Respiratory Treatment Guidelines

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

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