Respiratory Management
Respiratory Management
Breathing After an SCI
Normal Breathing
Normal Breathing
• Breathing is the voluntary and involuntary movement of air in and out of the lungs – Breathing in enables you to get g
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g
oxygen into your lungs which is then transported to the bloodstream and carried to your cells and tissues
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– Breathing out enables you to get rid of the waste products of the cells and tissues by transporting ll
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carbon dioxide via the bloodstream back to the lungs
Normal Breathing
Normal Breathing
• Breathing
Breathing is controlled by the brain
is controlled by the brain
• Breathing is something you do without thinking about it It is automatic
thinking about it –
It is automatic
• Muscles help you to breathe
• Muscles help you to cough to get rid of mucous
• Breathing requires energy
Normal Breathing
Normal Breathing
• Breathing Muscles
eat g usc es
– Diaphragm • Muscle which sits just under the lungs. Innervated by cervical nerves 3,4, and 5
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34 d5
– Intercostals
• Muscles which sit in between each rib. Innervated by the y
thoracic nerves 1‐12
– Abdominals
• Upper stomach muscles. Innervated by thoracic nerves 8‐10
Upper stomach muscles Innervated by thoracic nerves 8 10
– Neck • These muscles can assist breathing
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• Nerves that control breathing are located in your neck (C3, C4, & C5)
• If your injury is above C3, you may require a machine to breathe
require a machine to breathe
• If your injury is C3‐C5 you may require a machine to breathe some of the time or not at all
not at all
• If your injury is below C5, your diaphragm will work but your breathing may be weak because your rib and b
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abdominal muscles may not help you to breath
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• If
If you are at Touro, you do not need a machine you are at Touro, you do not need a machine
to breathe (ventilator)
• You may, however, have a tracheostomy You may, however, have a tracheostomy
(trach)
– This is to assist with clearing secretions g
(phlegm/mucous)
– As you get stronger with your cough, the trach may be
removed
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• All
All Cervical Level Injuries are at Risk of Cervical Level Injuries are at Risk of
Respiratory Complications
– Even upper thoracic level injuries have an Even upper thoracic level injuries have an
increased risk of respiratory complications
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• Ways to help your breathing get y
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stronger
– Incentive spirometer
– Resisted breathing
– Use of an abdominal binder
• Ways to clear mucous/secretions
Ways to clear mucous/secretions
– Suction catheter through the trach for upper secretions
– Bronchoscope for deeper secretions
– Assisted Coughing
– Assisted Cough Machine
Assisted Cough Machine
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• Complications
– Collapsed lung
– Pneumonia
– Pulmonary Embolism
– Aspiration
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Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• Keep your lungs healthy
–
–
–
–
NO Smoking
Do breathing exercises daily
Stay away from pollutants (dust smoke chemicals)
Stay away from pollutants (dust, smoke, chemicals)
Call your doctor at any sign of a respiratory illness
•
•
•
•
•
•
•
•
Fever
Green sputum
Green sputum
Thick sputum
Rapid Breathing
Shortness of Breath
Shortness of Breath
Increased secretions
Headache
Increased Drowsiness
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• What to do if sick
– Call physician if any sign of illness (as noted on previous slide)
– Stay hydrated: this helps the secretions from getting Stay hydrated: this helps the secretions from getting
to thick and stuck
– Change positions more often
– Increase the number of assisted coughs
– May have caregiver learn chest percussions
– May need respiratory treatments
May need respiratory treatments
– A warm bath or humidifier may be helpful to loosen secretions
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• Assisted Cough
Assisted Cough
• https://www.youtube.com/watch?v=vy2sXjc2
ni8&feature=player_detailpage&list=PLbDN6
maF6814r2c‐T4NuwKboQPVrheN1g
Breathing After Spinal Cord Injury
Breathing After Spinal Cord Injury
• Take Care of Yourself
Take Care of Yourself
• Stop Issues Before They Become Big Problems
• Don’t Hesitate to Call Your Physician
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