Mucous Clearance Flashcards
Disease contradictions of mechanical cough assist
Bullous emphysema
Pneumothorax or pneumomediastinun
Recent barotrauma
Prone to AW closure
What is chest PT a combination
Forced exhalation
Postural drainage
Percussion/ shaking
What patients is postural drainage used on
Stable and acute
How do you determine what segments need chest PT
Physician order
BS
Palpation
Percussion
X-Ray
How long should you percussion with CF or Bronchiectasis
5 minutes
How long should you preform percussion on the average patient
1-2 minutes
What should you avoid clapping on when preforming chest PT
Spine
liver
chest
scapula
clavicle
sternum
Kidneys (lower back)
Stomach
Procedure for chest PT
Patient performs diaphragmatic breathing
Percussion
Inhale slowly and deeply and exhale through pursed lips as you vibrate
When should you relieve pressure during chest PT
Thorax as patient inhales
How many vibrations do you do during chest PT
3 to 4
Last step to chest PT
Cough
How long does chest PT last
15 to 30 minutes
What sound should be heard during percussion
Hollow
When is chest PT best done
Before or 1.5-2 hrs after eating
(Early morning or bedtime)
OPEP devices
VPEP
Aerobika
Flutter
Acapella
Quake
Coronet
Pulmonary disorders for OPEP
CF
COPD
Brpnchoiectasis
What does OPEP combine
Positive pressure
Airway vibration
During exhalation
Interface for OPEP
Mouthpiece
tracheostomy tube
Resuscitation mask
Directions for OPEP
Inhale above VT hold for 2-3 seconds
6-10/ cycle
Huff followed by controlled breathing (1-3x)
6-10 cycles
Indication for IPV
Whenever the body’s ability to mobilize secretions is impaired
Disease that indicate IPV
Bronchiectasis
CF
Neuromuscular disease
COPD
Other medical patients that cause for IPV
Tracheostomized patients
Burns
Inhalation injury
How is IPV powered
Pneumatically (50 psi)
How many cycles per minute does IPV deliver
100-300 cycles/minute
Pressure changes to AW by IPV
5-35 cm H2O
What does IPV small burst do
Loosen and free mucus from AW walls
What does mist from IPV do
Makes mucus less sticky
What does the high flow rate from IPV do for the patient
Encourages deep breathing, which helps air get around mucus plug
What does IPV do during inspiration
Creates shear to loosen secretions
What does IPV do during exhalation
Creates asymmetrical flow pattern that moves secretions toward head
Application for metaneb
Deliver bronchodilator
Expand alveoli and move secretions
Inpatient or out patient
How is metaneb applied
Non-invasively
Interface for metaneb
Mask
Mouthpiece
Directions for the metaneb
Fill Nebulizer
Set to CPEP (lowest)
50 psi O2 source
Inhale exhale (3-4 sec)
CPEP 2 1/2 minutes
CHFO 2 1/2 minutes
10 minute treatment
Potential hazards for IPV
Gastric insufflation
Hyperventilation
Hemodynamic compromise
Air leak
Air trapping
What type of pressure does the HFCWC deliver
Both positive and negative
What does HFCWC do
Mobilizes secretions in the airway
Other name for the HFCWC
The vest
How long does HFCWC last
15-30 minutes
What should you do between different frequencies of the HFCWC
Huff cough
What does low frequencies of the vest do
Loosens secretions
What does the mid-level frequencies of the HFCWC do
Mobilizes secretions to the head
What is the inflation pressure of the HFCWC
5-20 cm H2O
What volume of air does the HFCWC generate
17-57mL
What flow does the HFCWC achieve
96L/min
Available HFCWC
The vest
Incourage
Smart vest
Deposition of meter dose inhaler
10-25 %
Position for upper lobe, apical segment
Seated up
Position for upper lobes, posterior segment
Seated up hunched over pilliow
Position for upper lobes, anterior segment
Flat on back
Position for lower lobes, anterior basal segment
Trendelenburg right side
Position for lingula
Trendelenburg right side
Position for middle lobe
Trendelenburg left side
Position for lower lobes, posterior basal segment
On stomach Trendelenburg
Position for lower lobes, lateral basal segment
Left side Trendelenburg
Position for lower lobe, superior segment
Flat on stomach.
