Open a physiotherapy office. Need help studying a topic? Modern equipment of rehabilitation and physiotherapy departments

In this material:

The effectiveness of physiotherapy when skillfully combined with medication and other types of treatment has been proven by many scientists and practitioners medical workers. A specialist physiotherapist is not a deceiver or a fraudster, and, unlike most practitioners of traditional and alternative medicine specialists, his procedures truly provide effective assistance to the human body. Among other things, a physiotherapist compares favorably with traditional and unconventional means treatment with higher medical education and experience working in medical institutions.

Description of the project and its advantages

A business plan for a physiotherapy office includes a description of the main stages of organizing a business, requirements for the selected premises, purchased equipment and hired personnel, as well as recommendations for the effective implementation of advertising and marketing activities and financial analytics of the business project.

The advantages of running a business based on providing physiotherapeutic assistance to the population are due to the demand for private physiotherapy offices in many cities and regions of the country. Such private offices compare favorably with physiotherapy departments that are part of local medical institutions, clinics and hospitals, the quality of the treatment provided, the level of service and qualifications of medical specialists, as well as the availability of modern professional medical equipment.

At the same time, in practice, there are often cases of opening private physiotherapy departments as full-fledged small clinics, providing, in contrast to a physiotherapy office, wide range procedures and services, but in this case there is a need to prepare additional documents, rent large premises, and form a large staff of qualified employees. Consequently - high level initial capital investments, ongoing expenses, long payback periods and slow movement to the break-even point of the project. A profitable option is to open a physiotherapy office (PTK).

What services does the physiotherapy office provide?

This medical field includes the following industries and services:

diadynamic therapy, based on treatment using directed electric current;
laser therapy, in which the therapeutic effect is exerted by directed beams of light laser energy;
electromyostimulation affecting muscles and nerve endings to return them to working condition;
amplipulse therapy, which is similar in principle to the effect of diadynamic therapy, affecting the body with the help of low-frequency currents;
heat therapy, which includes a variety of methods and techniques for the therapeutic effects of heat on the human body;
micropolarization, which is similar in principle to electrical myostimulation, but has a direct effect on the human central nervous system using electrical impulses;
cryotherapy, in which the body is exposed to cold rather than heat, as is the case with heat therapy;
halotherapy, which involves injecting purified sodium chloride into the lungs in a specially equipped room;
iontophoresis and phonophoresis, which are galvanic and ultrasonic effects on a drug applied to the human body for more effective and deep penetration remedy in fabric.

In addition to the industries mentioned, physiotherapy traditionally includes water and mud therapy procedures, as well as physical therapy and health massages.

Business organization

Registration, package of documents

To open a private office and provide physiotherapeutic services to the population in mandatory it is necessary to go through the state registration procedure by registering as a legal entity or individual entrepreneur, and also be puzzled by registration with the tax authority.

At the start of a business project you will need the following documents:

certificate of state registration as a legal entity or registration of a business in the form of an individual entrepreneur;
documents related to the rental of premises for a private physiotherapy office;
certificates of fire safety of the premises, as well as its compliance with sanitary and epidemiological standards and requirements, obtained from the relevant authorities;
evidence of payment of the fee for obtaining a license to carry out medical activities;
list of services provided by the organization;
proof of registration with the local tax authority.

Choosing a business format

The option of providing physical therapy services to the population in the form of a private office, rather than a full-fledged physiotherapy clinic, is obviously popular, due to the significant savings in initial capital investments and the absence of the need for complex procedures for selecting and leasing a large premises, forming a large staff, state registration and tax deductions.

Search for premises

A spacious, bright room is suitable, the area of which will directly depend on the range of physiotherapeutic services provided, the number of rooms and the necessary medical equipment for treatment and diagnosis. The premises must be rented; attention should be paid to residential areas, since the basis in this case is taken simultaneously by two factors: increased human traffic and the convenience of the location of the office for potential clients.

A special option for opening a private physiotherapy office is a partnership with a medical institution or health resort, provided that the physiotherapy office is opened in a separate room provided on the territory of the hospital or clinic. Thus, not only time and money are saved on searching and renting premises, but also the first clients appear.

Purchase of equipment

Depending on the specific types of physical therapy services provided and the number of clients served simultaneously, certain medical equipment will be needed, as well as modern hospital furniture. This initial investment item does not imply the opportunity to save money and purchase used equipment and furniture, since the general population makes a choice in favor of private medical offices and institutions, largely due to the quality and high cost of medical equipment, as well as the service of the health services provided.

Staff

A small private physical therapy office will need several physical therapists with higher medical education and experience in their chosen field of treatment services, as well as a receptionist who will answer calls. Management functions are carried out directly by the entrepreneur, while accounting is recommended to be entrusted to specialist outsourcers, and legal services contact third party representatives as necessary. You will also need an advertising and marketing department that will take care of attracting and retaining a stable flow of customers.

Advertising of physiotherapy services

Traditionally, pay attention to advertising in local print media, on thematic forums and popular social networks, also by posting advertisements and distributing leaflets in high-traffic areas. Collaborate with doctors from local medical institutions and clinics who will recommend your physical therapy office to patients if necessary. Traditional word of mouth will do most of the marketing work for you.

Financial indicators of the project: payback and profitability

Start-up investments are formed through acquisition necessary equipment, as well as procedures related to state registration of a legal entity or individual entrepreneur and the preparation of related documents. The amount of current office expenses is directly affected by wage employees, rent for office space, as well as tax payments, routine repairs and depreciation of equipment, replenishment of consumables.

On average, the starting investment in a business project is about 500 thousand rubles, and current monthly expenses range from 150 to 200 thousand rubles. With such indicators, payback will occur within the first year of operation of the office, and the profitability of the project will exceed 30%.

Order a business plan

	Investments: Investments 2,200,000 - 5,000,000 ₽ The first and only personal security service in Russia available on your smartphone. Personal Security ARMADA We met with the co-owner of the Armada.Vip company Alexander Aliev to find out why it is important to be able to call a bodyguard within an hour, in what situations he may be needed and how the market for such services is developing in Russia. Why did you decide to start a business related to...

	Investments: Investments 2,900,000 - 18,800,000 ₽ Lucky Bike is a bike sharing service that allows you to quickly rent a bike using a mobile application (QR code), as well as leave the bike in any of the permitted parking lots in the city (where it is convenient for the user). This is an excellent alternative to a personal car and public transport. Our bicycles are designed in China, taking into account the mentality and roads in the Russian Federation: they are made as vandal-proof as possible (...
	Investments: Investments 4,500,000 - 6,500,000 ₽ The owner of TM “Kotofey” is JSC “Egoryevsk-Obuv”. For more than 80 years, the company has been producing children's and teenagers' shoes. The result of many years of work confirms the presence of more than 120 branded stores in Russia. We constantly improve our skills and professionalism, which allows us to improve our range of products. By creating every pair of shoes, we take care of the younger generation and their health. Description…
	Investments: Investments 1,300,000 ₽ OWN BUSINESS BASED ON A UNIQUE PROCEDURE IN THE SPA FIELD Open a float studio under the Grand Float franchise We offer a franchise of the largest network of float studios in Russia - 38 partners in Russia and Europe - from RUB 1,300,000. investments - from 350,000 rubles/month. profit - from 11 months. payback 5 ADVANTAGES OF FLOATING BUSINESS: 1. Unique business idea Many guests visit the float studio,…
	Investments: Investments 2,500,000 - 11,000,000 ₽ “Elena Malysheva Medical Center” - a new project to create a network medical centers famous TV presenter, professor, doctor - Elena Vasilievna Malysheva. After returning to the screens of the “Health” program in 1997, Elena Malysheva became the host and ideologist of this program. Elena Vasilievna Malysheva defended her doctoral dissertation in medicine in 2007 on the topic “Reprogramming cellular responses of macrophages: new...
	Investments: Investments 650,000 - 850,000 ₽ “The ability to make informed choices transforms people. And we are participating in this transformation.” (c) Valentin Sherstobit (founder of the SOLNTSEMARKET chain of health food stores). Welcome! "SOLNCEMARKET" is a concept store for a healthy lifestyle. How often do we not have enough time to take care of our own health and the well-being of our loved ones. Maintain health and beauty for long years Can. Need to…
	Investments: Investments from 500,000 rubles. The company began its activities in 2007 under the brand “Island of Health” in the Russian Federation, Ukraine and other CIS countries. Now the company, after rebranding in the Russian Federation, has 20 retail outlets. Our mission is to improve the health of the nation through serving every person. Our massagers are one of the most effective and affordable ways to improve your health and have a positive impact on…
	Investments: Investments 500,000 - 1,500,000 rubles. "PensnE optic" is a chain of optical stores with wholesale prices for the end buyer. Products are produced both at our own factory and purchased from well-known global manufacturers. When making glasses, we use the most expensive raw materials because it makes no sense to sell low-quality glasses just because of the 3-year warranty we provide against manufacturing defects.…
	Investments: Investments 850,000 - 2,900,000 rubles. Children's clothing can bring joy to both the kids and their parents. In high-quality clothes, a child can actively have fun and participate in a wide variety of games, regardless of the weather. And moms and dads don’t have to worry about the baby’s health. We know everything about how to make fashionable and practical clothes for children, taking into account the needs of...
	Investments: Investments 230,000 - 265,000 rubles. The WENDLIGHT company was founded in 2012. We launched the production of vending machines for the preparation and sale of oxygen cocktails “Oxyvend”. More than 100 partners throughout Russia and neighboring countries have become our customers. We offer a new product on the vending market and a well-established business model for the vending business. The main idea of the project is a business for health. Where there is sports, health, children,... Investments: The International Lyceum "Renaissance" carries out educational activities since 1993. International level education – teaching children fine arts and design. Author's programs, textbooks, methodological developments, recommendations for parents - everything is thought out in detail for 13 years of study. We are unique! Our distinctive feature is development both in the field of organizing business processes and unique educational methodological complex, including...

