Pain: Heat and cold applications

Definitions & Key takeaways

The application of heat and cold techniques is a great way to help a client alleviate pain and discomfort. In addition to reducing pain, they can reduce muscle spasms, promote healing, improve mobility, and make the client more comfortable.

The heat helps to relax the muscles, loosens joints, and increases blood flow. It is good for musculoskeletal injuries such as neck and back pain. On the other hand, cold application can help reduce pain and inflammation and limit swelling by reducing blood flow to the affected area. When performing these procedures, it is crucial to observe and document any new or worsening skin changes and report back to the attending healthcare provider.

Chapters:

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Intro0:00–0:39

The application of heat and cold techniques are a great way to help a client alleviate pain and discomfort. In addition to reducing pain, they can reduce muscle spasms, promote healing, improve mobility, and make the client more comfortable.
They may also be used on their own or in conjunction with other pain relieving techniques, depending on the client and their severity of pain.
These include non prescription medications like ibuprofen, prescription medications like narcotics, and physical therapy treatments.
As a nursing assistant, when a client is in pain or discomfort, the first thing you should always do is make sure your clients are in a comfortable position with proper alignment.

Common care tips0:39–1:40

Make sure the wheels on the bed are locked and raise the bed in a good working position that’s comfortable for the client, and cover them so that only the treatment area is exposed.
Afterwards, even though there are many methods we can use to help with a client’s pain, oftentimes it will be decided on by the health care team to apply heat and cold to different areas of the body to make the client more comfortable.
In order to apply heat and cold safely, we need to understand the different ways to apply heat and cold and how to do so properly to avoid harm to the client.
However, as a nursing assistant, make sure you follow your facility’s protocol, the instructions provided when the nurse delegated the task to you and ensure the task is on your list of authorized duties before applying heat and cold application.
Furthermore, if you are ever unsure on how to use any of the heat and cold applications, consult a nurse on your team or refer to the manufacturers instructions.Heat application is typically used for musculoskeletal injuries, such as neck and back pain, to reduce pain and relax muscles.

Dry Heat Application1:40–3:51

It also promotes healing by dilating the blood vessels in the area and increasing circulation. Heat can also loosen up stiff joints and may help to reduce swelling.
The first way we can apply heat is through ‘dry heat application.’ This means the type of heating we use does not have water in direct contact with skin.
This method can be done using an aquathermia pad, heating pad, or commercial heat pack. To apply dry heat, you will need the heat pad or pack, including the heating unit and distilled water if using the aquathermia pad; a pillow; and tape.
To apply dry heat application, first prepare the heat pad and check that it is in good condition. There should be no leaks or worn out or frayed cords.
The aquathermia pad has tubes that fill it with distilled water, where heated water flows in the pad and water is returned to the heating unit.
For heat application, expose only the treatment area and place the pad securing it with tape if needed, and turn the device on once properly positioned and secured to the client, refilling the distilled water when needed.
Heating pads and commercial heat packs are applied in the same way but do not require filling with distilled water. These treatments usually last 15-20 minutes as prescribed, but make sure to check with your nurse.
Heat application can cause a normal amount of warmth and swelling. However, during the treatment, remember to check the treated area every 5 minutes for new or worsening redness, swelling, burns, as well as reports of numbness or pain causing the client discomfort.
If any of these appear, stop the treatment and inform the nurse right away. After treatment is done, turn off the device, remove the heating pad, and inspect the skin.
Help the client get into a comfortable position, reposition the bed, and finally, put away all of the equipment and supplies.
In contrast to dry heat application, ‘moist heat’ application is where water is in direct contact with the skin. Moist heat penetrates the skin deeper than dry heat and has greater and faster effects than dry heat.However, caution should be used with moist heat because it has a greater risk of causing new or worsening redness, swelling, and burns compared to dry heat.

Moist Heat Application 3:51–5:07

It’s crucial you remember to frequently check the treatment area every 5 minutes. There are a few different ways to apply moist heat.
First, hot compress uses a soft pad or cloth soaked in warm water and is applied to the treatment the same way as dry heat applications.
Next, there is the hot soak technique, where the body part or treatment area is placed into warm water. This is often used for areas such as the hand, foot, lower arm, and lower leg.
Finally, you can use a sitz bath, where a client’s lower half and rectal areas are immersed in warm or hot water, which can help to clean perineal and anal wounds, relieve discomfort, promote healing, and stimulate voiding.
After applying moist heat, follow the same steps listed previously for dry heat application for timing, things to observe for, and steps after the treatment is done.

Dry Cold Application5:07–6:47

Next is cold application. Cold application is often used immediately after an injury has occurred, such as sprains and fractures.
It’s used to reduce pain and inflammation and prevents swelling by reducing the blood flow to an area by constricting blood vessels.Now, dry cold applications do not involve water in direct contact with skin and are usually colder than moist cold applications.
Typical dry cold methods include ice bags, ice packs, and ice collars. When applying dry cold, you’ll need: an ice pack or similar method such as a bag with crushed ice, paper towels, a towel, and some tape.
If you don’t have a prepared chemical or gel cold pack, fill an ice bag with crushed ice about halfway. Use paper towels to dry the bag, and make sure the bag does not come in direct contact with the skin by wrapping a towel around it.
Place the ice pack on the treatment area, and secure it with tape if needed. These treatments usually last 15-20 minutes as prescribed, but make sure to check with your nurse.
Cold application can cause a normal amount of pale skin. However, during the treatment, remember to check the treated area every 5 minutes for new or worsening blueish color or paleness, burns or blisters, as well as reports of numbness or pain causing the client discomfort.
If any of these appear, stop the treatment and inform the nurse right away. If needed, add more ice to the ice bag as it melts.
After treatment is done, remove the ice pack, and inspect the skin. Help the client get into a comfortable position and reposition the bed while making sure to put away any equipment and supplies used.
In addition to dry cold application, there is the application of moist cold, which cools the tissue faster and can penetrate deeper than dry cold.

Moist Cold Application6:47–7:41

However, they are not as cold. You can use a cold compress, such as gauze or a chilled washcloth, for moist cold application.
For this procedure, you’ll need: ice, wash basin, a bed protector, and gauze or a washcloth. Before applying moist cold, prepare the cold water by filling the bath basin with ice and water and place the bed protector under the water basin and treatment area to make sure the bed sheets do not get wet.Wet the gauze or washcloth with the prepared water.
Place the wet gauze or cloth on the treatment area, and secure it with tape if needed. After applying, follow the same steps listed previously in dry cold application for timing, looking for complications, and steps after treatment is done.

Reporting and documentation7:41–8:13

While assisting with heat and cold applications, you should recognize important signs, symptoms, and situations where you should immediately tell the nurse.
Report any skin changes including new or worsening redness, swelling, burns, color changes, as well as any client-reported pain or numbness causing discomfort.
After each procedure, be sure to document the date and time of the procedure, type of treatment, treatment area, duration of treatment, and any abnormal observations.
All right, as a quick recap… The nursing assistant can help provide comfort to a client experiencing pain through the use of heat and cold application.

Recap8:13–8:44

Heat relaxes the muscles, loosens joints, and increases blood flow. It is good for musculoskeletal injuries such as neck and back pain.
Cold application can help reduce pain and inflammation and limit swelling by reducing blood flow to the treatment area. When performing these procedures, it is crucial to observe and document any new or worsening skin changes and report back
Pain: Heat and cold applications: Video and Causes | Osmosis