ULTRASOUND. To be able to undertake prescribed ultrasound treatment safely and effectively.

Transcription

1 ULTRASOUND Aim To be able to undertake prescribed ultrasound treatment safely and effectively. To be aware of contra indications and warning signs when undertaking the treatment Background Ultrasound is used for recent injuries and localised tenderness. Ultrasound is the use of high frequency sound waves which travel through tissues and cause the molecules which make up that tissue to vibrate. This vibration increases the cell s activity and increases the local blood supply, which can help to reduce inflammation, soften thickening and increase the elasticity of scar tissue. Different tissues absorb different amounts of sound energy; tendons, ligaments and scar tissue are good absorbers, air is a poor absorber. Where there are changes in the absorbency of tissues or boundaries e.g. air between the treatment head and the skin the energy will be reflected reducing the effectiveness of the treatment. To avoid this happening we use a gel on the skin which helps transmission of the waves from the treatment head to the skin. Ultrasound machines have various settings that can be adjusted to suit the area of injury and the stage of healing the injury is at. Firstly the depth that the sound waves will reach can be changed between 1 MHz and 3 MHz. 1 MHz will penetrate deeper (up to 3cm) than 3 MHz (up to 1.5cm). Sound waves are pulsed from the treatment head and the percentage or rate at which these are pulsed can be changed from 10 %( 1 pulse in 10) to 100% (continuous). The dosage or strength of the sound wave can also be adjusted; this is delivered in watts per square centimetre (W/cm2). The time the treatment is to be applied for is also set, this is dependent on the size of the area to be treated and the treatment head used, and most machines have two treatment heads. All the settings required for the specific Service User will be determined by the Registered Practitioner and will be documented in the Service Users plan prior to using the treatment. While performing ultrasound the treatment head should be kept moving, if the head is kept still standing waves can form which increases the risk of thrombi or air bubbles in the blood or at high doses can cause overheating and burning.

2 Contra Indications There are some medical conditions that mean ultrasound should not be used with a Service User. Ultrasound should not be used if: Service User has problems with circulation or blood clotting Service User has infections Service User has had recent radiotherapy On joints in children under 16 Near to the baby in pregnancy Service User has active implant e.g. pacemaker near to treatment area Ultrasound should only be used once a Service User has been assessed by a Registered Practitioner and it has been confirmed that there are no contraindications to use the treatment. Procedure 1. Check plan for area to be treated, ultrasound dosage, frequency, percentage treatment head required and time of treatment 2. Explain that you will be performing ultrasound treatment to the area which will involve you putting a cold gel onto the area and placing the treatment head onto the gel and moving the head around. Explain that the Service User should not feel anything other than the movement of the treatment head and should report immediately to you if they feel pain or heat. Gain consent. 3. Position the Service User so that they are comfortable and the area to be used is accessible and well supported. If using a treatment plinth ensure the plinth is raised to the appropriate height to enable you to maintain a good posture throughout treatment 4. Position of Rehabilitation Assistant Position yourself so that you can reach the area of the Service User to be treated comfortably with the treatment head Apply ultrasound gel to the treatment area Switch on the machine; connect the correct treatment head and set frequency, percentage, time and dose. The light on the treatment head should be on at this point Place the treatment head onto the area of ultrasound gel, the light on the treatment head should now go out, continuously move the treatment head in slow, small circles. The treatment head should not be still once it has been applied to the treatment area

3 If the light on the treatment head comes on the contact is poor, redistribute or add more gel. If the light continues to come on STOP the treatment and report to the Registered Practitioner If the Service User reports any heat or pain around the area to be treated STOP treatment and report to the Registered Practitioner 5. Completion Switch off the machine, wipe the gel from the Service User s skin, wipe the gel from the treatment head using tissue and then clean the treatment head with a sanicloth. 6. Feedback to Service User and check the skin. Seek feedback from them regarding the treatment. 7. Document the treatment in the Service User s notes ensuring to document, frequency (Hz), percentage, dosage (w/cm2), time and size or treatment head 8. Report back to the Registered Practitioner

4 SUPERVISED TASKS/EXERCISES CARRIED OUT BY REHABILITATION ASSISTANT COMPETENCIES NAME: TAUGHT MODELLED COMPETENT PT56 ULTRASOUND DATE DATE DATE 1 Read plan, identify site and dose of ultrasound 2 Explanation of ultrasound treatment. Gain consent. 3 Position of Service User 4 Position of Rehab Assistant and application of ultrasound i ii iii 5 i ii iii iv Apply ultrasound gel to the area Switch on machine and place head on treatment area. With continuity move head in small circles If appropriate STOP if Service User reports pain or heat Completion Switch of machine Wipe gel from Service User s skin Wipe gel from treatment head Clean treatment head 6 Feedback to Service User 7 Documentation

5 PT56 ULTRASOUND DATE DATE DATE 8 Feedback to Registered Practitioner Sign and date when achieved Signature of Learner Signature of Assessor Date of Review