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Management of COPD - Coggle Diagram

- - - - Breathing control
        
        Tidal breathing at the patient’s own rate & depth, encouraging use of the lower chest with upper chest and shoulder relaxation see dysponea map
      - Thoracic expansion exercises (TEEs) (deep breathing)
        
        Deep breathing exercises emphasizing inspiration with or without an inspiratory hold and the quiet expiration
        
        The patient is encouraged to take 3-4 deep breaths emphasising inspiration
        
        Inspiration is active and may (take care with hyperinflated patient) be combined with a 3 second hold before the passive relaxed expiration
        
        Thoracic expansion exercise can be facilitated by the therapist placing their hands onto the lateral aspect of the chest wall to promote proprioceptive input and an increase in chest excursion
        
        Get air behind retained secretions in order to aid removal using forced expiratory techniques
        
        Re-inflate areas of lung collapse
      - Forced expiration technique (FET) (huff)
        
        One or two huffs combined with periods of breathing control
        
        Mobilise retained secretions from the peripheral airways to the central airways to enable them to be expectorated
        
        Low Lung Volume Huff
        
        The patient should take a normal tidal volume breath in
        
        The patient is then encouraged to exhale actively in a sigh
        
        The patient may repeat this combined with breathing control until they feel (or the therapist assesses) that the secretions have mobilised into the larger more proximal airways. The patient should then carry out high lung volume huffs
        
        High Lung Volume Huff Technique
        
        The patient should take a deep breath in
        
        The patient is then encouraged to forcefully exhale actively, as if they are trying to steam up a mirror
        
        The patient may repeat this combined with breathing control until they feel (or the therapist assesses) that the secretions have mobilised into the upper airways where they may be huffed or coughed up.