Modalities Treatment Procedures

Selection of Treatment Modality

1. Selection based on assessment of the patient, clinical knowledge, and known effects of individual EPA’s.

Check Contraindications and Precautions

1. Read table of C/I and P.
2. If together with clinical assessment, specific risk(s) are identified, conduct relevant test(s) prior to use of modality.

Explain to Patient

1. Reasons for selecting a particular modality, how it works and how it will be applied.
2. Expected effects of the modality.
3. Possible risks of using the modality in the specific circumstances.
4. Ensure patient understands and consents to use of EPA.

Treatment Preparation

Patient

1. Fully expose area to be treated by EPA and check skin for damage, wounds, scars, condition, color etc.
2. Position patient appropriately for treatment and comfort.
3. Drape to minimize threat to modesty.

Treatment area

1. Eliminate sources of possible electrical interference
2. Ensure no metal furniture used or in vicinity in MW or SWD.

Equipment

1. Test machine output prior to use and also safety switch if applicable.
2. Set adjustable output controls at zero (except UV lamps – cover during warm up).

Warnings

On each occasion the patient should be advised:

1. What they can expect to feel during the treatment.
2. What they should not feel and responses they should not have.
3. What they are to do if they do feel or have unwanted responses.
4. Not to move during the treatment.
5. Not to touch the equipment or applicators.

See recommended warnings.

In conjunction with the warning, teach the patient to use a safety switch if relevant and available.

Signs

If radio-frequency equipment (MW/SWD) is present and might be in use, provide appropriate multilingual signs to advise all clinic entrants in case any have a pacemaker or other indwelling stimulator. Make every effort to ensure all patients can understand these signs.

Administration

Apply

1. As explained to the patient and only after informed consent to proceed is obtained from them.
2. As advised in most recent manufacturers’ guidelines relevant to specific item of equipment being used.
3. See notes on specific EPA’s.

Remain within call

1. So immediately accessible to patient.
2. To monitor treatment and make checks as possible.

Completion

1. Turn equipment off as advised by the manufacturer: usually output to zero first.
2. Question patient and examine treated and adjacent areas for any abnormal reactions to treatment.
3. Record specific details including:

• C/is checked, results of initial sensation tests and machine tests, that warnings were given and appeared to be understood, and consent obtained.
• ·All treatment details, including intensity and if continuous or pulsed (with on: off ratio), duration, area treated, location of electrodes, and method used, equipment details including which machine and frequency (as appropriate).
• Immediate result of treatment – including any abnormal reactions and any subsequent action taken or recommended. (ALF – ask, look and feel).

Subsequent Treatments

1. Re-evaluate effects and effectiveness of EPA used.
2. Modify treatment parameters/method of application as required.