Hot applications also known as thermotherapy involve applying heat to the body to relieve discomfort, promote healing, and improve circulation. They’re a staple in nursing care and physical therapy, especially for musculoskeletal issues.
Definition
It is the application of moist heat to the localized part of the body using hot water, microwaveable pads, and electrical and chemical pads.
It is also termed as hot fomentation or simple fomentation.
Purposes
- To increase the blood flow resulting in increased oxygenation to tissues.
- To reduce inflammation, swelling, and pain.
- To promote suppuration.
- To promote healing.
- To reduce stiffness and relax muscles.
- To promote warmth, sleep, and comfort.
- To relieve bladder distension.
Indications
- Muscle spasm.
- Joint pain.
- Inflammation.
- Bladder distension.
- Stiffened muscles.
Contraindications
- Open wounds.
- Metabolic disorders.
- Inflammatory conditions such as appendicitis.
- Impaired renal, cardiac, or respiratory functions.
- Hypertension and diabetes where circulation and sensation are impaired.
- Very young or very old patients
Articles
Preparation of Equipment
- Kettle with hot water (125-150°F).
- Basin to pour the water.
- A tray with;
- Lotion thermometer.
- Bowl with cotton and gauze piece.
- Gauze pads if wringer rod is not available.
- Duster.
- K-basin.
- Wringer rod.
- Wringer frame.
- Two forceps.
- Fomentation pad.
- Vaseline.
- Mackintosh or underpad.
- Clean towel to dry after application.
- Bandage and adhesive if needed.
Procedure for Hot applications
| Nursing actions | Rationale | |
| 1. | Check the doctor’s order. | To plan the care. |
| 2. | Explain the procedure to the patient. | Enhances cooperation and allays fear. |
| 3. | Provide privacy. | Reduces embarrassment. |
| 4. | Gather all the equipment at the bedside. | For convenient use. |
| 5. | Wash hands. | To prevent cross-infection. |
| 6. | Expose the needed area. | To reduce embarrassment. |
| 7. | Check the temperature of the water with the lotion thermometer. | To prevent injury when applying. |
| 8. | Apply vaseline over the localized part. | To reduce chance of burns. |
| 9. | Place fomentation pad in the wringer. Insert wringer rod and place it in the basin with hot water. Hold wringer rods with both the hands and turn each in opposite direction. | To wet the pads for application and to wring out excess water from pads. |
| 10. | In case of nonavailability of wringer rod, place the gauze or fomentation pads in basin or bowl with warm water; hold the gauze pad with forceps on either side; and squeeze extra water in the basin. | To wet the pads for application and to remove excess water from pads. |
| 11. | For fomentation pad, remove it from wringer rod with forceps and apply it over the area to be treated. In case of gauze pad, follow the same. | For application at the local part. |
| 12. | Check for discomfort, tolerance, burns, redness, blisters frequently. | To identify and to treat at the earliest. |
| 13. | Rewarm the fomentation or gauze pad and apply for 10 to 15 minutes. | To enhance effectiveness. |
| 14. | After the application, gently pat the skin dry with a clean towel. | To prevent moisture from being accumulated in the skin. |
| 15. | Wash hands. | To prevent cross-infection. |
| 16. | Replace the articles. | For the next use. |
| 17. | Document the procedure done. | Serves as legal evidence and to prevent duplication of care. |
Precautions
- Always check temperature before application
- Use protective layers to prevent burns
- Monitor skin condition during treatment
- Limit exposure to 20–30 minutes to avoid rebound vasoconstriction
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
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