Hot and Cold Applications: Indications & Contraindications

• Indications for heat application include sore muscles, painful joints, and general muscle pain.
• Examples of hot applications are moist heat applications (body part in water, heat pack with wet application), infrared heat lamp, and sitz bath.
• Heat application effects: relieves pain, relaxes muscles, promotes healing, and decreases joint stiffness.
• Heat application disadvantages: burns, blisters, redness, and decreased sensation.
• Heat application contraindications: thin, delicate, or fragile skin, and people with dementia or mental implants.
• Indications for cold application include sprains, fractures, pain, swelling, slowing or stopping bleeding, and fever.
• Examples of cold applications are an ice pack, ice bath, or coolant sprays.
• Cold application effects: constricts skin and blood vessels.
• Cold application disadvantages: frostbite, pain, cold burns/blisters, cyanosis, dilated blood vessels (when applied too long), and circulatory shock.
• Cold application contraindications: prolonged application, dry cold, and direct contact with the skin because it can cause burns and blisters.

Timing for Heat and Cold Therapy

• Applied area should be checked every 5 minutes
• Remove the device after 15 minutes to avoid thermal injuries.

Safety Assessments for Heat/Cold Therapy

• Check employer policy for Health Care Assistants (HCAs).
• Observe the client's skin every 5 minutes for complications.
• Observe changes in client's behavior that may indicate pain.
• Provide client's safety and comfort.
• Remove privacy measures and practice hand hygiene.

Determining if Heat/Cold Therapy is a Delegated Task

• It is a delegated task (DOT), and it should be confirmed with the employer policy beforehand.

Assessing Comfort Level of Non-Verbal Clients

• Observe behavior for pain or discomfort or if they are feeling uncomfortable
• Signs of discomfort: facial expressions, body movement, shaking, crying, and wailing.