PAMs Competency

Mechanical

traction, compression, water, sound

Thermal

deep heating, superficial heating, cooling

Electromagnetic

Electromagnetic fields, electric currents

Cryotherapy: How long ?

20 Minutes Max, 10-20 on and 60 off

Cryotherapy: What are the contraindications ?

open wounds, poor sensations, DO NOT USE BEFORE ACTIVITY AS IT CAN INCREASE STIFFNESS

Cryotherapy: What are the indications ?

Sprains, joint pain, muscle pain, reduce pain, reduce swelling, reduce inflammation

Paraffin Wax: What is it used for ?

Reduce pain, stiffness within the muscles and joints, psoriasis or psoriatic arthritis

Paraffin Wax: How long ?

20 Minutes as long as the patient can tolerate it

Paraffin Wax: What are the contraindications ?

Impaired/Neurological sensation, Non-intact skin, cognition limitations, and heat intolerance

Paraffin Wax: What are the precautions ?

Metal implants, circulatory impairment

Paraffin Wax: What temperature ?

126-130 degrees

Paraffin Wax: How to do it ?

Wash hands, inspect skin, DIP to ulnar styloid, 3-5x, wraps hand in plastic, and then wrap in a towel

Moist Hot Pack: What is it used for ?

Reduce pain, muscle spasm, stiffness, increase blood flow and flexibility, muscle tightness, prep for stretch/ exercise.

Moist Hot Pack: What are the contraindications ?

acute inflammation, impaired sensation, acute edema, cancer in the are, impaired cognition, impaired circulation, and open wounds

Moist hot pack: What’s the temperature ?

160-175 degrees

Moist hot pack: How long ?

20 minutes, check for blanching

Moist hot pack: What do you do ?

Remove with tongs, wrap in 6-8 layers of insulation, apply for 20 minutes while checking for blanching, stay with the patient

Ultrasound: What are the indications ?

Joint contractures, Pain, trigger finger, thumb, tendon irritation, and reduce muscle spasms

Ultrasound: What are the contraindications ?

Fluid filled cavities, DVT, Acute infections, not directly over a bone, decreased circulation, pacemaker, CA, Impaired cognition, skin disease, active inflection, sensation loss

Ultrasound: How long ?

8-10 minutes in one area

Ultrasound: Parameters

1 Mhz- Deep

3 Mhz- Shallow

Remain in full contact with a liberal amount of gel

TENS (transcutaneous electrical neuromuscular stimulation) - What is it used for ?

Pain management, TENS delivers electrical currents to the sensory nerves to block or reduce pain signals to the brain. Used commonly for: arthritis, nerve injuries and post surgical pain

NMES (neuromuscular electrical stimulation) - What is it used for ?

Used to facilitate muscle contracture for strengthening, retaining weak muscles, preventing atrophy and improving muscle function. NMES targets the motor nerves, causing muscles to contract as if they were being exercised. *Used for muscle re-education, strengthening after injury or surgery.

What are the E-Stim contraindications ?

Pacemakers, placement over carotid sinus, tissue infection, intact skin / no open wounds, Cognition, Pregnancy, DVT