Heat and Cold Application

Learners’ Names: Year Level and Section: BSN 1-A

CHAN, Althea Zen
CHUA, Sophia Maxine
CORNEJO, Kiara Elana
DELOS REYES, Quianne Kisha
DESPACIO, Jenix
DIAZ, Angel Chrizianne
ESTERIOSO, Bianca Lianne
GAMALLO, Khiarra Francheska
GENOVE, Rhys Aizel
LEGARDE, Amira Francheska
LIM, Guyll Gilbert

HOT WATER BAG

Materials Needed: A lined tray containing:

pitcher of hot
water hot water
bag towel

Note: All materials shall be provided by the Central Supply.

Procedure Guide: Hot Water Bag Application

PROCEDURE RATIONALE

1. Secure doctor’s order. Approach the

De Los Reyes. Obtaining a doctor's
patient and explain the purpose and
order will provide the nurse an idea of
nature of the procedure.
what procedures are necessary to be
performed on the patient. Explaining the
reason and nature of the procedure will
help the patient understand their
condition and will promote patient
cooperation.
2. Prepare the needed materials.
De Los Reyes. This is to save time and
energy, this also facilitates accurate skill
performance.
3. Get hot water bag and take out its
CHUA. To begin with the procedure, the
cover.
hot water bag will be utilized first. Once
the nurse grabs the hot water bag, the
nurse should remove its cover to prepare
for the next steps.
4. Remove air from the bag by pressing
CHUA. Prior to filling the hot water bag
its side against a flat surface.
with water, the air should be expelled in
order to make it flexible and inelastic, so
it would retain its desired shape and
position for an amount of time. If the hot
water bag were filled with air, then this
 would not be possible.
5. Hold the neck part of the inlet and fill
CHUA. Holding the neck part of the inlet,
3⁄4 of the bag with hot water.
fill the hot water bag to a three-fourths
capacity. If the hot water bag were to be
filled up completely, then this would not
allow the water to move freely, which
would cause pressure within the hot
water bottle. Once the nurse has finished
pouring the water into the hot water bag,
slowly squeeze the remaining air out of
the hot water bottle so that the water
level rises to just below the top.
Afterwards, tightly screw back on the
stopper to avoid the water from leaking
out.
6. Place filled hot water bag on a flat and
CHAN. It is critical that the hot water bag
press the side to expel the air. Cover
not be overfilled with either water or air. If
the inlet tightly. Lift the bag upside
the air is not expelled, pressure builds up
down to check for any leakage.
on the hot water bag. If you apply
pressure while using it, it will pop and
cause serious injury. Covering the inlet
tightly will secure the hot water inside the
hot water bag and prevent leakage.
Lifting it upside down will ensure that
there are no leaks. This is also to
guarantee that there is no hot water
dripping from the hot water bag to the
patient’s skin.
7. Bring the bag to the patient’s room
CHAN. Proper positioning is essential
and position patient comfortably.
for the comfort and well-being of a
patient. It is also to avoid discomfort
while exposing the body part that needs
heat application.
8. Wrap the hot water bag with the towel
CHAN. Putting hot water in a hot water
and place it over the affected area.
bag made from rubber can cause the
surface temperature of the bag to highly
increase. This kind of heat is intolerable
and can cause burns. That's why the hot
water bag needs to be wrapped with a
towel before placing it on the affected
area.
 PROCEDURE
9. Check the site or area every now and
then for signs of burns.
10. After the prescribed length of time,
remove the bag from site and perform
evaluation.
11. Bring the bag to the station, remove
the cover, wash the bag and hang
dry.
12. Record observations and evaluation
on the patient’s chart. Repeat
procedure as ordered or until nursing
objective is reached.
Updated: February 2022
RATIONALE
CHAN. To ensure that the heat is tolerable
and not causing any pain/burns towards
your patient.
ESTERIOSO. Apply cold and heat therapy
within the prescribed length of time to avoid
the occurrence of rebound phenomenon
where the opposite of the desired outcomes
occur.
CHAN. If the hot water bag is not washed, it
can serve as a breeding ground for bacteria.
CORNEJO. Recording observations and
evaluations ensures proper documentation
of the patient’s condition in the patient chart.
Following the proper procedures and
reaching the objective will help in alleviating
pain or discomfort that the client is
experiencing.
WARM STERILE COMPRESS
Definition: Sterile moist gauze placed on an open wound.
Materials Needed: A lined tray containing:
gauze pitcher of warm water
clean gloves basin
sterile gloves bath towel
waterproof pad kidney basin
solution in a closed bottle biohazard bag
sterile forceps
Note: All materials shall be provided by the Central Supply.

