Learning Resources

Clinical Flowchart – Pneumonia

Pneumonia Flowchart

Clinical reasoning & physiotherapy approach

Clinical Reasoning: Pneumonia Presenting Complaint Cough, fever, dyspnea, chest pain Fatigue, sputum production, chills ⚠️ RED FLAGS? Severe respiratory distress, hypoxia, confusion, sepsis signs If YES → Urgent hospital referral Initial Observations Vital signs: RR, HR, BP, Temp, SpO₂ Assess work of breathing, cyanosis Subjective Assessment Onset, duration, progression of symptoms Sputum characteristics, cough type Past medical history: COPD, immunosuppression Smoking history, vaccination status, patient goals Objective Assessment Inspection: respiratory rate, use of accessory muscles Palpation: chest expansion, tenderness Percussion: dullness over affected areas Auscultation: crackles, bronchial breath sounds Clinical Interpretation Community-acquired vs hospital-acquired pneumonia Severity assessment (CURB-65, PSI) Physiotherapy Management Airway clearance techniques (ACBT, postural drainage) Breathing exercises, incentive spirometry Early mobilisation and functional training Education: infection control, smoking cessation Liaison with MDT for medical management SMART Goals & Review Improve ventilation and oxygenation Enhance airway clearance and functional capacity Regular reassessment and plan adjustment Improving Continue plan Progress rehabilitation Not Improving Reassess & investigate Consider MDT referral
  • ACBT – Active Cycle of Breathing Techniques: a series of breathing exercises to help clear airway secretions.
  • CURB-65 – A clinical prediction rule to assess severity of pneumonia and need for hospitalisation; includes Confusion, Urea, Respiratory rate, Blood pressure, age ≥65.
  • MDT – Multidisciplinary Team: healthcare professionals from various specialties working together.
  • PSI – Pneumonia Severity Index: a scoring system to predict mortality risk in pneumonia patients.
  • SpO₂ – Peripheral capillary oxygen saturation: a measure of oxygen saturation in the blood.
  • Incentive Spirometry – A device used to encourage deep breathing to prevent lung collapse and improve lung function.
  • Postural Drainage – Positioning techniques to help drain mucus from the lungs.
  • Respiratory Rate (RR) – Number of breaths per minute.
  • Heart Rate (HR) – Number of heartbeats per minute.
  • Blood Pressure (BP) – The pressure of circulating blood on the walls of blood vessels.
  • Dyspnea – Difficulty or labored breathing.
  • Hypoxia – Low oxygen levels in the tissues.
  • Sepsis – A life-threatening organ dysfunction caused by a dysregulated host response to infection.
  • Chest Auscultation – Listening to lung sounds using a stethoscope to detect abnormalities.
  • Bronchial Breath Sounds – Harsh breath sounds heard over consolidated lung tissue, typical in pneumonia.
  • Crackles – Abnormal lung sounds indicating fluid in the airways.
  • Immunosuppression – Reduced efficacy of the immune system, increasing infection risk.
  • Smoking History – Patient’s history of tobacco use, a risk factor for respiratory infections.
  • Functional Capacity – The ability to perform activities of daily living.