Electrical Stimulation
Communicates with skin and other body tissues calling repair cells to the site of injury
What is called "current of injury" - estim
promotes healing through cell stimulation, removes bacteria and bioburden, reduces inflammation, and increased blood flow
what is Mist therapy
not generally accepted, no Medicare reimbursement, augment immune function, increase granulated, and applied directly to wound
what is topical HBO
Placement of electrodes over heart along phrenic nerve, over carotid sinus, over laryngeal musculature, over topicals with metal ions
what is electrical stimulation contraindication
When we discontinue NPWT what do we transition to
appropriate wound dressing
Treatment protocol for pulse frequency
what is 80-120 pps
Mist therapy parameters for frequency
40 KHz
the purpose of hyperbaric oxygen pt breathes 100% pure oxygen in a chamber that generates what
what is an atmospheric pressure greater than sea level
to do this modality with >80% granulation
what is NPWT indications
active bleeding, wound hemostasis, anticoagulation, exposed arteries/veins, acute or untreated infection
what are precautions of NPWT
Increases blood flow and, subsequently oxygen and other nutrients
what is to promote wound healing
painless, con-contact low frequency ultrasound waves transmitted to wound using saline
what is MIST Therapy System
To control by-products produced by patient (CO2, water vapor, odors, etc)
what is chamber vented
stage of pressure injuries indications for electrical stimulation
Stage II-IV
The guidelines time to change infected and noninfected wounds
infected wounds- change every 12-24 hours
non-infected wounds- change every 48-72 hours
Most effective to promote proliferative phase of wound healing, attracts macrophages, maintains low bacterial count, epithelial growth, granulation tissue formation
what is positive polarity
the parameters duration of mist therapy- US
3x/week for 3-20 minutes, depending on wound dimensions (more time required to cover later wounds)
Complications
what is flammable items in chamber, ear injuries, cardiopulmonary issues, temporary vision impairments, CNS oxygen toxicity seizures
cleansing of wounds with necrotic tissue, exudate or bacteria
what is mist therapy indications
We should discontinue NPWT until a physician is able to complete wound assessment and direct POC
BONUS: explain what the physiology is
what is a fistula
BONUS: an abnormal connection between two organs
Discontinue if no measurable signs of healing
what is 30 days or wound bed has re-epithelialized
Research supports using MIST Therapy for sDTI's (suspected deep tissue injury) if initiated within 24 hours of injury; how many days
performed daily for 5 days and adjusted as indicated pending progress
From Cochrane review hyperbaric oxygen therapy can be beneficial for what type of chronic wounds
Diabetic foot ulcers and venous
DVT, CHF (relative), COPD, phlebitis, severe ischemic ulcers, antineoplastic medications and untreated pneumothorax
what is hyperbaric oxygen contraindications
For pressure setting we typically start at 125 mmHg describe whether to titrate up or down and what amount in the following scenarios:
A. a 45 year old patient comes in with a large wound surface area with excessive drainage
B. A 60 year old patient comes in with a large wound surface area with excessive bleeding and noted pain
A. Titrate up 25 mmHg
B. Titrate down 25 mmHg