Procedure Guide: Applying warm sterile compress to an open wound

PROCEDURE RATIONALE

1. Review physician’s order.

CORNEJO. Reviewing the physician’s
order will allow the nurse to follow the
rights to administration. This makes sure
that the right procedure is intended for
the client and/or reasons. Reviewing will
also promote safety and security.
2. Gather the necessary materials.
De Los Reyes. Gathering the necessary
materials before doing any procedure
would save time and energy, this also
facilitates accurate skill performance.
3. Identify the patient using two
De Los Reyes. The use of two
identifiers and explain the procedure.
Identifiers also aids in ensuring a correct
match between the service or treatment
and the individual. It is important to
explain procedures to patients because
patient knowledge is likely to increase
compliance.
4. Close door if in private room and/ or
Genove. By closing the door in private
close bedside curtains.
rooms or by closing the bedside curtains
it will provide privacy for the patient.
5. Perform hand hygiene and apply
GENOVE. Hand hygiene must be
clean gloves.
performed when appropriate regardless
of the indications for glove use. Remove
gloves to perform hand hygiene, when
an indication occurs while wearing
gloves. Discard gloves after each task
and clean your hands
6. Place waterproof pad under patient.
CORNEJO. A mattress can be
irreparably damaged by moisture from
spills and accidents. Waterproof pads
offer some protection against allergens
and dust mites, resulting in a cleaner
sleeping surface.
7. Help patient to comfortable position in
CORNEJO. Proper body alignment and
proper body alignment. Expose body
mechanics can help both the patient and
part to be covered with compress and
the nurse to do the procedure in the
drape patient.
most appropriate and efficient way

