Cold sponging and tepid water sponging are the procedures use cooling properties of water to bring down temperature in the fever.
Apart from the difference in temperature of the water used, both procedures essentially are same.
Cold sponging is not preferred now a days and tepid sponging is done to control the fever.
Both the terms are used interchangeably in the clinical practice.
[Please also go through the NICE guidelines, 2007 which recommend against tepid water sponging]
So when a person is asked to be cold sponged by a physician, in the end what might actually be happening is tepid water sponging or bath.
The term bath is also used interchanged with sponging. However, bathing means bathing by sponging. Practically there is no difference.
The terms have been used interchangeably in this article too.
In case of high fever [>102° F], it is important to control it as further rise of the temperature may lead to febrile. By using the cold sponge method, you are trying to bring down the temperature of the body
Sponging helps control body temperature. Studies have shown that sponging a fevered patient down with water is extremely effective in reducing fever.
Water has been known to cool the body twenty times than air due to the evaporation process. Water applied to the body surface evaporates leaving the surface cooler. This skin surface is able to extract more heat from the inner body and thus reducing overall heat content.
Cold Water Sponging or Tepid Water Sponging?
For cold sponging temperature of water for cold sponging is below 70°F. Usually 65°F.
Temperature of water for tepid sponging—78°F—90°F.
The studies also have shown that sponging with colder water created no significant difference in temperature reduction.
With use of cold water, the temperature difference is too severe and it the cold water cause the body to constrict the blood vessels. This in fact may cause retention of the heat if the vessels are not dilated enough for heat exchange. So the outer surface of the body would be cooler whereas the internal heat would be retained.
Moreover, the cold water adds to discomfort and may cause shivering which in fact would result in increased heat.
Therefore, cold sponging is almost never done for fever. It could be part of treatment in acute injuries to reduce swelling but in fever tepid sponging or tepid water bath is the preferred procedure.
But somehow, the phrase has stuck and physician might just mention cold sponging when she actually wants tepid bath for the patient.
Procedure of Tepid Water Sponging [or Cold Sponging]
- Wash basin
- Tepid water
- Large rubber mackintosh to cover whole length of bed
- Bath towel
- Bucket for collection of waste water
- Before doing, the inform the proceeding to the patient.
- Take patient’s temperature before starting the procedure
- Remove patient’s clothing from body.
- Bath the face, upper half of the body and then lower half.
- Place a cool moist cloth over axilla and groin.
- Change the cloth when it is warm.
- Change the water when it is warm by discarding in bucket.
- Do not wipe and dry with towel. Let the water stick and evaporate as evaporation causes cooling.
- After whole body sponging is completed, dry the patient by dabbing with towel
- The entire sponging should take 15 to 20 minutes.
Tepid Sponging in a Child
For sponging the child, place her in a bath with 1 to 2 inches of tepid water. If child starts to shiver, then the water is too cold.
Seat the child in the water. Using a clean washcloth or sponge, spread a film of water over his trunk, arms, and legs.
If child resists actively just let her sit down and play.
Is Tepid Water Sponging Effective in Reducing Fever?
Sponging produces a more rapid reduction in body temperature. The effect though is short lasting and repeated sponging may be needed. For long time the use of antipyretic medicine like acetaminophen should be used.
Cold or tepid water sponging may serve to bring down the fever when the medicine is not available or is to be arranged.
In 2007, NICE guidelines for fever recommended against tepid sponging in children. You can read the guidelines by clicking following link.