HOT FOMENTATION (Hot Application) – Nurse Info

HOT FOMENTATION (Hot Application) – Purpose, Classification, Preliminary Assessment, Preparation of Patient and Environment, Equipment, Procedure and After Care

UPDATED 2024

Hot fomentation is a local moist heat application, over an area by means of two thick pieces of flannel or other soft material, wrung out from boiling water, protected by water, soft covering, wool and bandage

Hot
fomentation is defined as a process of applying moist heat to localized part of
body

Purpose

To relieve pain and congestion
To relieve inflammation
To relieve retention of urine
To relieve intestinal and renal colic
To stimulate nerve ending to stimulate
peristalsis
To provide comfort and warmth
To relax muscles
To promote suppuration
To apply sterile compress on wounds

Classification

Simple fomentation: boiled or dipped
in boiling water is used for fomentation, it is called simple fomentation.
Medicated fomentation: drug is added
to boiled water for fomentations and it is applied to unbroken skin used to
relieve tympanites by increasing the peristalsis and relaxing the muscle spasm
Surgical fomentation: this is a
fomentation to broken part of skin like over an open wound. The purpose is to
relieve pain and muscle spasm, to reduce swelling and congestion and to
accelerate the process of suppuration

Area of Application

Whole of the back and sides of axilla
are covered to relieve congestion of kidney
Joint stiffness or inflammation of
the whole joint and some areas above or below the joint are covered
In case of stomach pain, the area of
application is from xiphisternum to umbilicus and both sides of abdomen

General Instructions

Make sure that the skin in intact,
nor sored or abraded in case of medical fomentation
The skin is smeared with little
Vaseline/oil before the application of moist heat to prevent scalding
The skin is covered with a layer of
warm cotton (sterile) in care of open wound until a fresh application is made,
if any interval of time elapses between the removal of one and the application
of the next

Preliminary Assessment

Check

To correct patient
The doctors order for specific
instruction
General condition diagnosis of the
patient
Inspect the body part for any lesions
of the skin
Determine the duration and frequency
of the treatment
Assess the contraindication to the
application of heat
Self-care ability to follow
instructions
Articles available in the unit

Preparation of the Patient and Environment

Explain the sequence of the patient
Provide privacy if needed
Arrange the articles at the bedside
Drape the part according to the need
and expose only the needed part
Position the patient comfortable according
to the need
Place a Mackintosh and towel under
the patient to prevent protect the bed
Expose the area and apply the olive
oil, on the part to prevent burns

Equipment

A kettle of boiling water
Wringer with wringer rods placed in
basin
Lint or funnel pieces to apply warmth
Plates – 2 to take the compress to
the patient side

Methods of Fomentation

Boiling
Water Method

Fold a large bath towel lengthwise
and twist as much as possible; place middle three-quarters into boiling water
and let it become thoroughly soaked
Lift out of water and pull hard to
wring out all the water possible. Let it untwist by dropping one end and hold
the other end
Lay it over the towel placed on the
patient’s body if the towel is very hot

Place hot
towels on the skin surface and quickly remove it to avoid burning; watch it
very carefully to lift the towel if heat is not tolerated. The towel will cool
off rapidly. Practice this skill thoroughly before you work on your client

Cover with another towel
Repeat procedure 3 or 4 times. In
between the hot towels, briskly wipe the body surface with ice-cold cloth and
then blot the moisture quickly. It is the moisture that burns the skin,
therefore the skin must be dry completely before the next application

Streaming
Method

Soak completely and wring out 5 large
bath towels or fomentation pads in water
Place the towels or pads on the grid
of a large canner (32 quarts or liters)
Place enough water in the canner
below the grid and boil it for 20 minutes-towel or pads should not touch the
water

Microwave
Method

Take a large bath towel soaked in
cold water; wring out all the water possible
Place the single towel in a black
plastic garbage bag or other strong plastic bag
Place the bag in the micro-wave oven
and turn to high for 4 minutes (or until steaming)
Quickly remove towel and use it on
the body surface; if it is very hot, place a dry towel on skin area before
applying the very hot towel

A tray
containing:

Cotton balls in a container to apply
the oil
Forceps-to hold the cotton balls
Olive oil or Vaseline
Small Mackintosh
Waterproof cover and cotton pad
Abdominal binder and safety pin
Paper bag
Hot water bag and cover
Duster and lotion thermometer

Procedure

Wash hands
Expose the needed area and observe
for any lesions on the skin
Place the patient at the edge of the
bed near the working side
Expose the area and apply Vaseline
Place fomentation cloth/pack in
wringer. Insert wringer rods and place in basin
Check temperature of water (125-150
Degree F)
Pour water on fomentation cloth and
wet fully
Hold wringer rods with hands and
turns in opposite direction to wring out excess water from pad
Remove pad by holding one corner over
second basin
Place flannel Mackintosh over pad
Apply bandage/binder depending upon
site and secure with pins or adhesive
Remove after 10 to 15 minutes