Chest Physiotherapy

Indications of Chest Physiotherapy

1. to mobilize and eliminate secretions, reexpand lung tissue, and promote efficient use of respiratory muscles in patients who expectorate large amounts of sputum, such as those with bronchiectasis and cystic fibrosis and in those with artificial airway (tracheostomy &ET)

Indications of Chest Physiotherapy

2. Helps prevent or treat atelectasis in bedridden clients and may also help prevent pneumonia.

Contraindications of Chest Physiotherapy

- Active hemorrhage with hemodynamic instability

- Active pulmonary bleeding with hemoptysis

- Acute asthma or bronchospasm

- Bony metastasis

- Bronchopleural Fistula

Contraindications of Chest Physiotherapy

- Conditions with increased intracranial pressure (ICP) such sa hemorrhagic stroke

- Fractured ribs, flail chest or an unstable chest wal

- Empyema, lung abscess or tumor

- Lung contusions

- Pulmonary tuberculosis

Contraindications of Chest Physiotherapy

- Recent myocardial infarction

- Recent head injury or spinal cord injury

- Recent spinal & intracranial surgery

- Uncontrolled hypertension

- Unstable head or neck injury

- Untreated pneumothorax

uppermost

lung segment to be drained

postural drainage

performed by positioning client properly

percussion and vibration

done over affected lung segment to loosen secretions

Special Considerations

- modify chest physiotherapy according to the patient's condition

- Maintain adequate hydration to prevent mucus dehydration and promote easier mobilization.

- AVOID performing postural drainage immediately before or within 1 1/2 hours after meals to avoid nausea, vomiting, and aspiration of food or vomitus.

Special Considerations

- Because chest percussion can induce bronchospasm, any adjunct treatment (for example, intermittent positive-pressure breathing, aerosol, or nebulizer therapy) should precede or be carried out BEFORE chest physiotherapy.

- REFRAIN from percussing over the spine, liver, kidneys, or spleen to avoid injury to the spine or internal organs.

- avoid performing percussion on bare skin or the female patient's breasts.

Special Considerations

- Percuss over soft clothing (but not over buttons, snaps, or zippers), or place a thin towel over the chest wall.

- remove jewelry that might scratch or bruise the patient.

- Explain coughing and deep-breathing exercises preoperatively so that the patient can practice them when he's pain-free and better able to concentrate.

- Postoperatively, splint the patient's incision using your hands or, if possible, teach the patient to splint ti himself to minimize pain during coughing.