RICE: Difference between revisions

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'''RICE''' is an acronym that stands for '''R'''est, '''I'''ce, '''C'''ompression and '''E'''levation and is a way to remember the correct management in the first 24 hours following acute soft tissue injuries involving damaged blood vessels. Minimising bleeding inthis way at the injury site is important because the application of a more aggressive intervention, for example, [[massage]], will cause further tissue damageWhen used appropriately, the RICE approach can improve recovery time and reduce discomfort.
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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== References ==


* '''Rest''' - to reduce the likelihood of further damage to the tissues through increased bleeding, avoid [[weightbearing]] or any strenuous activity involving the injured part, which will increase the time required for tissue to repair.
References will automatically be added here, see [[Adding References|adding references tutorial]].  


* '''Ice''' - ice will reduce tissue metabolism <ref>Bleakley, C., McDonough, S. & MacAuley, D.  The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.  ''American Journal of Sports Medicine'', 2004; 32(1):251-61.</ref> and also cause blood vessel constriction which will in turn slow down and prevent further swelling, an important consideration when beginning active ROM exercises after the initial period of rest has passed and when pain has been reduced.  ''Note: applying ice for an extended period of time may be detrimental, as blood flow will be reduced excessively and skin burns and nerve damage may occur.  There is no good evidence for how long or how often ice should be applied, but systematic reviews suggest that intermittent, 10 minute ice treatments are most effective''<ref>Brucker, P. & Kahn, K. (2006). ''Clinical Sports Medicine'', page 130.</ref>.
<references />


* '''Compression''' - compression serves to prevent further [[oedema]] (swelling) as a result of the [[inflammation|inflammatory]] process and also by reducing bleeding.  An elasticated bandage should be used to provide a comfortable compression force without causing pain or constricting blood vessels to the point of occlusion.  Bandaging should begin distal to the injury and move proximally, overlapping each previous layer by one half.  It can also serve to provide minimal protection of the injured body part from excessive movement, although this is not it's primary purpose.
==Introduction==


* '''Elevation''' - will prevent swelling by increasing venous return to the systemic circulation, and reducing hydrostatic pressure thereby reducing oedema and facilitating waste removal from the site of injury. Ensure that the lower limb is above the level of the pelvis.
'''RICE''' is an acronym that stands for '''R'''est, '''I'''ce, '''C'''ompression and '''E'''levation and is a way to remember the correct management in the first 24 hours following acute soft tissue injuries involving damaged blood vessels. Minimising bleeding inthis way at the injury site is important because the application of a more aggressive intervention, for example, [[Massage]], will cause further tissue damage. When used appropriately, the RICE approach can improve recovery time and reduce discomfort.  


=== Variations ===
==Rest==


* '''HI-RICE''' - Hydration, Ibuprofen, Rest, Ice, Compression, Elevation.
Rest to reduce the likelihood of further damage to the tissues through increased bleeding, avoid [[Weightbearing]] or any strenuous activity involving the injured part, which will increase the time required for tissue to repair.
* '''PRICE''', Protect, Rest, Ice, Compression, Elevation (i.e. using crutches to protect the painful part from further injury).
* '''PRICES''' - Protection, Rest, Ice, Compression, Elevation and Support (e.g. bandaging or taping).
* '''PRINCE''' - Protection, Rest, Ice, [[NSAID]]s, Compression, and Elevation.
* '''RICER''' - Rest, Ice, Compression, Elevation, Referral.


=== In-text citations ===
==Ice==
<references/>


=== Sources ===
Ice will reduce tissue metabolism <ref>Bleakley, C., McDonough, S. &amp; MacAuley, D.  The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.  ''American Journal of Sports Medicine'', 2004; 32(1):251-61.</ref> and also cause blood vessel constriction which will in turn slow down and prevent further swelling, an important consideration when beginning active ROM exercises after the initial period of rest has passed and when pain has been reduced. ''Note: applying ice for an extended period of time may be detrimental, as blood flow will be reduced excessively and skin burns and nerve damage may occur. There is no good evidence for how long or how often ice should be applied, but systematic reviews suggest that intermittent, 10 minute ice treatments are most effective''<ref>Brucker, P. &amp; Kahn, K. (2006). ''Clinical Sports Medicine'', page 130.</ref>.


