TEPID SPONGE/COLD SPONGE (Cold Application) – Definition, Purpose, General Instructions, Preliminary Assessment Check, Effects, Physiologic Effects, Indications, Preparation of the Patient and Environment, Equipment, Procedure, After Care and Contraindications
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Updated 2024
Tepid
sponging or cold sponging is a general application of moist cold liquid to cool
skin, by evaporation and by the absorption of body heat in the cold water.
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Tepid sponge is a process of sponging with tepid water to reduce body temperature by evaporation. The temperature of water used for tepid sponge is 80-90 degree F.
- Tepid Sponge:
- Tepid water is lukewarm, neither hot nor cold. It is often recommended for cleaning wounds or sensitive skin.
- It can be more comfortable for general cleaning tasks, as extreme temperatures can be harsh on the skin.
- Tepid water is suitable for washing the face or body, especially if you have sensitive skin.
- Cold Sponge:
- Cold water can be refreshing and invigorating, making it a good choice for hot weather or when you need a pick-me-up.
- It can help reduce inflammation and soothe sore muscles or joints.
- Cold water may be preferred for some beauty routines, as it can tighten pores and give a refreshing feeling to the skin.
PURPOSE
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- Tepid sponge helps to reduce the
temperature between 102 and 102.8 degree F. - Cold sponge helps reduce the
temperature of above 103 degree F. - To stimulate circulation
- To decrease toxicity
- Nervousness and delirium
- To soothe the nerves and promote
sleep
GENERAL INSTRUCTIONS
- Cold sponging is used to reduce
temperature in a patient with hyperpyrexia - Large areas of the body are sponged
at one time, permitting the heat of the body to transfer to the cooler solution
on the body surface. - Often wet towels are applied to the
neck, axillae, groin and ankles, where the blood circulation is close to the
skin surface - The vital signs are checked very
frequently to detect the early signs of complications - The physiological effect of the cold
applications are vaso-constriction, decreased blood circulation, decreased
capillary permeability, decreased metabolism, decreased blood viscosity, etc. - The application moist cold is more
effective than the application of dry cold as the moisture distributes the cold
to large and deep area - There must be a written order for
tepid sponge or cold sponge - Use long strokes for sponging and
avoid circular movements or friction while sponging - Keep the hot water bag ready at the
foot end of the bed
PRELIMINARY ASSESSMENT
Check
- The doctors order for any specific
instructions - General condition and diagnosis
- Self-care ability of the patient
- Assess the duration of application
- For contraindication to cold
application - Articles available in the unit
PREPARATION OF THE PATIENT AND ENVIRONMENT
- Explain the sequence of the procedure
- Provide privacy
- Check the initial temperature and
should be checked every 15 minutes intervals - Position the patient comfortably in
the bed - Remove the patient gown and place
with bath blanket - Bring the patient to the edge of the
bed - Place the long Mackintosh and draw
sheet under the patient - Arrange the articles to the bedside
PROCEDURE
- Wash hands
- Mix the water with ice cubes
- Soak the wash cloths in the ice cold
water for some time - Place cold sponge cloths in each
axial and groin - Put the face towel under the head
sponge the face and dry with face towel - Sponge the neck, right arm from the
shoulder to the finger tips for 3 minutes - Change sponge cloth when it becomes
warm - Sponge the left arm, chest and
abdomen for 3 minutes - Change the water if it becomes dirty
and check the temperature - Cover the upper half, of the body and
expose the lower half of the body - Sponge the right and left lower limb
for 3 minutes - Then carefully turn the patient for
his side and bring patient to edge of bed. Sponge the back with long strokes
for 3 minutes - Dry the part with bath towel and
apply spirit on the back - Check the temperature at 20 minutes
interval and record it in the TPR chart
EQUIPMENT
- A large basin of water (80-90 degree
F) for tepid sponging - Jug with cold water
- Basin with ice pieces
- Bath thermometer
- Mackintosh and draw sheet
- Sponge clothes – 6
- Bath towel – 1
- Face towel – 1
- Thermometer tray
- Ice cap with cover
- Spirit rub
- Bucket
AFTER CARE
- Remove the sponge clothes from the
axilla and groin. Discard it in kidney tray - Dry the body with bath towel
- Remove the Mackintosh and draw sheet
- Replace the gown and remove the bath
blanket - Observe for any symptoms of chill or
any other abnormality - If needed give him hot drinks
- Position the patient comfortably in
the bed - Replace the articles after cleaning
- Wash hands
- Record the procedure in the nurse’s
record sheet and vital signs in TPR sheet
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