Question

A 72-year-old man who has COPD from working as a coal miner has pneumonia in his right lower and middle lobes. To help mobilize and drain the secretions, chest physiotherapy (CPT) is prescribed. The patient only wants to sit in bed because it is easier for him to breathe when in the semi-Fowler’s position.

What positions are the most important for successful CPT? What can you do to aid him during the treatments?

Make a simple illustration of the patient’s position and list down the ways you can assist him during these treatments (minimum of 5).

Answer 1

Chest physiotherapy is the term for a group of treatments designed to eliminate secretions cpt has two parts, postural drainage and percussion. The postural drainage ( gravity assisted drainage) needs the best positions to remove the secretion from a particular part of lung, percussion helps to mobilize the secretion.

Depending on the anatomical angle of the lobes or segments of the lungs to be drained the patient may be placed in sitting, prone, supine, side lying or in a head down tilt of between 15 and 30 degrees.I will help him in given the right postion to drain the secretion and after that I will do the percussion / vibrations to mobile the secretion and then tell the pt to cough and remove the section .

Assume pt is in side lying postion for darining section from the middle lobe, I will teach the pt to remain in such position for at least 30 mints, I will put the pillow under his hip .