Techniques of Application: Cryotherapeutic Agents

Cryotherapeutic Agents

General Technique of Application

1. Check Vital Signs

2. Inspect the patient’s skin before applying the cold to determine if any rashes or discolorations are present

3. Test for patient’s sensation

4. Verify the circulatory status of the area to be treated

5. Make sure that patient has not had frostbite in the area and never experience exacerbation of spasticity

6. Give rationale of the treatment

7. Position the patient relaxed and comfortable

8. Draped the patient properly and don’t exposed unnecessary parts

9. Apply the cold modality

10. Provide the proper treatment procedures of application

Post Treatment Procedure

1. Check patient’s skin for signs of adverse effects and frostbite

2. Check patients Vital Sign or prepare patient for the next treatment

Cold Packs

- Usually made of silica gel just like HMP and endothermic chemical gels

- Treatment temperature of -5 deg C for at least 2 hours before use

- Remains at low temperature for 15-20 mins

Ice massage

- an ice cylinder formed by freezing water in a styrofoam cup or juice

- a lollipop stick or wooden tongue depressor which may or may not be placed in water during freezing process

- Treatment duration – 5 -10 mins

- Technique of Application

1. Surface area of 10 cm by 15 cm

2. Overlapping longitudinal strokes or circular strokes covering one half of the previous stroke

- Advantage

1. The risk of damaging tissue is minimal because temperature will not drop below 15 deg C

- Disadvantage

1. Do not apply over bony areas and superficial nerve

- Four Distinct Sensation

C-old

B-Burning

A-ching

N-umbness

Ice Towels

- Terry cloth soaked in a bucket of crushed ice

- Treatment temp of 10-14 deg C for 10-15 mins duration

- Treatment Procedure: towel wrapped around the joint or muscle which changed every 4-5 mins(45-60 secs, other book)

- the most impractical method to use

Cold Baths

- a basin with water and crushed ice

- treatment temperature of 13-18 deg C (Braddom 4-10 deg C)

- best for treating distal extremities

- most practical method to use in treating distal extremities

Vapocoolant Sprays

-made of flourimethane and ethyl chloride

- non toxic, non inflammable volatile liquid which spray to the area being treated that produce rapid cooling

-today, most sprays are made up of organic materials due to hazardous effect

- used in treating trigger points in Myofascial Pain Syndrome and mucle spasm

-Technique of Application

1. Invert container, nozzle down and hold about 18-24 inches from the skin with 30 deg angle and spray 4 inches /sec

2. Repeat the first procedure for 2-3 times

3. Allow liquid to completely evaporate before applying the next sweep

4. The muscle should be passively stretched before and during the application

5. Cover the entire area from the origin of the pain to the referred pain

6. Then have patient exercise after the procedure

Controlled Cold Compression Units

- cooled water is circulated through a sleeve which applied to extremity which is then inflated intermittently

- treatment temp of 10-25 deg C or 7.5 deg C with pressure of 60 mm Hg

- acute musculoskeletal injury with soft tissue swelling after surgical procedure