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Question 1

What does PEEP stand for and what is its purpose?

Answer 1

Positive End-Expiratory Pressure; it is a ventilator setting that maintains pressure in the lungs at the end of expiration to keep alveoli open and improve oxygenation.

Question 2

What does PEP stand for and how is it used?

Answer 2

Positive Expiratory Pressure; it is a physiotherapy technique where the patient exhales against resistance to keep airways open and help clear secretions.

Question 3

How is PEEP different from PEP?

Answer 3

PEEP is applied by the ventilator in intubated patients to maintain lung volume passively, whereas PEP is a patient-driven technique used during breathing exercises.

Question 4

What is the main goal shared by both PEEP and PEP?

Answer 4

To prevent airway or alveolar collapse and improve lung function.

Question 5

In what patient population is PEEP typically used?

Answer 5

In mechanically ventilated, intubated patients.

Question 6

Who typically uses PEP devices?

Answer 6

Patients who are breathing spontaneously, often during chest physiotherapy.

Question 8

What is oral endotracheal intubation?

Answer 8

Insertion of a tube through the mouth into the trachea to secure the airway and provide mechanical ventilation or airway protection.

Question 9

What is nasal endotracheal intubation?

Answer 9

Insertion of a tube through the nose into the trachea, often used when oral access is difficult or for long-term intubation.

Question 10

What is tracheostomy?

Answer 10

A surgical opening created in the trachea through the neck to insert a tube, used for long-term ventilation, airway clearance, or when oral/nasal intubation is not suitable.

Question 11

When is oral intubation preferred?

Answer 11

For emergency airway management, short-term ventilation, or when rapid airway access is needed.

Question 12

When is nasal intubation preferred?

Answer 12

When oral intubation is not feasible or contraindicated, and for some surgical procedures or prolonged intubation.

Question 13

When is tracheostomy indicated?

Answer 13

For prolonged ventilation (>1-2 weeks), difficult airway management, or to improve patient comfort and airway clearance.

Question 14

What is oral endotracheal intubation?

Answer 14

Insertion of a tube through the mouth into the trachea to secure the airway and provide mechanical ventilation or airway protection.

Question 15

What is nasal endotracheal intubation?

Answer 15

Insertion of a tube through the nose into the trachea, often used when oral access is difficult or for long-term intubation.

Question 16

What is tracheostomy?

Answer 16

A surgical opening created in the trachea through the neck to insert a tube, used for long-term ventilation, airway clearance, or when oral/nasal intubation is not suitable.

Question 17

When is oral intubation preferred?

Answer 17

For emergency airway management, short-term ventilation, or when rapid airway access is needed.

Question 18

When is nasal intubation preferred?

Answer 18

When oral intubation is not feasible or contraindicated, and for some surgical procedures or prolonged intubation.

Question 19

When is tracheostomy indicated?

Answer 19

For prolonged ventilation (>1-2 weeks), difficult airway management, or to improve patient comfort and airway clearance.

Question 20

What are the main types of physiotherapy interventions for acutely ill patients?

Answer 20

Airway clearance techniques, respiratory muscle training, positioning and early mobilisation, breathing exercises, and ventilator management support.

Question 21

What are common airway clearance techniques used in acute care?

Answer 21

Active cycle of breathing techniques (ACBT), manual techniques (percussion, vibrations), suctioning, manual hyperinflation (MHI), and use of positive expiratory pressure (PEP) devices.

Question 22

How does positioning help acutely ill patients?

Answer 22

Positioning improves ventilation-perfusion matching, aids secretion drainage, and can enhance oxygenation (e.g., prone positioning in ARDS).

Question 23

What is the role of early mobilisation in acutely ill patients?

Answer 23

Prevents ICU-acquired weakness, improves muscle strength and function, and reduces complications like deep vein thrombosis or pressure sores.

Question 24

What breathing exercises are used in acutely ill cardiorespiratory patients?

Answer 24

Diaphragmatic breathing, inspiratory hold techniques, and incentive spirometry to improve lung expansion and reduce atelectasis.

Question 25

How do physiotherapists support ventilator management?

Answer 25

By collaborating on weaning protocols, optimising ventilator settings for synchrony, and ensuring respiratory muscle engagement during weaning.

Question 26

What is open suctioning?

Answer 26

A suction method where the patient is disconnected from the ventilator and a sterile catheter is inserted into the airway to clear secretions.

Question 27

What is closed suctioning?

