Complementary And Alternative Therapies HOT And Cold Therapies

Complementary And Alternative Therapies & HOT And Cold Therapies B. G. J. Sewwandi UGS 00065045

Learning Objectives: � Explain Complementary therapy and alternative therapy � Explain hot & cold therapy. � Explain effect of hot & cold application. � Explain how to apply hot & cold application. � Asking question about the lesson.

Introduction : � Complementary & alterative therapies are used most effective with pain management. It include meditation use of natural products and use herb and so no. In addition hot & cold therapies are used to relieve pain

�A Complementary medicine is treatment that are used along with Standard medical treatments but are not Considered to be Standard Treatments. � Complementary medicine refers to healing Practices and Products that work in Conjunction with traditional medicine

Some of the more popular Complementary therapies include � Acupuncture � Alexander technique � Aromathrapy � Herbal medicine � Homeopathy � Naturapathy � Yoga

�An alterative therapy is generally used in stead of conventional medical treatment. It differs in that it is not used as a complement to, but rather as a substitute for traditional therapy.

�An example would be a cancer patient who forgoes recommended chemotherapy and instead chooses to treat the disease with specific dietary changes.

Traditional alternative medicine may include : � Acupuncture � Ayurveda � Homeopathy � Naturopathy � Chinese or Oriental medicine

How can alternative medicine help people with cancer � Fatigue - Exercise, Massage, relaxation techniques, Yoga � Nausea and Vomiting - Acupuncture, aromatherapy, Hypnosis, music therapy � Pain - Acupuncture, Aromatherapy, Hypnosis, massage, Music therapy

Complementary and Alternative Medicine What Are the Categories 1. Mind –body medicine : Mind body medicine includes Treatments that focus on how our mental and emotional status interacts and affects the body’s ability to function. Example include meditation and various therapies expressed through art and music.

2. Whole medical systems : This Category refers to complete systems of medical theory and practice, many of which go back thousands of years and have roots in non-western cultures. Examples include traditional chinese medicine and Ayurveda, a therapy that originated in India whole medical systems from the west include homeopathy and naturopathy.

3. Manipulative and body – based practices: - Relying on the physical manipulation of the body this practice is intended to improve specific symptoms and overall health. Examples of these practices include Chiropractic and osteopathy. 4. Energy medicine : This from of alternative medicine uses energy fields to promote healing.

5. Biologically based Practices : - Since the fours in on herbs, nutrition, and vitamins, dietary supplements and herbal medicine are perhaps the mot common forms of biologically based complementary and alternative medicine

HOT AND COLD THERAPY: � Hot and cold therapy is one of the best methods to relieve any kind of pain. Hot compress is the application of heat to any part of the body to relieve certain kind of pain. It can be applied in many kind of forms such as hot water, hot towel, heating pads, deep heating rub and ultrasound. All of these tools. Can help in applying hot compress to affected part.

� Ice is used for cold compress, it can also relieve pain. Cold compress can reduce both swelling and pain in the affected are a of the body compress is very useful. Both of thee treatment can only offer short term relife but it is very helpful for people who are experiencing different kind of pain.

HOT APPLICATION Hot application is the application of a hot agent. Warmer than skin either in a moist nor dry from on the surface of thee body. v To relive pain and congestion v To Provide warmth v To Promote Suppuration v To Promote healing v To decrease muscle tone. v To soften the exudates v To relieves deep congestion v To Stimulates Peristalsis

COLD APPLICATION : Cold application is the application of a cold agent cooler than skin either in a moist or dry form. On the skin. § § § To reduce pain and body temperature To anaesthetize an area To control hemorrhage To control the growth of bacteria To Prevent gangrene To Prevent edema and reduce inflammation

CLASSIFIATION OF HOT APPLICATIONS LOCAL Dry heat GENERAL Moist heat § Hot water bottles § Worm Soaks § Chemical heating (Local baths) bottles § Infrared rays § Ultraviolet rays § Short wave § Hot fomentations (Compresses) § Poultices (Cataplasm) § Heating lamps § Stupes § Electric Cradks § Paraffin baths § Electric § Sitz bath Heating pads § Aquathermia pad Dry heat Moist heat § Sun bath § Steam baths § Electric cradles § Hot packs § Blanket bed § Whirlpool bath (Full immersion bath)

