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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
What temp may result in thermal damage to the tissues and lead to inflammatory response, edema, and tissue death?
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
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
- increased body metabolism to conserve body heat
What are some indications of cryotherapy?
- immediately post trauma-acute
- relief of muscle spasms and spasticity
- decrease pain
- reduce fever
- emergency care burns (burn pt with HP)
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
What are precautions for cryo?
- elderly people - dont tolerate cold well
- prolonged application -> tissue damage, especially ice
How long do ice pack treatments normally last?
What is the normal treatment time for ice massage?
What is the temp for a cool WP?
What is the temp for a cold WP?
What is the temp of a very cold WP?
What are vapocoolant sprays used for?
painful muscle guarding and desensitizing trigger areas
ethyl chloride or fluoromethane - volatile
cools thru evaporation
What are indications for a contrast bath?
- impaired venous circulation and idolent ulcers
- subacute or chronic traumatic and inflammatory conditions
- sinus or congestive headaces
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
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
What are some disadvantages for a contrast bath?
- uncomfortable for pt
- have to watch timer
- set up
- time consuming
- keep track of rounds
What sensations will a pt experience during cryo (mostly for ice massage)?
CBAN - stop after its numb