Cardiopulmonary physiotherapy by M Jones; F Moffatt

By M Jones; F Moffatt

content material: part 1: evaluate instruments part 2: Pathophysiology part three: Physiotherapy thoughts and Adjuncts part four: Case reports and Self-Assessment

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Even simple rib fractures can cause extreme pain. Analgesia is the key element of management, allowing mobilization, effective deep breathing and supported coughing. Appropriately managed, respiratory complications such as atelectasis or pulmonary infection may be minimized. f. pain management). • Multiple rib fractures (more than 2-3 ribs fractured in two places) result in a flail segment, whereby the affected part of the chest moves paradoxically due to instability. This constitutes a significant injury and is often associated with underlying lung contusion.

1992), caused by the peripheral chemoreceptors that are stimulated by a reduced PaO2. However, the increased respiratory rate is rapidly antagonized by the resultant hypocapnia. With time, this negative feedback loop is nullified by the blood-brain barrier active transport system producing shifts in levels of CSF bicarbonate, which normalizes CSF pH and allows ventilation to increase and further raise PO2 levels (Michel et al. 1963). • Arterial blood pH is also returned to normal by renal excretion of bicarbonate ions.

F. ACBT) • CHF patients may have increased symptoms when supine and often present with paroxysmal nocturnal dyspnea. f. control of breathing). f. CPAP, NIPPV). PATHOPHYSIOLOGY 43 Related topics CPAP (p. 76); Exercise training—1 (p. 79); Exercise training in cardiac rehabilitation (p. 82); NIPPV (p. 118); Positioning to relieve breathlessness (p. 131). References and further reading Braunwald E. M. (1997) Evidence-based coronary care. Ann Intern Med 126(7): 551–553. C. H. (2000) ABC of heart failure: Pathophysiology.

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