Cardiopulm Unit 7 Pulmonary Diagnostics, O2 Delivery systems and interventions Flashcards
What are Blood Gases?
These assess an individuals respiratory and metabolic status, guiding clinical decisions and interventions
In Arterial Blood, what do PaO2 and SaO2% indicate?
Indicated the Degree of Arterial Blood Oxygenation
In Arterial Blood, what does PaCO2 assess?
Adequacy of Ventilation
In Arterial Blood, what do pH and HCO3 assess?
Acid-Base Balance
What is the Normative Range of pH?
7.35 - 7.45
What is the Normative Range of PaCO2?
35 - 45 (40) mmHg
What is the Normative Range of HCO3?
22 - 26 (24) mEq/L
HCO3 is bicarbonate, its a buffer against acididty. It will raise pH if its too low
What is the Normative Range of PaO2?
80 - 100 mmHg
What is the Normative Range of %SaO2?
96 - 100%
With ABGs, what typically happens when CO2 levels go up?
(Arterial Blood gases)
Blood becomes more acidic and pH goes down
With ABGs, what typically happens when HCO3 levels go up?
(Arterial Blood gases)
pH goes up, the blood becomes more alkaline (basic), because there is more buffer introduced in the blood
What are the Primary Regulators of Acid-Base balance?
The kidneys and lungs
- The kideys are considered slow and the lungs fast
With the Primary Regulators of Acid-Base balance, what is Renal Regulation?
The kidneys adjust the reabsorption of bicarbonate and the excretion of H+ ions. These adjustments are more precise but slower, taking hours to days to effect significant changes in blood pH.
With the Primary Regulators of Acid-Base balance, what is Respiratory Regulation?
The lungs can increase or decrease the rate and depth of breathing to expel more CO2 (to decrease acidity) or retain CO2 (to increase acidity), respectively. This adjustment can happen quickly, within minutes to hours
What is Respiratory Acidosis?
A condition of blood acidity due to a primary respiratory phenomenon
- Causes the blood pH to go down
What are the S/S of Respiratory Acidosis?
- Headache
- Hyperkalemia
- Dysrythmias (increased K+)
- Drowsiness, dizziness, disorientation
- Muscle weakness, hyperreflexia
What is done for treatment for those with Respiratory Acidosis?
- Improve ventilation
- Intermittent positive pressure breathing
- Postural drainage
- Incentive spirometry
- Mechanical venilation
- HCO3 (bicarbonate) in emergencies
With ABGs, what values are used to confirm the diagnosis of Respiratory Acidosis?
- PH below 7.35 - 7.45
- PaCO2 higher than 45 mmHG (primary problem)
- HCO3 normal in acute stages or elevated in chronic stages/compensated stages
What may cause Respiraory Acidosis?
- Respiratory Depression (Anesthesia, Overdose, increased ICP)
- Airway obstruction, decreased capillary diffusion (Pneumonia, COPD, ARDS, PE)
What is Repsiratory Alkalosis?
This is a condition where the pH is high, due to some condition in the respiratory system
What is Repsiratory Alkalosis caused by?
- Hyperventilation (anxiety, fear, PE)
This will acutely lower CO2 in the blood
What are the S/S of Respiratory Alkalosis?
- Hypokalemia
- Numbness and tingling of extremities
- Hyper reflexes and muscle cramping
- Seizures
With ABGs, what values are used to confirm the diagnosis of Respiratory Alkalosis?
- pH is ABOVE normal range 7.35-7.45
- PaCO2 less than 35mmHG (Primary problem)
- HCO3 is normal in acute stages or decreased in chronic/compensated stages
How is Respiratory Alkalosis treated?
- Sedation
- Voluntary Breathing-Holding
- Change Mechanical Ventilation
What may cause Metabolic Acidosis?
- Diabetes Ketoacidosis
- Severe diarrhea
- Renal failure
- Shock
What are the S/S of Metabolic Acidosis?
- Headache
- Hyperkalemia
- Nausea, vomiting, diarrhea
- Changes in LOC (confusion, increased drowsiness)
- Kussmaul respirations (compensatory hyperventilations)
With ABGs, what values are used to confirm the diagnosis of Metabolic Acidosis?
