cold application in fundamental of nursing including of definition,purpose effect in physiology and secondary effect,therapeutic effect and procdure of applying cold application of patient

1. COLD
APPLICATION
PRESENTED BY-
KHUMBARON SONIA
2ND PB.BSC(N)

2. DEFINITION
Cold application is the application of cold agent, cooler
than skin either in a moist or dry form on the surface of
the body to relieve pain and body temperature, to
anaesthetize an area , to check hemorrhage, to control
growth of bacteria, to prevent edema and reduce
inflammation.

3. PURPOSES OF COLD
APPLICATION
• To reduce raised body temperature during high fever & hyper
pyrexia or sun stroke.
• To relieve local pain
• Cold decrease prostaglandin’s which decreases the sensitivity of
pain receptors, and other substances at the site of injury by
inhibiting the inflammatory processes
• To reduce subcutaneous bleeding. Eg- in sprain & contusion.

4. • To control bleeding. Eg- epistaxis.
• To relieve pain.
• To provide comfort to a patient in extreme hot
weather if desired.
• To reduce swelling and inflammation by
decreasing the blood flow to the area
(vasoconstriction effect).

5. PHYSIOLOGICAL EFFECT OF COLD
APPLICATION
• Peripheral vasoconstriction.
• Decreased capillary permeability.
• Decreased oxygen consumption.
• Decreased local metabolism.
• Increased blood viscocity.

6. •Decreased muscle tone.
•Decreased blood flow.
•Decreased lymph flow.
•Decreased motility of leukocytes.

7. SECONDARY EFFECTS OF COLD
APPLICATION
With the cold applications, the primary effects may
last only 30 mins to 1 hour. After this time, the
cold application must be discontinued and a
recovery time of one hour must be allowed or
secondary effect (vasodilation) will take place.

8. THERAPEUTIC USES OF LOCAL COLD
APPLICATION
1.COLD RELIEVES PAIN- cold decreases the nerve impulse
conduction.
2.PREVENTS GANGRENE-
- Cold decreases the tissue metabolism.
- Cold decreases the effects of tissue anoxia (oxygen lack) &
thereby delay the tissue necrosis.
3. PREVENTS EDEMA & REDUCES INFLAMMATION- It
decreases the blood circulation and prevent fluid congestion. Eg
– sprains.

9. 4.CONTROLS HEMORRHAGE- it causes vasoconstriction & increases the
blood viscosity which helps in the coagulation of the blood and checks
hemorrhage.
5.CHECKS THE GROWTH OF BACTERIA- cutaneous application of cold
reduces the tissue temperature and makes the environment less
favourable for the growth of the microorganisms.
6.REDUCES THE BODY TEMPERATURE- it is withdrawn from the body
by conduction, convection and evaporation. Thus, the body temperature is
reduced.
7.COLD ANAESTHETIZE AN AREA- it decrease the sensitivity of tissues
and creates a sensation of numbness. Thus it can be used as local
anaesthesia for a short period.

10. CONTRAINDICATIONS OF COLD
APPLICATION
• Cold should not be applied on clients who are in a state of
shock and collapse.
• When there is edema.
• In disease associated with impaired circulation. Eg – clients
with diabetes, arteriosclerosis & neurological disorder.
• When there is muscle spasm.
• When there is decreased sensation. Eg- numbness

11. • When there is infected wound which are to be dried of
the pus or if we intend to promote suppuration.
• When the client is having shivering of having a very low
temperature.

12. Classification
of cold
application
Local
Dry cold Moist cold
General
Dry cold Moist cold
- Ice bag - Ice to suck -Hypothermia - Cold sponging
- Ice collar - Cold compress - Cold bath
- Ice pack - evaporating lotion - Cold packs
-ice cradle
-chemical cold packs

13. COLD APPLICATION
ICE BAG
-ice kept in a bag
-covered with cloth and
applied on an area
- temperature <15° C

14. EQUIPMENTS
articles purpose
ice bag (1) To provide cold application
bowel (1) To keep ice cube
Duster (1) To wipe the outside of the jug
Towel (1) / ice bag cover To insulate the coldwater bag
Lotion thermometer (if possible) To check the temperature of the hot water
makintosh to protect the bed
a roll of tape or bandage to secure the bag
spoon (1) to take the ice pieces

15. PRELIMINARY ASSESSMENT OF THE PATIENT
• Explain the purpose and procedure to the patient
• Maintain a comfortable position
• Prevent draugths by covering the patient with a blanket
or a bed cover.

16. STEPS OF PROCEDURE
STEPS
• Break the ice into smalll
pieces
.Sprinkle sodium chloride
• Check the ice bag for
leakage by pouring water into
it.
• Empty the bag and fill it about
2/3 or with ice.
RATIONALE
• For easy insertion of ice into
bag.
• Salt lowers the melting point.
• To ensure that the bag is in
agood working condition.
• This makes the bag light in
weight.

17. • Keep the bag on a flat surface
and squeeze out the air.
• Screw the cap well and wipe it.
• Put on a flannel cover.
.Explain the procedure to the
patient.
.Spread the mankintosh and the
• Air is removed in order that the ice bag can
be moulded to the patient’s body.
• To ensure that the bag is not leaking.
• The cover retain cold for more gradual
application and it absorbs the water formed
by atmospheric condensation.
• To gain more co-operation.
• To protect pillow cover and pillow

18. •The ice bag is applied for about half
and hour and then it is discontinued
for atleast an hour for the recovery
period.
• Chart the treatment and its effect.
• Wash the icebag with water and dry
it.
• Dry & then powder between the
layers of the rubber and store after
• To prevent the effect of
prolonged exposure to cold.
•Recording is important for any
procedure.
• For re-use.
• To store it properly

19. AFTER CARE OF THE CLIENT & ARTICLES
• Remove the ice bag when the treatment completed.
• Dry the area if moist.
• Position the client comfortably on bed.
• Take all the articles to the utility room and replace all the
articles.
• Wash hands.
• Records the procedures with dates and times, the area or
where it is applied, the purpose of the application & the
reaction if any.