management

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Prevention is the best form of management. If postoperative atelactasis does occur then management is as follows:

  • removal of impacted secretions by coughing, managed by physiotherapists, and involves
    • active chest percussion and breathing exercises
    • passive postural drainage
  • ensure adequate analgesia, which may require an intercostal block in upper abdominal incisions
  • if the condition is severe then a catheter can be passed into the bronchi and secretions directly aspirated via the nose or an endotracheal tube
  • if pyrexia is persistent for more than 48 hours then there is a probable secondary chest infection:
    • likely organism is pneumococcus so treat with augmentin
    • if there was possible aspiration then treat also with metronidazole

Last reviewed 01/2018

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