Heat and Cold Applications
Applying a Hot or Cold Pack or an Ice Bag, Collar, or Glove
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- » Applying a Hot or Cold Compress
- » Applying a Hot or Cold Pack or an Ice Bag, Collar, or Glove
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Purpose
- Heat applications can be applied to almost any body part. They are often used for musculoskeletal injuries or problems (sprains, arthritis). They cause blood vessels to dilate (expand or open wider). Heat relieves pain, relaxes muscles, promotes healing, reduces tissue swelling, and decreases joint stiffness.
- Heat applications may be moist (water is in contact with the skin) or dry (water is not in contact with the skin). A hot pack may be a moist or dry heat application. It involves wrapping a body part.
- Water conducts heat. Moist heat has greater and faster effects than dry heat. Heat penetrates deeper with a moist application. To prevent injury, moist heat applications have lower temperatures than dry heat applications.
- Cold applications are often used to treat sprains and fractures. They reduce pain, prevent swelling, and decrease circulation and bleeding. Cold applications cause blood vessels to constrict. They are useful right after an injury.
- Cold applications may be moist or dry. Moist cold applications penetrate deeper—and are colder—than dry ones. A cold pack can be a moist or dry cold application. Ice bags, collars, and gloves are dry cold applications.
- Follow the rules for applying heat and cold:
- Know how to use the equipment. Follow the manufacturer’s instructions.
- Measure the temperature of moist applications. Follow agency policies for safe temperature ranges.
- Do not apply very hot (above 106˚F [41.1˚C]) applications.
- Ask the nurse what the temperature should be.
- Know the exact site of the application. Have the nurse show you the site.
- Cover dry heat or cold applications before applying them.
- Provide for privacy. Expose only the body part involved.
- Maintain comfort and body alignment during the procedure.
- Observe the skin every 5 minutes for signs of complications.
- Do not let the person change the temperature of the application.
- Know how long to leave the application in place—up to 15 to 20 minutes.
- Place the call light within the person’s reach.
- Complete a safety check before leaving the room.
Equipment
Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.
Basin
Cup for scooping ice
Bath blanket
Waterproof pad
Paper towels
Commercial hot pack with cover
Commercial cold pack
Ice bag
Tape
Gauze squares
PrintableDelegation
- Follow delegation guidelines. Before applying a hot or cold pack or an ice bag, collar, or glove, obtain this information from the nurse and care plan:
- The type of application—hot or cold pack or ice bag, collar, or glove
- How to cover the application
- What temperature to use
- The application site
- How long to leave the application in place
- What observations to report and record
- When to report observations
- What patient or resident concerns to report at once
Preparation
- Observe quality-of-life measures.
- Review the information under Delegation and Safety and Comfort.
- Practice hand hygiene.
- Collect equipment.
- Identify the person. Check the ID bracelet against the assignment sheet. Also call the person by name.
Safety
- Check the person every 5 minutes during application of a hot or cold pack or an ice bag, collar, or glove.
- For a commercial hot or cold pack, read the warning labels and follow the manufacturer’s instructions.
- Some persons have medicated patches or ointments applied to the skin. Do not apply heat over such areas.
- Wear gloves if you might be exposed to blood, body fluids, mucous membranes, or nonintact or contaminated skin.
Comfort
- Cold applications can cause chills and shivering. Provide for warmth. Use bath blankets or other blankets as needed.
Procedure Video
Audio Description: OFFFollow-up Care
- Provide for comfort.
- Place the call light within reach.
- Raise or lower bed rails. Follow the care plan.
- Unscreen the person.
- Clean, rinse, dry, and return re-usable items to their proper places. Follow agency policy for soiled linen. Wear gloves for this step.
- Complete a safety check of the room.
- Remove and discard the gloves. Practice hand hygiene.
Reporting/Recording
- Report and record your observations, including:
- Complaints of pain, discomfort, numbness, or burning
- Excessive redness
- Blisters
- Pale, white, or gray skin
- Cyanosis (bluish color)
- Shivering
- Time, site, and length of application
Review Questions
Select the best answer.
1. What is a purpose of an ice bag?
INCORRECT. Cold applications, such as a cold pack or an ice bag, collar, or glove, reduce pain, prevent swelling, and decrease circulation and bleeding.
INCORRECT. Cold applications, such as a cold pack or an ice bag, collar, or glove, reduce pain, prevent swelling, and decrease circulation and bleeding.
CORRECT. Cold applications, such as a cold pack or an ice bag, collar, or glove, reduce pain, prevent swelling, and decrease circulation and bleeding.
INCORRECT. Cold applications, such as a cold pack or an ice bag, collar, or glove, reduce pain, prevent swelling, and decrease circulation and bleeding.
Select the best answer.
2. When applying a hot or cold pack, which safety measure should you take?
Check the temperature because a temperature over 75˚F may burn the skin.- Check the person’s skin every 30 to 60 minutes until the treatment is complete.
- If you have a question about the procedure, ask another nursing assistant before you begin.
Activate a commercial hot or cold pack according to the manufacturer’s instructions.
INCORRECT. For a commercial hot or cold pack, read the warning labels and follow the manufacturer’s instructions. For example, activate the pack by squeezing, kneading, or striking it, as directed by the manufacturer.
INCORRECT. For a commercial hot or cold pack, read the warning labels and follow the manufacturer’s instructions. For example, activate the pack by squeezing, kneading, or striking it, as directed by the manufacturer.
INCORRECT. For a commercial hot or cold pack, read the warning labels and follow the manufacturer’s instructions. For example, activate the pack by squeezing, kneading, or striking it, as directed by the manufacturer.
CORRECT. For a commercial hot or cold pack, read the warning labels and follow the manufacturer’s instructions. For example, activate the pack by squeezing, kneading, or striking it, as directed by the manufacturer.
Select the best answer.
3. Which application may be a moist or dry cold application?
INCORRECT. A cold pack can be a moist or dry cold application. Ice bags, collars, and gloves are dry cold applications.
INCORRECT. A cold pack can be a moist or dry cold application. Ice bags, collars, and gloves are dry cold applications.
INCORRECT. A cold pack can be a moist or dry cold application. Ice bags, collars, and gloves are dry cold applications.
CORRECT. A cold pack can be a moist or dry cold application. Ice bags, collars, and gloves are dry cold applications.
Select the best answer.
4. Before filling an ice bag with ice, what should you do?
INCORRECT. Before filling an ice bag with ice, check it for leaks. To do this, fill the bag with water. Put in the stopper. Then turn the device upside down.
INCORRECT. Before filling an ice bag with ice, check it for leaks. To do this, fill the bag with water. Put in the stopper. Then turn the device upside down.
CORRECT. Before filling an ice bag with ice, check it for leaks. To do this, fill the bag with water. Put in the stopper. Then turn the device upside down.
INCORRECT. Before filling an ice bag with ice, check it for leaks. To do this, fill the bag with water. Put in the stopper. Then turn the device upside down.
Select the best answer.
5. What may you use to keep a hot pack in place?
INCORRECT. Secure a hot or cold pack in place with ties, tape, or rolled gauze. Some packs are secured with Velcro straps.
INCORRECT. Secure a hot or cold pack in place with ties, tape, or rolled gauze. Some packs are secured with Velcro straps.
CORRECT. Secure a hot or cold pack in place with ties, tape, or rolled gauze. Some packs are secured with Velcro straps.
INCORRECT. Secure a hot or cold pack in place with ties, tape, or rolled gauze. Some packs are secured with Velcro straps.
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