Bài giảng Medical Assisting - Chapter 43: Assisting with Cold and Heat Therapy and Ambulation

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 431Objectives:43-1 Explain how medical assistants might assist with some forms of physical therapy. 43-2 Describe ways to test joint mobility, muscle strength, gait, and posture.43-3 Discuss the benefits of cold and heat therapies.43-4 List contraindications to cold and heat therapies.43-5 Identify various cold and heat therapies.43-6 Demonstrate how to perform cold and heat therapies.Assisting with Cold and Heat Therapy and Ambulation 2Objectives (cont.)43-7 Describe hydrotherapy methods.43-8 Identify several methods of exercise therapy.43-9 Compare different methods of traction.43-10 Demonstrate how to teach a patient to use a cane, a walker, crutches, and a wheelchair.Assisting with Cold and Heat Therapy and Ambulation3Introduction Applying cold and heat therapy and assisting patients with ambulation are common duties of a medical assistant.You may also assist:Applying cold and heatTeaching basic exercisesDemonstrating the use of cane, walker, and crutches Demonstrating how to use a wheelchair and discussing specific therapies with the patient for use at home are also duties that you may be asked to perform.4General Principles of Physical Therapy Physical therapy is a medical specialty for treatment of musculoskeletal, nervous,and cardiopulmonarydisorders.5Assisting with a Therapeutic TeamTherapeutic team PhysiciansNursesMedical assistantsOther specialistsCoordinate schedulesMaking referralsExplaining treatment approachDocumenting treatments You must have a working knowledge of therapy techniques.6Assisting with Patient Assessment Joint mobility testing – range of motion (degree to which a joint is able to move) using a goniometerMuscle strength testing – determine the amount of force the patient can exert using a 5-point scale Gait testing – way a person walks (gait and swing)Posture – body position and alignment7Cryotherapy & Thermotherapy Cryotherapy – applying cold to a patient’s body for therapeutic reasonsWet or dryChemical or naturalIce packs or bagsThermotherapy – applying heat to a patient’s body for therapeutic reasons Dry heatElectric pads Heat lamps Hot soaks8Factors Affecting Use of Heat and Cold AgeTreatment locationCirculation or sensation impairmentTemperature tolerance9Principles of CryotherapyPhysiologic responses to cold include:Prevention of swelling by limiting edema.Control bleeding by constricting blood vessels.Lowering body temperature.Reduction of pus formation by inhibiting microorganisms.Activity10Principles of ThermotherapyPhysiologic responses to heat include:Relief of pain and congestionReduction of muscle spasmsMuscle relaxationReduction of inflammationReduction of swellingChemical Hot/Cold Pack11Administering ThermotherapyDry heat Chemical hot packsHeating padsHot-water bottlesHeat lampsFluidotherapyMoist heatHot soaksParaffin bath12Administering Thermotherapy (cont.)Diathermy – heat therapy in which a machine produces high frequency waves that achieve deep heat penetration in muscle tissueUltrasoundShortwaveMicrowave 13HydrotherapyUse of water to treat physical problemsWhirlpoolsContrast bathsUnderwater exercises14Apply Your KnowledgeThe physician has asked you to perform a moist heat application to a patient’s left leg. After about 10 minutes of treatment you check the area and notice it is very red, and the patient appears to be breathing fast. What should you do?15Apply Your Knowledge -Answer Remove the application immediately and take the patient’s vital signs. Report the results to the physician.The physician has asked you to perform a moist heat application to a patient’s left leg. After about 10 minutes of treatment you check the area and notice it is very red, and the patient appears to be breathing fast. What should you do?16Exercise TherapyOffer both preventive and therapeutic benefitsPrimary treatment for fractures, arthritis, and some respiratory diseases17Exercise Therapy (cont.)Exercise will help:Improve muscle tone and strengthPrevent or correct physical deformitiesPromote neuromuscular coordinationImprove circulationRelieves stress18Medical Assistant’s RoleProvide information on various types of exercise problems and treatment plan.Serve as source of support and encouragement.Assist with ROM exercises.Teach the patient and family about ROM exercises.19Type of ExerciseActive mobility – self directed exercises that patient performs without assistancePassive mobility – exercises the physical therapist or machine moves the patient’s body partAided mobility – self directed with assistance of a device such as exercise machineActive resistance – works against resistanceIsometric – patient relaxes and then contracts musclesROM Exercises – moving each joint through its full range of motions 20Electrical Stimulation Devices that deliver controlled amounts of low-voltage electric current to motor and sensory nerves to stimulate muscles.Prevents atrophy in muscles.Helps in healing injured joints.Retrain a patient to use injured muscles.21Apply Your KnowledgeA patient reports to you that he is having a lot of muscle aches when he performs his ROM exercises. What suggestions could you give him to prevent and treat this problem?22Apply Your Knowledge -Answer To prevent the problem he should keep track of the number or repetitions and amount of weight and increase each of these slowly. To treat the problem he should rest and soak in a hot tub.A patient reports to you that he is having a lot of muscle aches when he performs his ROM exercises. What suggestions could you give him to prevent and treat this problem?23TractionThe pulling or stretching of the musculoskeletal system to treat fracture bones and dislocation, arthritic, or other diseased joints.May be used to:Create and maintain bone alignmentReduce and prevent joint stiffeningCorrect deformitiesReduce and relieve muscle spasms24Type of TractionManual – performed by pulling a patient’s limb by using you hands.Static (weight traction) using a harness and weights to relieve muscle spasms.Skin – use of foam rubber and weights to prevent injury to the skin while decreasing muscle spasms.Skeletal – use pins, wires, or tongs inserted into bones which are attached to pulleys and weights for continuous traction.25Mobility AidsDevices to improve patients’ ability to ambulateCanesWalkersCrutchesWheelchairs26Mobility Aids (cont.)CanesStandardPatient who needs only small amount of supportTripod (3 legs) and Quad-base (4 legs)Create wide base of supportMake them more stable than standardCan stand alone, free patient’s hands when they sit27Mobility Aids (cont.)WalkersAluminum frame with four widely placed legs with rubber tipsLegs are adjustable Used by older patients who are too weak to walk unassisted or who have balance problems28Mobility Aids (cont.)CrutchesAllow patient to walk without putting weight on the feet or legs by transferring that weight to the arms.Aluminum or wood29Mobility Aids (cont.)Crutch gaitsFour point – used for slow gait for a patient who can bear weight on both legsThree point – used when patient cannot bear weight on one legTwo point – used when patient can have some weight on both legsSwing point – used when patient has severe disabilities 30Mobility Aids (cont.)WheelchairDepends on patient’s disability and length of time wheel chair neededYou may be responsible for transferring patient from wheelchair to exam tableEnsure safety for patient and you by following transfer techniques.31Apply Your KnowledgeWhen would a walker be an appropriatemobility device for use by your patient?32Apply Your Knowledge -AnswerWhen would a walker be an appropriatemobility device for use by your patient? Walkers are used by older patients who are too weak to walk unassisted or who have balance problems.33Summary Medical Assistant You will be asked to help with cryotherapy, thermotherapy, and other treatments. You will need to teach a patient how to use mobility aids.34End of ChapterEnd of Chapter35