PTA145-Unit2-Cold Modalities

Question 1

List the 6 indications for Ice Pack

Answer 1

• acute injury or inflammation
• acute or chronic pain
• prevention of swelling
• decrease muscle spasm
• neuralgia
• CNS spasticity

Question 2

List the 6 contraindications for Ice Pack

Answer 2

• uncovered open wounds
• circulatory insufficiency
• cold allergy or hypersensitivity
• anesthetized skin
• deep vein thrombosis
• cardiovascular disease

Question 3

List the 4 precautions for Ice Pack

Answer 3

• cardiac or respiratory involvement
• application over large superficial nerves
• signs of nerve dysfunction, tingling, unwanted reaction
• if vascular insufficiency, check for frostbite

Question 4

What is the treatment duration for Ice Pack?

Answer 4

20 minutes

Question 5

List steps to prepare Ice Pack.

Answer 5

fill bag 2/3 with ice
squish out the air
tie a knot

Question 6

List the 6 indications for Commercial Cold Pack

Answer 6

• acute injury or inflammation
• acute or chronic pain
• prevention of swelling
• decrease muscle spasm
• neuralgia
• CNS spasticity

Question 7

List the 7 contraindications for Commercial Cold Pack

Answer 7

• uncovered open wounds
• circulatory insufficiency
• cold allergy or hypersensitivity
• anesthetized skin
• deep vein thrombosis
• cardiovascular disease
• avoid use around face, eyes, sensitive areas

Question 8

List the 5 precautions for Commercial Cold Pack

Answer 8

• cardiac or respiratory involvement
• application over large superficial nerves
• signs of nerve dysfunction, tingling, unwanted reaction
• because of antifreeze, check for frostbite
• pack contents can cause chemical burns

Question 9

What is the treatment duration for Commercial Cold Pack?

Answer 9

continuous - 20-30 minutes

intermittent - 10 minutes on, 10 minutes off

Question 10

How is Commercial Cold Pack prepared?

Answer 10

wrap pack in a towel so that one layer of towel is between pack and patient’s exposed skin

Question 11

List the 7 indications for Cold Compression Therapy

Answer 11

• acute injury or inflammation
• acute or chronic pain
• prevention of swelling
• decrease muscle spasm
• neuralgia
• CNS spasticity
• post surgery/post traumatic injury

Question 12

List the 6 contraindications for Cold Compression Therapy

Answer 12

• uncovered open wounds
• circulatory insufficiency
• cold allergy or hypersensitivity
• anesthetized skin
• deep vein thrombosis
• cardiovascular disease

Question 13

List the 4 precautions for Cold Compression Therapy

Answer 13

• cardiac or respiratory involvement
• application over large superficial nerves
• signs of nerve dysfunction, tingling, unwanted reaction
• application over elastic wrap can be too much pressure

Question 14

What is the treatment duration for Cold Compression Therapy?

Answer 14

20-30 minutes

Question 15

How is Cold Compression Therapy prepared?

Answer 15

ice and water
32-65
set timer
set compression to low at first
set to one snowflake and make colder as needed
apply straps for tighter at distal, looser at proximal - knee

Question 16

List the 8 indications for Ice Massage

Answer 16

• acute or chronic pain
• subacute injury or inflammation
• need to reduce muscle spasms
• do prior to ROM exercises
• as trigger point therapy
• muscle strains
• contusions
• need rapid cooling of the skin

Question 17

List the 6 contraindications for Ice Massage

Answer 17

• uncovered open wounds
• circulatory insufficiency
• cold allergy or hypersensitivity
• when pressure is contraindicated
• suspected fractures
• (table 5-2)

Question 18

List the 1 precaution for Ice Massage

Answer 18

anesthetized skin

Question 19

What is the treatment duration for Ice Massage?

Answer 19

5-15 minutes or
until the skin is numb or
the ice melts

Question 20

How is Ice Massage prepared?

Answer 20

ice in cup or
ice in a ball in a towel
massage area not much bigger than the ice ball
4x4 cm area

Question 21

How is Ice Towel prepared?

Answer 21

layer of ice in the tub
some towel
some more ice
like lasagne
end with ice on top
apply to pt with plastic wrap so it doesn't drip; put  towels everywhere

Question 22

What is the treatment duration for Ice Towel?

Answer 22

10 minutes for pain, spasm

20-30 minutes for neuro patients

Question 23

How is Ice Immersion prepared?

Answer 23

tub with ice water at 50-60 degrees F

*higher temp for bigger body part

Question 24

What is the treatment duration for Ice Immersion?

