Hot and Cold Compression Therapy – Flashcards
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Rest, Ice, Compression, Elevation
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RICE
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Rest
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R
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Ice - application of cold, heat for more chronic pain
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I
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Compression - garments and their use in pain and other conditions
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C
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Elevation
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E
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Musculoskeletal injury Used for 24-72 hours or until swelling occurs
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When is cold used?
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Blood vessels constrict, reducing swelling Gate Control Theory - cold pathway stimulated so pain not perceived
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What is the MOA of cold therapy?
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Ice bag, cold packs, teething rings, sinus mask, buzzy
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What are the five cold products?
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Reusable, instant, or combination
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What are the different kinds of cold packs?
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Two different chemicals in different compartments, break the barrier and an endothermic reaction occurs
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How does an instant cold pack work?
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Provides cold and vibration to prevent the transmission of pain. Used for needle phobia (children and adults), self-injection, healthcare procedures (dental, cosmetic, and others).
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What is the buzzy device? Why is it used?
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Do not apply to areas that are open/damaged. Outer skin must be intact. Do not use for > 20 minutes. Do not use in patients with impaired circulation or sensation
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What are precautions when using cold therapy?
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48-72 hours after injury Cold is usually used first
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When is heat therapy given?
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Do not use cold which will not allow the area to drain
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What kind of therapy should be given if the area is swollen?
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Heat therapy Sometimes can alternate between hot/cold
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Which therapy is used in chronic pain?
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Causes vasodilation, allowing the body to deliver natural pain relieving substances (endorphins and enkephalins) to the area and helps speed up the healing process Can reduce muscle spasms
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What is the MOA of heat therapy?
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Moist and dry
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What are the two types of heat therapy?
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moisture helps deliver the heat; may penetrate deeper; may be less tolerable
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Moist heat
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Heating pad Hot water bottle Instant and reusable heat packs Moist heat pack Electric moist heat pad Paraffin wax bath Willow Cure
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What are the different heat therapy products?
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AKA Hydrocollator Contain silicone beads which absorb heat Placed in heated water, then wrapped in a terry cover Store in moist environment so beads don't dry out
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What is a moist heat pack?
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AKA Thermophore Electric heating pad which retains moisture with a flannel cover
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What is an electric moist heat pad?
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Used on the hands/feet for arthritis. Body is dipped into heated paraffin wax (126-130 degrees). Provides dry heat
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When is paraffin wax bath used?
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Smart computer assesses condition of treatment area Delivers photonic and thermal energy (heat lasers and light lasers) Thermal - delivers heat to the body; heating internal parts of the body could provide benefit Light therapy - supposedly absorbed by the mitochondria to stimulate healing
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Willow Curve
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Do not use on a laceration Put the product on top of the body, not the body on top of the product (trap heat --> burns). Need airflow Do not use in patients with impaired circulation or sensation (won't be able to tell if it's too hot)
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What are precautions regarding heat therapy?
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injuries, lacerations, circulatory problems, scar reduction after surgery or burns
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When is compression therapy used?
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Laplace's Law: P = T/R R = inversion radius of the skin surface area
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What law explains pressure?
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Compression provided by an inelastic product Support is provided only when the muscle contracts
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Passive compression
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Compression provided by an elastic product Compression is delivered at rest as well as upon muscle contraction
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Active Compression
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ACE bandage wrap Compression garments or devices for all parts of the body Compression garments for burn - custom-made, once skin starts healing to reduce scar formation
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What are the different products that driver compression?
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mm of compression
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What are the units for strength of compression?
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different levels of compression are provided to counteract the effect of gravity Helps prevent pooling of fluids in the legs Usually 100% at the kale and reduces as you move up the leg
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Graduated compression
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Mild Tired, aching legs Minor ankle, leg, and foot swelling
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8-15 mmHg
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Moderate Minor varicosities during pregnancy Tired, aching legs Minor ankle, leg, and foot swelling Postsclerotherapy
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15-20 mmHg
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Firm Moderate to severe varicosities Postsurgical Moderate edema Postsclerotherapy Helps prevent recurrence of venous ulcerations Moderate to severe varicosities during pregnancy Superficial thrombophlebitis
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25-30 mmHg
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Extra Firm Severe varicosities Severe edea Lymphatic edema Manage active venous ulcerations Helps prevent recurrence of venous ulcerations Chronic venous insufficiency Helps prevent posthrombotic syndrome Manages manifestations of PTS Orthostatic hypotension Postsurgical Postsclerotherapy
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30-40 mmHg
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Designed for non-ambulatory patients to prevent thromboembolisms Designed to keep the blood flowing to prevent thrombosis TED = Thrombo Embolism Deterrent
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What are thrombosis prophylaxis or TED stockings?
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Patient is horizontal so they do not need as much compression
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Why is there not as much pressured in TEDS?
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Ankle, calf, and length measurement (usually knee or thigh length) is needed Custom made stockings also available
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How do you determine the correct size of compression stockings?
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Put the stocking on your foot, gently working a ittle at a time over your heel Gently pull the stocking up your leg. Be sure to keep the stocking smooth (no wrinkles/folds) Do not pull or tug on your stockings, which may cause holes and runs. Remove any jewelry that may snag or catch on the stockings Rubber kitchen gloves may help your grip the stockings at your fingertips
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What are counseling points for putting on compression stockings?
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Donning gloves, foot slips (prevent toenail from tearing the stocking, help get it over foot/heel), stocking donner
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What are products that may help with application of compression stockings?
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All day and removed at nighttime
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How long are compression stockings worn?
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Every day with warm water and mild soap; may be placed in washing machine if in a hosiery bag on gentle cycle; check care instructions that come with stockings
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How often are compression stockings washed? How?
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At least two garments so that one can be washed while the other is worn
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How many compression stockings do patients generally have?
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Petroleum based ointments and lotions such as Vaseline
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What should not be used around the stockings because they may cause damage to the fibers?
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3-6 months
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How long do compression stockings generally last?
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Used for more severe circulatory issues. Usually on the lower body or extremities A compression is attached to the garment. These devices provide transient pressure to augment the circulatory system. Compression pump that intermittently inflates and compresses and then releases and repeats Mimics the circulatory system getting fluid in the area
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What is a lymphedema pump?
