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What 5 things does the extent of cooling depend on?
- 1. initial skin temp
- 2. temp of environment
- 3. duration of application
- 4. amount of cold applied
- 5. subcutaneous tissue thickness or fat present
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What temp may result in thermal damage to the tissues and lead to inflammatory response, edema, and tissue death?
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What are some physiological effects of cooling?
- 1. decreased blood flow and inflammation (vasoconstricts- symp. nervous system, hunting reaction-vasodilation, abnormal)
- 2. metabolism (decrease metastasis and prevent secondary tissue damage)
- 3. skin temp decrease (decreased circulation, cold is not easily dissipated, easy to damage tissue)
- 4. connective tissue (collagen-increases viscosity which increases the resistance to movement)
- 5. pain (counterirritant-gate theory, decreased throbbing or aching pain)
- 6. muscle (seen after 5 mins of application)- longer contraction time, longer time for relaxation, decreases spasticity and muscle spindle sensitivity and muscle tone for 2 hours
- 7. joints - increases viscosity - dont do motor activity right after ice with some people
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What are systemic responses to cold?
- vasoconstriction of body surface vessels - shunt blood away from surface to core
- decreased sweat production
- depression of cardiovascular system - decreases pulse and BP
- shivering
- increased body metabolism to conserve body heat
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What are some indications of cryotherapy?
- immediately post trauma-acute
- post-op
- relief of muscle spasms and spasticity
- decrease pain
- anti-inflammatory
- reduce fever
- emergency care burns (burn pt with HP)
- edema
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What are contraindications of cold?
- angina pectoris/cardiac dysfunction
- open wounds after 48-72 hours
- arterial insufficiency - PVD
- hypersensitivity to cold (cold urticaria, Raynauds disease-digit spasms when exposed to cold)
- anesthetic skin
- regenerating peripheral nerves
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What are precautions for cryo?
- elderly people - dont tolerate cold well
- prolonged application -> tissue damage, especially ice
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How long do ice pack treatments normally last?
10-15 mins
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What is the normal treatment time for ice massage?
5-10 mins
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What is the temp for a cool WP?
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What is the temp for a cold WP?
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What is the temp of a very cold WP?
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What are vapocoolant sprays used for?
painful muscle guarding and desensitizing trigger areas
ethyl chloride or fluoromethane - volatile
cools thru evaporation
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What are indications for a contrast bath?
- impaired venous circulation and idolent ulcers
- subacute or chronic traumatic and inflammatory conditions
- edema
- sinus or congestive headaces
- pain
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What are the temps for a contrast bath?
- warm - 80-104F.......38 to 44C
- cold - 55-67F........10-18C
warm 3 mins then cold 1 for 20-30 mins
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What water (warm/cold) do you want to end with during a contrast bath?
- if PVD end on warm
- acute end on cold
end with temp youd normall use for treatment
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What are some disadvantages for a contrast bath?
- uncomfortable for pt
- have to watch timer
- set up
- time consuming
- keep track of rounds
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What sensations will a pt experience during cryo (mostly for ice massage)?
- cold
- burning
- aching
- numbness
CBAN - stop after its numb
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