The document outlines the principles, applications, and physiological effects of heat and cold therapy in nursing practice. It covers the effects of these therapies on the body, specific conditions for their use, and the responsibilities of nurses in administering them safely. Additionally, it details various methods of application, including hot/cold packs, aquathermia pads, and sponge baths, while emphasizing the importance of client safety and monitoring.

1. HEAT AND COLD THERAPY
Mdm Rozila Binti Ibrahim
September 2022

2. Learning Outcome
At the end of the session, student would be able to;
• Identify the definition and physiologic effect of heat and cold
compress
• Describe the type and principle of the heat and cold application
• Understand the side effect and complication heat and cold
application
• Elaborate nurses’ responsibility in application heat and cold to the
patient

5. Heat and Cold
Application

8. Physiologic Effects of heat and cold
HEAT
• Vasodilation
• Increase capillary permeability
• Increase cellular metabolism
• Increase inflammation
• Sedative effect
COLD
• Vasoconstriction
• Decrease capillary permeability
• Decrease cellular metabolism
• Slow bacterial growth, decrease
inflammation
• Local anaesthesia effect

10. LOCAL EFFECTS OF HEAT
• Old remedy use for aches and pains, promote
comfort and relief.
• Heat cause vasodilation, increase blood flow to
affected area, bringing oxygen, nutrient,
antibiotics and leukocytes.
• Often use clients with musculoskeletal problem,
joint stiffness from arthritis, contractures and
low back pain.

12. LOCAL EFFECT OF COLD
• Cold lowers the body temperature due to
vasoconstriction.
• Vasoconstriction reduces blood flow  reduce
oxygen and metabolic supply, decrease removal
of waste and produces skin pallor and coolness.
• Prolonged expose to cold result in impaired
circulation, cell deprivation and subsequent
damage tissue from lack of oxygen and
nourishment.
• The sign of tissue damage due to cold are a
bluish-purple mottled appearance of the skin,
numbness, blister and pain.
• Often use sport injury eg; sprains, strains,
fractures. Reduce swelling and bleeding

15. Prepare for hot compress

16. Hot water bag
• The water temperature not more than100°F (37.8°C) for babies and
children.
• 120°F - 100°F / (49°C - 37.8°C) for adults
• Hot water bags is also called hot water bottles, are rubber bags filled
with hot water and used for heat therapy. It is used to manage pain,
such as headache or arthritis, or keep yourself warm on a cold night.
• Hot water bottle are safer than electrical heating pads, which can
start fires or cause electric shocks.
• Hot water bags may cause injury if we don’t use carefully.

17. SYSTEMIC EFFECT OF HEAT AND COLD
Heat applied to localized area. Application to large body area may
cause excessive peripheral vasodilation  drop in BP  painting.
Extensive cold application and vasoconstriction, clients BP increase.
Shivering is general effect of prolong cold, respond to warm itself.

18. Thermal tolerance
• Various part of body differ in tolerance to heat and cold.
• The physiologic tolerance individual also varies:
Body part: back, hand and foot not very temperature sensitive.
Inner aspect of wrist, forearm, neck, perineal area - > sensitive
Size exposed: The large area expose, the lower tolerance.
Individual tolerance: very young and very old have lower tolerance.
Length of exposure: People feel hot and cold application most
while temperature is changing, after period of time, tolerance
increase.
Intactness of skin: Injured skin area more sensitive to temperature.

19. Client
condition need
to consider
before
application of
heat and cold.
Neurosensory impairment
Impaired mental status
Impaired circulation
Immediate after injury or surgery
Open wounds

20. Adaption of
thermal
receptors
• Thermoreceptors are rapidly
adapting receptors, which are
divided into two types: cold
and warm.
• Thermoregulatory body
system.

21. Rebound phenomenon

22. Aquathermia Pad
• Aquathermia pad is a plastic or
rubber pad
• contains small channels, it contains
water.
• This water flows through the small
channels of pad. T
• may either used as heating or
cooling pad.
• If the patient needs to take heating
pad on any site of body, then hot
water is added in the aquathermia
pad, and then it is placed on the site.
• Likewise in case of cool pad, cold
water is added to aquathermia pad,
and place it on the site. An electrical
control unit is also attached along
with a motor.

23. Indication of Aquathermia pad
• swelling,
• redness,
• muscle pull,
• muscle sprain and inflammation.
• relief edema.
• relax stiff muscles and contracted muscles of body.

24. Hot and cold packs

25. Compress

28. Heating pad

29. Nurses role caring
patient with heating pad
• Do not apply very hot (above 106°F
or 41.1°C) applications can cause
tissue damage can occur
• Ensure heating pad in good
condition - not torn, not wet, cable
not broken
• Nurses’ role to prevent complication
example electrical shock
• Not more than 30 minutes
• Client wearing cloth. Avoid direct
application on client skin
• Client body is dry.

30. ARM AND FOOT SOAK
• Soaking your feet in warm water is good for
relaxation. It can help you fall asleep easier because
warm water can stimulate blood circulation.
• CONTRAST ARM / FOOT BATHS: This modality is often
given when someone has poor circulation to their
hands or feet (cold hands/feet) or has muscular
and/or fascial tightness in their forearms and hands
(or legs and feet).

31. Sitz bath
• Soak the client pelvic area.
• Often use basin or special tub or chair
 immersed client midthight to iliac
crest or umbilical.
• Use warm water 40C to 43OC…reduce
if client not tolerated.
• Duration for bath 15 – 20 minutes

32. Cooling sponge bath
(tepid sponging)
• To reduce client fever. Promoting
heat loss through conduction and
vaporization
• For high fever only. Temperature >
38⁰C.
• Consideration for rapid skin drop
cause chills that actually increase
heat production.
• Often given antipyretic medication
to reset hypothalamus set point.
• Use normal water temperature

33. Nurse role
provide tepid
sponging
• Sponge face, arms, legs, back
and buttock. Abdomen and
chest not usually sponged.
Use technique “dap and tap
gently” instead of rub. Avoid
rubbing because it will
produce heat.
• Leave area wet
• Use 6 towel to place at large
superficial blood vessels help
transfer of heat:
X 1 at forehead
X2 at both axillary
X2 at both femoral side
X1 for dap over the body

34. Cont…tepid
sponging
• Tepid sponging should
be done not more than
30 minutes.
• Discontinue the tepid
sponging if client
becomes pale or
cyanotic or shivers or if
the pulse becomes rapid
or irregular.
• Reassess temperature at
15 minutes and after
completing the tepid
sponging.