A 25-year-old patient with cystic fibrosis has been experiencing successful mobilization of thickened secretions by standard percussion and postural drainage. During the current treatment session, the patient coughs up sputum that has small, brownish streak of blood. The PT should:

A 25-year-old patient with cystic fibrosis has been experiencing successful mobilization of thickened secretions by standard percussion and postural drainage. During the current treatment session, the patient coughs up sputum that has small, brownish streak of blood. The PT should:

• A. percuss more vigorously in an attempt to clear out any other blood that is present in the airways
• B. perform postural drainage in upright positions for this type of patient only
• C. continue treatment with little modification unless more blood is noted
• D. stop the treatment and send the patient to the emergency room

Answer: (C)

The key idea is that a small amount of blood in the sputum during airway clearance in a person with cystic fibrosis is usually not a reason to stop therapy. In CF, the airways are inflamed and the bronchial vessels can be fragile, so minor irritation from coughing or chest physiotherapy can produce a small amount of blood without indicating a dangerous event. The priority remains effective clearance of thick secretions to prevent plugging and infection, so the treatment should be continued with only mild modification rather than abandoned. Proceed with gentle percussion and postural drainage, avoiding aggressive tapping or forceful techniques that could aggravate the bleeding. Monitor the patient for any changes: if the amount of blood increases, if the bleeding is bright red, or if there are signs of distress, dizziness, or hemodynamic instability, stop the treatment and seek urgent medical evaluation. If bleeding remains minimal, continue the session with careful observation and then reassess.

The key idea is that a small amount of blood in the sputum during airway clearance in a person with cystic fibrosis is usually not a reason to stop therapy. In CF, the airways are inflamed and the bronchial vessels can be fragile, so minor irritation from coughing or chest physiotherapy can produce a small amount of blood without indicating a dangerous event. The priority remains effective clearance of thick secretions to prevent plugging and infection, so the treatment should be continued with only mild modification rather than abandoned.

Proceed with gentle percussion and postural drainage, avoiding aggressive tapping or forceful techniques that could aggravate the bleeding. Monitor the patient for any changes: if the amount of blood increases, if the bleeding is bright red, or if there are signs of distress, dizziness, or hemodynamic instability, stop the treatment and seek urgent medical evaluation. If bleeding remains minimal, continue the session with careful observation and then reassess.