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G - Independence in Breathing

Figure 7.0 Healthcare Professionals Conducting Respiratory Assessments Figure 7.0 Healthcare Profesionals Conducting Respirator y AssesmenTS Respirologist 19% Respiratory Therapist 18% Respiratory Technician 9% PFT Technician 9% Rehabilitation Therapist Physiotherapist 18% Physiatrist 9% Nurse (RNA/RPN) Nurse (RN) 9% 6% 3% FIGURE 8.0 CURRENT CAPACITY TO CONDUCT SPECIFIC RESPIRATORY ASSESSMENTS Interventions and Specialized Equipment Current, best available evidence of rehabilitation interventions to maximize respiratory function, in individuals with SCI, is summarized by Clinical Practice Guidelines (CPGs) and systematic reviews. 1. Respiratory management following spinal cord injury: a clinical practice guideline for healthcare professionals. 2005.15 2. Respiratory Management. In: Spinal Cord Injury Rehabilitation Evidence. Volume 3.0. 2010. 1 3. Physiotherapy secretion removal techniques in people with spinal cord injury: a systematic review. 2010.20 4. Home mechanical ventilation: a Canadian Thoracic Society clinical practice guideline. 2011.18 The folowing respirator y interventions are supported by level 1 or 2 evidence 1, 20, 21: • Exercise training • Specific training of respiratory muscles – normocapnic hyperpnoea concomitant inspiratory and expiratory muscle training • Pharmaceutical interventions - bronchodilators • Interdisciplinary tracheostomy review and management team • Abdominal binding • Secretion removal techniques - mechanical insufflation/exsufflation with manual respiratory kinesitherapy • Neuromuscular electrical stimulation – abdominal muscles and pectoralis major. The folowing respirator y interventions are strongly recomended18: • Weaning protocol with progressive ventilator-free breathing • Non-invasive ventilation preferred over invasive ventilation • Regular lung volume recruitment, manually assisted cough and mechanical insufflation-exsufflation, for airway clearance. INDEPENDENCE IN BREATHING | BODY STRUCTURE AND FNUCTION 79


G - Independence in Breathing
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