The document discusses the Flutter device, which is used for airway clearance. The Flutter produces oscillatory positive expiratory pressure and can be used as an alternative to remove secretions from the airways. It works by vibrating the airways, intermittently increasing endobronchial pressure, and accelerating expiratory airflow. The Flutter is recommended for use three times per day for conditions like cystic fibrosis, emphysema, and bronchitis. It helps loosen and remove trapped mucus from the lungs.
The incremental shuttle walking test (ISWT) requires patients to walk between two cones that are 9 meters apart in time to auditory beeps that get faster each minute. The test ends when the patient can no longer keep up with the beeps or is too breathless. Standardization is important, including performing the test twice with rest in between and using only instructions from the audio recording. The ISWT measures exercise capacity and can track changes from exercise training programs in patients with conditions like COPD.
This document discusses various chest mobilization techniques used in physical therapy to improve chest wall mobility and ventilation. Some key techniques described include rib torsion, lateral stretching, and trunk rotation. Chest mobilization can help increase the length of intercostal muscles and improve biomechanics of chest movement. Specific exercises mentioned involve flexion/extension, lateral flexion, and trunk rotation while sitting. Counterrotation and butterfly techniques are also outlined to reduce neuromuscular tone and increase thoracic mobility. Controlled breathing can also be incorporated into walking exercises.
Intermittent positive pressure breathing (IPPB) is an assisted breathing technique that provides intermittent mechanical ventilation through a mouthpiece or mask. It is used to improve lung expansion and deliver aerosolized medications. While IPPB can help increase inspiration volume and support weak muscles, it is not usually the preferred treatment due to risks of barotrauma and availability of less expensive techniques. The Bird Mark 7 ventilator is commonly used for IPPB, which can benefit patients with atelectasis, secretion retention, or acute exacerbations requiring stronger inspiration. However, the effects of IPPB are short-lived and it is a more labor-intensive method of aerosol delivery than other available options.
physiotherapy management for chronic obstructive pulmonary disease Sunil kumar
role of physiotherapy in chronic obstructive pulmonary disease, principles of physical therapy management in copd, physiotherapy assessing and treatment for copd
Autogenic Drainage (AD) is a breathing technique developed in the 1960s/80s in Europe to clear secretions from the lungs using controlled breathing and minimal coughing. It involves three phases - unsticking secretions with small breaths, collecting secretions in the middle airways with medium breaths, and evacuating secretions into the mouth with deep breaths to be spit out. Each phase takes 2-3 minutes for a total of 6-9 minutes. The technique aims to hear and feel secretions being moved up the airways with exhalation instead of coughing.
This document outlines the physiotherapy management for various types of thoracic surgeries. It discusses:
1) Pre-operative and post-operative physiotherapy protocols for procedures like thoracotomy, pneumonectomy, pleurodesis, and thoracoplasty which involve breathing exercises, coughing techniques, ROM exercises, and early mobilization.
2) Common post-operative complications like pain, retained secretions, decreased mobility and focuses on ensuring analgesia and lung re-expansion exercises.
3) Timeline of post-operative physiotherapy starting from day of surgery, with progression of exercises and mobilization before discharge by 7-10 days on average.
The document discusses the Flutter device, which is used for airway clearance. The Flutter produces oscillatory positive expiratory pressure and can be used as an alternative to remove secretions from the airways. It works by vibrating the airways, intermittently increasing endobronchial pressure, and accelerating expiratory airflow. The Flutter is recommended for use three times per day for conditions like cystic fibrosis, emphysema, and bronchitis. It helps loosen and remove trapped mucus from the lungs.
The incremental shuttle walking test (ISWT) requires patients to walk between two cones that are 9 meters apart in time to auditory beeps that get faster each minute. The test ends when the patient can no longer keep up with the beeps or is too breathless. Standardization is important, including performing the test twice with rest in between and using only instructions from the audio recording. The ISWT measures exercise capacity and can track changes from exercise training programs in patients with conditions like COPD.
This document discusses various chest mobilization techniques used in physical therapy to improve chest wall mobility and ventilation. Some key techniques described include rib torsion, lateral stretching, and trunk rotation. Chest mobilization can help increase the length of intercostal muscles and improve biomechanics of chest movement. Specific exercises mentioned involve flexion/extension, lateral flexion, and trunk rotation while sitting. Counterrotation and butterfly techniques are also outlined to reduce neuromuscular tone and increase thoracic mobility. Controlled breathing can also be incorporated into walking exercises.
Intermittent positive pressure breathing (IPPB) is an assisted breathing technique that provides intermittent mechanical ventilation through a mouthpiece or mask. It is used to improve lung expansion and deliver aerosolized medications. While IPPB can help increase inspiration volume and support weak muscles, it is not usually the preferred treatment due to risks of barotrauma and availability of less expensive techniques. The Bird Mark 7 ventilator is commonly used for IPPB, which can benefit patients with atelectasis, secretion retention, or acute exacerbations requiring stronger inspiration. However, the effects of IPPB are short-lived and it is a more labor-intensive method of aerosol delivery than other available options.
physiotherapy management for chronic obstructive pulmonary disease Sunil kumar
role of physiotherapy in chronic obstructive pulmonary disease, principles of physical therapy management in copd, physiotherapy assessing and treatment for copd
Autogenic Drainage (AD) is a breathing technique developed in the 1960s/80s in Europe to clear secretions from the lungs using controlled breathing and minimal coughing. It involves three phases - unsticking secretions with small breaths, collecting secretions in the middle airways with medium breaths, and evacuating secretions into the mouth with deep breaths to be spit out. Each phase takes 2-3 minutes for a total of 6-9 minutes. The technique aims to hear and feel secretions being moved up the airways with exhalation instead of coughing.
