Revulsive Treatment with Chest Fomentations - PowerPoint Presentation

1. Revulsive Treatment with Chest FomentationsHydrotherapy Hub Autumn 2023Susan Pellandini

2. Revulsive Treatment with Chest Fomentations, Part 1

3. Revulsive Treatment with Chest FomentationsMODULE OBJECTIVESAfter completing this module and Life and Health Hydrotherapy Videos 3.7 & 3.8 the student will be able to: Describe the effects of local heat treatments. Identify the contraindications for local heat treatments. Perform local heat treatments in a safe and effective manner.The first part of this module will discuss ways of applying localized heat to the chest and back. The second half of the module will be the combination treatment of Chest Fomentations with Hot Foot Bath, which becomes a whole-body heat treatment.

4. Revulsive Treatment with Chest Fomentations Applied localized heat relaxes connective tissue and both smooth and skeletal muscle. It is also soothing, therefore helping to reduce nervous tension. Hot applications can be contrasted with cold ones to form a combination treatment to improve circulation and relieve pain. The localized combination treatment is sometimes referred to as the Revulsive Treatment with Hot Foot Bath. As stated in a previous segment, with all the advantages of applied heat, there are two major disadvantages: 1) hot applications can burn and so must be carefully monitored and 2) prolonged heat applications can raise core body temperature.

5. Revulsive Treatment with Chest FomentationsDefinitionRevulsive: a treatment cycle consisting of a single prolonged application of heat followed by a single brief application of cold.Fomentation: consists of a sustained local application of moist heat to the body surface. It is usually made of 50% wool to retain heat and 50% cotton to retain moisture and be more durable.Note: The Revulsive treatment can be done alone on the body part needed or in combination with the Hot Foot Bath with the client in the supine position. The latter will be discussed in the second half of this module.

6. Revulsive Treatment with Chest FomentationsEffectPromotes increase in circulating white blood cells.Increases blood flow to the skin, thereby relieving internal congestion. Capillaries of the skin dilate; oxygen exchange takes place at the venous anastomosis.Can increase elimination by evaporative cooling (sweating).Stimulates or sedates according to the temperature and duration of the application.Relieves muscle spasm by increasing circulation.

7. Revulsive Treatment with Chest FomentationsIndicationsChest congestion from colds, flu, bronchitis, pneumonia, asthma, SARS-CoV-2Insomnia (sedative duration)PancreatitisColon diseases: diverticulitis, constipation, IBS, Crohn’sArthritis (rheumatoid and osteo- )Muscle spasms and tension (sedative duration)Fibromyalgia

8. Revulsive Treatment with Chest FomentationsIndications, continuedSickle-cell anemia (increases RBC motility, increases oxygen)Nervousness (sedative to spine)Depression (stimulant to spine)Preparation for a cold treatmentAdrenal insufficiency (stimulant to low back above kidneys)Kidney infectionDysmenorrheaWarm tissues prior to massage, chiropractic manipulation or in preparation for a venipuncture (sedative duration)

9. Revulsive Treatment with Chest FomentationsCautionsUse caution with stomach or bowel ulcers (use stimulant duration as described in “Procedure section”)Use caution so as not to burn the client (very young child & elderly). Add another towel layer if needed.Body parts where bone is close to skin are especially apt to burn, such as the clavicles, scapulae, sacrum area, rib cage or anywhere along the spinal column. Keep extra washcloths and hand towels handy for layering.Be sure client is always properly draped to avoid chilling.

10. Revulsive Treatment with Chest FomentationsContraindicationsParalyzed parts of the bodyTendency to hemorrhage Be careful treating malignant tumors to avoid metastasisOpen woundEdema, varicose veins or advanced vascular disease of legs & feetLymphedema An unconscious person

11. Revulsive Treatment with Chest FomentationsNote: For more considerations that are important especially for this treatment, please refer to the Life and Health Hydro videos 2.1 – 2.6 “Preparation for Treatment” segments.

