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Application of Heat Using a Portable Heat Therapy Unit or Instant Hot Pack (4.18)

Application of Heat Using a Portable Heat Therapy Unit or Instant Hot Pack (4.18) - Policies, Clinical, UWHC Clinical, Department Specific, Nursing Patient Care, Integumentary

4.18

1
NURSING PATIENT CARE POLICY & PROCEDURE





Effective Date:
April 4, 2017

Administrative Manual
Nursing Manual (Red)
Other _______________

Policy #: 4.18AP

Original
Revision

Page
1
of 3

Title: Application of Heat Using a Portable
Heat Therapy Unit or Instant Hot Pack
(Adult & Pediatric)

I. PURPOSE

To provide guidance in the application and maintenance of sustained heat to a body
area or extremity for the purpose of medical treatment, patient comfort, or vein
dilation.

II. EQUIPMENT

A. Gaymar T-Pump from Central Services (CS) (ordered through patient’s electronic
medical record or downtime form)
B. Disposable T-Pad (CS Item Number 4000118)
C. Tap water
D. Instant hot pack from CS

III. POLICY

A. A provider’s order must be placed, including the desired temperature, frequency,
duration, and location of application, when heat therapy is to be used as a medical
treatment.
B. Portable Heat Therapy Units and Instant Hot Packs will be supplied by University
of Wisconsin Hospitals and Clinics (UWHC) for patient use. Heat units/packs
brought from home are not approved for use during inpatient admission and will
be sent home with patient representative.
C. A provider’s order is not required if heat application is needed to dilate veins for
an intravenous insertion. For these circumstances, one can either use the heat
therapy unit described above, or order an instant hot pack from CS. Remove heat
once intravenous catheter insertion is complete.
D. Moist compresses made with warm tap water and washcloths and towel are
permissible, however microwave ovens and warming cabinets are not to be used.
It is NOT permissible to make any other compresses on the unit.
1. The only exception is warm packs that have a clearly established process
for making/rotating the warm packs, where the logs for tracking have been
reviewed by someone in the Nursing Quality, Safety & Innovation
Department.

IV. PROCEDURE

A. Portable Heat Therapy Unit (Gaymar T-Pump and Disposable T-Pad)

Page 2 of 3

1. The heat therapy unit is ordered via Health Link. The disposable pad is
ordered via CS catalog. Enter Pad T pump in the search field.
2. Place central unit on bedside stand. This maintains the correct amount of
water in the pad during operation. The unit must be level with or above the
pad whenever the unit is turned off to prevent overflow in the reservoir.
3. Check reservoir for minimum water level. The unit may need to be refilled
with tap water periodically as the reservoir and pad hold over 500 mL.
4. Plug cord into power outlet; connect tubing from pad to the control unit.
5. Turn switch of control unit "on" and check the temperature setting.
a. Use the keypad to adjust the temperature per provider order.
b. Set the Therapy Time to 20 minute cycles for ALL heat therapy
c. When control unit is turned on, the pump circulates water
continuously through the pad. It may take up to 20 minutes for the
pad to initially reach maximum temperature.
6. Check patient's skin at application site. Apply pad over, rather than under,
the site.
a. Pad should be covered (pillowcase) when in direct contact with
patient's skin.
b. Do not use adhesive tape directly on pad surface.
c. Do not put pins through the pad.
7. At start of therapy, inspect skin at application site for signs of breakdown,
redness, tenderness or pain. Continue to monitor throughout therapy for
duration of the therapy.
a. Some patients have increased sensitivity to temperature changes
and should have more frequent skin inspections. Patients who may
have increased temperature sensitivity include: children, elderly,
those with vascular disease, diabetes, and/or insensate skin areas.
8. Record application of heat and patient response in the clinical record.
9. Return control unit and pad to the Soiled Utility room when treatment is
terminated.
10. Discontinue equipment order in computer.
B. Instant Hot Pack
1. Activate the hot pack by squeezing as indicated on the package. Once
activated, the instant hot pack heats to a temperature of 110 degrees
Fahrenheit (F) for approximately 45 minutes (according to the
manufacturer).
2. Apply to the desired area.
a. Do not use adhesive tape to attach hot pack.
b. Do not put pins through the hot pack.
c. Cover the hot pack to prevent direct contact with the patient’s skin-
may use gauze, washcloth, pillowcase or other cloth to prevent
direct contact between hot pack and skin.
3. At start of therapy, inspect skin at application site for signs of breakdown,
redness, tenderness or pain. Continue to monitor throughout therapy for
duration of therapy.
a. Some patients have increased sensitivity to temperature changes
and should have more frequent skin inspections. Patients who may
have increased temperature sensitivity include: children, elderly,
those with vascular disease, diabetes, and/or insensate skin areas.

Page 3 of 3

4. Record application of heat and patient response in the clinical record.

V. REFERENCES

A. Smith-Temple, J. & Young-Johnson, J. (2009). Nurses' guide to clinical
procedures (6
th
Ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
B. T/Pump Heat Therapy System Operator's Manual
C. Heat and Cold. (2009). Lippincott’s Nursing Procedures. (5
th
Ed.). Philadelphia,
PA: Lippincott Williams & Wilkins.

VI. REVIEWED BY

Clinical Nurse Specialist, Critical Care
Clinical Nurse Specialist, Universal Care Unit
Clinical Nurse Specialists, Pain
Director, Nursing Quality & Safety
Nursing Patient Care Policy & Procedure Committee, March 2017

SIGNED BY

Beth Houlahan, DNP, RN, CENP
Senior Vice President, Chief Nurse Executive