Physiotherapy (Klyachkin L.M., Vinogradova M.N.) - 1995

PREFACE

In the time that has passed since the publication of the first edition of the textbook (1988), physiotherapy has been enriched with new theoretical concepts and practical methods. This necessitated the need to reissue the textbook, in the preparation of which the authors took into account the comments and wishes of reviewers and readers. The content of the textbook has been significantly modernized and reflects the current level of development of physiotherapy.

When revising the textbook, ideas on the theory of action of physical factors were expanded and clarified. Information about modern equipment has been added and information about outdated equipment has been eliminated. Included is a description of such modern methods, such as millimeter wave therapy, fluctuarization, electrotonotherapy, the section devoted to sanatorium treatment has been expanded. Data is included on the features of physiotherapy in children, as well as the features of the use of its methods in obstetrics and gynecology. Some illustrations have been updated.

The textbook examines the subject and tasks of physiotherapy, the basics of organizing physiotherapy departments (offices), the responsibilities of their staff, safety rules, and characterizes the main natural and performed therapeutic physical factors, methods for performing procedures are outlined. Practical information, on which the main emphasis is placed, is based on the foundation of modern theoretical concepts, given in a volume that corresponds to the level of training of students. The volume of textbook sections is proportional-3

is allocated to the educational time that the discipline program allocates for working on relevant topics.

Each section ends with methodological recommendations, including the definition of goals, educational objectives of classes, the logical structure of their implementation, indicative principles and algorithms of actions for performing procedures, control questions, tests and situational tasks for self-monitoring of knowledge acquisition.

INTRODUCTION

The methods, methods and means of treating human diseases are extremely diverse. Along with medications, there are also many non-drug means of influencing the human body. The main place among them is occupied by healing physical factors, both natural - climate, air, sun, water (including mineral), and preformed, i.e. based on the use of various types physical energy in transformed form. The rational use of physical non-drug factors significantly increases the effectiveness of complex treatment and rehabilitation of patients, reduces the period of temporary disability, reduces disability, accelerates return to active life and creative work. These factors have certain advantages over drugs, since they are relatively free from allergic and toxic side effects. However, physical methods are no less active, sometimes they can even be considered potent, and if used incorrectly, they can be dangerous for the patient. Therefore, a paramedic or nurse must clearly understand the mechanism of action of physical factors on the human body and be fluent in the methodology for dispensing procedures.

Advances in science and the introduction of the results of scientific and technological progress into healthcare practice contribute to the creation of new medical devices and place increasingly high demands on the work of medical personnel.

The field of clinical medicine that studies medicinal properties physical factors and developing methods of their use for the treatment and prevention of diseases, as well as medical rehabilitation, is called physiotherapy.

Natural factors have been used for treatment since

ancient times (water and heat therapy, massage, etc.). However, only the development of the natural sciences (physics, physiology and biology) served as the basis for physiotherapy. Thus, the discovery of the phenomenon of electromagnetic induction in the 19th century. marked the beginning of electrotherapy. At the same time, other branches of physiotherapy emerged and improved. Of great importance for its development were the works of outstanding domestic physiologists I. M. Sechenov, I. P. Pavlov, as well as the works of the founders of domestic clinical medicine S. P. Botkin, G. A. Zakharyin, G. A. Ostroumov and others. Fundamentals physiotherapy in our country was founded by the works of A. E. Shcherbak, A. V. Rakhmanov, S. A. Brushtein. In subsequent years, A. P. Parfenov, A. N. Obrosov, K. N. Zavadovsky, E. I. Pasynkov, N. S. Molchanov, A. I. Nesterov, A. P. Speransky made a great contribution to its development and etc.

Physiotherapy has become an integral and important element of the system medical care to the population. Every year the arsenal of treatment methods used is expanding, and the technical equipment of physiotherapy departments and offices is growing. At the same time, the responsibility of medical personnel increases, including nurses, whose responsibilities include directly carrying out procedures as prescribed and under the supervision of doctors.

Physiotherapeutic procedures have a variety of effects on the human body. As a result of their use, pain syndromes disappear or are reduced, the secretory and motor functions of organs are normalized, the activity of inflammatory processes is reduced, the trophism of organs and tissues is improved, and reparative processes are enhanced. These clinical effects are based on the normalizing effect of physiotherapeutic procedures on metabolism, redox processes, neurohumoral regulation of the functions of internal organs, blood and lymph circulation in them. In general, they have a powerful sanogenetic effect and help mobilize the body’s defenses.

The mechanism of this action is very complex. The main aspects of this mechanism can be explained on the basis of the teachings of I.P. Pavlov. Physical factors cause irritation of receptors in the skin and underlying tissues. In response to this irritation, complex reflex-type reactions arise. They may be predominantly

local, i.e. localized in the affected area. More complex reactions associated with the involvement of the autonomic nervous system, are segmental in nature, similar to somatosympathetic reflexes that cause vascular and metabolic (trophic) changes in a particular organ. Finally, the spread of excitation from the zone of influence to the higher parts of the central nervous system affects all systems of the body.

Along with the neuro-reflex mechanism, there is also a humoral mechanism of action of physiotherapeutic procedures, which leads to the formation in the tissues of the body of biologically active substances, histamine, as well as neurotransmitters - norepinephrine, dopamine and acetylcholine, as a result of which the release of hormones from the pituitary gland, adrenal glands, thyroid and other endocrine glands, contributing to the implementation of the physiological and therapeutic effects of physiotherapeutic procedures.

As a result of neurohumoral responses to the action of physical factors, long-term readaptation (restructuring) of the body occurs, i.e., activation of its protective forces as a result of optimal adaptation to the therapeutic stimulus. The general biological effect of physical factors, both natural and preformed, is to mobilize the protective and adaptive reactions of the human body.

The skin plays an important role in the mechanism of action of physical factors. It performs not only barrier and receptor functions, but also promotes the accumulation, redistribution and transformation of effects with their subsequent transfer to internal organs.

In recent years, it has become clear that physical factors are capable of purposefully changing the body’s immune response and correcting its immune reactivity.

Currently, it is believed that physical factors have both nonspecific and specific effects, which depend on the area of influence, its duration and intensity, and mainly the nature of the physical factors.

Many of the effects of physiotherapeutic procedures can be explained on the basis of the theory of functional systems, developed by the Soviet physiologist Academician P.K. Anokhin. A functional system is a set of nerve centers and peripheral organs, the combined activity of which is involved in the formation

on the body’s response, for example, normalization of blood pressure, secretion of gastric juice, tissue trophism, muscle contraction, etc., which determines in each case the structure of one or another functional system and the activity of nerve centers regulating them. The essence of the system’s action is that the body’s reaction to a stimulus, including a physiotherapeutic procedure, does not end with a reflex response of the effector apparatus (for example, a muscle or gland), but continues further. Thanks to the feedback of the peripheral organ with the nerve centers, the latter evaluates the result and its compliance ultimate goal. If the goal is not achieved, then the system further searches for the desired reaction, turns on other organs, and promotes changes in their structure and function in order to adequately adapt to the environmental factor. Within the framework of the systems approach, the Pavlovian reflex principle was further developed. This approach helps to better understand the mechanism for achieving beneficial results when using physiotherapeutic procedures.

Physiotherapeutic procedures are included in the complex treatment of a number of diseases, mainly in the phase of beginning or complete remission. However, in recent years, physiotherapeutic methods have been used in the acute phase of the pathological process. Physiotherapy methods have a mainly pathogenetic, rather than etiological, impact, so the indications for them are determined not so much by the name of the diseases (their list would be too broad), but by the direction of their pathogenesis, the predominance of inflammatory, dystrophic or functional processes in it. Further clarification of the indications for the use of certain specific methods of physiotherapy are given in the relevant sections of the textbook.

This determines the breadth of the range of indications for the use of physical factors. The most common contraindications to their use are severe conditions of the body, severe exhaustion, a tendency to bleeding, malignant neoplasms, blood diseases, severe cardiovascular and respiratory failure, as well as impaired liver and kidney function.

Compatibility and consistency of procedures are important. Within one day

It is customary to perform no more than two procedures, provided that one of them has a predominantly local effect.

You should not prescribe simultaneously procedures that have an antagonistic effect - calming and stimulating, and also use two different baths, two thermal treatments, and different types of high-frequency electrical procedures on the same day.

The therapeutic possibilities of modern physiotherapy are very great, but, like everyone active method treatment, it requires a qualified and careful approach with strict adherence to the principle of individualization of each patient.

Chapter 1

ORGANIZATION OF WORK OF THE PHYSIOTHERAPY DEPARTMENT (OFFICE)

The modern physiotherapeutic department (PTD) includes a number of rooms: electrical and light therapy, ozokerito- and paraffin therapy, therapeutic massage, hydrotherapy with baths and showers, inhalation room, etc. They are equipped in accordance with sanitary and hygienic standards and are equipped with a variety of medical equipment. In addition, the FTO has doctors’ offices, utility rooms, and rest rooms for patients. Such departments are created in large hospitals, clinics, and sanatoriums, which also have rooms and equipment for balneotherapy and mud therapy.

