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S3 - Clinical Practice 2 > E-Stim Competency > Flashcards

E-Stim Competency Flashcards

1
Q

NMES

A

NMES

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2
Q

What is the purpose/goals of NMES?

A
  • Atrophy treatment/prevention
  • Strengthening
  • Achieve synchronous firing/recruitment of motor units
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3
Q

What is the pulse frequency of NMES?

A

30-100 pps

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4
Q

What is the pulse width/duration of NMES?

A

200-800 usec

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5
Q

With NMES, what should the intensity feel like for the patient?

A

Their max tolerance

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6
Q

What is the ramp up time and on/off time for NMES?

A
  • Ramp up= 1-5s

- On/off = 10s:50s

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7
Q

What is the electrode placement for NMES?

A

bipolar electrode placement parallel to the direction of the m. fibers

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8
Q

How would you describe NMES to the patient?

A

Ok “Zack”, today I’d like to go through and do some electrical stimulation if that’s ok with you. For NMES we’re trying to get our muscles to contract so we can kind of reeducate our muscle to prevent decrease in our muscle mass (atrophy). You might feel some tingling when we first start, I want you to try and work through that until we can get our muscles to contract. It should feel uncomfortable, but not painful. As we go through if you think you can handle more just let me know. We want to try and increase if we can so our muscles don’t adapt to what we’re giving it.

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9
Q

IFC

A

IFC

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10
Q

What is the purpose/goals of IFC?

A
  • most common for pain

- can be used for edema

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11
Q

What is the pulse frequency of IFC?

A

10-150 pps

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12
Q

What is the pulse width/duration of IFC?

A

200-400 usec

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13
Q

With IFC, what should the intensity feel like for the patient?

A

Strong but tolerable, no muscle contraction

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14
Q

How long do we perform IFC?

A

10-30 minutes

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15
Q

What is the electrode placement for IFC?

A

quadripolar electrode setup

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16
Q

How would you describe IFC to the patient?

A

Hi “Zack”, today I just wanna go through and do some electrical stimulation if thats ok with you. What I wanted to do today is try and treat the pain we’re having, to do this I’m going to use IFC. For IFC we’re going to feel some tinging and maybe some slight muscle contraction. This should feel strong but tolerable since we will be leaving it on for 10-30 minutes.

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17
Q

HIGH-RATE TENS

A

HIGH-RATE TENS

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18
Q

What is the purpose/goals of High-Rate TENS?

A

pain control through gate control theory

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19
Q

What is the pulse frequency of High-Rate TENS?

A

50-80 pps

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20
Q

What is the pulse width/duration of High-Rate TENS?

A

50-100 usec

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21
Q

With High-Rate TENS, what should the intensity feel like for the patient?

A

Comfortable tingling sensation with no muscle response

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22
Q

How long do we perform High-Rate TENS?

A

10 minutes to several hours

23
Q

What is the electrode placement for High-Rate TENS?

A

bipolar electrode placement

24
Q

How would you describe High-Rate TENS to the patient?

A

Hi “Zack”, today I just wanna go through and do some electrical stimulation if thats ok with you. What I wanted to do today is try and treat the pain we’re having, to do this I’m going to use High-Rate TENS. For this, we’re going to to feel some tingling without muscle contraction. This should be comfortable because we are going to leave this on for a little while.

25
Q

LOW-RATE TENS

A

LOW-RATE TENS

26
Q

What is the purpose/goals of Low-Rate TENS?

A

pain control through descending pathways

27
Q

What is the pulse frequency of Low-Rate TENS?

A

1-5 pps

28
Q

What is the pulse width/duration of Low-Rate TENS?

A

150-300 usec

29
Q

With Low-Rate TENS, what should the intensity feel like for the patient?

A

strong, but comfortable rhythmic muscle twitch

30
Q

How long do we perform Low-Rate TENS?

A

20-40 minutes

31
Q

What is the electrode placement for Low-Rate TENS?

A

biphasic electrode placement

32
Q

How would you describe Low-Rate TENS to the patient?

