The Space Age has rocketed medicine into new technologies. Unlimited vistas have opened in genetics, diagnostics, and therapies. Although since 1 799 there has been medical experimentation with electricity, only recently has electromagnetic energy been identified as the basis of life itself For centuries the medical profession relatively ignored the electricity of the body for therapeutic purposes, although it was accepted for diagnostic purposes, i.e. EEC, EKG, etc.

Medical equipment is indicative of the advances in medicine. Lasers of all types, MRI, Sonograms, etc. have become household words.

A micro-pipette developed by NASA opened a new world, that of measurements of electrical and electromagnetic potentials in living tissue. Studies have revealed the membrane potentials on cells; it is possible to accurately substantiate the differences between damaged cells and normal cells.

It must be emphasized that this discussion concerns non-thermal, non-invasive
high frequency high peak power electromagnetic energy (Diapulse Wound Treatment System), which is in the safe range of the Spectrum, with NO contraindications following years of research.
How does the body respond to trauma?The first reaction to stress is electrical; the second is electro-chemical and the third is chemical.

· The first can be illustrated by placing both hands behind your back, having a colleague prick one finger with a needle. You will immediately identify the intrusion because the brain received instantaneous information through nerve endings. The brain, by electrical transmission, orders all responses that are required by the traumatized tissue to restore normal function, including blood flow, antibody requirement, enzymes, proteins, etc.

· The electro-chemical reaction is a local defense response to maintain stability in the area, to block infection, assist in containment of excessive bleeding, and initiate the healing process.

· The chemical response is the final healing phase, with the return of normal electrical metabolic, enzymatic balances, re-establishment of blood flow and formation of new tissue.

· Edema
When a cell is damaged due to burn, laceration, contusion, abrasion, or surgical intervention, there is a depolarization of tissue. When this occurs, there is a slowing-down of the RNA, DNA synthesis and sodium pump. Due to the increased cell permeability, sodium and water enter the cell creating edema.

The cell membrane changes polarity. The reason for this reaction is that the body seeks to repolarize tissue. Sodium and water are excellent electrical conductors, and by the creation of edema, cause pressure against the cell walls of healthy cells. This creates a piezoelectric response and allows the healthy cell to transfer negative ions, thus causing restoration of the negative charge on damaged cells. Once the damaged cell is repolarized, by re-establishing its negative potential, sodium and water leave, and potassium is allowed to pass freely through the cell membrane and the polarization of tissue returns to proper balance. At this time, healing can proceed.

By placing damaged tissue in Diapulse’ electromagnetic field immediately following injury, the body repolarizes damaged cells rapidly. The elimination of edema is most dramatic in cases of acute traumatic injury. Edema creates pressure on capillary and micro-circulation in the area of involvement, retarding healing. Elimination of edema is necessary for the healing process and to prevent development of a chronic problem.

· Hematoma:
When trauma is induced in any area of the body, hematoma develops. Due to damage there is disruption of capillary and micro-circulation (as well as major blood vessels, with deep trauma), mast cells in that area produce histamine, which inhibits leukocytic reaction. When the body has produced sufficient platelet and prothrombin reaction, the same mast cell will produce heparin, which accelerates the activity of the leukocytes in phagocytosis of the hematoma. Delay in removal of the hematoma results in formation of fibrinogen, which creates scar tissue.

Diapulse therapy increases platelet production and prothrombin reaction, causing the mast cell to bypass the histamine stage and heparin is produced immediately to accelerate leukocytic activity in the absorption of hematoma. Therefore, very little or no scar tissue is formed in the wound area.

· Blood Flow
Injury or pressure caused interruptions of blood flow, which must be re-established as quickly as possible. Blood flow - not blood volume - increases oxygenation of tissue, vitally necessary for healing. The Diapulse parameters of high frequency high peak power electromagnetic energy increase blood velocity. When exposed to this energy, the various constituents of the blood align in chains, like cells with like cells. It can be compared with traffic on a multi-lane highway that moves slowly when vehicles continually change lanes, and with traffic that stays in specific lanes. The latter can move at a greater speed. Research at the University of Pennsylvania proved that the speed of the blood is increased by 1.75 times the testing pulse, with no hyperpyrexia, increase in temperature, or contraindications, with the use of Diapulse.

