Cold therapy promotes vasoconstriction, what is vasoconstriction?
Its the narrowing of blood vessels, decrease in vessel diameter, decreases blood flow to an area
If a patient has diabetes or atherosclerosis, why does cold therapy present increased risk of injury?
nerve endings in extremities are less sensitive do to decreased circulation
This type of cold therapy contains material that are activated by crushing bag or hitting on a hard surface, not reuseable, needs covered with washcloth.
chemical packs/cold pack
Describe moist cold therapy and dry therapy
dry- icepacks, even though the ice is wet it doesnt (shouldnt) touch the pts skin
What is a special consideration to remember about temperatures when applying cold and heat therapy?
short exposure to temp extremes are tolerated better then long exposure
the neck, inner aspects of wrist/forearm, perineal region more sensitive, foot and palm of hand are less sensitive
body responds best to minor temp adjustment and gradual change in temp is preferred
What are indications of adverse reactions to cold therapy?
burning of numbness, mottling of skin, erythema, extreme paleness of skin, bluish discoloration of skin (cyanosis)
What is the physiologic response of cold therapy?
blood vessel constriction-decreased circulation to treated area-inhibition of suppuration (formation of pus)-reduced body temperature- temporary anesthesia to local area-decreased cellular metabolism-slowed bacterial activity in presence of infection-prevent edema-relieve muscle spasm
As a nurse, it is your responsibility to know and inform the patient of normal progression of sensations to cold therapy, what is it:
1.cold
2. pain relief
3.numbness
4.burning pain
How does vasoconstriction help reduce inflammation?
reduces blood flow to an injured part
This type of cold therapy device is a moist/wet form of cold therapy, material is soaked in cold water, excess water removed, and then applied to affected area, with underpad placed beneath site. Typically used to treat inflammation and treat edema.
cool compress
What happens if cold application is left on too long or too cold?
The tissues involved will become damaged, this will be accompanied by a burning pain.
How does cold therapy help decrease localized pain?
causes local anesthesia, increases the pain threshold (able to tolerate pain longer)
What will the body do in an attempt to produce heat?
shiver so if a patient is already shivering, cold therapy is contraindicated
How does cold therapy decrease bleeding?
it increases blood viscosity (thickness) which causes blood to coagulate (clot) at the site of the injury
What does the RICE acronym mean?
ice- applied ASAP, followed by heat once swelling has gone down generally to 24 hours after .
compression- ACE bandage or compression bandage used to support injured area
elevation- elevate injured part above level of heart to promote venous flow and reduce edema
Why is cold therapy used?
treats localized inflammation, and prevents swelling (edema) and pain
improves joint mobility by reducing pain, swelling, muscle spasm, and muscle tension
commonly used to treat sprains, strains, and discomfort after injections and fractures
What temperature and how long should cold therapy be left on?
59 F
on for 20 minutes
This type of cold therapy contains small pieces of crushed ice inside a bag/container, used for mild to moderate pain from an injury, reduces localized swelling and decreases vasodilation.
ice bags/ice collars
What should you use on cold therapy to prevent skin damage?
use a cloth or towel between the device and skin
What do you do if you see an adverse reaction to cold therapy?
remove cold therapy immediately and notify charge nurse or physician
What are contraindications for cold therapy?
if edema is already present
patient has poor circulation
pt has nerve damage
pt shivering or has a high temp (fever)
pt disoriented or unresponsive
What should you assess before applying cold therapy?
circulation, skin color and temperature, pulses, edema, and sensation
What results are expected from cold therapy?
analgesic effects/pain control, reduced bleeding, prevention of edema, temperature reduction
What are special considerations for cold therapy when it comes to older adults and small children:
theyre more sensitive to the cold
remain with pt for first 5 mins of tx to evaluate response, if poor shorten duration of therapy and notify provider
they frequently require more covering for warmth during cold therapy
If edema is already present, why is it not a good idea to apply cold therapy?
cold decreases circulation to area, prevents absorption of interstitial fluid that has accumulated which prolongs edema