Contraindications and Precautions for Physical Agents

Thermotherapy Contraindications MIIA DATE

- malignancy

- impaired sensation/mentation

- irradiation to eyes or reproductive organs

- active bleeding (recent or potential)

- decreased circulation

- acute/early subacute/traumatic inflammatory conditions

- thrombosis/thrombophlebitis

- extremes of age

Thermotherapy Precautions PIIMP COTE

- Pregnancy

- Impaired circulation

- Inability to communicate

- Metal implanted close to skin

- Poor thermal regulation

- Cardiac insufficiency

- Open wound

- Topical irritants recently applied

- Edema

Cryotherapy Contraindications RCC PRO

- Raynauds

- cold hypersensitivity (cold urticaria)

- cold intolerance

- preexisting anesthetic skin/communication inability

- regenerating peripheral nerves (not apply over)

- over area with circulatory compromise or PVD

specific disorders:

- cyroglobulinemia

- paroxysmal cold hemoglobinuria

Cryotherapy Precautions E SHOPP

- extremes of age (young or old)

- superficial main branch of nerve

- hypertension

- over open wound

- poor sensation or mentation

- poor thermal regulation

Ultrasound Contraindications SHAMPOO PIIT JRR

- spinal cord/CNS tissue

- high doses of thermal US should be avoided over open epiphyseal plates

- avoid myositis ossificans

- malignancy

- pregnancy

- over eyes, brain, ear, heart, cervical ganglia or carotid sinuses

- over pacemaker

- plastic components

- impaired circulation

- impaired sensation or mentation

- thrombophlebitis

- joint sement

- reproductive organs

- recently irradiated tissue

Ultrasound Precautions BEAF

- breast implants

- epiphyseal plates in growing bone

- acute inflammation no CUS but PUS ok

- fracture

Diathermy (thermal) contraindications GIMP PET MG

- general thermo contras MIA IT

- implanted or transcutaneous neural stimulators or leads

- metal in treatment site including surfaces

- pacemakers

- pregnancy

- eyes

- testes

- malignancies

- growing epiphyses

diathermy (thermal and non thermal) precaution COFS

- copper- bearing intrauterine contraceptive devices

- obesity

- field clear of electronic or magnetic equipment

- skeletal maturity

Diathermy (non thermal) contraindications PSPD

- pacemakers, electronic devices or metal implants

- substitute for conventional therapy for edema

- pregnancy

- deep tissues (internal organs)

compression contraindication AA SOCAL CASA UE

- arterial revascularization

- ABI < 0.6 avoid static compression

- severe peripheral arterial disease PAD

- obstructed lymphatic or venous embolism

- cardiac/pulmonary edema

- acute fracture or other trauma

- limb movement is avoided

- cancer

- acute infections (cellulitis)

- significant hypoproteinemia (protein levels <2 g/dl)

- acute DVT or PE or thrombophlebitis

- underlying cause is unknown

- extremes of age

compression precaution SAD ICU RN

- superficial peripheral nerves

- ABI between 0.5-0.8 (do not exceed 27 mmHg for static devices; avoid intermittent devices)

- dermatologic infection

- impaired sensation or mentation

- cancer

- uncontrolled HTN

- recent skin graft

- neuropathy (monitor for ischemia)

traction contraindications JUAN'S FMS

- joint hyper mobility/instability

- uncontrolled hypertension

- acute injury/inflammation

- neuro signs or peripheralization of symptoms with traction

- spondylolisthesis

- fractures

- motion contraindicated (post op spinal surgery)

- spinal cord compression

traction precautions DIS SCAMPI

- disorientation

- inability to tolerate prone or supine position

- severe pain fully resolved with traction

- structural diseases affecting treatment area (tumor, infection RA, prolonged corticosteroid use)