- pH BELOW normal ranges of 7.34-7.45
- PaCO2 is normal in acute stages or decreased in chronic/compensated stages (Respiratory alkalosis)
- HCO3 level less than 22 mEg/L (Primary problem)
How is Metabolic Acidosis treated?
- Treat the cause of the Acid accumulation or HCO3 loss
- Give bicarbonate
- Give insuline
- Dialysis
What causes Metabolic Alkalosis?
- Severe vomiting
- Excessive GI suctioning
- Diuretics
- Excessive NaHCO3
What are the S/S of Metabolic Alkalosis?
- Dysrhythmias (Tachycardia)
- Compensatory Hypoventilation
- Confusion (decreased LOC, dizzy, irriatble)
- Tremors, Muscle cramps, tingling of fingers and toes
- Hypokalemia
With ABGs, what values are used to confirm the diagnosis of Metabolic Alkalosis?
- pH ABOVE normal ranges of 7.34-7.45
- PaCO2 is normal in acute stages or increased in chronic/compensated stages (Respiratory acidosis)
- HCO3 level above than 26 mEg/L (Primary problem)
How is Metabolic Alkalosis treated?
- Replace fluid loss
- Give K+ or Cl- as needed
- Stop suctioning
- GIve acid substance (HCL, NH4Cl)
What is the Step by Step Guide for ABGs?
- If pH is abnormal (ie., outside of 7.35-7.45), then verify which CO2 or HCO3 is consistent with the pH acidity or alkalinity (THIS IS THE PRIMARY PROBLEM)
- Then assess the other system (respiratory or metabolic) to verify if it is actively compensating for the primary problem or not
-If the other system is in its WNL range, then there is no apparent compensation happening
-If the other system is outside its WNL range and at a level that appears to compensate for the problem, then the we can say that the system is partially compensated. - If pH is WNL but either CO2 and/or HCO3 are abnormal, then that suggests that the system is compensated. At this point, assess which side of 7.4 is it on.
–Under 7.4 is on the acidic side
–Over 7.4 is on the basic side
Match the CO2 or HCO3 whichever side pH is on and that will tell you, as above, what the primary problem is.
Why is Supplemental Oxygen beneficial to those patients with cardiac and/or pulmomary disease or dysfunction?
Aim is to improve quality of life and functional activity for those who experience oxygen desaturation during activity or exercise
What is Hypoxemia?
When the partial pressure of oxygen in arterial blood (PaO2) falls below ~55-60 mmHG
- A subsequent increase in minute ventilation occurs as well as a decrease in partial pressure of Carbon Dioxide (PaCO2). This results in a compensatory rise in HR/CO to increase O2 delivery to tissues
What are the S/S of Hypoxemia?
- Impaired judgement
- Progressive loss of cognitive and motor functions as the hypoxemia progresses
- Decreased exercise tolerance
- Loss of consciousness develops with severe hypoxemia
- Other S/S include headache, breathlessness, or severe dyspnea, palpitations, angina, restlessness and tremors
When does Regional Pulmonary Vasoconstriction occur?
When there is alveolar hypoxia resulting in redistribution of blood in the lungs
What will Long-Term Hypoxemia lead to?
Pulmonary Hypertension, Increasing the work on the Right Side of the heart, leading to Right Heart dysfunction and subsequently failure (cor pulmonale)
What are some Short-Term Effects of Supplemental Oxygenation?
- Improve breathlessness, in individuals with decreased PaO2 and SpO2 at rest or exercise
- Improve Exercise Tolerance, in those with mild, moderate or even severe hypoxemia during exercise
- Decrease Minute Ventilation, in individuals who were breathless and hypoxemic both during rest and activity
- Improve ventilatory muscle function, in individuals who are hypoxemic
- Alleviate hypoxic pulmonary vasoconstriction, in individuals who are hypoxemic
If none of these happen, the patient did not have an O2 problem
When is Supplemental O2 therapy indicated?
- PaO2 < 55 mmHG or SaO2/SpO2 < 88% on room air
or
- PaO2 56-59 or SaO2/SpO2 89-90% with one or more:
-Pulmonary Hypertension
-Cor Pulmonary or Edema due to heart failure
-Hematocrit >56%
Supplemental O2 Therapy Algorithm
If you are monitoring a patients SpO2 and you notice that its ≥ 90%, what should you, the PT do?
