For use in packs take coarse, previously used and loosely woven linen,
which readily absorbs water and clings closely to the body.
After each pack the linen must be rinsed well and boiled and the woollen
material or blanket must be thoroughly aired. From time to time the
woollen covering must be washed, or chemically cleaned, if possible.
Raw silk is an excellent substitute for linen. It clings well to the
body, does not cause any discomfort, and has an excellent absorbing
quality for water and other substances.
The proper application of the pack is of course of great importance.
Adults can easily apply many of the packs without assistance, but
generally speaking a third person is necessary, whether in the case of
children or patients. It is consequently advisable for every mother to
become thoroughly familiar with the methods of applying packs, and she
should always have the necessary material on hand. It should be cut to
the proper size, and there should be duplicates of each piece for the
necessary changes. The approximate measurements for adults are:
=Width= =Length=
Neck pack 5" 40" to 60"
Shoulder pack 10" 40"
Abdominal pack 28" 40" to 60"
Breast or stomach pack 16" 52" to 60"
"T" pack 16" 52" to 60"
Cross piece alone 5" 24"
The shawl 32" to 40" 32" to 40"
Scotch pack (undivided) 16" 80" to 100"
Same for children 10" to 16" 60" to 80"
Calf pack 24" 26"
Leg pack 24" 30"
Three-quarter pack 56" 52" to 60"
Whole pack 68" 80"
The measurements for children are accordingly shorter and narrower.
As to the application of packs, a mother can learn a great deal by
experimenting on her own body. Packs at night are by no means
detrimental to adults, and the application of a regular abdominal pack,
a three-quarter pack, and a whole pack once a week or once every two
weeks is decidedly advantageous. Three-quarter and whole packs should
be occasionally tried on the body of children with dry linen so that in
case of disease the mother will be a well trained nurse, at least in
this respect.
To go about the application of the pack quietly and without much talking
is very comforting to the patient, who usually grows excited during the
procedure.
In case of acute feverish disease the packs and the changes must be
applied very quickly, so that the patient will not catch cold. While, as
a rule, the patient should not be disturbed in a quiet sleep,
unconsciousness or delirium must not prevent change of the pack.
Packs should be applied so as not to cause any creases which may hurt
the patient.
The temperature of the water used for packs should be as follows:
For the cooling packs, 59 degrees to 64 degrees.
For dissolving packs, 64 degrees to 71 degrees.
The higher temperature is used in the treatment of infants, nervous and
anaemic persons.
In chronic diseases a gradual return to a lower temperature by about
2-1/2 degrees per week is advisable.
No packs or compresses should be put on when parts of the body are cold.
In such cases the parts in question must first be warmed.
The linen should be wrung out less for short cooling compresses than for
dissolving packs of longer duration.
Cooling compresses must be changed as soon as the patient indicates that
he feels oppressed or irritated by the heat.
As a general rule, packs on the legs may be left on feverish patients
twice as long as packs on the upper parts of the body.
No fever being apparent, the abdominal pack may be changed after about
2-1/2 hours, the leg pack after 5 hours, and even not at all during the
night. Packs should be renewed according to requirements of the
individual patient, not in accordance with fixed rules.
Great care must be exercised to fasten the packs well and tightly. This
is usually done with good strong safety pins; these should be fastened
perpendicularly, or at right angles to the length of the material.
When changing the pack on feverish patients who are to receive an
ablution or a bath two or three times a day, all pins must be loosened
under the bedcovers so that the pack may be removed quickly.
If ablutions only are to be given, the pack is removed gradually as the
respective parts of the body are to be washed.
When the fever is moderate, there should be ablutions morning and
evening, or a bath in the morning and an ablution in the evening.
When packs are applied only at night, patients require only an ablution
in the morning.
If the packs are not renewed, an ablution must follow the removal. This
refreshes and strengthens the skin, closes the wide open pores and
prevents taking cold.
Dissolving packs, if annoying at night, may be removed under the
bedcovers without an ablution.
If the pack is changed without intervening ablution, the new pack must
be ready to be applied before the old, hot one, is taken off.
While in a pack, the patient should not leave his bed, not even for the
purpose of urinating or for stool.