Nursing Component Task
Nursing procedures & clinical learning

General Nursing (RGN)

TEPID SPONGING

Tepid sponging is the application of lukewarm water on the skin surface when the body temperature is above 39℃. The temperature of the water used should be between 27-37℃. The procedure is based on the principle of conduction and evaporation of heat.

Purpose

  • Gradually reduce a patient's body temperature by not more than 1℃ at a time
  • Ultimately reduce the body's temperature to a value between the normal range (36.5 – 37.2℃)

Indications

  • Fever or elevated body temperature when tepid sponging is clinically appropriate
  • Patient discomfort associated with elevated temperature
  • Adjunctive cooling when prescribed or included in the patient's plan of care

Equipment

  • A trolley containing the following:
  • Top shelf:
  • Two bowls/basin
  • 6-8 small towels
  • Vital signs tray
  • Bath thermometer (if available)

Procedure steps

  • Establish rapport with patient and relatives (Refer to steps)
  • Explain procedure to patient and relatives (Refer to steps)
  • Provide privacy
  • Perform hand hygiene
  • Prepare trolley and send to the bedside
  • Check and record patient's temperature
  • Arrange top bed/counterpane clothes leaving top sheet
  • Protect bottom sheet with a long mackintosh and bath blanket
  • Undress the patient leaving him/her covered with the top sheet
  • Prepare the tepid water in the bowl/basin, test the water with the bath thermometer or elbow
  • Place the pieces of towels into the basin with tepid water
  • Squeeze out excess water, place a wet towel in each axilla and groin
  • Change the wet towel frequently to keep them tepid
  • Sponge lower limbs, trunk, back and upper arms in strokes
  • Wash and dry the face of the patient to refresh him/her
  • Place the wet towel on the forehead of patient
  • Leave small drops of water on the skin
  • Change water as often as necessary
  • Leave patient for 15-20 minutes
  • Cover the patient with the top bedclothing
  • Recheck temperature and record
  • Repeat procedure till temperature falls by 1℃
  • Remove long mackintosh and bath blanket
  • Assist patient to dress up and put him/her into a desirable position
  • Perform hand hygiene
  • Serve cold drink if patient can tolerate
  • Serve prescribed antipyretic
  • Document procedures, chart temperature and report findings to appropriate officer

Precautions

  • Use tepid/lukewarm water and avoid ice-cold water
  • Monitor the patient's temperature and response throughout the procedure
  • Avoid excessive exposure of the patient and prevent chilling
  • Stop the procedure if the patient develops shivering, marked discomfort, cyanosis or deterioration
  • Use additional caution in vulnerable patients and follow facility protocol
  • Maintain standard infection-prevention precautions
  • Administer antipyretics only when prescribed or otherwise authorized

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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