This document outlines the physiotherapy management for various types of thoracic surgeries. It discusses:
1) Pre-operative and post-operative physiotherapy protocols for procedures like thoracotomy, pneumonectomy, pleurodesis, and thoracoplasty which involve breathing exercises, coughing techniques, ROM exercises, and early mobilization.
2) Common post-operative complications like pain, retained secretions, decreased mobility and focuses on ensuring analgesia and lung re-expansion exercises.
3) Timeline of post-operative physiotherapy starting from day of surgery, with progression of exercises and mobilization before discharge by 7-10 days on average.
Manual ventilation, or ‘bagging’, is the use of a manual resuscitator bag (MRB) for the ventilation of a patient via either a facemask or an endotracheal tube.
Artificial intelligence (AI) is the ability of machines to perform tasks that normally require human intelligence, such as visual perception, speech recognition, and decision-making. AI is an area of computer science that includes general problem solving, natural language processing, reasoning, learning, and many other activities. The goal is to create machines that can learn from experience, adjust to new inputs and perform human-like tasks.
Physiotherapy management of chronic obstructive pulmonary disease ppt by Oluw...OluwadamilareAkinwan
This document presents an overview of physiotherapy management for chronic obstructive pulmonary disease (COPD). It discusses the epidemiology, pathophysiology, clinical features, diagnosis, stages, and medical management of COPD. It then describes the role of physiotherapy during acute exacerbations, including techniques to reduce work of breathing and secretion removal. Physiotherapy is also involved in pulmonary rehabilitation to improve patient function and management through exercise training and education. Physiotherapy aims to prevent exacerbations and optimize lung function in stable COPD patients.
The 6-minute walk test (6MWT) is an easy to perform and practical test that has been used in the assessment of patients with a variety of cardiopulmonary diseases including pulmonary arterial hypertension (PAH). It simply measures the distance that a patient can walk on a flat, hard surface in a period of 6 minutes.
Bronchial hygiene techniques are non-invasive methods to clear airways and improve lung function. They include coughing, breathing exercises, postural drainage, active cycle of breathing techniques (ACBT), autogenic drainage, positive expiratory pressure, chest physiotherapy, and suctioning. The document describes the procedures, indications, contraindications, advantages and disadvantages of various airway clearance techniques.
Neurophysiological facilitation of respiration [npf]Rekha Marbate
NPF involves using selective external stimuli to reflexively assist respiration in unconscious patients. It can be used for those who are unconscious, have neurological deficits, are partially breathing, or on a ventilator. Contraindications include fractures to the rib cage or spine, children, and respiratory failure. Techniques include perioral stimulation to initiate epigastric movement, thoracic vertebral pressure over T2-T4 to increase abdominal excursion and over T9-T11 to increase thoracic movement, anterior stretch lift of the basal area to increase rib movement, intercostal stretching to increase epigastric movement and general respiration, co-contraction of abdominal pressure to increase excursion and stimulate coughing
Physiotherapy management for Bronchiectasis Sunil kumar
The document discusses physiotherapy treatment for bronchiectasis. The goals of treatment include maximizing quality of life and function by educating patients about self-management of their condition and optimizing secretion clearance, ventilation, lung volumes, and exercise capacity. Treatment involves monitoring patients and administering medication before physiotherapy sessions. The primary interventions include aerobic and strengthening exercises, breathing techniques, coughing maneuvers, airway clearance, and education to support long-term self-management.
This document describes the procedure of pneumonectomy and the role of physiotherapy both before and after the surgery. Pneumonectomy involves complete removal of a lung, usually done to treat lung cancer, infections, or other lung diseases. Physiotherapy before surgery focuses on teaching exercises and breathing techniques to prepare the patient. After surgery, physiotherapy aims to clear secretions, expand the remaining lung, prevent complications, and restore movement and exercise tolerance through a gradual recovery program over 2-3 weeks before discharge.
Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
This document discusses coronary artery bypass graft (CABG) surgery and cardiac rehabilitation. It defines CABG as a surgery that creates new routes around blocked coronary arteries using healthy vessels from other parts of the body. It then describes the various types of CABG procedures and the heart-lung machine used. Post-operation, patients undergo cardiac rehabilitation in phases to promote recovery through exercise and education while reducing risk factors. The goals are to restore blood flow, relieve chest pain, improve quality of life and lower heart attack risk.
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
Bronchial hygiene therapy involves noninvasive techniques to clear secretions and improve lung function. It includes techniques like positioning, coughing, breathing exercises, and chest manipulation. The goals are to prevent accumulation and promote removal of secretions to improve respiratory status. Indications are excessive sputum production and ineffective cough. Contraindications include conditions that increase risk of aspiration or compromise hemodynamics.
Asthma is a chronic inflammatory condition associated with airway hyperresponsiveness (an exaggerated airway-narrowing response to specific triggers such as viruses, allergens and exercise).
