Competency check Flashcards
(27 cards)
All E-Stim Contraindications
1) Areas where it can interfere with another mechanical deceive such as a pacemaker
2) Pregnant women on acupuncture points, abdomen or LB
3) Cancer
4) Active DVT or thrombophlebitis
5) Bleeding tissue or untreated hemorrhagic disorders
6) Infected tissue (TB or wounds with osteomyelitis)
7) Recently radiated tissue
8) Chest of someone with cardiac disease, arrhythmias or Heart Failure
9) Neck or head of an epilepsy patient
10) Transcranially
11) Reproductive organs
12) Over the eyes
13) Anterior neck or carotid
14) Damaged or at risk skin areas that can cause disruption in the current.
TENS specific contraindications
1) areas of impaired sensory awareness
2) cognitive or communication deficits
NMES Contraindications
1) Pregnant women
2) Areas of impaired circulation
3) Unstable areas (fx, osteoporosis, surgery)
4) Chest , intercostals and lower abdomen
All E-stim precautions
1) Active epiphysis (growth plate)
2) Person with a skin disease
HVPC specific precausions
1) Cognition or communication deficits
2) Impaired sensation
3) Impaired circulation
4) Superficial regenerating nerves
5) Chest wall or lower abdomen
NMES specific precausions
1) cognition or communication
2) impaired sensation
TENs specific precausions
1) impaired circulation
2) anterior chest wall or lower abdomen
E-stim all is safe for
1) intact skin overlying implants containing metal, plastic, or cement
2) inflamed tissues are a result of injury or exacerbation of chronic inflammation conditions.
TENS and HVPC is safe for
1) unstable areas: osteoporosis, surgery or fx
2) areas within or around chronic wounds or open wounds with localized infection.
things to look for in skin prep
1) Texture
2) Wounds
3) Cuts
4) Allergies
5) Dirt
6) OTC topicals
7) Rashes
8) Moles
9) Scares
10) Hair
11) Tattoos
12) Perfumes
monopolar set up
1 treatment electrode and 1 larger disperse non treatment electrode NOT on therapeutic site. allows for polarity
bipolar set up
2 treatment electrodes of equal sizes both in treatment area: gives stronger contraction and covers more area (more specific)
Tens specific bipolar set up
1) Over the site of pain
2) Through the sight (bracket)/ 3 dimensional
3) Around the site
4) Dermatone
5) Myotome
6) Peripheral nerve
7) Acupuncture or motor points.
what are the 3 things that can be modulated
1) amplitude (mA)
2) Duration (p.w. or nSec)
3) Frequency (pps or hz)
what are the 4 types of clinical current
1) DC
2) Medium frequency alternating current (russian or inferential)
3) Pulsatile current (mono/bi or HVPC)
4) mircocurrent
TENS modes
1) conventional
2) slow low rate
3) brief intense
4) pulse-burst
5) modulated
6) hyperstimulation
Conventional TENS setting
high frequency: 50-100 pps
Low amp
Short durations: 50-100 nSec
Strong Low rate TENS setting
low frequency: 2-4 pps
high amp: 40 mA (enough to produce rhythmical contractions)
longer pulse durations: 150 nSec
used for deep aching chronic pain
Brief-intense TENS setting
high frequency: 60->150pps
high amp: 40 mA
pulse durations; 50-250 nSec
gives muscular fasciculations
used during therapeutic procedures
Pulse-Burst TENS setting
high carrier frequency: 60-100 pps
low burst frequency: 0.5-4 pps
pulse durations: 50-200 nSec
High amp: gives intermittent tetanic muscle contractions and paresthesia
low amp: gives sensation of pulsating paresthesia
Modulated TENS setting
TENS unit automatically modulates by a given percentage and decreases accommodation.
Hyperstimulation TENS setting
high current density (1mm tip)
long pulse durations (500 msec)
frequency 1-4 pps
uses the endrogenous opiate theory and produces sharp and burning sensation.
NMES uses
1) FES
2) Edema reduction
3) spasticity
4) ROM
5) strength
6) motor re edu
acute edema placement
- monophasic pulsed HPVC
- frequency: 100-125
- duration: 2-100 microsec
- comfortable sensory perception
