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Friday, November 13, 2015

Physiotherapy and PROCEDURE: Manual techniques for the removal of bronchial secretions: vibrations and shaking

The application to the thorax of a rhythmical compression force in the direction of airflow. Movement occurs throughout the expiratory phase of respiration. The minimum effective compression force is applied, normally for a period of 3-5 respirations, interspersed with adequate periods of breathing control.
Vibrations are a smaller grade of the same movement carried out is a similar way.

-           prolonged history of use of steroids
-           metabolic bone disease e.g. osteoporosis, rib metastases
-           predisposition to paroxysms of coughing
-           presence of wheeze
-           predisposition to bronchial hypersensitivity
-           subject intolerance
-           thoracic burns
-           application directly over rib fractures
-           frank haemoptysis
-           low platelet count

-           a rigid & non-compliant thorax
-           increased bronchial constriction
-           precipitated paroxysm of coughing
-           breathlessness
-           pulmonary carcinoma (unless specifically indicated)

-           management of expectorated products
-           hand hygiene
-           appropriate disposal of clinical waste

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