Applying Moist Heat
Heat application is used to promote vasodilatation, increase capillary permeability, decrease blood viscosity, increase tissue metabolism, and reduce muscle tension. Moist heat can be in the form of immersion of a body part in a warmed solution or water. It can also be accomplished by wrapping body parts in dressings that are saturated with warmed solution.
EQUIPMENT NEEDED :
• Aqua heat pad
• Commercial heat pack
• Solution for heat treatment
• 434 Gauze and waterproof pads
• Examination gloves
• Sterile glove if open wounds
1. Assess the client’s skin for areas of redness, breakdown, or scar tissue. If open wounds are involved, carefully assess the open wounds.
2. Determine the client’s condition, medical diagnosis, and any history of diabetes mellitus or impairments in sensation.
3. Check the physician’s order and the reason for the warm compress.The reason for the compress should be explained to the client.
4. Wash hands.
5. Warm the container of sterile saline or tap water by placing it in a bath basin filled with hot tap water. Sterile saline should be warmed to 105°–113°F. If you are using a commercial compress, follow the manufacturer’s directions for heating the compress.
6. Place a waterproof pad under the body area that needs the warm compress
7. A thin layer of petroleum jelly may be placed on the client’s skin in the area to be treated.Do not put petroleum jelly on an open wound or use with oxygen therapy.
8. Pour the sterile saline into the sterile basin. Soak an appropriate-size piece of gauze or a towel, wring out the excess saline, and place it on the affected area .Wear gloves if there is any drainage of the client’s body fluids.Wear sterile gloves if there is an open wound.
9. Wrap the area with a waterproof pad or apply a disposable heat or aquathermia pad
10. Check the client’s skin periodically for signs of heat intolerance.Tell the client to report any signs of discomfort immediately.
11. If it is tolerated, leave the compress in place for approximately 30 minutes and then remove it.
12. Dry the affected area with sterile towels if there is an open wound and with clean towels if there is no open wound.
13. Properly dispose of all single-use equipment according to hospital protocol.
14. Clean the bath basin and thermometer. Return the sterile basin to the appropriate place for resterilization.
15. Remove gloves if they were worn and wash your hands.
16. Reassess the condition of the client’s skin.
17. Record the procedure. Note the condition of the client’s skin and the length of the application. Report any abnormal findings to the physician.
Applying Dry Heat
Dry heat can be used to enhance circulation, promote healing, reduce swelling and inflammation, reduce pain, reduce muscle spasms, and increase systemic temperature. Different types of equipment are used to apply dry heat to body surfaces, specific areas, and the entire body.
These can be divided into the following categories:
1. Body surfaces. Equipment used to apply heat to any body surface includes disposable instant hot packs, gel-filled hot packs, aquathermia pads, electric heating pads, and hot water bags or bottles. Aquathermia pads are waterflow rubber heating pads with tubing and a reservoir control unit, sometimes called aqua pads, k-pads, t-pump, or hydrocalculator. Hot water bags or bottles should be used only by clients at home because bags and bottles cannot be cleaned properly to meet universal standards.
2. Specific areas. Equipment used to apply heat to specific areas includes heat lamps or infrared lamps (generally for the abdomen, perineum, or the chest), heat cradles (generally for the lower extremities), and diathermy (generally for deep heat treatment, which utilizes electrical energy that is changed to heat).
3. Entire body. Equipment used to heat the entire body to treat cases such as hypothermia includes thermal blankets and infant radiant warmers, which are discussed in Skill 3-8. The principles and precautions are similar in most types of heat application.
• Equipment determined by type of heat treatment:
disposable gel-filled packs , aquathermia pad, heating pad, hot water bottle (generally
used only in home setting if at all), heat lamp or heat cradle, hot blankets, or hot air patient warming system
• Protective cover to be used between heat source and patient
• Electrical source for pads
• Timer or clock
1. Check the physician’s or qualified practitioner’s order and the purpose of the heat treatment.
2. Determine if there are any underlying problems that may affect the use of heat treatment such as decreased sensation; decreased mentation; or a history of diabetes mellitus, bleeding disorders, peripheral vascular disease, or peripheral neuropathy.
Heat should not be used over areas of scarring.
3. Wash hands.
4. Check the skin for lotions or ointments and remove if present.
5. Explain the reasons for heat treatment, the expected outcomes, any potential complications, and the necessity to alert the nurse of heat intolerance.
6. Gather equipment and complete as follows:
For a disposable heat pack:
• Activate the pack according to the manufacturer’s directions. Some packs must be
heated in boiling water, others can be heated by microwave, and some require
bending and chemical activation.
• Wrap the pack in a towel or protective covering (some manufacturers include cover). Do not use pins.Use tape if needed to secure the towel.
Discard after use.
For a heating pad:
• Note: Heating pads are generally not used in hospital facilities.
• Place a formed cover, usually a flannel, over the pad.Towels should not be used. Pins should never be used. If it is necessary to secure the cover, use tape.
• Instruct the client not to lie on the heating pad.
• Turn on the switch to low and place the heating pad on the affected area.The nurse
may increase heat after the client adjusts to the heat. Instruct the client not to adjust the heat level.
Generally the highest setting is not used and is blocked from use by taping the control
• Set a timer and remove the pad after 20 minutes.
• Clean appropriately after use.
For a hot water bottle:
• Hot water bottles are usually used only in home care settings.
• Fill the bottle with tap water, tighten the cap, turn the bottle upside down, then open
the cap and empty.
• Fill the bottle or bag with hot water (40.5°–46°C or 105°–115°F). Fill bag only
two/thirds full, expel any air from top, and secure cap. Wipe off excess moisture.
• Cover with protective cover or towel. Never use pins.Tape may be used.
• Keep the bottle in place for 20–30 minutes.
7. Wash hands.