Heat Therapy Therapeutic Benefits Physiological Responses

2. Decreases blood flow to site of injury, thereby decreasing inflammation & edema formation. Decreases blood flow, facilitating clotting & control of bleeding. Reduces oxygen consumption of tissues. Raises pain threshold Promotes vasoconstriction Increases blood viscosity Decreases tissue metabolism has a local anesthetic effect Decreases muscle tension Cold Therapy thereby reducing edema Promotes muscle relaxation & decreases pain from spasm or stiffness. Therapeutic Benefits Physiological Responses

3. Maximum vasodilation & vasoconstriction occurs in 30 minutes Heat & cold are directly transferred from on substance to another by conduction A poor conductor is called an insulator . Water is a good conductor; air is not --so skin will tolerated higher temperatures if heat is dry rather than moist --ex: moist, hot compresses are applied at a lower temp than hot water bottle covered in a cloth.

4. The body tolerates greater extremes in temperature when duration of exposure is shorter. The larger the area involved , the less tolerant the skin in to extremes in temperature. Consider the condition of the patient. --unconscious, debilitated, circulatory problems, broken skin have decreased tolerance to extremes in temperature. Selection of temperature depends on: 1. reason used 2. duration 3. method of application 4. condition of patient

5. Legal Aspects 4. Leave on only as ordered. 6. If patient is injured, you can be sued. 1. Always check the order and check hospital or agency's policy. 2. Assess client, especially his/her skin prior to application. 3. Check as frequency as needed depending on type of application, but at least q1h 5. Document: a. treatment used b. how patient tolerated procedure c. how skin looked afterwards