Lecture 4Respiratory therapy and physiotherpay PDF

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VET2700

Respiratory therapy and Physiotherapy

Lecture 4

Respiratory therapy Why might a patient require respiratory therapy? -Upper airways disease: -Tracheal disease: -Foreign bodies -Tracheal collapse -Nasal disease: -BOAS -Nasal foreign bodies -Trauma -Nasal/nasopharyngeal polyps -Laryngeal disease: -Most commonly laryngeal paralysis -Congenital or acquired -Lower airways disease: -Pneumonia -Pulmonary haemorrhage/ contusion, pulmonary thromboembolic disease -Pulmonary oedema -Bronchitis -Feline asthma -Canine chronic bronchitis -Pleural space disease: -fluid compromising breathing/neoplastic/ tumours/ plural infusion: Thorocentisis. -Pneumothorax -Diaphragmatic rupture -Flail chest Questions to ask on phone -Clinical history- any conditions to do with present problem -Heart issue -Obvious obstructions? -How long been like this for -What is happening now? Collapsed?? Assessment -ABC -Can he walk? -OXYGEN Blood gas analysis Apply local and take an arterial blood sample with an arterial syringe. Run through the machine to get an accurate oxygen level. This is gold standard. On results only look at Pa02 and PaCo2. Arteries used: pedal, dorso-metacarpal, back leg. Pulse ox: Infrared light measures amount of oxygen in haemoglobin in the blood. This can attach to the prepuce/vulva/pinna/interdigital/anywhere without hair. Need to make sure HR matches.

VET2700

Respiratory therapy and Physiotherapy

Lecture 4

Physiotherapy Physiotherapy is the treatment of illness and injury by physical means, designed to enhance the body’s ability to heal itself. -Manual therapies (stretches, massage): This is good for recumbent patients to stimulate blood flow. -Exercises -Hydrotherapy -Thermal modalities -Electrotherapeutic modalities -Respiratory physiotherapy: Nebulizer/ copauge Physiotherapy can be done by RVNs however must check with a VS first. E.g. after surgery check with VS if okay to ice pack. If performed inappropriately, can cause harm. A common issue is incorrect use of heat mats/ icepacks. Aims: -Accelerate recovery -Improve joint range of montion (ROM) -Improve muscle strength -Protect painful/healing structures -Return to normal function -Reduce pain, swelling, inflammation If used properly recovery should be increased. If not, muscles will atrophy e.g. recumbent patient will have less movement, so will be harder as the muscles wear away. Provide ice for pain relief, this could reduce the amount of drugs needed e.g. opioids, and should get them back to as normal as possible- QOL/less pain. When can treatment begin after ortho? -On the same day/ recovery period. The sooner the better. Passive ROM can encourage eating/interaction and builds a bond. -During the early post op period, cryotherpay, gentle passive motion and controlled weight bearing can begin. -Hydrotherapy can begin once the wound has healed (10-14 days post op). Manual therapies -Massage -Limb stretches -Joint mobilisations -Therapeutic exercises Massage: -Stroking -Effleurage: Gentle form of massage: stroking. This allows familiarisation with being touched. It improves circulation and drainage of lymphatic fluid. Go towards the heart. -Petrissage and percussion: Massage involving squeezing, kneading, rolling and compression of muscles. It increased circulation and warms the tissue. Softens superficial fascia, decreases muscle tension and breaks down adhesions in damage.

VET2700

Respiratory therapy and Physiotherapy

Conditions that may benefit: -Contracted ligaments muscles and tendons -Oedema -Scar tissue

Lecture 4

-Chronic inflammation -Peripheral nerve injuries

Conditions that are contraindicated: -Fractures -Haemorrhage -Infection at site of massage -Neoplasia at site of massage.

-Acute inflammation

Active: -Controlled lead -Sit to stand -Balancing -Dancing -Small herdals or steps -Weaving -Pedal reflex -Cavaletries Used for neurological or ortho patients. Not for the severely depleted. Gradual build up. Thermotherapy: -Use of heat to promote vasodilation which makes oxygen increase. The heat makes the muscles go elastic and it also helps the metabolism. It is good for wound healing. -Can be used once swelling and inflammation has subsided around 48 hours after surgery. Increases blood flow. Apply for 10 minutes three times a day prior to passive ROM. Can be alternated with cold packs. What does it do? -Relaxes muscles -Increases flexibility -Reduces muscle spasms -Reduces swelling -Alleviates pain Passive ROM: Used in reduced mobility, spinal and ortho patients. It improves flexibility but takes time to do. Support the joint above. Cryotherapy: -Application of cold to an area -Decreases the flow of fluid to the tissues: Slows release of chemicals that cause pain and inflammation. -Causes vasoconstriction: reduced swelling, haemorrhage or bruising. -Decreases sensitisation in a localised area. -Can begin on the day of surgery, once the patient’s temperature has normalised. Apply for 10mins at a time. Electrotherapy: -Treatment of soft tissue structures with machines that produce electrical energy in various waveforms, -Helps to promote healing and repair: -Ultrasound -Laser -Electrical nerve stimulation (TENS) Hydrotherapy: -Swimming or walking in a body water i.e pool or water treadmill -Relies on thee principles: -Buoyancy: Weak patients/Those with joint pain are able to move more freely in water -Hydrostatic pressure: (Pressure exerted by surrounding water) can help control swelling.

VET2700

Respiratory therapy and Physiotherapy

Lecture 4

-Viscosity: (Degree of resistance to movement created by the water molecules) reduces as temperature increases. -Patients should receive hydrotherapy in a veterinary run establishment, or one that has been approved by the canine hydrotherapy association. -Water is usually too cold for lakes/poinds to have a therapeutic effect- should be 26-30C. -Therapist must be present in pool at all times. -Swimming can causes joints to undergo large range of motion (not always appropriate straight after surgery) hydrotherapy treadmill may be a better option. Contraindictation: -Open wounds/unhealed surgical incisions -V+/D+ -High body temp or infection -Respiratory compromise -Severe systemic conditions (heart, liver, kidney) -uncontrolled epilepsy -External fixation of fractures -Severe skin irritations -Ear infection Hydro pool is for no limb movement/neurological deficit, hypoextension injuries. Treadmil: for the weak and young, spinal, brachycephalics, water phobia, obese, weight bearing (controlled).

VET2700

Respiratory therapy and Physiotherapy

Lecture 4...