Tepid Sponge and Cold Sponge Application Procedure - Definition, Purpose, Preparation and Procedure

TEPID SPONGE/COLD SPONGE (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

Tepid sponging or cold sponging is a general application of moist cold liquid to cool skin, by evaporation and by the absorption of body heat in the cold water.

Tepid sponge is a process of sponging with tepid water to reduce body temperature by evaporation. The temperature of water used for tepid sponge is 80-90 degree F.

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Tepid Sponge:
- Tepid water is lukewarm, neither hot nor cold. It is often recommended for cleaning wounds or sensitive skin.
- It can be more comfortable for general cleaning tasks, as extreme temperatures can be harsh on the skin.
- Tepid water is suitable for washing the face or body, especially if you have sensitive skin.
Cold Sponge:
- Cold water can be refreshing and invigorating, making it a good choice for hot weather or when you need a pick-me-up.
- It can help reduce inflammation and soothe sore muscles or joints.
- Cold water may be preferred for some beauty routines, as it can tighten pores and give a refreshing feeling to the skin.

PURPOSE

Tepid sponge helps to reduce the temperature between 102 and 102.8 degree F.
Cold sponge helps reduce the temperature of above 103 degree F.
To stimulate circulation
To decrease toxicity
Nervousness and delirium
To soothe the nerves and promote sleep

GENERAL INSTRUCTIONS

Cold sponging is used to reduce temperature in a patient with hyperpyrexia
Large areas of the body are sponged at one time, permitting the heat of the body to transfer to the cooler solution on the body surface.
Often wet towels are applied to the neck, axillae, groin and ankles, where the blood circulation is close to the skin surface
The vital signs are checked very frequently to detect the early signs of complications
The physiological effect of the cold applications are vaso-constriction, decreased blood circulation, decreased capillary permeability, decreased metabolism, decreased blood viscosity, etc.
The application moist cold is more effective than the application of dry cold as the moisture distributes the cold to large and deep area
There must be a written order for tepid sponge or cold sponge
Use long strokes for sponging and avoid circular movements or friction while sponging
Keep the hot water bag ready at the foot end of the bed

PRELIMINARY ASSESSMENT

Check

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

PREPARATION OF THE PATIENT AND ENVIRONMENT

Explain the sequence of the procedure
Provide privacy
Check the initial temperature and should be checked every 15 minutes intervals
Position the patient comfortably in the bed
Remove the patient gown and place with bath blanket
Bring the patient to the edge of the bed
Place the long Mackintosh and draw sheet under the patient
Arrange the articles to the bedside

PROCEDURE

Wash hands
Mix the water with ice cubes
Soak the wash cloths in the ice cold water for some time
Place cold sponge cloths in each axial and groin
Put the face towel under the head sponge the face and dry with face towel
Sponge the neck, right arm from the shoulder to the finger tips for 3 minutes
Change sponge cloth when it becomes warm
Sponge the left arm, chest and abdomen for 3 minutes
Change the water if it becomes dirty and check the temperature
Cover the upper half, of the body and expose the lower half of the body
Sponge the right and left lower limb for 3 minutes
Then carefully turn the patient for his side and bring patient to edge of bed. Sponge the back with long strokes for 3 minutes
Dry the part with bath towel and apply spirit on the back
Check the temperature at 20 minutes interval and record it in the TPR chart