Independent Secretion Removal Techniques

Question 1

Active Cycle of Breathing:

This is more removal of more peripheral secretions that _____ may not clear

Answer 1

Coughing

Question 2

Active Cycle of Breathing:

The pt should be breathing in a _______, __________, fashion

Answer 2

Controlled

Diaphragmatic

Question 3

Active Cycle of Breathing:
Perform thoracic expansion exercises with or without _______ and _______
These are deep __________ with a HOLD AT THE TOP, if possible

Answer 3

Percussion and shaking

INHALATIONS

Question 4

Active Cycle of Breathing:

Controlled _____ _____. Then the pt decides what is needed next

Answer 4

Diaphragmatic breathing

Question 5

Active Cycle of Breathing:

If no secretions seem to be mobilized, pt can go to the next steps of ______ ______ ______ and/or _______

Answer 5

Forced expiratory huffs

Coughing

Question 6

Active Cycle of Breathing:
If pt believes that secretions can be cleared, they should resumed controlled _____ _____
Then repeat as needed

Answer 6

DB

Question 7

Active Cycle of Breathing: For forced expiratory huffs, inhale at resting _____ _____
Contract _________ muscles to produce one or two forced expiratory huffs from _____ to _____ lung volume to raise secretions

Answer 7

Tidal volume
Abdominal
Mid to low

Question 8

Active Cycle of Breathing: For coughing, huff from _____ lung volume or cough to clear

Answer 8

HIGH

Question 9

Active Cycle of Breathing:

Try to list the steps… (4)

Answer 9

1. Breathe in controlled diaphragmatic fashion
2. Thoracic expansion exercises (deep inhalation with hold at top)
3. Controlled DB and pt decides what is needed next.
   3a. No secretions: forced exp. huffs and/or coughing
   3b. Secretions: resume controlled DB
4. Repeat as needed

Question 10

Autogenic Drainage: used to sense peripheral secretions and clear them without _______ _______ from coughing

Answer 10

Tracheobronchial irritation

Question 11

Autogenic Drainage: Amount of time spent in each phase is determined by where the pt _____ ____ ______

Answer 11

Feels the secretions

Question 12

Autogenic Drainage: What are the 3 phases (list)

Answer 12

Unstick phase
Collect phase
Evacuation phase

Question 13

Autogenic Drainage:

Unstick phase: _____ breathing and ___ lung volumes to effect peripheral secretions

Answer 13

Quiet

Low

Question 14

Autogenic Drainage:

Collect phase: breathing at ___ lung volumes to effect secretions in the ______ airways

Answer 14

MID

MIDDLE

Question 15

Autogenic Drainage:
Evacuation phase: breathing from ____ to ____ lung volumes to clear secretions from _____ airways
Replaces coughing as the means to clear secretions

Answer 15

Mid to High

Central

Question 16

Autogenic Drainage:

Repeat the phases until all secretions ________

Answer 16

Removed

Question 17

Flutter/Acapella Device:
Pt uses external device that _______ the airways on __________ to improve airway clearance with intermittent ______ ______ ______

Answer 17

Vibrates
EXHALATION

Positive expiratory pressure

Question 18

Flutter/Acapella Device:

Pt breathes in normal ____ ____ through the nose or around mouthpiece of the FLUTTER device

Answer 18

TV

Question 19

Flutter/Acapella Device:

Pt then ________ through the device, setting up vibration within the airways

Answer 19

Exhales

Question 20

Flutter/Acapella Device:

What position of the device is the most vibration possible with exhalation?

Answer 20

TIPPED position

Question 21

Flutter/Acapella Device:

Normal TV… then exhaling through the device should be repeated how many times?

Answer 21

5-10x

Question 22

Flutter/Acapella Device:
After normal TV, and exhalation through the device repeated 5-10x, the pt then breathes in full ______ through nose/mouthpiece

This is followed by a __-second hold at the top of inhalation and rapid forced ______ through flutter

This should be repeated how many times?

Then after this… the pt should ____/_____ to clear secretions

Answer 22

Inhalation
3 second
Exhalation

2-3x

Huff/cough

Question 23

Low pressure positive expiratory pressure (PEP) mask:

Pt uses _____ expiratory resistance to remove secretions

Answer 23

POSITIVE

Question 24

Low pressure positive expiratory pressure (PEP) mask:

Low pressure PEP = ______ cm H20

Answer 24

10-20

Question 25

Low pressure positive expiratory pressure (PEP) mask:
Seated pt breathes at _____ with mask
After (how many?) breaths, mask is ________ for cough/huff
Repeat until all secretions removed

Answer 25

TV
10
REMOVED

Question 26

High PEP mask:

Pt with ______ airway uses ____ expiratory pressure via face mask

Answer 26

Unstable

HIGH

Question 27

High PEP mask:

High pressure PEP = _______ cm H2O, where the pt is able to exhale a larger ____ with the mask than without

Answer 27

50-120

FVC

Question 28

High PEP mask:
Seated pt breathes at ___ with mask
After __ breaths, huff from ____ to ____ lung volumes is performed WITH MASK IN PLACE

Answer 28

TV
10
High to low

Question 29

High Frequency Chest Wall Oscillation:

Pt wears a _____ that fills with air then rapidly ___/___ pressure

Answer 29

VEST

Inc/dec

Question 30

High Frequency Chest Wall Oscillation:

Pressure oscillation _____ secretions in the airways

Answer 30

Loosens

Question 31

High Frequency Chest Wall Oscillation:

Freq is set to ________ Hz and pressure is inflated until snug on pt

Answer 31

12-16

Question 32

High Frequency Chest Wall Oscillation:

Time = _________ min with breaks to cough and drink water

Answer 32

20-30

Question 33

High Frequency Chest Wall Oscillation:

Can be completed in _______ _______ positions

Answer 33

Postural drainage