HOT FOMENTATION (Hot Application) – Purpose, Classification, Preliminary Assessment, Preparation of Patient and Environment, Equipment, Procedure and After Care
UPDATED 2024
Hot fomentation is a local moist heat application, over an area by means of two thick pieces of flannel or other soft material, wrung out from boiling water, protected by water, soft covering, wool and bandage
Hot fomentation is defined as a process of applying moist heat to localized part of body
Purpose
- To relieve pain and congestion
- To relieve inflammation
- To relieve retention of urine
- To relieve intestinal and renal colic
- To stimulate nerve ending to stimulate peristalsis
- To provide comfort and warmth
- To relax muscles
- To promote suppuration
- To apply sterile compress on wounds
Classification
- Simple fomentation: boiled or dipped in boiling water is used for fomentation, it is called simple fomentation.
- Medicated fomentation: drug is added to boiled water for fomentations and it is applied to unbroken skin used to relieve tympanites by increasing the peristalsis and relaxing the muscle spasm
- Surgical fomentation: this is a fomentation to broken part of skin like over an open wound. The purpose is to relieve pain and muscle spasm, to reduce swelling and congestion and to accelerate the process of suppuration
Area of Application
- Whole of the back and sides of axilla are covered to relieve congestion of kidney
- Joint stiffness or inflammation of the whole joint and some areas above or below the joint are covered
- In case of stomach pain, the area of application is from xiphisternum to umbilicus and both sides of abdomen
General Instructions
- Make sure that the skin in intact, nor sored or abraded in case of medical fomentation
- The skin is smeared with little Vaseline/oil before the application of moist heat to prevent scalding
- The skin is covered with a layer of warm cotton (sterile) in care of open wound until a fresh application is made, if any interval of time elapses between the removal of one and the application of the next
Preliminary Assessment
Check
- To correct patient
- The doctors order for specific instruction
- General condition diagnosis of the patient
- Inspect the body part for any lesions of the skin
- Determine the duration and frequency of the treatment
- Assess the contraindication to the application of heat
- Self-care ability to follow instructions
- Articles available in the unit
Preparation of the Patient and Environment
- Explain the sequence of the patient
- Provide privacy if needed
- Arrange the articles at the bedside
- Drape the part according to the need and expose only the needed part
- Position the patient comfortable according to the need
- Place a Mackintosh and towel under the patient to prevent protect the bed
- Expose the area and apply the olive oil, on the part to prevent burns
Equipment
- A kettle of boiling water
- Wringer with wringer rods placed in basin
- Lint or funnel pieces to apply warmth
- Plates – 2 to take the compress to the patient side
Methods of Fomentation
Boiling Water Method
- Fold a large bath towel lengthwise and twist as much as possible; place middle three-quarters into boiling water and let it become thoroughly soaked
- Lift out of water and pull hard to wring out all the water possible. Let it untwist by dropping one end and hold the other end
- Lay it over the towel placed on the patient’s body if the towel is very hot
OR
Place hot towels on the skin surface and quickly remove it to avoid burning; watch it very carefully to lift the towel if heat is not tolerated. The towel will cool off rapidly. Practice this skill thoroughly before you work on your client
- Cover with another towel
- Repeat procedure 3 or 4 times. In between the hot towels, briskly wipe the body surface with ice-cold cloth and then blot the moisture quickly. It is the moisture that burns the skin, therefore the skin must be dry completely before the next application
Streaming Method
- Soak completely and wring out 5 large bath towels or fomentation pads in water
- Place the towels or pads on the grid of a large canner (32 quarts or liters)
- Place enough water in the canner below the grid and boil it for 20 minutes-towel or pads should not touch the water
Microwave Method
- Take a large bath towel soaked in cold water; wring out all the water possible
- Place the single towel in a black plastic garbage bag or other strong plastic bag
- Place the bag in the micro-wave oven and turn to high for 4 minutes (or until steaming)
- Quickly remove towel and use it on the body surface; if it is very hot, place a dry towel on skin area before applying the very hot towel
A tray containing:
- Cotton balls in a container to apply the oil
- Forceps-to hold the cotton balls
- Olive oil or Vaseline
- Small Mackintosh
- Waterproof cover and cotton pad
- Abdominal binder and safety pin
- Paper bag
- Hot water bag and cover
- Duster and lotion thermometer
Procedure
- Wash hands
- Expose the needed area and observe for any lesions on the skin
- Place the patient at the edge of the bed near the working side
- Expose the area and apply Vaseline
- Place fomentation cloth/pack in wringer. Insert wringer rods and place in basin
- Check temperature of water (125-150 Degree F)
- Pour water on fomentation cloth and wet fully
- Hold wringer rods with hands and turns in opposite direction to wring out excess water from pad
- Remove pad by holding one corner over second basin
- Place flannel Mackintosh over pad
- Apply bandage/binder depending upon site and secure with pins or adhesive
- Remove after 10 to 15 minutes
After Care
- Observe skin for any pallor; extreme redness, pain and discomfort
- Remove and reapply as needed for better effect
- After removing, gently dry part
- Replace the articles after cleaning
- Wash hands thoroughly
- Record the procedure in nurse’s record sheet
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