E-Stim for Edema/Wound Care

Question 1

how can estim reduce edema

Answer 1

polarity effect
improve blood flow
muscle pumping

Question 2

estim setting for reduction of edema

Answer 2

high voltage pulsed current

Question 3

protocol for electrode placement

Answer 3

over edematous area

Question 4

catphoresis

Answer 4

movement of negatively charged cells through repulsion by cathode

Question 5

what is high voltage pulsed current also called

Answer 5

galvanic current

Question 6

polarity effect settings

Answer 6

monophasic high volt pulsed current
high pps (100-120)
90% of visible motor threshold
30 min or more, every 4 min
acute phase

Question 7

estim settings for improving blood flow

Answer 7

IFC or Premod option

– be careful of edema formation via vasodilation

Question 8

muscle contraction edema reduction

Answer 8

pumping action aiding venous return
– may elevate to assist

Question 9

electrode placement for muscle contraction edema reduction

Answer 9

muscle pump of agonist-antagonist muscles

proximal and distal to edematous area

Question 10

estim protocol for muscle contraction

Answer 10

monophasic high-volt pulsed
biphasic

200-500 microsecond pulse duration
40-60 pps
reciprocal / intermittent amplitude
1:1 duty
treatment duration = 20-30 min

Question 11

treatment methods for wound care via estim

Answer 11

current of injury
galvanotaxis
antimicrobial effects
facilitation of debridement

Question 12

current of injury

Answer 12

flow of positive polarity from inside the wound toward skin surface

Question 13

explain positive polarity for skin opened or intact

Answer 13

intact = no positive polarity
open = positive polarity

Question 14

explain time relationship between injury and positive polarity

Answer 14

positive for initial 3-4 days, then negative for the remainder

Question 15

galvanotaxis

Answer 15

charged cells are attracted to electric field of opposite polarity

Question 16

if neutrophils have a pH of ______ are attracted to the ______ pole

Answer 16

6.8-8.0 = attracted to positive pole
4.9 = attracted to negative pole

Question 17

macrophages are attracted to the _____ pole

Answer 17

positive

macrophages are negative themselves

Question 18

fibroblasts are attracted to the ____ pole

Answer 18

negative

fibroblasts are positive themselves

Question 19

explain negative/positive field and their effects

Answer 19

negative = bactericidal effect
positive = tissue healing

Question 20

electrode composition and antimicrobial effects

Answer 20

platinum/stainless steel = no antimicrobial effects

gold/silver = antimicrobial effects

Question 21

types of current for wound care

Answer 21

direct
alternating
pulsed

Question 22

forms of pulsed current that benefit wound care

Answer 22

low-volt monophasic
high-volt monophasic
low-volt asymmetric biphasic

Question 23

polar effects are produced by

Answer 23

monophasic current
unbalanced/asymmetric biphasic waveforms

Question 24

polarity changes can help with what

Answer 24

healing processes of wound care

Question 25

explain polarity charge and time of wound healing

Answer 25

negative = initial treatment positive = until healed

Question 26

electrode placement options for wound care

Answer 26

direct periwound technique

Question 27

direct technique electrode placement

Answer 27

of stimulating electrode over the wound monopolar technique low intensity direct current

Question 28

periwound technique electrode placement

Answer 28

2 electrodes on intact skin around bipolar technique asymmetric biphasic pulsed current

Question 29

for hand and ankle, what can be done for estim treatment

Answer 29

dacron silver mesh sock/sleeve - high voltage monophasic pulsed current diabetic ulcers, overnight application

Question 30

explain placement of electrode/precautions in direct placement

Answer 30

saline moistened sterile gauze between wound and electrode

Question 31

considerations for direct electrode placement

Answer 31

no metallic or petrolatum products be careful with intensity due to sensory issues and lower impedance in the wound

Question 32

explain dispersive electrode placement in direct placement protocol

Answer 32

on intact skin 15-20 cm proximal to wound

Question 33

advantages of periwound electrode placement

Answer 33

less potential for disturbance of wound bed reduced chance of cross-contamination less specialized training than direct

Question 34

what electrodes can be used for periwound placement

Answer 34

self-adhesive carbon rubber electrodes

Question 35

charge density definition

Answer 35

electrical charge per unit of a cross-sectional area of the electrode

Question 36

explain relationship between charge density and electrode size

Answer 36

larger electrode = smaller charge

Question 37

charge density dosage range for wound care

Answer 37

240-500 microCharge/sec

Question 38

how to quantify charge density

Answer 38

average spatial current density / effective duty cycle + total treatment duration

Question 39

absolute charge density range

Answer 39

0.1-2.0 C/cm^2