Lecture 4: PT Intervention

Question 0

What is tension pneumothorax?

Answer 0

Air trapped in the chest but every breath they take in there will be more air trapped.

Question 1

What are some contraindications to a head down position (head down position)?

Answer 1

(1) acute MI
(2) cerebral/aortic aneurysm
(3) post-op neurosurgery
(4) large increase in intracranial pressure
(5) hemoptosis
(6) tension pneumothorax
(7) BP over 180
(8) GERD

Question 2

When is trendelenburg position not indicated (but not contraindicated)?

Answer 2

(1) Congestive Heart Failure

(2) large pleural effusion

Question 3

How do you time these treatments (for postural drainage)?

Answer 3

(1) Treat when the pain medication is effective
(2) 1.5 to 2 hours after a meal
(3) discontinue feeding NG tube 30 minutes prior to treatment (<must coordinate with nursing staff)

Question 4

How long should treatment be if the PT is doing postural drainage with manual techniques?

Answer 4

5-10 minutes per segment

Question 5

How long should treatment occur if PT is just doing postural drainage?

Answer 5

20 minutes.

Question 6

When would you discontinue postural drainage?

Answer 6

(1) if it is an acute patient and they become afibrile
(2) the chest X-Ray no longer shows fluid or secretions
(3) if the patient develops hemoptosis

Question 7

What are contraindications to manual techniques (percussion, vibration, shaking)?

Answer 7

(1) severe bronchospasm- with active wheeze and SOB
(2) hemoptosis
(3) pulmonary embolism
(4) not over fractured rib
(5) low platelet count
(6) possible lung cancer

Question 8

What are precautions to manual techniques?

Answer 8

(1) osteoporosis
(2) chest wall regions around a fractured rib
(3) after radiation therapy (skin becomes fragile)
(4) frail skin
(5) anticoagulant medication
(6) platelet 25000 to 50000