a patient fo Cardiac Surgery is admitted at least 2 days and often 7 days prior to the operations. this
enables him to meet all the staff, find his way around the unit and to have tests. during this time the
aims of the physiotherapist are as follow :
2. To ensure that the lung fields are clear and that all areas of the thorax are expanding.
3. to explain where the incision site will be and how it will be supported during coughing or moving
Procedure
Introduction, explanation
The physiotherapist on a cardiothoracic unit should have a quiet, competent manner and be able to
adapt her instructions, explanations and sympathy according to each individual patient’s needs.
During her first visit she should explain the purpose of the physiotherapy that the patient will
receive. She must also examine and asses the patient along the following lines.
If there are secretions in the patient’s lungs, then actions must be taken to clear them as the
operations may have to be delayed. The physiotherapist will give breathing exercise, shakking,
clapping, postural drainage, and intermittent positive preassure breathing modified to take into
account the condition of the patient’s heart. Short, numerous treatment sessions may be necessary.
On the other hand, if the lungs are clear than the patient need only be taught expantion breathing
exercise for lower lateral costal, anterior basal, and posterior basal areas.
The important of maintaining thoracic expansion in prevention of lung collapse is explained. Bilateral
exercises are used when there is to be a sternotomy. Unilateral exercises may be used where there
is to be a lateral thoracotomy.
Incision site
The physiotherapist must know which incision site is to be used so that she can teach the patient
how support will be applied during moving, coughing or huffing.
The patient must be taught that caughing or huffing is essential for removing secretions from the
lungs. The incision has to be supported and the patient taught to cough at the beginning of
expiration after a deep inspiration.
Huffing should also be taught so that the patient is practised in both methods of huffing clearing.
Relaxation and diaphragmatic breathing are encouraged after coughing.
Exercise
It is important to teach the patient shoulder, trunk and leg exercise because these must be started
on the first day after the operation. The number of repetitions of each movements must be geared
to the patient’s tolerance.
One movement in each direction may be sufficient for teaching foot, knee and hip movements.
Pasien untuk Bedah Jantung (Cardiac Surgery) dirawat minimal 2 hari - 7 hari sebelum operasi. Hal ini
memungkinkan pasien untuk bertemu semua staf, menemukan jalan di sekitar unit dan untuk
melakukan tes. Selama ini tujuan fisioterapis adalah sebagai berikut:
1. untuk mendapatkan kepercayaan pasien
2. Untuk memastikan bahwa bidang paru-paru jelas dan semua area di dada berkembang.
3. untuk menjelaskan di mana lokasi sayatan dan bagaimana hal itu akan didukung saat batuk atau
bergerak
Prosedur
Pendahuluan, penjelasan
Fisioterapis pada unit kardiotoraks harus memiliki cara yang tenang dan kompeten dan dapat
menyesuaikan instruksi, penjelasan dan simpati sesuai kebutuhan masing-masing pasien.
Selama kunjungan pertamanya, fisioterapis harus menjelaskan tujuan fisioterapi yang akan diterima
pasien. Fisioterapis juga harus memeriksa dan menilai pasien seperti berikut :
Yang penting untuk mempertahankan ekspansi toraks dalam pencegahan keruntuhan paru
dijelaskan. Latihan bilateral digunakan bila ada sternotomi. Latihan unilateral dapat digunakan di
mana ada yang menjadi torakotomi lateral.
Situs insisi
Fisioterapis harus mengetahui tempat sayatan yang akan digunakan sehingga fisioterapis bisa
mengajari pasien bagaimana latihan yang akan diterapkan saat bergerak, batuk atau haffing.
Olahraga
Penting untuk mengajarkan latihan bahu, trunk dan kaki pasien karena ini harus dimulai pada hari
pertama setelah operasi. Jumlah pengulangan setiap gerakan harus disesuaikan dengan toleransi
pasien.
Satu gerakan di setiap arah mungkin cukup untuk gerakan kaki, lutut dan pinggul.