Additional physiologic responses in healing:
Diapulse, with its specific parameters, has been reported to increase:
Fibronectin - connective tissue, which gives strength to tissue
     healing in the wound - and synthesized in the liver.
Miiochondria - energy levels within the cells 
Enzymes - required in healing 
Hepatocyte reparatory processes - increase conclusively without
     necrosis or damage to the hepatocyte structure

Animal studies
Baylor University, Houston TX, using Diapulse, reported acceleration of wound healing by more than 500 % when compared with un-treated controls:
1. Transverse alignment: treated 3 days, untreated = 8 days.
2. Collagen formation treated = 6 days, untreated did not 
    appear within 10 days
3. WBC infiltration: treated = 24 hours, untreated 3 days
4. Phagocytosis: treated = 24 hours, untreated 4 days.
5. Histiocytic activity: treated = 48 hours, untreated = 4 days
6. Fat activity: treated = 48 hours, untreated = 5 days
7. Hematoma canalization: treated 3 days, untreated = 7 days

Accelerated nerve tissue regeneration was reported by Britain’s Royal College of Surgeons, Leeds University, and New York University.

Extensive additional animal research published on Diapulse technology, demonstrate its safety and effectiveness and pre-dated human studies.

What clinical applications have been reported?
Double blind and controlled studies as well as case reviews, all from leading medical institutions and published in peer-review journals, demonstrate the value of utilizing this non-invasive, safe technology in many areas where critical care nurses have responsibility. Following are brief reviews of selected articles:

Head Trauma and Coma:
A controlled study of 200 cases (100 treated with Diapulse, 100 control) demonstrated rapid resolution of brain edema without side effects in the treated group, and brought patients out of coma within ten days. The work was reported from the Medical College Hospital, Trivandrum, and published in a leading neurosurgery journal. The conclusion states that pulsed electromagnetic energy (Diapulse) has a definite role in the management of acute head injuries. The treated group of coma patients showed a marked improvement over the controls on the Glasgow Coma Scale. CT scans of the treated cases revealed elimination of cranial edema with no change in the controls.

Spinal Cord Injury:
The report on ninety-seven patients with crush injuries of the spine, treated with Diapulse at the Medical Academy, Warsaw University, revealed that spinal cord lesions evidenced improved neurological recovery when compared to results obtained previously with other methods. Patients had been admitted to the study within 24 hours post-injury, mainly with a total or substantial injury of the spinal cord. All patients improved; 40% recovered completely.

Burns:
Over 2000 patients with traumatic lesions before and after surgery received Diapulse treatment at the Clinic of Plastic Reconstructive Surgery, Post Graduate Medical School, Bucharest. The researchers used Diapulse therapy to ameliorate the local and general status of burned patients in the treatment of deep burns of the face and hands, smoke inhalation burns, severe extensive burns, and radionecrosis. They then performed an enzyme study to find objective proof for the healing results. This study revealed that LDH, GPT and alkaline phosphatase were significantly increased, while GOT continued to decrease. It was noted that the earlier Diapulse is applied to the injured tissue, the more rapidly the normal enzymatic activities are restored. The conclusion was that the data recorded demonstrated the beneficial effect of Diapulse therapy on traumatized tissues.

Hand Injury:
At the Accident and Emergency Department of Guy’s Hospital, London, a total of 230 patients with a variety of hand injuries took part in a clinical trial, in which half received Diapulse treatment and half were controls. Patients were measured for categories of swelling, disability pain. The improvement of the treated patients in each category was more than three times that of the controls. This randomized trial showed statistically significant results on healing of hand injuries with the use of Diapulse.

Foot Surgery:
A double-blind study of 100 patients to determine the effectiveness of Diapulse therapy following foot surgery was conducted at Civic Hospital, Detroit. Statistically significant results showed a reduction in postoperative edema, and a concomitant reduction of erythematic and pain in the treated group. Treatment was administered safely through surgical dressings and plaster casts.

