SITZ BATH

Sitz Bath

It is a local application of moist heat to the pelvic organ. The patient is usually immersed from the mid-thigh liac crest. The temperature of the water should be 110-115°F (43-46°C). Duration of bath is 15-30 minutes.

A sitz bath or hip bath is a bath in which a person sits in water up to the hips. It is used to relieve discomfort and pain in the lower part of the body, for example, due to hemorrhoids (piles), anal fissures, perianal fistulas rectal surgery, an episiotomy, uterine cramps, inflammatory bowel disease, pilonidal cysts and infections of the bladder, prostate or vagina.

PURPOSES

  1. To clean perineal and anal area, after surgery
  2. To promote healing and drainage after rectal surgery/perineal surgery
  3. To provide relaxation for the patient with hemorrhoids or rectal surgery.
  4. To reduce soreness.

SOLUTIONS USED FOR SITZ BATH

  • Potassium permanganate solution 15000
  • Dettol (1:40)
  • Boric acid dram to 1 pint.
  • Easol solution.

SCIENTIFIC PRINCIPLES OF HOT AND COLD APPLICATION

Anatomy and Physiology

  • All parts of the body may be influenced by heat.
  • The skin consisted of two layers the epidermis and dermis. The epidermis protects the dedicate sensitive organs underneath.
  • The dermis consists of nerves, blood vessels, hair follicles and sebaceous gland.
  • End organ of sensory nerve in the skin conveys the sensation of heat, cold, pain and pressure. The sensation are interrupted in the brain.
  • The skin has rich supply of blood vessel and lymph vessel.
  • Heat relaxes muscle and relieves stiffness and fatigue.
  • Heat increases exchange of oxygen and promotes absorption of exudates.
  • Moderate heat applied to skin dilates superficial blood vessel, bringing more blood to the area. 
  • An increased blood supply increases the number of leukocytes which aid in healing.
  • Extreme heat and cold may destroy tissue if the application is continued over prolonged time.

Microbiology

  • A sterile technique must be used for surgical fomentation. 
  • The nurse must wash her hands before and after the procedure.
  • To avoid transferring bacteria hot water bags, ice caps are washed with soap and water and dried well after patient's use.
  • Cold diminishes the formation and absorption of bacterial poisons.

Physics and Chemistry

  • While giving hot and cold application, physical agents like heat, water, light and electricity are used.
  • Water is a good conductor of heat.
  • Moist heat or moist cold application is more effective than dry heat or dry cold application.
  • Air is poor conductor of heat. Presence of air in the hot water bags and ice caps can reduce the heat conduction and make the treatment less effective.
  • Evaporation is faster on a large surface than a small one.
  • Friction produces heat so friction should be avoided during a cold/tepid sponge.
  • Oil acts as insulator and delays transmission of heat, so Vaseline is applied on the skin before the application of moist heat, to prevent burns.
  • The flow of heat is from the hotter area to the less hot area; the heat from the hot application will flow to the skin and make the area warm.
  • The heat from the skin will flow to the cold application and make the area cold.

Psychology

  • Explain the procedure to the patient to get the co-operation.
  • As patients are afraid of pain, the nurse must check the temperature of warm solution carefully.
  • Warm the patient just before applying the hot and cold material, so that the patient will be prepared for a different temperature. -
  • Watch the patient carefully during hot and cold application, so that the patient does not get injured and obtain benefit from the treatment.

Articles Required -

  1. A bed screen if treatment is to be done at bedside
  2. A suitable bath tub or basin
  3. A bath thermometer
  4. A jug with warm water
  5. A bed side stool 

Steps of the Procedure 

  • Explain the purpose of the procedure to the patient.
  • Fill the tub with water about half full at a temperature of 105 degree ferenhite or 40 degree Celsius.
  • Add the desire amount of solution that is potassium permanganate or betadine solution.
  • Screen the patient if at the bedside or wheel him to the bathroom in a chair if his condition permits.
  • Assist the patient to undress, avoid unnecessary exposure. Stand directly at the patients back; help the patient to sit down in the tub with the feet flat on the floor. There should be no pressure on the sacrum or thighs.
  • Be sure that the thighs, buttocks and lower abdomen are immersed in the solution.
  • Drape the patient’s legs and thighs. Wrap a bath blanket around the patient’s shoulders to protect him from chills.
  • Observe the patient closely for any signs of weakness and fatigue. Discontinue the bath if the patient has any signs of fatigue, pallor, rapid pulse and nausea.
  • Test the water in the tub several times and keep it at the desired temperature 105 degree ferenhite or 40 degree ferenhite. Additional hot water may be added by pouring it slowly from the jug.
  • Allow the patient to remain in the basin for 15 to 30 minutes. 
  • Do not leave the patient alone unless it is absolutely certain that it is safe to do so.
  • Help the patient to come out of the basin when the bath is completed. Stand in front of him. Place the hand under the axilla and partially lift him from the tub to the stool.
  • Dry the patient with the bath towel and cover him adequately. Assist him into the bed.
  • Avoid chill
    43. AFTER CARE • Rinse the basin, scrub well with soap, rinse, dry and replace. • Leave the patient comfortable, leave the bathroom in order. Remove the bedside stool. • Record time, duration, type of solution used reaction of the patient.

Points to Remember

  • Observe the patient carefully for any signs of weakness and fatigue.
  • Discontinue the bath if the patient has signs of faintness, pallor, rapid pulse and nausea.
  • Allow the patient to remain in basin for 15-30 minutes.

 

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