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| + | A '''heating pad''' is a pad used for warming of parts of the body in order to manage [[Pain and nociception|pain]]. Localized application of heat causes the blood vessels in that area to [[vasodilator|dilate]], enhancing [[perfusion]] to the targeted tissue. Types of heating pads include [[electric|electrical]], [[chemical]] and [[hot water bottle]]s. |
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| − | [[Image:SchoolchildrenWashingHands.jpg|right|thumb|Schoolchildren washing their hands before eating lunch.]]
| + | ==Types== |
| − | '''Hand washing''' is the act of [[cleaning|cleansing]] the [[hand]]s with [[water]] or another [[liquid]], with or without the use of [[soap]] or other [[detergent]]s, for the [[Sanitation|sanitary]] purpose of removing [[soil]] and/or [[microorganism]]s.
| + | ===Electrical=== |
| | + | Electric pads usually operate from household current and must have protection against overheating. |
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| − | ==Purpose==
| + | A '''moist heating pad''' is used dry on the user's skin. These pads register temperatures from 170 to 180 degrees Fahrenheit (76 to 82 °C) and are intended for deep tissue treatment and can be dangerous if left on unattended. Moist heating pads are used mainly by physical therapists but can be found for home use. A moist cloth can be added with a stupe cover to add more moisture to the treatment. |
| − | [[Image:Fingerprint.jpg|left|thumb|An example of how minuscule particles can be caught between dermal ridges in the hand, yet remain unseen by the naked eye. Washing one's hands removes such contaminants.]]
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| − | The main purpose of washing hands is to cleanse the hands of [[pathogen]]s (including [[bacterium|bacteria]] or [[virus]]es) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field. The [[Centers for Disease Control and Prevention]] (CDC) has stated that "It is well-documented that the most important measure for preventing the spread of pathogens is effective handwashing."
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| − | While hot water may more effectively clean your hands, this is primarily due to its increased capability as a solvent, and not due to hot water actually killing germs. Hot water is more effective at removing dirt, oils and/or chemicals, but contrary to popular belief, it does not kill microorganisms. A temperature that is comfortable for hand washing (about {{convert|45|C|F|0|lk=on|abbr=on}}) is not nearly hot enough to kill any microorganism. It would take more than double that temperature to effectively kill germs (typically {{Convert|100|C|F|lk=on|abbr=on}}).
| + | ===Chemical=== |
| | + | Chemical pads employ a chemical heat reservoir or a one-time chemical reaction such as [[catalyst|catalyzed]] [[rusting]] of [[iron]]. |
| | + | [[image:Hand warmer.jpg|right|thumb|A sodium acetate heat pad]] |
| | + | A '''sodium acetate heat pad''' is a reusable heat reservoir. It contains a [[supersaturated]] solution of [[sodium acetate]] (CH<sub>3</sub>COONa). [[Crystallization]] is triggered by flexing a (patented <ref>[http://www.sfu.ca/physics/ugrad/courses/teaching_resources/demoindex/thermal/th4c/patentheatpack.html Physics course on thermal heat packs]</ref>) small flat disc of notched [[ferrous]] metal embedded in the liquid. Pressing the disc releases very tiny adhered crystals of sodium acetate<ref>[http://www3.interscience.wiley.com/cgi-bin/abstract/108065684/ABSTRACT Article on sodium acetate]</ref> into the solution which then act as [[nucleation]] sites for the recrystallization of the remainder of the salt solution. Because the liquid is supersaturated, this makes the solution crystallize suddenly, thereby releasing the energy of the crystal lattice. |
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| − | ==Personal hand washing==
| + | See [[sodium acetate]] for a more technical discussion. |
| − | To maintain good [[hygiene]], hands should always be washed after using the toilet, changing a diaper, tending to someone who is sick, or handling raw meat, fish, or poultry. Hands should also be washed before eating, handling or cooking food. Conventionally, the use of soap and warm running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 20 seconds, before rinsing thoroughly and then drying with a clean or disposable towel.<ref>[http://www.mayoclinic.com/health/hand-washing/HQ00407 Hand washing] from [[Mayo Clinic]]</ref> After drying, a dry paper towel should be used to turn off the water (and open the exit door if one is in a restroom or other separate room). Moisturizing [[lotion]] is often recommended to keep the hands from drying out, should one's hands require washing more than a few times per day.<ref>[http://www.tufts.edu/med/apua/Patients/handwashing.html Hand washing] from [[Tufts University]]</ref>
