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ESTIM 3 PERKINS TEII
ESTIM PART III PERKINS TE II - Interferential, HVPC
| Question | Answer |
|---|---|
| PHASES OF HEALING Phase One | Inflammatory phase 3-7 days Marked by local vasodialation & increase in cell migration Need a lg. amount of cells to begin chemotaxis |
| PHASES OF HEALING Phase Two | Granulation tissue formation phase Formation of new blood vessels Production extracellular matrix Formuation granulation tissue |
| PHASES OF HEALING Phase Three | Can last up to 2 yrs. following injury Increase in collagen tissue Tissue becomes more organized Too organized = scarring |
| Current of Injury | presence of skin battery potential in a wound or injury where skin no longer provides a barrier to the tissue below |
| Why is a moist wound better than a dry wound? | A moist wound maintains the current of injury triggering healing |
| A dry wound consists of what kind of tissue? | Dry, leathery, necrotic tissue |
| Why is a dry wound slower to heal? | It loses the current of injury which decreases healing. |
| What is galvanotaxis? | A process in which all cells posses either a + or - charge that attract to the opposite pole. |
| What is the polarity of a neutraphil? | Negative |
| What is the polarity of a macrophil? | Negative |
| What is the polarity of a epidermal cell? | Positive |
| What pole do neutraphils attract to? | positive |
| What pole do macrphils attract to | Positive |
| What pole do epidermal cells attract to? | Negative |
| What does antimicrobial mean in reference to EStim? | Estim has been shown to have bactericidal effects in animal studies. NO HUMAN STUDIES-CONTOVERSY OVER |
| What happens to blood flow as an influence of Estim? | EStim is thought to increase blood flow in wounds hence speeding up the healing process. |
| What is the influence of EStim on necrotic tissue? | The positive pole is thought to increase macro & neutraphils to the wound hence, providing an autolitic reaction. |
| What is HVPC (aka HBGC)? | High Volt Pulsed Current (aka High Volt Galvantic Current) |
| What is the definition of HVPC? | Pulsed current delivered via high voltage to accomplish their means. |
| What is the waveform of HVPC? | Paired unidirectional impulses that rise instantaneously & then pulse fall exponentially (quick rise- slow fall) |
| What is the pulse duration of HVPC? | 50-100 microseconds with electromoto force up to 500 volts. In the U.S. most do not exceed 150 volts per the FDA |
| With higher volts what is the effect on the skin and why is this important? | Higher volt = less impedence from the skin which means we don't need high amp. |
| What is the purpose of HVPC? | -Stimulate lg. afferent neurons to promote pain relief -Promote blood flow & relaxation -Reduce edema via polarity -acceleration of tissue healing *high volt not best for pain - other methods work better |
| What are the indications of HVPC? | -Promote wound healing -Reduce edema (esp. acute) |
| What are the contraindications of HVPC? | -Pacemaker or medical devices including hardware -Over or near preg. uterus -Over eyes, carotid sinus, laryngeal or pharyngeal muscles -During operation of heavy machinery -Over areas of malignancy |
| What are the precautions of HVPC? | -Known cardiac condition -Over anesthetic skin (numb) -Elderly patients |
| What is the response to treatment with HVPC? | -Sensation or tingling or motor response is expected -Should have no obvious skin changes following tx (Check skin pre and post) |
| What is the intensity of HVPC? | strong but comfy (sensory level for edema or wounds) |
| What is the duration of HVPC? | 60 minutes w/ wounds 15-30 minutes for edema or pain (not 1st choice as far as estim) |
| What is the frequency of tx for HVPC? | daily up to 5x/day |
| What must a wound be free of before placing electrodes? | all metals or petroleum products - flush with sterile saline first. |
| What is the direct electrode placement method for wounds? (HVPC) | Pack the wound w/ moist gauze (sterile saline) & place electrode directly on the wound & dispersive electrode 15-20 cm away from wound. |
| What is the Peri method for wounds(HVPC electrode placment)? | electrodes are placed around the wound (on each side of) |
| For pain and edema what methods of electrode placement are used? | Surround the area or use high volt under water. |
| With underwater high volt, where are the electrodes placed? | Electrodes are secured to the side of a plastic or fiberglass tub. DO NOT WANT THEM TO TOUCH PATIENT!!!! |
| With underwater HVPC, what must be used in addition to the electrodes in the tub? | A disbursement pad on the trunk or under the thigh of the limb in the water. |
| While the estim machine is on, the limb is to remain where? | in the water - give pt. a bell, RISK OF HIGH VOLT SHOCK IF REMOVED! |
| What is Interferential Stim? | -Consists of 2 unmodulated medium frequency EStim waves that cross pathways & interfere with each other. -2 different frequencies that meet in multiple points in wave that cause constructive and destructive interference. |
| What is the waveform with interferential? | 2 unmodulated frequency sound waves |
| What is the frequency for interferential? | 2000-5000 Hz |
| What is the pulse duration for interferential? | 125 microseconds |
| What is the result as far as shape of interferential current? | clover leaf shaped wave |
| What is the purpose/effects of interferential with greater than 50 beats per second apart? | -greater than 50 beats per second apart relieves pain by stimulating lg afferent neurons (gate control theory) |
| What is the purpose/effects of interferential with 0-5 beats per second? | produces muscle contractions & relieve pain (endogenous opiates) |
| What is the purpose/effects of interferential with 1-10 beats per second? | Produce small pulsating contractions of innervated muscles. |
| What is the purpose/effects of interferential with 30-50 beats per second? | produce tentanic contractions. |
| What are the advantages of interferential? | -medium frequency face less impedance as they cross the skin thus they reach deeper target tissues. |
| What are the disadvantages of Interferential? | -Even w/ crossing of current, density remains high near the electrodes -pt. not as likely to perceive stim at targeted tissue. |
| What are the indications of Interferential? | -Pain relief -Muscle ex to increase blood flow, muscle relaxation, decrease edema -Relief of urinary incontinence -Tissue, bone healing (disputed) *MOSTLY FOR PAIN RELIEF |
| What are the Contraindications of Interferential? | -Pacemaker or medical devices including hardware -Over or near preg. uterus -Over eyes, carotid sinus, laryngeal or pharyngeal muscles -During operation of heavy machinery -Over areas of malignancy -Open areas, active bleeding |
| What are the precautions of interferential? | -Known cardiac condition -Over anesthetic skin (numb) -Elderly patients |
| As far as dosage of interferential, what is the amplitude? | -sensory level -strong but comfy -No mucle activation |
| As far as dosage, what is the duration of interferential? | 15-30 minutes |
| As far as dosage, what is the frequency of tx for interferential? | daily up to 3x/day |
| What is the response to tx for interferential? | -Tingling under the electrodes -No obvious skin changes following tx -Inspect skin pre & post |
| What is the electrode placement for interferential? | -Surround the area of pain -2 circuits that criss cross -leads on same side (polarities together) to form clover leaf wave |
Created by:
deepolzin
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