Monitor and continue plan of care
Supplemental O2 Therapy Algorithm
If you are monitoring a patients SpO2 and you notice that its NOT ≥ 90%, what should you, the PT do?
Decrease/Stop activity, Position change, deep breathing, pursed-lips breathing, coughing
Supplemental O2 Therapy Algorithm
When monitoring your patients SpO2, you notice that its NOT ≥ 90%, so you Decrease/Stop activity, Position change, deep breathing, pursed-lips breathing, coughing. After, you re-assess and you notice that their SpO2 is ≥ 90%. What should you do?
Monitor and continue plan of care
When monitoring your patients SpO2, you notice that its NOT ≥ 90%, so you Decrease/Stop activity, Position change, deep breathing, pursed-lips breathing, coughing. After, you re-assess and you notice that their SpO2 is still not ≥ 90%. However you notice that the patient is on O2 and the MD ordered to Titrate O2. What should you do?
- Adjust the flow as needed
- Change O2 delivery method
When monitoring your patients SpO2, you notice that its NOT ≥ 90%, so you Decrease/Stop activity, Position change, deep breathing, pursed-lips breathing, coughing. After, you re-assess and you notice that their SpO2 is still not ≥ 90%. The patient is NOT on O2 and you do not have an MD order to titrate after consulting the MD and they did not revise the order. What should you do?
If the Consult MD for revised order was denied, decrease activity level
- If the SpO2 IS ≥ 90%, monitor and continue plan of care
- If the SpO2 IS NOT ≥ 90%, stop activity and discuss with MD
- What are Recommendations for PTs providing interventions for patients in Acute Care who are using Supplemental Oxygen?
- What happens if a patient is experiencing signs or symptoms of hypoxemia and cannot maintain adequate oxygen saturation at the amount of supplemental oxygen prescribed at rest?
- In the event that the O2 prescription is not written as “Keep SpO2> —-%” the clinician should contact the referring practitioner to attempt to obtain a standing order
- Baseline vital signs including oxygen saturation must be measured before any activity
- Assess for patient stability and determine any changes that may be occurring in clinical status since the previous therapy session
- Monitor closely with activity during mobilization and interventions
- At the end of any physical therapy intervention, the supplemental oxygen must be returned to the delivery device and flow rate used prior to the intervention as oxygen is specifically prescribed at rest based upon resting arterial blood gases
In the event a patient is experiencing signs or symptoms of hypoxemia and cannot maintain adequate oxygen saturation at the amount of supplemental oxygen prescribed at rest, the prescribing health care provider should be contacted immediately
What are the considerations of Pulse oxymetry Monitoring?
- Motion and weight bearing can interfere with signal transmitted to sensor
- Placing probe on 3rd or 4th finger has been shown to be more accurate than index (Finger is more accurate than earlobe; however forehead probe may be the most accurate)
- Dirt, nailpolish, blood can interfere with sensor light path
- If the emitter and detector sensors are not in proper alignment, fasley low readings of oxygen saturation can occur
- weak signal strength can occur in patients with poor perfusion and with dysrhythmias (like a fib) therefore inaccurate reading may occur
What is FiO2? What is the equation for this?
This is Fraction of Inspired air, this represents the percentage of oxygen in atmospheric air
- FiO2 = (Flow Rate x 0.04) + 0.20
What is the General Information do we need to know about Nasal Cannula (NC)?
- Delivers flows from 0.25 to 6 L/min
- Generally recommended low flow NCs NOT used for flows > 6 L/min due to patient discomfort
With the Nasal Cannula, based on the O2 Tank Flow, what is the Approximate FiO2?
O2 Tank Flow - Approx FiO2
1 L/min - 0.24
2 L/min - 0.28
3 L/min - 0.32
4 L/min - 0.36
5 L/min - 0.40
6 L/min - 0.44
FiO2 goes up by 0.04; Maxes at 0.44
What is the General Information do we need to know about High Flow Nasal Cannula?
- Best for patients needing > 6 L/min
- More comfortable, can eat/drink/talk easier than with mask
With the High Flow Nasal Cannula, what is the Approximate FiO2?