Physiotherapy can provide relief from symptoms of uncontrolled asthma, including coughing, wheezing, tightness in the chest, shortness of breath and QOL.
Mechanical ventilation and physiotherapy managementMuskan Rastogi
Mechanical ventilation involves using a machine to breathe for patients who cannot breathe effectively on their own. It works by delivering pressurized air into the lungs via a tube in the airway. Physiotherapists help optimize ventilation, clear secretions, prevent complications, and facilitate weaning patients off the ventilator using techniques like suctioning, drainage positions, percussion, and vibrations. The ventilator settings control aspects of breathing like tidal volume, oxygen levels, and respiratory rate. Modes include mandatory breaths or assisting patients' own breaths. Weaning gradually reduces support as the patient recovers lung function and the ability to breathe independently.
Dr. Abhijit Diwate discusses physiotherapy management of ICU patients. Key points include:
1) Physiotherapists assess patients, set goals like pain relief and secretion clearance, and use techniques like positioning, manual hyperinflation, percussion and breathing exercises.
2) Assessment involves examining the chest and determining ventilator settings. Goals are to prevent complications and improve function.
3) Common techniques are positioning, mobilization, manual hyperinflation, percussion, coughing/huffing, and breathing exercises to clear secretions and strengthen respiratory muscles.
Physical therapists play a key role in identifying patients who have become too debilitated to independently perform daily living activities due to chronic diseases. They teach energy conservation and work simplification techniques to help patients pace themselves. These techniques include establishing routines with rest periods, sitting whenever possible, eliminating unnecessary tasks, avoiding strenuous activities, keeping cool, gradually increasing activity levels, organizing work areas, and using assisted devices.
Physiotherapy Management in Peripheral nerve & Plexus injuriesSreeraj S R
1. The document discusses various aspects of peripheral nerve anatomy and injury. It describes the formation and branches of the major plexuses from spinal nerves and classifies peripheral nerve injuries.
2. Mechanisms of nerve injury including compression, ischemia, traction and friction are outlined. The process of nerve degeneration and regeneration after injury is explained.
3. Methods for assessing peripheral nerve injuries are provided, including history taking, physical examination techniques, and electrodiagnostic studies. Specific peripheral nerves like the radial and ulnar nerves are used as examples.
Decortication of the lung is a surgical procedure to remove thick fibrous tissue from the lungs and chest cavity that has developed due to conditions like infection or cancer. This tissue prevents normal breathing by limiting lung expansion and deflation. The procedure involves making an incision between the ribs to access the chest cavity and carefully stripping the thickened tissue off the lungs to restore normal breathing function. Post-operatively, chest tubes and antibiotics are used to drain fluid and prevent infection while the lungs re-expand.
Journal Presentation on article Comparative efficacy of different combination...Shubham Jain
Journal Presentation on article Comparative efficacy of different combinations of acapella, active cycle of breathing technique, and external diaphragmatic pacing in perioperative patients with lung cancer
This document provides an outline for a presentation on acute lung injury (ALI). It defines ALI and describes the pathological process. Some key points include: ALI results from direct or indirect lung injury and involves two pathological phases. Common causes include sepsis or trauma. Symptoms include rapid breathing and low blood oxygen levels. Diagnosis involves tests like chest x-rays and blood gases. Treatment involves mechanical ventilation, fluid management, and prone positioning. Complications can include pulmonary fibrosis or cardiac issues. Nursing care focuses on managing breathing patterns, gas exchange, and reducing patient anxiety.
Manual ventilation, or ‘bagging’, is the use of a manual resuscitator bag (MRB) for the ventilation of a patient via either a facemask or an endotracheal tube.
Artificial intelligence (AI) is the ability of machines to perform tasks that normally require human intelligence, such as visual perception, speech recognition, and decision-making. AI is an area of computer science that includes general problem solving, natural language processing, reasoning, learning, and many other activities. The goal is to create machines that can learn from experience, adjust to new inputs and perform human-like tasks.
Physiotherapy management of chronic obstructive pulmonary disease ppt by Oluw...OluwadamilareAkinwan
This document presents an overview of physiotherapy management for chronic obstructive pulmonary disease (COPD). It discusses the epidemiology, pathophysiology, clinical features, diagnosis, stages, and medical management of COPD. It then describes the role of physiotherapy during acute exacerbations, including techniques to reduce work of breathing and secretion removal. Physiotherapy is also involved in pulmonary rehabilitation to improve patient function and management through exercise training and education. Physiotherapy aims to prevent exacerbations and optimize lung function in stable COPD patients.
The 6-minute walk test (6MWT) is an easy to perform and practical test that has been used in the assessment of patients with a variety of cardiopulmonary diseases including pulmonary arterial hypertension (PAH). It simply measures the distance that a patient can walk on a flat, hard surface in a period of 6 minutes.
Bronchial hygiene techniques are non-invasive methods to clear airways and improve lung function. They include coughing, breathing exercises, postural drainage, active cycle of breathing techniques (ACBT), autogenic drainage, positive expiratory pressure, chest physiotherapy, and suctioning. The document describes the procedures, indications, contraindications, advantages and disadvantages of various airway clearance techniques.