Medical institutions with relatively low capacity and capacity (some local hospitals) have a physiotherapy room. Its capabilities are more modest; it is located in one or two rooms with utility rooms. The rooms are dry, well lit, with an area of 32-38 m2, s wooden floor covered with oil paint or linoleum. The walls are painted with oil paint to a height of 2 m. Central heating radiators, water supply and sewer pipes must be covered with wooden casings painted with oil paint, current-carrying wires must be well insulated. In Fig. Figure 1 shows a plan of a physiotherapy room in a rural outpatient clinic. These offices are equipped with wooden couches and chairs. Metal structures of the cabin must be insulated. The physiotherapy room also houses a nurse's workplace.

A group electrical panel with a common switch is installed in the office, and switchboards are installed to connect individual devices. In addition, a “kitchen corner” is equipped with a sink for rinsing the electrode pads and a sterilizer is installed for boiling them.

Rice. 1. Plan of a physiotherapy room for a rural medical outpatient clinic (standard project 254-4-7).

1 - couch for light therapy; 2 - couch for electrotherapy; 3 - bedside table; 4 - single-bed table; 5 - semi-rigid chair; 6 - hanger; 7 - pedal bucket; 8 - apparatus for galvanizing; 9 - device for UHF therapy; 10 - apparatus for diadynamic therapy; 11 - portable ultraviolet irradiator;

12 - Sollux irradiator.

Safety instructions must be posted in a visible place in the office. It is also necessary to have an emergency first aid kit.

Larger rooms and specialized in types of physiotherapy are equipped with cabins with an area of 2.2 x 1.8 m. The partitions between the cabins have a height of up to 2 m. The cabin is equipped with an apparatus, a couch for the patient, a hanger for his clothes, and a chair.

The physiotherapist, head of the department (office), manages all the work of the staff, plans and ensures the work of the department, receives patients, controls the correctness of the prescription of physiotherapeutic procedures, enters them into the procedural card, checks the correctness of their implementation, advises patients, organizes and provides advanced training personnel, is responsible for all work of the unit.

Physiotherapeutic assistance is also provided in the conditions of a paramedic-midwife station, where a physiotherapy station is created, equipped with the most simple equipment.

The work of the physiotherapy department (office) is characterized by two indicators. The first of them reflects the coverage of patients with physiotherapy; it is determined by the percentage ratio of the number of patients treated in physical therapy to the total number of patients treated in

hospital, or the number of initial visits to the clinic. Average coverage figures are: for hospitals - at least 55%; for clinics - 25%; in sanatoriums - 70%; in specialized hospitals - 100%. The second indicator is the number of procedures per patient treated in the medical technical department. On average, this figure for clinics is 10-12, for hospitals - 13-14.

Responsibilities of a nurse

A nurse in a physiotherapy department (office) must have a secondary medical education and complete specialization courses in physiotherapy. She is responsible for the correct conduct of physiotherapeutic procedures, monitors the condition of patients during the procedure and the operation of the equipment, and ensures the sanitary condition of the office. In the process of work, she must strictly comply with safety regulations, be able to provide the patient with necessary cases emergency medical care. The nurse organizes the work of junior medical staff in the office, in particular in preparing pads for electrophoresis, baths, paraffin, changing linen, and maintaining cleanliness and order in the office.

The nurse receives the necessary information about the procedures prescribed for the patient from the doctor’s notes on the procedure card (Form 44 y). There, on the silhouette diagram of the human body, the doctor graphically marks the area of influence (Diagram 1).

The nurse must carefully read the assignment made and strictly follow it.

Having received the patient, the nurse prepares him for the procedure: introduces him to the necessary extent medical prescription, instructs about the rules of behavior during the procedure, helps to take the necessary body position, provides protection for the eyes and areas of the body that are not subject to exposure, and informs about the sensations during the procedure. After this, she applies the electrodes or sets the device in the working position, starts the signal clock and turns on the device.

Before the first and each subsequent procedure, the nurse must inquire about the patient’s well-being and examine the area of the procedure; report any violations to the physiotherapist.

During the procedure, the nurse should not leave the office; she must constantly monitor the operation of the device and the patient’s condition. After the procedure is completed, the nurse turns off the device, removes the electrodes, sends the patient to the rest room and makes a note in the procedure chart.

At the end of the office work, the nurse must turn off all devices, turn off the general network switch, close the windows and all water taps.

The responsibilities of the nurse also include keeping records of the work done and reporting on it. She must monitor the condition and safety of medical equipment, promptly prescribe and receive the necessary medications and solutions from the pharmacy.

Different procedures require different amounts of time, so conventional units are used to record the work of a nurse. By order of the Ministry of Health of the USSR No. 1440 dated December 21, 1984 “On approval of conventional units for the performance of physiotherapeutic procedures, time standards for massage, regulations on physiotherapeutic units and their personnel,” work that requires 8 minutes to complete and prepare is accepted for one conventional unit . So, for example, one conventional unit evaluates the implementation of such procedures as galvanization, UHF therapy, exposure to decimeter waves (UHF), two units - the procedure for exposure to diadynamic currents (DDT), sinusoidal modulated currents (SMC), determination of the biodose for UV irradiation , three units - electrosleep procedure, four units - underwater shower-massage. The work norm for a nurse is 15 thousand conventional units per year or about 60-65 conventional units per working day (b"/2 hours)..

One of the most experienced nurses in the department is appointed to the position of senior nurse. She completely performs all the work of the nurse and at the same time manages the work of all middle and junior staff, ensuring their placement and drawing up a work schedule. She monitors the work of personnel and the serviceability of equipment.

The work of a paramedic at paramedic-midwife stations, which are outpatient institutions that provide pre-medical care to the population under methodological guidance, has significant differences.

local doctor. The paramedic, in addition to other types of medical care, must conduct physiotherapeutic procedures and therapeutic massage.

Safety regulations

Carrying out physiotherapeutic procedures is associated with increased danger for patients, and sometimes also for the staff of physiotherapy departments and offices. Only solid knowledge and strict compliance by staff with safety regulations can prevent complications and accidents during procedures.

The nurse should be familiar with the basic situations that require emergency care, possible reasons their occurrence and consequences. Such cases include electrical trauma, burns, anaphylactic shock, severe balneological reactions, up to critical exacerbations of the underlying disease.

Electrical injury, or electric shock, poses the greatest danger. It may arise from errors in conducting electrical medical procedures, accidental contact with current-carrying parts of devices. A nurse can also be exposed to electric current if she simultaneously touches the body of the device and the electrode when the grounding is broken. The possibility of electrical injury may occur if the power cord is faulty,

twisting.

Depending on the method of protection against electric shock, all devices are divided into 4 classes:

devices of classes 01 and I have protective grounding, class U - protective insulation, class III - power supply from an isolated low voltage current source. Class I devices have a grounding pin on the plug and cannot be plugged into a regular socket without grounding. In class II devices, protective insulation eliminates the possibility of voltage occurring on accessible metal parts, which is especially important for portable equipment plugged into regular sockets outside the PTO.

Electrical injury occurs when electrical current passes through the human body during a grounding or short circuit. Grounding occurs when a person comes into contact with one pole of the device and at the same time

concerns water pipes or a heating radiator. A short circuit is characterized by the connection of both poles of an electrical circuit through the human body. In both cases, a large current passes through the human body.

To prevent possible electrical injuries, the nurse before starting work. is obliged to check the serviceability of all physiotherapeutic devices and grounding wires. If defects are detected, she must inform the doctor about this and make a record of the detected defects in the control and technical journal. Until the malfunction is resolved, operation of this device is prohibited.

When carrying out procedures with contact application of electrodes, metal grounded housings of devices should be installed out of reach of the patient. Do not use batteries as grounding conductors. heating system, water supply and sewerage pipes.

Electric shock causes pain, convulsive muscle contractions, and a sharp pallor of the visible skin. Convulsions do not allow the victim to release the wire from his hands, so the effect of the electric current continues. In severe cases, loss of consciousness, respiratory arrest, cessation of cardiac activity, and dilated pupils are noted. These signs indicate the onset of clinical death. It is necessary to immediately release the victim from the action of the current - open the electrical circuit, turn off the switch. If this is not possible, then the victim should be pulled away from the power source. In this case, the rescuer must wear rubber gloves or wrap his hands in a dry cloth and stand on a rubber mat. If current flows through wires, then their should be cut with wire cutters with insulated handles.

Resuscitation measures must begin immediately. A doctor should be called, but without waiting for his arrival, the nurse should begin artificial respiration using the mouth-to-mouth method, closed heart massage, and give an injection of cordiamine. When the doctor arrives, she must act according to his instructions.

Burns can be thermal (heat), electrical, or chemical, depending on the procedure. To prevent burns, the mercury-quartz irradiator and the Sollux lamp must be installed

directly above the patient, and from the side, to avoid contact with hot glass shards or parts of the lamp in case of accidental accidents. The outlet openings of the reflectors of Sollux lamps must be covered with safety wire mesh.

It is prohibited to carry out UHF therapy procedures without careful consideration. setting the therapeutic circuit in resonance with the technical circuit of the device and with a total chachor under both condenser plates of more than 6-10 cm.

