Week8 - Secretion Clearance Workshop

Question 1

What are three components to ACBT?

Answer 1

Controlled breathing, Deep breathing and FET.

Question 2

What are the two techniques used in FET?

Answer 2

Cough and Huff.

Question 3

What are five measures used in cough Ax?

Answer 3

Subjective from patient, Inspiratory, Glottic closure, Expiratory, Audible and Measurable.

Question 4

Recall what the cough assist machine is called.

Answer 4

Mechanical Insufflation-exsufflation (MI-E).

Question 5

When is MI-E indicated?

Answer 5

When the Cough Peak Flow (CPF) is <180L/min, it can then be used to augment.

Question 6

What are three C/Is to MI-E?

Answer 6

Surgical emphysema, Pneumothorax and Barotrauma.

Question 7

What are two precautions to MI-E?

Answer 7

History of pneumothorax or CV insufficiency.

Question 8

What pressures does the Phillips E70 Cough-Assist machine move between?

Answer 8

+40 to -40 cmH2O.

Question 9

Should a cough assist machine be utilised in any scenario where the patient can not reproduce sputum?

Answer 9

No, a formal cough Ax should be done first for efficacy and strength, and only used for those who have low CPF.

Question 10

What part of the airways does a low volume huff target, and how is it cued?

Answer 10

More distal airways; Normal breath then long huff out.

Question 11

What part of the airways does a high volume huff target, and how is it cued?

Answer 11

More central airways; Normal breath then short and sharp huff out.

Question 12

What is the ideal FET procedure for huffing?

Answer 12

Two low huffs, two medium then two high, then finish with a cough.

Question 13

Run through the full ACBT procedure.

Answer 13

20-30s of controlled breathing –> 3-4 deep breaths –> controlled –> deep –> controlled –> FET( huffing procedure then cough).

Question 14

When should you continue ACBT until?

Answer 14

Two rounds have been clear in a row.

Question 15

What do you need to be aware of when completing manual techniques on a patient?

Answer 15

Your own posture/positioning.

Question 16

What are manual techniques usually used as an adjunct with?

Answer 16

ACBT and Mobilisation.

Question 17

How could you describe the technique of a vibration?

Answer 17

Compression and oscillation on an expiratory breath.

Question 18

What is the main technique in postural drainage?

Answer 18

Target lung and lobe is uppermost.

Question 19

Recall the devices and types of PEP that can be used as adjuncts.

Answer 19

Aerobika, Acapella, Flutter, Oscillating, Non-oscillating and Bubble.

Question 20

What is the first and essential step prior to conducting a suctioning procedure?

Answer 20

Hand hygiene, PPE and Consent.

Question 21

Why is it recommended to pre-oxygenate prior to a suctioning procedure?

Answer 21

The procedure can decrease O2 in some patients - Evidence supports an FiO2 0.2 above baseline is sufficient.

Question 22

How long should the general suctioning procedure take?

Answer 22

15 seconds.

Question 23

What is the ideal pressure when performing the suctioning procedure?

Answer 23

150mmHg or 20kPa in adults for both closed and open suctioning.

Question 24

Recall the two types of open suctioning techniques.

Answer 24

Oropharyngeal/Guedel or Nasopharyngeal.