Neurophysiological facilitation of respiration [npf]Rekha Marbate
NPF involves using selective external stimuli to reflexively assist respiration in unconscious patients. It can be used for those who are unconscious, have neurological deficits, are partially breathing, or on a ventilator. Contraindications include fractures to the rib cage or spine, children, and respiratory failure. Techniques include perioral stimulation to initiate epigastric movement, thoracic vertebral pressure over T2-T4 to increase abdominal excursion and over T9-T11 to increase thoracic movement, anterior stretch lift of the basal area to increase rib movement, intercostal stretching to increase epigastric movement and general respiration, co-contraction of abdominal pressure to increase excursion and stimulate coughing
Physiotherapy management for Bronchiectasis Sunil kumar
The document discusses physiotherapy treatment for bronchiectasis. The goals of treatment include maximizing quality of life and function by educating patients about self-management of their condition and optimizing secretion clearance, ventilation, lung volumes, and exercise capacity. Treatment involves monitoring patients and administering medication before physiotherapy sessions. The primary interventions include aerobic and strengthening exercises, breathing techniques, coughing maneuvers, airway clearance, and education to support long-term self-management.
This document describes the procedure of pneumonectomy and the role of physiotherapy both before and after the surgery. Pneumonectomy involves complete removal of a lung, usually done to treat lung cancer, infections, or other lung diseases. Physiotherapy before surgery focuses on teaching exercises and breathing techniques to prepare the patient. After surgery, physiotherapy aims to clear secretions, expand the remaining lung, prevent complications, and restore movement and exercise tolerance through a gradual recovery program over 2-3 weeks before discharge.
Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
This document discusses coronary artery bypass graft (CABG) surgery and cardiac rehabilitation. It defines CABG as a surgery that creates new routes around blocked coronary arteries using healthy vessels from other parts of the body. It then describes the various types of CABG procedures and the heart-lung machine used. Post-operation, patients undergo cardiac rehabilitation in phases to promote recovery through exercise and education while reducing risk factors. The goals are to restore blood flow, relieve chest pain, improve quality of life and lower heart attack risk.
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
Bronchial hygiene therapy involves noninvasive techniques to clear secretions and improve lung function. It includes techniques like positioning, coughing, breathing exercises, and chest manipulation. The goals are to prevent accumulation and promote removal of secretions to improve respiratory status. Indications are excessive sputum production and ineffective cough. Contraindications include conditions that increase risk of aspiration or compromise hemodynamics.
Asthma is a chronic inflammatory condition associated with airway hyperresponsiveness (an exaggerated airway-narrowing response to specific triggers such as viruses, allergens and exercise).
Physiotherapy can provide relief from symptoms of uncontrolled asthma, including coughing, wheezing, tightness in the chest, shortness of breath and QOL.
Mechanical ventilation and physiotherapy managementMuskan Rastogi
Mechanical ventilation involves using a machine to breathe for patients who cannot breathe effectively on their own. It works by delivering pressurized air into the lungs via a tube in the airway. Physiotherapists help optimize ventilation, clear secretions, prevent complications, and facilitate weaning patients off the ventilator using techniques like suctioning, drainage positions, percussion, and vibrations. The ventilator settings control aspects of breathing like tidal volume, oxygen levels, and respiratory rate. Modes include mandatory breaths or assisting patients' own breaths. Weaning gradually reduces support as the patient recovers lung function and the ability to breathe independently.
Dr. Abhijit Diwate discusses physiotherapy management of ICU patients. Key points include:
1) Physiotherapists assess patients, set goals like pain relief and secretion clearance, and use techniques like positioning, manual hyperinflation, percussion and breathing exercises.
2) Assessment involves examining the chest and determining ventilator settings. Goals are to prevent complications and improve function.
3) Common techniques are positioning, mobilization, manual hyperinflation, percussion, coughing/huffing, and breathing exercises to clear secretions and strengthen respiratory muscles.
Physical therapists play a key role in identifying patients who have become too debilitated to independently perform daily living activities due to chronic diseases. They teach energy conservation and work simplification techniques to help patients pace themselves. These techniques include establishing routines with rest periods, sitting whenever possible, eliminating unnecessary tasks, avoiding strenuous activities, keeping cool, gradually increasing activity levels, organizing work areas, and using assisted devices.
Physiotherapy Management in Peripheral nerve & Plexus injuriesSreeraj S R
1. The document discusses various aspects of peripheral nerve anatomy and injury. It describes the formation and branches of the major plexuses from spinal nerves and classifies peripheral nerve injuries.
2. Mechanisms of nerve injury including compression, ischemia, traction and friction are outlined. The process of nerve degeneration and regeneration after injury is explained.
3. Methods for assessing peripheral nerve injuries are provided, including history taking, physical examination techniques, and electrodiagnostic studies. Specific peripheral nerves like the radial and ulnar nerves are used as examples.
Decortication of the lung is a surgical procedure to remove thick fibrous tissue from the lungs and chest cavity that has developed due to conditions like infection or cancer. This tissue prevents normal breathing by limiting lung expansion and deflation. The procedure involves making an incision between the ribs to access the chest cavity and carefully stripping the thickened tissue off the lungs to restore normal breathing function. Post-operatively, chest tubes and antibiotics are used to drain fluid and prevent infection while the lungs re-expand.
