Document Control Title Physiotouch Standard Operating Procedure Author Author s job title Macmillan Lymphoedema Clinical Nurse Specialist (CNS) Directorate Health and Social Care Department Version Date Issued Status Comment / Changes / Approval 0.1 October Draft Initial version for consultation 2016 1.0 October 2016 Final Approved by H M and G M to be published on BOB. Main Contact Tel: Direct Dial 01271 341551 Barnstaple Health Centre, Vicarage Street, Barnstaple, EX32 7BH Lead Director Director of Nursing Document Class Standard Operating Procedure Target Audience Lymphoedema Practitioners Distribution List Senior Management Distribution Method Trust s internal website Compliance Manager Superseded Documents N/A Issue Date October 2016 Review Date October 2019 Review Cycle Three years Consulted with the following stakeholders Contact responsible for implementation and Macmillan Lymphoedema Practitioner monitoring compliance: Approval and Review Process Local Archive Reference G:\Lymphoedema Filename Physiotouch standard operating procedure v1.7 03Jan13.doc Policies and Procedures/Lymphoedema/Physiotouch/SOP Education/ training will be provided by: Standard Operating Procedure V1.0 24.10.16.docxV1.0 24Oct16 Page 1 of 5
Policy categories for Trust s internal website (Bob) Lymphoedema, Cancer Services Tags for Trust s internal website (Bob) Lymphoedema, Physiotouch Standard Operating Procedure V1.0 24.10.16.docxV1.0 24Oct16 Page 2 of 5
CONTENTS Document Control... 1 1. Introduction... 3 2. Purpose... 3 3. Scope... 3 4. Location... 3 5. Equipment... 4 6. Procedure... 4 7. References... 5 8. Associated Documentation... 5 1. Introduction 1.1. This document sets out Northern Devon Healthcare NHS Trust s system for the use of the Physiotouch in the management of lymphoedema. 2. Purpose 2.1. The Standard Operating Procedure (SOP) has been written to: Identify the procedure for the assessment and delivery of the Physiotouch for patients with lymphoedema in the clinical setting. Improve treatment options for the patient and reduce the risks associated with lymphoedema care. 3. Scope 3.1. This Standard Operating Procedure (SOP) relates to the following staff groups who may be involved in the assessment and delivery of the Physiotouch treatment in the clinical setting: Lymphoedema CNS Lymphoedema Practitioners 3.2. Registered nurses, medical staff and those working with patients with lymphoedema can refer patients to the for assessment. 4. Location 4.1. This Standard Operating Procedure - Physiotouch treatment can be implemented in clinical areas where competent staff trained in the use of this device are available to undertake this role. Standard Operating Procedure V1.0 24.10.16.docxV1.0 24Oct16 Page 3 of 5
4.2. Staff undertaking this procedure must be able to demonstrate continued competence as per the organisations policy on assessing and maintaining competence. 5. Equipment Physiotouch is a device based on vaccum where pressure, pulsation and vibration can be precisely controlled. The negative pressure is formed in the mouthpiece and can be adjusted to customise the treatment for individual patients. Device pulsation can be adjusted to the desired work/rest ratio of continuous to pulsating negative pressure. The negative pressure range is 30-250 mmhg and the pulsation range is 0.3-5 seconds. The Physiotouch device has a high frequency vibration feature that offers even more treatment options. The high frequency vibration can be adjusted in the range of 20-90 Hz. The equipment has been approved by EBME and they will continue regular maintenance of the equipment. The Physiotouch information is kept in a file in the office. Training in the use of the Physiotouch will be undertaken by the lymphoedema practitioners prior to its use. Training will consist of a period of supervised practice followed by an assessment of competence. Each nurse will read, understand the user manual/basic training guide and refer to it as needed. 6. Procedure The mechanism of action is based on the effects of negative pressure in the tissues. The negative pressure created by the treatment device stretches the skin and the tissues underneath, pulling on anchor fibres to dilate the endothelial openings of the lymph vessels. Vertical stretching of the fascial (connective tissue) structures is accomplished at the same time, expanding the space for circulation of blood and lymph. Lymph and metabolic waste products that impede the healing process can flow more easily from the interstitial space into the lymph vessels and excess fluid is carried away by the body s own lymph transport mechanisms to rejoin the venous circulation. It also is of benefit in Axillary Web Syndrome and scar tissue. Physiotouch therapy will be performed by a lymphoedema practitioner who has completed training in the safe use and care of the device. Prepare the Physiotouch for use, checking for damage to the unit body, wires and suction caps. If any damage do not use and report to EBME. Standard Operating Procedure V1.0 24.10.16.docxV1.0 24Oct16 Page 4 of 5
Obtain the consent of the patient Ensure the area to be treated is clean and free from talcum powder. Assist the patient to position themselves in a comfortable lying or sitting position and that the couch is set at a comfortable height for the therapist to work. Switch the device on and set the pressure, pulse and vibration for the individual patient s treatment. Select the treatment head for the area to be treated, using the largest possible. Treatments are individualised as per the written guidelines. 7. References www.physiotouch.com Iivarinen J T, Korhonen R K, Julkunen P, Jurvelin J S Experimental and computational analysis of soft tissue mechanical response under negative pressure in forearm. Skin Research and Technology (2012);0:1-10 Vuorinen V-P, Airaksinen O. Management of post-mastectomy lymphoedema by novel vacuum suction device - a case report. Program & Abstract book. pp. 118. 22ISL. 22nd International Congress of Lymphology, 21-25 September 2009 Sydney, Australia 8. Associated Documentation 8.1. Northern Devon Healthcare NHS Trust Policies for : Northern Devon Healthcare NHS Trust Policies for: Infection Control Consent Competence Associated Documentation Physiotouch user manual Ver.A02 SW rev 2.0x Standard Operating Procedure V1.0 24.10.16.docxV1.0 24Oct16 Page 5 of 5