1. You were planning on giving your client a Contrast Shower. You discover that she is chilled. How would you proceed?
2. Your friend has congestion in the sinuses & nose and has a cough. Steam Inhalation would be a good treatment for him, but he gets overheated quickly and is unsure about tolerating humidity. How would you proceed?
I would offer her a hot foot bath to warm her up before the contrast shower treatment.
I would explain to him the steps of the treatment so he is clear on what the treatment is like. We could easily lower the heat intensity by dropping the temperature slightly without cutting too much steam down. Also, using a cold face washer for the back of the neck to assist with cooling. And lastly, the treatment can shortened to prevent the potential for overheating in a prolonged session.
1. Yes, you could offer a HFB instead of CS. Provided there is enough hot water, extend the length of the heat phase beyond 5 minutes, say 7-9 or 10 minutes for thorough warmth. Something I just thought of would be to offer the client a loofah sponge or body brush to friction themselves during the heat phase. This would stimulate the mechano-receptors as well as the thermo-receptors for quicker stimulation and thorough warming of the tissues.
2. Adding a cool compress to the back of the neck is something I had never thought of. That could help from overheating. It could also contribute to a claustrophic feel so I would ask if that would be comfortable without added anxiety. With the cool compress, I would also want to ensure that it not wet or dampen the client’s collar of a shirt he may be wearing.
1) I would not want to expose this client to the cold effects of the contrast shower while they are still chilled. I may delay the shower momentarily and give them something warm to drink until the chill has passed. As they now are fluid laden, I would encourage them to void themselves prior to starting the contrast shower. As the shower begins, I would consider prolonging the initial hot aspect of the shower for 6-10 min rather than the regular 3-5 min in order to thoroughly warm them and then proceed as per the regular sequential steps.
2) I would consider 2 options in this case. (A) we could utilize the hot foot bath as an alternative to steam inhalation as the temperatures could be lessened and a cool compress would be placed on his head to help deal with any symptoms of overheating while the treatment is progressing. (B) we could proceed with the steam inhalation but I would modify the procedure by not using a towel over his head while he is inhaling the steam or alternatively have him move a greater distance from the steam. Either adjustment would be to the extent that he felt comfortable. The time exposed to the steam could also be adjusted so that he would be under the towel for short exposures at a time.
1. Giving the client something warm to drink is a good idea I had not considered. I have extended the heat phase beyond 5 minutes to thoroughly warm them as you have indicated. Others have thought of giving the client a hot foot bath first or instead of the contrast shower.
2. Your modified options are well-thought through. A different treatment altogether as suggested or leaving the towel off the head or partially covered during inhalation is an excellent option. Either way, we are letting the client buy into the idea that the treatment is safe and effective even with modifications.
1. I would offer a hot foot bath, wrapped in a blanket, to warm the patient thoroughly before the contrast shower.
2. Ideally, I would have a portable steam inhaler that would just be used over his nose and mouth. I would allow the patient to control the distance of the portable steam inhaler from his face, encouraging him to work closer to it as he is comfortable.
If that was inaccessible, I would allow him to do a modified steam inhalation with a towel not entirely covering his head, or opt for a hot foot bath.
1. Performing a HFB is a safe start and saves water! The CS could still be performed with extending the first heat cycle to 5-7 minutes. If running out of hot water could be an issue, the HFB is an excellent choice.
2. Controlling the distance is a safe step as well as partial towel coverage over the head. A different treatment as you suggested is also a good alternative. Thinking quickly of what could be done with equipment available is key.
In best interest for the client we might consider another treatment that would warm them like the hot food bath or steam bath. It also depends on why we were giving the contrast shower in the first place. But we definitely want to elevate the core temperature rather than shock a depressed immune system with a contrast shower.
Proceed with caution. Review how the treatment works with client and let them know that they can stop at any time. They can adjust the towel over their head to their comfort. If they are unable to tolerate the treatment, I’d document what was tried and maybe try a hot foot bath to draw the congestion away from the head.
