Airway Clearance

Objectives:

At the end of the session, the participant will have:

 

  • Increased knowledge of the role and function of sputum and the mucociliary pathway in chronic lung diseases.
  • Increased ability to recognise a change in regular sputum production (if present) as one of the signs and symptoms of a chest infection.
  • Increased understanding of airway clearance techniques in chronic lung diseases where sputum retention is a clinical feature, with an emphasis on independent techniques.

Facilitator:

This session may be facilitated by a physiotherapist.

Topic Content Resources
Introduction to the role of sputum and usual muco-ciliary clearance Role of sputum and muco-ciliary clearance in COPD, bronchiectasis, asthma and ILD

ILD cough: generally dry and not associated with sputum production.
Better Living with COPD (Ch 13)

Bronchiectasis Toolbox
(Airway clearance in the normal lung; bronchiectasis pathophysiology)
Change in sputum production as part of identifying an exacerbation

Note - This is only one sign for some people and not relevant for lung conditions.
Signs and symptoms of an infective exacerbation. Signs and symptoms of an exacerbation (may be different for COPD, bronchiectasis, ILD, asthma).
Better Living with COPD (Ch 9).
Role of airway clearance as part of management plan General aims and principles: Who needs to include airway clearance and why? Who can help with assessing, prescribing and reviewing airway clearance ? Bronchiectasis Toolbox principles of Airway Clearance
Better Living with COPD (Ch 13)
Examples of airway clearance techniques and strategies Simple no-equipment examples: Active cycle of breathing technique (ACBT) and/or forced expiration technique (FET). Risks and precautions with techniques.

Role of humidification and hydration: eg Shower, Nebuliser.

Mucolytics.

Manual techniques,
Modified Gravity assisted drainage.

Positive expiratory pressure (PEP) – mask / mouthpiece. Oscillating PEP.

Role of exercise
Demonstration of ACBT and FET

Better Living with COPD (Ch 13)

Bronchiectasis Toolbox: Physiotherapy; Management plan

COPE – how to cough effectively

Nebuliser. Bronchiectasis Toolbox: Hydration and humidification

Bronchiectasis Toolbox for video and text resources

PEP devices – Mask / mouthpiece. – Flutter VRP1. – Acapella. Note – this is not applicable for all participants.
Summary and discussion.

The selection of airway clearance technique examples provided in the education session should be determined by the choice of technique relevant to the individuals requiring these techniques (eg. those with bronchiectasis, COPD with excess secretions).

The Toolkit

Getting Started
Getting Started
Patient Assessment
Patient Assessment
Exercise Training
Exercise Training
Patient Education
Patient Education
Patient Re-assessment
Patient Re-Assessment
Additional Resources
Additional Resources

Endorsed by the following organisations according to their respective approved criteria: