Pulmonary toilet

Pulmonary toilet, also called pulmonary hygiene,cite journal |author=Moody LE |title=Primer for pulmonary hygiene |journal=Am J Nurs |volume=77 |issue=1 |pages=104–6 |year=1977 |month=January |pmid=584121 |doi= |url=] is a set of methods used to clear mucus and secretions from the airways. The word "pulmonary" refers to the lungs. The word "toilet" is related to the French "toilette", refers to body care and hygiene; this root is used in words such as "toiletry" that also relate to cleansing.

Pulmonary toilet prevents atelectasis (the collapse of the alveoli of the lungs) and rids the respiratory system of secretions,cite journal |author=Allen GS, Coates NE |title=Pulmonary contusion: A collective review |journal=The American Surgeon |volume=62 |issue=11 |pages=895–900 |year=1996 |month=November |pmid=8895709 |doi= |url=] which could cause respiratory infections. It can also decrease pulmonary shunting, increase the functional reserve capacity of the lungs, and prevent respiratory infection after chest trauma.cite journal |author=Michaels AJ |title=Management of post traumatic respiratory failure |journal=Crit Care Clin |volume=20 |issue=1 |pages=83–99, vi – vii |year=2004 |month=January |pmid=14979331 |doi= |url=] Methods include using suction to remove fluids and placing the patient in a position that allows secretions to drain by gravity.

Methods

Methods used for pulmonary toilet include suctioning of the airways, chest physiotherapy, blow bottles, and nasotracheal suction.cite journal |author=Allen GS, Cox CS |title=Pulmonary contusion in children: Diagnosis and management |journal=Southern Medical Journal |volume=91 |issue=12 |pages=1099–1106 |year=1998 |month=December |pmid=9853720 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0038-4348&volume=91&issue=12&spage=1099] Bronchoscopy, in which a tube is inserted into the airways so that an examiner can view them, can be used therapeutically as part of pulmonary toilet. Incentive spirometry and use of analgesics (pain medications) that do not inhibit breathing are also parts of pulmonary toilet. Coughing is also important for ridding the airways of secretions, so healthcare providers are careful not to oversedate patients, because that could inhibit coughing.cite book |author=Goodman G|chapter= Chronic pulmonary disease: Bronchopulmonary dysplasia |editor=Perkin RM, Swift JD, Dale AN, Anas NG| title=Pediatric Hospital Medicine: Textbook of Inpatient Management |publisher=Lippincott Williams & Wilkins |location=Hagerstown, MD |year=2007 |pages=233 |isbn=0-7817-7032-7 |oclc= |doi= |accessdate=2008-06-30 |url = http://books.google.com/books?id=sV6-ifUGoMYC&pg=PA233&dq=%22pulmonary+toilet%22&client=firefox-a&sig=ACfU3U0ul-RTJgyhBEN6ewRc6yvdxMFo2w#PPR16,M1] Tracheotomy facilitates pulmonary toilet.cite book |author=Reilley JM, Sicard GA|chapter= |editor= Rosenthal RA, Zenilman ME, Katlic MR |title=Principles and Practice of Geriatric Surgery |publisher=Springer |location=Berlin |year=2001 |pages=492 |isbn=0-387-98393-7 |oclc= |doi= |accessdate=2008-07-01 |url = http://books.google.com/books?id=L3VO1gn47_0C&pg=PA254&vq=toilet&dq=%22pulmonary+toilet%22+%22pulmonary+physiotherapy%22&source=gbs_search_s&sig=ACfU3U1xxTRQGm7i5ajk5Kxojqdkw67Duw#PPA491,M1] Percussion, another method, loosens secretions and allows the cilia of the airways to remove material. Positioning is another method for promoting drainage of secretions; sometimes patients are placed in a prone position to aid in this purpose.

Applications

Pulmonary toilet is used for preventing infections such as pneumonia. It is also used in the management of conditions such as pneumonia and cystic fibrosis.cite book |chapter=Tracheobronchitis and lower respiratory tract infections |author=Virk A, Wilson WR |editor=Wilson WR, Sande MA, Drew L |title=Current Diagnosis & Treatment in Infectious Diseases |publisher=Lange Medical Books/McGraw-Hill |location=New York |year=2001 |pages=145 |isbn=0-8385-1494-4 |oclc= |doi= |accessdate=2008-06-30 |url= http://books.google.com/books?id=mv4AjrAATPIC&pg=PA145&dq=%22pulmonary+toilet%22&client=firefox-a&sig=ACfU3U25IAJrGm_mo5syM2OGPpZOwFVjKA] For people with chronic lung diseases, pulmonary toilet is used to prevent infections and lung abscesses.Virk and Wilson, p. 153] Pulmonary toilet is also used to prevent acute respiratory distress syndrome after chest trauma.

ee also

*Chest physiotherapy
*ThAIRapy Vest
*Intrapulmonary percussive ventilator

References