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Airway Clearance Techniques

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									Airway Clearance Techniques
   Positioning/Repositioning
• Promotes mobilization of secretions,
  lung expansion, redistribution of
  ventilation, blood perfusion, and
  lymphatic flow
• 3/4 prone
• Prone
• Sitting upright
• Dangling: sitting on edge of bed
• Ambulation
        Autogenic Drainage
• Mucus cleared during breathing exercises
• Coughing is avoided
• Slow, deep inspiration through nose
  – Warms humidified air and prevents cough
• Breath hold for 2-3 seconds
• Exhale to ERV with open glottis but not to
  RV
         Autogenic Drainage
• Phase 1
  – Peripheral unsticking of mucus
• Phase 2
  – Collection of peripheral and apical secretions
• Phase 3
  – evacuation
IRV



TV


ERV


RV    Phase 1   Phase 2   Phase 3
    Active Cycle of Breathing


• Breathing control (BC)
  – Relaxed tidal breathing
• Thoracic expansion exercise (TEE)
  – Inhale from end TV to IRV, i.e., IC with or without
    breath hold f/by relaxed exhalation
• Forced expiratory technique (FET)
  – Inhale to mid lung volumes f/by huff then inhale to
    higher lung volumes f/by huff
IRV




TV


ERV


RV
                   Huff
• Forced expiratory manuever (FET)
• Low to mid lung volumes
• Forced expulsion of air with open glottis
• Lower turbulence and impedence to air
  flow
• Moves EPP more peripherally towards the
  alveoli to reduce airway compression
                 Cough

• Large lung volumes increases lung
  elastic recoil
• High intrathoracic pressure with glottic
  closure increases pleural pressure
• EPP moves downstream towards mouth
  resulting in high resistance to air flow on
  expulsion
• Intraluminal pressure < extraluminal
  pressure resulting in early airway
  closure

								
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