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| − | Antibacterial soaps have been heavily promoted to a health-conscious public. To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature.<ref>{{cite journal |author=Weber DJ, Rutala WA |title=Use of germicides in the home and the healthcare setting: is there a relationship between germicide use and antibiotic resistance? |journal=Infect Control Hosp Epidemiol |volume=27 |issue=10 |pages=1107–19 |year=2006 |pmid=17006819 |doi=10.1086/507964}}</ref> However, antibacterial soaps contain common antibacterial agents such as [[Triclosan]], which has an extensive list of resistant strains of organisms. So, even if antibacterial soaps do not select for antibiotic resistant strains, they might not be as effective as they are marketed to be. These soaps are quite different from the non-water-based hand hygiene agents referred to below, which also do not promote [[antibiotic resistance]].<ref>[http://www.cdc.gov/cleanhands/ Clean hands] from the [[Centers for Disease Control and Prevention|CDC]]</ref>
| + | The pad can be reused by placing it in boiling water for 10-15 minutes, which redissolves the sodium acetate in the contained water and recreates a supersaturated solution. Once the pad has returned to room temperature it can be triggered again. Triggering the pad before it has reached room temperature results in the pad reaching a lower peak temperature, as compared to waiting until it had completely cooled. |
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| − | ==Medical hand washing==<!-- This section is linked from [[IgnazMa Semmelweis]] --> | + | ==High specific-heat capacity materials== |
| − | [[Image:Hand desinfection test with blood agar plate.jpg|thumb|right|Microbial growth on a cultivation plate without procedures (A), after washing hands with soap (B) and after desinfection with alcohol (C).]]
| + | Heating packs can also be made by filling a container with a material that has a high [[specific heat capacity]], which then gradually releases the heat over time. A hot water bottle is the most familiar example of this type of heating pad. |
| − | The purpose of hand washing in the health care setting is to remove or destroy (disinfect) [[pathogens|pathogenic microorganisms]] ("germs") to avoid transmitting them to a patient. The application of water alone is ineffective for cleaning skin because water is unable to remove fats, oils, and proteins, which are components of organic soil. Therefore, removal of microorganisms from skin requires the addition of soaps or detergents to water. Plain soap does not kill pathogens. However, the addition of antiseptic chemicals to soap ("medicated" or "antimicrobial" soaps) does confer killing action to a hand washing agent. Such killing action may be desired prior to performing surgery or in settings in which antibiotic-resistant organisms are highly prevalent.<ref>[http://www.who.int/patientsafety/events/05/HH_en.pdf WHO Guidelines on Hand Hygiene in Health Care]</ref>
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| − | The proper washing of hands in a [[medicine|medical]] setting generally consists of the use of generous amounts of soap and water to lather and rub each part of ones hands systematically for 15 to 20 seconds. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush is often used to remove it. Finally, it is necessary to rinse well and wipe dry with a paper towel. After drying, a dry paper towel should be used to turn off the water (and open any exit door if necessary).
| + | A '''microwavable heating pad''' is a heating pad that is warmed by placing it in a [[microwave oven]] before use. Microwavable heating pads are typically made out of a thick insulative fabric such as flannel and filled with grains such as [[buckwheat]] or [[flax seed]]. Due to their relative simplicity to make, they are frequently sewn by hand, often with a custom shape to fit the intended area of use. In rare instances, these types of pads have been known to ignite during or after the microwave process and cause fires. |
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| − | To 'scrub' one's hands for a [[surgery|surgical operation]], a tap that can be turned on and off without touching with the hands, some [[chlorhexidine]] or [[povidone-iodine|iodine]] wash, sterile towels for drying the hands after washing, and a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails are required. All jewelery should be removed. This procedure requires washing the hands and forearms up to the elbows, and one must in this situation ensure that all parts of the hands and forearms are well scrubbed several times. When rinsing, it is ensured at all times that one does not allow water to drip back from the elbow to your hands. When done hands are dried with a sterile cloth and a surgical gown is donned.
