Position for therapeutic effect Flashcards
When is positioning most affective
unilateral problems, bilateral- try both sides and see which side is more effective
what has to happen before consolidation is broken down
need to wait until consolidation is broken down by WBC to try and drain and remove
what is postural drainage
the drainage of secretions, by the effect of gravity, from one or more lung segments to the central segments, each position places the target lung segments superior to the carina, held for 3-15 mins, mostly used with younger patients
clinical application of true PD limited by
more active clearance techniques being promoted, precautions/unhelpful side effects (e.g. WOB), patient unable to tolerate due to co-pathologies, surgery etc.
clinical adjuncts to PD include
other clearance techniques (mannual techniques etc.), pre-PD bronchodilation/humidification
Upper lobes postural drainage- apical, posterior, anterior segments
apical segments= patient leans back on pillow- therapist taps between clavicle and top of scapula on each side
posterior segments= patients leans over folded pillow- tap upper back on both sides, anterior segments= patient lies on back with pillow under knees- therapist taps between clavicle and nipple on each side
postural drainage- right middle, left upper lobe, lower lobes
right middle lobe- bed slanted slightly- patient lies head down on left side and rotates back slightly- pillow behind shoulder to hip and knees should be flexed- therapist taps over right nipple, left upper lobe- bed slanted head downwards- patient rotates again, therapist taps over nipple areas
lower lobes- bed elevated even more (position on left and right side depending on area needed to drain)- therapist taps over ribs
postural drainage- lower lobes
lateral segments= bed elevated higher. patient lies on abdomen, head down, the rotates 1/4 turn, upper leg is flexed over pillow for support, therapist claps over uppermost ribs (position on left and right side depending on segment)
posterior basal segments= bed elevated, patient lies on abdomen with pillow under hips- tap over ribs close to spine, superior segments= flat table, patient lies on abdomen with 2 pillows under hips, therapist claps over middle of back
what does high WOB result in
breathlessness and distressed breathing pattern, increases energy use and therefore oxygen demand, position to optimise respiratory muscle function without excess energy demand, optimise diaphragm, decrease active fixation of shoulder girdle which uses muscular contraction
