The use of an ice pack: algorithm,contraindications

Update: October 2018

Ice pack is a thick rubber tank with tight
screw cap, filled with pieces of ice or snow,
immersed in cold water. This physiotherapeutic is applied.
device for effects associated with constriction of blood

As a bladder with ice can act pre
chilled salt water bottles in the freezer;
special gel cool elements. Due to the risk of
damage to the skin and underlying soft tissue overlay cold
appointed by the doctor, and the method of performing this manipulation
explained and monitored by a nurse.

Why do you need cold

Locally superimposed cold, constricting blood vessels not only
under the overlay location, but also in some radius around, leads to
these effects:

  • reduced pain;
  • stopping bleeding from small diameter vessels that
    mainly used for the prevention of post-traumatic or
    postoperative hematomas;
  • decrease in body temperature;
  • reducing the severity of inflammation;
  • reduced brain cell oxygen demand.

It is used in almost all areas of medicine, but
основные специалисты, которые  используют влияние холода – это
resuscitation specialists, neonatologists, surgeons, cosmetologists, neuropathologists,
heart surgeons. The latter, however, do not use local
coolers: they, cooling the entire blood of the body, may somewhat
minutes to work on a non-contracted heart without complications for

Thus, an ice pack is a serious procedure;
strict indications and contraindications.

When local cooling is needed

Local cold source is used for:применение в медицине пузыря со льдом

  • in the postoperative periods;
  • on the first day after a bruise, sprain or ligament rupture or
  • with external and internal bleeding;
  • on the first day of the postpartum period, especially if there is
    reasons to suspect not the best uterine contractility;
  • when the stomach hurts, but not cramping, but the pain is aching,
    pulling, spilled;
  • children apply ice after birth trauma or asphyxia. Here
    manifest scientifically proven and repeatedly tested effect
    reduce the need for brain cells for oxygen;
  • in violation of consciousness. This is where the same principle works.
    in the previous case: the brain will suffer less if less
    consume oxygen;
  • with insect and tick bites: less into narrowed vessels
    will get an allergen injected with insects;
  • with heat stroke;
  • if calcium chloride was administered intravenously, but it fell under
  • with increasing temperature, especially in children. Especially
    Concerns situations when a sufficient amount has already been taken
    antipyretic or last not recommended for use
    in this situation (for example, with leukemia or with brain damage)
    or in a given person (with peptic ulcer or aspirin
    asthma). Of course, an ice bubble can be used for any
    another temperature increase.

Such indications for the bubble with ice.

With migraine in children and adults, head injuries in children,
carrying out thermal procedures when the rush of blood to the head is unpleasant
or even dangerous, with mental arousal, and also if the child
injured without damaging the skin, should be applied
cold compresses. Under the word “compress” in this case
implies a folded piece of clean cloth several times or
bandage wetted with cold water. It needs to be changed as soon as
it heats up from the warmth of the skin (usually 5-7 minutes).


When you can not use ice

Contraindications to the use of an ice pack are the following:

  • hypothermia;
  • when, despite the high body temperature,
    cold extremities (in this case, antispasmodic medications are needed
    such as “no-shpa” in combination with the rubbing of cool limbs
    a cloth moistened with a mixture of water and alcohol 1: 1);
  • in shock, that is, the state when as a result of pain,
    hemorrhage, allergic reaction, profuse vomiting or diarrhea
    there is a decrease in pressure with a cooling of the extremities;
  • with paralysis or paresis;
  • in collapse, a state similar to passing out, with the difference
    that loss of consciousness is caused by a sharp drop in the arterial
  • if abdominal pain is cramping,
    causing a desire to lie curled up.