When heating the paraffin, it is necessary to prevent water from entering it.

Before carrying out water and other thermal therapeutic procedures, it is necessary to ensure each time that the temperature of the treatment environment corresponds to the prescribed temperature and does not exceed the critical limit (for water 38-40° WITH, for paraffin 50-55° C).

Burns during physiotherapeutic procedures rarely pose a threat to the patient’s life, but nevertheless require assistance. It lies first of all V termination of the source that caused the burn. For thermal burns, it is advisable to immediately moisten the burned part of the body with cold water, treat with alcohol, then cover the burn area with a sterile bandage and refer the patient to a doctor. No medications in any form (except for moistening the burned area with alcohol), including oils and ointments, should not be used before the doctor arrives, as this may interfere with further treatment of the burn.

The occurrence of burns may be facilitated by a general or local decrease in the sensitivity of the patient’s skin, of which the attending physician must notify the physiotherapist. Epilepsy seizures are very dangerous in this regard. during which the patient’s risk of electrical injury or burns sharply increases.

Anaphylactic shock occurs when exposed to drugs to which the patient has increased individual sensitivity (intolerance). In such cases, a severe anaphylactic reaction can occur when using these drugs even in small quantities, including during electrophoresis and inhalation.

To prevent the occurrence of such reactions, it is necessary to find out from the patient how he tolerates certain medications, especially antibiotics.

In doubtful cases, the patient should undergo drug sensitivity tests in the department and inform the physiotherapist that the patient does not have hypersensitivity to the prescribed drugs.

Anaphylactic shock is manifested by suffocation, anxiety, itchy skin, loss of consciousness (coma), a drop in blood pressure, sudden pallor of the skin, and dilated pupils. Possible death within minutes. If anaphylactic shock develops, the nurse should immediately stop the procedure, lay the patient down, inject subcutaneously 0.5 ml of a 0.1% solution of adrenaline hydrochloride and immediately call a doctor. Further emergency care measures are carried out as directed by the doctor. They include repeated intravenous injections lredni-zolongemisuccinate (50 mg), 10 ml of 2.4% aminophylline solution, subcutaneously - 2 ml of cordiamine. Further treatment is carried out in the department intensive care, where the patient is given intravenous drips of corticosteroid hormonal drugs, anti-shock plasma substitutes (polyglucin), and antihistamines (diphenhydramine, suprastin) are prescribed.

With intensive physiotherapeutic procedures (especially thermal ones), patients suffering from cardiac and pulmonary disorders may develop symptoms of exacerbation of the disease (hypertensive crisis, cerebrovascular accident, attack of angina, bronchial or cardiac asthma). In these cases, it is necessary to stop the prescribed procedures and begin using appropriate medications. Adverse reactions can also occur when mutually exclusive procedures are prescribed.

The operation of physiotherapeutic devices must be under constant technical supervision. Only persons with special education may be allowed to maintain and repair electrical medical equipment and equipment in physiotherapy rooms. At least once every two weeks, a preventive inspection of all electric light therapy devices should be carried out and any identified malfunctions should be eliminated. Allowing random persons to repair physiotherapy equipment is strictly prohibited.

In order to protect the health of medical personnel of physiotherapeutic institutions, whose work involves

with harmful working conditions, the legislation provides for certain benefits: shortened working hours, additional leave, increased salary, free milk, etc. Such benefits are used, in particular, by nurses working with UHF and microwave generators in reception rooms hydrogen sulfide baths and mud, busy preparing radon baths.

All staff of physiotherapeutic institutions undergo mandatory medical examinations upon entry to work, and then annually.

For staff rest and meals, the staff of physiotherapeutic institutions are allocated a separate room. It is also provided with protective clothing.

A physiotherapeutic office is a structural unit of a medical and preventive institution; a set of premises, equipment and auxiliary equipment intended for performing physiotherapeutic procedures. It is necessary to distinguish between a physiotherapy department, where all the main types are presented (electrical, light, water, heat therapy), and a physiotherapy room, which has only a part of the devices. In the latter case, one or two or three rooms (usually adjacent) can be allocated for a physiotherapy room.

The organization of a physiotherapy room (department) provides for the rational placement and arrangement of equipment, taking into account the ease of its operation and safety during procedures. The opening and operation of a physiotherapy department (office) is permitted only if it complies with the safety and sanitation rules approved by the USSR Ministry of Health and the Central Committee of the Health Workers' Trade Union.

The height of the premises of the physiotherapy room must be at least 3 m. The area of the premises for the physiotherapy room is determined at the rate of at least 6 m 2 per treatment couch. The area of the combined electric light therapy room must be at least 24 m2; if there are 4 or more low-power generators, a separate room with an area of also 24 m2 is allocated for them. The ratio of window area to floor area is at least 1: 6. The lowest artificial illumination at the level of 0.8 m from the floor with incandescent lamps is 75 lux, with fluorescent lamps - 150 lux.

The floor should be wooden. Walls to a height of 2 m are painted with light oil paint; the rest of the walls and ceiling are adhesive. Wall cladding with ceramic tiles is not permitted.

The physiotherapy room must have supply and exhaust ventilation with air heating, as well as transoms; the air temperature in the room should not be lower than 20°. The physiotherapy room must be equipped with a washbasin. Treatment areas (cabins) are separated from each other by curtains on a metal, plastic or polished wooden frame, attached to the ceiling at a height of 2 m. The metal structures of the cabins are insulated from the stone walls by placing 40 mm thick wooden socket boxes under the flanges, impregnated with paraffin and painted with oil paint.

Dimensions of cabins for electrolight therapy procedures: length 2-2.2 m, width (for all floor-standing and ultrasonic devices) - 2 m, for others - 1.6 m. Only one floor-standing device is installed in each cabin. In the physiotherapy room, where there are devices for, medicinal substances, treatment with low-frequency currents and devices for, a special insulated box (8 m2) is allocated for work on preparing the treatment procedure (boiling electrode pads, drying them, wetting with solutions of medicinal substances, etc. ) with a drying cabinet and exhaust ventilation.

The electrical equipment of the physiotherapy room must be carried out in accordance with the “Rules for the design, operation and physiotherapy departments (offices)”. Each office must have an independent electrical input from the main switchboard, laid with copper wire with a cross-section of at least 6 mm 2, and a group switchboard with a common switch or starter that has clearly marked “on” and “off” positions. The switch is installed at a height of 1.6 m from the floor level. A mains voltmeter with a phase switch is mounted on the switchboard. The group board is mounted from fuses or maximum current circuit breakers of 15 I with the number of groups corresponding to the number of installed devices, also taking into account sterilizers and electric stoves. In the booths for connecting devices, starter shields made of insulating material are installed at a height of 1.5 m from the floor level. A three-pole switch (starter) for 15-25 A is mounted on them, clearly marked “on”, “off”, four terminals in an insulating frame, of which two left ones are for connecting devices, the rest are for protective grounding of the device, one plug socket with self-catering.

Only portable equipment may be connected to the socket outlets. The line from the group to the starting panels is laid with copper wire with a cross-section of at least 2.5 mm 2. All starting devices are installed only in a protected form.

It is prohibited for personnel to remain in the direct radiation zone in front of the remotely located emitter of devices for microwave or decimeter wave therapy. The operation of such devices is carried out in specially designated rooms or in common rooms, subject to shielding using a metal mesh or chambers made of a metal mesh, shields coated with substances that absorb electromagnetic vibrations, cabins or screens made of cotton fabric with microwire.

It is necessary to distinguish between a physiotherapy department, where all the main types of physiotherapy are presented (electrical, light, water, heat therapy), and a physiotherapy room, which has only a part of the devices. In the latter case, one or two or three rooms (usually adjacent) can be allocated for a physiotherapy room.

The height of the premises of the physiotherapy room must be at least 3 m. The area of the premises for the physiotherapy room is determined at the rate of at least 6 m 2 per treatment couch. The area of the combined electric light therapy room must be at least 24 m2; if there are 4 or more low-power UHF generators, a separate room with an area of also 24 m2 is allocated for them. The ratio of window area to floor area is at least 1: 6. The lowest artificial illumination at the level of 0.8 m from the floor with incandescent lamps is 75 lux, with fluorescent lamps - 150 lux.

The floor should be wooden. Walls to a height of 2 m are painted with light oil paint; the rest of the walls and ceiling are adhesive. Wall cladding with ceramic tiles is not permitted.

Dimensions of cabins for electrolight therapy procedures: length 2-2.2 m, width (for all floor-standing and ultrasonic devices) - 2 m, for others - 1.6 m. Only one floor-standing device is installed in each cabin. In the physiotherapy room, where there are devices for galvanization, electrophoresis of medicinal substances, treatment with low-frequency currents and devices for light therapy, a special insulated box (8 m2) is allocated for work on preparing the treatment procedure (boiling electrode pads, drying them, wetting with solutions of medicinal substances etc.) with a drying cabinet and exhaust ventilation.

