Pulmonary toilet refers to the treatments and therapies used to remove mucus, secretions, and other obstructions from the airways in order to improve lung function and prevent respiratory problems. It is critical for people who have chronic obstructive pulmonary disease (COPD), cystic fibrosis, or are recovering from surgery.
It is performed by:
Pulmonary toilet is often performed by qualified healthcare professionals that specialise in respiratory care or physical therapy, such as:
Respiratory Therapists are experts in airway management and lung health who perform and guide procedures such as suctioning, chest physiotherapy, and the use of breathing equipment.
Physical therapists specialise in chest physiotherapy and postural drainage to aid with mucus clearance, especially in patients with limited mobility, and
Nurses frequently assist with routine airway suctioning, patient positioning, and education on breathing exercises.
Patients and Carers: With adequate training, patients and carers can do simple techniques at home, such as breathing exercises, device use (e.g., PEP), and postural drainage.
The provider is selected based on the setting (hospital, clinic, or home) and the patient’s individual requirements. Chest Physicians/ pulmonologists, and critical care doctors may recommend or supervise pulmonary toilet procedures for patients in clinical or ICU settings.
Techniques Used in Pulmonary Toilet:
• Deep breathing and coughing exercises help clear the airway of mucus naturally.
• Chest Physiotherapy (CPT) uses percussion and vibration to release mucus in the lungs.
• Postural Drainage involves positioning the body to allow gravity to drain mucus from certain lung regions.
• Suctioning involves using a catheter to remove secretions in patients who cannot clear their airways unaided.
• Use nebulisers or humidifiers to loosen and expel thick mucus.
• Mechanical devices, such as positive expiratory pressure (PEP), simple and oscillatory PEP (Acapella), and high-frequency chest wall oscillation (vest treatment), help clear mucus.
When Is Pulmonary Toilet Needed?
The pulmonary toilet is used for:
- Post-surgical patients to prevent atelectasis (lung collapse) and pneumonia.
- Patients with chronic lung disorders (e.g., COPD and bronchiectasis).
- Weak coughing due to neurological problems (e.g., stroke or spinal cord injury).
- Chest infection leading to excessive production of sputum.
For long-term care, pulmonary toilet is very helpful since it keeps airways free and promotes the best possible lung function in people with long-term respiratory disorders. Frequent airway clearing slows the course of lung damage and lowers the chance of recurring infections like pneumonia, which can get worse over time and require hospitalisation. It enhances independence, improves quality of life, helps individual to breathe better and lessens the need for invasive procedures or emergency treatment by fostering improved respiratory health.