Contraindications and Red Flags Flashcards
Contraindications: Joint Mobilizations
- • Active disease
- • Infection
- • Advacned osteoporosis
- • Articular hypermobility
- • Fracture
- • Acute inflammation
- • Muscle guarding
- • Joint replacement
- • *empty end feel
Contraindications: Absolute - Jt oscillations, mobilization and manipulation
- Joint ankylosis
- Malignancy w/ bone
- Dx/ligaments (RA & downs syndrome)
- Arterial insufficiency
- Active inflammatory or infective process
Contraindications: Relative - Jt Mobilization, Oscillation, and Manipulation
- Arthosis
- DJD
- Metabolic bone dx (osteoporisis, paget’s disease and TB)
- Hypermobility
- Total joint replacement
- Pregnancy
- Spondylolisthesis
- Steroids
- Radicular symptoms
Contraindications: HA and Cervical Mobilization
- HA are often an indication for cervical thrusts but can also be a contraindication - query female patients about smoking/BC combo - Remember HA often precede CVA
Contraindications: Absolute - Cardiac Rehab
- acute MI (within 2 days)
- unstable angina not previously stabilized
- uncontrolled arrhythmias causing sx or hemodynamic compromise
- acute PE or pulmonary infarction
- acute myocarditis or pericarditis
- acute aortic dissection
Contraindications: Relative - Cardiac Rehab
- Left main coronary stenosis
- moderate stenotic valve disease
- electrolyte abnormalities
- severe arterial hypertension
- tachy/brady arrhythmias
- hypertonic
- cardiomyopathy and other forms of outflow tract obstruction
- mental or physical impairment leading to inability to exercise adequately
- high degree AV block
Contraindications: Lymphedema Management
Strenuous actvities
Modalities :
Electric therapy > 30 Hz
Pressures > 45 mmHg
Precautions: Pulmonary Percussion
- rib fractures
- costal chondritis
- hemoptysis
- blood coagulation problems
- dysrhythmias
- pain
- severe dyspnea
- pneumothorax w/ w/o chest tube
- increased bronchospasm
Contraindications: Postural Drainage Positioning
- Intracranial pressure >20 mmHg
- Head or neck injury unstabilized
- Active hemmorhage
- Hemodynamic instability
- Recent spinal surgery
- Active hemoptysis
- Empyema
- Bronchopleural fistula
- Pulmonary edema associated with CHF Large pleural effusion
- PE Confused or anxious
- Rib fracture, flail chest
- Surgical wound or healing tissue
Precautions: Trendelenberg Positioning
- Pulm edema
- CHF
- HTN
- Obesity
- Ascites
- Pregnancy
- Hiatal hernia
- Nausea
- Recent food consumption
- Recent neuro surgery
- Increased intracranial pressure
- Aneurysm Precaution
- Pulmonary Shortness of breath
Considerations: Prior to Percussion
- Pain made worse by technique
- Aneurysm precautions
- Hemoptysis
- Increased PTT, PT or
- decreased platelet count (below 50,000) or
- anti-coagulation medications
- Fractured rib
- Flail chest
- Degen bone disease
- Bone metastasis
Contraindications: Gauze Dressings
****Contraindicated over granulation tissue without some type of intermediate nonadherent dressing***
Contraindications: PROM
Hemophelia
Myostis Ossificans
Contraindications: Cancer Patients and Exercise
- Day of intravenous chemotherapy or within 24 hours of tx
- Severe rxn to radiation
- Acute infection or febrile illness >100 F
- Severe nausea, vomitting, diarrhea w/in 24-36 hours, dehydration, poor nutrition
- Unusual or extreme fatigue, muscular weakness, recent bone pain
- Chest pain, rapid or slow HR, elevated BP, swelling of ankles
- Severe dyspnea, pain on deep breath, cough/wheezing
- Dizzy/lightheaded, disorientation, confusion, blurred vision, ataxia
- Pts w/ low PLT may have SOB, excessive fatigue, angina, petechiae, purpura, ecchymoses, hematuria, anemia, and hematochezia.
- Pts w/ extremely low PLT (<10k) may experience spontaneous bleeding
Cancer Specific Emergencies
Loss of limb function
Spinal cord compression
Fever in immune suppressed
Superior vena cava syndrome
