chest-physiotherapy

Indications of Chest Physiotherapy

Wed, 25 Mar 2009 14:30:45 +0100

Indications of Chest Physiotherapy

It is indicated for patients in whom cough is insufficient to clear thick, tenacious, or localized secretions. Examples include:
• Cystic fibrosis
• Bronchiectasis
• Atelctasis
• Lung abscess
• Neuromuscular diseases
• Pneumonias in dependent lung regions.

Assessment for Chest Physiotherapy

Wed, 25 Mar 2009 13:44:59 +0100

Assessment for Chest Physiotherapy

Nursing care and selection of CPT skills are based on specific assessment findings. The following are the assessment criteria:
• Know the normal range of patient’s vital signs. Conditions requiring CPT, such atelectasis, and pneumonia, affects vital signs.
• Know the patient’s medications. Certain medications, particularly diuretics antihypertensive cause fluid and haemodynamic changes. These decrease patient’s tolerance to positional changes and postural drainage.
• Know the patient’s medical history; certain conditions such as increased ICP, spinal cord injuries and abdominal aneurysm resection, contra indicate the positional change to postural drainage. Thoracic trauma and chest surgeries also contraindicate percussion and vibration.
• Know the patient’s cognitive level of functioning. Participating in controlled cough techniques requires the patient to follow instructions.
• Beware of patient’s exercise tolerance. CPT maneuvers are fatiguing. Gradual increase in activity and through CPT, patient tolerance to the procedure improves.

Key Terms of Chest Physiotherapy

Wed, 25 Mar 2009 13:18:23 +0100

Key Terms of Chest Physiotherapy

Coughing

Coughing helps break up secretions in the lungs so that the mucus can be suctioned out or expectorated. Patients sit upright and inhale deeply through the nose. They then exhale in short puffs or coughs. Coughing is repeated several times per day.

Deep breathing

Deep breathing helps expand the lungs and forces better distribution of the air into all sections of the lung. The patient either sits in a chair or sits upright in bed and inhales, pushing the abdomen out to force maximum amounts of air into the lung. The abdomen is then contracted, and the patient exhales. Deep breathing exercises are done several times each day for short periods.

Percussion

This consists of rhythmically striking the chest wall with cupped hands. It is also called cupping, clapping, or tapotement. The purpose of percussion is to break up thick secretions in the lungs so that they can be more easily removed. Percussion is performed on each lung segment for one to two minutes at a time.

Postural drainage

This technique uses the force of gravity to assist in effectively draining secretions from the lungs and into the central airway where they can either be coughed up or suctioned out. The patient is placed in a head or chest down position and is kept in this position for up to 15 minutes. Critical care patients and those depending on mechanical ventilation receive postural drainage therapy four to six times daily. Percussion and vibration may be performed in conjunction with postural drainage.

Turning

Turning from side to side permits lung expansion. Patients may turn themselves or be turned by a caregiver. The head of the bed is also elevated to promote drainage if the patient can tolerate this position. Critically ill patients and those dependent on mechanical respiration are turned once every one to two hours around the clock.

Vibration

The purpose of vibration is to help break up lung secretions. Vibration can be either mechanical or manual. It is performed as the patient breathes deeply. When done manually, the person performing the vibration places his or her hands against the patient's chest and creates vibrations by quickly contracting and relaxing arm and shoulder muscles while the patient exhales. The procedure is repeated several times each day for about five exhalations.

Risks of Chest Physiotherapy

Wed, 25 Mar 2009 13:15:31 +0100

Risks of Chest Physiotherapy

Risks and complications associated with chest physical therapy depend on the health of the patient. Although chest physical therapy usually poses few problems, in some patients it may cause

oxygen deficiency if the head is kept lowered for drainage
increased intracranial pressure
temporary low blood pressure
bleeding in the lungs
pain or injury to the ribs, muscles, or spine
vomiting
inhaling secretions into the lungs
heart irregularities

Precautions or Contraindication of Chest Physiotherapy

Wed, 25 Mar 2009 13:41:07 +0100

Precautions/Contraindication

Chest physical therapy should not be performed on people with

bleeding from the lungs
neck or head injuries
fractured ribs
collapsed lungs
damaged chest walls
tuberculosis
acute asthma
recent heart attack
pulmonary embolism
lung abscess
active hemorrhage
some spine injuries
recent surgery, open wounds, or burns
empyma
bronchoplueral fistula
uncontrolled hypertension
anticoagulation

Chest Physiotherapy

Wed, 25 Mar 2009 12:41:15 +0100

What is chest physiotherapy (CPT)?

Chest physical therapy is the term for a group of treatments designed to improve respiratory efficiency, promote expansion of the lungs, strengthen respiratory muscles, and eliminate secretions from the respiratory system.

Purpose

The purpose of chest physical therapy, also called chest physiotherapy, is to help patients breathe more freely and to get more oxygen into the body. Chest physical therapy includes postural drainage, chest percussion, chest vibration, turning, deep breathing exercises, and coughing. It is usually done in conjunction with other treatments to rid the airways of secretions. These other treatments include suctioning, nebulizer treatments, and the administration of expectorant drugs.

Chest physical therapy can be used with newborns, infants, children, and adults. People who benefit from chest physical therapy exhibit a wide range of problems that make it difficult to clear secretions from their lungs. Some people who may receive chest physical therapy include people with cystic fibrosis or neuromuscular diseases like Guillain-Barré syndrome, progressive muscle weakness (myasthenia gravis), or tetanus. People with lung diseases such as bronchitis, pneumonia, or chronic obstructive pulmonary disease (COPD) also benefit from chest physical therapy. People who are likely to aspirate their mucous secretions because of diseases such as cerebral palsy or muscular dystrophy also receive chest physical therapy, as do some people who are bedridden, confined to a wheelchair, or who cannot breathe deeply because of postoperative pain.