Workshop: Role of a Respiratory Physiotherapist

Question 1

What is Respiratory Physiotherapy?

Answer 1

specialised therapy to help patients who are suffering with respiratory difficulties or disorders and uses the same physical means to help people with breathing difficulties.

Question 2

What does respiratory physio input achieve?

Answer 2

• Improves the efficiency of ventilation- using positioning & breathing control techniques
• Mobilises and aids secretion clearance- using various techniques including ACBT, AD, PEP , CAD, Suction
• Reduces breathlessness and work of breathing- using positioning and breathing control
• Support weaning from mechanical ventilation and can set up NIV (Non Invasive Ventilation)

Question 3

What is the most common breathing technique?

Answer 3

Active Cycle of Breathing, which has 3 phases. It begins with a relaxed breathing control phase to help relax the patient and help them gain control of their breathing pattern, Phase two introduces alternating breathing styles to a few deeper thoracic expansion exercises to increase the volume of air entering the airways which will help mobilise the secretions. They complete the cycle with phase 3 which encourages a forced expiratory breath called a huff which if effective will dislodge secretions which the patient can then cough and clear more easily.
This is a simple, adaptable technique with no equipment required

Another breathing technique is called Autogenic Drainage and is a little more complicated but uses more focused breathing control to vary the depth, rate and volume of breathing to help mobilise and clear secretions from different levels within the lungs. This also uses the huff technique to remove secretions An adapted version of this is often used in children who have Cystic Fibrosis., but It can be little more complicated for some patients to follow. but is very effective in most cases.

Question 4

What are other adjucts or devices that can be used for airway clearance?

Answer 4

• The Acapella Choice is a form of hand held, oscillating, positive expiratory pressure, which is simple for most patients to use. The patient simply breaths out through the device which creates a bit of positive back pressure into the airways to help increase the lung volume and a bit of vibration to help loosen the secretions. The patient is encouraged to huff and cough as required. Increasingly used in bronchiectasis & COPD airway clearance management plans
• Cough Assist Device available and is administered by the respiratory physiotherapist. It is placed over the mouth and nose via a face mask or mouthpiece and cycles between a positive and negative air pressure to help mobilise secretions for those with an impaired ability to cough and where invasive nasal or oral pharyngeal suction is not indicated
• If the patient is less well and has reduced conscious levels they will not be able to play such an active role in clearing their secretions-in these circumstances oral or naso- pharyngeal suction can be performed. This is a delicate skill and requires adequate training to perform effectively.

Question 5

How is breathlessness managed?

Answer 5

-‘Belly’ breathing
-Pursed Lip Breathing (PLB)
-Square breathing
-Blow As You Go (BAYG)

Question 6

How is breathlessness managed?

Answer 6

-‘Belly’ breathing
-Pursed Lip Breathing (PLB)
-Square breathing
-Blow As You Go (BAYG)