* Brucker, P. & Kahn, K. (2006). ''Clinical Sports Medicine (third edition)''.  McGraw Hill Australia, Pty. Ltd.
==Compression==
* RICE (medicine). (2008, October 21).  In Wikipedia, The Free Encyclopedia. Retrieved 09:02, January 17, 2009, from http://en.wikipedia.org/w/index.php?title=RICE_(medicine)&oldid=246661676


Compression serves to prevent further [[Oedema]] (swelling) as a result of the [[Inflammation|inflammatory]] process and also by reducing bleeding. An elasticated bandage should be used to provide a comfortable compression force without causing pain or constricting blood vessels to the point of occlusion. Bandaging should begin distal to the injury and move proximally, overlapping each previous layer by one half. It can also serve to provide minimal protection of the injured body part from excessive movement, although this is not it's primary purpose.


[[Category:Intervention]][[Category:Open Physio]]
==Elevation==
 
Elevation will prevent swelling by increasing venous return to the systemic circulation, and reducing hydrostatic pressure thereby reducing oedema and facilitating waste removal from the site of injury. Ensure that the lower limb is above the level of the pelvis.
 
=== Variations  ===
 
*'''HI-RICE''' - Hydration, Ibuprofen, Rest, Ice, Compression, Elevation.
*'''PRICE''', Protect, Rest, Ice, Compression, Elevation (i.e. using crutches to protect the painful part from further injury).
*'''PRICES''' - Protection, Rest, Ice, Compression, Elevation and Support (e.g. bandaging or taping).
*'''PRINCE''' - Protection, Rest, Ice, [[NSAID]]s, Compression, and Elevation.
*'''RICER''' - Rest, Ice, Compression, Elevation, Referral.
 
=== Sources  ===
 
*Brucker, P. &amp; Kahn, K. (2006). ''Clinical Sports Medicine (third edition)''. McGraw Hill Australia, Pty. Ltd.
*RICE (medicine). (2008, October 21). In Wikipedia, The Free Encyclopedia. Retrieved 09:02, January 17, 2009, from http://en.wikipedia.org/w/index.php?title=RICE_(medicine)&amp;oldid=246661676
 
[[Category:Intervention]] [[Category:Open_Physio]]

Revision as of 22:38, 30 May 2011

Original Editor - Your name will be added here if you created the original content for this page.

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.


Introduction[edit | edit source]

RICE is an acronym that stands for Rest, Ice, Compression and Elevation and is a way to remember the correct management in the first 24 hours following acute soft tissue injuries involving damaged blood vessels. Minimising bleeding inthis way at the injury site is important because the application of a more aggressive intervention, for example, Massage, will cause further tissue damage. When used appropriately, the RICE approach can improve recovery time and reduce discomfort.

Rest[edit | edit source]

Rest to reduce the likelihood of further damage to the tissues through increased bleeding, avoid Weightbearing or any strenuous activity involving the injured part, which will increase the time required for tissue to repair.

Ice[edit | edit source]

Ice will reduce tissue metabolism [1] and also cause blood vessel constriction which will in turn slow down and prevent further swelling, an important consideration when beginning active ROM exercises after the initial period of rest has passed and when pain has been reduced. Note: applying ice for an extended period of time may be detrimental, as blood flow will be reduced excessively and skin burns and nerve damage may occur. There is no good evidence for how long or how often ice should be applied, but systematic reviews suggest that intermittent, 10 minute ice treatments are most effective[2].

Compression[edit | edit source]

Compression serves to prevent further Oedema (swelling) as a result of the inflammatory process and also by reducing bleeding. An elasticated bandage should be used to provide a comfortable compression force without causing pain or constricting blood vessels to the point of occlusion. Bandaging should begin distal to the injury and move proximally, overlapping each previous layer by one half. It can also serve to provide minimal protection of the injured body part from excessive movement, although this is not it's primary purpose.

Elevation[edit | edit source]

Elevation will prevent swelling by increasing venous return to the systemic circulation, and reducing hydrostatic pressure thereby reducing oedema and facilitating waste removal from the site of injury. Ensure that the lower limb is above the level of the pelvis.

Variations[edit | edit source]

  • HI-RICE - Hydration, Ibuprofen, Rest, Ice, Compression, Elevation.
  • PRICE, Protect, Rest, Ice, Compression, Elevation (i.e. using crutches to protect the painful part from further injury).
  • PRICES - Protection, Rest, Ice, Compression, Elevation and Support (e.g. bandaging or taping).
  • PRINCE - Protection, Rest, Ice, NSAIDs, Compression, and Elevation.
  • RICER - Rest, Ice, Compression, Elevation, Referral.

Sources[edit | edit source]

  1. Bleakley, C., McDonough, S. & MacAuley, D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. American Journal of Sports Medicine, 2004; 32(1):251-61.
  2. Brucker, P. & Kahn, K. (2006). Clinical Sports Medicine, page 130.