Contraindiciation And Precaution For Each Modality Flashcards
Cryotherapy (Gel Pack, Ice Pack, Ice Massage, Controlled cold compression unit, vapocoolant sprays)
Contraindications
Absolute contraindication:
- cardiac dysfunction
- cold hypersensitivity
- cold intolerance (urticaria)
- cryoglobulinemia (abnormal proteins in blood, thicken in cold temp)
- paroxysmal cold hemoglobinuria (abnormal presence of hemoglobin in urine)
- Raynaud disease or phenomenon
Relative contraindication (when present in area of treatment)
- Regenerating peripheral nerves
- circulatory compromise or peripheral vascular disease
Cryotherapy (Gel Pack, Ice Pack, Ice Massage, Controlled cold compression unit, vapocoolant sprays)
Precautions
General precautions
- impaired mentation
- very young & very old patients
- uncontrolled hypertension
Precautions (when in area of treatment)
- superficial main branch of nerve
- open wound
- poor sensation
Thermotherapy (hot pack, fluidotherapy, paraffin wax)
Contraindications
Absolute Contraindication:
- impaired mentation (patient must be able to tell you if heat becomes too warm)
- fever
Relative contraindication (when present in area of treatment)
- recent or potential hemorrhage
- thrombophlebitis (blood clot)
- impaired sensation
- malignant tumor
- infrared treatment over the eyes
- denervation or surgical repair
- peripheral vascular disease
Thermotherapy (hot pack, fluidotherapy, paraffin)
Precautions
Precaution
- edema (try to avoid application to extremity with edema in dependent position)
- pregnancy (avoid total body heating & treatment in area of low back/abdomen)
- cardiac insufficiency (monitor patient closely, especially if treating large body areas)
- Age extremes (older adults & children <4 years old)
Precautions (when in area of treatment):
- acute injury or inflammation
- impaired circulation
- poor thermal regulation
- the presence of metal
- open wound
- topical counter irritants have been applied
- demyelinated nerves
Ultrasound
Contraindication
Contraindication:
- malignant tumor (do not use if patient presently has cancer or signs of cancer (until ruled out by MD)
Relative contraindication (when present in area of treatment)
- pregnancy (do not treat low back, abdomen, pelvis, hips)
- Central nervous system (CNS) tissue (do not apply over spine if prior Laminectomy has been performed, as spinal cord may be exposed)
- Within 6 inches of pacemaker or implantable cardiac rhythm device (monitor closely for dizziness, lightheadedness, or shortness of breath)
- Joint cement
- Plastic components
- Thrombophlebitis
- Eyes
- Reproductive organs
Ultrasound
Precautions
Precautions (when present in area of treatment)
- Acute inflammation (would want to use 20% for only mechanical benefits)
- Epiphyseal plates
- Fractures
- Breast Implants
- Bony Prominences
ALL E STIM
Contraindications
Contraindication (when present in area of treatment)
- cardiac pacemaker, implantable defibrillator, or unstable arrhythmia (DO NOT use in vicinity of these devices; only with prior approval from the physician responsible for these devices can you use them in the extremities)
- Over the carotid sinus
- venous or arterial thrombosis or thrombophlebitis
- malignant tumors
- pregnancy (low back/abdomen) (sometimes TENS is used for pain control during labor & delivery)
E STIM
Precautions
Precautions:
- impaired mentation
- cardiac disease (monitor pulse, respiratory rate, and overall patient response)
Precaution (only when present in the area of treatment)
- impaired sensation
- areas of skin irritation
- allergies to adhesives
TENS and IFC
Contraindication
Contraindications specific to TENS/IFC
- Do NOT use electrically stimulated muscle contractions for pain control, as with acupuncture-like (low-rate) TENS or IFC, when muscle contractions may disrupt healing (e.g. muscle or tendon tear, overuse, or acute injury, or unhealed fracture in the area - may displace the fracture)
TENS/IFC
Precautions
Precautions (when present in area of treatment)
- malignant tumors
- areas of open wounds
- Because of the muscle contractions, acupuncture-like (low-rate) TENS & IFC may cause DOMS
(when using low-rate tens <10 pups, try to limit it to 15 minutes at a time. You can use this setting for no more than 20-30 mins every 2 hours)
- Because TENS & IFC can effectively reduce pain, patients may need to be instructed to avoid potentially symptom-aggravating activities
Iontophoresis
Contraindications
Contraindications
- intended medication contraindications
- over malignant tumor
- do not apply iontophoresis after any intervention that may alter skin permeability
- anesthetized skin in area
- Eschar or scarring in area
Iontophoresis
Precautions
Precautions
- area of infection (avoid spreading infection)
- discomfort or burn from excessive current density
High Volt Pulsed Current
Contraindication
Contraindication
- over malignant tumor
High volt Pulsed current
Precaution
Precaution
- area of infection (avoid spreading infection)
NMES (NMES, Russian, Functional Electrical Stimulation)
Contraindications
Contraindications:
- Do not use electrically stimulated muscle contraction when muscle contractions may disrupt healing (e.g., muscle or tendon tear, overuse, or acute injury, or unhealed fracture in the area- may displace the fracture)
