Airway Clearance Techniques

Thanks for checking out the first blog post in this series about respiratory interventions for Rehab Clinicians!

Airway Clearance Techniques (ACTs) are best practice for patients who are in acute exacerbation, sub-acute exacerbation, or are stable with obstructive lung conditions.
Long-term management of obstructive lung disorders including cystic fibrosis, COPD, bronchiectasis, and chronic bronchitis, and those with impaired cough including ALS, SCI, and post lung transplant should include instruction in ACTs.

Pulmonary Hygiene takes a team – reinforce regular performance of ACTs!

I have a special treat for you!

I created this a while back. All you MDTs out there will love it. This is a force progression (backed with evidence!) for applying, combining, and progressing airway clearance techniques. It starts out with the patient providing their own forces from the inside and outside, then adds the external forces you can apply as a part of your airway clearance techniques.

Brockway, K. (2017) Pulmonary hygiene toolbox – force progression tips
(Original content)

Tips for airway clearance techniques:

  • These are considered AGPs (Aerosol generating procedures)! Therefore, they require full PPE and an N95 mask per the CDC guidelines when performing with a patient with known or suspected COVID-19 (or any other viral infection of the lungs).
  • Always consider changing positions to utilize postural drainage positions to encourage increased secretion mobility.
  • When implementing oscillatory devices, keep in mind that not all oscillatory devices can be inverted or turned sideways and continue to function (such as the Aerobika). However, some can do this easily (like the Acapella).
  • Have tissues ready! My friends in ICU tend to use a cup. Secretion color and consistency matter and can tell you really important things!

Don’t forget about other tools in your toolbox!

  • Increase water intake: This thins secretions so they are more mobile.
  • Increase overall mobility: increasing mobility means increased respiratory rate and depth which natural mobilizes secretions.
  • Change positions frequently: utilizing postural drainage positions or just changing positions frequently throughout the day reduces consolidation.
  • Utilize Mucolytics: for very thick secretions and/or patients who are not mobile to improve secretion consistency for better mobilization and expulsion.

So that’s just the intro! Come back often to find all kinds of great techniques and information to update your skills and get you ready to practice in the cardiopulmonary setting!

More from the Pulmonary Rehab Toolbox…

Vibration and Percussion

Physical therapists are well known as the people who use their hands to promote healing (and also as the “mean ones who make me exercise”). Using our hands to support optimal respiratory function is just another piece of the manual therapy skillset. If you read my post on airway clearance techniques, you probably saw vibrationContinue reading “Vibration and Percussion”

Spilling the Box of Pearls: All the Tips on Supplemental Oxygen Management

In my recent post on COPD management, I mentioned that there are some really important parts of supplemental oxygen management that you need to be aware of and consider in your practice. If you are assisting patients who utilize supplemental oxygen regularly, you need to keep these things in mind. You also may be workingContinue reading “Spilling the Box of Pearls: All the Tips on Supplemental Oxygen Management”

Chronic Disease Part 2: Chronic Obstructive Pulmonary Disease (COPD)

This is part 2 in a multi-part series on the role of Rehab Providers in the management of chronic disease. Don’t forget to check out Part 1: Heart Failure! Chronic Obstructive Pulmonary Disease is a widely diagnosed disease of the lungs that includes the diagnoses of emphysema and chronic bronchitis. COPD can be caused byContinue reading “Chronic Disease Part 2: Chronic Obstructive Pulmonary Disease (COPD)”

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