ACBT

Question 1

What does ACBT consist of?

Answer 1

Breathing control
Thoracic expansion exercises
Forced expiratory technique

Question 2

BC

Answer 2

Recruits the diaphragm
Place hand over diaphragm
Breathing using lower chest- relaxed upper chest and shoulders
Patient’s own respiratory rate and volume

Question 3

BC benefits

Answer 3

Decrease WOB, maximise V/Q. Relieve breathlessness.

Relaxes use of accessory muscles.

Question 4

TEE

Answer 4

Deep breathing
Slow controlled inspiration through the nose (larger than normal vol)
3 second inspiratory hold with glottis open
May incorporate a sniff

Question 5

TEE mechanism

Answer 5

Facilitates collateral ventilation channels

Alveolar interdependence- high lung volumes achieved during TEE generates expanding forces between alveoli.

Question 6

TEE application

Answer 6

Limited to 3-4 breaths with pause for BC

Because more could cause patients to become alkalotic and hyperventilate

Question 7

TEE sniff

Answer 7

May not be appropriate for very breathless or hyperinflated patients
May be used for surgical patients who need further motivation to increase their lung volumes

Question 8

FET

Answer 8

1-2 huffs and BC
Huffing from low lung volumes- move peripheral secretions
Huffing from higher lung volumes- move central/upper secretions
FET is as effective as coughing and takes less effort

Question 9

FET mechanism

Answer 9

Equal pressure points- pressure in airway equals pressure outside airway

Question 10

FET and BC

Answer 10

BC is important as a recovery phase to minimize fatigue

Question 11

FET application

Answer 11

During huff, glottis is open.
Dynamic airway narrowing, causes inherent vibrations,
Could start with small huff unless secretions can be heard/felt in airways.
May use peak flow mouthpiece during huff to provide audible feedback and improve technique.
Requires upright positioning to optimize expiratory flow and pressure

Question 12

ACBT clinical application

Answer 12

Respiratory conditions with excess secretions
Sputum retention following thoracic trauma or surgery
Upright seated position
Can be combined with gravity assisted drainage
Effective in clearing secretions in CF, COPD

Question 13

ACBT no of cycles

Answer 13

Minimum of 10 mins
Stop when you get 2 cycles of non productive or dry sounding huff or patient becomes unstable/experiences adverse effects.