1. conduction
    cold object abstracting heat from object in contact and then lowers the temperature
  2. convection
    a body part being cooled in ice water or cold bath
  3. evaporaton
    a volatile liquid cools the part being treated by evaporation
  4. factors affecting temperature change
    • temp difference between cold object and tissue
    • time of exposure
    • thermal conductivity (fat poor conductor compared to muscle)
    • type of cooling agent (ice packs> ice bath)
  5. after an area is cooled it takes time for that area to return to precooled temp b/c
    • longer
    • vasoconstriction effect of cold and vasodilation effect of heat
  6. physiological response to cold
    vasoconstriction- will dec bleeding and swelling
  7. indications
    pain; acute inflammation; local bleeding; edema or swelling; spasm; spasticity; facilitation of motor response; acute burns;
  8. contraindications
    previous history of frostbite; arterial insufficiencies; hypersensitivity to cold; angina; anesthetic skin; regenearting peripheral nerves; patient too old or too young
  9. cold packs
    • silica gel in a plastic cover stored in refrigerator at 5 deg C for 2 hrs before treatment
    • layer of towels (wet) should be placed between the pack and skin surface
    • stay cold 15-20 min
  10. ice packs
    crushed ice inside plastic bag or wet towel; 10-20 min
  11. ice massage
    stroking of ice on a body part; water frozen in paper cup; applied in a circular, smooth, rhythmical strokes over the area that is being treated; 10 min
  12. cold bath
    ice and water mixed; used for extremities; 13-18 deg (lower temp shorter duration); compression wrap may be an added advantage; 10 min
  13. cold compression units
    cooled water is circulated through a sleeve that is applied over an extremity; the sleeve is inflated intermittently to pump edema fluid from extremity while cooling the area' 10-25 deg
  14. vapocoolant spray
    • the skin is cooled by evaporation of the substance sprayed on the skin
    • two types; spray is performed from distal to proximal; stretching is done while spraying; use for trigger points and muscle spasms
  15. convert F to C
    convert C to F
    • F-32 x 5/9
    • C x 9/5 +32
  16. application process
    • apply ice until pt is numbed (10-15 min)
    • exercise in pain free range
    • ice until numb
    • exercise again
    • ice
    • repeat cycle and end with ice
  17. things to do before cryotherapy
    • inspect skin
    • test for hypersensitivity
    • verify the circulatory status
    • determine no frostbite
    • proper position and draping
    • convert C to F and vise versa
  18. cold and exercise
    • must be performed in pain free range
    • reestablishes neuromuscular function
    • allows exercise sooner
    • helps limit atrophy, loss of function, and swelling due to muscle pump
    • disadvantage is ice can be uncomfortable and exercise can be over performed
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