Back tapping method:
1. The choice of posture is usually ideal. If the patient's body can't bear it or is limited by some treatment methods (such as mechanical ventilation), he can also choose the lateral position.
2. The choice of time should be 30 minutes before eating and drinking, or 2 hours after meals and 30 minutes after drinking. Generally, the treatment time of chest patting should not exceed 30 minutes, and 15-20 minutes is the best.
3. The right hand is generally selected for the correct gesture (depending on the patient's posture, the left hand stands on the right side, and vice versa). The thumb is close to the first knuckle of the index finger, and the four fingers are close together as if holding an egg in his hand. The way to judge whether the gesture is correct is to hear an empty button when slapping the chest, not a slap.
4. The direction and range of tapping is tapping from the lower part of the back to the upper part and tapping from the outside to the inside, which makes the sputum stuck on the tracheal wall easy to fall off. The location and range of the flap depend on the patient's condition. If you want to dig the whole lung field, you should start from the lobe or lung field with the greatest influence, usually from the lower lobe of the lung.
5. The intensity of percussion should be moderate, so as not to cause pain to patients.
6. Treatment sequence: it is recommended to dilute the sputum by atomizing inhalation first, and then knock on the back for treatment, so that the sputum is easier to cough up and the effect is better. Generally speaking, the order of atomizing inhalation-knocking on the back-expectoration-eating, drinking and sleeping should be adopted as far as possible to achieve the maximum therapeutic effect without affecting the rest and life of patients.
7. Patients with mechanical ventilation For patients with invasive ventilator-assisted breathing, 5- 10 ml of normal saline should be slowly instilled in the airway, and then tap one lung field when turning over to the lateral position; For patients who receive non-invasive ventilator-assisted breathing, they can be encouraged to drink more water and cough and expectoration according to the routine operation process.
Precautions:
1. Try not to wear thick clothes during the operation without making the patient catch cold. Generally speaking, it is better to wear a hospital gown or a thin cotton-padded jacket.
2. Ensure adequate water intake, dilute sputum and help cough up.
3. Change posture and turn over regularly. At present, it is believed that changing body position can not only prevent bedsore, but also achieve a certain drainage effect. If the conditions are not limited, you can choose lateral position, semi-recumbent position, sitting position and other positions.
4. Patients should also be given health education on other chest physical therapy measures, such as effective cough expectoration methods and postural drainage.
5. Patients with a history of hemoptysis, severe cardiovascular disease, pulmonary edema, unvented pneumothorax, rib fracture and pathological fracture are prohibited from doing chest percussion treatment.
6. Avoid knocking on traumatized skin, buttons and zippers when knocking. At the same time, you should also avoid bony processes such as heart, breast, scapula and spine.