12. Revulsive Treatment with Chest FomentationsHeating fomentationRange-oven Method1. Pre-heat oven to 500˚F (260˚C)If using a towel, fold cross-wise in thirds.Thoroughly wet towel or fomie pad in hot water with excess water wrung out.Place wet towel or pad on a sheet pan and cover completely with aluminum foil so as not to dry it out.Place in pre-heated oven to heat for 20 min. Towel or pad should be steaming.Remove sheet pan with oven mitt and carefully transfer towel or pad between layers of wool covering.Heat 2nd towel or pad in foil on sheet pan the same way.

13. Revulsive Treatment with Chest FomentationsMicrowave MethodIf using towel, fold cross-wise in thirds.Thoroughly wet towel or fomie pad in hot water, wringing out excess water.Fold in half, and half again and place in plastic bag.Place in microwave oven and heat for 5 minutes.Use caution when removing from microwave as this will be very hot! May want to use oven mitt or vinyl glove.Unfold and layer in wool as shown in video 3.7 demonstration segment.2nd towel or pad is now to be heated, prepared the same as the first.

14. Revulsive Treatment with Chest FomentationsKettle Stove-top MethodIf using towel, fold cross-wise in thirds.Prepare 5-qt. (4.L) kettle of water. Heat on stove-top or over prepared fire to near boiling.Holding both ends of towel or pad, immerse into water. Saturate, except the ends being held.Wring out excess water.Layer in wool covering.See demonstration segment of the L&H video 3.7

15. Revulsive Treatment with Chest FomentationsCanner Stove-top MethodIf using a towel, fold cross-wise in 3rds. Prepare canner or steamer kettle of water. Heat on stove-top or over prepared fire to near boiling. Use rack or rocks in bottom of kettle so that the towel or fomie will not be in water, but will heat from the steam.Thoroughly wet towel or fomie pad, wringing out excess water.Roll up towel or fomie pad, end to end. Place in kettle and let steam for 30 min. Use tongs to remove towel or pad as needed.

16. Revulsive Treatment with Chest FomentationsHydrocollator MethodIndustrial-sized equipment used in hospitals, Physical Therapy/Rehab clinics or Wellness CentersVarious sizesLow maintenanceHot packs filled with silica gel are stored, submerged in 170˚F (77° C) water.Hot packs are always hot, ready to apply for treatment.See demonstration segment L&H video 3.7

17. Revulsive Treatment with Chest FomentationsEquipment3 bath towelsIn place of towels, use what is called a “fomentation pad” made of very sturdy cotton. These can be submerged in water, wringing out the access (or spin-dry in clothes washer). We will show you what they look like in the Demonstration segment.3 hand towels2-3 washcloths for layeringWool covering to layer around hot fomentationBasin for cold waterIce for cold water

18. Revulsive Treatment with Chest FomentationsEquipment, continued7. Heat source (microwave or stove top with pot of extremely hot water or range oven or roaster oven)BP monitor, health history form, treatment form10.Time device11.Plastic bag for heating wet towels in microwave12.Possible extension cord13.Utility/latex gloves for handling extremely hot towels right out of heat source 14.Prayer

19. Revulsive Treatment with Chest FomentationsProcedureCheck subject for precautions, take vital signs and explain treatment.Have all equipment ready prior to beginning treatment.Have subject void in restroom.While subject is voiding, heat 1st towel. This will be explained at the end of the Procedure section.Pray with subject.Position subject appropriately with clothing removed for area being treated.Layer hot towel (or pad) in wool covering. Now a fomentation.Place another towel, 2-3 layers thick, on area being treated with fomentation on top of towel. Leave in place for desired duration (see next slide).

20. Revulsive Treatment with Chest FomentationsDuration: stimulant: short (3 – 5 minutes) sedative: long (6 – 8 minutes) Note: while 1st fomentation is in place have 2nd fomie already heating and ready to go just before the cold friction.

21. Revulsive Treatment with Chest FomentationsProcedure, continuedRemove fomentation followed by immediate 30 sec. brisk cold friction rub. Be sure to tell subject “It will be cold.” Thoroughly towel-dry.Place another fomie in area being treated for desired duration. Remember, moisture intensifies heat. May need to lift fomie occasionally to break moisture barrier.Remove fomentation followed by immediate 30 sec. brisk cold friction rub. Subsequent cold friction applications are not as intense as the first cycle.

