Cooling Treatments

Definition

Cooling treatments lower body temperature in order to relieve pain, swelling, constriction of blood vessels, and to decrease the liklihood of cellular damage by slowing the metabolism. Sponge baths, cold compresses, and cold packs are all wet cooling treatments. Dry treatments, such as ice bags and chemical cold packs, are also used to lower body temperature.

Purpose

The most common reason for cooling a body is fever or hyperthermia (extremely high fever). The body can sustain temperatures up to 104°F (40°C) with relative safety; however, when temperatures rise above 104°F (40°C), damage to the brain, muscles, blood, and kidneys is increasingly likely. Cooling treatments are also applied immediately following sprains, bruises, burns, eye injuries, and muscle spasms to help alleviate the resulting swelling, pain, and discoloration of the skin.

Cooling treatments slow chemical reactions within the body. For this reason, cooling tissues below normal temperature (98.6°F/37°C) can prevent injury from inadequate oxygen or nutrition. Cold water drowning victims suffering from hypothermia (cooling of the body below its normal temperature) have been successfully resuscitated after long periods underwater without medical complications because of this effect. For the past 40 years, heart surgeons have been experimenting with hypothermia to protect tissues from lack of blood circulation during an operation. Neurosurgeons are also working with hypothermia to protect the very sensitive brain tissues during periods of absent or reduced blood flow.

Description

Depending on the medical need, various cooling methods are used.

• Cold packs and ice bags are placed on a localized site and provide topical relief. These compresses should be covered with a waterproof material to protect the skin. Repeated treatments produce the desired pain and swelling relief.
• Cold treatments are placed on the groin and under the arms to treat hyperthermia. Treatments are refreshed periodically until the appropriate temperature is attained.
• A tepid sponge bath relieves fever without cooling the body too fast. Eighty degrees Fahrenheit is still 20°F below body temperature and yet warm enough not to drive blood from the skin, thereby preventing the cooling from getting to the body's core. Limbs are bathed first and then the chest, abdomen, back, and buttocks.
• Perfusion of isolated regions like the brain by using cooled blood is an experimental treatment, offering promising results for the treatment of stroke.

Preparation

Topical treatments are prepared with ice, cold water (59°F/15°C), and chemical cold packs. Tepid baths should be 80-93°F (26.7-34°C).

Risks

Small children, adults with circulation problems, and the elderly are all at risk of tissue damage. Rapid cooling causes chills, which in effect raise the body's temperature by raising its metabolism. Blood clots may form from thickened blood caused by the temperature change.

Resources

PERIODICALS

Plattner, O., et al. "Efficacy of Intraoperative Cooling Methods." Anesthesiology 87 (November 1997): 1089–1095.