8. Heat prescribed solution to desired
temperature by immersing closed
bottle solution in a basin of very
warm water.
9. Remove any existing dressing
covering wound. Dispose gloves and
dressing in biohazard bag.
10. Inspect condition of wound and
surrounding skin.
11. Perform hand hygiene.
12. Prepare compress.
-Open sterile supplies.
warmed solution into sterile
container.
-Use sterile technique to add sterile
gauze into warmed sterile solution
to immerse gauze.
possible.
ESTERIOSO. The immersion of a closed
bottle of prescribed solution in a basin of
very warm water heats its contents to the
desired temperature while preserving its
sterility. Heat transfer is done through
conduction since heat the heat from very
warm water in basin is in direct contact
with the bottle of prescribed solution,
consequently warming what is inside it
(The Physics Classroom Tutorial, n.d.).
CORNEJO. Proper disposal can
decrease operational costs, eliminate
risks to their employees, improve the
local environment, and improve
community relations by decreasing and
separating health care waste.
CORNEJO. Inspect the wound to see if
there are any abnormalities that may or
may not affect the process in applying
the warm sterile compress to the patient.
Genove. Washing your hands is one of
the easiest and most important things
you can do to stay healthy and stop the
spread of bacteria and viruses in the
hospitals.
GAMALLO
Pour
Preparing the compress is one of the first
steps the nurse must do before
proceeding to the next steps. Materials
and supplies must be prepared
beforehand as well so as to preserve
one’s time and energy. Furthermore,
using sterile materials as well as the
sterile technique aids in eliminating the
possibility of microorganisms that may
enter the patient’s body.
 PROCEDURE
13. Apply sterile gloves if dressing
change is sterile.
14. Pick-up one layer of immersed gauze,
wring out any excess solution, and
apply it lightly to open wound; avoid
surrounding skin.
15. After a few seconds, lift edge of
gauze to assess for redness.
16. If patient tolerates compress, pack
gauze snugly against wound. Be sure
to cover all wound surfaces with warm
compress.
17. Cover moist compress with sterile
dressing and bath towel. If necessary,
pin or tie in place. Remove and
dispose sterile gloves.
18. Change warm compress using sterile
technique every 5-10 minutes or as
ordered during duration of therapy.
19. After prescribed time, apply clean
gloves, remove towel and compress.
Reassess wound and condition of
skin. Place dry sterile dressing as
ordered.
20. Help patient to preferred comfortable
position.
21. Dispose soiled compress. Perform
hand hygiene.
RATIONALE
GAMALLO
The principle of Microbiology is practiced in
this procedure since applying sterile gloves
helps reduce or eliminate the possibility of
microorganisms that may harm the patient’s
body.
GAMALLO
Wringing out the excess solution from the
gauze helps in avoiding tissue macerations
and the possibility of the solution to
contaminate surrounding areas.
Furthermore, when a gauze is too damp, it
may lose its ability to stick properly on the
patient’s skin.
LIM. There are times when there is a need
to check the redness whether the condition
got better or worse.
GAMALLO
By placing the gauze snugly against the
wound and covering the wound surfaces
with warm compress, it helps in aiding all
areas to be treated uniformly since air would
not be able to enter the wound (prevents
rapid cooling).
GAMALLO
Covering the moist compress with the sterile
dressing and bath towel and pinning it helps
in insulating the compress as well as
preventing heat loss from the wound. And
since the gloves are already used, throwing
it away is the right thing to do since it
prevents the possibility of microbial growth.
GAMALLO
Changing the warm compress every 5-10
minutes helps in preventing cooling. This
also helps in maintaining the therapeutic
benefits that the compress has provided.
GAMALLO
Applying clean gloves aid in preventing the
spread of microorganisms on both the nurse
and the patient. Removing the compress
after a certain type helps in preventing skin
macerations. Furthermore, applying the dry
sterile dressing aids in preventing the
entrance of microorganisms upon the
patient’s wound.
LIM. A patient's posture in bed should be
changed every few hours to keep blood
flowing. This keeps the skin healthy and
keeps bedsores at bay. A patient’s
comfortability throughout the procedure
should also be considered.
Genove.The ability to control sanitation and
prevent transmission improves with the
 disposal of soiled compresses. It should be
properly disposed of, specifically in the
hazardous bin. Performing medical
handwashing following patient contact aids
in the prevention of the transmission of
infectious disease.
22. Do documentation.
GAMALLO
Documentation helps in the verification of
the procedure, and ensures the continuity of
the care. These documents are useful for
future cases as well, especially when it
comes to monitoring the patient and their
recovery or stability.
Updated: February 2022
NON-STERILE COMPRESS (Hot or Cold)
Materials Needed: A lined tray containing:
wash cloth
basin with hot water or ice cubes
waterproof pad
bath
handtowel
clean gloves

Note: All materials shall be provided by the Central Supply.

Procedure Guide: Application of non-sterile compress (hot or cold)

