Transcript superficial heating

SUPERFICIAL HEATING
MISS HIRA JABEEN
HOT PACKS
 Moist heat
 Made of canvas and filled with silica gel
 Immersed in water of about 170ºF (77° C) in a thermostatically controlled
heater
 Retain heat for about one-half hour
PURPOSE AND EFFECTS
 Superficial heating
 Same heating effects
 Local metabolism inc
 Local perspiration inc
 Local vasodilation with hyperemia
 Initial vasoconstriction in deeper tissue layers vasodilation
 Muscle relaxation
 Sensory nerve endings sedated with mild heat
 If applied for long time inc temp, inc resp rate, inc pulse rate, dec BP to
dissipate excess heat
 With repeated strong doses, mottled pigmentation , called erythema ab
igne.

Reason:

Destruction of RBC

Paralysis of arterioles in a dilated state
 Capillary pressure and cell permeability inc edema
ADVANTAGE
 Gradually become cooler so less risk of burning if enough padding given
 Local areas treated effectively
 Reusable and cost effective
 Circumferential heating
DISADVANTAGE
 Larger packs can be heavy, problem in case of tenderness
 Potential risk for infection in case of open wound
 Area treated is not visible during treatment making monitoring the skin
difficult
 Risk of scalds
INDICATIONS
 Pain
 Muscle spasm
 Stiffness of major joints of extremities, neck & trunk
 Subacute and chronic traumatic & inflammatory conditions
 Pre heating prior to EMS
CONTRAINDICATIONS
 Acute inflammatory conditions
 Fever
 Malignancies
 Active bleeding
 Cardiac insufficiency
 Extremely old adults& children less than 4 have unreliable thermoregulatory
system fever
 Peripheral vascular disease
 Tissues devitalized by X-ray therapy
PRECAUTION
 Already existing edema
 Pts with sensory loss
 Confusion
INSTRUCTION
 Education of pt
 Inspect skin & sensations
 Clothing and jewelry removed
 Position and drape the pt appropriately, comfortably
 Cover the area to be treated with clean terry cloth towel
 Place the pack in towels with 6-8 layers covering
 Place on area to be treated
 Intensity governed by pt’s tolerance
 15-30min (10-15 min before EMS)
 After completion of treatment remove pack, dry the ski , inspect skin
 Reheat one half hour before using again
PARAFFIN BATH
DESCRIPTION
 Therapeutic application of molten mixture of paraffin wax & mineral oils for
relief of pain and joint stiffness, suitable for small peripheral joints
 Tank containing a mixture of paraffin wax, liquid paraffin and petroleum
jelly in a ratio of 3:1:1
 Melts at 42-45ºC
 Self sterilizing in nature
 Temperature sustained by thermostat controlled heater
 Molten wax mixture solidifies on contact with skin, giving up latent heat of
solidification
PURPOSE AND EFFECTS
 Apply heat to areas difficult to heat
 All heating effects (localized)
 Retains perspiration
 Help soften the skin
ADVANTAGE
 Distal extremities
 Soften skin
 Circumferential heating
 Prolonged analgesia
 Re-useable & cost effective
DISADVANTAGE
 Some pts feel excessive heat
 Mild heat cannot be given otherwise wax solidifies
 Messy
 Movements must be minimized
 Tank difficult to clean
INDICATIONS
 Soft tissue contractures
 Subacute and chronic inflammatory conditions
 Stiffness of joints and pain due to degenerative disorders, RA, OA
CONTRAINDICATIONS
 Open wounds in area to be treated
 Acute inflammatory joint pathologies
 Skin rashes
 Allergic reaction
 Defective arterial supply
 Impaired skin sensation
APPLICATION
 Jewelry and metals removed
 part washed and inspected for wound or infection
 Greatest to lowest inc in skin temperature
 Immersion bath> dip immersion method>glove method
IMMERSION BATH
 Educate the patient
 Check the temperature of bath
 Check sensations
 Position comfortably
 Immerse the part to be treated avoiding movement
 Warn him not to touch the bottom of the tank
 Duration of treatment= 20min
 During treatment; layers of paraffin form over skin
 At conclusion of treatment , remove the part and let it harden
 Remove paraffin by peeling it off or by performing AROM exercises
 Dry the perspiration
DIP IMMERSION
 Same instructions
 Pt dip the part once or twice and let it harden
 Then immerse the part for 20 min
 This hardened layer insulates excessive heat
GLOVE
 Fold two terry towels length wise and set aside
 Pt dip the part , remove it and allowed to harden until it looks dull, repeat
this process 6-12 times until a glove is formed
 Quickly wrap this in polythene bag and then in several layers of terry towels
 Secure with rubber bands or tape
 20 min
BRUSHING TECHNIQUE
 Brush size 4-6 inch same technique as glove
 4-6 layers are brushed
 Used for proximal parts