1. Choosing a different treatment is an alternative choice. You could also extend the hot part of the contrast shower to 5-7 min. until the individual is warmed. The first cold cycle is always shocking, even if thoroughly warmed.
2. Thorough reasoning. Adjusting the towel gives the individual a sense of control. A HFB could work also.
1) If the client was chilled before the contrast shower, I would either give them a hot foot bath, or if there was enough water I would extend the length of the shower time to ensure the client had warmed enough before the cold cycle (I would definitely not try this in our rented apartment:)
2) I would explain the treatment to the client and allow for adjustments. The distance to the heat source could be adjusted, as well as the positioning of the towel. A cool cloth applied to the back of the neck and the client feeling in control of how much he can handle and adjusting accordingly would be helpful in aiding a successful treatment.
1. Yes, either way would work. One thing for sure, we never apply cold on an already cold client.
What is your current apartment situation like?
2. Maryann also suggested a cool cloth to the back of the neck. That is something I had not thought of. As I explained to her, I would want to use caution so as not to get the shirt collar wet or damp.
1. I would offer the client a hot foot bath and perhaps wrap the client in the wool blanket to enhance their warmth. I’d retake the vitals afterwards to ensure appropriate temperature.
2. I’d add cold compresses to the head and cool the face as needed. I might also offer a drink of water throughout the treatment. I’d also either leave the towel off the head or vent it more so that their whole head is not covered in the cloth. I would also check the clients heart rate during treatment to ensure safety.
1. A HFB is an appropriate alternative to the Contrast Shower. You could also extend the heat phase of the CS 5-8 minutes.
2. I like your idea of adding cool compresses to the forehead, yet it may be a challenge to keep it there as the client would be leaning forward and over to breathe steam. A couple other students mentioned adding compresses to the back of the neck which is a good idea, provided that the shirt collar will not get damp. 🙂
1. If your client is chilled you would not proceed with performing a contrast shower on them. Depending on the reasoning for treatment of desired results you could do something like a hot foot bath instead.
2. We could modify the treatment by having the client lift the sides of the towel, sit a bit farther back from the steam, or shorten the duration. If need be, we could see if the client would be more comfortable with a different treatment such as a hot foot bath or contrast shower.
1. A HFB is an excellent alternative. One could also extend the hot phase of the CS to 5-8 minutes so that the client is thoroughly warmed.
2. The modifications for the SI treatment are good options. And the alternative treatments you mentioned would work as well.
You may have picked up from these questions and scenarios that it’s good to have 2 treatments in mind for a client. One to fall back on in case of contraindications for the first treatment you had in mind.
If the person heading into the contrast shower is chilled, I would extend the first hot part of the shower to make sure they’ve thoroughly warmed up before the first contrast comes along! Ie. instead of 3 min hot, I would extend that to 5 or 6 minutes before changing to cool. And I would be careful that the first cool contrast is not more than a 20 degree difference, (no cranking it all the way cold… 😉
For the steam inhalation on someone who overheats easily and isn’t sure if they can tolerate humidity, I would have them use an umbrella tent, (open umbrella on the table over the heat source, cover person and umbrella with a queen size sheet). They can then have some control over how near or how far they are to the steam source, and I would show them how they could lift the edges of the sheet if they needed a little bit of cool air here and there. Another option to try would be the hot and cold face bath with a snorkel. Not very glamorous, and its messy, but it works quite well. (Faces can’t tolerate as much heat as other parts of the body, so steam may be a stronger treatment?)
1. Thorough in your thinking once again. You could also choose a different treatment: hot foot bath or steam bath. But as long as you have enough hot water, extending the hot phase is sufficient. And like you said, not as contrasty for the fist cold cycle.
