Transcript Shortwave Diathermy Clinical Application

Shortwave Diathermy
Clinical Application
Treatment Dosages
Dose Sensation
NT
No warmth
1Mild warmth
2Moderate warmth
3Vigorous warmth
Pulse
Width
Rate (pps)
65 µsec
100 – 200
100 µsec
800
200 µsec
800
400 µsec
800
Pulsed SWD Setup
Parameter
Setting
Output mode:
Bursts per sec:
Burst duration:
Interburst
interval
Output intensity
Pulsed
800
400 sec
850 sec
150 W RMS
48 W/burst
RMS
RMS = Root Mean Squared
Set-up and Application
Treatment Duration
Nonthermal, Mild, and Moderate Heating
• Duration – 20 to 30 minutes
• Repeated as needed
• Two weeks
Vigorous Heating
• Duration – 15 minutes
• Applied every other day
Precautions
• Remove contact lenses when applying SWD around the head, face, or
eyes.
• Cover the skin with at least 0.5 inch of toweling
• Do not allow perspiration to collect in the treatment field.
• Thick adipose tissue in the treatment area can result in overheating.
• Never allow the skin to come into contact with the heating unit or cables.
• If the cable method is used, do not allow them to touch each other.
• If electrode pads are used, space them at least the distance of their
diameter apart.
• A deep, aching sensation may be a symptom of overheating the tissues.
• Overheating of the patient’s tissues may cause tissue damage without any
immediate signs.
• The SWD energy scatters 2 to 3 feet from the source
– A distance of 3 feet from the source of the energy should be
maintained to ensure the operator’s safety.
Instrumentation
Master Power Switch: Turns
the unit on.
Output Intensity (Power):
Adjusts the amount of
energy delivered to the
patient.
Patient Interrupt Switch
(Safety Switch): Allows
the patient to end the
treatment.
Pause: Interrupts the
treatment to allow
repositioning of the patient,
etc.
Instrumentation (Cont.)
• Pulse Rate (Pulse Frequency): Sets the number
of pulses per second (PPS) for the output.
• Start/Stop: Initiates or terminates the treatment.
• Treatment Timer: Sets the treatment duration.
• Tuning: Adjusts the output resonance to match the
patient’s tissues.
– Some units will shut off if an out of tune state is detected
– Most contemporary units are self-tuning
Patient Preparation
• Ensure the absence of all
contraindications.
• Remove all jewelry, clothing, coins,
and other metallic items from the
patient.
• For personal safety, remove your
rings, watches, bracelets, etc.
• No metal can be within the
immediate treatment area
• Keep the patient out of reach of
any metal objects that can serve
as a ground (e.g., outlets, pipes).
• Clean and dry the body part.
Water, skin oils, etc. can increase
superficial heat production.
Patient Preparation (Cont.)
• Position the patient in the most appropriate manner for the
body area being treated.
• To encourage venous return, elevate the treated extremity.
• To prevent burns cover the area with a dry terry cloth towel:
– This provides spacing between the source of the shortwave diathermy
– Absorbs perspiration
– A portion of the treatment area must remain visible to check for burns
during the treatment..
• Explain to the patient that mild warmth should be felt.
• Instruct the patient to inform you if any unusual sensations
are experienced.
Patient/Generator Tuning
If
•
•
•
the unit must be manually tuned:
Position the electrodes over the patient.
Increase the output intensity to appx. 40% of the max.
Adjust the TUNING control until the output meter reaches its
peak…
• … then decrease the TUNING to the patient’s comfort.
• A unit is tuned when less than half of the maximum output is
used.
– Some units will automatically shut off if more than 50 percent of the
maximum output is used. If this occurs, the unit must be tuned again.
Initiation of the Treatment
Drum Method
• Turn the unit on; allow it to warm up if necessary.
• Some units must be tuned to allow for maximal
energy transfer.
• If indicated by the manufacturer’s instructions, place
a folded towel between the body part and the drum.
• Position the drum approximately 0.5 to 1 in. above
the toweling.
• The surface of the drum must be parallel to the skin
surface being treated, otherwise the skin closest to
the drum will overheat (the Cosine Law)
Initiation of the Treatment (Cont.)
• Instruct the patient not to move until the unit is shut
off.
• Set the TIMER to the desired treatment duration.
• Increase the intensity until the patient feels mild
warmth.
• If the drum must be moved or if it becomes
necessary to dry the area, return the intensity to
zero before making any adjustments.
• Do not leave the patient left unattended
• Regularly check the skin for signs of burns and
inquire about unusual sensations.
– Adjust the INTENSITY, PULSE RATE, and/or electrode
placement as necessary.
Termination of the Treatment
• After the treatment, return the intensity to
“zero” and shut off the unit.
• Inspect the skin for signs of burns or other
abnormal treatment outcomes.
• Record the treatment parameters in the
patient’s file.
Maintenance
Daily Maintenance
• Clean the face of the drum or cables using a
manufacturer-approved cleanser.
Regular Maintenance
• Inspect electrical cords for kinks and frays.
Annually
• The unit must be serviced and calibrated by a
qualified service technician.