The video provides a tutorial on how to apply iontophoresis with dexamethasone to the proximal biceps tendons to reduce inflammation associated with tendinopathy and tynosynovitis.
So we’re going to go ahead and find the bicipital groove so i’m going to just bar your arm we’re going to palpate the front of the shoulder okay the right one right yeah so you just go in and relax on so i feel like we’re pretty close somewhere right in there is that accurate yeah all right so go ahead and relax your arm great all right so it’s going to be our
Marker okay we’re doing this bilateral okay and this one we have the nice freckle that i recall from last time that kind of like denoted the spot which is like right there okay we’re going to prep the area sometimes it’s better to rub it down with alcohol first because sometimes it’ll take off the marker but you still have a guide there come over to the other
Side same thing rubbing around you can still kind of see where we left the mark okay so tissue is prepped and then we are going to come over here because we got two shoulders we need two patches i’m only going to demonstrate one but it would be the same exact steps for the subsequent one okay so here’s a little card that denotes um the led flashing sequence as
Well as the dosage timer so you can orient yourself to that but for all intents and purposes for the video not necessarily important at this moment so we want to first ensure that our patch is going to be working for us so we have this little pull tab pull it out flip it over and our light should be blinking green which it is so we’re good start okay then you
Have this adhesive that’s easier to pull off prior to the medication being administered to the pad put that there okay you have two additional little tabbies we’ll leave that one on because it’ll be helpful in a moment all right then we’re gonna flip our bottle over and we’re gonna pull it down to where it says two milliliters just like that and then without
Overflowing the pad we’re going to start in the middle and gradually add some drops and i usually go in a concentric fashion so it has even distribution throughout the pad so the pad will last or the patch will last up to four hours and when you put the patch on you don’t want to compress the pad you want to compress the adhesive because otherwise you’ll you know
Just like a sponge if you squeeze the sponge all the liquid will flow out of it but you want it to be uniform and comprehensive in getting the entire pad there we go and i don’t have any left okay so then when you’re putting it on our epicenter of discomfort or pain in this case it’s the proximal biceps tendon and then this is going to be going lower down
The arm okay it can be quite sticky with gloves so the key is to keep that last little bit of adhesive covered so we’re going to come in like this make sure that our pad is directly over said marker we’re going to come around the pad without actually pushing on it so that we’re not leeching out all the medication and then i’m gonna have you just open up your
Arm just a little bit perfect yep there we go okay and so it’s creating an electrical current they’ll otherwise cause the medication to be administered to the superficial tissue of the biceps tendon and then we just take off our little tabby just like this okay so once the medication begins it will the green light will be blinking every 30 seconds and it will
Do so for the next four hours and the little card tells us that so three flashes per 10 seconds the transition to the second dosage period right so there may be it may take a moment before it actually falls into the cycle but this one’s looking good and that’s how you administer it we replicate the same thing for the opposing shoulder
Transcribed from video
Shoulder – Pain – Iontophoresis with Dexamethasone By Dr. Michael Jeanfavre