Answer 24

10-15 minutes

Question 25

List the 4 indications for Ice Immersion

Answer 25

- acute injury or inflammation - acute, chronic, post surgical pain - prior to ROM exercise - irregular surface

Question 26

List the 6 contraindications for Ice Immersion

Answer 26

- uncovered open wounds - circulatory insufficiency - cold allergy or hypersensitivity - absolute inability to tolerate the cold temperature - cardiac or respiratory involvement - (table 5-2)

Question 27

List the 5 precautions for Ice Immersion

Answer 27

- anesthetized skin - is very uncomfortable, may need toe caps - avoid immerse and withdraw - increases duration of pain - anti-gravity position may increase swelling - subcutaneous nerves may need slightly higher temp and more checking

Question 28

How is Cold Whirlpool prepared?

Answer 28

``` 50-65 degrees F temperature increased for bigger part check temperature first chair safety test air flow bits intensity to pt discretion ```

Question 29

What is the treatment duration for Cold Whirlpool?

Answer 29

10-15 minutes

Question 30

List the 5 indications for Cold Whirlpool

Answer 30

- decreased range of motion - subacute or chronic inflammatory conditions - promoting muscular relaxation - decreasing pain and muscle spasm - peripheral nerve injuries (but avoid extreme temps)

Question 31

List the 5 contraindications for Cold Whirlpool

Answer 31

- acute conditions where turbulence would irritate - acute conditions where limb would be gravity dependent - patients requiring postural support - skin conditions in spa-type tubs - (table 5-2)

Question 32

List the 8 precautions for Cold Whirlpool

Answer 32

- keep switch out of patient reach - keep patient in view of staff - may decrease temp gradually maybe for cold - gravity-dependent and increased circulation may increase edema - flowing water may nauseate patient - patients under influence drugs at risk losing consciousness - patients with seizure disorder or heart disease at risk losing consciousness - patients suffering respiratory disease may have impaired breathing with full immersion

Question 33

How is Contrast Therapy prepared?

Answer 33

``` one tub, hot 105-110 degrees F one tub, cold 50-60 degrees F two thermometers two timers towels bell within reach of pt tubs close to pt extra ice and warm water for temperature maintenance ```

Question 34

What is the treatment duration of the cold immersion for Contrast Therapy?

Answer 34

1-2 minutes

Question 35

What is the treatment duration of the hot immersion for Contrast Therapy?

Answer 35

3-4 minutes

Question 36

For Contrast Therapy, how do you know whether to end on hot or cold?

Answer 36

If vasoconstriction is desired, end on cold. | If vasodilation and relaxation are desired, end on hot.

Question 37

What are the primary effects of Contract Therapy?

Answer 37

alternating periods of vasoconstriction and vasodilation of cutaneous vessels

Question 38

List the 4 indications for Contrast Therapy

Answer 38

- subacute or chronic inflammatory conditions - impaired circulation (monitor patient closely) - pain reduction - increasing joint ROM

Question 39

List the 5 contraindications for Contrast Therapy

Answer 39

- acute injuries - hypersensitivity to cold - contraindications relative to whirlpool use - contraindications relative to cold applications - contraindications relative to heat applications

Question 40

List the 3 precautions for Contrast Therapy

Answer 40

- same as for whirlpool - neoprene toe cap - edema and gravity

Question 41

List the primary effects for cold packs (ice pack, CCT, commercial cold pack) - acute pathology

Answer 41

- decreases cell metabolism, reducing the amount of secondary hypoxic injury - with compression and elevation, limits the formation of edema

Question 42

List the primary effects for cold packs (ice pack, CCT, commercial cold pack) - other than acute

Answer 42

- decreased metabolism reduces the release of inflammatory mediators and cellular by-products - decreases pain by slowing nerve conduction velocity and increasing the threshold of nerve endings - causes local vasoconstriction

Question 43

List the primary effects for Ice Massage

Answer 43

- decreases the sensitivity of cutaneous nerve receptors - decreases pain - breaks pain-spasm-pain cycle

Question 44

List the primary effects for Ice Immersion

Answer 44

- decreases cell metabolism, reducing the amount of secondary hypoxic injury - decreased metabolism reduces the release of inflammatory mediators and cellular by-products - decreases pain by slowing nerve conduction velocity and increasing the threshold of nerve endings - causes local vasoconstriction

Question 45

List the primary effects for whirlpool

Answer 45

- provides a supportive medium for range of motion exercises - the water provides resistance to rapid motions - agitation and aeration of the water causes sedation, analgesia and increased blood flow - also includes all the effects of hot and cold treatments - cold whirlpool treatments result in longer lasting cooling of intramuscular tissue