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Heat and Coldused for centuries as a treatment of pain.

Why nurse should advocate for atrial of heat or cold?

- It works well for somepatients

- it works quickly

- Adverse effects are virtuallynon-existent

-

It can provide somepatients/families withinimportant sense of controlover the relief of pain.

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Rationale:

applying heat to the skin will increase blood flow and

reduce neurotransmitters, which sensitize pain nervefibers. Heat may compete for nerve transmission with

pain and therefore, in the brain there is a perception of

heat and a reduced perception of pain.

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Contraindications:Avoid use of heat in the following situations:

- any are that is bleeding

- any area with decreased feeling

-any injury within the first 24 hours

- if the person is using any menthol-

containing products(vicks,ben gay etc)

- within the site of radiation therapy while

receiving radiation-may use this area five daysafter completing treatment, provided that the

skin is not flaky, red or tender.

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Avoid use of cold in the following

situations:

-any area with poor circulation.

- within a site of radiation therapy while

receiving radiation- may use this area five days

after completing treatment, provided that the

skin is not flaky, red or tender.

- on a wound in the healing phase.

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Relaxation and Imagery:

appropriate for almost any type of pain with a goal

of reducing muscle tension and anxiety. Patient maybenefit from simple relaxation centered on slow ,deep

breathing. Progressive muscle relaxation in which patient

uses isometric exercise to systematically relax muscles

from head to foot may also be helpful.

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Caution should be used in in using relaxation and imagerytechniques in patients who are either:

- confused

- drowsy

- have a poor grasp of the language of the relaxation

therapist.

- Have a previous history of significant psychiatric

history, such as having hallucinations.

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Distraction

the idea is to divert the attention by actively

involving the patient in the performance of a

distracting task that is interesting and more pleasantthan the painful procedure.

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Other Therapies

recognize that the complementary

therapies such as therapeutic touch, massage,

reflexology, Reiki and aromatherapy, including

acupuncture acupressure may be useful non-

pharmacological adjuncts to pain management.

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These modalities can be administered by

individuals with training in their application.

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Recommendations:Combine pharmacological methods with non-

pharmacological methods to achieve effectivepain management.

Non-pharmacological methods of treatment

should not be used to substitute for adequatepharmacological management.

The selection of non-pharmacological methods of

treatment should be based on individual

preference and the goal of treatment.

Any potential contraindications to non-

pharmacological methods should be considered

prior to application.

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Thank you very much!