Role of the PTA
- Check the POC for inclusion of heat and cold
- Observe and inspect for signs and symptoms of inflammation
- Consider patient age and medical status when selecting a heating agent
- Intentionally select heat or cold based on the expected change in impairment or functional limitation as it relates to the goals
- Inspect equipment to confirm good working order
- Inform the patient about the procedure: what to expect and what is unexpected
- Check skin for sensory response
- Screen for contraindications and precautions
- Leave patient with call bell if unattended
- Document treatment (informed consent, skin check, type, position, parameters, outcome)
Consider the Evidence
In the literature, particularly in studies whose aim is to systematically review intervention effectiveness, there is weak evidence supporting the use of heat and cold as pain reducers or in impacting function. Parameters for treatments have been derived from research studies and analysis of effectiveness is ongoing. As a PTA, you are responsible for understanding and applying treatment parameters that are consistent with today's literature and in the PT plan of care. Selecting parameters will always include careful analysis of each patient's condition and interests at the time of treatment. You are also equipped, through evidence-based research skills, to engage in discussions and best practices as we work to restore function with our patients.
