Question

Describe all the postural drainage positions for a chest physical therapy rehabilitation process for high accumulation of mucus in the lung lobes.

This is a physio question. There were no physio options under the subject section so this is why i clicked on nursing

Answer 1

Postural drainage uses gravity to drain secretions from segments of the lungs. It may be combined with chest physiotherapy (percussion and vibration over thorax to loosen secretions in lungs).

The lungs are divided into 5 lobes with three on the right lung and two on the left lung. There are 18 segments in the lungs, which can be drained by 18 positions.

The purpose of each poition is to drain each segment towards the larger airways.

Postural drainage positions

Upper Lobes
Posterior Segment	o Patient leans forward 30 degrees over the back of a chair (or in bed). Vibration and percussion can be performed over the upper portion of the back on either side, if ordered.
Apical Segment	o Patient leans backward 30 degrees. Vibration and percussion can be performed between the clavicle and the top of the scapula on either side, if ordered.
Anterior Segment	o Patient lies supine with a pillow under the knees, which enables the abdominal muscles to relax and makes breathing easier. Vibration and percussion can be performed between the clavicle and nipple of a male patient on either side, if ordered. It may not be possible in a female patient.
Right Middle and Left Lingual
Right Lateral and Medial Segments	o Same position is used to drain both lobes. o Patient lies one-fourth turn up from the back-down position and a pillow may be placed between flexed knees. o The foot of the bed is elevated 15 degrees (14 inches). Vibration and percussion can be performed below the right nipple area in a male patient, if ordered. It may not be possible in a female patient.
Left Superior and Inferior Lingual Segments	o Same position is used to drain both lobes. o Patient lies one-fourth turn up from the back-down position and a pillow may be placed between flexed knees. o The foot of the bed is elevated 15 degrees (14 inches). Vibration and percussion can be performed below the left nipple area in a male patient, if ordered. It may not be possible in a female patient.
Lower Lobes
Posterior Basal Segment	o Patient lies face down on the bed with the pillow between hips. o The foot of the bed is elevated 30 degrees (18 inches). Vibration and percussion can be performed over the appropriate lobe, if ordered.
Lateral Basal Segment	o Patient lies one-fourth turn up from the face-down position on the opposite side of that which is needed to be drained. o The foot of the bed is elevated 30 degrees (18 inches). Vibration and percussion can be performed over the postero-lateral areas of the lower ribs, if ordered.
Anterior Basal Segment	o Patient lies straight up on their opposite side of that which is needed to be drained. o The foot of the bed is elevated 30 degrees (18 inches). Vibration and percussion can be performed over the lower ribs below the axilla, if ordered.
Superior Segment	Patient lies face down on the bed with a pillow beneath the hips. The bed is in the flat position. Vibration and percussion can be performed in the middle of the back below the scapula on whichever side is needed, if ordered.

The modified postural drainage positons includes the following;

• Anterior upper
• Posterior upper
• Apical upper
• Lingula
• Right middle
• Superior lower
• Lateral basal lower
• Anterior basal
• Posterior basal lower

Guidelines for Postural drainage

• Position the client with the lung segment to be drained in the uppermost position.
• Procedure can be best done early morning on arising, one hour before meals or 2 - 3 hours after meals.
• Maintain position 5 to 20 minutes after procedure.
• The degree of slope can be obatained with pillows, blocks, books, or a tilt board.
• Provide mouth care after procedure.
• Stop prosedure if cyanosis or exhaustion occurs.
• While in the positions, try to breathe in through your nose and out through your mouth for longer than you breathe in for maximum effectiveness.