Highest % O2 is up to 0.75 FiO2 at 15 L/min
What is the General Information do we need to know about Simple Face Mask?
Covers mouth and nose, useful for patients unable to breath through nose
With the Simple Face Mask, what is the Approximate FiO2?
O2 Tank Flow - Approx FiO2
6 - 10 L/min - 0.35-0.50 (can vary)
What is the General Information do we need to know about Venturi System?
- O2 system providing more specific O2 concentration than other devices
- Easy system for mobilizing patients
- Can provide O2 via face mask or tracheostomy tube
With the Venturi System, what is the Approximate FiO2?
O2 Tank Flow
- Turn dial and provide O2 as stated on dial for need FiO2
Approx FiO2
- 0.24 - 0.50
What is the General Information do we need to know about Non-rebreather Mask?
- Mask with O2 reservoir (bag) providing higher FiO2
- Advantage: Requires a lower flow of FiO2 from the tank for the FiO2 needed
With the Non-Rebreather Mask, what is the Approximate FiO2?
O2 Tak Flow - Approx FiO2
6 L/min - 0.60
7 L/min - 0.70
8-10 L/min - 0.80+
What is the General Information do we need to know about Ambo Bag?
- Can be used to manually ventilate patients during ambulation when a portable ventilator is not available, give supplemental O2 for suctioning etc.
- For mobility, atracheostomy swivel connector with expandable tubing should be used to prevent extubation
With the Ambo Bag, what is the Approximate FiO2?
Up to 1.00 FiO2
What is the Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport?
The premis: The Position of Optial Physiologic function is Upright and moving
1. Mobilizaton and Exercise
2. Body Positioning
3. Breathing control maneuvers
4. Coughing maneuvers
5. Relaxation and energy Interventions
6. ROM exercises (Cardiopulmonary indications)
7. Postural drainage positioning
8. Manual Techniques
9. Suctioning
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Mobilization and Exercise?
To elicit an exercise stimulus that addresses one of the three effects on the various steps in the oxygen transport pathway or some combination
Mobilizations and exercise, reduces stress on the pulmonary system during mobility and exercise
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the considerations for Mobilization and Exercise?
- Dyspnea on exertion – Use Dyspnea Scale with target of 4-6/10 rating during activity
- Use pulse oximetry and monitor for signs of hypoxemia / respiratory distress
- Consider physician orders for titrating supplemental oxygen to maintain SpO2 above > X%
- Consider bronchodilator therapies before exercise training
- Resistance training emphasis on function and musculature that support anti-gravity function and ADLs
- Balance training due to common observation of falls in some populations with chronic pulmonary diseases (COPD, for example)
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Body Position?
To elicit a gravitational stimulus that stimulates being upright and moving as much as possible: Active, active-assist, passive
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the benefits of Body Position?
- V/Q Matching
- When standing, gravity pulls the mediastinal and abdominal structures down, creating more space in the thoracic cavity, which allows further expansion of the lungs and greater lung volumes. This, along with the decrease in compression on the lung bases, allows for greater alveolar recruitment.
- Sitting often leads to the somewhat reduced lung volumes compared with standing due to abdominal organs being higher, interfering with diaphragmatic motion. Second, the abdominal muscles are in a less optimal point in the length-tension curve, since the combination of hip flexion and higher position of the abdominal contents exert upward pressure. Third, the back of the chair may limit thoracic expansion.
- Supine position negatively affects diaphragmatic strength and an increase in blood volume within the thoracic cavity can lead to congestion of the pulmonary vasculature, which reduces lung compliance. This makes the lungs stiffer and harder to expand during inspiration
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Breathing Control Maneuvers?
To augment alveolar ventilation, to facilitate mucociliary transport, and to stimulate coughing
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what are examples of Breathing Control Maneuvers/Ventilatory Strategies?
- Pursed-Lip Breathing
- Paced Breathing (Controlled exhalation during effortful movement)
- Diaphragmatic Breathing
- Lateral Costal Breathing
- Inspiratory Hold Technique
With Breathing Control Maneuvers/Ventilatory Strategies, what are the indications of using Pursed-Lip Breathing?
