USES

1. Children whose fever does not respond to antipyretics

or who are very uncomfortable, e.g., fever > 104° F
(40° C)

2. Children whose temperature elevation is caused by

heatstroke or malignant hyperthermia

NOTE: The procedure is controversial and may not be
used in all agencies.

EQUIPMENT
Washbasin or bathtub
Tepid water (body temperature; should not feel warm or

cold to touch)

Washcloths, small towels, or gauze squares
Dry towels and/or bath blanket
Plastic sheet to protect bed (optional)

SAFETY

1. Physical modalities should not be used until 30 minutes

to 1 hour after administering antipyretics. Use of physi-
cal modalities may activate heat conserving and produc-
ing mechanisms. Using physical modalities for treating
fever provides no additional benefit over antipyretics
alone and frequently are associated with increased client
discomfort. Physical modalities, however, are appropri-
ate measures for treating hyperthermia.

2. Never use cold water or alcohol for a sponge bath to

reduce fever.
a. Cold water can cause vasoconstriction and shivering,

which raises the central body temperature.

b. Alcohol reduces fever too rapidly and may lead to

convulsions, especially in a small child.

c. Alcohol fumes are toxic.
d. Both can make the child uncomfortable.

PROCEDURE

1. Gather equipment. Promotes organization and effi-

ciency.

2. Explain procedure to child and family. Enhances cooper-

ation and participation and reduces anxiety and fear.

3. Wash hands. Reduces transmission of microorganisms.
4. Take temperature, pulse, and respirations before pro-

ceeding. Provides a baseline for determining effective-
ness of treatment.

5. Undress child or expose areas where there are large

superficial blood vessels such as the axillary and inguinal
regions. Facilitates heat loss.

6. Sponge with tepid water. Avoid chilling. Shivering will

increase heat production and decrease heat loss.
a. Child may be placed in tub for sponge bath or in bed

using a basin of water. Protect the bed with a plastic
sheet covered with a bath blanket.

b. Use gentle friction and slowly stroke the wet wash-

cloth over body. Brings blood to surface to help dissi-
pate heat.

7. Sponge for 12–30 minutes unless child becomes chilled.
8. Pat child dry with a towel and redress in lightweight

clothing.

9. Take child’s temperature immediately after discontinu-

ing sponging and again 30 minutes later.

DOCUMENTATION

1. Time and duration of sponging.
2. Temperature and other vital signs.
3. How procedure tolerated, including child’s response.

48

Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.

SKILL 17

SKILL 17

Sponge Bath