Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Equipment Required
Towels or pillow cases for hygiene and/or
insulation
For cold packs
Cold packs in a variety of sizes and shapes
appropriate for
different areas of the body
Freezer or specialized cooling unit
For ice packs
Plastic bags
Ice chips
Ice chip machine or freezer
Procedure
1. Remove all jewelry and clothing from the area
to be treated
and inspect the area.
2. Wrap the cold pack or ice pack in a towel. Use
a damp towel if
a maximal rate of tissue cooling is desired. It is
recommended
that warm water be used to dampen the towel to
allow the
patient to gradually become accustomed to the
cold sensation.
A thin, dry towel can be used if slower, less
intense cooling is
desired. A damp towel is generally appropriate
for a cold pack,
whereas a dry towel should be used for an ice
pack because ice
provides more intense cooling.
3. Position the patient comfortably, elevating the
area to be
treated if edema is present.
4. Place the wrapped pack on the area to be
treated, and secure
it well. Packs can be secured with elastic
bandages or towels to
ensure good contact with the patients skin.
5. Leave the pack in place for 10 to 20 minutes to
control pain,
inflammation, or edema. When cold is applied
over bandages
or a cast, application time should be increased to
allow the
cold to penetrate through these insulating layers
to the skin.78
In this circumstance, the cold pack should be
replaced with a
ICE MASSAGE
Equipment Required
Small paper or Styrofoam cups
Freezer
Tongue depressors or popsicle sticks
(optional)
Towels to absorb water
Procedure
1. Remove all jewelry and clothing from the
area to be treated
and inspect the area.
2. Place towels around the treatment area to
absorb any dripping
water and to wipe away water on the skin
during treatment.
3. Rub ice over the treatment area using
small, overlapping circles.
Wipe away any water as it melts on the skin.
4. Continue ice massage application for 5 to
10 minutes, or until
the patient experiences analgesia at the site of
application.
5. When the intervention is completed,
inspect the treatment
area for any signs of adverse effects such as
wheals or a rash.
It is normal for the skin to be red or dark pink
after the application
of ice massage. Ice massage may be applied
in this
manner for local control of pain,
inflammation, or edema. Ice
massage can also be used as a stimulus for
facilitating the
production of desired motor patterns in
patients with
impaired motor control. When applied for
this purpose,
the ice may be rubbed with pressure for 3 to
5 seconds or
quickly stroked over the muscle bellies to be
facilitated.
This technique is known as quick icing.
Advantages
Treatment area can be observed during
application.
DOCUMENTATION
The following should be documented:
Area of the body treated
Type of cooling agent used
Treatment duration
Patient positioning
Response to the intervention
Documentation is typically written in the SOAP
(Subjective, Objective, Assessment, Plan) note format.
The following examples only summarize the modality
component of the intervention and are not intended to
represent a comprehensive plan of care.
EXAMPLES
When applying an ice pack (IP) to the patients (pt) left (L)
knee to control postoperative (postop) swelling, document
the following:
S: Pt reports postop L knee pain and swelling that increases with
walking.
O: Pretreatment: Midpatellar girth 1612 in. Gait step to when
ascending stairs.
Intervention: IP L anterior knee for 15 min, L LE elevated.
Posttreatment: Midpatellar girth 15 in. Gait step through when
ascending stairs.
A: Decreased midpatellar girth, improved gait.
P: Instruct pt in home program of IP to L anterior knee, 15 min,
with L LE elevated, 33 each day until next treatment session.
When applying ice massage (IM) to the area of the right
(R) lateral (lat) epicondyle to treat epicondylitis, document
the following:
S: Pt reports pain in R lat elbow.
O: Pretreatment: 8/10 R lat elbow pain. R elbow unable to fully extend.
Intervention: IM R lat elbow for 5 min.
Posttreatment: Pain 6/10. Full elbow extension.
A: Pain decreased and elbow ROM improved.
P: Continue IM at end of treatment sessions until pt has
pain-free elbow function.