Best way to remove a phlegm in adult

AirwayClearance Techniques

Bismillahirahmanirahim , i would like to share this info regarding method and tips to remove out of phlegm.

Type and technique to Clear Secretions

·         Hydration

·         Humidification

·         Nebulisation

·         Mobilisation

·         Breathing exercises

·         Postural drainage

·         Manual techniques

·         ACBT

·         Autogenic Drainage

·         Mechanical aids

·         Cough

·         Naso-pharyngeal suction

·         Mini-tracheotomy

·         Pain control

Airway Clearance (ACT)

·         ACT enhances the clearance of excess bronchial secretions.

·         By removing obstructive secretions they aim,in the short term,  to reduce airway obstruction, airway resistance and improve ventilation

·         In the long term delay the progression of some respiratory diseases and maintain optimal respiratory function.

·         Chest physiotherapy is a universally accepted part of respiratory management of disorders such as cystic fibrosis and bronchiectasis.

·         Research into airway clearance techniques has primarily focused on comparing the efficacy of two or more treatment modalities as to achieve  a definitive answer a RCT of treatment versus no treatment would need to be undertaken, which would have ethical implications

Active Cycle of Breathing Technique (ACBT)

·         It was initially described as the forced expiratory technique, and later documented as the ACBT.

·         This technique has been shown to have benificial effects on both airway clearance and lung function

·         It consists of a cycle of breathing adapted to individual need, but with each component of the clearly clearly defined

ACBT – Technique

·         The ACBT are principally used in combination with gravity assisted positioning but equally can be used in modified PD positions or sitting as indicated by the patients needs

Components

Breathing Control

·         This is an integral part of the cycle as it minimises any potential increase in air flow obstruction and maintains oxygen saturation

Forced Expiratory Technique (FET)

·         1 or 2 forced expirations with an open glottis from mid to low lung volumes to mobilise peripheral secretion.

·         When the secretions reach the proximal airways they can be cleared by a huff or a cough at high lung volume

·         This physiological mechanism is explained using the concept of the equal pressure point (EPP),whereby compression of the airway occur downstream to the EPP, I.e. where the pleural pressure equals intrabronchial pressure at a point dependent on lung volume. The EPP moves distally as lung volume falls, hence mobilising peripheral secretions

Wallahuaklam