| + | Often, [[aroma compound|aromatic compound]]s will also be added to the filler mixture to create a pleasant or soothing smell when heated. The source of these can vary significantly, ranging from adding [[essential oil]]s to ground up [[spices]] such as [[clove]]s and [[nutmeg]], or even dried [[rose]] petals. |
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| − | In the late 1990s and early part of the 21st century, [[Alcohol rub|non-water-based hand hygiene agents]] (also known as alcohol-based hand rubs, antiseptic hand rubs, or hand sanitizers) began to gain popularity. Most are based on [[isopropyl alcohol]] or [[ethanol]] formulated together with a humectant such as glycerin into a gel, liquid, or foam for ease of use and to decrease the drying effect of the alcohol. The increasing use of these agents is based on their ease of use, rapid killing activity against microorganisms, and lower tendency to induce irritant contact dermatitis as compared to soap and water hand washing. Despite their effectiveness, the non-water agents do not clean hands of organic material, they simply disinfect them. However, disinfection does prevent transmission of infectious microorganisms.
| + | == Function == |
| | + | Many episodes of pain come from [[muscle]] exertion or strain, which creates tension in the muscles and [[soft tissue]]s. This tension can constrict [[circulatory system|circulation]], sending pain signals to the [[brain]]. Heat application eases pain by: |
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| − | Visible soiling of any sort on the hands must be washed with soap and water because alcohol-based hand rubs are ineffective in the presence of organic material. In addition, alcohols are ineffective against non-lipid-enveloped viruses (e.g., Noroviruses) and the spores of bacteria (e.g., Clostridium difficile) and protozoa (e.g., Giardia lamblia). When such microorganisms are likely to be encountered, soap and water hand washing is preferable.
| + | *jessica hyun surrounding the painful area. Increased [[blood]] flow provides additional [[oxygen]] and nutrients to help heal the damaged muscle tissue. |
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| − | The [[New England Journal of Medicine]] reports that hand washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients.<ref>{{cite journal |author=Goldmann D |title=System failure versus personal accountability--the case for clean hands |journal=N. Engl. J. Med. |volume=355 |issue=2 |pages=121–3 |year=2006 |pmid=16837675 |doi=10.1056/NEJMp068118}}</ref> One study has shown that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.<ref>{{cite journal |author=Pronovost P, Needham D, Berenholtz S, ''et al'' |title=An intervention to decrease catheter-related bloodstream infections in the ICU |journal=N. Engl. J. Med. |volume=355 |issue=26 |pages=2725–32 |year=2006 |pmid=17192537 |doi=10.1056/NEJMoa061115}}</ref>
| + | * stimulating sensation in the [[skin]] and therefore decreasing the pain signals being transmitted to the brain |
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| − | == Truths, myths, and misinformation ==
| + | * increasing the flexibility (and decreasing painful stiffness) of soft tissues surrounding the injured area, including muscles and [[connective tissue]]. |
| − | {{Cite-section}}
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| − | {{cleanup-section}}
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| − | ; Washing your hands with soap and water kills germs:''This is misinformation''
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| − | Plain [[soap]]s have minimal if any [[antimicrobial]] activity. In several [[clinical studies]], hand washing with plain soap failed to remove bad microorganisms ([[pathogens]]) from the hands of hospital personnel. Hand washing with plain soap can result in an increase in bacterial counts on the skin. Occasionally, contaminated plain soaps have colonized hands with [[Gram-negative bacteria
| + | As many heating pads are portable, heat may be applied as needed at home, at work, or while traveling. Some physicians recommend alternating heat and [[ice]] for [[pain management|pain relief]]. ''As with any pain treatment, a physician should be consulted prior to beginning treatment.'' |
| − | ;Killing germs on your hands decreases your immunity:''This is a myth''
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| − | The [[skin]] on your body is covered with microorganisms. Our environment is contaminated with good and bad microorganisms. You cannot kill all of the microorganisms on your hands. Your [[large intestine]] contains large numbers of microorganisms. All of these sources of germs stimulate your [[immune response]]. [[Centers for Disease Control and Prevention|CDC]] guidelines for health care workers call for [[alcohol rub]]s to be used 60 or more times a day between patients and after touching contaminated surfaces. Killing germs on your hands will not decrease your immunity but it will help prevent disease
| + | ==See also== |
| − | | + | *[[Hand warmer]] |
| − | ;Alcohol rub hand sanitizers do not kill germs:''This is misinformation''