22. Revulsive Treatment with Chest FomentationsProcedure, continued Repeat steps #10 & #11 at least 3 cycles, ending with cold friction.13. Thoroughly towel-dry area.14. Have subject rest 30 minutes.15. Retake vital signs. Record treatment.

23. Revulsive Treatment with Hot Foot Bath, Part 2EffectPromotes increase in circulating white blood cells.Increases blood flow to the skin, thereby relieving internal congestion.Can increase elimination by evaporative cooling (sweating)Stimulates or sedates according to the temperature and duration of the application.Relieves muscle spasm by increasing circulation.

24. Revulsive Treatment with Hot Foot BathIndicationsPromote profuse sweating for detoxification a. Use sedative duration with the fomentations b. Keep hot foot bath as hot as client can tolerate without burning2. Hot foot bath can be used with other indications listed in L & H video segment 4.3 and will be more efficient and beneficial to the client.

25. Revulsive Treatment with Hot Foot BathIndicationsChest congestion from colds, flu, bronchitis, pneumonia, asthma, SARS-CoV-2InsomniaPancreatitisColon diseases: diverticulitis, constipation, IBS, Crohn’sArthritis (rheumatoid and osteo- )Muscle spasms and tensionFibromyalgia

26. Revulsive Treatment with Hot Foot BathIndications, continuedSickle-cell anemia (increases RBC motility, increases oxygen)Nervousness (use sedative duration ― 5-8 minutes to spine)Depression (use stimulant duration―3-5 minutes to spine)Preparation for a cold treatmentKidney infectionDysmenorrheaChilled fever

27. Revulsive Treatment with Hot Foot BathCautionsUse caution with stomach or bowel ulcers (use stimulant duration as described in “Procedure section”)Use caution so as not to burn the subject (very young child & elderly). Add another towel layer if needed.Body parts where bone is close to skin are especially apt to burn, such as the clavicles, scapulae, sacrum area or anywhere along the spinal column. Keep extra towels handy for layering.Be sure client is always properly draped to avoid chilling.Diabetes: footbath should not exceed 102°F (39°C)Note: Revulsive fomentations should be mild heat.

28. Revulsive Treatment with Hot Foot BathContraindicationsParalyzed parts of the bodyTendency to hemorrhage Be careful treating malignant tumors to avoid metastasisOpen woundEdema, varicose veins or advanced vascular disease of legs & feetLymphedema Caution on legs and feet of the diabetic – water no hotter than 102˚F (39˚C)Be careful of using extreme temperatures on hypertensive persons. Over days and weeks with drop in blood pressure, be more aggressive with treatment in using extreme temperature and more cycles.An unconscious person

29. Revulsive Treatment with Hot Foot BathPregnancy. As this treatment is whole-body heating with the Hot Foot Bath, this is a contraindication.Seizure disorders. Omit the Hot Foot Bath and apply mild fomentation revulsive.Extreme Obesity.Lack of sensation: Use mild treatment.Ingestion of alcohol or drugs.Advanced cardiovascular disease.Multiple SclerosisWait 1 hour after a full meal

30. Revulsive Treatment with Hot Foot BathNote: For more considerations that are important especially for this treatment, please refer to the “Preparation for Treatment” segment, L & H videos 2.1 – 2.6.

31. Revulsive Treatment with Hot Foot BathEquipment5 bath towels (2 for the fomentation pad, 3 for layering)In place of towels, you may use what is called a “fomentation pad” made of very sturdy cotton. These can be submerged in water, wringing out the access (or spin-dry in clothes washer). We will show you what they look like in the Demonstration segment.Thermophore heating pad or additional fomentation for the backWool covering to layer around hot fomentation3 hand towels4-5 washcloths for layering and cold compress for head

32. Revulsive Treatment with Hot Foot BathEquipment, continuedBasin for cold waterIce for cold water + extra ice1 medium-sized towel or large hand towel or friction mitts (mitts are made of towel-material. Will be available to purchase at www.hydrotherapyhub.com )Basin for hot water

33. Revulsive Treatment with Hot Foot BathEquipment, continuedHot water: 100 - 104˚F (38 - 40˚C)Extra hot water from tea kettle or other heat sourceThermometerSet of bed linensSmall pillow for subject’s headBlanket – wool preferred. If wool is not available use thermalGlass of water and drinking strawPlastic tarp or shower curtain or table cover to cover bed so as not to get linens or mattress wet.

