[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Mobility and comfort](https://durgical.com/en/nursing/areas/mobility/) › Heat and cold applications, and hypothermia and hyperthermia blankets # Heat and cold applications, and hypothermia and hyperthermia blankets - Procedure Heat widens blood vessels and cold narrows them; both ease pain or swelling when applied briefly, with a cover and frequent skin checks. Updated Nov 12, 2026 ## Key points - Heat dilates vessels and increases blood flow; cold constricts them, reduces swelling and numbs nerve endings. - Time limits: heat about 5 to 20 minutes as tolerated; cold no longer than 20 minutes. - Never put ice or a hot source on bare skin: always use a cloth or cover. - Numb skin cannot feel excess heat or cold: reduced sensation, poor circulation and diabetes call for extra caution. - Warming or cooling blankets need an order, a target temperature, frequent temperature checks and skin checks. ## What it is Local heat causes vasodilation: more blood flow, relaxed muscles and less stiffness. Local cold causes vasoconstriction: less swelling and bleeding, and numbed nerve endings. Both are treatments with real risks, not just comfort measures. The skin can be burned or frozen, above all when the person cannot feel or report what is happening. Warming and cooling blankets act on the whole body. They are used only with an order and a target temperature, with frequent temperature checks and skin checks, because the body can overshoot the target and the skin under the blanket can be injured. ## Indications - Cold: a recent injury such as a sprain or bruise, to limit swelling and pain. - Heat: muscle stiffness, spasm or chronic joint pain, to relax muscle and increase blood flow. - Cool, moist compresses, cool cloths and a fan to help lower body temperature in heat illness, as ordered. - Warm blankets and warm covers for low body temperature after surgery or exposure, per protocol. - Cooling blanket for high body temperature or a temperature-control protocol, only with a medical order. ## Contraindications and precautions - Reduced sensation (neuropathy, spinal cord injury, sedation, confusion): the person cannot report a burn or a cold injury. - Poor circulation, peripheral vascular disease, diabetes or Raynaud phenomenon: higher risk of tissue injury. - Do not apply heat to a fresh injury, an area that is bleeding or new swelling: it can increase bleeding and oedema. - Avoid direct dry heat (heating pad, lamp, hot water bottle on bare skin) on numb or damaged tissue. - Children, older adults and people who cannot communicate need closer checks. - Use only the devices and settings the order and the institutional protocol allow; do not improvise. ## Equipment - Cold pack or ice in a sealed bag, or a cool compress, with a cloth cover. - Warm moist compress or warm pack at a tested, comfortable temperature, with a cover. - Warming or cooling blanket with its control unit, and a sheet between the blanket and the skin. - Thermometer; for blankets, the temperature probe the protocol requires. - Gloves if there are body fluids, a waterproof pad and the record sheet. ## Step by step (and why) - Check the order, identify the patient and explain the purpose — heat and cold are treatments with risks. - Assess skin, sensation, circulation and alertness in the area — numb or poorly perfused skin burns or freezes easily. - Wrap the pack in a cloth and test its temperature — a barrier prevents direct contact injury. - Apply it and note the time; cold up to 20 minutes, heat about 5 to 20 — longer use causes injury and rebound effects. - Check the skin after a few minutes and ask about burning or numbness — redness, pallor or blisters mean stop. - Remove the pack on time and inspect the skin again — confirms there is no injury before any repeat. - Blanket: place a sheet between blanket and skin and set it as ordered — protects the skin from burns and cold injury. - Measure temperature often, check skin and watch for shivering — avoids overshoot; shivering raises oxygen use. - Record site, method, duration, skin condition and response — allows safe repetition and follow-up. ## Complications - Burns, especially on numb skin or with dry heat. - Cold injury: pale, mottled or numb skin, blisters and, in severe cases, frostbite. - Rebound effects when heat or cold is left on too long. - More swelling or bleeding when heat is applied to a fresh injury. - With blankets: the temperature overshooting the target, shivering, and skin injury under the blanket. ## Next step: when to call for help - Stop and tell the nurse in charge if the skin blisters, turns white, grey or mottled, or stays numb. - Call if pain increases or new swelling or bleeding appears. - With a blanket, call if the temperature leaves the ordered range, changes quickly, or the patient shivers hard. - Call if the patient becomes confused or drowsy, or the vital signs change. ## Test yourself Think of the answer, then tap the question to see it. ## Why should ice never be placed directly on the skin? Because it can cause a cold injury. A cloth barrier and a time limit of about 20 minutes protect the skin. ## Which patients need extra caution with heat or cold? Those with reduced sensation, poor circulation, diabetes, confusion or sedation, because they cannot feel or report an injury. ## What does heat do to blood vessels, and what does cold do? Heat dilates them and increases blood flow; cold constricts them, reduces swelling and numbs nerve endings. ## What is monitored while a patient is on a warming or cooling blanket? Body temperature against the ordered target, the skin in contact with the blanket, and shivering. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/heat-and-cold-applications-and-hypothermia-and-hyperthermia-blankets/) ## Connections ## Related 2 - [Measuring body temperature: sites, devices and technique](https://durgical.com/en/nursing/measuring-body-temperature-sites-devices-and-technique/) - [Non-drug pain relief: what nurses do](https://durgical.com/en/nursing/non-drug-pain-relief-what-nurses-do/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Nursing Fundamentals, 11.4: Pain Management](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/11%3A_Comfort/11.04%3A_Pain_Management) (Open RN (Chippewa Valley Technical College), LibreTexts, 2021); [Frostbite: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000057.htm) (MedlinePlus, US National Library of Medicine, 2026); [Hypothermia: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000038.htm) (MedlinePlus, US National Library of Medicine, 2026); [Heat emergencies: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000056.htm) (MedlinePlus, US National Library of Medicine, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. 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