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2. AirwayClearence
also called
Bronchial
hygine
therapy
it
is
a non
invasive technique
clear
secretion
->
improve
gas
exchange
epethial
lining
in
away
is
pseudostrated
ciliated
If
more
than 30m
mucus
sputum
increas
->
airway
not
clear
Factors
to
efficacy
of
mucociliary
function:
smokers
->
damage
eptilium
Surgery
->
painful
to
Cough
(have to
go
for
airway
obstruction)
aging
->
bedriden
->damge
lower
zone)
Respiratory
disease
St
Obstructive -
use technique
Restrictive
asthma
TB
CopD
pneumonia
Neuroresp
dysfunction
-> Muscular
dystrophy, stroke, spinal
cord
injuries
6.1. lots
of
secretions
->
based on oscillation
C.
patient
Cough
is
weak
3. artificial
tubes
Airway
Cleance
techniques:
v
v v
Conventional /
tradition(chest
indpendutly breathing
Mechanical devices- advance
physio)
postural
draing
/ bronchial
drainge
- active
cycle
breaking
1. devices
dependent
tech
- Modied bronchial
drainge
autogent
drainge
Peptherapy
osciting
pep
3. Manual
by
as
clapping
bevibration 3.
force
expiratory
mult
Machin
dependent
(costly)
passive
tech
patient
helps
if
unconciuss, by Chronic Cases: se
injury
eldery,undevelope, infants
I
POStural
and
Molded
post
tornalbed
↑B
·
position so that
growing
assist
diff
position
to
treat
diff
lobes
and
segments
to drain
from
periphual to center.
·
stay
in
posture
for 20mins
1. RUL Capical) and
LuL
Japical)
sitting
/ offline
position
2.RUL Canterior) and Lul
anteriou
supine
post(dangerous
sepratfor
sides)
(RUL)
(prone
((UL) have
to raise head up,
turning
is
face sid
damaged lung
should be
up
pillow
under
pelvis
Bed 30cm
up ->
insid
Segment
sit 120
4. RML
(Medial
and
lateral)
superior
and
interior
lingula
patientSideline (Quarter turn)
patient
turns
on
pillow (pillow
from shoulder
a pelvis)
bed hit
35 cm
Segment
hit 14
Superior
apic
basal
segment-prone
all
lower
lobes
fillow
under
buttock
or
pehis-
all fit
except
apico/superior apic
basal
Seg
CRcm
Segment
tilt16)
- Cateral basal
segment
Sideline
damage
lung
up
pillow
under
Delvis
Right
side
medial
basal
keep
it
on
same side
(only
one
lateral
opposit
side
gets
drained too
when secretions Come
out patient
1.cough
hyperinflate
Suctioning
(done
if
patient
can't
eoughs
Coughing
and
hulling
tech: combination for all
3-
min
Coughing
is an expiratory
effort with a closed
glottis
huffing
is
expiratory
effort with a open glottis
->
for coop
patient
teach
hulling ->
chronic condition
4
stages
of
coughing:
- deep inspiration (hold)
causes
- Closure of
glottis
- forceful contraction
of abdominal ms.
->
into abdominal
and thoracic press
8
opening
of
glottis
and
forceful exhaltion
(sputum
Comes out)
independly
breathing
performed:
1. active
cycle breathing
technique
3 SlepS:
Breathing
Control
patient
lay
dowen and breath 5-10 secs) ->
to
preventbronchospasm
Thoracic
expansion ex->
Chest
physio
(clapping,
vib,
postural)
->
to
lung
volume
surgery
patient hand up inhale,
dowen exhale
3. Forced
expiratory
tech-hults to more secretions from
peripural
to upper
airway.
Autoging drainage:
FET:
we don't practice
itis hard to make
patients understand.
used in 1 and 2
Moblize secretions
excessive inhale -> athal all
air outin isec
deep
keep
glotti's
open
Low volume, don'tfill
low volume to mid volume a volume -> cough
lungs
-> peripheral
secretions
mobilized secretions
orsee
moblize
2:
Mudfied
autogenic
drainag
breath
several breaths with diff volume,
lough
deep
Mechanical
/
advanced
airway
cleannce:
it has 5 sets
of 10
breathes or S
1.pEp
therapy
what
does
it
stand for?
postive
expiratory
pressure
· We put
water in
tube
and
blow this creates a
backward
pressure
feel resistance
as
air
goes
behind
and
pushes
mucus
forward
Oscillating
pep
therapy
has both vibration and backward
pressure depends
on
patient
expiratory
flow.
flutter
-> whenfor
->
when expiratory
i.
Glowiso
e
Machine dependent
technique:
treairway
(airgetin
lung
end
too weak
used for patients
with
creats-ve pressure to
tube and
lung
throat
get
secretions out
very
expensive
