ATechniques of Chest Physiotherapy

[sulemanSAMI]

oh .. i see.. the brand on the lube bottle was indian .. probably an indian ICU

[janmarie0725]

I am an R.T student in my first semester and I already noticed 20 things wrong with this video....

[SONIC4399]

vibrating the chest is much better

[sudhee26]

I see lot of physiotherapist not happy with your techniques. may you must post a better video or withdraw this.

[sudhee26]

hey by the way, you must throw old gloves before using new one. please change your habbit.

[sudhee26]

@sudhee26 To shoot this video and post it on Youtube..good but i suggest you better take necessary consent and hide identity of patient. thanks.

[sudhee26]

E2VtM3? or GCS5t would be proper score i believe. because of intubation regular GCS scoring can not be used. however, he has good gag and cough reflexes. wonder whether patient was extubated a day after. Techinque is nice. congratulations. mandatory sterile practices have been followed. may not be of ULTRA HOSPITAL level but sufficient. since patient would also been on antibiotics, that must take care of it. I wonder whether consent from patient party has been taken or not.

[jjose0013]

I don't care about other say about the video, i just want to ask what happened to the patient as a whole and what happened after every session of this?

[lucaocv]

Sou Fisioterapeuta e vou confessar uma coisa... Senti pena do paciente!

Que atendimento é esse?!

Acho impossível a sonda de aspiração ter contaminado mais do que isso que apareceu no vídeo meew.. hahahaha

Em pleno século XXI ainda usam tapotagem? PQP!

[toraldagli]

hey buddy think it is high time u withdrew this video;everything about it is not right---i say this as i m a senior physiotherapist working in icu setup for 17 years treating patients and getting them well

[iHeartCWU]

I didn't hear a soul speaking English, so I am willing to bet HIPPA doesn't apply because it isn't being done in the US. Furthermore, why is it wrong to apply more then one set of gloving? It is not a violation of health codes to wear more than one pair of gloves... sorry. And what is up with the Ebonics in your medical info... fyi, if I were your patient I would demand someone else, because by NO means is speaking let a lone typing that way at all professional... PS, I also work in a hospital.

[latinahottie3232]

I don't know if I'm more discusted or saddened by the unethical practices contained in this video.

[schuzhikees]

karma is true for assholes like you

[schuzhikees]

all of you should be sued for malpractice. poor man.

[navina27]

hey does chest pt consists of only clapping..? it seems like, beating the subject.. also u r increasin the ICP of subject..and that is very dangerous in TIB patient..

[thejohhny69]

and the nigger patient died hahahahahahahehehehehehehe

[razzikatta]

@thejohhny69 stupid ass

[thejohhny69]

@razzikatta just shut the fuck up you got damn motherfucker bitch go to hell moron fuck hahahahahahahahahahehehehehehe­hehe

[thejohhny69]

@razzikatta hey piece of trash when you're gonna die you got damn mother fucker asshole jackass bitch i hope you die just like this nigger ass patient hahahahahahahehehehehe

[JoyBoorin]

another standard clip should be replaced this!

[JoyBoorin]

These technics haven't up to date jet n are unsterile also

[stylesister1]

hw did they let u take d video ,U MUST NOT DISCLOSE THE PATIENT'S FACE,dont percuss on the heart n the liver.Hyperventillate-Suction-­Hyperoxygenate.Make sure that the humidifier is attached to the patient end of the ventillator tubing else the patient will b breathing dry air .dont wear glove over glove.its nt recommended.

REF:AARC Clinical Practice Guidelines

Endotracheal Suctioning of Mechanically Ventilated Patients

With Artificial Airways 2010

[swimgal81]

im sorry i cant stand to watch this,... poor guy!

[lubsam]

OMG! what they r doing ......they doing like new electives .....PLz plz plz dont treat ur patients like this ...when u dont know the proper way ........this is ridiculous

[Andy86lv]

OMG! this video should be taken out! Where did you go to school mate?? If he's alive he's lucky... why on earth would you do that?? ALL that and the Endotracheal Suctioning??? where's the sterile procedure?? did you know he could get an infection?? his family should sue you!!!! WHAT A disgrace!!!

[hphearts83]

im a first year RT student, just curious as to why his chest/stomach area keeps jolting, looks like he has the hiccups...??i have my cpt test on wednesday, thanks for the video!

[Chawnb]

@hphearts83 This patient is being mechanically ventilated. The jolts you see is the air pressure from the machine.

[dbrooks12009]

Your sterile technique is not up to standard. You put new sterile gloves over used gloves. You should had taken off old gloves first. You also should not had allowed the suction catheter to hang before you coiled it. You should had coiled it as you were pulling from packaging. Your other nurse with clean hands should only touch the outside of suction catheter pack without touching any part of catheter. Sterile nurse should only touch catheter without touching any part of packaging.