A

Hi “Zack”, today I just wanna go through and do some electrical stimulation if thats ok with you. What I wanted to do today is try and treat the pain we’re having, to do this I’m going to use Low-Rate TENS. For this, were going to start feeling some tingling until we get up to muscular contraction. This muscular contraction should be strrong but comfortable enough to get through 30+ minutes of treatment.

33
Q

CONTINUOUS ULTRASOUND

A

CONTINUOUS ULTRASOUND

34
Q

What is the purpose/goals of continuous US?

A
  • modulate pain
  • increase tissue extensibility
  • facilitate healing and blood flow
35
Q

What is the duty cycle for continuous ultrasound?

A

100%

36
Q

What are the two frequencies for US and when do we use them?

A 
3MHz= used for superficial structures (up to 2.5cm)
1MHz= used for deep structures (up to 5cm)
37
Q

What is the intensity used for continuous US?

A

0.5W/cm² - 2.0W/cm²

38
Q

How long do we perform continuous US?

A

5-10 minutes

39
Q

When do we turn on the US machine?

A

When our soundhead is on the patient and the US gel is applied.

40
Q

How would you describe continuous US and its purpose to the patient, as well as what they will feel?

A

Hi “Zack”, today we’re going to be going through and doing some US treatment if that’s ok with you. This will just help us to decrease the pain we feel in that area and possibly treat the extensibility of the tissue there as well. What I’m going to do is apply some gel to the area and then apply my ultrasound head. You’ll start to feel some heat in the area, I just want you to tell me if it gets too hot so we can turn it down or redirect our US head.

41
Q

NON-CONTINUOUS ULTRASOUND

A

NON-CONTINUOUS ULTRASOUND

42
Q

What is the purpose/goals of non-continuous US?

A
  • Stable cavitation of gas bubbles in tissue to help diffusional changes in cell membrane.
  • Acousting streaming of fluid and ions along the boundaries of the cell membrane.
43
Q

What is the duty cycle for non-continuous ultrasound?

A

10%, 20%, 50%

44
Q

What is the intensity used for non-continuous US?

A

0.5W/cm² - 2.0W/cm²

45
Q

How long do we perform continuous US?

A

5-10 minutes

46
Q

When do we turn on the US machine?

A

When our soundhead is on the patient and the US gel is applied.

47
Q

How would you describe non-continuous US and its purpose to the patient, as well as what they will feel?

A

Won’t feel anything, so might have to bump up or down next session depending on how patient feels at the next session.

48
Q

How would you describe non-continuous US and its purpose to the patient, as well as what they will feel?

A

1

49
Q

CONTRAINDICATIONS AND PRECAUTIONS

A

CONTRAINDICATIONS AND PRECAUTIONS

50
Q

What are the contraindications for E-Stim?

A
  • Anywhere in the body for someone with a pacemaker or other electronic medical device (insulin pump)
  • Over carotid artery, thrombosis, eyes, phrenic nerve, pelvis and/or low back in pregnant women
  • Transcerebrally
  • In presence of active bleeding or infection
  • Over superficial metal implants
  • Over malignant tumors
  • Over pharyngeal or laryngeal muscles
  • Motor-level stimulation in conditions that prohibit motion
51
Q

What are the precautions for E-Stim?

A
  • Cardiac disease
  • Impaired mentation
  • Impaired sensation
  • In areas of skin irritation or open wounds
  • In patient with uncontrolled hypo/hypertension
  • Bleeding disorders
52
Q

What are the contraindications for US?

A
  • Impaired circulation
  • Impaired cognitive function
  • Absent sensation
  • Cancer
  • Joint cement
  • Directly over plastic components
  • Over vital areas (brain, eyes, heart, ear, reproductive organs)
  • Pregnancy
53
Q

What are the precautions for US?

A
  • Acute Inflammation
  • Open epiphyseal Plates
  • Healing fracture
  • Breast Implants

S3 - Clinical Practice 2 (13 decks)

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