Journal Presentation on article Comparative efficacy of different combination...Shubham Jain
Journal Presentation on article Comparative efficacy of different combinations of acapella, active cycle of breathing technique, and external diaphragmatic pacing in perioperative patients with lung cancer
This document provides an outline for a presentation on acute lung injury (ALI). It defines ALI and describes the pathological process. Some key points include: ALI results from direct or indirect lung injury and involves two pathological phases. Common causes include sepsis or trauma. Symptoms include rapid breathing and low blood oxygen levels. Diagnosis involves tests like chest x-rays and blood gases. Treatment involves mechanical ventilation, fluid management, and prone positioning. Complications can include pulmonary fibrosis or cardiac issues. Nursing care focuses on managing breathing patterns, gas exchange, and reducing patient anxiety.
Pulmonary rehabilitation is a comprehensive intervention designed to improve the physical and psychological condition of people with chronic respiratory disease. It includes exercise training, education, and behavior change therapies. Pulmonary rehabilitation aims to promote long-term adherence to health-enhancing behaviors. The summary describes restrictive and obstructive lung diseases, as well as various treatments used in pulmonary rehabilitation including exercise, airway clearance techniques, nutrition management, and psychosocial support.
This document discusses airway secretion clearance techniques in the ICU, including mechanical insufflation-exsufflation (MIE). It provides a timeline of MIE devices including the CoughAssist. A case study describes how MIE was used successfully via face mask in an 18-year-old post-op patient to avoid intubation. Typical treatment protocols for the CoughAssist E-70 are outlined. Studies show MIE can improve respiratory parameters and allow extubation of restrictive patients to noninvasive ventilation. The evidence suggests MIE is safe and effective for both obstructive and restrictive lung diseases.
Pulmonary rehabilitation is a comprehensive intervention for patients with chronic respiratory diseases. It includes exercise training, education, breathing exercises, and nutritional counseling. The goals are to improve physical and psychological health and promote long-term management of the respiratory condition. Pulmonary rehabilitation programs typically last 6-12 weeks with two or three supervised sessions per week. A multidisciplinary team provides personalized treatment that matches the severity of lung involvement. Exercise is individually prescribed according to testing and progressively increased. Pulmonary rehabilitation provides benefits like reduced symptoms, improved quality of life and exercise capacity.
This document discusses the use of non-invasive ventilation (NIV) as a physiotherapeutic approach. It defines NIV as the delivery of oxygen via a face mask without an endotracheal tube. NIV works by creating positive airway pressure to force air into the lungs, reducing respiratory effort. There are two main types of NIV: non-invasive positive pressure ventilation and negative pressure ventilation. The document then discusses specific NIV techniques like CPAP and BiPAP and their indications. It also covers contraindications and how NIV can be used to manage acute respiratory failure, improve secretion removal, exercise capacity, and treat chronic respiratory failure.
Noninvasive ventilation may provide benefits as a weaning strategy compared to invasive weaning from mechanical ventilation. A systematic review and meta-analysis of randomized controlled trials found that noninvasive weaning significantly reduced mortality, rates of weaning failure and ventilator-associated pneumonia. It also decreased length of stay in the ICU and hospital as well as total duration of mechanical ventilation compared to invasive weaning. Subgroup analysis showed greater reduction in mortality for patients with COPD using noninvasive weaning.
Chronic obstructive pulmonary disease (COPD) is a common lung disease characterized by airflow limitation and tissue destruction due to chronic inflammation from smoke exposure. Symptoms include cough, dyspnea, and sputum production that worsen over time. The diagnosis is confirmed by spirometry showing airflow limitation that is not fully reversible with treatment. Management includes smoking cessation, pulmonary rehabilitation, inhaled bronchodilators and corticosteroids to control symptoms and reduce exacerbations.
Weaning from mechanical ventilation , also called ventilator liberation, refers to the process of the patient assuming more and more of the work of breathing and finally demonstrating that ventilator support is no longer required.
Simply it means the process of withdrawing mechanical ventilatory support and transferring the work of breathing from the ventilator to the patient . Weaning can be accomplished with an endotrachel tube ( ETT) or a tracheostomy tube in place.
In the case of the ETT, the final step in the process is the removal of the tube( extubation). With a tracheostomy, the final step may be the ability to breath spontaneously for a designated period of time with the tube in place.
Weaning success is defined as absence of ventilatory support 48 hours following the extubation.
While the spontaneous breaths are unassisted by mechanical ventilation, supplemental oxygen, bronchodilators, low level pressure support ventilation or continuous positive airway pressure (CPAP) may be used to support and maintain adequate spontaneous ventilation and oxygenation.
Purpose
The purpose is to assess the probability that mechanical ventilation can be successfully discontinued.as
75% of mechanically ventilated patients are easy to be weaned off the ventilator with simple process.
10-15% of patients require a use of a weaning protocol over a 24-72 hours.
5-10% require a prolonged weaning plan.
1% of patients become dependent on chronic mechanical ventilation.
Indication
Improvement of the cause of respiratory failure.
Absence of major system dysfunction.
Appropriate level of oxygenation.
Adequate ventilatory status.
Intact airway protective mechanism.
Contraindication
Altered sensorium either drowsiness or restlessness.
