Chest Physiotherapy (CPT)
Chest Physiotherapy (CPT)
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Chest Physiotherapy (CPT) is one of the common exercises in paediatric units. It is mainly conducted by nurses, respiratory therapists, and respiratory therapists. CPT refers to manual percussion over the posterior and anterior lung fields. This is aimed at loosening secretions from the bronchial walls, facilitating the movement of secretions out of the airways through coughing. This helps clearance of the airways, which decreases difficulty in breathing thus facilitating gas exchange and reduces the length of hospitalization (Lisy, 2014).
Despite its increased application in the paediatric ward, there is insufficient information that supports the effectiveness of these interventions in management of asthma, pneumonia, and bronchiolitis or as a prophylactic therapy for the management of atelectasis. For instance, one study found that use of CPT to manage pneumonia is limited as they lacked defined inclusion criteria, and failed to demonstrate reduction of illness or fever. Similar studies have been found in bronchiolitis. Additionally, CPT is associated with risks including, development of atelectasis, intraventricular haemorrhage, rib fractures and increased pain especially in post-operative patients (Makic, Rauen, Kimmith, and Fisk, 2015).
The healthcare providers have the responsibility to ensure that they deliver cost effective and evidence based care to all the patients. Evidence based research indicates that patient’s CPT tolerance, signs and symptoms must be evaluated before integrating CPT as a potential treatment intervention. In patients with severe or unstable conditions, EBP supports the use of airway suctioning as the most effective strategy for airway clearance. Therefore, there is need to conduct thorough studies focusing on methodological aspects using an appropriate sample size in order to identify evidence that will justify or critique the application of chest physiotherapy in paediatric departments (Lisy, 2014).
References
Lisy, K. (2014). Chest Physiotherapy for pneumonia in children. American Journal of Nursing, 114(5), 16. doi:10.1097/01.NAJ.0000446761.33589.70
Makic, M.B., Rauen, C., Kimmith, J., and Fisk, A. (2015). Continuing to challenge practice to be evidence based. Critical Care Nurse 35(2), 39-50. doi:10.4037/ccn2015693
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