Cryotherapy is growing in popularity for pain and inflammation reduction. It uses nitrogen to quickly cool the body, to trigger a cold-shock response. This response increases blood flow to the extremities along with neurotransmitters that the cold-shock response causes your body to release, both of which help with inflammation, recovery and other health benefits.
Like any spa procedure, there are risks that are inherent with the therapy and this is why safety measures for cryotherapy are vitally important. You owe your clients the utmost in quality care, which means taking steps to make sure that their experience is safe.
The best safety measure you can have is trained operators. All spa employees working with cryotherapy need to be fully trained not only on spa procedures but on how to operate the machines themselves. New staff should be fully trained and comfortable with operating any equipment prior to operating it on their own with clients. All staff should be fully trained on any new equipment prior to operating it with clients.
All staff should be trained on your basic safety measures, such as client health screening, client interactions, setting up equipment for use, cleaning equipment and rooms between clients, steps to take in case of an emergency, etc. Having a written safety manual that is strictly enforced is important for client safety. Checklists or an emergency plan, clearly outline the steps to take in case of a medical emergency, equipment malfunction or just a general problem outside of normal operations.
CPR training for all staff is another safety measure. By requiring CPR certification for staff, as well as keeping a portable defibrillator on hand that staff has been trained to use, it will help ensure patient safety in the event of a medical emergency.
The outer extremities are the most susceptible to cold. Clients should wear a face mask to protect their nose, gloves, and socks before using the chamber. These can be provided or clients can bring their own socks, gloves or mask, but these should be required, at a minimum for every client when using cryotherapy. Earmuffs or a hat can also be provided in case a client requests it.
As with any therapy, certain medical conditions mean that cryotherapy is not appropriate to use. It should be standard procedure to have new clients complete a health history form prior to any treatment. This will ensure that proper screening for conditions that make cryotherapy inappropriate for patients with certain health conditions. For existing patients, an updated medical history should be completed every 6 months to every year to ensure no new conditions have developed that could cause a problem during treatment.
Oral histories are not sufficient, as a file should have clear documentation. If you take an oral history, have a form that can be completed by an employee so it can then printed, reviewed and signed by a client. Clients should also sign waivers stating that they understand the risks of Cryotherapy and new waivers should be signed yearly or every six months.
Cryotherapy should not be used by anybody under 18 or those with the following conditions:
- Raynaud’s Syndrome
- Seizure disorder that is not well managed with medication
- Uncontrolled hypertension that is considered severe
- Venous Thrombosis
- Implanted medical devices
- Peripheral arterial diseases
- Recent or acute myocardial infarction
- Recent or acute cerebrovascular accidents
- Cardiovascular disease that is symptomatic
- Lung disorders that are symptomatic
- Angina pectoris that is unstable
- Bleeding disorders
- Urinary Tract or Kidney diseases that are acute
- Cancer patients
- Those suffering from claustrophobia
Cryotherapy should be limited to a maximum time of three minutes only. Most machines have built-in timers and shut off timers, but in the case of equipment failure, there should always be somebody monitoring the use of the equipment when it is in use.
Unattended usage of cryotherapy is a leading reason for injury or death. There should always be a trained staff member present for every session. At no time should any session ever go over three minutes, which is another reason why clients should be monitored the entire time. In the event that there is no automatic shut off, you need to have trained staff monitoring the time of use to end the session at three minutes or before.
Another reason for having constant supervision is to make sure there are no medical problems that arise during the session. Although sessions are only three minutes or less, that is all it takes for somebody who did not disclose a known medical condition to have a problem, or for somebody to have a panic or anxiety attack in the chamber. Sessions should be stopped immediately and established procedures followed for medical emergencies.
Nitrogen is odorless and colorless. While it is not a toxic case, it displaced the oxygen in the air, which can cause asphyxiation. If there is a malfunction or a gas leak, there needs to be a way for it to be detected. Oxygen monitors are necessary to measure oxygen levels. Oxygen levels should be monitored to detect if nitrogen is leaking into the chamber, making the oxygen levels drop too low.
Oxygen monitors will alert prior to oxygen levels dropping to dangerous levels. Oxygen monitors should be placed wherever the gas is in use or being stored. Overlooking placing a monitor in the rooms where nitrogen is stored is highly dangerous in the event of a leaking container of gas.
Signs need to be posted, per OSHA standards, warning of the risks of exposure to nitrogen, and for handling it. Signs should be posted in the storage area and in the chambers.
Cryotherapy chambers and equipment need to have a way to vent the nitrogen. Proper ventilation through the use of exhaust fans is necessary.
All equipment should be inspected and tested on a regular basis. Any irregularities in how they operate need to be addressed immediately. Using a machine that is not functioning properly is dangerous. Use checklists for daily inspections for all aspects of the equipment to ensure it is not damaged and working properly.
Of course, with the risk involved you need the proper cryotherapy insurance while running a business with this type of exposure. Please contact us and we will be happy to help in any way that we can.