[cscorpster]

Hi dbrooks12009. I would like to know where do u work and how do u do it in your set-up.

[Xydella21]

I mean it's great to see actual demonstration of the technique but isn't this a violation of HIPPA?

[adnankhanpt]

listen my friend!positioning is very important i have noticed ,u did everthing in supine which is not the best position, u can treat patient in side lying, or high sitting, , there are other techniques , like shaking/vibs and rib springs to loosing up secretion and get lung expansion as well, the way guy introduced suctioning catheter, it need to be there only for 20 sec lots of flaws , and poor patient handling in this technique ,

[adnankhanpt]

i,m sorry it is wrong techniques, u should padded the chest and and should not clapp on heart side as HR is 99..where did u learn this buddy!!! i feel it is india and where there is no ethics

[sezsams]

itz better u ask some sr physios worked in a trauma icu...n guyz trust me any ramu kakka cant come one day morning and handle such a responsible icu... and maintain some med ethics buddy... this is not avideo to be posted on a public site... think these too that patient is also a father ,son, brother , uncle of someone... itz not correct....

[physioconvideos]

where do u work? i agree this is not a video for public domain

[mackeyphotography]

thank you for posting this. helps to see this done in real life, and not just on a dummy.

[lomax886]

Appreciate your initiative to post the video. but. I would agree with most of the people here.. the way sterile gloves were put was POOR. It can be easily done in a sterile method.

[TheProtege81]

Thanks so much for the video . Point of correction you do not auscultate ontop of clothing. and when manual hyperinflating try synchronising the patients inspiration with the squeeze.

[23Nadja]

The way the sterile gloves were put on is definetly not a good one. Sorry.

[sil3ntbqb]

you gotta wonder what the pt was thinking the whole time hes getting his chest clapped hehe nice material though

[zoomzamzamy]

very interesting

[sezsams]

stupid physios hav done a lot of flaws... being an icu therapist they dont knw hw to maintain sterility of the gloves... ask him how much one sterile gloves cost..... he won knw... its 35 bucks for one single piece...  and a supine posn manipulation drains only 40% secretions... pls dont teach wrong techniques dude...

[physioconvideos]

this video has been taken on a real patient of head Injury (GCS 5) and sterile gloves have been used. It is very difficult to maintain exact positions as given in books -- or as we have learnt these techniques on dummies..

[sezsams]

GCS 5 so wat... u can surely turn the patient to side lying... until and unless the patient have any of these....

severe rib #. scapulo humeral#, pelvic # or LL complex#... or severe lung collapse n have a ICD placed to the side u turn to.... n for RTA itz imp to maintain sterility althro ur procedures.. n hav to maintain 10* to 15* head raise to keep icp to normal... i am a physiotherapist working in emergency neuro trauma icu in a tertiary hospital

[LushLucid]

I think the supine position was chosen because of the tubes in his mouth?

[Sam73830]

I am a UK based Respiratory Physiotherapist. Having watched the film, although it is educational, I must admit that I do have a couple of points of concern. Firstly the complete lack of communication with the patient at any point during his treatment session - of particular importance when the patient begins to awake during suctioning and Manual Hyperinflation. Secondly the repeated use of the Suction Catheter must surely pose a significant infection control risk.

[cscorpster]

the patient is head injury patient GCS Scale 4, so patient is totally dependent on ventilator.

After each suction we have dipped the catheter tip in sterile antibiotic saline to make it sterile.

Further we have used seperate catheter for nasal and oral suctioning.

[Sam73830]

I was actually meaning the lack of communication from the therapist to the patient i.e. informing the patient of what was about to happen to him at each stage.

[physioconvideos]

i am sorry ..this patient was a GCS 5.

[physioconvideos]

If you have any further suggestion kindly let me know. Please tell me about your experiences if any with these kind of patients.

[dbrooks12009]

On the other hand, thanks for posting. This was very educational. Reading about these procedures and actually seeing them done are two entirely different things.

[dbrooks12009]

Oh my god. The quality of life and struggle of these patients is way worse here than what's seen on tv.  I just want to cry. To think that some peoples lives have been reduced to this.

[physioconvideos]

you should see the PO2 level or oxygen saturation level ( as it slowly goes up)

[leedwi]

thx for the informative video, I dont really understand the monitor to the right of the patient. What should be taken note there?

[devau942]

never auscultate with clothes on..

did u get informed consent ??

[dodgecaravantinted]

Nice video but the sterile gloves were not put on properly.

[katching]

i noticed that.

[loveneiljac]

not all lobes were covered in the procedure, was sidelying contraindicated? what's the patient case?

[cscorpster]

ya sidelying was contraindicated

[liaaa90]

what happen in that patient?

[1992peter]

VERY WELL DONE. Hey, what is that tapping noise in the background from 0 to 1:51 befor the CPT starts?

[physioconvideos]

we dont know we shot it in a very busy ICU setup.