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Chest Physical Therapy to the Patient with Multiple Trauma: Two Case Studies

Ms. Ciesla and Ms. Klemic are Physical Therapists, Maryland Institute for Emergency Medical Services Systems, University of Maryland, 22 S Greene St, Baltimore, MD 21201 (USA).
Ms. Imle was Staff Physical Therapist, Maryland Institute for Emergency Medical Services Systems, when this paper was written. She is now a graduate student at Towson State University, Towson, MD 21204.

This excerpt was created in the absence of an abstract.

Significant pulmonary complications have been reported in 20 to 40 percent of patients following abdominal or thoracic surgery, making pulmonary complications the single largest cause of mortality and morbidity in the postoperative period.¹ Thoren² and others^3–5 have concluded that chest physical therapy is effective in the prevention and resolution of postoperative pulmonary complications.

The Maryland Institute for Emergency Medical Services Systems (MIEMSS) consists of a 52-bed trauma unit that receives patients with multisystem injuries, 80 percent of whom arrive directly from the scene of injury. Prior to the institution of chest physical therapy in this trauma unit, therapeutic bronchoscopy was the means of treating retained secretions and lobar collapse. Since 1973, chest physical therapy has been performed on more than 2,500 critically ill patients. Because of our success in treating these patients, our protocol has now become the treatment of choice for respiratory complications caused by retained secretions.

Key Words: Respiratory distress syndrome, adult • Physical therapy

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