Dyspnea at rest and/or with exertion, wheezing
With Breathing Control Maneuvers/Ventilatory Strategies, what are the indications of using Paced Breathing?
Low Endurance, Dyspnea on exertion, tachypnea, fatigue, anxiety
With Breathing Control Maneuvers/Ventilatory Strategies, what are the indications of using Diaphragmatic Breathing?
Dyspnea, impaired lower lung expansion, hypoxemia, tachypnea, atelectasis, anxiety, excess pulmonary secretions.
- Note: individuals with severe hyperinflation and flattened diaphragms will most likely not benefit from this technique because the muscle length tension relationship is abnormal and will not result in an appropriate movement of the diaphragm
With Breathing Control Maneuvers/Ventilatory Strategies, what are the indications of using Lateral Costal Breathing?
Asymmetric Lateral chest wall expansion, localized lung consolidation or secretions
With Breathing Control Maneuvers/Ventilatory Strategies, what are the indications of using Inspiratory Hold Technique?
Hypoventilation, Atelectasis, Ineffective cough
What positions are best for those patients practicing Diaphragmatic Breathing?
- Initially we can start the patient in supine, although this requires the patient to breath against increased visceral organ resistance. Consider the sidelying position as better alternative for some
- When the pt has mastered the breathing pattern in supine or sidelying progress to sitting, then standing then walking and finally stairs
What are the benefits of Inspiratory Hold Technique? What is the patient instructed when doing this techinque?
- This may improve the flow of air into poorly ventilated regions of the lungs
- The patient is instructed to hold thier breath (without using valsalva maneuver) at the height of inspiration for 2 or 3 seconds followed by a relaxed exhalation
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Coughing Maneuvers?
To facilitate mucociliary clearance with the least effort on dynamic airway compression and the fewest adverse cardiovascular effects
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Relaxation and Energy-Conversation intervention?
To minimize the work of breathing and of the heart and to minimize undue oxygen demand
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of ROM exercise?
To stimulate alveolar ventilation and altre its distrubution
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Postural Drainage position?
To facilitate airway clearance using gravitational effects
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Manual Techniques?
To facilitate airway clearance in conjunction with specific body positioning
With Dean’s Hierachy for Treatment of Patients with Impaired Oxygen Transport, what is the goal of Suctioning?
To facilitate the removal of airway secretions collected centrally
What are different Airway Clearance Techniques?
- Cough Facilitation
- Active Cycle Breathing
- Postural Drainage with/without Percussion and Vibration
What are the Indications of using Airway Clearance Techniques?
Impaired mucociliary transport, excessive pulmonary secretions, ineffective or absent cough
What is the desired outcome for Airway clearance technique?
Optimize airway patency, increase ventilation and perfusion matching (V/Q), promote alveolar expansion and ventilation and increased gas exchange
What are the considerations of Airway Clearance Techniques?
- Pain Management
- Inhaled Bronchodilaters ~30 minutes prior
- Meal Timing: Before or at least 30 min after end of meal or tube feeding
What is the Simplest form of airway clearance? Which patients should use these techniqes?
- Simplest form is deep breathing and applying techniques to improve coughing function
- These techniques should be used with ALL patients in inpatient care (e.g., acute care, skilled nursing facilites) to improve airway clearance or prevent pulmonary dysfunction.
-However, IF an individual has retained secretions or has an ineffective cough, THEN alternatative airway clearance techniques should be used to mobilize the secretions and expel them from the airways to prevent futher pulmonary dysfunction
Mobility (e.g. ambulation) is an additional airway clearance technique that should be used early
When is a Cough Evaluation Indicated?
Indicated with any suspicion of real or potential retained secretions
- Productive vs. Non-productive
- If Productive:
-Timing (e.g., Paroxysmal vs Persistent)
-Appearance (e.g., color, presence of blood, frothy)
What are the Stages of an Effective Cough?
- Adequate Inspiration (greater than tidal volume)
- Glottic Closure
-Otherwise, its called a huff - Building up of intrathoracic pressure and intraabdominal pressure
-Facilitated by abdominal and intercostal muscle contraction - Glottic opening and expulsion
With Cough Interventions, what takes place in the Extension Position?
