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Debunked: No, postural drainage is not an 'easy' way to treat Covid-19 pneumonia

The HSE said routine breathing tests and mobilising are more appropriate for Covid-19 patients than this method.

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A POST SHARED on Facebook has claimed that postural drainage, a technique used to clear mucus from the lungs, can be used to treat Covid-19 pneumonia. 

This technique involves using gravity to drain mucus from the lungs by putting the body in different positions. It’s used to treat some patients with certain lung issues.  

The post on Facebook advises people to start doing this technique “as soon as you feel your lungs getting filled” and says it is “easy to do for yourself and family members”.

“Don’t wait until you are too sick to bother. 3-5 minutes several times per day,” one post says. It adds that one easy way to get into this position is on an exercise ball.

However, there is no evidence this treatment is being widely tested against Covid-19 pneumonia and the HSE said other routine breathing tests and mobilising are more appropriate for Covid-19 patients. 

The claim

Postural drainage - facebook One Facebook post about postural drainage.

Postural drainage also uses vibrations to loosen a build-up of mucus and make it easier to clear the airways and cough it up.

This Facebook post says this technique was used “many years ago” to treat pneumonia and advises people to “simply get in position and let it flow”. 

Responding to a query from TheJournal.ie, the HSE said postural drainage can be used by physiotherapists for people with chronic suppurative lung diseases such as bronchiectasis or cystic fibrosis.

“Occasionally it is used in acute pneumonia but generally other techniques are utilised. In fact, generally alternate techniques are used in all these patients,” the HSE said.  

It said Covid-19 patients can sometimes produce mucus when coughing, but they generally have a dry, non-productive cough.

“In these patients, routine breathing tests and mobilising would be far more appropriate,” the HSE said.  

Early mobilisation of Covid-19 patients is encouraged when safe to do so as a lack of movement can cause other issues to arise. 

  • A ‘breathing test’ of holding your breath for more than ten seconds is not an effective test to see if you have the coronavirus, despite some claims circulating in March. 

“In sicker, productive, Covid-19 patients they should not be in the community, they should be following self-isolation guidance,” the HSE said.  

Following medical review our physiotherapists generally use airway clearance techniques other than postural drainage on our in-patients within this category.

A possible confusion 

A respiratory consultant who preferred to remain anonymous said the claims in this Facebook post could be confusing postural drainage with a different treatment called prone ventilation.

This is when ventilation is delivered to a patient while they are lying face-down on their chest. 

Other breathing techniques have been recommended by doctors in the past, including one doctor in Queen’s Hospital in London

However, prone ventilation is being trialed around the world to help treat Covid-19 patients.

The respiratory consultant said this treatment is commonly used for ICU patients who are intubated and not responding well to the mechanics of the ventilator. 

Until a few months ago this technique would not generally be used on conscious patients, but it is being used on some conscious Covid-19 patients at the moment. 

It is often used as a tool to improve oxygenation in severely ill patients. 

One scientific article said putting Covid-19 patients who develop acute respiratory distress syndrome (ARDS) in prone position (face-down on their chest), along with using two other treatment strategies, can lead to improvement in oxygenation and survival.

Prevalence of ARDS in Covid-19 patients is reported to be up to 17%, according to an article by doctors in Wuhan. 

“Prone ventilation may be beneficial because it may help people move a little bit more and the last thing you want is for someone to lie static in bed,” the respiratory consultant said. 

I would imagine whoever described the postural drainage in this post was probably misinterpreting what is awake prone ventilation.

position paper by physiotherapists in Italy published by the European Respiratory Society earlier this month said that anecdotal reports from those dealing with large numbers of critically ill Covid-19 patients suggested prone ventilation is an “effective strategy” in patients who are on ventilators. 

So back in terms of postural drainage, it is generally not recommended as an “easy” practice to start doing yourself at home if you feel symptoms of Covid-19. 

There is no evidence it is being widely used in treating hospitalised Covid-19 patients. 

Other techniques such as prone ventilation have proven more beneficial in increasing oxygenation to the lungs of those severely ill with Covid-19. 

Misinfo Graphic 0605 Drainage V1

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There is a lot of false news and scaremongering being spread in Ireland at the moment about coronavirus. Here are some practical ways for you to assess whether the messages that you’re seeing – especially on WhatsApp – are true or not. 

STOP, THINK AND CHECK 

Look at where it’s coming from. Is it someone you know? Do they have a source for the information (e.g. the HSE website) or are they just saying that the information comes from someone they know? A lot of the false news being spread right now is from people claiming that messages from ‘a friend’ of theirs. Have a look yourself – do a quick Google search and see if the information is being reported elsewhere. 

Secondly, get the whole story, not just a headline. A lot of these messages have got vague information (“all the doctors at this hospital are panicking”) and don’t mention specific details. This is often – but not always a sign – that it may not be accurate. 

Finally, see how you feel after reading it. A lot of these false messages are designed to make people feel panicked. They’re deliberately manipulating your feelings to make you more likely to share it. If you feel panicked after reading something, check it out and see if it really is true.

TheJournal.ie’s FactCheck is a signatory to the International Fact-Checking Network’s Code of Principles. You can read it here. For information on how FactCheck works, what the verdicts mean, and how you can take part, check out our Reader’s Guide here. You can read about the team of editors and reporters who work on the factchecks here

Have you gotten a message on WhatsApp or Facebook or Twitter about coronavirus that you’re not sure about and want us to check it out? Message or mail us and we’ll look into debunking it. WhatsApp: 085 221 4696 or Email: answers@thejournal.ie. 

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