BASIC GUIDELINES FOR THE APPLICATION OF 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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