ADMINISTERING

COLD THERAPY
ICEBAG/COLLAR/GLOVE/
COMMERCIAL COLD PACK/COLD
MOIST COMPRESSES
What is cold therapy?
 Definition
Cold application means the
application of an agent cooler
than the skin. Cold application is
also either moist or dry.
PURPOSES
• Cold relieves pain
• To prevent inflammation
• To prevent edema
• To arrest bleeding and hematoma
• To decrease the elevated baby temperature
• To anesthetize an area
• To decrease metabolic rate of the body
• To provide comfort
PHYSIOLOGICAL
Cold Application: Primary Effects

EFFECTS
• Peripheral vasoconstriction
• Decreased capillary permeability
• Blood flow w is decreased
• Decreased local metabolism
• Decreased oxygen consumption
• Blood viscosity is increased
• Lymph flow is decreased
• Motility of leukocytes is decreased
• Muscle tone is decreased
Secondary Effects
The primary effect of cold application may last only for 30 minutes to one hour, after this time, a recovery time of one
hour must be allowed or secondary effects (vasodilatation) will take place.
When cold is applied the immediate response is ______ of blood vessels
and decrease/increase of blood flow.

A. Vasodilation, increase
B. Vasoconstriction, decrease
C. Raynaud’s Phenomenon, decrease
D. Thrombosis, increase
EQUIPMENT

•Ice Bag/ collar/glove/

prepackaged cold pack
•Small towel or washcloth
•Tape
•Two pairs of disposable gloves
IF AN ICE BAG/ COLLAR/GLOVE/PREPACKAGED COLD
PACK
is not available/preferred.

Substitute materials
•Plastic lined linen saver
•Clean Basin
•Bath Thermometer
•Pack of 4x4 inch gauze pads
•Solution cooled with ice, 15C
•Cotton Swab Stick
•Ice chips
Assessment should focus on:
• Treatment order and response to previous treatment, if used
• Status of treatment area (edema,local bleeding, integrity)
• Temperature, pulse rate and rhythm)
• Degree of pain and position of comfort, if any
• Ability of the client to maintain appropriate position without
assistance
• Client’s ability to perceive and report pain or freezing sensation
• Presence of medical conditions that may impair sensation or
circulation
• Proper functioning and safety of cooling device
• Sensitivity of skin to cold treatment
STEPS RATIONALE

1. Explain procedure to client. • Decreases anxiety.

2. Perform hand hygiene and prepare • Reduces microorganisms transfer;

equipment. promotes efficiency.
Proceed to step 4 for Ice
bag/Collar/Glove/Commercial cold
pack or cold and moist compress
depending on equipment.
STEPS RATIONALE

Preparing the ice bag/collar/glove Provides cold surface area.

3. Fill the bag/collar/glove about three-fourths

full with ice chips.

4. Remove excess air from the bag/collar/glove

by placing it on a flat surface and gently Improves functioning of the pack; prevents
pressing on it until ice reaches the opening. water seepage.
Contain ice securely (fasten end of bag or collar
or tie the end of the glove).
5. Cover bag etc. with a small towel or wash • Promotes comfort .
cloth (if the bag is made of a soft cloth exterior,
this is not necessary)Proceed to Step 7.

Preparing a commercial cold pack

6. Remove the ice pack from the outer package • promotes efficiency; provides access to pack.
if present.

7. Break the inner seal; hold the pack tightly at

the center in an upright position and squeeze. • Activates chemical ingredients to provide
Do not use a pack if leaking is noted. (chemical coldness.
burn may occur)
8. Lightly shake the pack until the inner contents Localizes activated chemicals.
are lying at the lower portion of the pack. Proceed
to step 7.

PREPARING COLD MOIST COMPRESSES

9. Cool prescribed solution to desired temperature. Facilitates cooling of solution; saturates gauze with
(15C)by running cold tap water over the container solution.
or placing it over a basin of ice. Discard cold tap
water or the basin of ice and pour cooled solution
into the bath basin. Place gauze into the basin.
Prepare Client

Assist client into a comfortable position for • Facilitates compress placement.

application.

• Prevents soiling of linens

Place a plastic pad under the treatment area

Drape client with loose bed linen. • Provides privacy while allowing access to
treatment site.
10. Wring one layer of wet gauze until it is
dripless. • Removes excess solution.

Put on gloves.
• Reduces microorganism transfer.
12. Remove and discard old dressings if • Provides access to treatment site.
present.

13. Remove and discard old gloves and put on • Reduce microorganism transfer,
new gloves.

14. If necessary clean and dry the treatment • Facilitates effectiveness of treatment.
area.

15. Discard and dispose properly for

prepackaged bag/cold packs.
Applying Ice Bag/Collar or Glove or Commercial Cold Pack

16. Place the pack lightly against the treatment • Allows for gradual initiation of
area. vasoconstrictive effect.

17. Remove pack and assess client's skin for • Prevents cold injury.
redness of skin or complaint of freezing
sensation after 30 seconds. Stop treatment if
not tolerated(redness or complaint) and notify
the physician.
• Resumes treatment, stabilizes cold pack.
18. Replace pack snugly against the area if no
problems are noted, and secure with tape.
Applying a Cold Moist Compress
19. Place compress in the wound for several seconds. • initiates vasoconstictive therapy

20. Pick up the edge of the compress to observe the

initial skin response to therapy. • Allows assessment of skin for adverse response to
therapy.
21. Replace compress gauze every 5 minutes or as
needed to maintain coolness, assessing treatment area • Promotes safety; Provides reassessment of
each time. treatment area,.

22. Place the call light within reach and raise the
siderails.
• Promotes communication and safety.
23. Reassess the treatment area every 5 minutes by
lifting the corners of the gauze.
• Monitors effects of treatment over time.
24. After 20 minutes terminate treatment and dry skin.
• Prevents local injury due to overexposure to
treatment.
25. Apply new dressing over
the wound if necessary
26. Reposition client and
raise side rails.
27. Remove all equipment
from the bedside, remove
gloves and perform hand
hygiene.
• Promotes wound
healing.
• Facilitates comfort and
safety.
• Maintain clean
environment; maintains
asepsis.
 DOCUMENTATION
The following should be noted on the client's chart:

• size, location and appearance of treatment area

• status of pain
• type of treatment
• Position of client
• duration of treatment
• client tolerance of treatment
 CONTRAINDICATIONS

Cold should not be applied:

• patients who are in a state of shock and collapse
• there is edema
• there is muscle spasm
• in diseases or disorders associated with impaired circulation
• when there is decreased sensation
• when there is infected wound
• when the patient is having shivering or having a very low temperature
 PRINCIPLES INVOLVED
• Cold causes construction of blood vessels and decrease the blood supply to the area
• Cold decreases metabolism and the cell activity or growth
• The end organs of the sensory nerves in the skin convey the sensation of cold; the
sensations are interpreted in the brain
• Woolen materials absorb moisture slowly, but hold moisture longer and colds off
less quickly than the cotton materials
• Moisture left on the skin causes rapid cooling due to evaporation of the moisture
• Prolonged exposure to moisture increases the skins susceptibility to maceration and
skin breakdown
 COMPLICATIONS

• Pain
• Blisters and skin breakdown
• Maceration (with moist cold)
• Gray-bluish discoloration
• Thrombus formation
• Hypothermia
QUESTIONS
THANK YOU