Orchidopexy:
Fifty boys (eighteen months to twelve and one-half years of age) were paired sequentially in a double-blind trial of Diapulse therapy on children undergoing orchidopexy at Queen Mary’s Hospital for Children, Carshalton. Researchers reported a statistically significant increase in the rate of bruise resolution and healing in the treated group as compared with the controls. Treatment was applied during the first four postoperative days. There were no side effects, and the youngsters found the treatment reassuring and soothing.

Donor Sites:
A randomized, double-blind study at Wordsley Hospital, Stourbridge, evaluated the effects of Diapulse on wound healing in patients ages fifteen to sixty-five. Approximately twice as many patients were healed in seven days where active treatment was given as opposed to those receiving placebo treatment. Thirty minute treatments were applied to the donor site at the time of pre-medication and post-operatively every six hours, for seven days. The published results state that clinically and statistically, the treated patients healed faster than the placebo treated. This trial indicates that reparative processes are clearly accelerated by pulsed radio-energy (Diapulse).

Ulcers. Decubitus and Diabetic:
At the Veterans Administration Hospital in Castle Point NY, a randomized, double-blind study, had a follow-up period of twelve weeks or until healed, over a two-year period. The study was comprised of thirty male, spinal cord patients (20 with stage 11 and 10 with stage III) pressure ulcers. Diapulse treatment was applied for thirty minutes twice daily. The report statistically concluded that Diapulse treatment is safe and accelerates wound healing in SCI patients with stage 11 and stage III Decubitus Ulcers

Goldwater Memorial Hospital, NY, added Diapulse to the conventional regimen of treatment of twenty-two patients with non-healing stage II (mean of 8.22 weeks) and stage III (mean of 34.62 weeks) pressure ulcers. Patient selection was limited to chronic ulcers without any sign of healing, or ulcers of short duration that were deteriorating rapidly with conventional treatment. All of the ulcers completely healed with Diapulse: mean average of stage II was 2.33 weeks; mean average of stage III was 8.85 weeks. The researchers completed an economic evaluation of these recoveries compared with conventional therapies without healing. They indicated the cost savings with the use of this therapy to be more than $65,000 for these twenty-two ulcers in the nine-month study Gouverneur Hospital, NY reported total healing of stage IV diabetic ulcers, which allowed limb salvage with the use of Diapulse. Researchers state that the therapy can be unattended, no electrodes or accessories are needed, the energy penetrates surgical dressings - all of which reduced nursing time.

Traumatic injuries:
Brooke Army Medical Center, Fort Sam Houston, TX, reported on a randomized, prospective double-blind study of fifty grade I and II sprained ankles. A statistically significant decrease in edema was noted, following one treatment with Diapulse. The fifty patients were assigned a number from I to 50 on arrival. Twenty-five randomly selected numbers were assigned to the treatment or the placebo groups. All patients were seen within the first 72-hours following injury. Researchers found the reduction in swelling effected by Diapulse was 4-fold greater than that effected by placebo treatment. Because Diapulse causes no change in tissue temperature or skin sensation, patients were unable to determine if they were receiving active treatment or placebo care. Diapulse significantly reduced the pain associated with walking on a sprained ankle: twice as many subjects in the treated group reported a decrease in pain experienced with standing on a sprained ankle as compared with the control group. The statistical conclusions state that non-thermal pulsed, electromagnetic energy as delivered by Diapulse can be used to decrease swelling and pain in the acutely sprained ankle. They add that this can be important in a population required to wear restrictive foot wear and is expected to return to active training as rapidly as possible. Diapulse eliminated the possibility of burns that can occur with hot or cold packs as well as the need for pneumatic compression devices. Use of Diapulse can result in significant decreases in time lost to military training.

Patients with severe ankle inversion injury were treated within 36-hours at the Accident and Emergency Department of Leeds General Infirmary. With a non-sequential analysis of 20 placebo and 20 treated, Diapulse treatment was found to be statistically significant compared to the placebo on swelling, disability, pain, and total scores of measurement.