i. Careful monitoring is needed because of transient increases that can occur in systolic and diastolic blood pressure.
ii. Treatment should be discontinued if increase in blood pressure is seen.
b. Elderly patients
i. Decreased efficiency with vasoconstriction.
ii. Therefore, they have decreased ability to conserve heat.
c. Length of treatment
i. Do not use cold gel packs longer than 15-20 minutes directly on skin, and do not apply any cryotherapy directly to skin for > 1 hour continuously.
ii. Extended treatment may lead to neurapraxia or axonotmesis of superficial peripheral nerves.