Cardiopulmonary Physiotherapy in Trauma by Morrow Brenda Van Aswegen Heleen & Brenda Morrow

Author:Morrow, Brenda,Van Aswegen, Heleen & Brenda Morrow
Language: eng
Format: epub
ISBN: 9781783266531
Publisher: World Scientific Publishing Company
Published: 2015-12-15T00:00:00+00:00

6.9.1.1. Discussion

6.9.1.1.1. Precautions and contraindications

Regarding her pulmonary system, it would be important to ensure that bronchodilator therapy was administered to address her bronchospasm prior to the use of manual chest clearance techniques. Manual chest percussion and shaking should not be used over acute burn wounds on the chest wall; gentle manual vibrations may be used but ensure firm pressure of the physiotherapist’s hands against the chest wall to avoid any sliding friction on the open wounds, which may increase bleeding. In the case of a skin graft on the chest wall, no manual chest therapy techniques may be used until the skin graft has taken; in this instance MHI or VHI to mobilise and clear excessive retained secretions might be a better option. Ensure that a pressure manometer is placed in the MHI circuit to monitor the amount of pressure administered to the airways, especially in the case of inhalation injury. Ensure that the patient is pre-oxygenated at 100% prior to suction and that a sterile suction procedure is used.

In relation to her neuromusculoskeletal system, it is important to assess the amount of bleeding that occurs after debridement; if bleeding is excessive, physiotherapy rehabilitation should be postponed until bleeding is under control. In the case of skin grafting, the graft area should be immobilised to allow the graft time to take. The duration of immobilisation should be discussed with the plastic surgeon to guide rehabilitation intervention.

It is also important to communicate regularly with the nursing staff to ensure optimal analgesia during physiotherapy treatment sessions. The patient’s response to physiotherapy interventions should be monitored closely during each treatment session, and adverse responses should be addressed rapidly with the assistance of the nursing and medical personnel.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.