Before initiating heat or cold therapy, assess the patient’s
physical and mental status, the condition of the body area to
be treated with heat or cold, and the condition of the equip-
ment to be used. Carefully evaluate factors influencing
the patient’s ability to tolerate heat and cold applications.
These factors are the basis for the following considerations:
How long will the heat or cold be applied? Prolonged
exposure increases tolerance, and rebound effects are
undesirable.
rWhat body part is involved? Some body areas, such as
the neck, perineum, and inner aspects of the wrist and
forearm, are more sensitive to thermal changes.
Is the skin intact? Open tissue or abraded skin is more
sensitive to thermal changes.
How large is the area? Applications of heat or cold to
large areas of the body cause systemic responses and
lower tolerance of temperature change.
What is the patient’s age? Infants, children, and older
adults do not tolerate temperature changes as well as
adults.
What is the patient’s physical condition? Patients with
certain alterations in health, such as those with cardio-
vascular or peripheral vascular diseases, might have
reduced response to or tolerance of thermal changes.