manual clearance techniques Flashcards
1
Q
manual clearance indications
A
presence of secretions
Pt who can’t clear secretions with ACBT alone
eg. small child / weak / paralysis
pt with acute lobar atelectasis due to sputum plugs
may be done concurrently with postural drainage
2
Q
Percussion
A
mechanical effects to dislodge sputum from walls of airway nd move proximally during inspiration and expiration single. / double hands infant 2-3 fingers combine with deep breaths slow rate for patients with bronchospasm
3
Q
shaking
A
coarse vibratory action during expiration
loosens secretions
stop before end-expiration
and in direction of ribs
4
Q
vibrations
A
fine, light vibratory actions enhances MMA
loosens secretions
action during expiration
stop before end exp
5
Q
manual techniques
A
after inhaled bronchodilators before inhaled corticosteroids should be comfy and effective performed over layers clothing depth and force is pt dependent watch for signs of fatigue: increase RR increase SOB, change of colour
6
Q
manual techniques caution
A
thin malnourished patients elderly patients pts on steroid bronchospasm PAC - pulmonary artery catheter timing of feeds?
7
Q
CI
A
rib fracture. / lung contusion recent / excessive haemoptysis cardiac arrhythmias metastatic Ca thorax Osteoporosis. / osteomyelitis lung abscess Subcutaneous emphysema Burns/skin grafts/open wounds – thorax Coagulopathy Recent pacemaker Pulmonary embolus Suspected pulmonary TB Untreated tension pneumothorax Complaint of chest wall pain
