What are the techniques that can improve alveolar ventilation?
- DB- LBE
- DB- inspiratory hold
- incentive spirometry
what are the techniques used for secretion clearance?
- FET (forced expiration technique)
- postural drainage
- positive expiratory pressure
- oscillating PEP (flutter, acapella)
What are the techniques to reduce WOB and control dyspnoea?
- breathing control strategies (pursed lips)
- positioning for breathing control
What is the best postural drainage position for upper lobe- apical segment?
- sitting up
- this is why pts dont get a great deal of pathology in this part
What is the best postural drainage position for UL ant segment?
- bed flat
- vibes- both hands on front
What is the best drainage position for UL posterior segment?
- 1/4 off prone
- bad lobe up
- pt cuddling pillow in lying
- L shoulders elevated 30 cm
- vibes on either side
What position for postural drainage would you have for the middle lobe segments and lingula?
- 1/4 off supine (lean back on pillow)
- bed 1/2 tip (tip head down)
- head down
what is the best postural drainage position for the Lower lobe apical segment?
- prone- bed flat
What is the best position for the rest of the segments of the lower lobe? (besides apical and medial)
- bed full tip
- 4 sides round
- sidelying L+R
What is the best position for the medial segment of the Right lobe lobe postural drainage?
- need to lie on that side
Why is the ligula not a lobe?
because it doesnt have a fissure to make it distinct
Who dont you tilt?
- pts with heart problems
What is the point of vibes?
- compress chest
- force air out
- like a cough
- brings speutum up
Where must the pillow be for the pt
- under head not under shoulders
What does modified mean?
- sidelying- affected side up- no tip
Percs then vibes then percs- pt needs to be in a position for a while for drainage to occur
What is TEE?
- DB with hold
Note no more than 2 huffs if unproductive
When is FET used?
- huff and BC
- used when pt is hyperinflated eg COPD
What is DB exercises- LBE used for?
- improve alveolar ventilation
What is the DB exercises- LBE performance physiological rationale?
- produce a large, increased transpulmonary pressure, which distends the lung and reinflates collapse
- with the aim to improve lung volume
FRC to TLC