CLASSIFIATION OF COLD APPLICATIONS LOCAL Dry cold GENERAL Moist cold Dry cold Moist cold § Ice bag § Ice to Suck § Ice collar § Cold Compress § Cold bath § Ice Pack § Evaporating § Cold Packs § Ice Cradle § Chemical Cold Packs lotion § Hypothermia § Cold Sponging

Local application of heat and cold to the body can be therapeutic, but before using these therapies, the nurse must understand normal body response to application of heat and cold how and when to use. The required time for this hot and cold compress is only 20 minutes but it can be used more often if needed until swelling and pain diminish.

Temperature For hot and cold application Description Temperature Application Very Cold Below 15 C Ice bag Cold 15 -18 C Cold Packs Cool 18 – 27 C Cold Compresses Tepid 27 -37 C Alcohol Sponge bath Warm 37 -40 C Worm bath Hot 40 – 46 C Hot Soak, hot Compresses Very Hot Above 46 C Hot water bag for adult

Body’s Physiologic Response To Heat and Cold

Primary / Physiological effects HOT APPLICATION COLD APPLICATION Peripheral Vasodilation Peripheral Vasoconstriction Increased Capillary Permeability Decreased Capillary Permeability Increased Oxygen Consumption Decreased Oxygen Consumption Increased local metabolism Decreased local metabolosm Decreased blood viscosity Increased muscle tone Decreased muscle tone Increased blood flow Decreased blood flow Increased lymph flow Decreased lymph flow Increased motility of leucocytes Decreased motility of leucocytes

Secondary effect of hot and cold application With the local heat application, the maximal increase in the of circulation & temperature occurs after 20 to 40 min exposure. It can overheat the tissue on affected part of the body. we need to observe a two to four hours before using the same therapy again.

� Hot & cold compress can both shock the tissues and the blood vessels on the affected area due to sudden change of temperature. The affected part will be flooded by more white blood cells to fight the infection. � But this process the circulation of the blood’s red cells in the affected area is blocked by the white blood cells. red blood cells carry oxygen that is needed for the normal functing of each cell.

� In this case, accumulation of spasms spread through the part of the body especially through the leg area. The application of hot & cold compress can increase blood circulations that carry the 02. The hot & cold sensation relaxes the herves that can trigger the pain to the brain.

Factors affecting heat and cold tolerance : �Body Part : - Certain areas of the skin have a sensitivity to temperature variations. The inner aspect of the wrist and forearm, the neck, and the perinea are temperature – Sensitive , while the back of the hand the foot re not as sensitive. �Duration of application : - Therapeutic benefits of heat and cold applications are achieved with short periods of exposure to temperature variations. Tolerance increases as the length of exposure increase

�Area of the exposed : - The larger the area exposed to heat and cold the lower the tolerance to temperature changes. �Damage to body surface area : Injured skin areas are more sensitive than intact areas to temperature Variations. �Age: Thinner skin layer in children and elderly people increase the risk for burns from the heat and cold applications. Older adults have a decreased sensitivity.

Contraindications of Hot applications: Malignancies Impaired Kidney, heart & lung functions. Acutely inflamed areas On client with Paralysis Open wounds Edema associated with venous or lymphatic diseases. Headache. Client with metabolic disorders. Very young & very old client. Client with very high temperature.

Complication of Hot applications : Pain Burns Maceration (With moist heat) Redness of the skin Edema Pallor (secondary effect) Hyperthermia

A hot water bag is for varied indication such as: 1. To relieve Pain 2. To help desorption of a hematoma. 3. To help a patient with urinary retention to pass urine 4. To keep a patient of hypothermia warm 5. To keep a newborn baby warm in conditions like premature birth, asphyxia, hypothermia etc. .

Hot water bag : Ø Fill two-thirds to half full with warm water and remove air at the top so the bag is easier to mold over the body part. Ø Dry the outside of the bag & test for leakage by holding the bag upside down. Ø Cover bag with towel or pillowcase (never apply directly on the skin surface) Ø Keep bag in place for 20 -30 minutes and then remove. Ø Do not allow the client to lie on the hot water bag.

