The postural Drainage ppt for physiotherapist

Postural drainage uses gravity to help clear mucus and other secretions from the lungs, often in combination with techniques like percussion, vibration, and coughing. The body is placed in specific positions, which may include sitting, lying on the back, or on the side, to allow gravity to drain mucus from affected lung segments. This process helps to prevent infection and breathing difficulties associated with conditions like cystic fibrosis or bronchiectasis.

2. POSTURAL
DRAINAGE

3. PD or bronchial drainage is a means of
mobilizing secretions in one or more lung
segments to the central airways by
placing the patients in various positions
so that the gravity assist in the drainage
process
It include the manual techniques such as
percussion, shaking, vibration and
voluntary coughing

4. When secretions are moved to the
larger airways, they are then cleared
by coughing or Endotracheal
suctioning.

5. Positions are based on the anatomy of the
lungs and the tracheobronchial tree.
The patient may be positioned on a
Postural drainage table that can be elevated at
one endeg;Tilt table
A small child can be positioned on the
physio’s lap.

8. To Prevent accumulation of secretions in
patients who are at risk for pulmonary
complications
This may include:
Patients with pulmonary diseases that
are associated with increased production
or viscosity of mucus, such as chronic
bronchitis and cystic fibrosis.
Patients who are on prolonged bed
rest.

9. 
Postsurgicalpatientswhohave
receivedgeneral anesthesia and who may have
painful incisions that restrict deep
breathing and coughing postoperatively.
Any patient who is on a ventilator if they
are stable enough to tolerate the
treatment.

10. Patients with acute or chronic lung disease, such
as pneumonia, Atelectasis, acute lung
infections, and COPD.
Patients who are generally very weak or are
elderly.

11. Cystic fibrosis
Bronchiactesis
Atelectasis
Lung abscess
Pneumonias
Acute lung disease
COPD –emphysema, chronic bronchitis
For patients with a high spinal cord lesion/
spinal cord injury, myopathies etc.
After surgeries (thoracic or abdominal surgery)

12. On prolonged bed rest
Patient received general anesthesia and
have painful incision that restrict deep
breathing and coughing postoperatively
Who is on ventilator (if stable enough to
tolerate PD)
Patient who is generally weak or old

13. Increased ICP
Unstable head or neck
injury
Active hemorrhage
Hemoptysis
Recent spinal injury
Empyema
Bronchoplueral fistula
Flail chest
Uncontrolled hypertension
Rib or vertebral fractures
Tuberculosis

14. Pulmonary embolism.
aged, confused, or anxious patients who don't
tolerate position changes

15. Loosen the dress
Sputum cup
Pillows
Explain the Rx and teach the patient
deep breathing and cough

16. Determine segments
Vital signs
Position the patient
Stand in front of pt
Maintain position
Apply manual
techniques
Do coughing or
suctioning

18. This is used to mobilize secretions by
mechanically dislodging viscous or adherent
mucus from the lungs
It is done by the cupped hand over the lung
segments being drained
Here the PTs cupped hand alternatively strikes
the patients chest wall in a rhythmic fashion to
help loosen thick secretions
The PT should try to keep his shoulder elbow
and wrist loose and mobile during the
maneuver
The procedure should not be painful

20. Contraindication to percussion
Over #
Osteoporotic bone
Spinal fusion
Over tumor area
Pulmonary embolus
Condition in which hemorrhage could easily
occur (low platelet count ,anticoagulation
therapy)
Patient with unstable angina
Case of chest wall pain (after any surgery
CABG or trauma

21. This is done in conjunction with percussion
It is applied only during expiration
It is applied by placing both hands directly over the
chest wall or one hand on top of other and gently
compressing

The therapist stiffen his arm and shoulder and
apply light pressure and rapidly vibrating the chest
wall as the patient breaths out
Vibration

22. The vibrating action is achieved by the PT
isometrically contracting the muscles of the
upper extremity from shoulder to hand
Ask the patient to breathe in deeply and
exhale slowly and completely.
Taking a deep breath and then exhaling
slowly and forcefully without straining will
hopefully stimulate a productive cough

24. It is a more vigorous form of vibration which is
applied during exhalation using an intermittent
bouncing maneuver coupled with wide
movements of the PTs hand
The PTs thumb are locked together the open
hands are placed directly over the patients
chest the fingers are wrapped around the
chest wall
The PT simultaneously compress and shake
the chest wall

26. •To drain mucus from the upper lobe apical
segments, the patient sits in a comfortable
position on a bed or flat surface and leans on
a back rest.
•The PT percusses and vibrates over the
muscular area between the collar bone and
very top of the shoulder blades on both
sides for 3 to 5 minutes.
•Encourage the patient to take a deep breath
and cough during percussion in order to
help the airways clearance

28. The patient lie on his left side and then
turn 45º on to his face , resting against a
pillow with an another pillow supporting
his head
The left arm should kept comfortably
behind his back with right arm resting on
a pillow, the right knee should be flexed

30. The patient lie on his right side and then
turn 45º on to his face with 3 pillows to
raise the shoulder 30cm (12 in) from the
bed.
The right arm should kept comfortably
behind his back with left arm resting on a
pillow, both knee should be slightly flexed

32. 
The patient lies flat on the bed or table
with a pillow under his head and legs and
arms relaxed by his side.

The chest PT is given to right and left
sides of the front of the chest, between
the collar bone and nipple.

34. Patient lie on his back with his body
quarter turned to the left maintain by a
pillow under right side from shoulder to
hip
Arm should relaxed by his side
Foot of the bed should be raised 35cm
(14in) from the ground
Chest is tilted to an angle of 15º

36. Patient lie on his back with his body
quarter turned to the right maintain by a
pillow under left side from shoulder to hip
Arm should relaxed by his side
Foot of the bed should be raised 35cm
(14in) from the ground
Chest is tilted to an angle of 15º

38. •Patient lie prone with the head turned to
one side
•Arm relaxed in a comfortable position by
the side
•A pillow under his hips

40. Patient lie flat on his back with the
buttocks resting on a pillow and knees
are flexed
The foot of the bed is elevated 46cm (18
in) from the ground
The chest is tilted to an angle of 20º

42. Patient lie prone with his head turned to
one side
Arms in a comfortable position by the
side
A pillow under his hip
The foot of the bed is elevated 46cm (18
in) from the ground
The chest is tilted to an angle of 20º

44. Patient lie on his right side with a pillow
under his hips
The foot end is raised 46cm (18in) from
the ground
The chest is tilted to an angle of 20º

46. Patient lie on his left side with a pillow under
his hips
The foot end is raised 46cm (18in) from the
ground
The chest is tilted to an angle of 20º