Chest Physiotherapy

Chest Physiotherapy
it include definition, steps of CPT
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1. Chest physiotherapy VIPIN PATIDAR Tutor/Clinical Instructor College of Nursing, AIIMS Deoghar www.vipinpatidar.wordpress.com

2. DEFINITION It is a method of facilitating respiratory functions by removing thick, tenatcious secretions from the using technique of percussion, vibration and postural drainage. It can be performed using either cupped hands or a mechanical airway clearance device. that involves clapping on the chest and/or back to help loosen thick secretions. www.vipinpatidar.wordpress.com

3. Purposes To removing thick, tenatcious secretions from bronchial wall. www.vipinpatidar.wordpress.com

4. Indications Preoperative patients with excessive secretions by any cause such as chronic bronchitis, smoking etc Post-operative patients with excessive secretions. Bronchial or lobar pneumonia. Risk of atelectesis. patient is unable to initiate a voluntary cough or effort to expel the sputum www.vipinpatidar.wordpress.com

5. Contraindications Undrained lung abscess. Unstable head and neck Injury. Increased ICP Active Hemorrhage. pneumothorax Bronchopleural fistula. Rib Fracture Lung Tumor. Chest wall Disorder. Painful chest condition. www.vipinpatidar.wordpress.com

6. To be most effective, postural drainage should be accompanied by chest physiotherapy, which includes percussion and vibration, deep breathing and coughing. Once a patient assumes the correct postural drainage position, the caregiver performs chest percussion and vibration to the desired area. Chest physiotherapy is generally performed for 3-5 minutes on each segment. During this time, the patient is encouraged to take a slow, deep breath followed by a vigorous cough in an attempt to clear the airways of mucus. This technique should be repeated several times during the chest physiotherapy session . www.vipinpatidar.wordpress.com

7. Chest Percussion Clap with cupped hands over chest wall for 1-2 min in each lung area. Lower ribs to shoulder on the back. Lower ribs to top of chest in front. Avoid clapping over spine, liver, kidney, spleen, breast, clavicle etc. www.vipinpatidar.wordpress.com

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9. Vibration Vibration is an airway clearance technique , Vibration helps to gently shake mucus and secretions into the large airways, making them easier to cough out . During vibration, place your flat hand firmly against the chest wall, a top the appropriate lung segment to be drained. Stiffen your arm and shoulder, apply light pressure and create a shaking movement, similar to that of a vibrator. Ask patient to breathe in deeply during vibration therapy, and exhale slowly and completely . Taking a deep breath and then exhaling slowly and forcefully without straining will hopefully stimulate a productive cough. www.vipinpatidar.wordpress.com

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12. Articles Comfortable Surface (hospital Bed, Chair) pillows (01 to 04) Towel. Sputum Mug with antiseptic solution. stethoscope. screen to maintain privacy www.vipinpatidar.wordpress.com

13. Preparations Identify the patients and check physicians order regarding specific position. Assess the airway patency. check the last meal time. identify the ways/sign and symptoms that indicate need of procedure. www.vipinpatidar.wordpress.com

14. Procedure Wash hands. Instruct the patient to perform Diaphragmatic Breathing. Position the patient in prescribed postural drainage position. Cover area with Towel. PERCUSSION: Clap with cupped hands over chest wall for 1-2 min in each lung area. Lower ribs to shoulder on the back. Lower ribs to top of chest in front . VIBRATION: Remove towel and place hand, palm down on chest area to be drained with one hand over the another, finger toghter. instruct patient to inhale deeply and exhale slowly though persed lip. Tense all muscle of hand and arm and vibrate the hand with light pressure. www.vipinpatidar.wordpress.com

15. Procedure Stop vibration and relieve pressure on inspiration. vibrate for 5 exhalation over each lung area, after that encourage the patient for cough out (huff Technique). allow patient to rest for 3-5 min. ascultate for any changes in breath sound. repeate the procedure as per patient tolerance. (usually 10-15 min) wash hands. assist him/her in comfortable position. documents the findings replace the articles. www.vipinpatidar.wordpress.com

16. Special Points to Remember Provide Inhalation using bronchodilator 20 min before the procedure to prevent bronchospasm. in case of severe hemoptysis, stop the Procedure. best time to perform. in morning Before 1 hour of meal. 1-3 hour after meal. do not perform chest physiotherapy after taking food. The length of the treatment depends on the tolerance of the patient . www.vipinpatidar.wordpress.com

17. Thank you…  www.vipinpatidar.wordpress.com