The electrical equipment of the physiotherapy room must be carried out in accordance with the “Rules for the design, operation and safety of physiotherapy departments (offices)”. Each office must have an independent electrical input from the main switchboard, laid with copper wire with a cross-section of at least 6 mm 2, and a group switchboard with a common switch or starter that has clearly marked “on” and “off” positions. The switch is installed at a height of 1.6 m from the floor level. A mains voltmeter with a phase switch is mounted on the switchboard. The group board is mounted from fuses or maximum current circuit breakers of 15 I with the number of groups corresponding to the number of installed devices, also taking into account sterilizers and electric stoves. In the booths for connecting devices, starter shields made of insulating material are installed at a height of 1.5 m from the floor level. A three-pole switch (starter) for 15-25 A is mounted on them, clearly marked “on”, “off”, four terminals in an insulating frame, of which two left ones are for connecting devices, the rest are for protective grounding of the device, one plug socket with self-catering.

Only portable equipment may be connected to the socket outlets. The line from the group to the starting panels is laid with copper wire with a cross-section of at least 2.5 mm 2. All starting devices are installed only in a protected form.

Physiotherapy: types of procedures

Physical therapy (PT), also known as physical therapy, is a physical medicine and rehabilitation specialty that uses mechanical force and movement to address impairments and promote mobility, function, and quality of life through assessment, diagnosis, prognosis, and physical intervention.

Why is physiotherapy needed?

Physiotherapy is a professional medical specialty performed by physical therapists.

Physiotherapists use their knowledge and skills to improve a range of conditions related to different body systems, such as:

neurological (stroke, multiple sclerosis, Parkinson's disease);
musculoskeletal (back pain associated with whiplash, sports injuries, arthritis);
cardiovascular (chronic heart disease, rehabilitation after a heart attack);
respiratory (asthma, chronic obstruction lungs, cystic fibrosis).

You can benefit from physical therapy at any time in your life.

Classification of physiotherapy

Modern science is exploring a large number of types of energy. The main component of many procedures is a natural factor of physical origin.

With its use, the main physical procedures are distinguished:

Application different options electrical: (various medications with electrophoresis, galvanization procedures, electrosleep, diadynamometry, impulse therapy, electrical analgesia, ultratonotherapy).
Use of heated preparations on the patient's skin: ozokerite, Naftalan, treatment with paraffin, therapeutic mud, clay and sand.
Use of various magnetic fields: inductothermy, magnetotherapy.
The use of electromagnetic fields of excessively high frequency: terahertz, decimeter, centimeter and extremely high frequency therapy.
Consumption of fresh water, artificial and natural waters: balneotherapy, hydrotherapy.
Mechanical vibrations: vibration therapy, ultraphonotherapy.
Using an electric field: ultra-high-frequency procedure, infective therapy, franklinization.
Electromagnetic vibrations of the optical range: visible, infrared, ultraviolet and laser radiation.
Applied modified or special air environment: aeroionotherapy, inhalation therapy, climatotherapy, barotherapy.
Combined procedures are based on the use of various therapeutic factors from one or two different groups: magnetic laser therapy, vacuum-darsonvalization, inductothermoelectrophoresis, etc.

Types of physiotherapeutic procedures

The type of procedure is selected by specialists for each patient individually. Based on: general condition of the body, immune activity, concomitant diseases, allergies, as well as the main pathology with which this patient came in. There are a large number of physiotherapeutic procedures.

Electrotherapy

This procedure is a form of medical treatment that uses small electrical impulses to repair tissue and stimulate muscles and tissue.

The benefits of electrotherapy include a more advanced healing process, improved circulatory system and increased muscle tone.

The effectiveness of electrotherapy provides: reduction of pain, increase in strength, range of motion, muscle tone and absorption rate.

The reason for using this method is that injuries that cause swelling respond well to electrotherapy. These include sprained ankles and overuse injuries such as tennis or golfer's elbow.

Magnetotherapy

Magnetotherapy is a procedure that is a natural phenomenon and is based on the application of certain magnetic fields on the human body. Magnetic therapy is used to treat pain, reduce inflammation and swelling.

Clinical studies have shown that it is necessary to treat osteoporosis with magnetotherapy and use it for regeneration of superficial tissues and bone fractures. The procedure is used in orthopedics and sports.

The low-intensity and low-frequency magnetic field itself is not used, but a set of several factors that optimize the method of application to produce therapeutic results:

choice magnetic field and waveforms;
choice various methods transmission of magnetic field into tissue;
manual or automatic;
method of application, contact - general or local;

Therapeutic expectations can be summarized as follows: non-abrasive and painless treatment, contracture reduction and muscle relaxation, analgesic, anti-inflammatory and drainage effect, tissue repair, even deep.

Shock wave therapy

Shock wave therapy is a procedure using a multidisciplinary device necessary for the treatment of tendons, muscles, joints, orthopedics, to stimulate bone healing, physical therapy, instant pain relief, sports medicine, stone crushing, and urology.

Its main assets are lightning-fast pain relief and restoration of mobility. Together with non-surgical therapy without the need for painkillers, it is an ideal therapy for accelerating recovery, as well as treating various symptoms that cause various types of pain.

These processes are used simultaneously and are necessary for the treatment of acute and chronic pathologies.

Laser therapy

Laser therapy is a therapy that uses the necessary wavelength of light to interact with cells and speed up the healing process.

It can be used by patients suffering from a variety of acute, subacute, chronic diseases to help eliminate pain syndrome, swelling, reduce vascular contractions and increase functionality.

During this time, non-thermal light photons emitted by the device penetrate the skin, subcutaneous tissue and reach the required organ. After passing through the skin, at the moment it reaches the desired organ, it penetrates the tissue cells.

When cells absorb these photons of light, their metabolic process is enhanced and their regenerative ability is activated. As a result, swelling, signs of inflammation, pain subsides and enhanced wound healing occurs due to an increase in intracellular metabolism.

Balneotherapy

Balneotherapy is the treatment of diseases through bathing. Balneotherapy may include hot or cold water, massage through moving water, relaxation or tension. Most mineral waters are rich essential minerals: silica, sulfur, selenium and radium.

Healing clays are also used in balneotherapy. Balneotherapy is used for patients with big amount diseases.

Most serious pathologies include: fibromyalgia, depression, anxiety, insomnia, osteoarthritis, rheumatoid arthritis, psoriatic arthritis, syndrome chronic fatigue, spasticity, stroke, acne, dermatitis, psoriasis and cardiovascular diseases.

Other benefits of balneotherapy include pain reduction, faster collateral circulation, increased cellular fluids, muscle relaxation, and numerous healing benefits from the absorption of minerals and botanicals.

Climatotherapy

Climate therapy is the temporary or permanent movement of a patient to a region with a climate more favorable for recovery or management of a condition.

For example: The partial pressure of oxygen is lower at high altitude, so a person with sickle cell disease may move to a lower altitude to reduce the number of sickle crises. There are also possible therapeutic benefits for patients with psoriasis, especially in the Dead Sea region.

Detensor therapy

Detensor therapy treatment works by canceling the force of gravity and it only takes the pressure off the compressed discs and in return the body relaxes. The system consists of a traction device, a bed system and a therapy mat for systematic traction treatment.

This treatment is very important because it can be applied to the patient without weights, belts, etc. This method made primarily for people who experience pain when degenerative disease disc, herniated disc, sciatic nerve, bone spurs, or something like a pinched nerve in the neck.

Since proper spinal alignment, decompressed joints, and pain relief are the result of spinal decompression, the therapy stretches the bones and muscles of the back so they can resist the effects of gravity.

Ultraviolet irradiation

Ultraviolet germicidal irradiation is a disinfection method that uses short-wave ultraviolet (UV-C) light to kill or inactivate microorganisms by destroying nucleic acids and destroying their DNA, rendering them unable to perform vital functions.

UV irradiation is used in a variety of applications in the treatment of many skin diseases, including psoriasis and vitiligo.

Mechanotherapy

Mechanotherapy is a treatment using a series of manual and instrumental methods, which mainly use pressure, smoothing and stretching to prevent pain, improve blood circulation and cellular metabolism.

Mechanotherapy includes all therapeutic, underwater and mechanical massages and training. Mechanotherapy uses many other relaxing techniques such as traditional manual massage, manual lymphatic drainage and foot reflexology massage to combat muscle strain caused by forced posture, which is typical for most patients.

Peloid therapy

Peloid is mud or clay used therapeutically, as part of balneotherapy, or therapeutic bathing.

Peloids consist of humus and minerals formed over many years as a result of geological and biological, chemical and physical processes.

Today, numerous peloids are available, of which the most popular are: peat masses, various medicinal clays mined in various places throughout the world, as well as various plant substances.

The most common treatments are peloid wraps, mud baths and peloid sets, applied locally to the part of the body being treated.

Peloids are widely used in cosmetology. They are used as a face mask. Applying peloid masks once a week helps revitalize the skin, tighten it and bind fluids in the skin layers. Regular use peloids leads to the disappearance of wrinkles and the prevention of the appearance of new wrinkles.

Thermotherapy is the use of heat in therapy to relieve pain and heaviness. It can take the form of hot cloth, hot water bottle, ultrasound, heating pad, hydrocollator packs, whirlpool baths, cordless heat therapy wraps.

Therapeutic effect includes increased extensibility of collagen tissues, decreased joint stiffness, pain reduction, relief muscle spasms, reducing inflammation and swelling. Increased blood flow to the affected area provides proteins, nutrients and oxygen for better healing.

It may be useful for people with arthritis and stiff muscles, deep skin tissue damage. Heat can be effective in treating conditions such as rheumatoid arthritis. Thermotherapy is most often used for rehabilitation purposes.

Phototherapy

Light therapy or phototherapy consists of exposure to daylight or specific wavelengths of light using polychromatic polarized light, lasers, LEDs, fluorescent lamps, or very bright full-spectrum lamps.

