RICE (medicine)


RICE (medicine)

RICE is a treatment method for soft tissue injury which is an acronym for Rest, Ice, Compression and Elevation.[1][2][3] When used appropriately, recovery duration is usually shortened and discomfort minimized.[citation needed]

RICE is considered a first-aid treatment, rather than a cure for soft tissue injuries. The aim is to manage discomfort and internal bleeding.[4]

Contents

Primary four terms

Rest

Rest is a key part of repair. Without rest, continual strain is placed on the area, leading to increased inflammation, pain, and possible further injury. Also, most soft tissue injuries will take far longer to heal. There is also a risk of abnormal repair or chronic inflammation resulting from a failure to rest. In general, the rest should be until the patient is able to use the limb with the majority of function restored and pain essentially gone.

Ice

Ice is excellent at reducing the inflammatory response and the pain from heat generated[citation needed]. Proper usage of ice can reduce the destruction over-response which can result from inflammation.[citation needed] A good method is ice 20 minutes of each hour. Other recommendations are an alternation of ice and no-ice for 15–20 minutes each, for a 24–48 hour period.[5] To prevent localised ischemia or frostbite to the skin, it is recommended that the ice be placed within a towel before wrapping around the area.

Exceeding the recommended time for ice application may be detrimental, as blood flow will be too reduced to allow nutrient delivery and waste removal.

Compression

Compression aims to reduce the edematous swelling that results from the inflammatory process. Although some swelling is inevitable, too much swelling results in significant loss of function, excessive pain and eventual slowing of blood flow through vessel restriction.[citation needed]

An elastic bandage, rather than a firm plastic bandage (such as zinc-oxide tape) is required. Usage of a tight, non-elastic bandage will result in reduction of adequate blood flow, potentially causing ischemia. The fit should be snug so as to not move freely, but still allow expansion for when muscles contract and fill with blood.

Elevation

Elevation aims to reduce swelling by increasing venous return of blood to the systemic circulation. This will not only result in less edema, but also aid in waste product removal from the area.[citation needed]

Variations

Variations of the acronym are sometimes used, to emphasize additional steps that should be taken. These include:

  • "HI-RICE" - Hydration, Ibuprofen, Rest, Ice, Compression and Elevation
  • "PRICE" - Protection, Rest, Ice, Compression and Elevation[6][7][8]
  • "PRICE" - Pulse (Typically Radial or Distal), Rest, Ice, Compression, and Elevation
  • "PRICES" - Protection, Rest, Ice, Compression, Elevation and Support
  • "PRINCE" - Protection, Rest, Ice, NSAIDs, Compression, and Elevation[9]
  • "RICER" - Rest, Ice, Compression, Elevation, Referral[10]
  • "DRICE" - Diagnosis, Rest, Ice, Compression, Elevation

Alternatives

As RICE and its variations work[citation needed] by reducing blood flow to the injured area, some people argue that for some types of injuries (such as ligaments and tendons) a protocol that increases blood flow, such as MEAT (Movement, Exercise, Analgesics and Treatments) should be used instead.[11]

See also

References

  1. ^ "R.I.C.E - Best for Acute Injuries". http://sportsmedicine.about.com/cs/rehab/a/rice.htm. Retrieved 2007-08-15. 
  2. ^ "Sports Medicine Advisor 2005.4: RICE: Rest, Ice, Compression, and Elevation for Injuries". Archived from the original on 2007-09-11. http://web.archive.org/web/20070911021102/http://med.umich.edu/1libr/sma/sma_rice_sma.htm. Retrieved 2007-08-15. 
  3. ^ Mnemonic at medicalmnemonics.com 235
  4. ^ Järvinen TA, Järvinen TL, Kääriäinen M, et al. (2007). "Muscle injuries: optimising recovery". Best practice & research. Clinical rheumatology 21 (2): 317–31. doi:10.1016/j.berh.2006.12.004. PMID 17512485. 
  5. ^ RICE: Rest, Ice, Compression, and Elevation for Injuries on the website of the University of Michigan Health System, retrieved 28 July 2008
  6. ^ "Sprains and strains: Self-care - MayoClinic.com". http://www.mayoclinic.com/health/sprains-and-strains/DS00343/DSECTION=9. Retrieved 2007-08-15. 
  7. ^ Ivins D (2006). "Acute ankle sprain: an update". American Family Physician 74 (10): 1714–20. PMID 17137000. 
  8. ^ Bleakley CM, O'Connor S, Tully MA, Rocke LG, Macauley DC, McDonough SM (2007). "The PRICE study (Protection Rest Ice Compression Elevation): design of a randomised controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain [ISRCTN13903946"]. BMC Musculoskelet Disord 8: 125. doi:10.1186/1471-2474-8-125. PMC 2228299. PMID 18093299. http://www.biomedcentral.com/1471-2474/8/125. 
  9. ^ "Ankle sprain - Yahoo! Health". http://health.yahoo.com/other-other/ankle-sprain/healthwise--te7580.html. Retrieved 2008-02-23. 
  10. ^ "SmartPlay : Managing your Injuries". http://www.smasa.asn.au/smartplay/ouch/injury_manage/injury_info.html. Retrieved 2008-05-28. 
  11. ^ "MEAT vs RICE treatmentwork=". http://www.caringmedical.com/symptoms/meatvsrice.asp. 

External links


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