What is the expected outcome when implementing CPT What are

What is the expected outcome when implementing CPT?

What are the risks of performing CPT? Do the risks outweigh the benefits?

Is the practice of CPT supported by evidence? Are there safe, alternative interventions that the RN can implement to achieve the same outcome as performing CPT? If so, identify at least one (1).

Solution

Ans. a) Chest physiotherapy is used to mobilize or loose secretions in lungs and the respiratory tract. Techniques like chest percussion, postural drainage, vibration are used to clear away the airway secretions,mucus etc. By this technique we expect to move the bronchial secretions to central airways via gravity or external manipulation or via a catheter. Postural drainage is usually the most effective whereas the patient lung segment is positioned nearly perpendicular to the ground as possible and the secretions are moved to central airways for elimination.

b) There are risks involved during chest physical therapy and therapy must be modified according to patients need, tolerance, condition and therapeutic goal. The risks are as follows -

i) oxygen deficiency during drainage.

ii) increased intracranial pressure.

iii) temporary lowering of blood pressure.

iv) bleeding in lungs.

v) pain or injury in ribs.

vi) vomiting.

vii) heart irregularities.

viii) inhalation of secretions into lungs.

c) We can say that risks might outweigh benefits. American Association of respiratory care does not recommend CPT as a part of routine care but encourages early ambulation. It has limited benefit in children with pneumonia.

d) There is not much evidence suggesting CPT is the best technique. Studies suggest that when CPT was employed in pneumonia patients and it did not demonstrate any improvement in signs or symptoms of illness. It is found to be more beneficial in patients with neuromuscular disease. In some other studies they claim that CPT improved respiratory rate, oxygen saturation and reduced the recurrence of lung disease.

e) CPT\'s main use is to remove the secretions collecting in the patient using various methods of suction or clapping or percussion methods, This is usually stressful and painful for the patient. Alternative methods can be making the patient cough out the secretion. He can be turned and positioned to alleviate the secretions from tine to time.