Flashcards
Integ Quiz 3- modalities
Cards in this deck (44)
- 1Hydrotherapy: what is is used for- not good for-moistens eschar
-makes it easier to debride w/ sharps
-can cross contaminate - 2Pulsatile lavage: What is it?"gold standard"
-cleans wound
-stimulates wound bed
-4-15psi (more than 15= risk to push bacteria back in)
-suction: 60-100mmhg
-uses saline to irrigate - 3What is Pulsatile lavage w/suction used for?-moist wound healing
-facilitate debridement
-may increase: granulation/profusion/epithelial migration - 4Contraindications to pulsatile lavage-exposed arteries, nerves, tendons, capsules,bone
-face
-recent grafts
-latex allergies
-anticoagulants/insensate - 5Benefits of Pulsatile lavage-less tx. time
-at bedside
-no cross contamination
-no maceration of tissue - 6disadvantages of PLWS-risk of over exposure
-could traumatize new tissue
-increase pain
-need full PPE
-landfill burden - 7What is monochromatic infrared photo-energy? (MIRE)-not reimbursed
-IR light, single wavelength 880-890nm
-can pulse at 50% duty cycle
-therapy in flexible pad with up to 60 diodes
-sessions last 30-45mins - 8benefits of MIREincreased circulation b/c increased NO
-relieves pain
-not approved to help increase sensation - 9Specs on using infrared with hand probewavelength: IR: 880nm/ Red diodes: 660nm
Duty cycles: CW,90,50,20
Power output: 500mW
Dose: 65/cm(squared)
1min treatment - 10Benefits of IR-promote healing (4-16 j/cmsquared)
-improve nerve conduction velocity and regeneration
-pain management
- reduce post mastectomy lymphedema - 11Precautions for IR-pregnant
-epiphesial plates in children
-impaired sensation
-mentation
-photophobia
-photosensitizers - 12Contraindications of Infrared-Radiation to eyes
-malignancy
-4-6mo post. radiography b/c skin still isn't healthy
-over hemorrhage
-over thyroid/endocrine glands - 13Use of traditional ultrasound-to periwound to help Increase BF
-over wound with hydrogel (3 b/c not deep)
-acute intensity: 0.3
Reparative: 0.5
Early remodeling: 0.5-1 - 14Application of traditional ultrasound-treating wound base: 3MHz (shallow)
- 20% duty cycle
-2-3min per zone
1-2x/day to treat acute wounds
-chronic treated 3-5x/week - 15Benefits of traditional ultrasound-cell membrane permeability
-release growth factors
-stimulate myofibroblasts
-angiogenesis
-improve tensile strength of collagen
-upregulates ATP production - 16Contraindications of traditional US-simple/uncomplicated wounds
-over necrotic tissue
-acute wound infections
-osteomyelitis - 17Mist ultrasound: Non-contact us -what is it?-40kHz saline mist of US
-want acoustic streaming +cavitation but not thermal
-helps w/debridement + hydration - 18How often do we use Mist us (per week?)- 2-3x/week
4-12mins
-3-5days in row b/c it kills top bacteria and the bottom ones come to top, so kill those next and keep going. - 19What is the purpose of cavitation with Non-contact US?-kills bacteria/fungi/ biofilms
- 20Benefits of Mist US-antibacterial
-helps with fibrinolysis.
-improves microcirculation
-increases GF, collagen production - 21Contraindications of Mist US-active cancer
*will activate both good and bad cels - 22Ultraviolet- what is it/what are the specs- UVC 254nm Wavelength
-2.5cm lamp to skin distance
-range of 5-90 sec with 30sec being typical
-daily tx for chronic wounds
-1-2x daily on infected wounds - 23Benefits of Ultraviolet-vasodilation
-pigmentation
-stratum corneum thickening
-vit D
-bacteriocidal
-cell prolif - 24Precautions for UV-photosensitive
-recent radiation
-eye exposure - 25Contraindications of UV-TB (pulmonary issues)
-cardiac/liver/renal disease
-systemic lupus
-carcinoma in wound
-psoriasis/herpes/eczema
-hyperthyroid
-severe diabetes - 26Ultraviolet with hand probeblue light: 28 diodes
IR: 8 diodes
Wavelength: 405nm (blue)
880nm (IR)
Duty: continuous
Power: 500mw
Dose: 6j/cm square
tx time: 1min - 27Hyperbaric Oxygen (HBO) -what is it-100% oxygen
-2-2.5 ATM more than earth
-systemic applicatoin - 28how long is someone in a HBO chamber/day?90-120mins
1-2x/day
10-60tx total - 29what is the cost per session HBO$250-800
- 30Benefits of HBO-slows progression of infection
-anaerobes can't live
-increase macrophage fxn.
-fibroblastic activity
-avoid limb amputation
-eliminate o2 free radicals
-enhance angiogenesis
-increase tensile strength of wound - 31Precautions of HBO-upper respiratory infection
-seizures
-emphysema
-fever
thoracic surgery
-spontaneous pneumothorax
-viral infections
-optic neuritis hx.
-pregnant - 32Contraindications of HBO-antineoplastic meds
-untreated pneumothorax
-DVT
-uncontrolled CHF - 33-ve wound pressure therapy: what is it-subatmospheric pressure (50-125mmHg)
facilitates: granulation/angiogenesis/wound contraction/exudate control/edema control
-mechanical force on tissue helps make more blood vessels in response - 34NPWT application-3 types of open cell foam can be used:
-black/white/silver impregnated
-covered by an occlusive film
-sponge and drape changed every 48hours in clean wound
-changed every 12hours in infected.
-if we leave it alone= mitosis - 35Parameters for NPWT-125mmHg continuous
-post skin graft = back off a little
-if can't handle continuous: 5min on 2min off)
-125 works best for angiogenesis but isn't always necessary to be this high - 36Advantages of NPWT-reduce local edema
-increase BF
-enhance epithelial migration
-help secure skin graft/flap
-enhance granulation tissue - 37disadvantages of NPWT-painful
-hard to mobilize patients
-noisy
-skin integrity under foam can decrease - 38What general concepts do we need to remember when thinking about NPWT?- clean and debride of Necrotic tissue
-apply skin protectant to periwound
-avoid wrinkles in drape
-monitor pain control
- - 39NPWT precautions-active bleeding
-anticoag
-difficult wound hemostasis - 40NPWT Contraindications-necrotic tissue
-untreated osteo
-malignancy in wound
-fistula to organs/cavities - 41Thermal and non-thermal pulsed diathermy-short wave: thermal
-pulsed radio frequency: non-thermal
-transmits magnetic field into target tissue to make micro currents in cells - 42precautions for thermal and non-thermal diathermy-pregnant
-non-closed epiphyses
-metal - 43contraindications for thermal/non thermal diathermy-metal implants that makes loops/are wires
-pacemakers
-implanted electric device
-metastatic cancer
-growing epiphyses
-eyes/testes - 44How do you choose your modality:-wound type/physiological needs to progress it
-wound location
-size
-underlying etiology
-contraindications/indications
-advantages/disadvantages
-tx. settings
-equipment availability
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- Flashcards on Integ Quiz 3- modalities, created by kathleen michaels on 29/09/2018.
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- kathleen michaels
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