Apical Segment
Patient sitting leaning back at a 45 degree angle, Percuss below clavicle
Right and Left anterior Segments
Patient is supine (flat face up) with the bed flat, percuss above the nipple
Lingular Segment
Patient is positioned 1/4 turn from supine and resting on right side with foot of the bed elevated 12 inches. Area to percuss is just above the left nipple and under the armpit
Right Middle Lobe
Patient is positioned 1/4 turn from supine resting on left side with the foot of the bed elevated 12 inches. percuss just above the right nipple and under the armpit
Left and Right anterior basal segments
Patient is supine with the foot of the bed elevated 18-20 inches, percuss over lower ribs
Left Lateral basal segment
Patient is positioned on right side with foot of the bed elevated 18-20 inches. Percuss over the lower ribs
Right Lateral Basal Segment
Patient is positioned on left side with foot of the bed elevated 18-20 inches . Percuss over lower ribs.
Apical Posterior segments
Patient is sitting leaning forward at a 45 degree angle. Percuss above the scapula with the fingers extending up onto shoulders
Posterior segment of left upper lobe
Position the patient 1/4 turn from prone (laying flat with face down) and resting on the right side with the head of the bed elevated 18 inches. Percuss over left scapula.
Posterior segment of the right upper lobe
Position the patient 1/4 turn from prone and resting on the left side with the bed flat. Percuss just above the right scapula
Left and Right posterior basal segments
Patient is positioned prone with the foot of the bed elevated 18-20 inches. Percuss over lower ribs
Superior Segments
Position the patient prone with the bed flat. Percuss just below the lower margin of the scapula
necessity of performing postural drainage
Removes mucus, important for the prevention of diseases like pneumonia and bronchiectasis
Postural drainage after meals
Postural drainage should not be performed directly after meals as there is a risk that the patient could vomit and aspirate. perform before meals or wait 1-2 hours after patient has eaten.
use of o2 during postural drainage
Postural drainage can increase oxygen consumption. Some physicians give 100% o2. If hypoxemia occurs put patient on 100% o2 stop treatment return patient to original resting position and contact dr.
Risk of Hemoptysis
Lung Carcinoma treated surgically or with radiation therapy. Trendelenburg position is a contraindication
2 factors to utilize during postural drainage
gravity and external manipulation of the thorax
factors to record during postural drainage
subjective response, pulse rate, dysrhythmia, breathing pattern and rate, symmetrical chest expansion, synchronous thoracoabdominal movement, sputum production, mental function, skin color, breath sounds, blood pressure, oxygen saturation by pulse oximetr
Correct setting for g5
ONLY at its low speed setting of 36 cycles per second
Contraindications
All positions are contraindications for ICP, head and neck injury, Active hemorrhage, acute spinal injury, emphysema, bronchopleural fistula, pulmonary edema
factors that can improve cough
Percussion, vibration, varying pressure on applicator, moving the applicator
Most important factor in sputum management
Coughing
Upper Right Lobe
Apical, posterior, anterior
Middle Right Lobe
Lateral, Medial
Lower Right Lobe
Apical, posterior, anterior, superior lingular, inferior lingular
Lower Left Lobe
Superior, Anteromedial Basal, Lateral Basal, Posterior Basal