POSTURAL DRAINAGE

1.

DEFINITIONS
Postural drainage is the drainage of secretions from the various segments of lung with gravity.

2.

PURPOSE
a.
b.

3.

Removing the secret of the lungs.

Releasing secret restrained or attached to the bronchus.

INDICATION
a. Prophylaxis to prevent the buildup of secretions in:
1) Patients who are using ventilation
2) Patients who did a long lay tirah
3) Patients with increased sputum production as cystic fibrosis or bronchiectasis.
4) Patients with an ineffective cough.
b. Mobilization secretions withheld:
1) Patients with atelectasis caused by secretions
2) Patients with lung abscess
3) Patients with pneumonia
4) The patient pre and post operative
5) Neurological Patients with general weakness and swallowing disorders

4.

CONTRA INDICATION
a. Not performed on pulmonary edema patients.
b. Not performed on patients with thoracic trauma.
c. Not performed on patients tension pneumothorax.
d. Not performed on patients hypotension, hypertension, myocardial infarction and acute
myocardial arrhythmia.
e. Not performed in patients with cardiovascular problems.
f. Not performed on patients haemoptysis.

5.

PREPARATION EQUIPMENT

6.

a.

Pillows (2 or 3 pieces)

a.
b.
c.
d.
e.

Regulatory board positions

Facial tissue
A glass of warm water
Sputum pots
Masks

PATIENT PREPARATION
a. Patients sat dikursi, leaning on the pillow.
b. Patients lie on your right side with your arms above your head on trendelenberg position,
with the foot of the bed elevated 30 cm. Put a pillow on his back and roll the patient onto
the round pillow.
c. The patient lies on her back with trendelenberg position, the foot of the bed elevated 4550 cm.
d. Patients lying on his stomach with a pillow under the stomach with a foot of the bed
elevated 45-50 cm.

7.

STEP PROCEDURE
a. Wash hands.
Reduces transmission of microorganisms.
b.

Select the area to be drained congestion based on the assessment of all areas of the lung,
clinical data and chest photograph images.
To be effective, action must be made individually to address a specific area of the
blocked lung.

c.

Put the client in a position to mendrainase the blocked area (first area selected may vary
from one client to another client). Help clients choose appropriate position to position
clients kebutuhan.Ajarkan posture and arms and legs as a buffer tepat.Letakkan pillow
sebagai panyangga..

Particular position chosen for each area mendrainase clogged.

d.

Ask the client to maintain the position for 10-15 minutes.

In adults, drainage of each area of need that time.
In children, this procedure is 3-5 minutes.
Drainage for 10-15 minutes at this position, do the chest percussion and vibration
over the drained area.
Provide the mechanical drive aimed at mobilizing airway secret.
e.

After drainage in the first position, ask the client to sit and batuk.Tampung the
dikelurakan secretion in sputum pot.Jika client can not cough, suction should be
done.

Every secret is mobilized into the airway must be removed through coughing or
suctioning before the client was placed in the position selanjutnya.Batuk drainage is most
effective when the client sat down and leaned forward.
f.

Ask the client to rest for a while, if necessary.

Brief rest period between postural drainage to prevent fatigue and helps clients to tolerate
client better.
g.

Ask the client to drink some water

Keeping my mouth still wet so that helps in secret ekspektorasi

h.

Repeat steps ch until the selected area has been clogged terdrainase.Setiap action
no more than 30-60 minutes.

Postural drainage is used only for a clogged drain areas and based on individual
assessment.

i.

Repeat chest examination in all areas of the lung

Allows you to further assess the drainage requirements or change the drainage programs.
j.

Wash hands.

Reduces transmission of microorganisms.

k.

Documented in nursing records.

REFERENCES

Kusyati, Eni.2004. Skills and Procedures Laboratory. Jakarta: EGC