Card Set Information
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
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
-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?
- similar to flutter but allows a variable resistance and can be used at any angle
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
What are the indications for autogenic drainage?
- secretion clearance
- unstable airways
what are the contrindications for autogenic drainage?
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
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
What is the main self management for pts with secretions?
- mostly are effective
need to consider:
- specific pathology
- pt preference
- ability to perform technique