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

Procedure : Manual Vibration and Shaking

DEFINITION/DESCRIPTION:

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.

CONTRAINDICATIONS:

-           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

HAZARDS/COMPLICATIONS/PRECAUTIONS:

-           a rigid & non-compliant thorax

-           increased bronchial constriction

-           precipitated paroxysm of coughing

-           breathlessness

-           pulmonary carcinoma (unless specifically indicated)

INFECTION CONTROL:

-           management of expectorated products

-           hand hygiene

-           appropriate disposal of clinical waste