Tuesday, July 21, 2015

Hot Moist Packs

These are the commercially available superficial heating modality used by many PT clinics and hospitals to provide moist heat. This consists of a silicate gel enclosed in a cotton canvas fabric. Silicate gel is the main property because it absorbs more water and when it is immersed in  hot water it provides a considerable store of heat energy that last 30 to 40 minutes. Heating is through conduction and has little to or no effect on the temperature of  deeper tissues. Hot packs are available in different size and shape to fit different body areas.

Physiologic Responses:
  • Increases circulation - promotes soft-tissue healing
  • Increases muscle temperature - decreases pain and stiffness
  • Relaxes spasm 






Treatment Parameters:
  • Hot packs are stored in a tank filled with hot water between 70 to 75 degrees Celcius.
  • Application of the packs requires six to eight layers of towels around the hot pack to provide thermal insulation thus lessening the danger of burn
  • Ideally, it should be applied on top of the patient. If the patient lies on top of the hot pack additional toweling is required
  • Check skin after five minutes for excess or sign of a burn.
  • Call the attention of the PT for discomfort
  • Applied at least 20 to 30 minutes to achieve the desired effects

Method of Application:

One-towel method

  • Fold four towels in half, width-wise.
  • Place each towel on top of the other, forming eight layers of toweling.
  • Place towels on the treatment area.
  • Place pack on towels and cover pack with folded towel to retard heat loss.

Two-towel method

  • Fold two towels lengthwise and
  • Place one perpendicular over the other, forming a cross.
  • Place pack in the center of the towels.
  • Fold the ends of the towels over the pack, forming eight layers of toweling on top of the pack. Invert pack placing the eight layers of toweling on the patient.

Contraindications and Precautions:

  • Impaired skin sensation
  • Circulatory dysfunction - varicose veins, DVT, and arterial diseases
  • Taking analgesic drugs
  • Infections and open wounds - danger of cross-contamination
  • Cancer and tuberculosis - may enhance the progression of the disease
  • Gross edema
  • Impaired cognitive - lack of comprehension
  • Deep x-ray therapy
  • Liniments
  • Pregnancy - should not be applied directly over the uterus
  • Fever
  • Acute inflammation
  • Presence of metal implants 
  • Advanced age
  • Menses - increases menstrual flow if applied to the lower back or over the pelvis

Advantages:
  • Easy to apply
  • Saves time for personnel
  • Efficient in heat conduction
  • Available in different sizes and shape to fit clinical needs
  • Has more sedative effects than dry heat
  • Low cost
  • Long life
  • Patient acceptance

Disadvantages:
  • Not easily applied around shoulders and hips
  • Somewhat heavy
  • Cannot be used on extremely sensitive patients
  • May cause skin rash

Alternatives:

Hot Compress 
  • Ideal for home use; an alternative to hot moist pack
  • Greater heat loss and need constant change.
  • Place the towel in hot water and wrung out t properly if you use this method of application.
Hot Water Bottle

  • A rubber hot water bottle applied in the same way as hot moist packs
  • Ideal for home use


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