Applying Cold Treatment
Cold therapy is used to decrease blood flow to an area by promoting vasoconstriction and increased blood viscosity. These changes facilitate clotting and control bleeding. Cold decreases tissue metabolism, reduces oxygen consumption, and decreases inflammation and edema formation. Cold therapy has a local anesthetic effect by raising the threshold of pain receptors. It causes a decrease in muscle tension. Cold is used to reduce fever. Sources of cold include ice packs, ice bags, cold collars, or commercial cold packs. If the client’s systemic temperature is elevated, cooling blankets or cooling tepid sponge baths can be used. Moist cold compresses or immersion of a body part can be used for large areas of acute inflammation or swelling. Cooling the extremity decreases blood flow and may also decrease pain and suppress inflammation.
(Select equipment depending on the treatment chosen
and supplies available.)
• Pan for cold soak
• Ice or ice bag
• Gauze or towel
• Water bottles or reusable containers if used for one client only
• Compresses (if moist cold) consisting of gauze dressing, iced or chilled solution, and a container of the appropriate size for the body part
• Commercially prepared ice pack
1. Wash hands.
2. Assess the client’s sensation and skin color at the site of planned application.Determine if any tissue damage is present. Assess for bleeding
or wound drainage
3. Determine the diagnosis. Identify whether the client has a history of circulatory impairment or neuropathy.
4. Check the physician’s or qualified practitioner’s order and the reason for the application of cold.
5. If using an ice bag with moist gauze or towels, fill the bag three-fourths full with ice and remove the remaining air from the bag. Close the bag. Check for leaks.Wrap the bag in a towel or protective cover and place it on the affected area. If cold soaks are being applied, use the appropriate-size basin for the body part to be soaked.
6. If an ice collar is used, fill the collar threefourths full with ice and remove the remaining air from the collar before closing the collar. Check for leaks. Place the collar in a protective cover and around the client’s neck.
7. If a disposable cold pack is used, activate the pack according to the manufacturer’s directions, wrap the pack in a towel, and place it on the affected area. Some packs come with covers. Secure pack in place with tape, elastic wrap, or bandage. Dispose of the pack after the treatment.
8. Assess the client’s skin periodically for signs of cold intolerance or tissue damage.
9. If the client can tolerate the cold, leave the cold application in place for
approximately 20–30 minutes at approximately 15°C (59°F).
10. Reassess the condition of the client’s skin or exposed tissue.
11. Wash hands.