Application of Ice or heat to a specific area of the body Flashcards
What is the rationale behind using this treatment (Pain/Increase ROM/strengthen)? (Heat)
increase in metabolic rate encourages healing
mild inflammatory conditions may benefit due to the increase in phagocytosis
however heat may promote bacterial or viral growth
reduce pain due to stimulation of sensory heat receptors which can activate pain modulation mechanisms.
reducing muscle spasm
sedative effects
increase range of joint motion
treat skin diseases, like fungal infection by keeping skin dry
treating chronic oedema
What the physiological effects of the treatment? (Heat)
increase in metabolic activity, so there is then an increase in the demand for oxygen and nutrients, also all cell activity increases
lower viscosity of blood (thickness and stickiness) due to decreased friction
reduce joint stiffness
increase extensibility of collagen
stimulates sensory receptors of skin
reduce muscle spasm
vasodilation due to the increase in waste products (metabolites)
superficial dilation causes erythema
reduced blood pressure
What structures are affected by the technique? (Heat)
vessels
muscles
sensory receptors
collagen
joint
blood
metabolic activity
What principles are used in carrying out the technique? (Heat)
need to make sure the skin can sense hot/cold to avoid burns
pt should never put their full weight on the heat pack as this could cause a burn
Precautions and contraindications? (Heat)
impaired cutaneous thermal sensation
defective arterial cutaneous circulation
eczema and dermatitis
deep x ray therapy
defective bp regulation
tumours
deep vein thrombosis-active (blood clot in deep vein)
Precautions: cardiac failrue, pregnancy
What is the procedure for applying a hot pack?
position pt, ask if they have used deep heat
explain treatment and recheck any contraindications
gain informed consent
perform skin test
remove pack from hydrocollater tank w tongs
wrap hot pack in a towel (2 layers)
carry over to patient
add further towels so that there are 8 layers total
explain that it should be mild, comfortable warmth and burn is at risk if not
apply hot pack
check area after 5 mins for adverse effects
after treatment, usually 15/20 mins, check for adverse effects
What is the rationale behind using this treatment (Pain/Increase ROM/Strengthen etc)? (Cold)
reduce pain, through endorphin release, reducing oedema and decreasing the release of toxic irritants
reducing muscle spasm by reducing the sensitivity of muscle spindle afferents.
reduce muscle spasticity and the rate of swelling
reduce bleeding and oedema
used to treat OA and RA, helpful due to its effects on reducing pain.
treatment of pressure sores as cooling reduced vascular stasis
What are the physiological effects of the treatment? (Cold)
vasoconstriction to try and preserve heat, therefore restriction of blood flow, after some minutes there is a period of vasodilation and these then alternate
increase in blood viscosity which leads to a decreased blood flow
decrease metabolic activity and phagocytotic activity
delay in synaptic transmission
slowed healing due to reduction in blood flow and metabolism, causing a reduction in oxygen uptake
What structures are affected by the technique? (Cold)
vessels
synapses
phagocytes
metabolic activity
What principles are used in carrying out the technique? (Cold)
if there is knee pain, may be painful to keep the knee extended for a long period of time so place towel underneath in flexion.
can also do ice immersion and ice cube massage (oil not required)
ice placed on top of limb, so it doesn’t go numb and leave risk for burns
make sure ice pack shapes around the joint
make sure towel ends folded up
the ice needs to melt to get the largest cooling effect
Precautions and contraindications? (Cold)
contraindications:
arteriosclerosis
active DVT
peripheral vascular disease
chronic wound
impaired cognition
vasospasm (Raynauds disease)
precautions:
cardiac disease
hypertension
skin hypersensitivity
defective skin sensation
What is the procedure for ice pack application?
explain procedure and check contraindications
gain informed consent
a gutter of polyethene placed under the knee
pt positioned in a half lying position (for knee)
area exposed and put in a comfortable position
perform thermal test to area to be treated
apply oil to area
place ice pack over knee for 20/30 minutes
inspect skin after several minutes to check the skin reaction
after treatment check area for any adverse reactions to the treatment
