Cold Sponge Bath

Cold Sponge Bath

Cold Sponge is moist cold application using ice water when the patient's temperature is dangerously raised to more than 103°F. The temperature of water used for the patient's cold sponge is 60° to 70.

Purpose

To reduce body temperature

Contraindication

Patients with rigors

Procedure

• Check your body's temperature.
• To the patient: Describe the procedure.
• Prepare the water as directed by the doctor.
• Ensure privacy.
• Under the patient, place a mackintosh and a drawing sheet.
• Take off your clothes, then put the top sheet over the patient.
• To prevent a sudden bodily cooling, place a hot water bag on the bottoms of the feet.
• Put gloves on.
• Dip your sponge cloths in the basin, then gently squeeze off the extra water.
• Dry the face with a cloth after wiping it.
• Make the upper body visible.
• Put a cool, damp sponge in the axilla of each hand. As they warm up, swap out the washcloth.
• With a cold sponge cloth, clean your back and abdomen.
• Starting with the thigh, move laterally to the foot and medially to the groin for legs. Maintain sponge in groin.
• Repeatedly wipe your neck and face.
• Every 15 minutes, check the patient's temperature.
• When the temperature reaches 1000F, stop the process.
• Keep going for a maximum of 20 to 30 minutes, then stop.
• After the operation is over, take off the hot water bag, makeup, and bath towel.
• With a towel, dry the patient off. Help him or her put on clothes.
• Make the patient's bed comfy.
• After 15 minutes, 30 minutes, and an hour of treatment, take your temperature.
• Implement additional temperature-lowering methods if the temperature stays the same.

Hypothermia Blanket

A hypothermia blanket (cooling blanket) is a plastic mattress pad through which very cold water flows continuously. Its role is to decrease temperature. Hypothermia blankets are used primarily in surgery to slow body processes and to prevent complications resulting from unstable temperature.

Ice Cap/Ice Collar

Ice cap is defined as a small rubber bag filled with small pieces of ice and salt, that serves as a device for cold application. An ice collar is a narrow rubber or plastic bag, curved to fit the neck. Often, prepared single use ice bags are used.

Purposes

• To relieve pain of muscle strain.
• To reduce temperature between 101-102°F.
• To relieve urinary retention.
• To relieve inflammation.
• To decrease metabolic rate of body.
• To prevent bleeding specially after thyroid surgery tonsillectomy and dental surgery.

Articles

• Ice cap with cover
• Ice in a bowel
• Towel and makintosh
• Kidney tray
• Salt
• Duster to wipe ice cap after filling.

Procedure

• Assess the patient's temperature.
• Explain the procedure to the patient.
• Fill 2/3rd ice cap with ice cubes and expels air before closing cap.
• Add salt to ice chips. It prevents the ice from melting faster.
• Check if any leakage.
• Screw on the cap tightly and put cover over the ice cap.
• Apply the ice cap to the area for about 30 minutes.
• Check tolerance of the patient periodically.
• Replace articles after cleaning.
• Position the patient in a comfortable position.
• Wash hands.
• Record the procedure in the nurse's notes including time of application and observation.

Cold Pack

Cold pack is defined as application of moist cold when the temperature rises to 104°F and above.

Purposes

• To reduce temperature above 104°F.
• To treat heat stroke and malignancy hyperthermia.

Contraindication

Circulatory disorders like peripheral vascular diseases.

General Instructions

• The pack could be a washed cloth, towel, and flannel.
• A basin of cold water is prepared and the packs are immersed into it.
• When cooled the excess water is wrung out and the pack is applied to the body area.
• Replace the packs as necessary to maintain.

Procedure

• Pour cold water into basin; add ice cubes to bring temperature to 65°f and wet bath towels.
• Remove top sheet and protect bed with a long makintosh and big sheet.
• Remove the patient's cloths, cover with wet bath towel from chest to public area.
• Place compress on forehead, ice cap on head and hot water bag at feet.
• Wrap hand and legs with wet towel.
• Check the temperature every 15 minutes and replace wet clothes.
• Continue the procedure for 30 minutes.
• After completing the procedure, remove towels and dry the patient thoroughly.
• Change wet sheets.
• Keep the patient in a comfortable position.
• Replace articles.
• Wash hands.
• Record the procedure.

