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Exam 2 session 15 (lecture 5)
Terms in this set (22)
Describe anode and cathode electrode and the type of reaction that each produces for iontophoresis
1. Anode- (+) charge that produces an acidic reaction
to harden tissue and for analgesics
2. Cathode- (-)charge that produces an alkaline reaction for more softening
Indications for Ionto. (3)
Most often used for inflammatory conditions but can also be used for scar management, anesthesia for pain, and hyperhidrosis (excessive sweating)
1. Amplitude (intensity) to deliver medication for Ionto
2. dosage define and what's the formula to calculate this?
3. what does pad size indicate?
1. Typically .5-4mA but will be based on client tolerance
2. # of ions being delivered. Current amplitude x time. So the most common is 40mA but it can be 40, 60, or 80 mA-min. So all you do is take the milliamp-time for ex. 40mA and divide it by 1mA (client intensity) =40 min. of treatment time. 40mA-time/2mA (client intensity will be 20 min of treatment time, etc
3. how much med is being used
3 things you can use for Ionto?
What will it feel like to the client?
1. portable stimulators (phoresor)- machine
2. Iontopatch- look like boobs electrode that has a built in battery to deliver medication over a longer period of time.
3. Hybresis (hour-glass looking giant electrode)
4. Feels like irritating sensation pins and needles but it shouldn't feel like its burning
1. Whats the patch size we normally use for UE into?
2. How do we know which electrode to attach to tx site and which one to attach to dispersive?
3. What is the Chattanooga?
2. will depend on what polarity the medication you are using is so if the medication is negative, you would place the black electrode (cathode) over tx site and vice versa for the anode if its positive.
3. the blue phoresor we used for actual skills check
Iontopatch Describe, how long is tx time in clinic and home
Has built in battery in the electrode for longer medication delivery inside and outside of clinic.
For 7 hours use 40mA-time patch and for 14 hours its 80mA-time patch.
This is used for clients who can't tolerate normal ionto. Orient + and - sides of the patch based on mediation.
Similar to iontopatch but it has a self-contained battery on top. Client wears it at home and 1 hour= 40mA-min dose and 2 hours= 80mA-min.
Nice because wear time is shorter than iontopatch
1. Common medications (inflammation, pain, scar tissue and adhesion, wounds/infection, soft tissue mineralization
2. can you use 2 medications on same pad?
1. Dexa for inflammation (-), lidocaine (+) for analgesic aka pain, sodium and potassium chloride (-) for scar tissue and adhesion; zinc (+) for wounds and infections, acetic acid (-)
2. yes, a good ex. would be dex for inflammation and lidocaine for pain but polarity would be switched during tx.
contraindications and precautions for Ionto.
2. allergy to medication
4. skin irritation
5. open wounds
6. impaired sensation
1. ion sensitivity
2. drug sensitivity
4. other known allergies
Explain how LLLT works
Light energy is transmitted in waves and photons that consists of mechanical and electrical properties. The energy vibrates, penetrating underlying tissues which is absorbed and reflected modulating cellular behavior =facilitates healing and modulates pain. (cell absorbs energy and stimulates ATP in mitochondria) We use low intensity cold lasers.
1. What light is used for laser therapy? at what nm?
2. Is it monochromatic?
3. is it coherent?
4. is it collimated?
1. Use visible red with infrared spectrum between 600-1000nm.
2. Yes 1 wave = 1 color if visible
3. Yes the photons travel in one direction in the same phase and can penetrate 1-4mm deep
4. yes because its directional
Super luminous Diodes define and say why its good
Type of laser therapy with high intensity monochromatic light (up to 800nm) and is not coherent or collimated since it spreads.
IT has a shorter application time than LED and spreads to wider areas but doesn't penetrate as deep as LLLT (penetration goes LED, SLD, LLLT)
Laser therapy indications
3. wound healing
5. musculoskeletal conditions (RA, OA)
1. Define dosage for laser
2. what is the output of the energy related to? (how did we get joules?)
3. What is the common dosage? acute dosage? chronic dosage?
4. what dosage (J) should you never exceed In 1 tx?
1. Energy density measured in joules which can be continuous of pulsed so think of this kinda like frequency.
2. time (sec.), output of laser (w), and surface area (cm^2)
3. common- 3-5 J/cm^2, acute for low dosage- .5-1w/cm^2, chronic for higher dosage 4J/cm^2
4. 100-200 J in any 1 tx area due to cumulative effects of tx
If you are using superficial thermal with LLLT should you use heating thermal before tx or after? what about cold tx?
Should use cold tx before laser therapy to decrease blood flow and decrease energy removed from the area and heat after laser to increase blood flow and remove more energy from the area. Billing is 97026
Should laser therapy be used?
Theres conflicting research. The FDA approved many conditions but Nebraska is the one state that prohibits this.
Vasopneumonic devices purpose
Decreases edema or lymphoma by providing compression by filling air into the sleeves/chambers (looks like that air figure in front of car dealers)
Contraindications for vasopneumonic devices and 1 precaution
1. bone fractures
3. Severe PVD
4. uncontrolled HTN
5. CHF and pulmonary edema
careful not to overload the heart when mobilizing edema
CPM (continuous passive motion) devices
The device that moved your limb during skills check with Hebert. most commonly used for the knee but can be used for UE and LE and is good for ROM and edema.
Whats the overall goal for CPM?
1. joint stiffness
5. granulation tissue
Get the client to 80% max of joint motion without significant pain. Can be used post surgically and at home
CPM contraindications and precautions
1. bone fractures
2. severe infections
1. decreased sensation
2. muscle spams and spasticity
is CPM billed?
Not billed as a skilled intervention its billed to insurance more as a rental so it has no code.
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