The latter condition is called pain cramping character
and is an indication for setting the heater. Consider the differences
when it is necessary to use a hot-water bottle, and when – and a bladder with ice:

Symptom Ice Warmer
Trauma: soft tissue contusion, sprain or ligament rupture,
tendons muscle fibers
On the first day In the next 2-3 days, to accelerate healing
Боль под челюстью,  в области шеи или над ключицей, когда
there is defined a “ball” – lymph node
Not applicable If the “ball” rolls freely, it is painful, while its
appearance not associated with a tumor or purulent process
If the arm or leg is “pulled”, “lumbago” are noted in the neck or
Not May be
Reddened and enlarged joint above it rose
Yes Not
It hurts to perform a certain movement, such as turning
Not Yes
Cramping abdominal pain Not, до согласования с врачом On the advice of a doctor
Abdominal pain of any nature Yes, до осмотра врачом Not
Nose bleed Yes Not
Vaginal bleeding during pregnancy Yes, по согласованию с врачом Not
Bleeding from a tooth extraction hole Yes Not
Rebleeding from the surgical site Yes Not
Cheek swelling after removal or after prolonged pain in the tooth Yes Not
For pain in the sinuses near the nose, in the forehead or in the ear Not After examining the ENT doctor, with his consent
For any pain in the head, even accompanied by an increase
temperature, nausea, increased sensitivity. BUT!
If they did not occur in a person suffering from atherosclerosis, CHD,
thrombosis or cardiac arrhythmias.
Yes Not
With painful areas of hardening in any area, including
number and mammary glands, especially if they are raised above
Yes Not
For earache Not If the ENT doctor permits

In any case, before using cold or heat,
consult with your doctor, so as not to harm yourself.

How to apply a cold

The algorithm for applying an ice pack is as follows. You
will need:

  • pieces of ice from the freezer. Fit or those that
    were in ice tins, or lay flat
  • if a conglomerate (“lump”) is taken, it should be wrapped in 2-3 layers
    cloth and beat with a wooden hammer into small pieces;
  • find a towel or a dry diaper;
  • put pieces of ice or snow in the tank, 1/3;
  • pour another 1/3 with cold water of 10-15 degrees;
  • put a bubble on a horizontal surface so that from it
    the air came out and the tank acquired softness and suppleness;
  • screw the lid on;
  • turning over, check for tightness: from the tank should not
    drip water;
  • wipe off the ice tank;
  • can be applied, but only – on a dry cloth.

Technique of using an ice pack:

  1. to the intended place, which should not be an open wound (in
    otherwise, ice can be applied side by side), dry is applied
    napkin or diaper, folded in 3-4 layers;
  2. an ice pack is placed on the napkin for 15-20 minutes;
  3. after this time the container is removed for 20-30 minutes, estimated
    the skin beneath it (it should not be red or other
    colors, it should not appear bubbles);
  4. if the reason for using ice is bleeding, swelling, or
    высокая temperature, повторяем подачу пузыря со льдом через 20-30
  5. the frequency of repetitions is coordinated with the attending physician. Usually
    2-3 approaches are applied twice or thrice a day, but fever or
    bleeding may require another dosing. Breaks on
    20-30 minutes are required;
  6. as it melts, the water is drained and the ice is added.

After the procedure, the water with ice must be drained, and the bubble
leave stored in clear. Put it in the freezer
with water is unacceptable.

Ice Places

Ice может быть приложен:

  • for disturbances of consciousness, headache, or rising
    temperature is not due to inflammation of the internal organs, but
    due to swelling of the brain during inflammation or swelling of the brain – to the frontal and
    occipital head;
  • at high temperature: on the area of ​​large vessels: in the fold
    between the leg and lower abdomen (but not touching the genitals),
    briefly – on the neck, in the armpits, and also – in
    right hypochondrium;
  • to places of bruises or sprains;
  • in the area of ​​edema and tissue redness, if they are caused
    suppuration, trauma, insect bites, or the introduction of
  • with pain in the abdomen – to the place of pain. This is only possible after
    examination by a gastroenterologist or surgeon.

The setting of an ice pack for a child is somewhat different. Here
the bubble is not placed directly on the diaper that fits
on the skin. «Iceяная» емкость располагается на расстоянии 2-3 см от
necessary area, children under 3 years old should use replaceable every 5-7
минут cold compresses. Если же нужно охладить head ребенка,
a special tripod is used to keep the ice “hanging” on
a distance of 6-10 cm. In this case, cold

Автор: Кривега Мария Салаватовна врач-реаниматолог

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