EPA PSE

Question 1

thermal US mode

Answer 1

continuous

Question 2

thermal US intensity

Answer 2

0.8-2 W/cm2
- gradually increase intensity so the patient feels heat

Question 3

time for thermal US delivery

Answer 3

10-15 mins

Question 4

US frequency for superficial

Answer 4

3 MHz (MEGA Hz)

Question 5

US frequency for deep

Answer 5

1 MHz

Question 6

how often should you apply thermal US

Answer 6

3x/week

Question 7

athermal US mode

Answer 7

pulsed 20% or 1:4

Question 8

athermal US intensity

Answer 8

1 W/cm2

Question 9

athermal US delivery time

Answer 9

15 mins per 10-15cm2

Question 10

how often should you apply athermal US

Answer 10

5x per week for 2-3 weeks then 3x per week for 2-3 weeks

Question 11

what is ultrasound?

Answer 11

this machine delivers high frequency mechanical sound waves to your tissues, creating tiny vibrations in your tissues that you can’t actually feel

Question 12

type of energy delivered by US

Answer 12

mechanical (high frequency sound waves)

Question 13

purpose of thermal US

Answer 13

heat tissues and increase collagen extensibility

Question 14

purpose of athermal US mode

Answer 14

promote tissue healing, wound healing, and potentially delivery of drug across tissue
- provides optimal environment for healing

Question 15

contraindications for US

Answer 15

• areas of known malignancy
• areas with acute infection or sepsis
• tissues where bleeding could occur
• areas of vascular insufficiency

Question 16

measurable changes with athermal US

Answer 16

AROM before and after treatment

Question 17

measurable changes with thermal US

Answer 17

pain before and after treatment

Question 18

C-TENS frequency

Answer 18

80-120 Hz

Question 19

C-TENS pulse duration

Answer 19

150-200 microseconds

Question 20

C-TENS amplitude

Answer 20

strong and sub-noxious but tolerable, should “mask the pain”

Question 21

time for C-TENS application

Answer 21

as long as required to mask the pain

Question 22

placement of C-TENS electrodes

Answer 22

along dermatome/bracketing pain/over areas of pain/over muscle at same spinal segment
- don’t want to cross the electrodes

Question 23

what is C-TENS?

Answer 23

TENS is a non-invasive electrical stimulation that helps to treat pain, specifically short term acute pain

Question 24

what should the patient feel with C-TENS

Answer 24

buzzing or tingling sensation that masks your pain
- strong but tolerable
- no muscle twitching

Question 25

type of energy with C-TENS

Answer 25

electrical stimulation

Question 26

potential risks of C-TENS

Answer 26

potential skin irritation, small danger of electrical burn

Question 27

contraindications for C-TENS

Answer 27

heart problems pace maker seizure disorder areas of venous thrombosis family history of cancer pregnancy skin allergies or rashes

Question 28

measurable factors for C-TENS

Answer 28

pain pre and post treatment

Question 29

how long do you have relief with C-TENS

Answer 29

only last 0-20 minutes post treatment

Question 30

IFC for acute/immediate pain relief frequency (AMF)

Answer 30

80-120 Hz

Question 31

IFC for longer term pain relief frequency (AMF)

Answer 31

1-10Hz

Question 32

carrier frequency for IFC

Answer 32

4000 Hz

Question 33

frequency sweep for IFC

Answer 33

6 ^ 6 (6 sec up, 6 sec down)

Question 34

vector for IFC?

Answer 34

ON! modulates intensity of the 2nd channel

Question 35

what can you use for IFC if treatment area is small?

Answer 35

pre-modulated IFC (2-pole)

Question 36

IFC delivery time

Answer 36

20-30 mins

Question 37

what is IFC?

Answer 37

IFC is used to treat pain through the delivery of 2 electrical currents into your skin. additionally, where the 2 lines cross, there will be a third, lower intensity current that will stimulate directly over the area we are looking to treat. These currents will be sent into your skin to help with reducing the pain and muscle tension

Question 38

what will you feel with acute IFC (80-120)

Answer 38

buzzing, tingling sensation that is comfortable

Question 39

what does patient feel with chronic IFC treatment (1-10)

Answer 39

non-painful tapping or buzzing with a small muscle twitch

Question 40

how do we adjust intensity for IFC?

Answer 40

it is patient specific, we increase to a place that is comfortable for our patient!

Question 41

importance of frequency sweep with IFC

Answer 41

helps to prevent habituation

Question 42

contraindications for IFC

Answer 42

over: malignancy, abdominal region/back in pregnancy, infection, damaged skin, active DVT

Question 43

communication criteria

Answer 43

- explains modality in lay terms - type of energy delivered - type of expected sensation - goal/benefit of treatment - risk of treatment and how I will mitigate it - how long treatment will last - ask for informed consent after listing benefits and risks

Question 44

knowledge criteria

Answer 44

screens patient for appropriate contraindications/precautions for the required modality

Question 45

treatment preparation criteria

Answer 45

- patient position maximizes comfort - appropriate draping of patient - position optimizes body mechanics - optimal treatment parameters - verbalize relevant baseline measures

Question 46

justification of treatment criteria

Answer 46

student justifies treatment modality to achieve desired response - student states goal of treatment and justification for the appropriate length of treatment and parameters

Question 47

treatment administration criteria

Answer 47

- adjusts intensity appropriately with feedback - adjusts intensity continuously while obtaining feedback - describe to patient the sensation they should experience and what they should not experience as applicable while adjusting intensity

Question 48

conclusion criteria

Answer 48

- verbalize relevant measure after treatment (reassess baseline) - cleans up patient/removes equipment from patient/disconnects patient from equipment - turn off machine - provide instruction for follow up to patient