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ELECTROTHERAPY                       (Back to contents)
Before applying any modali ty of electrotherapy to a patient the following
Questions should be considered:

1 What effect is intended and can this treatment achieve this effect? In
many instances it cannot be known if treatment is effective until it is
tried. Sometimes effectiveness can be seen at once, e.g. relief of pain
due to transcutaneous electric nerve stimulation or ice; in other cases
it cannot be recognized,for days or weeks.

2 Is it safe, i.e. will the desired effect be achieved without undesirable
effects? There is no effective treatment that does not carry some risks
but for most electrotherapy treatment the risks are negligible provided
reasonable and proper precautions are taken. Each modality has its
own potential dangers and contraindications and no treatment should
be considered without a thorough knowledge of these.

3 Is it the best method of treatment tb achieve this effect? Is it the most
economical in terms of patient andtor therapist time, or other costs?
Physioth4rapists should confine themselvestotheuseofelect
   modalities in which they are competent. Usually electrotherapy is part
   of an overall treatment plan which is selected and modified on the basis
   of repeated examination and assessment. However, there are some basic
 guidelines which can provide the framework for sound practice:
1 Preparation of patient
a Explanation. An explanation of the treatment is an essential precursor
of application. This not only reassures the patient but ensures in-
former consent. 'Ihe type of sensation to be experienced is explained,
and the patient is warned of any effects that should be reported.
b Examination and testrng. This refers to specific examination of the
part to be treated for possible dangers afld contraindications plus
any relevant tests, e.g. for normal thermal sensitivity. The results
should he recorded.

2 Assembly ofapparatus: All the apparatus and equipment needed should
be assembled and suitably positioned. Visual checks are made of
electrodes, leads, cables, plugs, power outlets, switches, controls, dials
and indicator lights.

3 Preparation and testing of apparatus: This includes setting up the apparatus
and any necessary testing of it prior to application. When this has been
done satisfactorily treatment can begin. The operator should minimize
their own exposure to the effects of the modality being used.

4 Preparation of the part to be treated:      This involves any preparatory
   procedure, e.g. washing the area and positioning the patient, and in
particular the part to be treated, comfortably and appropriately, so that
he or she is relaxed and unnecessary movement is avoided.

5 Setting up:   The apparatus is set up to ensure optimum therapeutic
effect and safety.

6 Instructions and warnings: Before the treatment commences it is man-
datory to instruct the patient in what he or she must and must not do,
e.g. keep still and not touch the apparatus, and to give essential
warnings, e.g.'If this becomes more than a comfortable warmth it can
bum'. The warning given should be noted on the patient's record card.

7 Application:  The patient must be observed throughout to ensure that
treatment is progressing satisfactorily and without adverse effects.
Accurate timing is essential.

8 Termination oftreatment: At the termination of treatment the part treated
should be examined to ensure that the desired effects have occurred
if visible, e.g. superficial vasodilation, and that there are no unwanted
effects. If electrotherapy is a precursor to another form of treatment,
the patient is prepared for that. If it forms the whole treatment, e.g.
UVR, an explanation of what to expect is given as well as instructions
of when to come again and what must be done between treatments.

9 Recording: An accurate record of the treatment and its effects must be
made for assessment purposes, and for legal requirements.

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