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effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients
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effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal injury patients

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ABSTRACT …

ABSTRACT

Effectiveness of Mechanical Vibrator for Chest Physiotherapy in Ventilated head & spinal injured patients
Shiny Thomas, Deepak Agrawal
Department of Neurosurgery, JPNA Trauma Centre, AIIMS, New Delhi

Background: Chest infection is one of the major factor in morbidity & mortality in ventilated head & spinal injured patients. It is hypothesized that mechanical vibrators may help in improving the quality & frequency of chest physiotherapy in these groups of patients.
Aims & Objectives: To assess the decrease (if any) in chest infection rates & mortality in ventilated patients with head & spinal cord injury who received mechanical vibrator chest physiotherapy.
Materials & methods: This retro-prospective study was carried out in all ventilated head & spinal injured patients over 6 months in Neurosurgery ICU. The clinical (demographics, admission GCS & in hospital mortality) & microbiological data (Modified tracheal culture) was collected over the two time periods. The ‘control’ group consisted of patients in whom data was retrospectively collected from January 2011 to March 2011 (before the introduction of Vibrators). The ‘test’ group consisted of patients in whom data was prospectively collected from April 2011 to June 2011 (following introduction of Vibrators). All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly.
Results: A total of 575 patients were evaluated in the study. Both Control & test groups were well matched with respect to [p<0><0.01).

Conclusions: Use of mechanical vibrators by nurses for chest physiotherapy can dramatically improve outcomes & chest infection rates in ventilated head & spinal injury patients. We recommend their use as standard of care for ventilated patients.

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  • 1.   EFFECTIVENESS OF MECHANICAL VIBRATOR FOR CHEST PHYSIOTHERAPY IN VENTILATED HEAD & SPINAL INJURED PATIENTS Ms. SHINY THOMAS STAFF NURSE NEUROSURGERY ICU JPNATC, AIIMS New Delhi
  • 2. BACKGROUND <ul><li>Chest infection is one of the major factor in morbidity & mortality in ventilated head & spinal injured patients. </li></ul><ul><li>Chest physiotherapy (CPT) has been used to improve airway clearance and treat lung collapse; however, the evidence to support its use has been conflicting. </li></ul><ul><li>It is hypothesized that mechanical vibrators may help in improving the quality & frequency of chest physiotherapy in these groups of patients. </li></ul>
  • 3. AIMS & OBJECTIVES <ul><li>To assess the effects of active CPT techniques, such as percussion and vibration along with mechanical vibrator. </li></ul><ul><li>To assess the decrease (if any) in chest infection rates & mortality in ventilated patients with head & spinal cord injury who received mechanical vibrator chest physiotherapy. </li></ul>
  • 4. MATERIALS & METHODS <ul><li>This retro-prospective study was carried out in all ventilated head & spinal injured patients over 6 months in Neurosurgery ICU. </li></ul><ul><li>The clinical (demographics, admission GCS & in hospital mortality) & microbiological data (Modified tracheal culture) was collected over the two time periods. </li></ul>
  • 5. MATERIALS & METHODS
  • 6. MATERIALS & METHODS
  • 7. MATERIALS & METHODS All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly.
  • 8.  
  • 9. MODIFIED TRACHEAL CULTURE
  • 10.  
  • 11. RESULTS <ul><li>A total of 575 numbers of patients were evaluated in the study. Both Control & test groups were well matched with respect to the: </li></ul>*p>0.05 CONTROL GROUP TEST GROUP Number Of Head Injuries 234 206 Number of Spinal Injuries 74 64 Mean Age 30.75 years 31.9 years Male: Female Ratio 89:13 77:13 Mean Admission GCS 9.6 9.9 Average Ventilator Days 7.46 days 7.9 days Tracheal culture positivity (On surveillance)* 9.83% 15.18%
  • 12. CONTROL GROUP TEST GROUP VENTILATOR DAYS
  • 13. 8.3% 10.63% 15.84% PERCENTAGE OF TRACHEAL CULTURE POSITIVE PATIENTS CONTROL GROUP TEST GROUP
  • 14. RESULTS <ul><li>The mortality was significantly lower in the test group 17.4% as compared to the control groups 27.21%. </li></ul>
  • 15. CONTROL GROUP TEST GROUP MORTALITY RATE IN PERCENTAGE 31.48% 15.84%
  • 16. CONCLUSIONS: <ul><li>Use of mechanical vibrators by nurses for chest physiotherapy can improve outcomes & chest infection rates in ventilated head & spinal injury patients. We recommend their use as standard of care for ventilated patients. </li></ul>
  • 17.  

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