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What are the techniques that can improve alveolar ventilation?
- - DB- LBE
- - DB- inspiratory hold
- - incentive spirometry
- - positioning
- - mobilisation
what are the techniques used for secretion clearance?
- - cough
- - huff
- - FET (forced expiration technique)
- - ACBT
- - percussion
- - 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?
- - supine
- - 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
- - supine
- - prone
- - 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?
- - supine
- - 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