Recent weight loss and current BMI 17. Tumour identified and biopsy taken during colonoscopy, Lives alone, independent with ADL, non-smoker, Acute desaturation this morning requiring increased FiO2, not been out of bed as yet due to reduced blood pressure, otherwise stable, SV FiO2 0.6 via face mask cold humidification RR 12 SpO2 96%, Pain score VAS 2/10 at rest 3/10 on movement/coughing, Epidural analgesia (Bupivacaine and Morphine mix), UO 30 mL/hr +1.5 L cumulative balance to date, Breath sounds throughout, reduced at left base, Reduced expansion left base, no secretions palpable, Day 3 post-laparotomy for bowel resection, Presented to A&E with painful distended abdomen. Predominately a shallow, apical breathing pattern with increased use of accessory muscles. If the initial treatment plan were to be unsuccessful in clearing secretions, how would you modify your treatment? Physiotherapy in Respiratory Care 3rd Edition PDF : An Evidence-Based Approach to Respiratory and Cardiac Management E-BOOK DESCRIPTION This work contains case studies and question-and-answer sections that facilitate student learning. What is this patient’s main physiotherapy problem? Two episodes of frank haemoptysis also reported. All subjects used both circuit A (without a visible manometer) and B (with a visible manometer) in a predetermined random order. Attempted decompression by colonoscopy unsuccessful therefore proceeded to theatre for open procedure. A similar increase was found in minute ventilation, however the pattern of breathing seen during each treatment was very different. It appears that if one of the aims of ambulation is to increase tidal volume, patients may need to be encouraged to augment their tidal volumes. Moving all four limbs, Obese man with barrel shaped chest and large abdomen. Our Respiratory Physiotherapist, Helen van Uem, discusses the types of respiratory conditions we treat and how Respiratory Physiotherapy can help benefit our clients. Over the years, this syndrome has been given several names, including progressive pulmonary collapse, traumatic wet lung, congestive atelectasis, shock lung and many others. How will you resolve this issue? Explain the patient’s drug history in relation to the past medical history. H+ 49.8 nmol/L pCO2 4.87 kPa pO2 10.16 kPa HCO3− 18.0 mmol/L BE –8, UO 35 mL/hr +6 L cumulative fluid balance to date, Breath sounds throughout reduced bibasally, expiratory crackles upper zones, Expansion equally reduced bilaterally, no secretions palpable, Day 7 post-laparotomy for subtotoal colectomy and extensive bowel resection, formation of ileostomy, Emergency admission from A&E in shock with reduced BP, abdominal pain, Unwell for 3–4 days, intermittent diarrhoea and vomiting, Theatre findings – patchy infarction of small and large bowel, Possibly for extubation. This case discusses the essential components of a case report, important issues of respiratory confidentiality, and how authorship should be determined. Patient previously agreed to perform twice daily ACBT in alternate side lying/supine for 20 minutes, but generally non-compliant with suggested airway clearance programme and prescribed medications, Lives at home with parents and sister (non-CF), Unemployed and sedentary lifestyle due to health status, Patient exhausted and only able to clear small amounts of very thick, purulent bronchial secretions with difficulty. Patient previously agreed to perform twice daily ACBT in alternate side lying/supine for 20 minutes, but generally non-compliant with suggested airway clearance programme and prescribed medications, X-ray for Case Study 3 showing hyperinflated, chronic bronchiectatic/fibrotic changes throughout upper and mid zones bilaterally. Learning outcomes Level 1 case study: You will be able to: describe the risk factors describe the disease describe the pharmacology of the drug outline the formulations available, including drug molecule, excipients, etc. Is this patient adequately oxygenated? Stable overnight, difficulty clearing secretions, SV FiO2 0.28 via face mask cold humidification RR16 SpO2 89%, Scoliosis, rotated, hyperinflated, nil focal. Please find here a selection of cases we have assessed and treated. Case studies. No family living locally. Physiotherapist skills and knowledge were enhanced through the acute respiratory assessment, and subsequent treatment of respiratory patient autonomously within the patient’s home. Also demonstrating in-drawing of his lower chest wall on inspiration. A problem-orientated treatment plan may include a combination of a number of interventions such as mobilisation, positioning, breathing techniques (e.g. No lift. It has been proposed that the fast expiratory flows generated during cough clear secretions via mist flow, one type of two-phase gas-liquid flow. The isolation of viruses from acute respiratory infections. Helen has over 15 years experience in providing physiotherapy care,she is HCPC registered and qualified at the … A respiratory assessment is mainly indicated for patients who have undergone surgery, those with medical respiratory conditions, e.g. Under review for lung transplantation assessment. These real examples from the service show the difference good support can make to a person living with a lung condition. A bench test evaluation of simulated tracheal suction. What could be your initial treatment plan for each of these problems? You feel this lady seems a little vague regarding her diagnosis, how will you deal with this issue? A systematic method to aid arterial blood interpretation is identified, together with discussion regarding the importance of interpreting PaO(2) readings in relation to the amount of inspired oxygen a patient is receiving (FiO(2)), the practice of temperate correction and the relationship between standardized and actual bicarbonate readings. Sixty-four nurses and physiotherapists who regularly apply TS to patients in the intensive care units of this hospital. What goals would you hope to have achieved before this patient was discharged home? Share This Paper. In this scenario, which medical and physiotherapy interventions are inappropriate and why? IPPB, CPAP) or more invasive measures (e.g. Tracheobronchial suctioning is a routine practice frequently carried out in intensive care units (ICUs). What are the specific signs of hyperinflation on this patient’s X-ray (Figure 5.1)? Welcome to Respiratory Cases Set #1. CHAPTER FIVE Case studies in respiratory physiotherapy Lead authorJanis Harvey, with contributions fromSarah Ridley, Jo Oag, Elaine Dhouieb, Billie Hurst Case study 1: Respiratory Medicine – Bronchiectasis Out-patient 34 Case study 2: Respiratory Medicine – Lung Cancer Patient 36 Case study 3: Respiratory Medicine – Cystic Fibrosis Patient 38 Case study 4: Respiratory … Following diagnosis, patient was deemed appropriate for a course of chemotherapy, but had limited response to intervention. … Book • Second Edition • 2009 The area of respiratory physiotherapy reaches a number of patient groups, both in the in-patient and out-patient settings. Working within the multidisciplinary team approach, working towards person centred goals with links to the third sector ensure the benefits are … Breathing pattern laboured and has a dry, spontaneous cough. The purpose of case studies is not to imply that their findings can or should be applied to entire patient populations, but rather to highlight unique and challenging situations encountered …