here i explained about some of airway clearance technique with some animation videos

1. PRACTICAL CONSIDERATION
IN AIRWAY CLEARANCE-
VIEW OF THERAPIST
Manivel Arumugam.
Senior physiotherapist

2. Why this topic?
• During mechanical ventilation
• Weaning and extubation planning
• During weaning failure or extubation failure
• Selection of techniques based on patients
conditions
• How to prescribe ACT in ICU?

3. Airway clearance techniques
• Need of airway clearance
• Basics of airway clearance
• Indications of airway clearance
• Techniques
• Current trends in airway clearance.

4. Basic physiology of airway clearance

6. Indications for airway clearance

9. Extra thoracic manipulation
• Postural drainage
• Chest percussion
• Vibration and shaking
• High frequency chest wall oscillatory device

10. Frequent positioning/
kinesio bed may
alleviate the problems.
But economy/
manpower need more

13. HFCWO

14. Intra thoracic/oral manipulation
• Bagging/ manual hyperinflation
• Intra percussive ventilation
• Cough assist device/ cough insufflators-ex
sufflator

15. IPV
COUGH INSUFFLATOR
EXSUFFLATOR

17. ACTIVE AIRWAY CLEARANCE
DEVICES & TECHNIQUES
PEP THERAPY DEVICES
• ACAPELLA
• FLUTTER
• EZPAP
• CORNET
• QUAKE DEVICE
TECHNIQUES:
• ACTIVE CYCLE OF BREATHING
• AUTOGENIC DRAINAGE
• FORCED EXPIRATORY TECNIQUE

18. ACAPELLA
• Acapella combines the benefits of both PEP therapy and airway vibrations to
mobilize pulmonary secretions and can be used in virtually any position allowing
patients to move freely and sit, stand or recline.
• It improves clearance of secretions, is easier to tolerate than Chest Physical
Therapy (CPT), takes less than half the time of conventional CPT sessions*
• facilitates opening of airways in patients with lung diseases with secretory
problems such as COPD, asthma and Cystic Fibrosis.
• Color-coded units (green for high-flow, blue for low) help customize treatment
for each patient based on their clinical needs.
• Can adjust the Acapella frequency and flow resistance simply by turning an
adjustment dial.

19. • Allows inhalation and exhalation without removing
from mouth
• Prolongs expiratory airflow to increase removal of
secretions
• Allows use with mask or mouthpiece attachment
• Allows use with inline nebulizer when fitted with the
adapter.
• Accommodates virtually any patient’s lung capacity

20. Acapella FLUTTER

21. cornet Quake & Bubble PEP

24. EzPAP-positive airway pressure
system
• The EZPAP positive airway pressure system is used to expand the lungs by
increasing Functional Residue Capacity (FRC). Increasing FRC has been found to
contribute to the prevention and reversal of atelectasis.
• EzPAP is the easy option for the prevention and treatment of atelectasis and a
medical need for lung expansion therapy.
• When incentive spirometry alone won't open patient's airways, expand your options
with EzPAP. It makes providing positive airway pressure positively easy.
• Simply connect to a flow meter (wall air or O2 for enhanced FiO2), adjust 5-15
lpm, and instruct the patient to breathe normally through the mouthpiece or mask.
Just a few minutes of therapy, as needed - not for hours at a time.

25. • Can be used with mask or mouthpiece
attachment
• Allows use with inline nebulizer when fitted
with the adapter Prevents inadvertent
occlusion
• Connects to gauge tubing
• Eliminates collecting components
• Eliminates the need to carry a manometer

26. EzPAP

27. Inspiratory muscle trainer

28. Threshold trainer
• It has an adjustable spring-loaded valve that
imposes the inspiratory load.
• The inspiratory load can be increased by
winding the spring more tightly.
• Advantage of this trainer is that the same load
is imposed on the inspiratory muscles
regardless of breathing pattern.

29. Resistive trainer
• It has holes of different diameters.
• The inspiratory load can be increased by setting
the dial to holes of lesser diameter.
• Disadvantage of this trainer is that the subject
can reduce the inspiratory load by breathing
more slowly.
• If this device is used for training, a target must be
used. Various targets have been designed that
set a breathing rate (flow and/or inspiratory
pressure) for the subject.

30. Isocapneic Hypernea Trainer
• It has a rebreathing bag that can be adjusted to ensure that
the person’s CO2 level is maintained within a physiologic
range.
• A target is provided for the person to increase the level of
ventilation to a training intensity.
• This device enables training at low loads but much higher
inspiratory and expiratory flow such that the inspiratory and
expiratory muscles training at higher speeds of contraction.
• In contrast, the threshold and resistive trainers, place high
loads while the speed of contraction is relatively low