TEPID SPONGE/COLD SPONGE

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

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.

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

EQUIPMENT

  • A large basin of water (80-90 degree F) for tepid sponging
  • Jug with  cold water
  • Basin with ice pieces
  • Bath thermometer
  • Mackintosh and draw sheet
  • Sponge clothes – 6
  • Bath towel – 1
  • Face towel – 1
  • Thermometer tray
  • Ice cap with cover
  • Spirit rub
  • Bucket

AFTER CARE

  • Remove the sponge clothes from the axilla and groin. Discard it in kidney tray
  • Dry the body with bath towel
  • Remove the Mackintosh and draw sheet
  • Replace the gown and remove the bath blanket
  • Observe for any symptoms of chill or any other abnormality
  • If needed give him hot drinks
  • Position the patient comfortably in the bed
  • Replace the articles after cleaning
  • Wash hands
  • Record the procedure in the nurse’s record sheet and vital signs in TPR sheet

COLD APPLICATION

COLD COMPRESS

COLD PACK

ICE CAP / ICE COLLAR

TEPID SPONGE/COLD SPONGE - Definition, Purpose, General Instructions, Preliminary Assessment Check, Effects, Physiologic Effects, Indications, Preparation of the Patient and Environment, Equipment, Procedure, After Care and Contraindications
TEPID SPONGE/COLD SPONGE – Definition, Purpose, General Instructions, Preliminary Assessment Check, Effects, Physiologic Effects, Indications, Preparation of the Patient and Environment, Equipment, Procedure, After Care and Contraindications

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