ICE CAP/ICE COLLAR

ICE CAP/ICE COLLAR (Cold Application) – Definition, Purpose, General Instructions, Preliminary Assessment Check, Effects, Physiologic Effects, Indications, Preparation of the Patient and Environment, Equipment, Procedure, After Care and Contraindications

Updated 2024

The ice bag is another means of applying local cold to the skin. It should be filled with finely chopped ice so that it is about 2 cm thick. The air is driven out by water. Then the cap is screwed on; the bag should hold its shape by reason of the predominance of ice. It is covered with a layer of face towel before it is applied to skin. Commonly, the ice bag is not kept in place continuously but is removed for 20 minutes after 20 minutes application. Specially shaped ice bags are mad for the spine, the neck (cravat) and head (ice cap).

DEFINITION

Ice cap is defined as small rubber bag filled with small pieces of ice and salt, that serves as a device for cold application.

PURPOSE

• To reduce temperature between 101-101.8 degree F.
• To prevent bleeding especially after thyroid surgery, tonsillectomy and dental surgery
• To relieve urinary retentions
• To relieve inflammation
• To decrease metabolic rate of body

GENERAL INSTRUCTIONS

• Fill the ice bag and ice collar with small pieces of ice and sprinkle sodium chloride
• The salt lowers the melting point and prevents the ice from melting
• Check the ice bag for leakage by pouring cold water into it. Empty the water and fill the bag about 1/3^rd with the ice
• The ice bag/ice collar is colder than the skin, the ice takes up heat from the body and reduce the body temperature
• Condensation of moisture collects on the outside of the bag, and the flannel cover with absorb this moisture
• The ice bag is applied for about ½ hour, and then it is discontinued for at least one hour to hollow for the recovery period

PRELIMINARY ASSESSMENT

Check

• The doctors for any specific instructions
• General condition and diagnosis of the patient
• Self care ability of the patient
• Frequency and duration of application
• For any contraindication of cold application
• Articles available in the unit

PREPARATION OF THE PATIENT AND ENVIRONMENT

• Explain the procedure to the patient
• Provide privacy, if needed
• Assess the temperature of the patient
• Position the patient comfortably in the bed
• Arrange the articles at the bedside
• Assess the part of body needs to be applied

EQUIPMENT

A clean tray containing

• Small Mackintosh with towel
• Ice cap with ice cubes
• Flannel cover
• Salt
• Thermometer tray
• Duster

PROCEDURE

• Wash hands
• Fill 2/3^rd ice cap with ice cubes and expels air before closing cap
• Add pinch of salt to ice cubes before closing
• Check for any leakage
• Cover bag with flannel cover after drying with duster
• Placed on desired area
• Apply for ½ hour and then remove

AFTER CARE

• Observe for bluish skin discoloration or mottling
• Recheck patient’s temperature
• Replace the articles after cleaning
• Position the patient in a comfortable position
• Wash hands
• Record the procedure in the nurse’s record sheet and vital signs in TPR sheet

COLD APPLICATION

COLD COMPRESS

COLD PACK

TEPID SPONGE / COLD SPONGE

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NURSE FUNDAMENTAL PROCEDURES

MEDICAL SURGICAL NURSING

IMPORTANT KEY POINTS

Using an ice cap or cold collar is a common method for applying cold therapy, which is often used to reduce pain and inflammation. Here are key points to consider when applying an ice cap or cold collar:

1. Indications:
   • Cold therapy is typically indicated for acute injuries, such as sprains, strains, and swelling.
   • It can also be used post-surgery to minimize swelling and relieve pain.
2. Timing:
   • Apply cold therapy as soon as possible after an injury or surgery to maximize its effectiveness.
   • Duration of application is usually 15-20 minutes at a time. Longer application may cause tissue damage.
3. Frequency:
   • Apply cold therapy multiple times a day if necessary, with at least a 1-hour gap between sessions.
4. Protection:
   • Place a cloth or thin towel between the ice pack or cold collar and the skin to prevent frostbite or ice burns.
   • Avoid direct contact of the ice with the skin.
5. Adjustment:
   • If the cold sensation becomes too intense, remove the ice pack for a few minutes and then reapply.
   • Check the skin regularly for signs of irritation or numbness.
6. Compression:
   • Cold collars often come with straps or fasteners that allow for compression along with cold application, which can help control swelling.
7. Elevation:
   • Elevate the injured or swollen area whenever possible, especially when applying cold therapy. This helps reduce swelling.
8. Medical Advice:
   • Seek advice from a healthcare professional before using cold therapy, especially if there are pre-existing health conditions like circulatory problems.
9. Contraindications:
   • Cold therapy is not suitable for everyone. Individuals with conditions like Raynaud’s disease, cold hypersensitivity, or compromised circulation should avoid using cold applications without consulting a healthcare provider.
10. Ice Pack Rotation:
    • If using multiple ice packs, rotate them to ensure a continuous cooling effect.
11. Temperature:
    • Commercial ice packs or cold collars are designed to maintain a specific temperature range. Homemade ice packs should not be too cold and should conform to the recommended temperature guidelines.
12. Storage:
    • Follow manufacturer guidelines for storing and caring for reusable cold packs or collars.
    • Ensure the ice pack is fully frozen before each use.