Pulm Interventions and Airways

Question 1

airway clearance techniques

Answer 1

coughing
huffing
percussions
vibrations

often used in combination with expectorants and mucolytics

Question 2

huff

Answer 2

Breath in slowly through nose hold 3 sec exhale open mouth – fog mirror

Small breath by long exhale  small airways to large airways

Deep breath short forceful breath  larger airways out of lungs

Question 3

cough

Answer 3

Forceful exhale to clear mucous

Four Stages of a cough: inspiration greater than tidal volume, closure of the glottis, abdominal and intercostal muscle contraction, sudden opening of the glottis expulsion of air, mucous, etc through the trachea to the mouth

Question 4

ACT percussion

Answer 4

Chest percussion aimed at loosening retained secretions can be performed manually or with a mechanical device

Used with postural drainage techniques

Identification of target lung segment is important

Question 5

ACT Percussion manual

Answer 5

Rhythmical clapping with cupped hands over the affected lung segment

Always with a protective layer over skin

Air is trapped between the cupped hand and the patient’s chest

A hollow thumping sound should be produced

NO SLAPPING SOUNDS**

Question 6

ACT vibrations and shaking

Answer 6

Manually or with a mechanical device

Used with postural drainage positions to clear secretions from affected lung segments

Palmer surface of the clinician’s hand on the patient’s chest wall

Other hand partially or fully overlapping

At the end of a deep inspiration the clinician exerts pressure on the patient’s chest wall and gently oscillates it through the end of expiration

Repeat the sequence until secretions are mobilized

Alternate with percussions

Question 7

3 main phases of Active cycle breathing

Answer 7

Breathing Control: Diaphragmatic Breathing – slow and controlled breathing with use of abdominals – in through the nose and out through the mouth  airway relaxation

Deep Breathing Exercises or Thoracic Expansion Exercises: In postural drainage position the patient performs deep inhalation with relaxed exhalation at vital capacity, can be coupled with percussion  loosen secretions

Huffing or Forced Expiratory Technique (FET)  movement of secretions

Question 8

active cycle breathing

Answer 8

Consists of a series of maneuvers performed by the patient to emphasize independence in secretion clearance and thoracic expansion Self-care Management

Question 9

precaution to active cycle breathing

Answer 9

splinting post op incision

Question 10

medium volume huff

Answer 10

This helps to move secretions that are lower down in your airways
Take a normal-sized breath in and then an active, long breath out until your lungs feel quite empty
Imagine you are trying to steam up a mirror

Question 11

high volume huff

Answer 11

This helps to move secretions in your upper airways
Take a deep breath in, open your mouth wide and huff out quickly
Only perform 1-2 huffs together, as repeatedly huffing can make your chest tight
Listen for crackles  crackles indicate a need to cough and clear secretions
Spit any secretion into a tissue or a sputum bowl
Repeat the whole cycle for about 10 minutes or until the chest feels clearer

Question 12

difference in huffs

Answer 12

Small long huffs move sputum from low down into chest whereas big short huffs moves sputum from higher up into chest use the more forceful huff when secretions are ready to be mobilized

Question 13

inspiratory hold technique

Answer 13

Patient instructed to hold breath at end of inspiration for 2-3 seconds

Used to improve the flow of air into poorly ventilated regions of the lungs

Question 14

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