Current through Register Vol. 56, No. 18, September 16, 2024
(a) For purposes
of this section and
13:44E-2.7(c)5
ii, "electro-therapy devices" such as "TENS" (transcutaneous electric nerve
stimulation), "MES" (micro-ampere electric stimulation), or "EMS" (electric
muscle stimulation) devices, means devices which generate an electrical current
that is applied to the skin via electrodes to cause a physiological
effect.
(b) A licensee may not
order an electro-therapy device for home use which:
1. Uses AC electrical current; or
2. Is an interferential device which crosses
two medium frequency alternating currents through the body.
(c) A licensee may order a battery
operated electro-therapy device for home use provided that the patient:
1. Is not using a cardiac pacemaker or
implanted defibrillator;
2. Is not
epileptic;
3. Does not suffer from
any cognitive impairment which affects the patient's ability to follow
instructions;
4. Is willing and
able to assume responsibility in writing for use of the electric therapy
device;
5. Will have adequate home
assistance, where such assistance may be necessary in the opinion of the
treating chiropractor, especially when the electrodes are to be placed
paraspinally;
6. Is provided with a
complete set of instructions for home use which includes:
i. The operation of the unit;
ii. Battery charging or changing;
iii. Care of the unit and supplies;
iv. The preferred and alternative electrode
placements and stimulation parameters;
v. The suggested schedule of treatment times
and rest periods;
vi. Precautions
against misuse of the unit, including using the device for any purpose other
than that for which it was ordered;
vii. The avoidance and treatment of skin
irritation;
viii. The address and
phone number of an information source for troubleshooting; and
ix. The chiropractor's name and phone number;
and
7. Has provided a
written acknowledgment that a complete set of instructions for home use has
been received.
(d) A
battery operated electro-therapy device may be ordered for home use, provided
that the chiropractor has instructed the patient that the electro-therapy
device should not be applied over:
1. The
carotid sinus;
2. Blood vessels
with thrombosis or emboli;
3.
Tissue or blood vessels vulnerable to hemorrhage or inflammation;
4. Lumbar or abdominal areas of pregnant
women;
5. The eyes or
internally;
6. A malignancy;
or
7. Trans-thoracic applications
in asthenic patients.
(e) The licensee shall document the ordering
of care using an electro-therapy device in the patient record pursuant to
13:44E-2.2, which shall also
include the following:
1. A specific treatment
protocol, including the specific electro-modality to be used, the electrode
type, and the electrode placement;
2. An evaluation of the patient's response
and documentation of any necessary adjustments to the treatment;
3. The estimated period of time necessary to
achieve the treatment goals of the electro-stimulation device;
4. Regular follow-up evaluations of the
patient's participation in the at-home electro-therapy device program;
and
5. The acknowledgment from the
patient that a complete set of instructions for home use has been received
pursuant to (c)7 above.
