Clinical Scenario:
You are called at home at 9pm: the patient is a 40 yr old man with autism who was admitted 2 days ago with a large pericolonic abscess. He developed peritonitis and sepsis & had an emergency laparotomy for a perforated jejunum yesterday.
He had significant desaturation today, is suspected to have aspirated post-op and was moved to ICU this evening. He has been requiring 60% FiO2 at 50L/min via HFNP to maintain SpO2 in high 80s.
Stage 1 – Assessment information:
Build further understanding of patient’s clinical picture through the following:
View Clinical notes history of current condition
View Obs Chart
View Drug Chart
View Blood results
View Chest X-ray
Listen to Auscultation
Watch video of patient (actor) not done yet, written details instead:- patient slumped sitting in bed, has midline laparotomy wound, NG tube, awake but unable to communicate, not coughing, doesn’t appear to be in pain
Stage 2 -Treatment Options:
Q: What physiotherapy techniques would you try, to benefit this patient’s situation?
Select options from a standard list of respiratory physiotherapy interventions below: (only some links created so far, others to be created to show possible outcomes to patient’s benefit or detriment)
Active Cycle of Breathing exercises
Bird IPPB
Breathing pattern correction / breathing control
Cough Assist Machine
Expiratory chest wall vibrations / stretch facilitation
Manual hyperinflation
Manually-assisted cough
Mobilisation
Modified postural drainage
Non-invasive ventilation
Percussion
Positioning to affect ventilation
Positive Expiratory Pressure
Suction
Supported cough
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