Cold Application

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Application, General Rules : 

Application, General Rules

Application of Cold : 

Application of Cold Assess patient and establish goals of treatment Determine if cryotherapy most appropriate treatment No Contraindications Select appropriate mode of application based on body part and desired response Explain procedure, reasons for treatment, and expected sensations

Sensory Response to Cryotherapy : 

Sensory Response to Cryotherapy Due to stimulation of thermal receptors and pain receptors followed by blocking of nerve conduction In this order: Intense cold Burning Aching Analgesia, numbness

Cold Packs and Ice Bags : 

Cold Packs and Ice Bags

Cold Packs/ Ice Packs : 

Cold Packs/ Ice Packs Commercial Silica or mix of saline/gel Stored in freezer at 23 C Moldable to patient’s body Should be cooled at least 30 minutes between treatments or 2 hrs. prior to initial use.

Application of Cold : 

Application of Cold Ice Bags Crushed ice best conforms better Get all/most air out of bag. Colder than ice packs specific heat of ice higher than gels Either decrease time or provide slight insulation.

Application of Cold Packs : 

Application of Cold Packs Home Treatment Ice bags, or frozen peas/vegetables Remove frost from outside of bag or insulate with towel. Homemade cold packs 4:1 mix of water, rubbing alcohol

Application of Cold Pack/ Ice Bags : 

Application of Cold Pack/ Ice Bags Use warm damp towel with cold pack, dry towel with ice bag (?) Secure pack with strap or ace wrap Elevate extremity if indicated Position patient comfortably Check skin periodically Give bell/ set timer

Advantages and Disadvantages : 

Advantages and Disadvantages

Advantages of Ice Packs/Cold Packs : 

Advantages of Ice Packs/Cold Packs Easy to use Inexpensive Short use of clinician’s time Low skill level required Covers moderate to large areas Can elevate limb simultaneously

Disadvantages : 

Disadvantages Must remove pack to inspect skin Patient may not tolerate weight Difficult to mold to contoured areas Longer treatment time (than ice cup)

Ice Massage or Ice Cup : 

Ice Massage or Ice Cup

Ice Massage : 

Ice Massage Ice cups or frozen water “Popsicles” Styrofoam nice, but often bust as ice expands

Application of Ice Massage : 

Application of Ice Massage Use towels in surrounding areas to catch drips. Use small, overlapping circles Keep ice moving rapidly Continue for 5-10 minutes or until analgesia achieved “Quick Icing” used as quick strokes with ice cup to facilitate motor response

Advantages of Ice Massage : 

Advantages of Ice Massage Treatment area can be observed during treatment Excellent for small, irregular areas Short-duration of treatment Increases compliance Can elevate limb if desired

Disadvantages of Ice Massage : 

Disadvantages of Ice Massage Requires clinician throughout treatment, unless patient independent

Intermittent Cold Compression and Cryocuff : 

Intermittent Cold Compression and Cryocuff

Controlled Cold Compression : 

Controlled Cold Compression Intermittent Compression/ Cold Pump Usually used in post-op patients Allows for intermittent cold and compression proven more effective than ice alone

Cryocuff : 

Cryocuff Relatively inexpensive Effective compression with cold Patients often need assistance in applying device

Vapocoolant Sprays : 

Vapocoolant Sprays Ethyl chloride Fluorimethane sprays Work by rapid cooling Desired treatment of trigger points Applied in parallel strokes along skin of muscle immediately prior to stretching

Vapocoolant Sprays : 

Vapocoolant Sprays Often done after injection Purpose is to provide counter-stimulus Causes reflex decrease in motor neuron activity Secondary decrease in resistance to stretch

Documentation of Cryotherapy : 

Documentation of Cryotherapy Area of body treated Type of cryotherapy used Treatment duration Patient position Response to treatment

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