Physical Agents Competency #2 Estim for Pain and Tissue Healing

100-150 pps

what is the frequency/rate for high rate to gate pain?

10 pps or less

what is the frequency/rate for low rate for endogenous opioid release?

50-80 microseconds

what is the pulse duration/width for high rate?

200-300 microseconds

what is the pulse duration/width for low rate?

continuous

what is the on/off time for IFC/TENS/Premod for pain?

continuous

what is the ramp time for IFC/TENS/Premod for pain?

strong but comfortable tingling sensation

what is the intensity for high rate for IFC/TENS/Premod for pain?

muscle twitch, strong and possibly uncomfortable sensation but not painful (as much as they can tolerate)

what is the intensity for low rate for IFC/TENS/Premod for pain?

during pain provoking activity or up to continuous when awake

what is the treatment time for high-rate for pain?

20-30 minutes every 4-5 hours

what is the treatment time for low-rate for pain?

comfort with the wound visible and no pressure on the wound

how should you position a patient for an open wound estim treatment?

comfort without stress on target tissues and electrodes clearly visible

how should you position a patient for iontophoresis estim treatment?

comfort with extremity elevated

how should you position a patient for edema control for acute inflammation/lack of muscle contraction?

directly on the wound with gauze in between or surrounding the area with a dispersive electrode far away

where should you place the electrode(s) for open wounds?

active electrode over target tissue, dispersive over large muscle belly in the area

where should you place the electrodes for iontophoresis?

1-2 electrodes surrounding area of edema

where should you place the electrode(s) for edema from acute inflammation?

2 electrodes on motor points of muscle belly in the area of edema

where should you place the electrodes for edema for lack of muscle contraction?

HVPC

what is the waveform we use for open wounds and edema from acute inflammation?

direct current

what is the waveform we use for iontophoresis?

pulsed biphasic or russian

what is the waveform we use for edema due to lack of muscle contraction?

negative

what polarity do we use for open wounds in the acute inflammatory stage or infected wounds?

positive

what polarity do we use for open wounds in the proliferative stage, clean wounds, or if following 3-7 days of negative electrode use?

same polarity as the drug to be delivered

what is the polarity we use for iontophoresis?

negative

what is the polarity we use for edema from acute inflammation?

125-300 microseconds (usually fixed rate between 250-300)

what is the pulse duration for edema due to lack of muscle contraction?

preset

pulse duration for open wounds and acute inflammation edema is usually _____

100-105 pps

what is the frequency/rate for open wounds?

120 pps

what is the frequency/rate for edema from acute inflammation?

35-50 pps (20-30 for smaller muscles, up to 80 for larger muscles)

what is the frequency/rate for edema from lack of muscle contraction?

no

is there an on/off time for open wounds, iontophoresis, and edema from acute inflammation?

1:1 ratio, 2-5 seconds

what is the on/off time for edema due to lack of muscle contraction?

no

is there a ramp time for open wounds, iontophoresis, and edema control?

strong but comfortable tingling sensation, no muscle response

what is the intensity for open wounds?

up to 4 mA as tolerated

what is the intensity for iontophoresis?

strong but comfortable tingling sensation

what is the intensity for edema from acute inflammation?

strong enough to produce a visible contraction

what is the intensity for edema from lack of muscle contraction?

45-60 min, at least 5 days/week

what is the treatment time for open wounds?

40-80 mA-min, time adjusted to how long the dosage will take to be administered

what is the treatment time for iontophoresis?

30 minutes, as needed to control, up to once every 4 hours

what is the treatment time for edema control?

over area of malignant tumors and iontophoresis after an intervention that may alter skin permeability (heat/cold)

what are the contraindications specific to tissue healing?

infection control

what is the precaution specific to tissue healing (open wounds)?