Week 7.1 Secretion Clearance

Question 1

What is cough?

Answer 1

Normal clearance mechanism to help clear secretions away from main airways (clears secretion from large airways)

Question 2

What are the components of a cough: (Effective cough requires?)

Answer 2

• ability to increase lung volume
• ability to close the glottis (Compressive phase)
• sufficient respiratory and abdominal strength
• ability to maintain airway calibre during cough

Question 3

Why would a huff be used instead of a cough?

Answer 3

• to prevent dynamic airway collapsing
• limited by pain, exhaustion

Question 4

Huffing from high lung volumes clear secretions in which area?

Answer 4

Proximal airways (Central and larger)

Question 5

Huffing from high lung volumes clear secretions in which area?

Answer 5

Distal airways

Question 6

What is FET (Forced expiratory technique) ?

Answer 6

• a huff combined with relaxed diaphragmatic breathing
• Involvement of breathing control -> 1-2 huffs -> Breathing control (Can be modified)

Question 7

What does breathing control minimise?

Answer 7

• minimises airway compression/collapse
• minimise airflow obstruction
• minimise fatigue

Question 8

What is ACBT (Active cycle breathing technique) ?

Answer 8

• involvement of Breathing Control, Thoracic Expansion Exercise, and Huff/cough

Question 9

The addition of TEE in ACBT helps prevent and maintain?

Answer 9

• helps maintain alveolar volume
• prevents collapse of airways and alveoli

Question 10

What is Percussion?

Answer 10

• Application of mechanical force to the chest wall with a cupped hand
• helps move phlegm to larger airways - so you can cough it easier

Question 11

Is Percussion effective in little to no secretions? True or false

Answer 11

False

Question 12

What is Vibrations?

Answer 12

• application of oscillatory and compressive force (also related to mechanical energy)
• helps shear of (lessen stickiness) of mucus in the airways

Question 13

What are the Contraindications and Precautions of percussion and vibration?

Answer 13

• fractured ribs
• franks haemoptysis (Coughing blood)
• Rib Ca
• Bronchospasm (?)
• haemodynamic instability
• severe osteoporosis
• low platelet levels
• raised ICP

Question 14

Percussion should not be used in patients with high or low secretions?

Answer 14

• Should not be used in patients with low or scant secretions

Question 15

What is postural drainage?

Answer 15

• The use of gravity to assist the clearance and secretions from lung segments

Question 16

What is PEP (positive expiratory pressure)?

Answer 16

• a mechanical device that increases resistance to airflow-> positive expiratory pressure in the airways during expiration
• helps significantly with Collateral ventilation

Question 17

What is the rationale behind PEP?

Answer 17

• when there is an increase in resistance to the ordinary route,, resistance in collateral channels distal to the obstruction is relatively reduced
• greater air enters collateral channels during inspiration than escapes during expiration
• better lung volume, better alveolar ventilation, and recruitment atelectatic lungs

Question 18

What is flutter/acapella

Answer 18

• mechanical device that applies variable resistance to airflow (Oscillation is angle dependent)