Cautions & contraindications powerpoint voice over version 2

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Cautions & contraindications powerpoint voice over version 2

  1. 1. PRECAUTIONS & CONTRAINDICATIONS for MASSAGE (Unit 1 : Lecture 2)
  2. 2. Precautions and Contraindications <ul><li>Precautions- Proceed with caution, be careful, monitor closely for response </li></ul><ul><li>Contraindications- DO NOT DO or strongly consider risk/reward involved </li></ul>
  3. 3. Why may massage produce harm? <ul><li>Presence of disease or dysfunction </li></ul><ul><li>Failure to avoid or modify technique </li></ul><ul><li>Inappropriate application </li></ul>
  4. 4. General Principles <ul><li>Perform a thorough examination </li></ul><ul><li>Be aware of indications as well as precautions/contraindications </li></ul><ul><li>ALWAYS ASK PERMISSION </li></ul><ul><li>Tune into your patients response </li></ul><ul><li>Be aware of your mood </li></ul>
  5. 5. General Principles <ul><li>Avoid HEAVY pressure over sensitive areas </li></ul><ul><li>Communicate with your patient throughout treatment </li></ul><ul><li>Be aware of your anatomy and physiology </li></ul><ul><li>Be aware that some patients have an aversion to touch </li></ul>
  6. 6. Massage Safety
  7. 7. Case Studies <ul><li>Danchik JJ, Yochum TR, Aspengren DD. Myositis Ossificans Traumatica. Journal of Manipulative and Physiological Therapeutics . 1993;16:605-614. </li></ul><ul><li>Yeo TC, Choo MH, Tay MB. Massive Haematoma from Digital Massage in an Anticoagulated Patient: A Case Report. Singapore Medical Journal . 1994;35:319-320. </li></ul><ul><li>Kalinga MJ, Lo NN, Tan SK. Popliteal Artery Pseudo Aneurysm caused by an Osteochondroma: A Traditional Medicine Sequelae. Singapore Medical Journal . 1996;37:443-445. </li></ul>
  8. 8. Contraindications & Precautions <ul><li>Nature of lists </li></ul><ul><li>Make sense of it </li></ul>
  9. 9. Contraindications <ul><li>Physical Illness / nausea / fever >101.5F </li></ul><ul><li>Severe Pain – Identify </li></ul><ul><li>Acute conditions </li></ul><ul><li>Advanced respiratory, kidney or liver failure </li></ul><ul><li>Rashes, boils, open wounds, skin infection </li></ul><ul><li>Metastatic cancer, including skin tumors </li></ul>
  10. 10. Contraindications <ul><li>Haemophilla, haemorrhage, severe ecchymosis </li></ul><ul><li>Whiplash within 24-48 hours: need X-ray </li></ul><ul><li>Acute inflammatory disorder: acute RA, local inflammation from recent trauma </li></ul><ul><li>Thrombophlebitis </li></ul><ul><li>Severe varicose veins </li></ul>
  11. 11. Contraindications <ul><li>Severe atherosclerosis- esp. ant. Neck </li></ul><ul><li>Unstable medical condition, including unstable hypertension, acute MI, acute CVA </li></ul><ul><li>Aneurysms </li></ul><ul><li>Frostbite </li></ul>
  12. 12. Precautions <ul><li>Endangerment sites </li></ul><ul><li>Diminished sensation due to CVA, diabetes, drugs, Etoh </li></ul><ul><li>Medication use </li></ul><ul><li>Hyperaesthesia: RSD </li></ul><ul><li>RA- remission stage </li></ul><ul><li>Immune system depression (transplant, AIDS, Chronic Fatigue) </li></ul>
  13. 13. Precautions <ul><li>Drug withdrawal & psychiatric conditions </li></ul><ul><li>Recent neurological injury- CVA, CHI, SCI, presence of spasticity or tone changes </li></ul><ul><li>Osteoporosis </li></ul><ul><li>Facial Massage with contact lenses </li></ul><ul><li>Lymphedema- need trained specialist </li></ul>
  14. 14. Observation: Skin Cancer <ul><li>Benign or Malignant </li></ul><ul><li>Three basic types: </li></ul><ul><ul><ul><li>Malignant Melanoma </li></ul></ul></ul><ul><ul><ul><li>Basal Cell Carcinoma </li></ul></ul></ul><ul><ul><ul><li>Squamous Cell Carcinoma </li></ul></ul></ul>
  15. 15. Malignant Melanoma <ul><li>1:90-100 expected to develop </li></ul><ul><li>Spreads horizontally or deep </li></ul><ul><li>Common in people who have: </li></ul><ul><ul><ul><li>A large number of moles </li></ul></ul></ul><ul><ul><ul><li>Red/Fair hair, blue eyes, fair skin, freckles </li></ul></ul></ul><ul><ul><ul><li>A tendency to burn easily </li></ul></ul></ul><ul><ul><ul><li>A family history of malignant melanoma </li></ul></ul></ul><ul><li>Early detection = Early cure (99%) </li></ul>
  16. 16. Is it Malignant ? <ul><li>A = Asymmetry </li></ul><ul><li>B = Borders </li></ul><ul><li>C = Color </li></ul><ul><li>D = Diameter </li></ul><ul><li>E = Evolution </li></ul><ul><li>** Most develop in early childhood and early adulthood </li></ul>
  17. 17. Other suspicious signs <ul><li>Inflammation </li></ul><ul><li>Pain </li></ul><ul><li>Itching </li></ul><ul><li>Crusting or Bleeding </li></ul><ul><li>Satellite lesions: small brown changes around the edge of a mole </li></ul>
  18. 18. Skin Tumors continued… <ul><ul><ul><li>Basal Cell Carcinoma </li></ul></ul></ul><ul><ul><ul><li>Squamous Cell Carcinoma </li></ul></ul></ul>
  19. 19. Visit this website: <ul><li>How to recognize a melanoma: </li></ul><ul><li>http://dermnetnz.org/lesions/melanoma.html </li></ul>

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