Hot and cold therapy is through the use of cold or heat on the body’s local or whole body, in order to achieve hemostasis, analgesia, anti-inflammatory, cooling and enhance comfort, is a common clinical physical therapy methods. Influencing factors Mode: under the same conditions, the effect of wet cold and wet heat is better than dry cold and dry heat; Area: the area used is proportional to the effect; Time: within a certain period of time, the hot and cold effect increases over time, if the time is too long, it will make the body less sensitive to cold, resulting in pale skin, pain, frostbite, burns, etc.; Temperature: the greater the difference between the temperature of hot and cold therapy and the temperature of the body surface before treatment. The greater the difference between the temperature of hot and cold therapy and the temperature of the body surface before treatment, the stronger the body’s response to cold and heat stimulation, and vice versa; Department: clinically for physical cooling of patients with high fever, more ice packs are placed on the neck, axillae, groin and other large blood vessels flowing through the body surface to increase heat dissipation. Individual differences: infants and children are less tolerant to cold and stimulation; elderly people are less sensitive to cold and heat stimulation and less responsive; women teach men to be more sensitive to cold and heat stimulation; patients in coma, blood circulation disorders, vascular sclerosis, sensory retardation, etc. are less sensitive to cold and heat stimulation and attention should be paid to prevent burns and frostbite. Cold therapy Local cold therapy includes ice bags, ice capsules, ice caps, ice troughs, cold wet compresses, chemical cooling bags ice blanket machine and semiconductor cooling caps. Traditional ice bags, ice capsules, ice caps and ice troughs are now rare in the clinic, and chemical ice bags, ice caps, ice blanket machines and semiconductor cooling caps that can be used repeatedly are mostly used. Whole-body cold therapy includes warm water rubbing bath, ethanol swabbing bath. The purpose of cold therapy 1, reduce local congestion or bleeding: clinically used for early hemostasis of local soft tissue injury, post-tonsillectomy, nasal bleeding, etc. 2, reduce pain: applicable to acute injury caused by the initial pain, reduce toothache, burns pain, etc. 3.Control the spread of inflammation: applicable to the early stage of inflammation, such as the early stage of soft tissue inflammation of the nose. 4.Lowering body temperature: it is mostly used clinically for cooling patients with high fever, heat stroke, traumatic brain injury, cerebral hypoxia and other patients to prevent and control cerebral edema. Contraindicated conditions 1, blood circulation disorders are commonly found in patients with large tissue damage, poor blood circulation in local tissues, systemic microcirculatory disorders, shock, peripheral vascular disease, arteriosclerosis, diabetes, neuropathy, edema, skin bruising, etc. Due to poor circulation and inadequate nutrition of tissues, it can further constrict the blood vessels and aggravate the circulatory disorder, resulting in local tissue ischemia and hypoxia and degenerative necrosis. 2, chronic inflammation or deep septic lesions, which reduce local blood flow and prevent inflammation absorption. 3, tissue injury, wound rupture or at open wounds, reducing blood circulation, increasing tissue damage and affecting wound healing. 4, allergic to cold, allergic to cold can appear erythema, urticaria, joint pain, muscle cramps and other allergic symptoms. 5, other cautious use of cold therapy, such as coma, abnormal sensation, the elderly and infirm, infants and children, joint pain, heart disease, breastfeeding maternal milk should be used with caution. Prohibited parts behind the occiput, auricle, scrotum: easy frostbite; precordial area: lead to reflex slowing of heart rate, atrial or ventricular fibrillation and atrioventricular block; abdomen: easy to cause diarrhea; soles: lead to reflex peripheral vasoconstriction, affect heat dissipation or cause transient coronary artery constriction. Ice bag application: forehead, top of head, lateral neck, axilla, groin and other large vascular areas, tonsils placed under the premaxillary neck after surgery. The time spent with cold does not exceed 30 min. Warm water rubbing and ethanol swabbing: place ice bags on the head to prevent headache caused by head congestion; place hot water bags on the soles of the feet to promote peripheral vasodilation and make the patient comfortable; swab in a centrifugal direction, in a light patting manner, avoiding friction (friction is easy to generate heat), and control the time within 20 min; warm water rubbing temperature is 32~34 degrees; ethanol swabbing ethanol concentration is 25 The concentration of ethanol is 25-35%; in the axilla, groin, N fossa and other vascular-rich places, the time can be extended to increase heat dissipation; neonates and patients with hematological diseases are prohibited from ethanol swabbing. Heat therapy Local heat therapy includes hot water bag, infrared lamp and baking lamp, hot wet compress, hot water sitz bath, chemical heating bag and heat-transfer method, etc. The purpose of heat therapy is to promote the dissipation of inflammation and to limit the inflammation by using heat to promote the absorption and dissipation of inflammatory exudates in the early stages of inflammation and to limit the inflammation by using heat in the late stages of inflammation. It is suitable for patients with blepharitis (wheals), mastitis, etc. 2.Reducing pain is suitable for patients with lumbar muscle strain, renal colic, gastrointestinal spasm, wheals, mastitis, etc. 3.Reducing deep tissue congestion skin vasodilation, increased blood flow and redistribution of circulating blood volume. 4, warmth and comfort for elderly and frail, premature infants, critical, poor peripheral circulation patients. Contraindicated conditions 1.Acute abdominal pain without clear diagnosis: misdiagnosis and treatment, or may cause peritonitis. 2.Infection in the dangerous triangle of the face: the area is richly vascularized, and the facial veins have no venous valves and are connected to the intracranial cavernous sinus, which can easily cause intracranial infection and sepsis. 3, various organ bleeding, hemorrhagic disease: increase blood flow to aggravate bleeding. 4, soft tissue injury or sprain in the early stage (within 48 hours): promote blood circulation, aggravate subcutaneous bleeding, swelling, pain. 5, other: heart, liver, kidney insufficiency: reduce the blood supply to the internal organs, aggravate the condition. Hot water bag application General patients – water temperature 60 ~ 70 degrees, coma, the elderly, infants and children, sensory retardation, poor peripheral circulation and other patients <50 degrees; filling water: 1/2-2/3 full; prevent direct contact, if the skin is found to be flushed, pain, should stop using, and local application of skin protection agent. Infrared lamp and baking lamp Used for irradiation treatment of infant red buttocks, perineal wounds and skin donor area for skin implants, etc. The general lamp distance is 30~50cm, the temperature is suitable, the time is 20~30min; the power of the lamp is different for different treatment areas: most of them are 500~1000w, the extremities are 250w; the irradiation is appropriate for the skin to appear erythematous; when irradiating the forehead, face and neck, tinted glasses should be worn or gauze should be used to cover. Hot and wet compresses are used for antispasmodic, anti-inflammatory, anti-swelling and pain relief. Hot and wet compress time is 15~20min, 3~5min change the dressing cloth, water temperature 50~60 degrees; with wounds, trauma or crust, hot and wet compress according to aseptic technique. Hot water bath is used for women after rectal and pelvic surgery and postpartum. Hot water sitz bath is easy to cause urination and defecation reflex, so it should be used for urination and defecation before sitz bath; configure the solution as 1/2 full, water temperature 40~45 degrees or 1:5000 potassium permanganate for 15~20min; if there is a wound, the material used must be sterile; female patients should not take sitz bath during menstruation, late pregnancy, within 2 weeks after delivery, vaginal bleeding and acute inflammation of pelvis; if bleeding dizziness, dizziness, weakness, panic If bleeding dizziness, dizziness, weakness, panic and other symptoms, the sitz bath should be stopped immediately.