Dylan Crake RMT & R.KIN

Pre-Treatment

• Wash hands
• Assist client onto the table
• Teach how to do a productive cough before treatment (if asked in stem)
  • Have client lean forward, or have them seated
  • Tell client to take a deep breath from their abdomen
  • Show client which muscles to use, by doing three huffs when exhaling
  • Ask client to make a “K” sound and that’s how their throat should be when their about to cough
  • Tell client to do a deep inhale, close throat, contract abs, unlock abs and perform TWO sharp coughs
  • Perform first, then have the client try.
  • Tell the client to stop if they get a headache

Positioning

• Anterior lobe, apical: Elevate supine
• Anterior lobe, medial : Side-lying on left, slight decline, 1 pillow
• Anterior lobe, lingual : Side-lying on right, slight decline
• Anterior lower lobe : Supine, declined ( 2-3 pillows)
• Posterior lobe, apical : Prone, elevate
• Posterior lobe, medial : Side-lying on left, slight decline
• Posterior lobe, lingual : Side-lying on, slight decline
• Posterior lobe, lower : Prone, decline

Specific Treatment

• Rib mobilization
  • Perform over area
  • Communicate to do deep breaths
  • Perform 2 smooth rib mobilizations, 2 vibrations techniques at rubs, 2 jostling techniques at ribs
• Percussive
  • Communicate they may feel like they’ll need to cough, tell them about the garbage pale and napkins in the end
  • Perform 5 techniques: cupping, beating, pounding, loose hacking, firm hacking
  • State you’ll be doing it for 3 -5 minutes
  • Communicate about pressure
• Muscles to treat
  • Anterior : SCM, scalenes, upper traps, rhomboids, pectoralis major and minor, subclavius, serratus posterior superior
  • Medial: Serratus anterior, intercostals, QLs, serratus posterior inferior, lattissimus dorsi, erector spinae
  • Posterior : QL, intercostals, diaphragm, erector spinae, lattissimus doris
• Assisted Expiration
  • Pressure while they expire
  • Smooth x 2
  • Vibration x 2

Post Treatment

• Ask client to cough and get the garbage bin and tissue for them