Superficial Heat Agents Flashcards
what are Superficial Heat Agents?
therapeutic application of any modality to the skin which results in an increased skin and superficial subcutaneous tissue temperature (1-2 cm depth of superficial heat.)
Produces a moderate dose of increase in body tissue to 102 – 106 degrees with a slight increase in blood flow lasting up to 20 minutes post treatment. (Mild dose is achieved through dry heating pad or warm water soaks at home.).
Conduction: heat on skin causes a transfer of energy (hot pack, contrast bath, paraffin) or
convection (conveyance of heat by the movement of heated particles (water , air or fibers) (whirlpool, fluidotherapy)
what are superficial heat agents good for?
Good for: stiff joints,muscle spasms, subcutaneous adhesions, contractures, chronic arthritis, subacute and chronic inflammation, neuromas, sympathetic nervous system disorders (like Chronic Regional Pain Syndrome) because of the following effects:
- Analgesic effect; reduces pain by acting on free nerve endings, tissues and peripheral nerve fibers
- Vascular: 6-14 degree increase in tissue temperature facilitates the release of substances such as histamine that result in vasodilation. Incresas in blood flow reduces ischemia, muscle spindle activity, and tonic muscle contractions (so does cardio exercise) This aids in pain relief and decrease muscle spasm.
- Metabolic: increase of blood flow and oxygen with tissure brings greater antibodies, leukocytes, nutrients, and enzymes to injured tissues. Aids in pain relief and tissue repair.
- Connective tissue: improved properties of collagen and extensibility of the tissue when combined with movement.
Techniques/Indications:
hot pack
whirlpool
fluidotherapy
paraffin
hot pack
hot pack: Used when a quick and low maintance heat is adequate for delivering heat. Allows for stretch and elevation but NOT movement. Be aware of the weight on patients.
whirlpool
whirlpool: Water bath with aeration used when buoyancy and ease of movement is desired. Can use with an open wound without the heat, Good for cleaning and debridement. Have to be aware of dependent position. Much time spent in set up and cleaning.
fluidotherapy
fluidotherapy: Fine particles called cellulose from ground up corn husks are suspended in hot air. Used when buoyancy, higher heat level (can tolerate higher temperatures with dry air) desired for benefits of stretch, allows opportunity for desensitization. Have to be aware of dependent position. Can be messy and safety hazard due to slippage on spilled fibers. Minimal set up or clean up.
paraffin
paraffin: Immersion in a wax (a 6:1 ratio of wax to mineral oil). Used when an even distribution of heat is desired or when hand joints are specifically needing to be heated. Can use in conjunction with a passive stretch of a digit.
contraindications for superficial heat agents
- Acute injury or inflammation
- Impaired sensation ( worse than 2.83 on Semmes Weinstein)
- malignancy
precautions for superficial heat agents
- Mild Impaired sensation
- Tumors/cancer in past
- Acute inflammation
- DVT (deep vein thrombosis)
- Pregnancy
- Bleeding tendencies
- Infection
- Advanced cardiac disease
- Impaired mental status
- RA (rheumatoid arthritis)
application of hot packs
Clay pack stored in water of 165 -170 degrees is removed from water, placed in a cover then layered with towels. (total of 6-8 layer of toweling with the cover counting as 3 layers, more layers if sandwich or laying body part on top of heat). Hot pack is then placed on the area assuring positioning allows for relaxation of the area as well as elevated if needed for edema. Delivers heat at 104 – 113 level. Leave on 15 – 20 minutes.
application of whirlpool
Fill the whirlpool monitoring temperature (100 – 104 for heating, 90 – 100 for wounds). Position patient close using towels to protect clothing, adjust height of whirlpool to assure maximum coverage/comfort. Turn on and adjust agitation to patient comfort. Treatment length 20 minutes.
application of fluidotherapy
Pre-heat unit to 105 – 118 degrees (dry heat is tolerated at higher levels.) Wash hands and thoroughly dry. Remove jewelry. Place the patient so both legs are positioned on one side of the machine so they can move close in to the machine. Open the arm sleeve, have the patient insert his/her arm and wrap the Velcro closure snuggly around the upper arm. Adjust the settings to 15-20 minutes and after beginning adjust the agitation level (higher creates more buoyancy and lower creates more desensitization).
application of paraffin
Remove jewelry. Clean and thoroughly dry hand. Check that wax is the right temp ( 118 – 135 degrees) With fingers apart have patient slowly immerse hand into the wax avoiding contact with sides and bottom. (demonstrate first). Allow to air dry a few seconds until loses its shiny appearance. Dip 6 – 10 times until a thick coating is achieved. Wrap in plastic bag then towel or mitt. Leave on 15 minutes. Remove paraffin and discard. Can combine with heat for longer treatment time if wish to achieve greater heat.
contrast baths
Uses the effects of heat and cold modalities in combination. Produces alternating vasodilation and vasoconstriction which improves peripheral blood flow. Requires access to ice and involves set up.
- Reduce edema
- Reduce pain; esp seen in those with hypersensitivity
Precautions and Contraindication for contrast baths
include those listed for both cryotherapy and heat therapy::
contraindications
• Acute injury or inflammation
• Impaired sensation ( worse than 2.83 on Semmes Weinstein)
• malignancy
precautions: • Mild Impaired sensation • Tumors/cancer in past • Acute inflammation • DVT (deep vein thrombosis) • Pregnancy • Bleeding tendencies • Infection • Advanced cardiac disease • Impaired mental status • RA (rheumatoid arthritis)
