Heat and Cold Applications
Performing a Hot or Cold Soak
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- » Performing a Hot or Cold Soak
- » Performing a Sitz Bath
- » Applying a Hot or Cold Compress
- » Applying a Hot or Cold Pack or an Ice Bag, Collar, or Glove
- » Using an Aquamatic or Aquathermia Pad
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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 soak is a moist heat application in which a body part is put into water. It is usually used for smaller parts—a hand, lower arm, foot, or lower leg. A tub is used for larger areas.
- 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 soak is a moist cold application.
- 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.
- 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.
Wash basin
Bath thermometer
Waterproof pad
Bath blanket
Towel
Gloves, if needed
PrintableDelegation
- Follow delegation guidelines. Before performing a hot or cold soak, obtain this information from the nurse and care plan:
- The type of application—hot or cold soak
- 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 a hot or cold soak.
- Some persons have medicated patches or ointments applied to the skin. Do not apply heat over such areas.
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 place. 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
Review Questions
Select the best answer.
1. What is a purpose of a hot soak?
INCORRECT. Heat applications, such as a hot soak, relieve pain, relax muscles, promote healing, reduce tissue swelling, and decrease joint stiffness.
CORRECT. Heat applications, such as a hot soak, relieve pain, relax muscles, promote healing, reduce tissue swelling, and decrease joint stiffness.
INCORRECT. Heat applications, such as a hot soak, relieve pain, relax muscles, promote healing, reduce tissue swelling, and decrease joint stiffness.
INCORRECT. Heat applications, such as a hot soak, relieve pain, relax muscles, promote healing, reduce tissue swelling, and decrease joint stiffness.
Select the best answer.
2. When performing a hot soak, which action should you take?
Observe the person’s skin for jaundice (bluish color).- Check the skin every 30 minutes until the treatment is complete.
Keep the person covered and expose only the area being treated.- Check the temperature of the hot soak with the inside of the wrist.
INCORRECT. During a hot or cold soak, cover the person with a bath blanket for warmth. Expose only the body part involved.
INCORRECT. During a hot or cold soak, cover the person with a bath blanket for warmth. Expose only the body part involved.
CORRECT. During a hot or cold soak, cover the person with a bath blanket for warmth. Expose only the body part involved.
INCORRECT. During a hot or cold soak, cover the person with a bath blanket for warmth. Expose only the body part involved.
Select the best answer.
3. Which water temperature is appropriate for a cold soak?
CORRECT. For a cold application, use a temperature of 50˚F to 65˚ F (10.0˚C to 18.3˚C). For a cool application, use a temperature of 65˚F to 80˚ F (18.3˚C to 26.6˚C).
INCORRECT. For a cold application, use a temperature of 50˚F to 65˚ F (10.0˚C to 18.3˚C). For a cool application, use a temperature of 65˚F to 80˚ F (18.3˚C to 26.6˚C).
INCORRECT. For a cold application, use a temperature of 50˚F to 65˚ F (10.0˚C to 18.3˚C). For a cool application, use a temperature of 65˚F to 80˚ F (18.3˚C to 26.6˚C).
INCORRECT. For a cold application, use a temperature of 50˚F to 65˚ F (10.0˚C to 18.3˚C). For a cool application, use a temperature of 65˚F to 80˚ F (18.3˚C to 26.6˚C).
Select the best answer.
4. What part of the body is most likely to receive a hot soak?
INCORRECT. In a hot soak, a body part is put into water. It is usually used for smaller parts—a hand, lower arm, foot, or lower leg. A tub is used for larger areas.
INCORRECT. In a hot soak, a body part is put into water. It is usually used for smaller parts—a hand, lower arm, foot, or lower leg. A tub is used for larger areas.
INCORRECT. In a hot soak, a body part is put into water. It is usually used for smaller parts—a hand, lower arm, foot, or lower leg. A tub is used for larger areas.
CORRECT. In a hot soak, a body part is put into water. It is usually used for smaller parts—a hand, lower arm, foot, or lower leg. A tub is used for larger areas.
Select the best answer.
5. During a cold soak, how often should you check the person?
CORRECT. During a hot or cold soak, check the person every 5 minutes. Check for signs and symptoms of complications. Remove the application if any occur. Tell the nurse at once.
INCORRECT. During a hot or cold soak, check the person every 5 minutes. Check for signs and symptoms of complications. Remove the application if any occur. Tell the nurse at once.
INCORRECT. During a hot or cold soak, check the person every 5 minutes. Check for signs and symptoms of complications. Remove the application if any occur. Tell the nurse at once.
INCORRECT. During a hot or cold soak, check the person every 5 minutes. Check for signs and symptoms of complications. Remove the application if any occur. Tell the nurse at once.
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