Step-by-Step Fomentation Instructions

Articles Needed:

1)  Large pot or canner of boiling water
2)  4 Fomentations towels (bath towels)
3)  6-8 additional bath towels
4)  Basin of warm water (104 degrees) for the feet

5)  Kettle of hot water (to be added to the foot bath as needed)
5)  Basin of ice water with 2 washcloths
6)  Rubber gloves for handling the hot fomentations

Procedure:

1)  Have the room warm, with no drafts.

2)  Place a plastic sheet (shower curtain) on the bed to protect from spills.

3)  Cover the plastic with a sheet.

4)  Place a pillow on the bed.

5)  Prepare the first fomentation for the patient to lie on: Fold one fomentation towel into two or three thicknesses (fomentation should be about 10-12 inches wide by 24 inches long). Grasp the ends and twist the fomentation. Immerse into the boiling water all but the ends you are holding. Lift and continue twisting. Stretch or pull the twisted fomentation to wring as dry as possible. Untwist quickly, and lay on a dry towel. Fold double and roll tightly to hold the heat. Carry to the bedside.

6)  Lay fomentation on the upper end of the bed and cover with a dry towel.

7)  Have patient lie down on the bed. Patient should be wearing only shorts or underwear. If the fomentation is too hot, add another dry towel.

8)  Cover patient with a sheet and a blanket.

9)  Uncover the patient’s feet and help them lift their legs and place them in a basin of warm water. Completely wrap the basin and the legs with the sheet and the blanket. Have a kettle handy to add more hot water. When adding hot water, be sure to place your hand between the stream of water and the feet to prevent burns. Note: Do NOT use the foot bath if the patient has diabetes or neuropathy in their lower limbs.

10)  Prepare the next fomentation (follow step 5 above).

11)  Pull the sheet and blanket back and lay a dry towel on patient’s chest. Place the hot fomentation over the towel and cover with another dry towel to hold the heat in. Have more towels handy to add if the fomentation is still too hot. Leave fomentation in place for 3-5 minutes. Have the next fomentation ready to replace the one being removed.

12)  Between changes, wring out the washcloth in the ice water and rub it over the chest area for 20-30 seconds. Wipe moisture from the skin before applying the next fomentation. All changes should be made quickly with the treatment area exposed as little as possible.

13)  When the patient begins to sweat, wring out the washcloth in the ice water, fold in half, and place on patient’s forehead.

14)  Do three to six applications. Finish with the ice water rub and dry thoroughly.

15)  Raise the patient’s feet above the basin of warm water and pour the ice water over them. Dry thoroughly.

16)  Cover patient and have them rest for at least 30 minutes.

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Alternate Methods for Heating Fomentations

Steaming Method:

1)  Soak completely and wring out 4-6 towels in warm water. Roll them up.
2)  Fill a canner with 2 inches of water and bring to a boil.
3)  Turn the canner rack upside down in the canner and place the towels on the rack, being careful to keep them above the water.
4)  Boil for 20 minutes.

Microwave Method:

1)  Soak towels in cold water and wring them out. Roll them up.
2)  Place a single towel in a plastic bag.
3)  Place the bag in the microwave and heat on high for 4 minutes.

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For those who want to make fomentation treatments a bit easier, you can purchase the DynaHeat Moist Hot Packs in both the 14” x 24” and 10” x 24” sizes. Follow the instructions in the box to heat both packs and then wrap them in towels. These will hold heat for 30 minutes. The larger size would be the one for the spine and the smaller one would be used to place over the lungs, following the above instructions.

 

The Theratherm Automatic Moist Heat Pack can also be used. Mist the outside covering for more moist heat. Amazon links for these items are on the Home page.

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For more detailed information on hydrotherapy, see: Hydrotherapy for COVID-19.