Question

An 86 year old male is admitted from the PACU after a slow recovery from anesthesia following a procedure to replace his pacemaker. The patient has a history of diabetes, peripheral vascular disease, and peripheral neuropathy. The patient’s daughter requests an ice pack to reduce swelling at the surgical incision site and states the “stitches appear stretched and taunt”. What are some possible concerns you may have regarding the use of cold treatment at the surgical site? Include at least three.

Answer 1

Ans) Some possible concerns regarding the use of cold treatment at the surgical site are:

- Continued application of cold affects deeper tissues. Prolonged exposure to extreme cold may cause actual freezing (frostbite).

- Some are ready-for-use packs filled with a solution. Sometimes they can be reused but for only one client. Ice packs are also available for one-time emergency use. They have a capsule that when broke, or crystals, that when the bag is shaken, release a chemical that causes the bag to become cold.

- Inspect bag stopper or closure and test bag for leakage.

- When cold is left too long blood vessels dilate, blood flow increases.

- Older and fair skinned persons are persons with sensory impairments.