P7 - Gas Exchange 1 (Manual echniques)

Question 1

What is the Active Cycle of Breathing Technique (ACBT) used for?

Answer 1

The Active Cycle of Breathing Technique (ACBT) is a breathing exercise used to:

• Clear mucus from the lungs.
• Improve lung function.
• Help manage conditions like COPD, bronchiectasis, and cystic fibrosis.

Question 2

What are the 3 key phases of ACBT?

Answer 2

The 3 key phases of ACBT are:

• Breathing Control
• Thoracic Expansion Exercises (Deep Breathing)
• Forced Expiratory Technique (Huffing)

Question 3

How do you perform Breathing Control in ACBT?

Answer 3

• Relax your shoulders and upper chest.
• Take slow, gentle, normal breaths in through your nose and out through your mouth.
• Focus on using your lower chest and diaphragm to breathe.
• This phase helps to relax the airways and prepare for the next steps.

Question 4

What is the purpose of the Breathing Control phase in ACBT?

Answer 4

Breathing Control helps to:

• Relax the airways.
• Prevent bronchospasm (airway narrowing).
• Prepare the body for deeper breathing and huffing phases.

Question 5

How do you perform the Thoracic Expansion Exercises in ACBT?

Answer 5

• Take a slow, deep breath in through your nose, expanding your chest fully.
• Hold the breath for 3 seconds.
• Breathe out slowly and gently through your mouth.
• Repeat 3–4 deep breaths, focusing on expanding the lower chest.

Question 6

What is the purpose of Thoracic Expansion Exercises in ACBT?

Answer 6

Thoracic Expansion Exercises help to:

• Loosen mucus in the lungs.
• Improve lung volume and ventilation.
• Open up the small airways, allowing better air flow.

Question 7

How do you perform the Forced Expiratory Technique (Huffing) in ACBT?

Answer 7

• Take a medium breath in.
• With your mouth open, huff the air out quickly (as if steaming up a mirror).
• Focus on squeezing the air out from the lungs.
• Perform 1-2 huffs, and follow it up with Breathing Control to recover.

Question 8

What is the purpose of the Huffing phase in ACBT?

Answer 8

Huffing helps to:

• Move mucus from smaller airways to larger airways where it can be cleared more easily.
• Reduce the strain on the lungs compared to coughing.
• Clear mucus effectively without tiring the patient.

Question 9

How many cycles of ACBT should you perform?

Answer 9

4-5 cycles of ACBT are recommended in one session, but this can vary based on the patient’s condition and needs.

Question 10

What are some important tips for performing ACBT effectively?

Answer 10

• Stay relaxed: Tension in the upper body can limit the effectiveness.
• Use good posture: Sit upright to allow for full lung expansion.
• Alternate breathing control and deeper breaths to avoid getting light-headed.
• Stop if you feel dizzy or short of breath and return to Breathing Control.

Question 11

How does positioning help with gas exchange?

Answer 11

Positioning can improve gas exchange by optimizing the ventilation-perfusion matching in the lungs.

Question 12

How does positioning help with breathing mechanics?

Answer 12

Positioning can improve breathing mechanics by:

• Reducing the load on the respiratory muscles.
• Enhancing lung volumes, particularly in positions like sitting or standing, which help expand the lungs.
• Forward-leaning positions can assist the diaphragm and increase the efficiency of breathing.

Question 13

How does positioning assist with postural drainage of secretions?

Answer 13

Positioning can use gravity to help move mucus from smaller to larger airways (postural drainage), making it easier to clear. For example:

• Side-lying helps drain secretions from one lung to the other.
• Bed-tilting can promote drainage from different lung areas, aiding in airway clearance.

Question 14

What are the benefits of sitting for respiratory patients?

Answer 14

• Increases lung volumes by allowing the diaphragm to move more freely.
• Enhances chest expansion and improves ventilation.
• Useful for patients with respiratory difficulties as it reduces the effort of breathing.

Question 15

How does the forward lean position benefit breathing?

Answer 15

• Reduces the workload of the diaphragm by optimizing its movement.
• Helps improve gas exchange and lung volumes.
• Commonly used in patients with COPD as it eases the effort of breathing by stabilizing the shoulders.

Question 16

What are the benefits of side-lying positioning?

Answer 16

• If one lung is more affected, lying on the good lung (good lung down) improves ventilation-perfusion matching.
• Can assist in postural drainage by using gravity to mobilize secretions from one lung to the other.
• May improve gas exchange in patients with unilateral lung conditions.

Question 17

Why is the prone position beneficial for patients?

Answer 17

• The prone position improves ventilation and perfusion to the anterior part of the lungs.
• Shifts the weight of the heart off the lungs, improving lung function and oxygenation.

Question 18

What is the benefit of the cardiac chair position or bed tilt?

Answer 18

• The cardiac chair position elevates the head and torso, reducing pressure on the diaphragm and improving breathing mechanics.
• Bed tilting allows gravity to assist in the postural drainage of secretions and can improve lung volumes.

Question 19

How does leaning on a side table (prop pillows) help?

Answer 19

• De-weights the upper body, reducing the effort needed for breathing.
• Helps relax upper limbs while supporting the chest.
• Improves energy efficiency by optimizing breathing mechanics, useful for patients with COPD.

Question 20

How does percussion help with airway clearance?

Answer 20

Percussion uses rhythmic tapping or clapping on the chest wall to create an energy wave, which helps to:
* Loosen secretions from the chest wall.
* Move them toward the mucociliary escalator for clearance.

Question 21

What is the purpose of expiratory vibrations?

Answer 21

Expiratory vibrations are applied during exhalation to:

• Move sputum more centrally towards the trachea.
• Assist with clearing mucus from the airways, especially during or after breathing techniques like huffing or coughing.

Question 22

How do expiratory shakes differ from vibrations, and what do they do?

Answer 22

Expiratory shakes are a stronger, more forceful version of expiratory vibrations, used to:

• Move thicker or more tenacious mucus toward the central airways for clearance.
• Often used when secretions are difficult to shift with vibrations alone.

Question 23

What are the primary aims of manual techniques in respiratory therapy?

Answer 23

The primary aims of manual techniques are:

• Improving airway clearance by loosening and mobilizing secretions.
• Enhancing gas exchange by improving ventilation-perfusion matching and allowing easier breathing.