P.T. Plan of Care for Cardiac and Pulmonary Conditions—PTP 673 –Handout I Pulmonary Practice Patterns, Physics, Physiology, & Physical Therapy-Occupational Therapy Barb Bernard Butler, PT, MS PT, DPT, (“Lung Whisperer” per Keri Hutchins, 1976-2010) University of Michigan-Flint July 11, 2013 1
30
Embed
P.T. Plan of Care for Cardiac and Pulmonary Conditions—PTP 673 –Handout I Pulmonary Practice Patterns, Physics, Physiology, & Physical Therapy- Occupational.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
P.T. Plan of Care for Cardiac and Pulmonary Conditions—PTP 673 –Handout I
Pulmonary Practice Patterns, Physics, Physiology, &
Physical Therapy-Occupational Therapy
Barb Bernard Butler, PT, MS PT, DPT,
(“Lung Whisperer” per Keri Hutchins, 1976-2010)
University of Michigan-Flint
July 11, 2013
1
2
Our Job: Improve O2 Transport
• Pulmonary History? Red Flags: “If you can’t breathe, you can’t function” & “Function trumps structure”.
• “Screen Cardio-Vascular-Pulmonary Systems first!– imaging, labs, meds, tests
HOW DO YOU KNOW YOU DID YOUR JOB? (EFFECTS OF O2 TRANSPORT FOR THE BETTER?)
• Changes in heart rate• Changes in blood pressure• Changes in O2 saturation• Changes in ECG (rhythm & pattern)• Changes in blood gases• Changes in respiratory rate & pattern• Changes in symptoms
– (e.g., measures of the hidden impairments)
22
Pulmonary Common Hierarchy “Screen the Hidden Impairments First”
• 1. Activity & exercise• 2. Body positioning• 3. Breathing control
maneuvers• 4. Coughing
maneuvers• 5. Relaxation &
energy conservation maneuvers
• 6. Exercise throughout the ROM
• 7. Gravity assisted postural drainage
• 8. Manual / device airway clearance modalities
• 9. Suctioning(--adapted from Dean &
Frownfelter 3rd study guide)
23
“Caring for your Lungs”
Frequent position change– In bed, include prone, ¼ from prone, ¼ from supine
Stretch, twist, bend• Swallow correctly; avoid reflux• Aerobic exercise; lots of fluids; good diet• Avoid aerosols; avoid airway infections• No smoking; avoid / prevent air pollution• Avoid hard exhalation / cough spasms
– emphasize relaxed in-breaths
24
Key Findings
Pattern A
• Prevention / Risk Reduction– Functional work capacity– Max. aerobic capacity– Dyspnea on exertion– Sedentary job / role– Client knowledge– Central vs. peripheral
impairments
Pattern H
• Lymphatic System Disorders– Perceived body image– Difficulty dressing– Edema– Skin integrity– Pain