Light is administered for a set time and, in some cases, at certain time days. Phototherapy deals with the treatment of skin diseases, mainly psoriasis, acne vulgaris, eczema and neonatal jaundice.

Effectiveness of physiotherapy

The advantages of physiotherapeutic methods are their natural influence on the human body, and is considered as a replacement for drugs or surgical interventions. Basically, a combination of drugs and physiotherapy is used to treat the disease.

Together with other types of therapies, physical factors have their own advantages:

increase the range of interventions of different treatment methods, reducing recovery time;
do not cause allergies to medications;
increase the impact of medicinal drugs;
there is no addiction or dependence on medications;
there are no side effects on other systems and organs;
provide painless treatment;
no invasive treatments are used;
prolong periods of remission.

Contraindications

There are these contraindications to the inability to undergo physiotherapy:

malignant tumors, leukemia, myeloid leukemia, cachectic conditions;
III stage of hypertension, atherosclerotic lesions of the arteries of the head, decompensated cardiovascular vascular pathologies, worsening blood clotting;
seriously ill patients, hectic fever;
active tuberculosis, epileptic seizures, convulsions;

Design and equipment of a physiotherapy room

The premises are allocated no lower than the 1st floor. It should be dry (humidity not higher than 70%), warm (temperature not lower than +20 ° C), bright, spacious (the area of the office is allocated at the rate of 6 m 2 per 1 stationary device, but not less than 24 m), supply air is required exhaust ventilation, only hidden electrical wiring, walls to a height of 2 m are covered with oil paint, floors are covered with linoleum.

All metal grounded objects are protected by wooden casings. A panel with a common switch is installed at a height of 1.6 m from the floor.

The following cabins are equipped according to the number of stationary devices:

There is a separate service cabin for preparation for procedures. A table for the nurse is placed outside the service cabin. On the table there are: a file cabinet with patient cards and a procedural electric clock. The nurse's desk contains a stopwatch, a measuring tape, rubber gloves, and safety glasses.

The equipment is placed strictly according to the plan approved by the manager. All devices mounted in metal enclosures must be grounded. It is necessary to carry out a preventive inspection of the equipment at least once every 7 days. A preventive examination is carried out by a physical technician. Monitoring compliance with the frequency of preventive examinations is carried out by a nurse, about which a special entry is made in the journal. The devices must be protected from dust, dampness and overload. Maintenance of the equipment is the responsibility of the nurse.

Medical card

A bad doctor treats a disease, a good doctor treats the cause of the disease.

Physiotherapeutic procedures

Many parents consider physiotherapeutic procedures not very effective and do not take them seriously - they violate the schedule and conditions of implementation, or even completely interrupt the course of treatment prescribed by the doctor. The name of the method comes from two ancient Greek words - “physio”, which means “nature”, and “therapy” - treatment. You can’t say more precisely: natural factors - water, air, sunlight, heat, cold, electromagnetic radiation Help the body get rid of diseases without medications and side effects. The choice of techniques is large: some have been known since time immemorial, that is, time-tested, others have appeared recently.

What is physiotherapy

Physiotherapy is a separate medical specialty To obtain it, you need to master knowledge from the field of physics and chemistry, which is not taught to representatives of other areas of medicine. Only those who have undergone the necessary training are able to correctly prescribe the procedure; other doctors do not have full information. Many clinics have physiotherapy departments or physiotherapists. By visiting their offices more often, parents will be able to learn more about non-drug methods of preventing and treating diseases.

The unpopularity of physical therapy among parents is due to several circumstances, for example, mothers are able to refuse inhalations, fearing that nebulizers are a carrier of infection because they are not properly sterilized. Often such suspicions are unjustified: everyone little patient receives “its” nozzle, and the used one is sent for disinfection. The second argument: physiotherapeutic procedures are difficult to comply with, since they require a strict regime - preparation “before” and compliance with certain rules “after”. So that the baby gets maximum benefit from manipulation, he should be well-fed, rested, calm. Taking into account the biorhythms of children, it is better to carry out treatment in the first half of the day, 1 hour after feeding. At the end of the session, the baby needs to rest - lie down in the crib, or better yet, sleep. The younger the child, the more difficult it is to follow these requirements.

Technological progress offers an excellent way out of this situation: by creating a home physiotherapy office using portable devices, you can solve both the first and second problems. The algorithm is this: get a doctor’s prescription, purchase the device, master it and use it, following the rules.

How does physiotherapy work?

All natural factors influence the child’s body to one degree or another - they change body temperature, blood pressure, breathing and heart rate, and cause muscles to tense or relax. This observation formed the basis of physiotherapy and prompted the ancient Aesculapians to conduct experiments. For example, this - if the sun's rays or hot baths are beneficial healthy person, then why not treat the patient with their help? The guesses were confirmed, and doctors began to take advantage of the discovery. Modern doctors do not stop at what their predecessors achieved and continue to develop methods of physiotherapy. The achievements of the founders of medicine are replenished, but many of the rules for conducting sessions discovered by them remain unshakable.

The most important thing is that physiotherapeutic procedures are always prescribed during the recovery period, when the crisis has passed and the patient is on the mend. At the height of the illness - at elevated temperature And acute manifestations- physiotherapy can be harmful, since the body is disoriented, and any intrusion into its work will be perceived inadequately. So, heating with any of the devices will cause heat stroke and dehydration.

What are the types of physiotherapeutic procedures?

The range of physiotherapeutic procedures is very diverse. Methods are divided into groups according to sources of influence: light, heat and radiomagnetic devices, water and air. Many of them are interchangeable. Children are most often prescribed the simplest ones.

UHF stands for Ultra High Frequency. The method is used for the treatment and prevention of inflammatory processes. Around the source is formed protective barrier- the walls of the capillaries become denser, as a result, blood flow improves and swelling goes away, ulcers and ulcers dry out.

Magnetic therapy involves warming tissues, after which all processes in them are activated. At the same time, metabolism, blood circulation, protein and hormone synthesis are improved, spasms are relieved, blood pressure and pain are reduced. It is used for neuroses, rhinitis, sinusitis, atopic dermatitis, dyskinesia of the digestive system.

Light therapy is exposure to any light sources, including lasers. It is prescribed to children who are often ill in order to improve their work immune system and metabolism. You can “shine” the whole body, small areas and individual organs, for example, the ear, nose or knee.

Phototherapy is a type of light therapy that helps babies cope with newborn jaundice in the first days after birth. Under light energy, such as from a blue light fluorescent lamp, toxic, dangerous forms bilirubin (excess bilirubin causes jaundice) are converted into safe forms.

Ultraviolet radiation is also a type of light. It protects children from rickets. And since ultraviolet rays have a detrimental effect on dangerous microbes, they also help with purulent inflammation and allergies, and disinfect indoor air and water in swimming pools.

Electrophoresis - using current through the skin or mucous membranes, medications are introduced into the body, which immediately reach the target, bypassing the gastric tract and respiratory organs, and thus pain is often relieved.

Babies of all ages, starting from birth, benefit from massage and physical therapy. These methods help babies quickly cope with the “shortcomings” of nature and grow healthy and strong.

Kinesiotherapy is a combination of morning and therapeutic exercises, staying in the fresh air, sports and applied exercises and outdoor games. In newborns born ahead of schedule, and small children with neurological problems have their own activities - for these categories of children, special bed-baths with a porous bottom, filled with glass microbeads and simulating intrauterine living conditions, have been created. A filter sheet separates the baby’s body from them, and the baby calmly floats in the “dry liquid”.

Physical office what procedures

Treatment of any disease should not only be effective, but also as safe as possible, without unpleasant consequences and side effects. “Do no harm” is precisely the principle on which all modern medical techniques. Physiotherapy is one of the long-known, absolutely safe, and therefore extremely popular techniques. main feature, or rather, the advantage of the technique is that such a course of treatment eliminates the use of chemicals and drugs. The name physiotherapy itself suggests that treatment is carried out using physical factors affecting the patient’s body. There are many such physical factors - ultrasound, currents, laser, magnetic field, different kinds radiation (ultraviolet, infrared), massage and others. So, physiotherapy has a big advantage - high efficiency combined with safety of use.

The undoubted advantage of physiotherapy over other treatment methods is its high efficiency coupled with safety. Physiotherapy awakens the body’s internal reserves, strengthens the immune system and thereby shortens treatment time, accelerates the healing of wounds and inflammation, and activates the most important biochemical processes in the body, tuning the body’s natural forces for recovery. As an independent method of treatment, physiotherapy is effective in the initial stages of the disease. Physiotherapy is an excellent means of preventing many diseases. Most often it is used as an additional method in the general course of treatment.

Physiotherapy is prescribed to each patient strictly according to individual indications, since the nature of the disease, its stage, the person’s age and other factors play a role. The occurrence of side effects after the use of physiotherapeutic techniques is practically excluded. Often, physical therapy helps to cope with diseases that for a long time were not treatable using traditional methods.

Methods of hardware physiotherapy:

Inductothermy is a method of electrotherapy, the active factor of which is a high-frequency alternating magnetic field.