Answer 27

A suction system where a catheter is enclosed in a sterile sleeve and connected to the ventilator circuit, allowing suctioning without disconnecting the patient from the ventilator.

Question 28

What are the key differences between open and closed suctioning?

Answer 28

Open suctioning requires ventilator disconnection; closed suctioning does not. ## Footnote Open suctioning carries a higher risk of hypoxia and infection; closed suctioning reduces these risks. Closed suctioning allows for continuous ventilation and oxygenation during suctioning.

Question 29

When is open suctioning appropriate?

Answer 29

When there is heavy, thick secretions that may clog closed suction catheters or when closed suction is unavailable.

Question 30

When is closed suctioning preferred?

Answer 30

In critically ill, ventilated patients to maintain oxygenation and reduce infection risk, especially in ICU settings.

Question 31

How is open suctioning performed?

Answer 31

The ventilator is briefly disconnected, sterile catheter is inserted into the airway, suction is applied while withdrawing the catheter, and the patient is reconnected immediately.

Question 32

How is closed suctioning performed?

Answer 32

The closed suction catheter is advanced into the airway through the ventilator circuit, suction is applied while withdrawing the catheter, all without disconnecting the ventilator.

Question 33

What is Pneumonia?

Answer 33

Infection causing inflammation and consolidation of lung tissue, leading to cough, fever, sputum production, and impaired gas exchange. ## Footnote Treatment: Airway clearance, positioning for drainage, breathing exercises, early mobilisation. Goals: Improve secretion clearance, enhance oxygenation, prevent complications (e.g., atelectasis), restore functional capacity.

Question 34

What is Chronic Obstructive Pulmonary Disease (COPD)?

Answer 34

A progressive lung disease characterized by airflow limitation, chronic bronchitis, and emphysema, causing breathlessness and sputum production. ## Footnote Treatment: Breathing retraining (e.g., pursed-lip breathing), airway clearance, exercise training, energy conservation techniques. Goals: Reduce dyspnoea, improve ventilation, enhance exercise tolerance, and prevent exacerbations.

Question 35

What is Asthma?

Answer 35

A chronic inflammatory airway disorder with reversible airway obstruction, bronchospasm, and hyperresponsiveness causing wheezing and breathlessness. ## Footnote Treatment: Breathing control techniques, airway clearance if mucus present, education on symptom management. Goals: Reduce bronchospasm, improve breathing efficiency, maintain activity levels.

Question 36

What is Pulmonary Edema?

Answer 36

Fluid accumulation in the lungs’ alveoli due to cardiac or non-cardiac causes, leading to impaired gas exchange and breathlessness. ## Footnote Treatment: Positioning to optimise oxygenation, gentle breathing exercises, early mobilisation as tolerated. Goals: Improve oxygenation, reduce breathlessness, prevent deconditioning.

Question 37

What is Atelectasis?

Answer 37

Collapse or incomplete expansion of lung tissue, resulting in reduced gas exchange and possible hypoxia. ## Footnote Treatment: Deep breathing exercises, incentive spirometry, airway clearance, mobilisation. Goals: Re-expand collapsed lung segments, improve ventilation, prevent pneumonia.

Question 38

What is Bronchiectasis?

Answer 38

Chronic dilation and inflammation of the bronchi causing persistent cough, sputum production, and recurrent infections. ## Footnote Treatment: Regular airway clearance techniques, exercise training. Goals: Maintain airway patency, reduce infection risk, improve quality of life.

Question 39

What is Acute Respiratory Distress Syndrome (ARDS)?

Answer 39

Severe inflammatory lung injury causing widespread alveolar damage, hypoxia, and respiratory failure. ## Footnote Treatment: Optimising ventilator settings, positioning (e.g., prone), early mobilisation when possible. Goals: Improve oxygenation, minimise muscle wasting, support recovery.

Question 40

What is Pulmonary Embolism (PE)?

Answer 40

Obstruction of pulmonary arteries by blood clots, leading to sudden breathlessness, chest pain, and impaired oxygenation. ## Footnote Treatment: Early mobilisation as safe, breathing exercises, monitoring for signs of deterioration. Goals: Prevent complications (e.g., DVT), improve respiratory function, promote circulation.

Question 41

What is Congestive Heart Failure (CHF)?

Answer 41

The heart's inability to pump effectively, causing fluid buildup in the lungs and other tissues, leading to breathlessness and fatigue. ## Footnote Treatment: Exercise training, breathing control, energy conservation, education. Goals: Improve functional capacity, reduce symptoms of breathlessness and fatigue, enhance quality of life.