Chapter 8 Flashcards
What is CPT?
A variety of techniques aimed at the
mobilization of pulmonary secretions and
promotion of greater use of the respiratory
muscles, which should result in the in an
increase in the distribution of ventilation.
What are some techniques included in CPT?
- Postural drainage
- Chest percussion
- Chest vibration
- Cough techniques
- Breathing exercises
What are the goals of CPT?
- To prevent the accumulation of pulmonary
secretions - To improve the mobilization of retained
secretions - To improve the distribution of ventilation
- To decrease airway resistance
What are some indications for CPT?
- Lung conditions that cause increased
difficulty in mobilizing secretions
Bronchiectasis
Cystic fibrosis - Acute resp. failure with retained pulmonary
secretions - Acute atelectasis
- V/Q abnormalities resulting from reatined
pulmonary secretions - Inefficient breathing patterns in patients
with COPD - Prevention of post-op resp. complications
What are some contraindications for CPT?
- Patients with ICP > 20mmHg
Percussion should be performed over each
specified area for how long?
2-5 minutes
Percussion should not be performed over which
areas?
Spine
Sternum
Scapulae
Clavicles
Surgical sites
Areas of trauma
Bare skin
Female breasts
Do not apply the vibrator to one area for more
than how long?
45-60 seconds at a time
What are some complications of CPT?
Hypoxemia
Rib fractures
Increased ICP
Hemorrhage
Decreased cardiac output
Aspiration
The patient should hold his breath for how long
when doing the huff cough?
3-5 seconds
Autogenic drainage has shown promise in which
patients?
Cystic fibrosis
What is intrapulmonary percussive ventilation?
An airway clearance technique that uses a small
pnuematic ventilator to deliver a series of small
VTs at a high frequency (110-225 cycles/min)
The length of each cycle can be controlled by
who?
How?
The therapist of the patient
By a thumb control button
How long is an IPV treatment?
15-20 mins
What can also be administered at the same time
through the pnuematic neb?
Bronchodilating or mucolytic agents
IPV is very promising in what patients?
Cystic fibrosis
What is the MetaNeb?
A system that combines mobilization techniques
and lung expansion therapy.
What can be given through the metaneb?
Aerosolized meds and 02
How long does a metneb treatment last?
10 min
What are the 2 modes of metneb?
CPEP & CHFO
What is CPEP (continuous positive expiratory
pressure)?
A mode that provides nebulized meds and
hyperinflation therapy for 2.5 minutes.
What is the CHFO (continuous high frequency
oscillation).
A mode that provide nebulized meds and
continuous pulses of positive pressure to
mobilize secretions for 2.5 minutes.
Both treatments are repeated 2.5 minutes each
to complete the full time of how long?
10 min
What are some indications for the metaneb?
COPD
CF
Asthma
Bronchiectasis
Neuromuscular disorders
Post-op airway management
Atelectasis
Chest wall trauma (when percussion
would be painful)
How long is the duration of HFCWO?
What is the frequency?
30 min
5-25 Hz (300-1500 cycles/min)
What are some therapeutic affects of PEP?
Improved distribution of inspired volume in
the lung by means of collateral air
channels (pores of Khon)
Prevention of expiratory airway collapse
Generation of pressure on exhalation in an
are distal to the site of mucous obstruction
What are some contraindications to PEP?
Acute sinusitis
Middle ear infection
Epistaxis (nose bleed)
Recent facial, oral, or skull injury or surgery
Active hemoptysis
What is the appropriate expiratory resistor?
10-20cmH20
The patient should perform how many PEP
breaths?
10-20
How many huff coughs should the patient
perform?
2-3
How many times is the procedure repeated?
4-6
If the pressure seems to be ineffective what
should you do?
Increase the PEP to 3-5 cmH2O
The patient should produce a PEP between
what?
10-25 cmH2O
How long should patient hold flutter valve
breath?
2-3 sec
The flutter valve technique should be repeated
how many times?
5-10 times
How should the flutter valve be cleaned?
every 2 days in 1:3 solution for 15 minutes dried
and reassembled.
Directed cough will not be effective in which
patients?
paralyzed, obtunded, uncooperative, COPD,
degenerative muscular disorders, neuromuscular
disorders
The patient should be taught to do what for
directed cough?
inhale slowly
MIE delivers a pressure of what?
Over what period?
30-50cmH20
1-3 second period
The pressure is then reversed to what?
For how long?
-30-50 cmH2O
2-3 seconds
MIE is contraindicated in what patients?
COPD
For quad coughing the pressure should never be
applied to what?
The ribs or sternum
For quad coughing what is the patient instructed
to do?
Take 3 deep breaths
The quad coughing procedure should be related
until what?
Secretions are cleared