- claustraphobia

- annular disc fragment displacement

- medial disc protrusion

- pregnancy, hiatal hernia, vascular compromise, osteoperosis

- impaired mentation

cervical specific traction precautions T

- TMJ problems

hydrotherapy contraindications BAM A MINI PIG

- Bleeding surface area

- Acute inflammation

- Maceration around a wound

- Advanced cardiovascular/pulmonary

disease

- Malignancies

- Impaired sensation or mentation

- Nephritis - renal infection

- Incontinence - bowel/bladder

- Poor thermoregulation - pregnancy, MS

- Impaired circulation - PVD, Buerger's

disease

- Gangrene

hydrotherapy precautions ICE CIGARS

- Infection in the area to be immersed

- Cardiac insufficiency

- Existing edema

- Contamination of the wound

- Impaired thermal/cold sensation in the

area

- General heat/cold temp difficulties

- Age extremes - old & infant

- Recent skin grafts

- Seasick - if anxious or over warm

Full body immersion contraindications SCIBS

- Suicidal patients

- Cardiac instability (uncontrolled HTN or

heart failure)

- infection in immersed area (potential for cross contamination)

- Bowel incontinence

- severe epilepsy

Full body immersion precaution FRAIL UMMP

- Fear of water

- Respiratory problems

- Alcohol ingestion

- Impaired thermal sensation

- Limited strength, endurance, balance,

ROM

- Urinary incontinence

- Medications

- Multiple sclerosis (MS)

- Pregnancy

contrast bath contraindication DA

- Diabetes type 2 with impaired arterial

circulation

- Ankle sprains

contrast bath precautions ARE

- Age extremes - very young or very old

- Raynaud's phenomenon

- Existing edema

pulsed lavage non immersion contraindication FEW

- Facial wounds

- Exposed vessels, nerves, tendons,

capsules, bone

- Wounds that extend into body cavities

pulsed lavage non immersion precautions MMR

- Maceration

- May not be effective

- Recent skin grafts

Massage general contraindication UC FANS

- Under influence of drugs/alcohol

- Contagious or infectious disease

- Fever

- Acute injuries or recent operations

- Neuritis (nerve inflammation)

- Skin diseases

Massage local contraindications VISA CUB UP

- Varicose veins

- Inflammation, including arthritis

- Sunburn

- Abrasions

- Cuts

- Undiagnosed lumps/bumps

- Bruising

- Undiagnosed pain

- Pregnancy

E-stim contraindications PASTA SAUCE

- pregnancy

- areas where venous or arterial thrombosis/thrombophelbitis is present

- suspected epilepsy or seizure disorder

- transcerebral or transthoracic

- areas motion is prohibited

- superficial metal implants

- areas of uncontrolled bleeding or infection

- unstable arrhythmia

- cardiac pacemakers, implantable defribillator, insulin pumps

- electrodes over carotid sinus, eyes, phrenic nerve, urinary bladder stimulator, pharyngeal/laryngeal muscles

E stim precautions MBA CHIME

- malignancies

- bleeding disorders

- areas of skin irritation or open wounds

- cardiac disease

- hypotension or hypertension

- impaired sensation or mentation

- menstruating uterus

- excess adipose tissue or edema

E-stim muscle contraction (nmes), contraindication M

muscle contraction may disrupt healing (muscle or tendon tear, overuse)

E-stim muscle contraction names precaution M

may cause delayed onset muscle soreness DOMS

E-stim pain control tens contraindication M

muscle contraction may disrupt healing (muscle or tendon tear, overuse)

E-stim pain control tens precaution DOME P

- do not apply where current path would pass through; developing fetus, eyes, laryngeal/pharyngeal muscles, head, carotid sinus, neck patient following stroke or with epilepsy

- over chest of patient with cardiac disease

- may cause DOMS

- educate patient to avoid aggravating activities if using TENS

- pregnancy during labor and delivery (may be used for pain control)

E-stim soft tissue healing - iontophoresis contraindication MA

- malignancy

- after treatment that may alter skin permeability

E-stim soft tissue healing - iontophoresis precaution AI

- application of iontophoresis after another physical agent in the same area

-infection control

biofeedback contraindication APB

- Acute inflammatory conditions

- Pregnancy

- Bladder or vaginal infection