PROCEDURE RATIONALE

1. Check the physician's order.

2. Explain to the client the nature and
purpose of the procedure.
3. Prepare the materials in the
preparation room and bring to
bedside.
4. Don gloves.
5. Immerse wash cloth in basin and
wring it until no water flows out of it.
ESTERIOSO. Physician’s order must be
reviewed prior to approaching the client and
performing non-sterile compress to check for
doctor’s instructions for the kind of
non-sterile compress (hot or cold), site of
application, duration of application, and other
specific orders for client care.
De Los Reyes. Explaining the nature and
objective of the procedure to the patient
would minimize patient anxiety and improve
patient compliance. This also allows the
patient to choose whether or not to get
treatment.
CHUA. Beforehand, the following
materials in the procedure should be
prepared: wash cloth, basin with hot
water or ice cubes, waterproof pad, bath
towel, and clean gloves. Once the
materials are prepared and checked for
its functionality, the nurse will bring them
to the patient’s bedside, where the nurse
can easily access the materials during
the duration of the procedure. The
scientific principle involved in the
preparation of the materials is the
principle of time and energy. The nurse’s
time and energy is conserved during the
procedure as this can effectively and
efficiently save the time and energy of
both the client and the nurse.
ESTERIOSO. In line with the principle of
Microbiology, gloves are used in this
procedure to prevent cross-contamination of
germs and harmful microbes. This promotes
the safety of both the client and the nurse.
DIAZ
This step ensures that the cloth will be wet (
but not excessively) and applied to specific p
arts or sections of the body, assisting in wou
nd cleansing and lowering the risk of infectio
n.
 6. Apply on intended area. Repeat
applications as needed. Be sure to
inspect area for any untoward
reactions.
7. After application, bring materials to the
preparation room and do after care.
8. Do documentation.
Updated: February 2022
DIAZ
This guarantees that it is applied to the corre
ct part, and inspection reduces danger, such 
as open wounds, which are not encouraged i
n this technique since it is not sterile. 
Additionally, this is to limit the likelihood of th
e rebound effect, which can result in more fa
tal occurrences if compression is prolonged, 
thus inspection is essential.
DIAZ
This is to maintain cleanliness and to ensure
that the materials used are kept.
LEGARDE
Document the procedure that was
provided to the patient. This is to record
the patient's care so that other medical
professionals can monitor and plan the
patient's status and care.
PACKS
Materials Needed: A lined tray containing hot or cold pack and towel
Note: All materials shall be provided by the Central Supply.
Procedure Guide: Application of a chemical pack (hot or cold)
PROCEDURE
1. Refer to the healthcare provider’s
order for type, location and duration
of application.
2. Explain procedure to the patient.
3. Prepare necessary materials.
4. Shake the crystals to the bottom of the
bag. Squeeze the bag firmly with your
hands to break the inner water bag.
Shake bag vigorously to mix the
contents.
Preparation of chemical packs vary per
manufacturer. Follow manufacturer’s
instruction how to elicit heat or cold from
the pack.
5. Wrap pack with towel.
6. Apply the pack to the affected area.
Check the patient’s skin periodically.
RATIONALE
GAMALLO
By being informed on the healthcare
provider’s orders, the nurse will be able to be
informed as well on the type of pack to be
given (be it heat or cold), the location as to
where the pack will be placed on the
patient’s body, as well as how long the pack
will be placed. By doing so, this would save
the nurse’s time and energy since the nurse
would not need to go back and forth from the
nurse’s station.
GAMALLO
Informing the patient on the procedures that
will be done on their body is one of their
rights. It is only natural for nurses to accept
these and keep the patient informed on what
they will undergo during the procedure.
GAMALLO
Preparing the necessary materials will save
the time and energy of a nurse since he/she
won’t need to go back and forth from the
nurse’s station if ever the nurse has missed
something. This is also done to ensure that
all materials needed for the procedure are
sterile and has no damages that could
possibly harm the patient.
GAMALLO
Breaking the inner water bag by squeezing it
must be done in order to mix the crystals
together with the water which will create an
endothermic reaction. This reaction allows
the bag to turn cold for several minutes
which will allow the nurse to move on to the
next procedures in administering proper
patient care.
LEGARDE
Placing a towel is a protective barrier
between yourself and the source of heat
or cold to prevent direct skin contact.
Applying directly to the skin may cause
blotchy, red, and rashes.
LEGARDE
Applying hot to the affected area can
reduce joint stiffness and muscle spasm.
The cold application can reduce pain and
tenderness of the area. Checking the
patient’s skin periodically ensures the
temperature of the pack does not harm