UHF therapy A method of electrotherapy based on the effect on the patient’s body of a predominantly ultra-high-frequency electromagnetic field (UHF e.p.). Physical action e. UHF consists of the active absorption of field energy by tissues and its conversion into thermal energy, as well as the development of an oscillatory effect characteristic of high-frequency electromagnetic oscillations. The main heat generation occurs in tissues that do not conduct electrical current well (nervous, bone, etc.). E.p. UHF has an anti-inflammatory effect by improving blood and lymph circulation, tissue dehydration and reducing exudation, activates the functions of connective tissue, stimulates the processes of cell proliferation, which makes it possible to limit the inflammatory focus to a dense connective capsule. E.p. UHF has an antispastic effect on the smooth muscles of the stomach, intestines, gall bladder, accelerates regeneration nerve tissue, enhances the conduction of impulses along the nerve fiber, reduces the sensitivity of the terminal nerve receptors, i.e. promotes pain relief, reduces the tone of capillaries and arterioles, lowers blood pressure, and causes bradycardia. Treatment is indicated for various acute and chronic inflammatory processes of internal organs (bronchitis, cholecystitis, pneumonia), musculoskeletal system, ear, throat, nose (sore throat, otitis), peripheral nervous system (neuritis), female genital area, degenerative processes

Magnetotherapy A new direction of physiotherapy based on the effect of a low-frequency alternating magnetic field on the entire body or part of it. Computer support of the devices allows for continuous monitoring and creation of an individual program for each patient.

Magnetotherapy has an analgesic, antispasmodic effect, lowers blood pressure, activates repair and regeneration processes, has a powerful anti-inflammatory and anti-edematous effect, due to the normalization of circulatory and lymphatic vessels and rheological properties of blood improves microcirculation and peripheral blood and lymph flow, activates the activity of the sympathoadrenal and hypothalamic-pituitary-adrenal systems, improves the functioning of the autonomic nervous system and endocrine system, restores immunity. The general effect of magnetic therapy is manifested by an improvement in the psychophysical and emotional state, and normalization of sleep.

A wide range of indications for treatment and versatility of action on the body, as well as a small number of contraindications, allows the use of devices for general magnetic therapy not only for the treatment of diseases, but also in the process of rehabilitation, as well as for the prevention of diseases (including immune-related and oncological). Contraindications: pregnancy; circulatory failure II B – III stages; systemic blood diseases; the presence of foreign magnetic bodies (for example, pacemakers); spicy infectious diseases; hemorrhagic vasculitis and other pathological processes accompanied by increased bleeding.

Ultrasound therapy has a mechanical, physico-chemical and weak thermal effect on the body. The mechanical action of ultrasound, caused by variable acoustic pressure, causes microvibration, a kind of “micro-massage” of tissues. Thanks to the physicochemical effects of ultrasound, the intensity of tissue redox processes increases, the formation of biologically active substances increases - heparin, histamine, serotonin, etc. Ultrasound has a pronounced analgesic, antispasmodic (eliminating spasms), anti-inflammatory, antiallergic and general tonic effect. It stimulates blood and lymph circulation, restoration processes, and improves tissue nutrition. Ultrasound therapy has found wide application in the clinic of internal medicine, for diseases of the joints, skin, ear, nose and throat.

Phonophoresis (syn.: sonophoresis, ultraphonophoresis) is a treatment method that consists of a combined effect on certain areas of the patient’s body with ultrasound and solutions, emulsions or ointments applied to their surface. It is used for diseases of the joints and spine, urological and gynecological diseases.

Laser therapy is a relatively new method of therapy. The history of its use goes back a little over 30 years. The priority in the development of all laser technology in general - be it in the field of space research or in medicine - belongs to Soviet scientists. The first lasers were used in surgery. Currently, laser treatment methods occupy one of the leading places in the list of the most promising areas modern medicine. Currently, laser therapy, being a special branch of medicine, is successfully used in almost all its areas and is officially recognized by all developed countries.

When used externally, laser treatment occurs by exposing certain areas and points of the body to the emitting terminal. Light penetrates tissue to a great depth and stimulates metabolism in affected tissues, activates healing and regeneration, and overall stimulation of the body as a whole occurs. With intravenous laser therapy, through a thin light conductor that is inserted into a vein, a laser beam affects the blood. Intravascular action of low-intensity radiation allows you to influence the entire blood mass. This leads to stimulation of hematopoiesis, strengthening of the immune system, increasing the transport function of the blood, and also helps to enhance metabolism.

Drug electrophoresis(Greek phoresis - carrying) - electropharmacotherapeutic method of combined effects on the body direct current and medicinal substances administered with its help. Pharmacological activity of medicinal substances increases against the background of direct current, since they are introduced into tissues in ionic form. Deposition of medicinal substances in the skin ensures their long-term reflex and focal effects on the body (for a day or more). The side effects of drugs are reduced because they enter the body in small quantities, bypassing the gastrointestinal tract. At the same time, the concentration of the drug in the pathological focus increases and can be several times higher than the concentration at parenteral administration medicines. Medicinal electrophoresis has an anti-inflammatory, absorbable, local anesthetic effect on the body, improves blood supply to tissues and conductivity of peripheral nerve fibers, reduces pathological impulses from the periphery, normalizes the functional state of the central and autonomic nervous systems.

Electrical stimulation A method of electrotherapy using various pulsed currents to change the functional state of muscles and nerves. Electrical stimulation supports muscle contractility, enhances blood circulation and metabolic processes in tissues, creates flow nerve impulses, entering the central nervous system, which in turn has a positive effect on recovery motor functions, prevents the development of atrophies and contractures. Electrical stimulation is most widely used in the treatment of diseases of the nerves and muscles. Such diseases include various paresis and paralysis of skeletal muscles, such as flaccid, caused by disorders of the peripheral nervous system and spinal cord(neuritis, consequences of polio and spinal injuries with damage to the spinal cord), and spastic post-stroke, as well as hysterogenic. Electrical stimulation is indicated for aphonia due to paresis of the laryngeal muscles, paretic condition respiratory muscles and diaphragm. It is also used for muscle atrophy, both primary, which developed as a result of injuries to peripheral nerves and the spinal cord, and secondary, resulting from prolonged immobilization of the limbs due to fractures and osteoplastic operations. Electrical stimulation is also indicated for atonic conditions smooth muscle internal organs (stomach, intestines, bladder, etc.). It is used for atonic bleeding, to prevent postoperative phlebothrombosis, to prevent complications during prolonged physical inactivity, and to improve the fitness of athletes. Contraindications for electrical stimulation are varied. For example, it is impossible to perform electrical stimulation of the muscles of internal organs in case of cholelithiasis and kidney stones, acute purulent processes in the abdominal organs, or in spastic conditions of the muscles. Electrical stimulation of facial muscles is contraindicated in case of early signs of contracture or increased excitability of these muscles. Electrical stimulation of the muscles of the limbs is contraindicated in case of ankylosis of the joints, dislocations until they are reduced, bone fractures until they are consolidated.

Sinusoidal modulated currents - SMT This original domestic method is based on physiological action amplitude pulsations of alternating currents with a frequency of kHz. C MT has a pronounced analgesic effect associated with the direct effect of current on nerve receptors and muscle formations. Exposure to a series of low-frequency oscillations in an orderly manner leads to the extinction of pain. The duration of the analgesic effect is due to the neurohumoral mechanism: the release of morphine-like peptides - mediators of the nervous system - into the central nervous system. Another mechanism of pain relief is improving blood circulation and reducing tissue swelling.

Shock wave therapy (SWT). The therapeutic effect of shock wave therapy on body tissue is based on the so-called microcavitation effect, which occurs when sound waves pass through the boundaries of tissues of different densities, for example, between bone and soft tissues(muscles, ligaments, fascia, etc.), between cartilage and softer tissues, as well as between soft tissues of different densities (scars and muscles, fascia and muscles, etc.). During shock wave therapy, due to the microvibration that occurs, the process of loosening calcium microcrystals in places of their excess deposition, as well as fibrous and scar tissue in places of damage, inflammation and other painful changes occurs. A shock sound wave, penetrating into trigger zones, causes activation of regeneration processes. The concept of the shock wave effect in orthopedic diseases is based on the fact that the shock wave stimulates and activates revascularization and other adaptive possibilities for restoring normal tissue structure. In addition, the shock wave helps to block the transmission of impulses by pain receptors and thus reduce sensitivity and pain.

SWT has proven effective in treating many different musculoskeletal conditions including plantar fasciitis ( heel spur), epicondylitis, tendonitis and non-union of bones. In all situations, shockwave therapy is considered an atraumatic alternative to surgical treatment methods.

Effects of shockwave therapy on tissues: increased metabolism in target tissues; destruction of calcium deposits and further resorption (around the inside of the tendons); reducing the activity of inflammatory processes; reduction of pain; increasing the strength of fabrics.

Indications for shock wave therapy (SWT): calcific tendinosis of the supraspinatus tendon (supraspinatus syndrome), a disease of the tendon of the supraspinatus muscle, accompanied by its calcification; Syndrome of the apex and patellar ligament; traumatic injury ligamentous apparatus knee; trochanteroperiostosis - a disease of the capsule and tendon hip joint, trochanteritis - inflammation of the hip joint; Achilles' tendonitis, Achilles tendon pain and inflammation; Dupuytren's syndrome - chronic traumatic overstrain of the muscles and tendons of the anterior edge tibia; radiation epicondylitis, inflammation of the head radius at the site of attachment of muscles and ligaments; heel spur"; glenohumeral periarthrosis - a disease of the periarticular soft tissues (muscles, ligaments and tendons) of the shoulder joint; deforming osteoarthritis - degenerative-dystrophic (age-related) disease of the joints; Post-traumatic arthrosis; sprains and micro-tears of muscles; ligamentoses (ligament diseases) various localizations; SIJ (sacroiliac joint) blocks; trigger and muscle-tonic pain in osteochondrosis; delayed consolidation of fractures; muscle contractures in cerebral palsy; "diabetic foot"

There are very few contraindications to UVT: cancer; pregnancy; acute infectious diseases; shock wave therapy not carried out in case of blood clotting disorders; the patient has a pacemaker; the patient is taking anticoagulants.

