Local medical distractions
Local warm-up procedures include warming compresses, hot-water bottles, mustard wraps, mustards, poultices and cans.
1. The warming compress is one of the most frequent local thermal procedures, which is widely used both in a hospital environment, both at home and at home. It provides a mild heat effect in the inflammatory process on a limited surface( lymphadenitis, middle ear inflammation, abscesses, phlegmon, bruises, etc.).
Local warming compress is used as a distracting and relaxing remedy. As a result of the local reflex action of the heat formed under the bandage, the blood rushes, the metabolic processes increase, the surface sensitivity decreases. The main layers of warming compresses should be:
• wet, or internal, consisting of 6-8 layers of gauze napkins or bandage;
• insulating, or medium, polyethylene film, thin oilcloth or wax paper;
• Insulating, or outer, made of cotton wool( preferably hygroscopic) 2-3 cm thick.
In the absence of cotton wool, a piece of flannel, woolen shawl or other heat-retaining material is used for this purpose.
To obtain the desired heat effect, it is important to maintain the correct size ratio between the layers. The moist layer should correspond to the size of the inflamed part of the body, the middle - to cover the wet by 2-4 cm, the outer layer - to cover all the underlying layers. Layers of compresses are best laid first on the table.
The inner layer is wetted with water in a mixture with alcohol( 1: 1) or with oil( camphor or other) and squeezed. The compress prepared in this way is applied with a wet layer to the skin of the diseased part of the body and tightly bandaged so that air does not pass through.
The compress is usually held for 4-8 hours, then take a break for 1-2 hours and re-apply - and so for 2-4 days.
If the compress is changed, the inner layer should be changed, since microorganisms can actively multiply in a humid warm environment. After removing the compress, the skin is wiped with cotton wool soaked in pure boiled water with the addition of alcohol.
If it is necessary to apply a compress on the ear, wet wipes are placed on the mastoid process somewhat lower. They should be covered with polyethylene film or waxed paper, and cotton covers the entire ear, including the auricle, and tightly bandaged.
You should not prescribe compresses on the chest, because the tight banding of the compress leads to a restriction of the respiratory chest excursion.
If after the application of a compress the patient feels a chill, then the compress is not applied correctly - the film or cotton wool is not completely covered with gauze or the compress is not properly bandaged. In these cases, outside air and water penetrate between the compress and the skin and, intensely evaporating, cause not skin warming but cooling. Therefore, the compress should be applied very carefully, observing the above rules.
To increase the effect of warming compresses, its inner layer should be moistened not with water, but with solutions of medicines and oils: 5% alcohol solution, 3% solution of soda, camphor oil.
A local hot compress causes a local rush of blood and reflexively gives an analgesic effect. The napkin folded in several layers is moistened in hot water( 50-60 ° C), squeezed and applied to the body, then covered with an oilcloth and a thick( desirable woolen) cloth from above. You can attach a compress to the bandage, but only lightly, as after every 5-10 minutes the compress should be changed. Local poultices act like a hot compress, but cool down more slowly, within 1-2 hours. To avoid burns, you must first check the temperature of the poultice. Poultice is covered with an oilcloth on top, put cotton wool or a woolen shawl on top and cover with a bandage;when the poultice has cooled, the bag is reheated in boiling water and again applied.
Indications and contraindications are the same as for wiping. General wrapping lasting 15-20 minutes is prescribed as an antipyretic and stimulating procedure, while the activity of the nervous, cardiovascular systems and metabolism are activated. A longer procedure( within 20-45 minutes), on the contrary, lowers the excitability of the nervous system, and a total wet wrapping lasting 50-60 minutes gives a sweating effect.
On a semi-soft couch with a headboard lay out woolen blankets and put a moistened and wrung out sheet over them. Between a blanket and a sheet you can put an oilcloth of the same size as a sheet. The naked patient lays down on the sheet, it is quickly wrapped into it and wrapped in a blanket, leaving only the head open, on which a cold compress is laid. During the first 15-20 minutes( the first phase), while the sheet and the air between it and the patient's body warm up to body temperature, there are phenomena of excitation of the nervous and cardiovascular systems and increased heat production. Subsequently( the second phase) warming causes a decrease in the excitability of the nervous system and the onset of sleep - the pulse becomes less frequent, blood pressure decreases, and breathing deepens. This procedure is technically complex, which is why it is used less often than local warming compresses.
If necessary, general thermal effects are often used by other methods of heat treatment: mud and peat, paraffin and ozokeritotherapy, etc.
2. Warmers. It is used as a local thermal procedure with a superficial inflammatory focus in the infiltration phase, resorption with hematomas, with myositis, to relieve spasms of smooth muscles of the gallbladder and bile ducts, intestines and other organs.
Rubber heating pad is filled with hot water( temperature 60-70 ° C) only half. The air above the water is removed as much as possible, after which the bottle cap is tightly closed with a stopper. In order to avoid burns before applying to the patient area of the body, the heating pad is wrapped in a towel. You can also use electric heaters. Contraindications: acute inflammatory processes in the abdominal organs( appendicitis, cholecystitis, pancreatitis), tumors, bleeding in the first hours after tissue contusions.
3. Mustard wraps - a frequently used thermal procedure, has a calming and diaphoretic effect. Mustard wraps are indicated for acute respiratory infections, pneumonia, etc. You can make general mustard wraps or local - only on the chest( children of preschool and school age).
100-200 g of dry mustard powder in the room are 2-3 liters of boiling water and mixed thoroughly with a stick or spoon. The prepared mixture should stand for 3-4 minutes. Then the liquid part of the mixture is poured into another dish, dampened with a sheet or diaper in it, squeezed it and spread on a flannel or flannel diaper, laid on a wool blanket or towel. After 5-10 minutes, the application is removed and the skin is washed with warm water.
A mustard pack is prepared in the same way as a mustard wrap, but do not soak the towel in the mustard solution, and a smaller piece of fabric folded into several layers is applied to the sore spot, covered with oilcloth or wax paper, then covered with a towel and cover the patient with a blanket. The patient should tolerate the burning sensation 8-12 minutes, then remove the compress, wash the reddened patch of skin with warm water, lubricate with Vaseline and heat cover the patient.
The mustard is used for the same purpose as the mustard wraps. Their use contributes to the effect on blood circulation due to the action of essential mustard oil, which irritates the skin and dilates the blood vessels.
The mustard is used as follows: the mustard is wetted and applied to the skin area with mustard down for 10-15 minutes. If the patient has an increased skin reaction and he feels a burning sensation quickly, put a piece of tissue paper on the skin before putting a mustard plaster on the skin. On top of the mustard plaster napkins or towels are applied, and the patient is covered with a blanket. With the correct setting of mustard plasters, burning of the skin and its redness are felt. It must be remembered that with prolonged use of mustard plaster on the skin, especially with its increased sensitivity, burns can occur. At the end of the procedure, the mustard plasters are removed, the remains of mustard are washed off with warm water, the skin can be lightly coated with petroleum jelly.
Contraindications .Mustard must not be used for skin diseases, as well as for bleeding. It is not recommended to put mustard plasters on the same place, as this can cause the development of skin pigmentation.