34. Revulsive Treatment with Hot Foot BathEquipment, continuedHeat source (microwave or stove top with pot of extremely hot water or range oven or roaster pan)BP monitor, health history form, treatment formTime devicePlastic bag for heating wet towels or fomentation pad in desired heat sourcePossible extension cordUtility/latex gloves for handling extremely hot towels or fomentation pad right out of heat source

35. Revulsive Treatment with Hot Foot BathProcedureCheck subject for precautions, take vital signs and explain treatment.Have all equipment ready prior to beginning treatment.Have subject void in restroom.While subject is voiding, heat 2 towels or pads. (Refer to previous segment for heating instructions).Have plastic tarp, linens and pillow prepared on bed or treatment table.

36. Revulsive Treatment with Hot Foot BathProcedure, continuedPlace 1 fomentation or Thermophore heating pad where subject’s back will be.Place a towel, 3-layers thick, on top of Thermophore or fomentation pad.Place a towel at the place where hot foot bath will be.Pray with subject.

37. Revulsive Treatment with Hot Foot BathProcedure, continued10. Assist subject on bed or table with clothing removed for best results. Subject should be laying on fomentation.11. Layer 2nd hot towel or pad in wool covering (fomentation)12. Place another towel, folded 3-layers thick, on subject’s chest. 13. Position fomentation on folded towel on subject’s chest.14. Cover subject with sheet.15. Place subject’s feet in basin of hot water.16. Sheet is also covering hot foot bath17. Cover all with wool blanket to trap heat. This now can be a whole-body heat treatment.

38. Revulsive Treatment with Hot Foot BathProcedure, continuedLeave fomentation in place for desired effect. Duration: stimulant: short (3 – 5 minutes) sedative: long (6 – 8 minutes)Note: 2nd fomentation is heating now.Communicate comfort level with subject. Use active-listening skills.Note: In case of pleurisy, renal colic or dysmenorrhea, omit cold

39. Revulsive Treatment with Hot Foot BathProcedure, continuedAdd cold compress washcloth to subject’s forehead to keep brain cool. Replace compress every 1-2 minutes or to subject’s tolerance. Can also add cold compress to neck if subject is heating and beginning to perspire. Intensity of cold can be controlled.Remove fomentation followed by immediate 30 second brisk cold friction rub. Be sure to tell subject “It will be cold.” Thoroughly towel-dry.Place another fomentation in area being treated for desired duration. Remember, moisture intensifies heat. May need to lift fomentation occasionally to break moisture barrier. Note: 3rd fomentation towel or pad is now heating in desired heat source.

40. Revulsive Treatment with Hot Foot BathProcedure, continuedAdd more hot water to hot foot bath to subject’s tolerance by moving subject’s feet to one side of basin and using free hand to stir in hot water as you pour.Keep foot basin covered with sheet and blanket.Periodically have subject drink water.Repeat revulsive cycles until desired effect keeping head cool every 1-2 minutes and adding hot water to foot bath periodically to maintain temperature.Throughout treatment use active-listening skills to ensure comfort of subject.

41. Revulsive Treatment with Hot Foot BathProcedure, continuedEnd treatment in the following steps:30 second brisk cold friction to chest followed by thorough towel-drying.Remove hot foot bath & immerse subject’s feet in cold water bath for only 30 seconds.Thoroughly towel-dry feet and re-cover.Assist subject in sitting up.Remove Thermophore heating pad or fomentation and apply 30 second brisk cold friction. Thoroughly towel-dry back.

42. Revulsive Treatment with Hot Foot BathProcedure, continued End, continuedSubject returns to supine position30 sec. cold friction arms and hands & thoroughly towel-dry30 sec. cold friction both legs, ankle to groin & towel-dry Allow subject to rest covered and undistracted for 30 minutes. Retake vital signs and record treatment.

43. References Sinclair, Marybetts, Modern Hydrotherapy for the Massage Therapist, Chapter 5, Lippincott Williams & Wilkins, 2008Thrash & Thrash, Home Remedies: Hydrotherapy, Massage, Charcoal and Other Simple Treatments. Seale, AL: Thrash, 1981

44. End of Presentation