Precautions, operation process and methods of postural drainage

Postural drainage is a commonly used method for the discharge of pus and sputum in clinical practice. However, when performing postural drainage, there are related matters that need to be paid attention to. So, what are the precautions for postural drainage?

Notes on postural drainage:

(1) Old age and general weakness, inability to tolerate the required posture, and inability to drain secretions (in this case, postural drainage will lead to hypoxemia)

(2) Anticoagulant therapy

(3) Thoracic or spinal fractures, recent severe hemoptysis, and severe osteoporosis.

Pre-examination contraindications

(1) Drainage should be performed before meals, usually in the morning or evening, because vomiting is more likely to occur after meals.

(2) Convince the patient to cooperate with drainage treatment and encourage the patient to cough appropriately during drainage.

(3) During the drainage process, carefully observe the patient to see if hemoptysis, cyanosis, dizziness, sweating, fatigue, etc. If any of the above symptoms occur, postural drainage should be terminated immediately.

(4) The drainage position should not be rigidly followed. It must be a position that the patient can accept and that facilitates expectoration.

Operation method and steps:

(1) Postural drainage should be performed in different postures according to the location of the lesion. If the lesion is in the lower lobe, lingular lobe, or middle lobe, the patient should lie down with the head lowered and the feet raised slightly toward the healthy side; if the lesion is in the upper lobe, the patient should sit or take other appropriate postures to facilitate drainage.

(2) During drainage, the patient takes a deep breath intermittently and then coughs hard. The nurse pats the patient's chest or back with the hand (with the palm bent and concave), from the lower back upwards, until the sputum is exhausted. Alternatively, a mechanical vibrator can be used to loosen the accumulated secretions and move them to make them easier to cough out or drain. This should be done 3-4 times a day, for 15-30 minutes each time.