Ice Pack Application Research Articles

Conservative management of hemophilic arthropathy

Intraarticular bleeding and muscle bleeding occur spontaneously or as a result of trauma in hemophilia A or B. The most common sites for hemarthrosis are the knees joints, elbows and ankles joints. Resorption of intraarticular blood induces reactive hemophilic synovitis Hyperplasia of the synovium can be followed by recurrent bleedings. These early reactions can change to a chronic synovitis and cause cartilage damage, finally resulting in a complete destruction of the joint. Since 1981 158 adults and 61 children with a hemophilia A or B were treated at the Center for hemophilic disorders Frankfurt in an interdisciplinary approach. Consequent prophylactic treatment with factor substitution can prevent the incidence of severe hemarthrosis. Minor joint bleedings are treated by adequate factor substitution, temporarily non-weight bearing of the extremity, application of ice-packs and physical therapy. More severe joint hemorrhages should be aspirated in order to reduce the acute synovitis. This is followed by a consequent physical therapy (joint and soft tissue techniques) and anti-inflammatory drugs. The goal is a sufficient muscular balance of the joint, the improvement of the coordination, and the proprioception. The chronic synovitis is less painful and poorly responses to conservative interventions. Local ice application, systemic and local anti-inflammatory treatment support the physical therapy. Soft heel shock absorber, elastic and semi-rigid bandages prevent recurrent bleeding episodes by shock absorption and decrease of synovial impingement. Synovectomy is indicated in cases of chronic persistent synovitis. Radiosynoviorthesis (RSO), which is an alternative in certain cases, has been performed with great success in 12 cases in our hospital. In advanced arthropathy joint mobilization should be the emphasis of the physical therapy. Bandages, crutches and ortopaedic shoe devices improve the walking capacity.

Noninvasive cerebral cooling in a swine model of cardiac arrest.

Mild cerebral hypothermia improves neurologic outcome in animals resuscitated from cardiac arrest. This study examined whether one practical external cooling method, i.e., local application of ice to the heads and necks of swine, during resuscitation induces cerebral cooling. Local external cerebral cooling was examined in a prospective laboratory investigation using 24 female swine in a model of cardiac arrest. The swine were randomized into hypothermia and normothermia groups. Intracerebral temperature was measured in the parietal cortex. Eight minutes after induction of ventricular fibrillation, chest compressions and mechanical ventilation were initiated. The hypothermia group was treated with 1,500 mL of ice in plastic bags applied to the head and neck, while the normothermia group received no extra interventions. Data were analyzed using repeated-measures ANOVA. In the normothermia group, there was no significant change in nasopharyngeal (-0.8 +/- 0.6 degree C), intracerebral (-0.6 +/- 0.8 degree C), or esophageal (-0.2 +/- 0.6 degree C) temperatures during 20 minutes of resuscitation. However, in the hypothermia group, application of ice during resuscitation significantly reduced nasopharyngeal (-2.9 +/- 1.4 degrees C), intracerebral (-2.1 +/- 0.6 degrees C), and esophageal (-1.4 +/- 0.8 degrees C) temperatures. External application of ice packs during resuscitation effectively reduced intracerebral temperatures in swine by an amount that improved neurologic outcomes in previous large animal studies. These data suggest that clinically significant cerebral cooling could be accomplished with a noninvasive, inexpensive, and universally available intervention. Further studies are required to assess the clinical feasibility and therapeutic efficacy of this intervention.

Vulvar edema as a complication of laparoscopic surgery

Vulvar edema occurred in three women within 24 hours after operative laparoscopy. In addition to local swelling and discomfort, inability to void was a common complaint. All three patients were treated with Foley catheter urinary drainage, local application of ice packs, and bedrest for 1 to 2 days with spontaneous resolution of the edema. We conclude that vulvar edema is a possible complication of endoscopy. Although it may require hospitalization because of inability to void, the condition is self-limited.

Effectiveness of ice packs in reducing skin temperature under casts.

