ABSTRACT Effectiveness of Mechanical Vibrator for Chest Physiotherapy in Ventilated head & spinal injured patients Shiny Thomas, Deepak Agrawal Department of Neurosurgery, JPNA Trauma Centre, AIIMS, New Delhi Background: Chest infection is one of the major factor in morbidity & mortality in ventilated head & spinal injured patients. It is hypothesized that mechanical vibrators may help in improving the quality & frequency of chest physiotherapy in these groups of patients. Aims & Objectives: To assess the decrease (if any) in chest infection rates & mortality in ventilated patients with head & spinal cord injury who received mechanical vibrator chest physiotherapy. Materials & methods: This retro-prospective study was carried out in all ventilated head & spinal injured patients over 6 months in Neurosurgery ICU. The clinical (demographics, admission GCS & in hospital mortality) & microbiological data (Modified tracheal culture) was collected over the two time periods. The ‘control’ group consisted of patients in whom data was retrospectively collected from January 2011 to March 2011 (before the introduction of Vibrators). The ‘test’ group consisted of patients in whom data was prospectively collected from April 2011 to June 2011 (following introduction of Vibrators). All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly. Results: A total of 575 patients were evaluated in the study. Both Control & test groups were well matched with respect to [p<0><0.01). Conclusions: Use of mechanical vibrators by nurses for chest physiotherapy can dramatically improve outcomes & chest infection rates in ventilated head & spinal injury patients. We recommend their use as standard of care for ventilated patients.

1. EFFECTIVENESS OF MECHANICAL VIBRATOR FOR CHEST PHYSIOTHERAPY IN VENTILATED HEAD & SPINAL INJURED PATIENTS Ms. SHINY THOMAS STAFF NURSE NEUROSURGERY ICU JPNATC, AIIMS New Delhi

5. MATERIALS & METHODS

6. MATERIALS & METHODS

7. MATERIALS & METHODS All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly.

9. MODIFIED TRACHEAL CULTURE

12. CONTROL GROUP TEST GROUP VENTILATOR DAYS

13. 8.3% 10.63% 15.84% PERCENTAGE OF TRACHEAL CULTURE POSITIVE PATIENTS CONTROL GROUP TEST GROUP

15. CONTROL GROUP TEST GROUP MORTALITY RATE IN PERCENTAGE 31.48% 15.84%