一、目的
使黏附在支氣管壁的濃稠痰液因受震動而易咳出
二、適用狀況
1.肺部分泌物黏稠或量多者
2.長期臥床或固定不動者
3.咳嗽能力差者
4.意識不清或肥胖者
三、注意事項
1.先了解痰液聚集部位,讓病人將枕頭抱在胸前臥向左側或右側(可藉胸部X光片或聽診呼吸音找出痰積聚處)
2.叩擊肋骨覆蓋之胸廓,勿叩擊脊椎及軟組織部位如乳房,腹部
3.叩擊時該部位先墊毛巾,將手做成杯狀,用腕部力量,有節律的叩擊胸壁,勿直接拍打胸壁,而致疼痛不適
4.叩擊時病人最好採橫膈式呼吸,可在呼氣-吸氣期間執行
5.同一區域至少連續叩擊3-5分鐘
6.叩擊後鼓勵病人將痰液咳出,或請護士來抽痰
7.進食後一小時避免做叩擊
8.注意顱內壓升高之徵象如頭痛,噁心,嘔吐等主訴
四、禁忌:
1.整個區域已知或懷疑癌症或轉移病變
2.當執行時,反而促使支氣管攣縮
3.叩擊部位有出血情形
4.抽搐發作
5.病人非常非常胖(因力量波無法充分穿經脂肪組織)dating a married woman
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