Skin temperature lowering effects were measured after application of crushed ice packs to the surface of synthetic and plaster casts. The skin temperature of legs in synthetic casts decreased an average of 10.4 degrees C (range, 8.3 degrees-12.6 degrees) to a minimum temperature of 19.7 degrees C (range, 16.2 degrees-21.8 degrees), and the temperature of legs in plaster casts decreased an average of 11 degrees C to a minimum of 18.7 degrees C (range, 13 degrees-22.8 degrees). It took an average of 56 minutes (range, 40-80 minutes) for the legs in synthetic casts and 63.8 minutes (range, 26-116 minutes) for the legs in plaster casts to reach the minimum temperature. Cryotherapy is used clinically with the intention of lowering skin temperature and presumably decreasing the pain and swelling of a patient's injured extremity. The presence of a synthetic or a plaster cast does not eliminate the lowering effects of skin temperature when crushed ice packs are applied to the surface of the casts.

Effects of Ice pack application for the postcardiac surgery toddlers before C-tube removal

Effects of Ice pack application for the postcardiac surgery toddlers before C-tube removal

Waveform Shape Analysis: Extraction of Physiologically Relevant Information from Doppler Recordings

1. Doppler recordings were made from the brachial artery of healthy female subjects during a series of manoeuvres which altered the pressure-flow characteristics of the vessel. 2. Changes were induced in the peripheral circulation of the forearm by the application of heat or ice-packs. A sphygmomanometer cuff was used to create graded occlusion of the vessel above and below the point of measurement. Recordings were also made whilst the subjects performed a standardized Valsalva manoeuvre. 3. The Doppler recordings were analysed both with the standard waveform indices (systolic/diastolic ratio, pulsatility index and resistance index) and by the method of Laplace transform analysis. 4. The waveform parameters obtained by Laplace transform analysis distinguished the different changes in flow conditions; they thus had direct physiological relevance, unlike the standard waveform indices.

The Effect of Ice Packs upon Nasal Mucosal Blood Flow

The effect on nasal mucosal blood flow of ice packs on the forehead and ice packs within the mouth was investigated in 16 healthy subjects. The laser Doppler flowmeter was used to record changes in blood flow to the inferior turbinate, as measured by change in the flux. Ice packs within the mouth produced a significant decrease in nasal mucosal blood flow (p less than 0.05). The average fall was 23% (SEM 5.9) compared with the control measurements. No significant change was recorded following the application of ice packs to the forehead. The results of this study question the scientific rationale behind the use of forehead ice packs in clinical practice.

Intravenous verapamil in the prehospital treatment of paroxysmal supraventricular tachycardia

The prehospital treatment of paroxysmal supraventricular tachycardia (PSVT) with verapamil alone or in comparison with other interventions has not been studied. A sequential protocol consisting of Valsalva maneuver, ice packs, pneumatic antishock garment inflation, and verapamil 0.5 mg IV was implemented in an urban emergency medical services system after appropriate paramedic education. On-line physician discretion could alter the protocol in specific clinical situations. Inclusion criteria required a narrow-complex regular tachycardia at a rate of between 150 and 250. Of 43 patients identified, the protocol was applied sequentially in 26 (60%) and with valid physician discretion in 15 patients (35%) (due to hypotension, chest pain, or dyspnea). Conversion to a more stable rhythm occurred in 25 patients (59%). Of these, all but one achieved a sinus mechanism. The Valsalva maneuver and ice pack application were ineffective in achieving rhythm conversion, being successful in only two of 33 (6%), one of 31 (3%), and four of 24 (17%) attempts, respectively (P greater than .05). Verapamil, however, was significantly more effective (18 of 24 attempts, 75%) than any of the other interventions either singly (P less than .01) or in combination (P less than .0001). No clinically important adverse effects occurred with any intervention, but application of the protocol increased mean on-scene time to 30.6 minutes. We conclude that verapamil is an effective agent for the prehospital termination of PSVT but that careful on-line physician supervision and a system for confirming rhythm identification are both essential.