2. You have some creative ideas to make the client comfortable and trustworthy towards you. 🙂
1. You were planning on giving your client a Contrast Shower. You discover that she is chilled. How would you proceed?
2. Your friend has congestion in the sinuses & nose and has a cough. Steam Inhalation would be a good treatment for him, but he gets overheated quickly and is unsure about tolerating humidity. How would you proceed?
I would offer her a hot foot bath to warm her up before the contrast shower treatment.
I would explain to him the steps of the treatment so he is clear on what the treatment is like. We could easily lower the heat intensity by dropping the temperature slightly without cutting too much steam down. Also, using a cold face washer for the back of the neck to assist with cooling. And lastly, the treatment can shortened to prevent the potential for overheating in a prolonged session.
1. Yes, you could offer a HFB instead of CS. Provided there is enough hot water, extend the length of the heat phase beyond 5 minutes, say 7-9 or 10 minutes for thorough warmth. Something I just thought of would be to offer the client a loofah sponge or body brush to friction themselves during the heat phase. This would stimulate the mechano-receptors as well as the thermo-receptors for quicker stimulation and thorough warming of the tissues.
2. Adding a cool compress to the back of the neck is something I had never thought of. That could help from overheating. It could also contribute to a claustrophic feel so I would ask if that would be comfortable without added anxiety. With the cool compress, I would also want to ensure that it not wet or dampen the client’s collar of a shirt he may be wearing.
1) I would not want to expose this client to the cold effects of the contrast shower while they are still chilled. I may delay the shower momentarily and give them something warm to drink until the chill has passed. As they now are fluid laden, I would encourage them to void themselves prior to starting the contrast shower. As the shower begins, I would consider prolonging the initial hot aspect of the shower for 6-10 min rather than the regular 3-5 min in order to thoroughly warm them and then proceed as per the regular sequential steps.
2) I would consider 2 options in this case. (A) we could utilize the hot foot bath as an alternative to steam inhalation as the temperatures could be lessened and a cool compress would be placed on his head to help deal with any symptoms of overheating while the treatment is progressing. (B) we could proceed with the steam inhalation but I would modify the procedure by not using a towel over his head while he is inhaling the steam or alternatively have him move a greater distance from the steam. Either adjustment would be to the extent that he felt comfortable. The time exposed to the steam could also be adjusted so that he would be under the towel for short exposures at a time.
1. Giving the client something warm to drink is a good idea I had not considered. I have extended the heat phase beyond 5 minutes to thoroughly warm them as you have indicated. Others have thought of giving the client a hot foot bath first or instead of the contrast shower.
2. Your modified options are well-thought through. A different treatment altogether as suggested or leaving the towel off the head or partially covered during inhalation is an excellent option. Either way, we are letting the client buy into the idea that the treatment is safe and effective even with modifications.
1. I would offer a hot foot bath, wrapped in a blanket, to warm the patient thoroughly before the contrast shower.
2. Ideally, I would have a portable steam inhaler that would just be used over his nose and mouth. I would allow the patient to control the distance of the portable steam inhaler from his face, encouraging him to work closer to it as he is comfortable.
If that was inaccessible, I would allow him to do a modified steam inhalation with a towel not entirely covering his head, or opt for a hot foot bath.
1. Performing a HFB is a safe start and saves water! The CS could still be performed with extending the first heat cycle to 5-7 minutes. If running out of hot water could be an issue, the HFB is an excellent choice.
2. Controlling the distance is a safe step as well as partial towel coverage over the head. A different treatment as you suggested is also a good alternative. Thinking quickly of what could be done with equipment available is key.
In best interest for the client we might consider another treatment that would warm them like the hot food bath or steam bath. It also depends on why we were giving the contrast shower in the first place. But we definitely want to elevate the core temperature rather than shock a depressed immune system with a contrast shower.
Proceed with caution. Review how the treatment works with client and let them know that they can stop at any time. They can adjust the towel over their head to their comfort. If they are unable to tolerate the treatment, I’d document what was tried and maybe try a hot foot bath to draw the congestion away from the head.
