Airway clearance techniques Flashcards
1
Q
HFCWC
A
- High frequency chest wall compressions
- relies on recoil of chest to return to FRC
- Vest
2
Q
HFCWO
A
- High frequency chest wall oscillations
- creates both positive and negative forces, actively moving tiny volume both in and out of the lunds
- 600-720 cycles per minute
- chest cuirass
- active inhalation and exhalation
*
3
Q
Hazards of CPT
A
- Hypoxemia
- Increased ICP
- Pulmonary Hemorrhage
- Dysrhythmias
- Hypertension
- Bronchospasm
- Aspiration
- Injuries to skin or skeleton
4
Q
Autogenic drainage
A
- A technique that aims to reach the highest possible airflow in the different generations of the bronchi to move secretions without forced expiration
- start with low volume breaths - for ERV
- repeat for 10-20 breaths until secretions are felt gathering in the airways
- suppress the urge to cough and take 10-20 larger breaths
- take a series of even larger breaths (near vital capacity)
- take several huff coughs
5
Q
Complications of coughing
A
- Regurgitation – aspiration
- Bronchospasm
- Incontinence
- Excessive pain
- Muscle fatigue, strain
- Transmission of disease transmitted by droplet nuclei (e.g. TB)
- Thoracic damage
- Rib fractures, tendon separation
- Pneumothorax
- Abdominal damage
- Aneurysm, hernia, premature delivery
- Reduced blood flow to brain
- dizziness, syncope, paresthesia, numbness, confusion
- Increased ICP
- Unstable head, neck, spinal trauma or lesions.
- Reduced blood flow to heart
- cardiac ischemia, infarction
- Retinal damage
6
Q
Mid-Expiratory point coughing
A
- Have patient take 5 TLC deep diaphragmatic breaths
- Utilize Pursed Lip Breathing
- Have patient cough 3-5 times down to FRC level.
Cough to FRC not RV. FRC is volume at the end of a normal VT. Going past that can cause atelectasis
7
Q
Directed force (Huff) cough
A
- Uses same techniques as Mid-Expiratory Point Cough
- Have patient huff 3-5 times.
- Will often initiate coughing
8
Q
Directed cough
A
- instruct the patient to take a deep breath, then hold, using abdominal muscles force air against a closed glottis, then cough with a single exhalation
- several relaxed breaths before doing the next effprt
9
Q
TCDB
A
- Turn cough deep breathe
- rotate the patient so a different area of the lungs gets filled with oxygen to help all alevoli get inflated
10
Q
cough assistance
A
- Usually done in combination with administration of large VT ventilations with manual resuscitation bag.
- Time compression of the abdomen with exhalations
- Usually accompanied by suctioning
11
Q
What are some signs of intolerance?
A
- Vomiting
- hypotension
- decrease in SpO2
- increase HR
12
Q
What is the procedure for a VEST treatment?
A
- 30 minute treatment, 3 settings at 10 minutes each
- 1st setting: slow speed with higher pressure
- cough
- 2nd setting more speed with less pressure
- cough
- 3rd setting more speed and even less pressure
13
Q
What are 2 ways to recruit alveoli?
A
- Voluntary hyperinflation- take a deep breath
- pressurized splinting- holds airway open with pressure
14
Q
What are side effects or hazards of coughing?
A
- Regurgitation
- bronchospasm
- incontinence
- excessive pain
- transmission of disease
- thoracic damage
- abdominal damage
- increased ICP
- reduced blood flow to the heart
- retinal damage
15
Q
What is the effective cough routine?
A
- Diaphragmatic breathing
- 5 breaths with inspiratory hold
- pursed lip breathing
- MEPC
- IC breath with inspiratory hold
- cough 3 times
- cover mouth