SWT allows the doctor to carry out targeted effects on the site of the disease without injuring other tissues. The course of treatment usually consists of 4-10 sessions. each, carried out once within 5-7 days.

Indications for therapeutic massage: headaches; pain in the back, lower back, neck; osteochondrosis; bruises, sprains of muscles, tendons and ligaments; fractures at all stages of healing; functional disorders after a fracture and dislocation (joint stiffness, muscle changes, scar tissue adhesions); arthritis in the subacute and chronic stages; neuralgia and neuritis; radiculitis; paralysis; chronic failure of the heart muscle; angina pectoris; hypertonic disease; arterial hypotension; rehabilitation period after myocardial infarction; chronic gastritis; impaired motor function of the large intestine; bronchitis; pneumonia; bronchial asthma; peptic ulcer of the stomach and duodenum (beyond exacerbation).

General classical massage (general massage is a massage of the whole body, otherwise - wellness, preventative massage): an active means of promoting health, maintaining the body’s activity, preventing diseases, and caring for normal skin.

Indications for general massage: for mental and emotional disorders; general poor health; muscle tension; headaches and occipital pain; back pain; apathy, bad mood; digestive problems, lack of appetite; sleep disorders, night restlessness.

Anti-cellulite massage - a type of massage aimed at combating cellulite, improves the inflow and outflow of blood, lymph, and intercellular fluid throughout the body. Anti-cellulite massage helps remove toxins, improves metabolic processes in the body, and helps burn your own fat.

Contraindications are given in a generalized form: for acute febrile conditions and high temperature; bleeding and tendency to it; blood diseases; purulent processes any localization; various diseases skin, nails, hair; for any acute inflammations blood and lymphatic vessels, thrombosis, severe varicose veins; atherosclerosis of peripheral vessels and cerebral vessels; aortic and cardiac aneurysm; allergic diseases with skin rashes; diseases of the abdominal organs with a tendency to bleeding; chronic osteomyelitis; tumors; mental illness With overexcitement; circulatory failure of the 3rd degree; during hyper- and hypotonic crises; acute ischemia myocardium; severe sclerosis of cerebral vessels; acute respiratory disease(ORZ); in case of intestinal dysfunction (nausea, vomiting, loose stool); Pulmonary heart failure of the 3rd degree.

Massage works not only on a physical, but also on a psychological level. It fills the body with energy, helps us feel better about ourselves, and makes us optimistic. Massage, affecting vital organs, returns the body’s ability to heal itself.

ORGANIZATION OF THE WORK OF THE PHYSIOTHERAPY DEPARTMENT

Guiding documents on labor organization.

The organization of the work of the FTO and the functional responsibilities of its employees are regulated:

1. By order of the People's Commissariat of Health dated February 22, 1939, “Regulations on the head of physical education and physiotherapist.”

2. Order of the USSR Ministry of Health No. 817 dated September 1, 1949 “Regulations on the physiotherapy room and department.”

3. Order of the USSR Ministry of Health No. 100 dated February 8, 1968 “On measures to improve and further develop therapeutic care to the population.”

4. Order of the USSR Ministry of Health No. 245 of August 30, 1991 “On alcohol consumption standards for healthcare, education and social security institutions.”

5. Order of the Ministry of Health of the USSR No. 1092 of December 29, 1972 “On the maintenance and installation of medical equipment.”

6. Order of the Ministry of Health of the Russian Federation No. 35 of February 20, 1995 “On remuneration of healthcare workers in the Russian Federation.”

7. Order of the Ministry of Health of the Russian Federation No. 33 of February 16, 1995 “On approval of the Regulations on the certification of doctors, pharmacists and other specialists with higher education in the healthcare system of the Russian Federation.”

8. Order of the Ministry of Health of the USSR No. 1440 of December 21, 1984 “On approval of conventional units for the performance of physiotherapeutic procedures, time standards for massage, regulations on physiotherapeutic units and their personnel.”

9. Order of the USSR Ministry of Health No. 693 dated May 25, 1981 “On the name of the position of acupuncturist.”

10. SSBT. Departments, physiotherapy rooms. General safety requirements. OST 42-21-1686 Ministry of Health of the USSR, 1987.

11. Order of the USSR Ministry of Health No. 850 dated July 4, 1988 “On additional leave of medical and pharmacy workers.”

12. Order of the Ministry of Health of the Russian Federation No. 126 of April 29, 1997 “On the organization of work on labor protection in management bodies, institutions, organizations and enterprises of the system of the Ministry of Health of the Russian Federation.”

13. Order of the Ministry of Health of the USSR No. 1000 dated September 23, 1981. Estimated standards of service for doctors in outpatient clinics.

14. Order of the Ministry of Health and MP of the Russian Federation No. 286 of December 19, 1994 “On approval of the Regulations “On the procedure for admission to professional (medical and pharmaceutical) activities.”

15. Order of the Ministry of Health and MP of the Russian Federation No. 318 of November 17, 1995 “On the regulations on the qualification exam for obtaining a specialist certificate.”

Principles of rational placement of physiotherapy units.

When constructing new or reconstructing existing FTOs (FTC), an approved standard design is required, which indicates the placement of equipment, electricity, water and heat supply, ventilation. The commissioning of a medical technical service (FTC) is formalized by a special act, which is kept by the head physician of a medical institution or the head of a medical technical institution (FTC).

When planning FTO and FTC in hospitals and clinics under construction, they use Construction Norms and Rules - SANPIN 2.1.3.1375-03, introduced by Decree of the Chief State Sanitary Doctor of the Russian Federation No. 124 of June 6, 2003 (reg. No. in the Ministry of Justice 4709 of June 18, 2003 ). They define a list of premises for physical technical training (FTC) with detailed characteristics of the areas and interior.

The optimal organization and layout of individual physiotherapy rooms and the entire physiotherapeutic complex should ensure the use of modern methods of physiotherapy during all operating hours of the hospital and clinic in accordance with current labor protection standards, sanitary hygiene and occupational safety regulations.

The rational design, layout and equipment of the physical technical department (FTK) should provide the following general conditions: effective use of modern methods of physiobalneotherapy; creating the most comfortable conditions for patients during treatment and relaxation; ensuring labor safety standards for medical workers (mechanization of labor-intensive processes, protective equipment, rest rooms, wardrobes, shower facilities).

Expedient, economically justified placement of the physiotherapy department and equipment in it reduces the downtime of the devices and increases the efficiency of physiotherapeutic care. Comparative study economic and therapeutic efficiency of physiotherapeutic services in large united hospitals with different types of placement of physical therapy allowed us to establish the advantage of institutions where work is carried out in a single physiotherapy department for the hospital and clinic.

In each medical and preventive institution, it must be developed and approved by the head "Regulations on the physiotherapeutic department (PTD) or on the physiotherapeutic office (PTK)", approved by Order of the USSR Ministry of Health No. 1440 of December 21, 1984.

REGULATIONS ON THE DEPARTMENT (OFFICE) OF PHYSIOTHERAPY OF A TREATMENT AND PREVENTIVE INSTITUTION

1. The physiotherapy department (office) is a structural unit of a medical institution that provides qualified physiotherapeutic care to the population. If there is a rehabilitation treatment department (office) in a medical institution, the physiotherapy department (office) is included in its composition.

2. The opening and closing of the physiotherapy department (office) is carried out in accordance with the established procedure.

3. The physiotherapy department (office) is located in specially equipped premises that fully meet the requirements of the Rules for design, operation and safety.

4. The management of the work of the physiotherapy department (office) is carried out by a physiotherapist, and in his absence - by the head of the institution or by a doctor trained in physiotherapy.

5. The staffing levels of medical personnel in the physiotherapy department (office) are established according to current staffing standards.

6. The equipment of the physiotherapy department (office) is carried out in accordance with the current report card. Preventive monitoring and repair of physiotherapeutic equipment in the physiotherapy department (office) is carried out by the relevant enterprises for servicing medical equipment.

7. The activities and scope of work of the physiotherapy department (office) are determined depending on the profile of the medical institution and the relevant regulatory documents.

8. The main objectives of the physiotherapy department (office) are:

– carrying out therapeutic, restorative and preventive measures using physical factors;

– monitoring the implementation of prescribed physiotherapeutic procedures and analysis of errors in the prescription of physiotherapeutic procedures by doctors of other specialties;

– organization of events for training and advanced training of doctors and nursing staff in the field of physiotherapy;

– introduction into practice of new methods of physiotherapy and physioprophylaxis;

– organizing the promotion of physiotherapy methods among medical workers;

– recording the work of the department (office) in accordance with the accounting and reporting documentation approved by the Ministry of Health of the Russian Federation within the established time frame.

9. The work of the physiotherapy department (office) is carried out according to a schedule, the responsibility for drawing up which is assigned to the head of the department (office).