Shortwave Diathermy Clinical Application

Treatment Dosages Pulse DoseSensationWidthRate (pps) NTNo warmth65 µsec100 – 200 1Mild warmth100 µsec800 2Moderate warmth200 µsec800 3Vigorous warmth 400 µsec800

Pulsed SWD Setup ParameterSetting Output mode:Pulsed Bursts per sec:800 Burst duration:400 sec Interburst850 sec interval Output intensity150 W RMS 48 W/burst RMS RMS = Root Mean Squared

Set-up and Application

Treatment Duration Nonthermal, Mild, and Moderate Heating Duration – 20 to 30 minutes Repeated as needed Two weeks Vigorous Heating Duration – 15 minutes Applied every other day

Precautions Remove contact lenses when applying SWD around the head, face, or eyes. Cover the skin with at least 0.5 inch of toweling Do not allow perspiration to collect in the treatment field. Thick adipose tissue in the treatment area can result in overheating. Never allow the skin to come into contact with the heating unit or cables. If the cable method is used, do not allow them to touch each other. If electrode pads are used, space them at least the distance of their diameter apart. A deep, aching sensation may be a symptom of overheating the tissues. Overheating of the patient’s tissues may cause tissue damage without any immediate signs. The SWD energy scatters 2 to 3 feet from the source –A distance of 3 feet from the source of the energy should be maintained to ensure the operator’s safety.

Instrumentation Master Power Switch: Turns the unit on. Output Intensity (Power): Adjusts the amount of energy delivered to the patient. Patient Interrupt Switch (Safety Switch): Allows the patient to end the treatment. Pause: Interrupts the treatment to allow repositioning of the patient, etc.

Instrumentation (Cont.) Pulse Rate (Pulse Frequency): Sets the number of pulses per second (PPS) for the output. Start/Stop: Initiates or terminates the treatment. Treatment Timer: Sets the treatment duration. Tuning: Adjusts the output resonance to match the patient’s tissues. –Some units will shut off if an out of tune state is detected –Most contemporary units are self-tuning

Patient Preparation Ensure the absence of all contraindications. Remove all jewelry, clothing, coins, and other metallic items from the patient. For personal safety, remove your rings, watches, bracelets, etc. No metal can be within the immediate treatment area Keep the patient out of reach of any metal objects that can serve as a ground (e.g., outlets, pipes). Clean and dry the body part. Water, skin oils, etc. can increase superficial heat production.

Patient Preparation (Cont.) Position the patient in the most appropriate manner for the body area being treated. To encourage venous return, elevate the treated extremity. To prevent burns cover the area with a dry terry cloth towel: –This provides spacing between the source of the shortwave diathermy –Absorbs perspiration –A portion of the treatment area must remain visible to check for burns during the treatment.. Explain to the patient that mild warmth should be felt. Instruct the patient to inform you if any unusual sensations are experienced.

Patient/Generator Tuning If the unit must be manually tuned: Position the electrodes over the patient. Increase the output intensity to appx. 40% of the max. Adjust the TUNING control until the output meter reaches its peak… … then decrease the TUNING to the patient’s comfort. A unit is tuned when less than half of the maximum output is used. –Some units will automatically shut off if more than 50 percent of the maximum output is used. If this occurs, the unit must be tuned again.

Initiation of the Treatment Drum Method Turn the unit on; allow it to warm up if necessary. Some units must be tuned to allow for maximal energy transfer. If indicated by the manufacturer’s instructions, place a folded towel between the body part and the drum. Position the drum approximately 0.5 to 1 in. above the toweling. The surface of the drum must be parallel to the skin surface being treated, otherwise the skin closest to the drum will overheat (the Cosine Law)

Initiation of the Treatment (Cont.) Instruct the patient not to move until the unit is shut off. Set the TIMER to the desired treatment duration. Increase the intensity until the patient feels mild warmth. If the drum must be moved or if it becomes necessary to dry the area, return the intensity to zero before making any adjustments. Do not leave the patient left unattended Regularly check the skin for signs of burns and inquire about unusual sensations. –Adjust the INTENSITY, PULSE RATE, and/or electrode placement as necessary.

Termination of the Treatment After the treatment, return the intensity to “zero” and shut off the unit. Inspect the skin for signs of burns or other abnormal treatment outcomes. Record the treatment parameters in the patient’s file.

Maintenance Daily Maintenance Clean the face of the drum or cables using a manufacturer-approved cleanser. Regular Maintenance Inspect electrical cords for kinks and frays. Annually The unit must be serviced and calibrated by a qualified service technician.