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| − | Hand sanitizers containing a minimum of 60 to 95% [[alcohol]] are very efficient germ killers. Alcohol rub sanitizers kill bacteria, multi-drug resistant bacteria ([[MRSA]] and [[VRE]]), [[tuberculosis]], and [[viruses]] (including [[HIV]], [[herpes]], [[RSV]], [[rhinovirus]], [[vaccinia]], [[influenza]], and [[hepatitis]]) and [[fungus]]. Alcohol rub sanitizers containing 70% alcohol kill 3.5 log<sub>10</sub> (99.9%) of the bacteria on hands 30 seconds after application and 4 to 5 log<sub>10</sub> (99.99 to 99.999%) of the bacteria on hands 1 minute after application. Alcohol rub sanitizers can prevent the transfer of health-care associated pathogens ([[Gram-negative bacteria]]) better than soap and water. Alcohol rub sanitizers are not appropriate for use when your hands are visibly dirty, soiled or contaminated with blood. Use soap and water for dirty or soiled hands.<ref name="hhforhw"/>
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| − | ;Alcohol will dissolve the natural oils on your skin and cause dry skin:''This is true''
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| − | Frequent use of alcohol-based formulations for hand sanitizers can cause [[dry skin]] unless [[emollient]]s and/or skin [[moisturizer]]s are added to the formula. The drying effect of alcohol can be reduced or eliminated by adding [[glycerin]] and/or other emollients to the formula. In several prospective clinical trials, alcohol based hand sanitizers containing emollients caused substantially less skin irritation and dryness than soaps or antimicrobial [[detergents]]. [[Allergic contact dermatitis]], contact [[urticaria]] syndrome or hypersensitivity to alcohol or additives present in alcohol hand rubs rarely occurs
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| − | ;Alcohol rubs cause (bacterial) mutation and resistance:''This is misinformation''
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| − | Dead microorganisms don’t [[mutate]]. Alcohol rubs (biocides) kill microorganisms. Current scientific evidence has not shown a link exists between the use of topical antimicrobial formulations and [[antiseptic]] or [[antibiotic]] resistance. Antiseptics (biocides) have multiple (thousands) of nonspecific killing sites on and in the microbial cell which cannot easily mutate. Antibiotics and antibacterial soaps ([[triclosan]]) have one very specific killing site on and in the microbial cell which can easily mutate. Antibiotic resistance has no effect on the effectiveness of antiseptics
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| − | ;Alcohol rub and combination hand sanitizers kill germs better than soap and water:''This is true''
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| − | Alcohol rubs and combination hand sanitizers are effective at killing germs on your hands, but not effective at removing dirt. Conversely, soap and water are very effective at cleaning dirty or soiled hands, but are not good at killing germs (as discussed above
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| − | ;Alcohol rubs with two germ killers are significantly more effective germ killers than alcohol rubs with one germ killer:''This is true''
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| − | Many clinical studies have shown that alcohol rubs containing two germ killers (ie. Alcohol and [[Chlorhexidine gluconate]] or [[Benzalkonium chloride]]) are significantly better germ killers than alcohol rubs containing alcohol alone.
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| − | ==Hand washing as compensation==
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| − | Excessive hand washing is commonly seen as a symptom of [[obsessive-compulsive disorder]] (OCD).
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| − | It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.<ref>Benedict Carey. [http://www.nytimes.com/2006/09/12/health/psychology/12macbeth.html Lady Macbeth Not Alone in Her Quest for Spotlessness.] ''[[The New York Times]]'', 12 September 2006</ref><ref>{{cite journal |author=Zhong CB, Liljenquist K |title=Washing away your sins: threatened morality and physical cleansing |journal=Science |volume=313 |issue=5792 |pages=1451–2 |year=2006 |pmid=16960010 |doi=10.1126/science.1130726}}</ref>
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| − | ==Symbolic hand washing==
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| − | [[Image:Tsukubai2.JPG|Tsukubai|thumb|[[Tsukubai]], provided at a Japanese temple for symbolic hand washing and mouth rinsing]]
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| − | [[Ritual purification|Ritual handwashing]] is a feature of many religions, including [[Bahá'í Faith]], [[Hinduism]] and [[Ablution in Judaism|tevilah and netilat yadayim]] in [[Judaism]]. Similar to these are the practises of [[Lavabo]] in [[Christianity]], [[Wudu]] in [[Islam]] and [[Misogi]] in [[Shintō]].
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| − | == Idioms ==
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| − | When someone "washes their hands of" something, this means that they are declaring their unwillingness to take responsibility for it or share complicity in it. [[Gospel of Matthew|Matthew]] 27:24 gives an account of [[Pontius Pilate]] washing his hands of the decision to crucify [[Jesus]]: "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, I am innocent of the blood of this just person: see ye to it."