7. Administer treatment for the proper
length of time.
8. Discard the bag in an appropriate
receptacle (if disposable).
Refer to manufacturer’s instruction for
reusable packs.
9. Perform hand hygiene.
10. Document the procedure in the
patient’s medical record.
Updated: February 2022
the patient's skin.
DIAZ
It is necessary to adhere to the treatment
schedule in order to avoid any negative side
effects.
LIM. Proper disposal of waster material must
be observed, in order to preserve
cleanliness during and after the procedure.
Some bags may defer as to how it may be
disposed of, some may be recycled and
some one-time use only.
Genove. Hand hygiene is critical because it
protects both patients and healthcare
workers. We wash our hands to avoid the
spread of bacteria and the illnesses they
bring. When giving medical care, keep in
mind the possibility of germ spread and,
eventually, infection.
LEGARDE
Documentation of the procedure is
essential to determine the quality of care
and safety provided to the patient. It is
also to track assessment that was given
to the patient.
ICE BAG/ ICE COLLAR
Materials Needed: A lined tray containing:
Ice bag/ ice collar
chips Bath towel
Note: All materials shall be provided by the Central Supply.
Procedure Guide: Use of Ice Bag or Ice Collar
PROCEDURE
1. Refer to healthcare provider’s order
for type, location and duration of
application.
2. Approach the patient and explain the
purpose and nature of the procedure.
3. Prepare the needed materials.
4. Get the ice bag/ ice collar and take
out its cover.
5. Remove air from the bag/collar by
pressing it against a hard surface with
the opening facing up.
6. Hold the neck part of the inlet and fill
1⁄2 of the bag/collar with ice chips.
Small basin of ice
Spoon or ice picker
RATIONALE
GAMALLO
Being informed on the patient’s
information beforehand will help save
the nurse’s time and energy, since
he/she won’t need to go back and forth
from the nurse’s station. Furthermore,
the nurse will also need the patient’s
information since it will guide the nurse
on how the procedure will be
administered.
GAMALLO
One of the patient’s rights is the right to
be informed on the different procedures
that he/she will undergo. By doing so,
the nurse will not only be making the
patient aware of the procedure, but will
also be able to build trust with the patient
as well.
CHUA. Prior to the application of the ice
bag or ice collar, the following materials
should be prepared: a lined tray
containing an ice bag or ice collar, small
basin of ice chips, bath towel, and a
spoon or an ice picker. The principle of
time and energy is conserved as the
nurse prepares the materials beforehand
to ensure that time management is
followed accordingly.
DIAZ
The ice bag will be used
as part of the treatment.The nurse shoul
d remove the ice bag's lid once it has be
en grabbed.
LIM. Remove air as much as possible to
avoid excess condensation. Air trapped
inside could result in forming water
molecules outside which can be a
hindrance or annoyance throughout the
procedure.
LIM. Properly hold the opening of the
bag to minimize spillage. Funnel or
carefully insert ice chips inside.

7. Cover the inlet tightly. Lift the bag
upside down to check for any
leakage. Dry the outside portion.
8. Bring the bag to the patient’s room
and position the patient properly.
9. Wrap the ice collar with towel. Place
the ice collar/ bag over the intended
area.
10. Remove the bag from the site
when coldness is no longer
appreciated.
11. Repeat application as ordered.
Evaluate once done.
Afterwards, fill a sufficient quantity of
water that can cover the ice and fill up
the bag.
ESTERIOSO. Check for any inlet
leakages to ensure that ice chips are
contained within the ice bag/collar and
the bag is dry for application to prevent
any direct skin contact with ice which
can cause discomfort or frostbite (in
extreme cases) to client (Arctic Zone,
2016).
LEGARDE
Positioning the patient properly ensures
comfort and stability. It also prevents
nerve damage and unnecessary
extension or rotation of the body.
DESPACIO
Collar ice bags are intended to
alleviate pain and/or to promote
healing in minor injured areas
DESPACIO
Always keep an eye on the time. It can
take anywhere from 10 to 20 minutes for
a cold sensation to turn into numbness,
so don't leave an ice pack on the area
for longer than that.
DESPACIO
Applying the cold application for the
recommended period of time improves
the efficiency of the treatment and helps
to prevent discomfort.
 12. Bring bag to the station, remove the DESPACIO
cover, wash the bag and hang it to By hanging the bag upside down, you may
dry. dry it quickly. Fill it with air and keep it in a
safe location once it has dried.

13. Record observations and DESPACIO

evaluation in the patient’s chart.
Updated: February 2022
Date, time, the area to which the processing
is completed, the purpose of the application,
and any reactions, if any, should all be
recorded.

Sources

Arctic Zone. (2016, November 23). What do I do if my ice pack leaks? - Arctic Zone Customer Support

Help Desk. https://support.arcticzone.com/article/13-what-to-do-if-an-ice-pack-leaks

The Physics Classroom Tutorial. (n.d.). Retrieved April 4, 2022, from

https://www.physicsclassroom.com/class/thermalP/Lesson-1/Methods-of-Heat-Transfer

Ice Packs vs. Warm Compresses For Pain - Health Encyclopedia - University of Rochester Medical

Center. (n.d.). URMC. Retrieved April 9, 2022, from

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=p0

0918

Kutz, S. (n.d.). 3 Useful Tips for Icing Your Injury. Sports-health. Retrieved April 9, 2022, from

https://www.sports-health.com/blog/3-useful-tips-icing-your-injury