Red Flags And Contraindications Flashcards
Contraindications for prone positioning
- Facial trauma
- Unstable spinal cord injury
- Uncontrolled intracranial pressure
- Burns over anterior body
- Open chest/abdomen wounds
- Pelvic fractures
- Multiple support lines/tubes
Contraindications for incentive spirometry
- Cannot use the device properly
- Non compliance
- Young patients with development delay
- Any injury or surgery that limits ability to use device
- Hemodynamic instability
- Recent myocardial infarction
- Respiratory infection
- Recent pneumothorax
- Pulmonary embolism
- Aneurysm of the thoracic, abdominal aorta
- Hemoptysis of acute onset
- Intracranial hypertension
- Retinal detachment
- Recent abdominal, thoracic, brain, eye, ear, nose or throat surgeries
- Unstable Hypertension
Contraindications to resistance exercise
- Pain with AROM/PROM
- Acute inflammation
- Joint effusion
- Uncontrolled hypertension
- Severe/Unstable cardio vascular disease
- Congestive heart failure
- Fracture
- Within 4-6 weeks of myocardial infarction
- Metastatic Bone cancer
- Osteoporosis
- Low platelet count
Contraindications for postural drainage
- Increased Intracranial pressure
- Aneurysm
- Haemoptysis
- Recent laminectomy
- Esophageal anastomosis
- Untreated pnuemothorax
- Pulmonary embolism
- Congestive heart failure
- Unstable cardiovascular status
- Patient upset/agitated
Contraindications for assisted cough
Contraindications
* ruptured diaphragm
* direct pressure on rib fractures
* direct pressure on surgical site
Precautions
* Bowel obstruction
* Increased ICP
* Gastric reflux
* Fractures
* Abdominal aorta aneurysm
* Chest trauma
* Pregnancy
* Abdominal surgery
* Cardiac instability
* Osteoporosis/fragile ribs
* Spinal trauma
Contraindications for stretching
- Acute inflammation/infection
- Forcing beyond normal joint ROM
- Surgical movement restrictions
- Unhealed fracture
- Joint effusion
- Haematoma
- Sharp/acute joint pain
- Recent corticosteroids in area
- Hypermobility/instability
- Bony block
Contraindications for Deep tendon frictions
- Infection
- Skin breakdown
- Inflammatory joint disease
- Recent local injection
- Calcification/ossification in soft tissue
- Bursitis
- Connective tissue disease (eg EDS)
- Neural irritation
- Long term steroids/ anticoagulants/ NSAIDS
Signs of the buttocks
Purpose - to determine non musculoskeletal causes of pain in the area.
1 - large/swollen/tender
2 - Straight leg raise limited and painful
3 - Limted trunk flexion
4 - Hip flexion with with knee flexion limted and painful
5 - Empty end feel on hip flexion
6 - Non capsular pattern of hip restriction (flex, abd, IR)
7 - Resisted hip testing weak and painful
Contraindications for joint mobilisations
- Unhealed fracture
- Tumour in area
- Osteoporosis
- Acute inflammation/joint effusion
- Instability/hypermobility
- Bone infection (osteomyelitis)
- Joint infection
- Empty end feel
- Inflammatory arthritis
- Ligament rupture
- VBI signs/symptoms (area specific)
- Craniovertebral ligament instability (area specific)
- Fusing ankylosing spondylitis (area specific)
- Sign of the buttocks (area specific)
- Neural signs/symptoms of spinal core injury (area specific)
Contraindications to percussion/vibrations and rib spring
- Increased intracranial pressure
- Uncontrolled seizures
- Unstable head injury
- LIkely haemorrhage
- Haemoptysis
- Pain intolerance
- Pneumothorax
- Pulmonary embolus
- O2 desaturation
- Subcutaneous emphysema
- Lung tumours
- Unstable cardiovascular status
- Recent pacemaker
- Fractured ribs
- Osteoporosis
- Metastatic bone cancer
- Burns and skin lesions
- Recent skin grafts
- Tube feeding (precaution - stop 30mins before treatment)
Contraindications to mobilising
Neuro status
* Severely agitated distressed or combative
* unable to understand instructions
Respiratory status
* Sp02 less than 88%
* Respiratory rate <5 or >40
* Fi02 >60%
* Ventilator issues
* Uncontrolled asthma
Cardiovascular status
* Mean arterial pressure <65 or >110
* Blood pressure >20mmhg systolic drop during mobilising
* Blood pressure >200mmhg systolic
* Blood pressure >110mmhg diastolic
* Heart rate <40 or >130
* Uncontrolled hypertension
* Active bleeding
* Acute or Unstable cardiac status
* Pulmonary embolism
* DVT not cleared by doctor
Contraindications mobilising with chest tube
- Do not lift drainage container above insertion site
- Do not lay or roll onto chest tube
- Do not compress, kink or clamp tube
- Do not tip or knock over drainage container
- Do not perform percussion directly over chest tube
COntraindications mobilising with a catheter
- Do not lift bag above bladder
- Do not pull or tension drainage tube
Contraindications for taking blood pressure
- Lymphedema
- Mastectomy on side
- Stroke (affected side)
- IV catheter in that arm
Contraindications to nasopharyngeal suctioning
- Basal skull fracture
- Nasal bleeding/bleeding disorders
- Nasal stenosis
- Nasal infections
- Nasal polyps
- Acute head or facial injury
- Cerebral spinal fluid leakage
- Croup / epiglotitis
- Restlessness and agitation
- Cardiovascular instabilities