- Consider cueing for upward gaze, scapular retraction, UE elevation as needed
- “Take a deep breath in…in…in…in…in… and now hold it”
With Cough Interventions, what takes place in the Flexion Position?
- Consider cueing for downward gaze, scapular protraction, UE depression and squeezing chest as needed
What is Active Cycle Breathing?
ACVT is an airway clearance technique that emphasizes the patient’s control over a sequential combination of breathing strategies to accomplish the goals of mobilizing and evacuating bronchial secretions
What is the Suggested Sequence for Active Cycle Breathing (ACBT)?
Breathing Control (BC):
- Relaxed, diaphragmatic breathing, normal tidal volume, 15-30 seconds
Thoracic Expansion Exercises (TEE):
- Deep, slow breathing in the vital capacity range
This cycle alternates until the patient feels prepared to expectorate the accumulated secretions, then:
Forced Expiratory Techniques (FET):
- 1 or 2 Huffs
- Huffs may be better for airways prine to collapsing
When is Active Cycle Breathing performed?
This is performed at rest and can be combined with breathing strategies (e.g., inspiratory hold) and/or performed in a postural drainage position with or without an application of percussion/vibration
With Postural Drainage, how should the bronchi be positioned?
- Segmental bronchi positioned perpendicular to the floor
- If used exclusively, each affected segment position should be maintained 5-10 minutes
-Prioritize most affected segment
Note some general trends:
- The more caudal the lung segment to be drained, the lower the head of bed is to be positioned
- The lung segment to be drained is often positioned superiorly so it can drain toward to proximal airways at the midline
What are the Precautions for Postural Drainage?
- Pulmonary Edema
- Hemoptysis
- Massive Obesity
- Large Pleural Effusion
- Massive Atelectasis
What are the Contraindications for Postural Drainage?
- Increased ICP
- Unstable hemodynamics
- Recent esophageal anastomosis
- Recent spinal fusion or injury
- Recent head trauma
- Diaphragmatic hernia
- Recent eye surgery
How do you do Percussion and Vibration?
- Lumbrical hand positioning with firm hands and loose wrists
- 2-5 minutes per segment followed by vibration (exhalation only) and coughing/huffing
When doing Percussion and Vibration, what are signs of Intolerance and Decompensation?
- Marked increase in RR or BP
- Decrease in SpO2
- Dyspnea or increased work of breathing
- Mental status change
- Cyanosis
When doing Percussion and Vibrations, what should we consider?
- Meal Timing: before or way after eating
- Nebulizer treatment may assist
- Can coordinate with nursing /RT in the event that is needed for suctioning is anticipated
RT = Respiratory therapist
What are the Precautions for Percussion and Vibration?
- Uncontrolled bronchospasm
- Osteoporosis
- Rib fx
- Metastatic CA to ribs
- Tumor obstruction to airway
- Anxiety
- Coagulopathy
- Convulsive or seizure disorder
- Recent PM placement
- Chest tube
What are the Contraindications for Percussion and Vibration?
- Hemoptysis
- Untreated Tension Pneumothorax
- Platelet count < 50,000
- Unstable hemodynamic status
- Open wounds, burns in the thoracic area
- PE
- Subcutaneous Emphysema
- Recent Skin grafts or flaps on thorax
What is Inspiratory Muscle Training? What S/S may indicate this?
This is intended to improve on impaired strength and/or endurance of the respiratory muscles
S/S of those impairments include:
- Decreased (chest expansion, breath sounds, tidal volumes)
- Dyspnea
- Uncoordinated breathing
The Concepts of IMT are the same as muscles, we incorporate the concepts of overload, specificity and reversibility
WIth IMTs, a major discrepancy may exist in the diagnosis for which this treatment is applied
What is Pulmonary Rehabilitation?
A comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long- term adherence of health enhancing behaviors
A comprehensive Pulmonary Rehabilitation program should incorpate what?
- Patient assessment and goal-setting
- Exercise and functional training
- Self-mangement education
- Nutritional Intervention
- Psychosocial management
A PT may participate in any or all of these pulmonary rehabilitation program components, but makes the greatest contributions in the areas of evaluation, outcome measurement, exercise and functional training, airway clearance and education