Physiological Effects of Cold and Heat Application

Sitz Bath or Hip Bath 

It is bathing the perineal area which is taken in a sitting position. The patient sits in a tub with hot water to immerse buttocks, perineal and rectal areas. The temperature of the water should be from 40 to 43°C (105-110F), unless the client is unable to tolerate the heat. The duration at the bath is generally 15 to 20 minutes, depending on the client's health. Sitz bath is used after rectal or perineal surgery or vaginal delivery to decrease inflammation and discomfort.

Purposes

• To relieve pelvic congestion.
• To promote drainage of rectal abscess e.g. haemorrhoids.
• To relieve pain and discomfort.
• To promote relaxation of bladder sphincter and retention of urine.
• To aid the healing process of perineal wounds.
• To reduce swelling and irritation.
• To increase circulation.

Indications

• Following surgery in the ano-rectal region.
• Following incision on the perineum e.g. episiotomy.
• Swollen, painful haemorrhoids.

Contraindications

• Peripheral vascular diseases
• Impaired peripheral sensory function
• Immediate post haemoredectorny
• Pregnancy
• Menstruation
• Renal inflammation

Solutions Used

• Potassium permagnate 1:5000
• Boric acid 1 dran to 1 pint
• Eusol solution

Articles

• Sitz bath basin
• Warm water 105°F to 110°F
• Medicine if ordered
• Bath thermometer
• Clean gloves
• Towel
• Rubber sheet

Procedure

• Check the physician's order.
• Identify the patient.
• Assess the patient's condition, pain level and ability to ambulate to the bathroom.
• Wash hands.
• Explain the procedure to the patient to get his co-operation.
• Collect the required articles in the treatment room.
• Add required quantity of ordered medication e.g. potassium, betadine.
• Fill 2/3 the of basin with warm water at temperature of 105°F to 110°F
• Maintain the privacy of the patient.
• Assist the patient with removal of any dressing or peripad and assist to sit in sitz bath basin.
• Keep the basin on a low stool/potty chair/toilet bowel with toilet seat up.
• Leave the patient to sit 20 minutes, instruct the patient to contract and relax anal sphincter while taking sitz bath, then assist with drying and applying dressing or perineal pad as required.
• Assist the patient back to bed, and instruct to stay in bed for 20 minutes with hip elevated. Use of warm water and prolonged sitting in one position may result light headache on arising.
• Clean and replace all the reusable articles.
• Wash hands.derati
• Record date, time, solution used, temperature and duration of bath, reaction of the patient on nurses' record and patient's chart and sign.

General Instructions

• Care must be taken to prevent burn and fainting.
• Discontinue the procedure if the patient complains of dizziness, weakness or fainting due to shift in blood supply to the perineal area.
• Observe the patient frequently; never leave an unstable patient alone.
• Assist the patient in and out of bath basin.
• Vasodilation application over a large area of the body may cause hypotension. All clients should be monitored closely and assisted when rising.
• If the patient has received epidural anesthesia, be sure that complete sensation has returned before using a warm sitz bath.

Nursing Responsibilities during Hot and Cold Application

• For the location to be treated, the type of therapy, the frequency, and the length of therapy, always check the order and hospital policy.
• To the patient: Describe the procedure.
• Evaluate the patient's condition prior to, during, and after treatment. Throughout the treatment, periodically check the temperature.
• Analyze the patient's tolerance for the therapy and the best way to apply it.
• Check for any conditions that prevent the use of heat, such as those that occur within 24 hours of a severe injury, active bleeding, non-inflammatory edema, localized malignant tumours, and skin disorders that cause redness and blisters.
• Find out if any conditions exist that call for extra care during therapy, such as neurosensory deficits or altered mental status.
• Think about the patient's health. People who are unconscious, weak, have circulation issues, or have skin that is broken are less tolerant of temperature extremes.
• Depending on the status of the client, choose the temperature.
• Avoid directly applying dry heat and cold to the skin.
• Avoid applying cold compresses to the chest and abdomen.
• Apply the therapy for no more than 30 minutes, and if necessary, repeat every two to three hours.
• Examine circuits; prevent moisture and item infiltration in electrical locations.
• Keep accurate records and reports of the treatments employed, the patient's tolerance, and the effects of the devices. of treatment.