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Extremities > eStim for Wound healing and edema > Flashcards

eStim for Wound healing and edema Flashcards

1
Q

Name the 6 wound healing indications (3 ulcers and 3 wounds)

A

1) Pressure Ulcers
2) Diabetic Ulcers
3) Venous Ulcers
4) Traumatic Wounds
5) Surgical Wounds
6) Burn Wounds

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2
Q

Define galvanotaxis

A

Cellular movement that is stimulated by electric current

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3
Q

What activates the alteration of cellular membranes?

A

Electric current leads to synthesis of collagen and DNA (60-90 volts)

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4
Q

Name 2 modifications electrical stimulation can have on the cells

A

1) Reverse the normal electrical potential of cells

2) Enhance the electrical potential of cells

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5
Q

Name 2 ways the electrodes can be placed with wound healing

A

1) Electrodes with wet surface placed directly on the wound bed
- Keeping wound wet w/ 0.9% saline maintains the appropriate charge of tissue needed to encourage healing.
2) Electrodes placed around the wound not in direct contact with the wound

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6
Q

How does the HVPC waveform look like?

A

2 spikes

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7
Q

HVPC (High Volt Pulsed Curent): Non-motor or non sensory quality?

A

Non-motor quality

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8
Q

HVPC (High Volt Pulsed Curent): Long or short pulses?

A

Short pulses

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9
Q

HVPC (High Volt Pulsed Curent): Rapid reduction or slow reduction of current amplitude?

A

Rapid reduction of current amplitude

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10
Q

HVPC for wound healing: Pulse width?

A

40-100 microseconds

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11
Q

HVPC for wound healing: Polarity?

A

Polarity (+) or (-)

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12
Q

HVPC for wound healing: Pulse rate?

A

60-125 (pps)

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13
Q

HVPC for wound healing: Treatment time?

A

45-60 min

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14
Q

HVPC for wound healing: Treatment frequency?

A

Up to 5 days/week

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15
Q

HVPC for wound healing: Sevel protocols exist and are depending on what?

A

Depends on phase of tissue healing: inflammatory, proliferative/epithlialization, remodeling

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16
Q

Name 10 contraindications for HVPC wound healing

A

1) Cardiac Pacemaker, Bladder stimulator
2) Superficial metal implants
3) Significant impaired sensation
4) Pregnancy
5) Osteomyelitis
6) Transthoracic/cervical region
7) Along phrenic nerve
8) Malignancy
9) Carotid sinus, laryngeal musculature
10) Over topical substances with metal ions

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17
Q

What type of charge does injured tissue have?

A

Positive

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18
Q

When a wound has necrotic tissue; proliferative stage of healing; inflammation is not present, what type of charge does it attract?

A

(+) anode

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19
Q

When a wound is infected; inflammed tissue, what type of charge does it attract?

A

(-) cathode

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20
Q

In wound healing, (+) anode attracts these 3 things?

A

1) inactive neutrophils
2) Macrophages
3) Epidermal cells

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21
Q

In wound healing, (-) cathode attracts which 6 things?

A

1) Active neutrophils
2) Lymphocytes
3) Platelets
4) Mast cells
5) keratinocytes
6) fibroblasts

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22
Q

Wound healing activation: Cellular membranes are altered by electric current leading to synthesis of __ and __ (__-__ volts)

A

Cellular membranes are altered by electric current leading to synthesis of collagen and DNA (60-90 volts)

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23
Q

Acute edema - Lower or higher frequency?

A

Higher frequency

24
Q

Acute edema - motor or no motor response?

A

no motor

25
Q

Acute edema - HVPC or Biphasic?

A

HVPC

26
Q

Chronia edema - Lower or higher frequency?

A

lower freq

27
Q

Chronia edema - motor or no motor response?

A

motor response

28
Q

Chronia edema - HVPC or Biphasic?

A

Biphasic waveform

29
Q

Name 3 mechanistic theories behind acute edema

A

1) Decreases initial surge of blood following acute injury
2) Repels negatively charged proteins involved in inflammatory process
3) Decrease porous properties of blood vessels thereby affecting protein migration

30
Q

Acute Edema: Polarity?

A

(-)

31
Q

Acute Edema: Pulse frequency?

A

100-120 pps

32
Q

Acute Edema: Pulse Duration?

A

40-100 microsec

33
Q

Acute Edema: Current Amplitude?

A

pt comfort

34
Q

Acute Edema: Treatment time?

A

20-30 min

35
Q

Chronic Edema: Polarity?

A

Biphasic waveform

36
Q

Chronic Edema: Pulse freq?

A

35-50 pps

37
Q

Chronic Edema: On:off (surge)

A

equal, b/w 2-5 sec

38
Q

Chronic Edema: Pulse Duration?

A

150-350 microsec

39
Q

Chronic Edema: Amplitude?

A

Motor response

40
Q

Chronic Edema: Treatment time?

A

20-30 min

41
Q

Iontophoresis: Which stage of tissue healing?

A

inflammatory

42
Q

Iontophoresis: What two types of pain?

A

acute and chronic

43
Q

Iontophoresis: 2 advantages over other types of treatment?

A

1) pts who are unable to receive injections (fear, supressed immune system)
2) Bypasses liver and GI tract so no absorbed in GI tract, therefore, potency is maintained

44
Q

5 Therapeutic goals of Iontophoresis: 1) Relieve pain and inflammation associated with these 3 things 2) Dissolving __ __ 3) E__ 4) Scar __ and a__ 5) hyper__

A

1) Relieve pain and inflammation associated with:
2) Tendonitis, Plantar fasciitis (PF), bursitis
3) Dissolving calcium deposits (calcific tendonitis)
4) Edema
5) Scar tissue and adhesions
6) Hyperhidrosis

45
Q

Iontophoresis: Dose in mA-min

A

40-60 (80) mA-min

46
Q

Iontophoresis: Current Amplitude? no greater than what?

A

no > 4.0 mA

47
Q

Iontophoresis: Treatment time?

A

Dependent on dose and current

48
Q

Iontophoresis: Equation?

A

Current Amplitude (mA) x Treatment Duration (min)= Dose (mA-min)

49
Q

Iontophoresis: Adverse Effects?

A 
Alkaline Reaction (-)
Acidic Reaction (+)

Current Density
Current Amplitude

50
Q

Iontophoresis: Maximum current density for anode (+)?

A

no > 1.0 mA/cm2

51
Q

Iontophoresis: Maximum current density for cathode (-)?

A

no > 0.5 mA/cm2

52
Q

Iontophoresis: Dexamethasone, - or +?

A

(-)

53
Q

Iontophoresis: Acetic Acid, - or +?

A

(-)

54
Q

Iontophoresis: Lidocaine, - or +?

A

(+)

55
Q

Iontophoresis: Name the 6 contraindications (4 of them you ask the patient)

A

1) Impaired sensation
2) Cardiac pacemakers/arrhythmia
3) Pregnancy
4) Previous drug allergy/adverse drug reaction
5) Altered skin integrity
6) Carotid Sinus

Extremities (6 decks)

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