Contraindications
Which biophysical technology does not have strict contraindications set as osteomyelitis & malignancy?
Compression Therapy
You can apply Negative Pressure Therapy over wounds with necrosis; however, the wound must be debrided to < _____ % of a necrotic base.
10%
You are about to visit your patient with a wound that just doesn't seem to be responding to treatment. He's been here for 3 weeks now without any significant improvement. Name 3 technologies that would be helpful in this non-healing wound.
1. Pulsed High Frequency US
2. Low Frequency US
3. Topical Oxygen Therapy
4. Negative Pressure Therapy
5. Pulsed Electromagnetic Energy
6. Monochromatic Infrared Energy (MIRE)
7. Ultraviolet C
8. Cold Laser
In E-Stim:
_____ stimulation should be applied in the ______ phase of healing.
_____ stimulation should be applied in the _____ phase of healing.
1. cathodal; inflammatory
2. anodal; proliferative
These 2 biophysical technologies should not be used in wounds with fistulae...
1. Topical Oxygen Therapy
2. Negative Pressure Therapy
Which biophysical technologies require plastic bags/transparent films to prevent machine contamination (one is sneaky ladies)...
1. Compression Therapy
2. Monochromatic Infrared Energy (MIRE)
3. Cold Laser
You are determining the next line of treatment for your patient, Zac Efron, who originally came to you in critical condition as a result of an advanced case of necrotizing fasciitis. Since then, he has stabilized but recently, developed osteomyelitis as a complication. Which would be the best technology to employ at this point in time? (Bonus Q: By telling your colleague you're working with Zac Efron, which basic tenant of PT are you breaking?)
Systemic Hyperbaric Oxygen
Bonus Q: HIPAA
What is the difference between the mechanism of action between Systemic Hyperbaric Oxygen & Topical Oxygen Therapy?
1. Pressure level (2-3x HBO; 1.03 TOT)
2. Chamber: full body chamber v. extremity chamber
3. HBO saturates plasma
4. HBO - osteomyelitis as indication; TOT - osteomyelitis as contraindication
Monochromatic Infrared Energy mainly works via this mechanism of action...
stimulating RBCs to release nitric oxide (endogenous vasodilator), thus increasing microcirculation
This biophysical technology shouldn't be used in skeletally immature patients...
Pulsed Electromagnetic Energy (nonthermal)
Which biophysical technologies require a coupling agent/medium?
1. High Frequency US
2. Low Frequency US (mist & contact)
This biophysical technology is indicated for those patients with diabetic neuropathy, specifically.
Monochromatic Infrared Energy (MIRE)
Which biophysical technologies decrease the bioburden?
1. E-Stim
2. Low Frequency US
3. Negative Pressure Therapy
4. Ultraviolet C
5. Cold Laser
When a biophysical technology says outlines pregnancy as one of its contraindications, does this mean that this technology can't be used systemically? Explain.
No, not necessarily. It may mean the technology can't be used over a pregnant uterus or low back (the area the fetus is growing in).
1. E-stim
2. Pulse High Frequency US
3. Low Frequency US
4. Pulsed Electromagnetic Energy
_____ can treat through dressings & casts;
_____ cannot transmit through hydrogels & transparent films.
1. Pulsed Electromagnetic Energy
2. Ultraviolet C
Your next patient has a very low threshold for pain. Even before you begin your treatment, she winces in pain. Which technologies would be best for decreasing her pain level?
1. Low Frequency US (non-contact MIST)
2. Monochromatic Infrared Energy (MIRE)
Which biophysical technology is both bactericidal & virucidal?
Ultraviolet C
What is the most common coupling agent used in Low Frequency US?
Saline spray
You are treating the wound of a patient who recently came into the hospital with an acute upper respiratory infection secondary to his pulmonary TB exacerbation. Which 2 biophysical technologies should you rule out as they are contraindications to his wound care?
1. Systemic Hyperbaric Oxygen
2. Ultraviolet C
Today, you are treating the wound of a woman who works at an aluminum production factory as a line-worker. She suffered a traumatic wound to her thigh due to a blast injury. So far, the large shards of aluminum have been removed from her leg, but you are unsure if all of the smaller pieces have been removed. Which technology do you know you cannot use immediately?
Electrical Stimulation
This biophysical technology is most effective in all phased of healing if it's begun in the inflammatory phase of healing...
Pulsed High Frequency US (nonthermal)
Name 2 biophysical technologies that enhance cellular membrane permeability...
1. Pulsed High Frequency US
2. Low Frequency US
3. Pulsed Electromagnetic Energy
You're treating a patient with a venous wound on his lower medial leg. The wound is draining heavily and seems to be slightly infected according to your initial observation. You stick your sterile cue-tip down into the center of his wound and probe around, find the bottom of his wound which you can see, and then pull your cue-tip out (seems to be 3 mm deep).
1. What is this type of "hole" called?
2. Can you treat this wound with the Negative Pressure Therapy? Why or why not?
1. Sinus Tract
2. Yes you can. Even though it's infected, you just have to change the dressing every 12 instead of 24 hours. You also can because you can see the bottom of his wound (aka no fistulae).