Spo2 ˂90%
Rising PaCO2 with drop in PH
Tachypnoea ˃35/ min
Tachycardia ˃120 /min
Drop in systolic blood pressure
Sweating
Cold clammy skin
Signs of diaphragmatic weakness
Paradoxical abdominal wall movement
Assessment of readiness for weaning
Hemodynamic stability
Minimum inotropic support
Adequate cardiac output
Afebrile
Hematocrite greater than 25%
Respiratory stability
Improved chest x-ray
Arterial oxygen tension (PaO2) greater than 60mm Hg with fraction of inspired oxygen ( FiO2) less than 0.5
PaO2/FiO2 greater than 300 mm Hg
Positive end expiratory pressure (PEEP) less than 0-5 cm H2O
Vital capacity (VC) 10-15ml/kg
Spontaneous tidal volume (VT) 5ml/Kg
Respiratory rate less than 30 breaths/mim
Minute ventilation 5-10 L/min
Negative inspiratory pressure greater than -20cm H2O
Rapid shallow breathing index (RSBI) less than 105
metabolic factors stable
Electrolytes within normal range.
ABGs( Arterial blood gases) normalized
Other
Adequate management of pain and anxiety.
Patient is well rested
Weaning criteria
Weaning criteria are used to evaluate the readiness of a patient for a weaning trial and the likelihood of weaning success.
Clinical criteria
Ventilatory criteria
Oxygenation criteria
Biphasic Cuirass Ventilation for Respiratory Failure and ARDSGary Mefford RRT
There is a great deal of information that points to the potential efficacy of BCV for acute and chronic respiratory failure as well as ARDS. Some is gathered here with a discussion of the open lung concept with BCV.
Spirometry is a common pulmonary function test that measures breath volume and flow. It can be used to detect lung disease, monitor occupational exposures, and assess medication effects. This document provides an overview of how to properly perform and interpret spirometry tests, including ensuring patient preparation and positioning, using correct technique, assessing test quality, and comparing results to reference values to determine if lungs are normal or abnormal. Quality is important for obtaining accurate and reproducible results.
This document provides an overview of physiotherapy techniques for lung disease, including airway clearance, pulmonary rehabilitation, and dysfunctional breathing. It summarizes the pathophysiology of mucociliary clearance and the impact of abnormal clearance. A variety of airway clearance techniques are described, along with evidence and guidelines supporting their use. The importance of exercise in pulmonary rehabilitation programs is discussed. Referral information for physiotherapists is outlined to optimize patient care in both acute and non-acute situations.
Pulmonary rehabilitation is a comprehensive, multidisciplinary intervention for patients with chronic respiratory diseases. It aims to reduce symptoms, optimize functional status, increase participation and quality of life. For patients with neuromuscular disorders, pulmonary rehabilitation includes education, exercise training, breathing retraining, chest physical therapy, nutritional interventions, psychological support and outcome assessments. It can improve symptoms, exercise tolerance and quality of life. Mechanical ventilation may be needed for some patients and decisions around long-term support require consideration of individual circumstances and goals of care.
This research proposal aims to study the effects of mechanical ventilation using Chest Compression Synchronized Ventilation (CCSV) combined with Aortic Balloon Occlusion (ABO) on resuscitation outcomes and post-resuscitation organ injury following long-term cardiac arrest in a porcine model. The study will involve establishing a cardiac arrest model in pigs, randomizing them into groups receiving different interventions, and observing resuscitation parameters and post-resuscitation organ function. The expected outcomes are that CCSV+ABO will improve resuscitation outcomes, reduce resuscitation time and defibrillation needs, and significantly prevent post-resuscitation organ damage compared to other ventilation strategies without ABO. The results
RECENT EVIDENCE BASED PRACTICES IN NURSING & CHALLENGES ENCOUNTERED IN NURSIN...Asokan R
The document discusses evidence-based practices in nursing. It begins by defining evidence-based practice and outlining the key components of EBP, which include best research evidence, clinical expertise, and patient values. Recent examples of EBP in nursing are then provided, such as optimal techniques for blood pressure measurement and gastric tube placement verification. Challenges to implementing EBP are also examined, like lack of knowledge, negative attitudes towards research, and organizational constraints.
This document discusses pre-operative lung function testing for patients undergoing lung resection surgery. It recommends evaluating patients' pulmonary function via spirometry, DLCO, VO2 max testing, and predicting post-operative lung function to assess surgical risk. High-risk factors include COPD, smoking history, obesity, and poor nutrition status. Pre-operative optimization of lung function can help reduce post-operative complications.
Pulmonary function testing (PFT) evaluates the respiratory system through tests, patient history, and exams. PFT identifies the severity of lung impairment and helps clinicians understand lung disease. Tests measure lung volume, air flow, and gas exchange. Abnormal results can indicate conditions like asthma or COPD. PFT is used for diagnosis, monitoring disease progression, and pre-operative evaluation.
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
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ACBT VS AUTOGENIC DRAINAGE
1. RESPIRATORY PHYSIOTHERAPY IS A SUBTLE
COCKTAIL OF
• A pinch of Patience
• A spoonful of Ability
• A bowl of Kindness and
• An ocean of Passion
2.
3. A COMPARISON OF AUTOGENIC DRAINAGE AND
THE ACTIVE CYCLE OF BREATHING TECHNIQUES
IN PATIENTS WITH CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
Presented by
J.ARUL JOSEPH ARUN M.P.T(cardio),M.H.A,
APPASAMY PHYSIOTHERAPY & REHABILITATION CENTRE
PUTHUR,TIRUCHIRAPALLI
4. INTRODUCTION
• Chronic obstructive Pulmonary Disease(COPD) according to
National Lung Education Program is defined as a group of disease that
includes chronic bronchitis, emphysema and asthmatic bronchitis.