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| − | == See also == | |
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| − | * [[Antibacterial soap]] | |
| − | * [[Escherichia coli O157:H7|E. coli O157:H7]]
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| − | * [[Antibiotic resistance]]
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| − | * [[Ignaz Semmelweis]]
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| − | * [[Soap dispenser]]
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| | == References == | | == References == |
| | + | <references/> |
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| − | *[http://www.internationalhygiene.org Hygiene Standard Institute] (HSI)
| + | [[Category:Medical treatments]] |
| − | {{reflist|2}}
| + | [[Category:Medical equipment]] |
| − | | + | [[Category:Heating devices]] |
| − | == External links ==
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| − | * [http://www.cdc.gov/handhygiene/ Centers for Disease Control on hand hygiene in healthcare settings]
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| − | [[Category:Hygiene]] | |
| − | [[Category:Medical hygiene]] | |
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| − | [[de:Händedesinfektion]] | + | [[de:Wärmekissen]] |
| − | [[fr:Hygiène des mains]] | + | [[nl:Natriumacetaat-verwarmertje]] |
| − | [[ja:手洗い]]
| + | [[sv:Värmekudde]] |
| − | [[simple:Hand washing]]
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| − | [[sv:Handtvagning]] | |
A heating pad is a pad used for warming of parts of the body in order to manage pain. Localized application of heat causes the blood vessels in that area to dilate, enhancing perfusion to the targeted tissue. Types of heating pads include electrical, chemical and hot water bottles.
Types
Electrical
Electric pads usually operate from household current and must have protection against overheating.
A moist heating pad is used dry on the user's skin. These pads register temperatures from 170 to 180 degrees Fahrenheit (76 to 82 °C) and are intended for deep tissue treatment and can be dangerous if left on unattended. Moist heating pads are used mainly by physical therapists but can be found for home use. A moist cloth can be added with a stupe cover to add more moisture to the treatment.
Chemical
Chemical pads employ a chemical heat reservoir or a one-time chemical reaction such as catalyzed rusting of iron.
A sodium acetate heat pad
A sodium acetate heat pad is a reusable heat reservoir. It contains a supersaturated solution of sodium acetate (CH3COONa). Crystallization is triggered by flexing a (patented &) small flat disc of notched ferrous metal embedded in the liquid. Pressing the disc releases very tiny adhered crystals of sodium acetate& into the solution which then act as nucleation sites for the recrystallization of the remainder of the salt solution. Because the liquid is supersaturated, this makes the solution crystallize suddenly, thereby releasing the energy of the crystal lattice.
See sodium acetate for a more technical discussion.
The pad can be reused by placing it in boiling water for 10-15 minutes, which redissolves the sodium acetate in the contained water and recreates a supersaturated solution. Once the pad has returned to room temperature it can be triggered again. Triggering the pad before it has reached room temperature results in the pad reaching a lower peak temperature, as compared to waiting until it had completely cooled.
High specific-heat capacity materials
Heating packs can also be made by filling a container with a material that has a high specific heat capacity, which then gradually releases the heat over time. A hot water bottle is the most familiar example of this type of heating pad.
A microwavable heating pad is a heating pad that is warmed by placing it in a microwave oven before use. Microwavable heating pads are typically made out of a thick insulative fabric such as flannel and filled with grains such as buckwheat or flax seed. Due to their relative simplicity to make, they are frequently sewn by hand, often with a custom shape to fit the intended area of use. In rare instances, these types of pads have been known to ignite during or after the microwave process and cause fires.
Often, aromatic compounds will also be added to the filler mixture to create a pleasant or soothing smell when heated. The source of these can vary significantly, ranging from adding essential oils to ground up spices such as cloves and nutmeg, or even dried rose petals.
Function
Many episodes of pain come from muscle exertion or strain, which creates tension in the muscles and soft tissues. This tension can constrict circulation, sending pain signals to the brain. Heat application eases pain by:
- jessica hyun surrounding the painful area. Increased blood flow provides additional oxygen and nutrients to help heal the damaged muscle tissue.
- stimulating sensation in the skin and therefore decreasing the pain signals being transmitted to the brain
- increasing the flexibility (and decreasing painful stiffness) of soft tissues surrounding the injured area, including muscles and connective tissue.
As many heating pads are portable, heat may be applied as needed at home, at work, or while traveling. Some physicians recommend alternating heat and ice for pain relief. As with any pain treatment, a physician should be consulted prior to beginning treatment.
See also
References
de:Wärmekissen
nl:Natriumacetaat-verwarmertje
sv:Värmekudde
