C/R Discussion

Question 1

What is Autogenic Drainage ?

Answer 1

Its an AW clearance technique that is characterized by breathing control where the individual aims to adjust the rate, depth, and location of lung volumes during respiration.

Question 2

Who is more likely to use autogenic drainage ?

Answer 2

CF
Bronchiectasis
Chronic excessive mucus

Question 3

What are the Positive things about Autogenic Drainage

Answer 3

• No equipment is required
• Less effort is required
• Lessen the number of coughs

Question 4

What are the possible reasons for NOT using Autogenic Drainage ?

Answer 4

• The technique can be difficult to teach
• Patient generally needs to be 8y/o

Question 5

What is the aim of suctioning ?

Answer 5

• Removal of secretions
• Maintain Patent AW
• Reduce WOB
• Improve Ventilation and oxygenation

Question 6

What are the complications that can occur during suctioning ?

Answer 6

• Pneumothorax
• Infection
• Tissue trauma
• Psychological effects
• Bronchospasm
• Nasal Fracture

Question 7

What does Manual Hyper Inflation do ?

Answer 7

Its a bag that provides normal tidal breaths / deep breaths to:
- Increase Lung volume
- Opens atelectasis Lung areas improving oxygenation
- Facilitate removal of secretions
- Improve lung compliance

Question 8

What are the possible complications of MHI ?

Answer 8

• Barotrauma
• Cardiovascular Instability (decreased venous return)
• Undrained Pneumothorax
• Emphysematous Bullae

Question 9

What is CPAP ?

Answer 9

Its a NIV that delivers a flow of gas whereby, +ve pressure is applied keeping AW Pa higher than atmospheric throughout the respiratory cycle.
It keeps alveoli splint open which helps with V/Q matching and Gas Exchange.

Question 10

What are the possible use of CPAP ?
(aids oxygenation only)

Answer 10

• To improve gas exchange between alveoli
• Type 1 Respiratory Failure
• Pneumonia

Question 11

What are some contraindications for CPAP ?

Answer 11

• Dementia
• Vomiting
• Facial Abnormalities/fractures
• suspected Pneumothorax

Question 12

What are some possible complications that can occur due to CPAP ?

Answer 12

• V/Q mismatch
• Discomfort
• Complications of high O2
• Weakened Respiratory muscles

Question 13

What are the Respiratory PEP ADJUNCT ?

Answer 13

Acapella / Flutter / Bubble PEP

Question 14

What does PEP do ?

Answer 14

It creates a back positive pressure to keep AW open because when you breath out there is a slow drop on the positive pressure.

Question 15

What does the positive Pressure from the PEP do ?

Answer 15

• Stabilise AW
• Prevent premature AW closure
• Less tiring than ACBT

Question 16

What are some precautions/contraindications for using PEP ?

Answer 16

• Haemoptysis
• CVS instability
• Bullae
• Undrained Pneumothorax
• Intracranial pressure

Question 17

What are the possible uses of PEP?

Answer 17

• To increase lung volume by increasing FRC.
• Reduce air trapping
• Improve AW clearance (CF)

Question 18

What is the NIPPY CLEARWAY ?

Answer 18

The Nippy Clearway is a pressure controlled, mechanical insufflator / exsufflator cough assist machine. It assists in the mobilisation and clearance of bronchial secretions by inflating the lungs with a positive airway pressure then providing a rapid change to negative pressure to assist the patient’s cough.

Question 19

What are some contraindications of NIPPY CLEARWAY?

Answer 19

• Risk of bullous emphysema
• Recent or existing barotrauma
• Facial Trauma
• Increased intracranial pressure

Question 20

What is NIV ?

Answer 20

Its a type of ventilator that delivers O2 and helps increase the size of each breath a patient will take.
(just like CPAP)

Question 21

What are the possible use of NIV ?

Answer 21

• Type 2 Respiratory Failure
• Pneumonia
• COPD
• Post extubation

Question 22

What are some Contraindications/Precautions when using NIV ?

Answer 22

• Undrained pneumothorax
• Frank haemoptysis
• Vomiting blood (haematemesis)
• Facial fractures
• Cardiovascular system instability
• Cardiac Arrest