CP

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Author:
jessiekate22
ID:
170736
Filename:
CP
Updated:
2012-09-13 18:34:36
Tags:
secretion clearance
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Description:
Exams stuff
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  1. What are the two forms of oscillating PEP?
    • flutter and acapella
    • - the flutter is mechanical device that applies a variable resistance to expiratory airflow
    • - the oscillation is angle dependent adjusted to create the highest frequency for the individual 8-26Hz
    • - this causes an oscillation of the air within the airways, intermittent acceleration of expiratory pressure
  2. What is the physiolgical rationale behind oscillating PEP
    • - oscillation of the airwaydiameter and airflow:
    •  - approximates the 'pulmonary resonance' or cilia 'beat' frequency of 8-16Hz, to maximize vibration of the bronchial walls.
    •  - improves gas-liquid interaction
    •  - may reduce sputum viscosity by mechanically rupturing the rigid mucus gel, rearranging crosslink and reducing molecular size
  3. flutter PEP
    • -device held at best angle for oscillations
    • - breathe in slightly deeper than normal, brief hold
    • - expire through device
    • - 5-10 breaths out through flutter then a forced expiration through the flutter
    • - continue as appropriate - 15 min?
  4. acapella PEP
    - similar to flutter but allows a variable resistance and can be used at any angle
  5. Seretions clearance and autogenic drainage
    • -developed in germany
    • - uses breathing exercises at different lung volumes to enhance expiratory airflow and therefor secretion movement
    • - 3 phases unstick, collect, evacuate
    • - aims to achieve maximum expiratory flow without airway collapse
  6. What are the indications for autogenic drainage?
    • - secretion clearance
    • - unstable airways
  7. what are the contrindications for autogenic drainage?
    -none
  8. what are the issues to autogenic drainage?
    • - not many people know how to perform this technique effectively
    • - difficult to learn
    • - difficult to teach
    • -takes times to learn
    • - hard to breathe at low lung volumes
  9. what is hypertonic saline?
    • - used to aid secretion clearance
    • - usually 9% saline
    • - shown to increase clearance in CF, chronic bronchitis
    • - main issue- may cause bronchoconstricion
    • - mark elkins
  10. What is the main self management for pts with secretions?
    • - mostly are effective
    • need to consider:
    • - specific pathology
    • - pt preference
    • - ability to perform technique
    • - outcomes

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