Managing skin damage induced by doxorubicin hydrochloride and daunorubicin hydrochloride

The pathophysiology and mechanisms of toxicity of anthracycline-induced skin damage are reviewed, and the various available therapeutic interventions are discussed. Skin ulcers caused by the vesicant antineoplastic agents doxorubicin hydrochloride and daunorubicin hydrochloride begin slowly, and the extent of the tissue damage produced is often underestimated. Within a week, untreated infiltrations of these agents can advance to serious indurations and ulcerations, causing extensive damage to underlying structures such as tendons and bones. Two theories have been proposed to explain the mechanism of action of anthrocycline-induced tissue damage; one holds that doxorubicin-DNA complexes form causing cell death, and the other holds that these agents are reduced to free radicals that can cause cell-membrane damage. Nonpharmacologic treatment of extravasation consists of stopping the infusion at the first sign of a problem and attempting to aspirate fluid and drug back through the same needle. The application of ice packs for the next 24-72 hours is recommended. A variety of pharmacologic approaches have been evaluated to ameliorate tissue damage. Corticosteroids, sodium bicarbonate, beta-adrenergic agents, and dimethyl sulfoxide have been used with some success. Patients who do not respond to initial conservative treatments should be referred to a plastic surgeon for skin grafting and reconstruction. The best treatment for anthracycline toxicity is prevention.

Responses of superficial and deep blood Vessels to cooling

Dilation of blood vessels seems desirable from a therapeutic point of view. Results suggest that application of icepacks may not be the ideal technique to use, as icepacks, although lowering skin temperature to levels at which skin vessels will dilate, will not lower muscle temperatures to levels at which deep vessel constriction is inhibited. Results further show that to achieve dilation of vessels, it is not necessary to apply icepacks for longer than 8-10 minutes.

Puerperal mastitis: Causes, prevention, and management

Breast infection can be a pathologically based negative influence on breast feeding. There are basically five types of lactational mastitis: subclinical mastitis, acute puerperal mastitis (cellulitis and adenitis), supperative mastitis, mammary infection with uncommon organisms, and virus infection in mammary neoplasms. The first three types are seen most often. Mastitis patients present, along with fever, a rapid pulse, and hot, reddened, tender areas on one or both breasts. Symptoms are most severe in supperative mastitis. In these cases, the developing breast abscess may be clearly identifiable. Nipple trauma and engorgement are thought to be predisposing factors to mastitis. Nipple trauma may lead to fissured nipples, thereby facilitating entry of bacteria into the connective tissue of the breast and development of acute cellulitic mastitis. Engorgement leads to stasis of milk and plugged milk ducts, which may create a setting conclusive to development of acute adenitis. Nurse-midwives should be actively involved in prevention and early detection of mastitis. Prevention may include instruction in hand expression and breast massage; encouragement of early, unrestricted nursing; identification of mothers with increased risk of nipple trauma and engorgement; instruction in signs and symptoms of infection; identification of support and information sources; and scheduling of early postpartum clinic visits. Treatment of mastitis includes rest in bed, increased oral fluids, temperature monitoring, and either continuation of breast feeding or discontinuation with binding of breasts and application of ice packs. Research seems to indicate that continuation is preferable. Treatment with antibiotics, usually antistaphylococcal drugs, is also necessary.

Experimental study on Methods of Fever Control Effects of ice-pack application on different body areas?

Experimental study on Methods of Fever Control Effects of ice-pack application on different body areas?

Effects of Testosterone Propionate and Stilbestrol on the Mammary Gland Postpartum

There have been several reports On the Value of testosterone propionate and stilbestrol in combating the pain of breast engorgement and in inhibiting lactation following delivery (1–6). The results reported have, in the main, been favorable and if they are confirmed by a sufficient number of investigators, these materials may be safely added to the obstetrician's armamentarium. The opportunity was presented for observation of some effects of testosterone propionate on the mammary gland and its secretion following delivery. The study was made on 139 patients. Of these, 55 were used as controls and 84 were given testosterone propionate or stilbestrol. There were 15 patients in whom it was necessary to stop lactation; of these, 7 received testosterone propionate by deep hypodermic injections and 8 were given stilbestrol orally. Sixtynine patients received testosterone propionate. The procedure employed for combating the pain of breast engorgement in the control group consisted of the application of ice packs with tight binders to the breasts, the limitation of fluids and the use of codeine.