Procedures unit 4

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Cough and breathing

why do we cough

coughing is a pulmonary defense mechanism that attempts to maintain the airway, It is the major defense mechanism against retained secretions, the cough mechanism is often destroyed or inadequate in pulmonary disease ( commonly from destruction of cillia)

weak patients should cough how

have the patient draw in several breaths, holding each until a larger volume is attained

series of three coughs

patient starts with a small breath and a small cough, then bigger breath and harder cough, and finally a really deep breath and a hard cough

cough twice in one breath

patient takes a deep breath and coughs twice with the air from that breath

Modified heimlich maneuver

an assisted cough is used with patients suffering from neuromuscular disorders that cause the cough mechanism to be ineffective (quadraplegia, paraplegia, guillainbarre, myasthenia gravis) the manuel compression is applied to the abdomen and lateral thorax at the exact time the patient reaches peak inspiratory effort

controlled cough

patient takes three deep breaths, at the end of the third breath the patient is encouraged to perform two hard coughs this technique increases the volume available for a more effective cough

huff cough

patient generates pressure from deep in the lungs it is often used in conjuction with autogenic drainage technique

slinting

supporting a surgical incesion or injured area with hands, pillow or blanked patiens with abdominal surgery should bend knees and splint incesion

sniffing

patient is instructed to take a deep breath at the end of maximal inspiration the patient is instucted to sniff additional air sniffing used the diphragm

perched lip breathing

for patients who experinece premature airway closure (COPD or ashma) patiens should be instructed to inahlae through the nose and exchal through perched lips

diaphragmatic breathing

teaches patient to use diaghpram rather than excessory muscles

segmental breathing

breathin is concentrated over specific lung area affected by atelectasis, secretions or decreased airflow

autogenic drainage

concentrated breathing technique used to direct secretions to central airways patient takes shallow breaths, working up to deeper breaths as secretions move to the larger airways while suppressing the need to cough used mostly with CF patients it is a very time consuming and difficult technique to teach and to learn therefore it is seldom used in most hospitals however when done correctly it is very effective

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