Ice should be placed over the injured part as soon as possible. Cold will cause constriction of the blood vessels, which will reduce internal bleeding and fluid exudate. This will prevent excessive bleeding and swelling. Cold also reduces the sensitivity of pain receptors and the conductivity of nerves. It numbs the area, reducing muscle spasm and tension.
Care must be taken when applying the ice as there is a risk of producing ice burns if the ice is in direct contact with the skin for some time. A wet towel should be placed on the skin to protect it and the ice placed on top. There are various ways of applying ice - freezer gel packs are the most convenient, but packs of frozen food can also be used. These are placed over the towel and held in place by another towel wrapped around the part, which will also apply compression. Ice cubes can be crushed and placed inside a towel and placed over the area. Injuries to the ankle or wrist can be treated by immersing the injured part in a bucket of iced water. The part should be held in the water for as long as is tolerable, removed for a few minutes and then re-immersed. Ice packs are kept in place for 10-15 minutes and applied every three or four hours initially, decreasing to three times a day as healing progresses.
Cold sprays are commonly used in sport as they are easy to carry and convenient to use. However, they are not as effective as ice packs as they do not cool the deeper tissues. They are effective only on superficial tissues and are not recommended for use on acute traumas. Overuse in an attempt to reach deeper tissues can result in ice burns to the skin.
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