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Therapeutic Modalities > E-Stim for Pain > Flashcards

E-Stim for Pain Flashcards

1
Q

Iontophoresis

A

Use of mild direct current (DC - monophasic) to drive negatively or positively charged ions of drug solution into the patient’s skin and underlying tissues

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2
Q

Iontophoresis - electrodes

A

2 electrodes - one delivers the drug and one is the dispersive electrode

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3
Q

Current for Iontophoresis

A

monopolar direct current

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4
Q

Benefits of Iontophoresis

A

delivers medication with the need for a needle stick, risk of infection, or systemic effects

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5
Q

Evidence that DC current can move ions _______ below the skin

A

6 to 20mm

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6
Q

Iontophoresis Set Up

A

Uses a monopolar electrode arrangement
Active electrode has the medication
There is increased blood flow under the active electrode, so you may see hyperemia (increase blood flow)
Feels pins and needles on a more noxious level
If the patient complains of increased skin irritation during treatment, turn off the unit and inspect the skin under the active electrode
Dispersive electrode completes the circuit
Away from the active electrode
Warn patient of sensation of warmth and see some redness
If it is uncomfortable for the patient, stop and readjust

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7
Q

Iontophoresis Dosage

A

amount of charge that is delievered; typical treatments consist of 40 to 80 mA*min

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8
Q

Dose

A

Dose = Current (mA) * Time (min)

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9
Q

Standard dosage for Iontophoresis

A

40 to 41 mA*min

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10
Q

Dexamethasone

A

Negative ion, reduces acute inflammation by inhibiting the response of inflammatory cells

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11
Q

Half life of Dexamethasone

A

36 to 48 hours, can’t give someone this more than once per day

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12
Q

3 Types of TENS

A

Sensory, Motor and Breif-intense

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13
Q

Sensory (high) TENS

A

Primarily used for pain control but can elicit muscle contraction

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14
Q

Sensory TENS decreases the perception of pain by decreasing signals from the ____ and ____ fibers to the thalamus and cortex

A

A delta; C

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15
Q

Sensory TENS works by…

A

the gate control theory

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16
Q

Sensory (high) TENS parameters

A

Asymmetrical balanced biphasic current (the amount of energy is equal on both sides of the line)

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17
Q

Sensory - Amps

A

maximum tolerable sensation; no contraction and no pain

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18
Q

Sensory - Frequency

A

60 to 100 pps

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19
Q

Sensory - Pulse width

A

60 to 100 μsec

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20
Q

Sensory - Duration

A

as needed; anywhere between 5-30 minutes

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21
Q

Sensory - Onset of relief

A

< 10 minutes

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22
Q

Sensory - Lasting relief

A

minutes to hours

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23
Q

Sensory - Goal

A

relieve pain

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24
Q

Motor (Low) TENS parameters

A

Asymmetrical balanced biphasic current

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25
Q

Motor - Amps

A

to muscle twitch

26
Q

Motor - Frequency

A

2 to 4 pps

27
Q

Motor - pulse width

A

150 to 250 μsec

28
Q

Motor - duration

A

30 minutes (at minimum)

29
Q

Motor - onset of relief

A

20 to 40 minutes

30
Q

Motor - lasting relief

A

hours

31
Q

Motor TENS works by…

A

gate control theory and descending pathways

32
Q

Brief-Intense (Noxious) TENS parameters

A

Asymmetrical balanced biphasic current

33
Q

Brief-Intense - Amps

A

painful and muscle contraciton

34
Q

Brief-Intense - Frequency

A

> 100 pps

35
Q

Brief-Intense - Pulse width

A

300 - 1000 μsec

36
Q

Brief-Intense - Duration

A

15 to 30 minutes

37
Q

Brief-Intense - Onset of relief

A

< 15 minutes

38
Q

Brief-Intense - Lasting relief

A

< 30 minutes

39
Q

Brief-Intense (Noxious) TENS works by…

A

Endogenous opiate mechanism (descending pain mechanism)

40
Q

Interferential Current

A

by crossing two slightly different medium frequency alternating currents within a tissue, a third frequency current of greater intensity is created in deeper tissues

41
Q

IFC Example

A

Channel 1 is set to 4000 Hz interfering with Channel 2 which is set at 4080 Hz then creates a 3rd frequency of 80 Hz

42
Q

IFC

A

alternating currents

43
Q

IFC Channel 1

A

high frequency sine wave (4000 Hz - 5000 Hz)

44
Q

IFC Channel 2

A

variable frequency sine wave

45
Q

IFC - Duration

A

15 to 30 minutes

46
Q

IFC - Intensity

A

tolerable sensory or muscle twitch

47
Q

Why IFC?

A

The high carrier frequency passes through skin and other tissues with ease; more comfortable for your patient

48
Q

Electrodes are set up in a _______ arrangement when using IFC

A

quadripolar

49
Q

Premodulated Current

A

A single AC current that is mixed within the generator to provide a sine wave of varying amplitude

50
Q

Premodulated feels similar to IFC, but you use _____ independent channels for stimulation

A

2; 2 electrodes (bipolar)

51
Q

Premod. base frequency

A

4 to 5000 Hz

52
Q

Motor (low) TENS

A

Chronic pain

53
Q

Sensory (high) TENS

A

acute injuries

54
Q

TENS vs. IFC

A

TENS - accessibility, take home, easier to control; IFC - creates beat frequency making it more comfortable for the patient

55
Q

Microcurrent Electrical Stimulation

A

Patient should not feel anything; works at cellular level to assist healing and pain; uses micro-amperage current (1/1000th of a milli-amp)

56
Q

MENS Paraments

A

monophasic, biphasic, direct, or alternating current

57
Q

MENS - Current

A

1-999 μamps

58
Q

MENS - frequency

A

0.1-1000 Hz

59
Q

MENS - pulse duration

A

0.5-5000 μsec

60
Q

MENS - intensity

A

subsensory

61
Q

MENS - duration

A

30 minutes to 2 hours

62
Q

MENS is used for……

A

acute & chronic pain, wound healing, scar tissue break up

Therapeutic Modalities (6 decks)

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