• Common characteristic of these disease include chronic or
progressive dyspnea, cough with sputum production, and recurrent
lower respiratory tract infections.
• COPD is the fifth leading cause of death worldwide and its prevalence
is increasing gradually.
• Crude estimates suggest there are 30 million COPD patients in India.
• Smoking constitutes 90% cause of COPD population. Besides air
pollution, occupational pollutant and deficiency in alpha1 antitrypsin
are also other causes.
5. OBJECTIVES
• This study aims to provide effective physical therapy measure with
objectives of pulmonary rehabilitation in mind.
• The patient is considered to suffer from COPD if he or she has functional
limitation due to cough and excessive sputum production for a period of two
months to three years along with dyspnea
6. THE STUDY
• The study aims to compare Autogenic Drainage and Active Cycle of
Breathing Technique, thereby maintaining good bronchial hygiene
Active Cycle of Breathing Technique
Initially designed by Thompson(1973) from New Zealand as forced Expiration
technique later renamed as active cycle of breathing technique. It consists of
repeated cycle of controlled breathing and thoracic expansion exercise which
ends by breathing control and forced expiration technique(huffing)
Autogenic Drainage
It is an anti dyspneic technique designed by Chevallier(1967) from Belgium.
It consist of three phases, Unstick phase, collection phase and evacuation
phase where the breathing pattern alters in each
7. NEED FOR THE STUDY
• Main objective of physical therapy for COPD patients are clearing of
secretion, dyspnea control and to improve the functional activities.
These can be achieved from various techniques but more focused
towards these objectives are
1.Active cycle of breathing technique
2.Autogenic Drainage
3.Conventional Chest Physiotherapy
8. LITERATURE REVIEW
• Miller et al has concluded that Autogenic Drainage was found to be as
good as ACBT at clearing mucous in patients with cystic fibrosis.
• Giller et.al has concluded that Autogenic drainage is less likely to
produce oxygen desaturation and may be better tolerated by patients with
cystic fibrosis.
• Savci et.al has concluded in their studies that Autogenic Drainage is
as effective as ACBT in clearing secretion and improving lung function
• GE Wilson et al has concluded in their study that the Active Cycle of
Breathing appears to be more effective than traditional methods of
physiotherapy
• Cecins NM et al has concluded in their studies that the ACBT
in the horizontal position is a simple airway clearance regimen suitable for
individuals who produce greater than 20 gm of sputum per day
9. HYPOTHESES
• Based on the literature review available supporting the effect
of Autogenic Drainage and Active cycle of Breathing
Technique. It is necessary that the study is done on unbiased
null hypotheses which could be stated as
“There is no significant difference between Autogenic
Drainage and Active Cycle of Breathing Technique in
maintaining bronchial hygiene in patients with chronic
obstructive pulmonary diseases”
10. MATERIALS
• MATERIALS
The study aims to use two advanced techniques of cardio respiratory
physiotherapy namely ACTIVE CYCLE OF BREATHING TECHNIQUES &
AUTOGENIC DRAINAGE
ACTIVE CYCLE OF BREATHING TECHNIQUE: It has three components in a set
cycle
1.Relaxation and breathing control
2.Thoracic expansion techniques
3.Forced expiration Technique
This cycle is repeated until the huff becomes dry or is non-productive or 20
minutes
13. MATERIALS
• AUTOGENIC DRAINAGE
• It is also known as anti dyspnea technique and is based on quiet expiration
in a relaxed state
• It has 3 phases
• Unstick phase: in this phase quiet inspiration and breath hold is followed
by deep exhalation in the expiratory reserve volume range
• Collection phase:in this phase breathing takes place at low to mid lung
volume, intensity of breathing is at expiratory reserve and inspiratory
reserve volume range, helps to move secretion to central airways
• Evacuation Phase: in this phase breathing level is at mid to high lung
volume, deep inspiration in the inspiratory reserve volume range is
followed by huffing which thereby helps in removing the secretion
15. STUDY DESIGN
• This study is conducted in the format of EXPERIMENTAL PRETEST
POST TEST MULTIVARIATE STUDY DESIGN
• Group I : These patients received Active Cycle of Breathing
Technique apart from conventional physiotherapy
• Group II : these patients received Autogenic Drainage apart from
conventional physiotherapy
• STUDY SETTING: The study was carried out in the department of
Pulmonology and Critical are, Sri Ramakrishna Hospital Coimbatore
16. METHODOLOGY
• DURATION OF STUDY :The study was conducted for a duration of three months
• Sampling: subjects were selected by systematic random sampling
Patients with a clinical diagnosis of COPD were assigned to group I and group II.
Each group had 10 patients each.
