OMM for Pediatric Patients With Pertussis

Introduction

This tutorial provides a step-by-step guide on using osteopathic manipulative treatment (OMT) for pediatric patients suffering from pertussis, commonly known as whooping cough. The technique demonstrated focuses on balanced ligamentous tension, which is beneficial in alleviating symptoms associated with this respiratory illness.

Step 1: Understand Pertussis and Its Impact

• Recognize that pertussis is caused by the bacteria Bordetella pertussis.
• Understand that it primarily affects unvaccinated children under 10 years old, leading to severe coughing fits followed by a whooping sound and potential vomiting.
• Note that supportive care is the primary treatment, but early antimicrobial management is recommended for high-risk individuals.

Step 2: Assessing the Patient

• Position the child supine (lying on their back).
• Avoid any compressive forces on the ribcage or diaphragm.
• Place hands around the child's thorax:
  • Thumbs at the inferior costal margin (lower edge of the rib cage).
  • Fingers along the thoracic vertebrae on the back.
• Monitor ribs 9 through 12, thoracolumbar vertebrae, and diaphragm during the child’s breathing.
• Look for areas of restriction or decreased motion in these regions.

Step 3: Performing Balanced Ligamentous Tension Technique

• Maintain contact with the ribs while gently decompressing the costovertebral articulations of ribs 10, 11, and 12.
• Focus on creating balanced tension throughout the dome of the diaphragm without applying compression:
  • Move the diaphragm gently superiorly, inferiorly, left, or right.
• Hold the position until you notice an improvement in motion or changes in tissue texture.
• Example:
  • Move the tissues superiorly and to the left, holding until a release is felt, then reevaluate.

Step 4: Consider Contraindications

• Be aware of contraindications for this technique, which include:
  • Lower rib or vertebral fractures.
  • Malignancy in the treatment area.
  • Open wounds, incisions, or infections on the thorax.
• Ensure that the treatment does not exacerbate any existing conditions.

Step 5: Evaluate Treatment Effectiveness

• After completing the technique, assess the child’s respiratory biomechanics.
• Observe for symptomatic and physiological improvements.
• This technique can be beneficial for patients of all ages, particularly vulnerable infants with respiratory illnesses.

Conclusion

Using osteopathic manipulative treatment, particularly the balanced ligamentous tension technique, can aid in the management of pertussis symptoms in pediatric patients. By carefully assessing and treating the diaphragm, healthcare providers can optimize respiratory function and support the child's recovery. Always consider contraindications and evaluate the effectiveness of the treatment throughout the process.