PT intervention Flashcards
Postural drainage
positioning the pt in varying positions for optimal gravity drainage of secretions and inc expansion of the involved segment
Indication for use of postural drainage
Inc pulmonary secretions
Aspiration
Atelectasis or collapse?
Percussion
force rhythmically applied with PT hand cupped to specific area of chest wall corresponding to lung segment
Percussion is used to
increase the amount of secretions cleared from the tracheobronchial tree
Usually used in conjunction with postural drainage
Indications for percussion
Excessive pulm secretions
Aspiration
Atelectasis or collapse due to mucous lugging obstructing the airways
Shaking/Vibration
Following a deep inhalation, a bouncing maneuver is applied to the rib cage throughout exhalation
Commonly used following percussion in the postural drainage position
Indications for shaking/vibration
Excessive pulm secretions
Aspiration
Atelectasis or collapse due to mucous lugging obstructing the airways
Airway clearance techniques - cough
Pt should be asked to cough in upright sitting position
coughing clears secretions from major central airways
Airway clearance techniques - Huffing
more effective in pts with collapsible airways (COPD)
Prevents high intrathoracic pressure that causes premature airway close
Ha, Ha, Ha
Airway clearance techniques - assisted cough
PT hand or fist become the force behind the pts exhaled air
Used when pt abdominal mm can’t generate en effective cough
Airway clearance techniques - Tracheal stimulation
used with patients who are unable to cough on command like infants or patients with TBI or stroke
Airway clearance techniques - Endotracheal suctioning
Used only when other airway clearance techiques fail to remove secretions
Independent secretion removal - Active cycle of breathing
An ind. program to assist in removal of more peripheral secretions that a cough may not clear
Independent secretion removal - Autogenic draining
an indp program used to sense peripheral secretions and clear them without tracheobronchial irritation from coughing
Independent secretion removal - Autogenic draining phases
Unstick phase - quiet breathing at low lung volumes
Collect phase - breathing at mid lung volumes
Evacuation phase - breathing from mid to high lung volumes
Independent secretion removal - FLUTTER or Acapella device
Pt uses an external device that vibrates the airways on exhalation to improve airway clearance
Pt breathes in normal TV, exhales through device
Independent secretion removal - Low pressure positive expiratory pressure mask
Pt uses positive expiratory resistance via face mask to help remove airway secretions
Independent secretion removal - High pressure expiratory pressure mask
Pt with an unstable airway uses a high expiratory pressure with the face mask to assist in removal of airway secretions
Breathing exercises - Diaphragmatic breathing used to
inc ventilation improve gas exchange dec work of breathing facilitate relaxation maintain or improve mobility of chest wall
Breathing exercises - Segmental breathing used to
improve ventilation to hypoventilated segments
alter regional distribution of gas
maintain or restore functional residual capacity
maintain or improve chest wall mobility
prevent pulmonary compromise
Breathing exercises - Sustained maximal inspiration used to
increase inhaled volume
sustain or improve alveolar inflation
maintain or restore functional residual capacity
Breathing exercises - pursed lip breathing used to
reduce RR inc TV Reduce dyspnea Dec mechanical disadvantages of impaired vent. pump Improve gas mixing Facilitate relaxation
Breathing exercises - abdominal strengthening used when
Used when abdominal mm are too weak to provide effective cough
Activities for increasing functional abilities
General conditioning
Inspiratory muscle trainer
Paced breathing
Energy conservation