• INCLUSION CRITERIA: All patients referred for physiotherapy with diagnosis of
COPD were included in the study
• EXCLUSION CRITERIA:
1.Patient with cardiac disorder
2.Patient with infectious disease
3.Patients with neuromuscular and musculoskeletal disorder for which exercise
modification are required
17. STATISTICAL TOOLS
• The study was conducted in a pretest-postest study design with a
multi variate format. The parameters recorded were
1.Peak Expiratory flow rate
2.Dyspnea Grade
3.Chest expansion
4.Pre and post exercise pulse rate and blood pressure
5.Post exercise rate of perceived exertion
6. Six minute walking distance
18. STATISTICAL TOOLS
To analyse these variables ,two tailed ANOVA F–test between the pre
and post values of same group performed to establish the effect of
F-test
19. STATISTICAL ANALYSIS
Data collected were analyzed and the mean value, standard deviation and two
tailed ANOVA F test were performed
The two tailed ANOVA F test ratios calculated showed Table values of F=4.2839 at
P=0.05. The F ratio calculated were not significant. Based on these results the null
hypotheses has to be accepted
Techniques PEFR BP RPE DI C.EXP 6MWD PR TOTAL
ACBT 0.69 8 1.05 1.2 0.734 311.5 3.2 326.374
AD 0.47 8 1.4 0.7 0.586 326.1 3.2 340.456
TOTAL 1.16 16 2.45 1.9 1.32 637.6 6.4 666.83
21. RESULTS
The mean value calculated for
• PEFR showed 0.9 in ACBT and 0.47 in autogenic drainage,
• whereas for BP it showed a value of 8 for both the techniques.
• In calculating the value for rate of perceived exertion it shows 1.05 for ACBT
and 0.7 for AD.
• Chest expansion showed a value of 0.734 for ACBT and 0.586 for AD.
• Six minutes walking distance recorded a value of 311.5 n ACBT and 326.1 in
AD.
• Pulse rate showed values of 3.2 in ACBT and autogenic drainage.
In general, the parameters recorded higher levels of improvement in autogenic drainage than ACBT
though it was not significantly evident in the F Ratio
22. RECOMMENDATION
Based on the outcome of the statistical analysis it is suggested that the future studies should
be modified to accommodate the following changes
1. Larger sample size and a long term follow up to analyze the effect.
2. more objective parameters could be utilized in recording the efficacy of these
parameters and their difference analyzed for variation
3. To apply the techniques in lung disease other than COPD and comparing their efficacy.
23. CONCLUSION
In prudence to the above discussion and analysis of the outcome it is suggested that though Autogenic Drainage produces
benefits in treating Chronic Obstructive Pulmonary Disease, it is not significant to produce any added benefit by itself
when compared with Active Cycle of Breathing Technique.
it should be emphasized that six minutes walking distance and dyspnea index showed significant increase in autogenic
drainage and this means that a better improvement in functional status is expected at least as far as Exercise Tolerance is
concerned.
Since the F ratio does not record any significant variation, the study is concluded by accepting the null hypotheses which
is stated as There is no significant difference between Autogenic Drainage and Active Cycle of Breathing Technique in
maintaining Bronchial Hygiene in patients with Chronic Obstructive Pulmonary Disease.
24. REFERENCE
• 1.Shen M, Li Y, Ding X, et al. Effect of active cycle of breathing techniques in patients with chronic obstructive pulmonary disease: a
systematic review of intervention. European Journal of Physical and Rehabilitation Medicine. 2020 Oct;56(5):625-632. DOI:
10.23736/s1973-9087.20.06144-4. PMID: 32397703.
• 2. Mckoy NA, Wilson LM, Saldanha IJ, Odelola OA, Robinson KA. Active cycle of breathing technique for cystic fibrosis. The
Cochrane Database of Systematic Reviews. 2016 Jul;7:CD007862. DOI: 10.1002/14651858.cd007862.pub4. PMID: 27378490;
PMCID: PMC8682958.
• 3 McCormack P, Burnham P, Southern KW. Autogenic drainage for airway clearance in cystic fibrosis. The Cochrane Database of
Systematic Reviews. 2017 Oct;10:CD009595. DOI: 10.1002/14651858.cd009595.pub2. PMID: 28984368; PMCID: PMC6485652.
• 4. Grillo LJF, Housley GM, Gangadharan S, Majid A, Hull JH. Physiotherapy for large airway collapse: an ABC approach. ERJ Open
Research. 2022 Jan;8(1). DOI: 10.1183/23120541.00510-2021. PMID: 35211621; PMCID: PMC8864626.
• 5. Savci S, Ince DI, Arikan H. A comparison of autogenic drainage and the active cycle of breathing techniques in patients with
chronic obstructive pulmonary diseases. J Cardiopulm Rehabil. 2000 Jan-Feb;20(1):37-43. doi: 10.1097/00008483-200001000-
00006. PMID: 10680096.
• 6. Miller S, Hall DO, Clayton CB, Nelson R. Chest physiotherapy in cystic fibrosis: a comparative study of autogenic drainage and the
active cycle of breathing techniques with postural drainage. Thorax. 1995 Feb;50(2):165-9. doi: 10.1136/thx.50.2.165. PMID:
7701456; PMCID: PMC473916.
• 7. Pereira JS, Lemos FA, Di Naso FC, Krüger R, de Oliveira A, Knorst MM, Dias AS. Effect of 6-minute walk test on neuromuscular
properties of patients with chronic obstructive pulmonary disease. Clin Respir J. 2017 Nov;11(6):812-819. doi: 10.1111/crj.12420.
Epub 2015 Dec 28. PMID: 26620735.