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Chest physiotherapy- CPT – purposes,articles,points to remember

INTRODUCTION

Chest physiotherapy (CPT) refers to a group of therapies used in combination to mobilize pulmonary secretions. CPT is helpful to mobilize or loosen the secretions in the lungs and respiratory tract especially for patients with large amount of secretions or ineffective cough. It includes postural drainage, chest percussion, vibration, coughing and deep-breathing exercises.

Postural drainage performed in conjunction with percussion and vibration encourages peripheral pulmonary secretions to empty secretions by gravity into the major bronchi or trachea and is accomplished by sequential repositioning of the patient.

Percussing the chest with cupped hands mechanically dislodges thick, tenacious secretions from the bronchial walls. Vibration can be used with percussion to enhance secretion mobility or as an alternative to it in a patient who is frail, in pain, or recovering from thoracic surgery or trauma.

PURPOSES

The main purposes of performing chest physiotherapy are:

  • To mobilize the secretions
  • To re expand lung tissue
  • To promote efficient use of respiratory muscles.

POINTS TO REMEMBER

  1. Instruct the patient to always inhale through the nose. This permits filtration, humidification, and warming of air.
  2. Instruct the patient to breathe slowly in a rhythmic and relaxed manner. This will help in complete exhalation and emptying of lungs.
  3. The exercises for draining secretions are usually performed two to four times daily, before meals and at bedtime. Each position for postural drainage is held for 3 to 15 minutes.
  4. The procedure should be discontinued if patient is having symptoms of hypoxemia like tachycardia, palpitations, dyspnea, or chest pain.
  5. Nebulize the patient with Bronchodilators or mucolytic agents before postural drainage and chest percussion to decrease thickness of mucus and sputum thereby enhancing removal of secretions.
  6. Patient should be made comfortable before the procedure and while assuming each positions.
  7. Auscultation of the chest should be performed to determine the areas of needed drainage.
  8. Encourage the patient to deep breathe and cough after performing postural drainage.
  9. Encourage diaphragmatic breathing throughout postural drainage as this helps to widen airways so that secretions can be drained.

ARTICLES

  • Stethoscope
  • Pillows for positioning
  • Gloves
  • Emesis basin
  • Facial tissues/face towel
  • Articles for oral care
  • Kidney tray / Paper bag

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