Postural drainage

Definition
Postural drainage (bronchial drainage) is a means of mobilizing secretions in one or more lung segments to the central airways by placing the patient in various positions so that gravity assists in the drainage process. When secretions are moved to the larger airways, they are then cleared by coughing or Endotracheal suctioning. Postural drainage therapy also includes the use of manual techniques, such as percussion and vibration, as well as voluntary coughing.
1. Positions are based on the anatomy of the lungs and the tracheobronchial tree.
2. The patient may be positioned on a.

Bronchial Drainage

• Postural drainage table that can be elevated at one end.
• Tilt table.
• Reinforced padded table with a lift.
• Hospital bed.
• A small child can be positioned on the therapist’s lap.

Goals of Postural Drainage
1. Prevent accumulation of secretions in patients at risk for pulmonary complications. This may include:

• Patients with pulmonary diseases that are associated with increased production or viscosity of mucus, such as chronic bronchitis and cystic fibrosis.
• Patients who are on prolonged bed rest.
• Post surgical patients who have received general anesthesia and who may have painful incisions that restrict deep breathing and coughing postoperatively.
• Any patient who is on a ventilator if they are stable enough to tolerate the treatment.

2. Remove secretions already accumulated in the lungs of:

• Patients with acute or chronic lung disease, such as pneumonia, Atelectasis, acute lung infections, and COPD.
• Patients who are generally very weak or are elderly.
• Patients with artificial airways.

  To drain the middle and lower portions of your lungs, you should be positioned with your chest above your head. Possible techniques to achieve this position are:

  • If a hospital bed is available, put in Trendelenburg position (head lower than feet)
  • Place 3-5 wood blocks, that are 2 inches by 4 inches, in a stack that is 5 inches high, under the foot of a regular bed. Blocks should have indentations or a 1 inch rim on top so that the bed does not slip
  • Stack 18-20 inches of pillow under hips.

  • Place on a tilt table, with head lower than feet.

  • Lower head and chest over the side of the bed.

     To drain the upper portions of your lungs, you should be in a sitting position at about a 45 degree angle.

     When you are in the proper postural drainage position, change your position per the following sequence:

  • Turn side to side
  • Lay on stomach
  • Lay on back

  Remain in each position approximately five to ten minutes. Use suction or assisted cough before changing position to insure removal of any secretions drained while in that position. Postural draining is usually taught by your physical therapist.

  Inspiratory Muscle Trainer is a device to assist in building inspiratory muscle strength. The device should be used daily as part of your daily routine to keep lungs healthy.