Non-medical prescribing – Implications for physiotherapy education in Australia and New Zealand

Laakso, Liisa

doi:10.15619/nzjp/45.1.01

Cited by 1 publication

(10 citation statements)

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“…Among them, the majority of them did not state the parameters they used during the application of VHI. These results are similar to the study conducted in New Zealand and Australia [ 22 ]. As VHI is a new approach, it may not be commonly used.…”

Section: Discussionsupporting

confidence: 91%

“…VHI refers to the adjustment of ventilator settings to deliver tidal volumes larger than the baseline, without the drawbacks associated with disconnecting from the ventilator as seen in MHI [ 22 ]. In the current study, a percentage of users used VHI in their ICU setting.…”

Section: Discussionmentioning

confidence: 99%

“…In the third section, we used a previously designed questionnaire that assessed VHI with prior permission [ 22 ] consisting of the need for medical approval to perform VHI; the staff category performing VHI; availability of VHI protocol; frequency of performing VHI; indications for performing VHI; reasons for choosing to perform VHI instead of manual hyperinflation; the modes of ventilation commonly using in performing VHI; commonly performed VHI; altering the technique of VHI when treating lung collapse versus sputum retention; maximum pressure or maximum volume not to exceed during VHI; deep breaths providing in one set; sets of deep breathe provided; and how to learn the practical aspects of performing the technique of VHI.…”

Section: Methodsmentioning

confidence: 99%

“…VHI is a relatively newer technique and uses different ventilator settings to give breaths larger than the normal tidal volume. This method does not require the patient to be disconnected from the ventilator and has an advantage over MHI in providing hyperinflation [ 22 ] for high positive-end expiratory pressure (PEEP) dependent patients. The VHI can be performed using different ventilator modes [ 23 ], such as, synchronised intermittent mandatory ventilation (SIMV) volume control mode (VC) or pressure control mode (PC) [ 22 ].…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

“…This method does not require the patient to be disconnected from the ventilator and has an advantage over MHI in providing hyperinflation [ 22 ] for high positive-end expiratory pressure (PEEP) dependent patients. The VHI can be performed using different ventilator modes [ 23 ], such as, synchronised intermittent mandatory ventilation (SIMV) volume control mode (VC) or pressure control mode (PC) [ 22 ]. In VHI, the ventilator is set to deliver hyperinflation followed by suctioning.…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

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Manual and ventilator hyperinflation parameters used by intensive care physiotherapists in Sri Lanka: An online survey

Liyanage,

Dassanayaka,

Chellapillai

et al. 2024

PLoS ONE

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Introduction Hyperinflation is a common procedure to clear secretion, increase lung compliance and enhance oxygenation in mechanically ventilated patients. Hyperinflation can be provided as manual hyperinflation (MHI) or ventilator hyperinflation (VHI), where outcomes depend upon the methods of application. Hence it is crucial to assess the application of techniques employed in Sri Lanka due to observed variations from recommended practices. Objective This study is aimed to evaluate the application and parameters used for MHI and VHI by physiotherapists in intensive care units (ICUs) in Sri Lanka. Methodology An online survey was conducted among physiotherapists who are working in ICUs in Sri Lanka using WhatsApp groups and other social media platforms. Results A total of 96 physiotherapists responded. The survey comprised of three sections to obtain information about socio-demographic data, MHI practices and VHI practices. Most of the respondents (47%) worked in general hospitals and 74% of participants had a bachelor’s degree in physiotherapy; 31.3% had 3–6 years of experience; 93.8% used hyperinflation, and 78.9% used MHI. MHI was performed routinely and as needed to treat low oxygen levels, abnormal breath sounds, and per physician orders while avoiding contraindications. Self-inflation bags are frequently used for MHI (40.6%). Only a few participants (26%) used a manometer or tracked PIP. In addition to the supine position, some participants (37.5%) used the side-lying position. Most physiotherapists followed the recommended MHI technique: slow squeeze (57.3%), inspiratory pause (45.8%), and quick release (70.8%). VHI was practised by 19.8%, with medical approval and it was frequently performed by medical staff compared to physiotherapists. Treatment time, number of breaths, and patient positioning varied, and parameters were not well-defined. Conclusion The study found that MHI was not applied with the recommended PIP, and VHI parameters were not identified. The study indicates a need to educate physiotherapists about current VHI and MHI practice guidelines.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introduction and Literature Reviewmentioning

confidence: 99%

Section: Introduction and Literature Reviewmentioning

confidence: 99%

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