‫أعوذ باهلل من الشيطان الرجيم‬

‫بسم هللا الرحمن الرحيم‬

‫س ْب َحا َن َك الَ عِ ْل َم َل َنا إِالَّ َما‬

‫ُ‬ ‫ْ‬
‫ا‬ ‫و‬ ‫ُ‬ ‫ل‬ ‫ا‬ ‫َ‬
‫ق‬
‫َع َّل ْم َت َنا إِ َّن َك أَ َ‬
‫نت ا ْل َعلِي ُم ا ْل َحكِي ُم‬
‫صدق هللا العظيم‬
Chest Physiotherapy

Prepared by

Dr. Ahmed
Elmarakby
 What is the chest physiotherapy
 Indications of chest physiotherapy
 Objectives of chest physiotherapy
 Contraindications of chest physiotherapy
 Techniques of chest physiotherapy
 Nursing role before and after chest physiotherapy
 Complications of chest physiotherapy
 Chest physiotherapy

It is an a manual techniques that helps to remove patient

mucus from the lungs

• This techniques mobilize or loose secretions in the

airway.
 Cont.,
Chest physiotherapy consists of six technique/maneuvers;

• Turning
• Deep breathing
• Coughing exercises
• Chest Percussion
• Vibration
• Postural drainage.
 Note

 Chest physiotherapy is usually

done in conjunction with other
treatments include:
 Suctioning.
 Nebulizer (Farcolin, Atrovent,
Pulmicort).
 Administration of expectorant drugs
(Acetylcysteine).
 Indications of chest physiotherapy

 Patients with excessive secretions and insufficient

cough to clear secretions.
 Objectives from chest physiotherapy

1. Mobilization and clearance of

airway secretions.
2. Promote ventilation and restoring
effective breathing patterns.
3. Prophylaxis against alveolar
collapse and secondary infection.
4. Re-expansion of collapsed lung.
 Contraindications of chest
physiotherapy

1. Empyema active symptoms

2. Pneumothorax.
3. Active hge.
4. Anti-coagulation (large dose).
5. Uncontrolled hypertension.
6. Increased ICP.
Cont.,

7. Hiatus hernia.
8. Trauma.
9. Flail chest.
 Techniques of Chest Physiotherapy

1. Turning:
 Needed to: Bedridden patient.

 Frequency: Once every two hours

according to turn o'clock

 Action: Permits lung expansion.

1. Frequency: several times a day.
2. Action: Helps break up the secretion in the lungs.
3. Technique:
 Patients sit up right
 Inhale deeply through the nose.
 Then exhale in short puffs or coughs.
1. Frequency: Several times a day for short periods
2. Action:
 Expand the lungs
 Move the loosened mucus.
 Promote distribution of the air into all sections of the lung
3. Technique:
 Sits up right in bed.
 Inhales and pushing the abdomen out to force maximum a
mount of air into the lung.
 Then the abdomen contracted and the patient exhales
 Frequency: several time a day each lung segment for 1:2
min. at a time only on the rib cage.
 Action: break up thick secretions in the lungs.
 Technique; is rhythmically striking of the chest wall with
cupped hands by flexing the fingers and placing the thumb
tightly against the index finger.
Percussion
 Vibration is a manual compression and tremor applied to
the chest wall during exhalation either mechanical or
manual to help break up lung secretion.

 N B. vibration used instead of percussion therapy if the

chest wall is extremely painful
Vibration
1. Action: gravitational clearance of airway secretions
from specific bronchial segments by using different
body positions and may also improve oxygenation.
2. Frequency: Four to six times daily.
3. Technique:
 Patient is placed in trendelenburg position and kept in
this position for up to 15 minutes
Postural drainage
 Contraindications of postural drainage/percussion:-
1. After meals.
2. Hypoxia/respiratory instability.
3. Recent eye surgery.
4. Obesity.
 Complications of Chest
physiotherapy

 Hypoxemia—from suction.
 Increased intracranial pressure (ICP).
 Vomiting and aspiration
 Pain or injury to the ribs.
 Laryngeal edema from suctioning.
 Nursing role before chest physiotherapy

 Assess the patient's vital signs.

 Determine the patient's medications such as:
 Anticoagulant.
 Determine the patient's medical history such as:
 Increased ICP.

 Thoracic trauma and chest surgeries.

 Nursing role after chest physiotherapy

1. Oral hygiene to lessen the bad taste or odor.

2. Reassess patient vital signs.
3. Reassure patient.