Tepid Spong Bath: � Water � May between 80 F and 95 F be ordered to reduce a client’s elevated temperature. � This first effect of this water on the skin in blood vessel constriction.

Sitz Bath / Hit bath : � Used for clients who have had rectal surgeries, an episiotomy during child birth, painful hemorrhoids, or vaginal inflammation. � Only the client’s pelvic are is immersed in warm fluid, the client sits In a special tub or chair or in a basin placed on the toilet seat so that the leg and feet remain out of the water.

�Water temperature should be from 43 to 46 C (110 f to 115 f) & duration of the bath is usually 15 -30 minutes �Prevent overexposure and chilling by draping a both blanket over the client’s shoulders and thighs and prevent drafts.

Contraindications of cold applications: � Client in the state of shock & collapse � Edema � Diseases � Muscle associated with impaired circulation. spasm. � Decreased � Client Sensation have shivering or having very law temperature.

Complication of cold applications : � Pain � Blisters and skin breakdown � Maceration � Grey (With moist cold) or blush discoloration. � Thrombus � Redness formation. (Secondary effect )

Application of cold : § Ice Bags - Crushed ice best Get all/ most air out of bag Colder than ice packs. § Cold Packs - Commercially prepared single – use ice packs provide for designated period of time. § Indication - Acute injury (may use with wet wrap) Acute or chronic pain Postsurgical Pain and edema.

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

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

Nursing Process for Heat and Cold Therapy Assessing : � Before initiating heat or cold therapy assess the patient’s physical & mental status. � The condition of the body area to be treated with heat or cold. � Condition of the equipment to be used.

• Carefully evaluate factors in fluencing the patient’s ability to tolerate heat & cold application. Ex: - Some of body area such as neck, perineum and inner aspect of the wrist & forearm more sensitive • to thermal changes. Tissues with decreased or absent pulses those that appear pale or cyanotic

Heat or cold Suggest Possible Nursing Diagnosis : � Infective thermoregulation. � Infective tissue perfusion. � Acute Pain � Chronic Pain

Conclusion : �Emphasis on importance of hot & cold therapy. In addition to use methods of hot & cold therapy. Complementary & alternative methods & How to apply this methods.

References 1. 2. 3. 4. 5. 6. Ambardekar, N (2017), Osteoathitis Heat & Cold therapy https//www. webmd. com Complementary & alternative medicine www. cancer. gov. treatment. Complementary & alternative medicine www. med. Umich. edu Hohnschuler, s (2006), ice massage therapy for back pain relief, https//www/spine health. com treatment / heat therapy –cold- therapy/ ice – massage- backpain –relief. Weremeka, u (2004) British journal of cancer, potential health risk of complementary alternative medicine in cancer patient. What is hot & cold therapy www. quora. com

Questions 1. Complementary and alternative medicine include? A. Meditation B. Chiropractic C. Use of natural products such as herb D. All of the above

2. Yoga orgined in ? A. China B. Thailand C. India D. Russia

3. Research has shown that acupuncture may provide pain relief pro people with ? A. Migraines B. Broken bones C. Digestion Problem D. Osteoarthritis

4. In selecting alternative therapies, thu nurse recognizes that therapeutic touth may be most effective with ? A. Premature infant B. Headache Sufferer C. Pregnant Woman D. Psychiatric client

5. Alternative medicine and complementary medicine mean the same thing ? A. True B. False

Matching question 1. 2. temperature sensitive areas Postoperative Shivering A. 3. Disadvantages of dry heat B. 4. example of moist heat and cold Thermal therapy to entire body areas C. 5. D. E. Un comfortable, rhythmic muscle contractions to maintain core temperature Compresses, warm or cold soaks, hyrocollator packs, sitz baths Increased fluid loss, doesn’t penetrate deeply, dries skin Cooling sponge baths, whirlpool, hypothermia and hyperthermia blankets inner aspect of the wrist and forearm, the neck and perinea area

Thank You…