The patient had a history of smoking two or three
packs of cigarettes a day. She was endotracheally
intubated on admission. An exploratory laparotomy
with repair of the liver lacerations and drainage by
Shirley sumps was performed. The right lower extremity
was placed in a cylinder cast. About eight
hours after admission, the patient was extubated.
Following extubation, a left lower-lobe atelectasis
developed with diminished breath sounds over the
left base. At that time, chest physical therapy was
initiated. Treatment consisted of turning the patient
on her right side, one-third turn from prone, in the
Trendelenburg position for bronchial drainage with
vigorous percussion and vibration.