1. Choosing a different treatment is an alternative choice. You could also extend the hot part of the contrast shower to 5-7 min. until the individual is warmed. The first cold cycle is always shocking, even if thoroughly warmed.
2. Thorough reasoning. Adjusting the towel gives the individual a sense of control. A HFB could work also.
1) If the client was chilled before the contrast shower, I would either give them a hot foot bath, or if there was enough water I would extend the length of the shower time to ensure the client had warmed enough before the cold cycle (I would definitely not try this in our rented apartment:)
2) I would explain the treatment to the client and allow for adjustments. The distance to the heat source could be adjusted, as well as the positioning of the towel. A cool cloth applied to the back of the neck and the client feeling in control of how much he can handle and adjusting accordingly would be helpful in aiding a successful treatment.
1. Yes, either way would work. One thing for sure, we never apply cold on an already cold client.
What is your current apartment situation like?
2. Maryann also suggested a cool cloth to the back of the neck. That is something I had not thought of. As I explained to her, I would want to use caution so as not to get the shirt collar wet or damp.
1. I would offer the client a hot foot bath and perhaps wrap the client in the wool blanket to enhance their warmth. I’d retake the vitals afterwards to ensure appropriate temperature.
2. I’d add cold compresses to the head and cool the face as needed. I might also offer a drink of water throughout the treatment. I’d also either leave the towel off the head or vent it more so that their whole head is not covered in the cloth. I would also check the clients heart rate during treatment to ensure safety.
1. A HFB is an appropriate alternative to the Contrast Shower. You could also extend the heat phase of the CS 5-8 minutes.
2. I like your idea of adding cool compresses to the forehead, yet it may be a challenge to keep it there as the client would be leaning forward and over to breathe steam. A couple other students mentioned adding compresses to the back of the neck which is a good idea, provided that the shirt collar will not get damp. 🙂
1. If your client is chilled you would not proceed with performing a contrast shower on them. Depending on the reasoning for treatment of desired results you could do something like a hot foot bath instead.
2. We could modify the treatment by having the client lift the sides of the towel, sit a bit farther back from the steam, or shorten the duration. If need be, we could see if the client would be more comfortable with a different treatment such as a hot foot bath or contrast shower.
1. A HFB is an excellent alternative. One could also extend the hot phase of the CS to 5-8 minutes so that the client is thoroughly warmed.
2. The modifications for the SI treatment are good options. And the alternative treatments you mentioned would work as well.
You may have picked up from these questions and scenarios that it’s good to have 2 treatments in mind for a client. One to fall back on in case of contraindications for the first treatment you had in mind.
If the person heading into the contrast shower is chilled, I would extend the first hot part of the shower to make sure they’ve thoroughly warmed up before the first contrast comes along! Ie. instead of 3 min hot, I would extend that to 5 or 6 minutes before changing to cool. And I would be careful that the first cool contrast is not more than a 20 degree difference, (no cranking it all the way cold… 😉
For the steam inhalation on someone who overheats easily and isn’t sure if they can tolerate humidity, I would have them use an umbrella tent, (open umbrella on the table over the heat source, cover person and umbrella with a queen size sheet). They can then have some control over how near or how far they are to the steam source, and I would show them how they could lift the edges of the sheet if they needed a little bit of cool air here and there. Another option to try would be the hot and cold face bath with a snorkel. Not very glamorous, and its messy, but it works quite well. (Faces can’t tolerate as much heat as other parts of the body, so steam may be a stronger treatment?)
1. Thorough in your thinking once again. You could also choose a different treatment: hot foot bath or steam bath. But as long as you have enough hot water, extending the hot phase is sufficient. And like you said, not as contrasty for the fist cold cycle.
2. You have some creative ideas to make the client comfortable and trustworthy towards you. 🙂