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Printed at: 10:56:51 / 25-02-2021

Chest Percussion

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What is it?

Chest percussion or ‘chest physiotherapy’ is a technique used to help loosen secretions from the lungs. This can help to stimulate a cough and assist with secretion clearance from the lungs.

Why is it useful?
Children with respiratory conditions or those who are susceptible to respiratory complications may benefit from this technique. Chest percussion mobilises secretions to prevent them from pooling in the lungs. Pooling secretions can have the effect of reducing the amount of oxygen that can get into the bloodstream making breathing harder and may also result in infections and
secondary complications.

Which conditions is it used for?
• Cystic fibrosis (CF)
• Bronchiectasis
• Neurological conditions with respiratory compromise
• Chest infections

Technique:
You will be taught how to perform chest percussion by your physiotherapist – see last page of the leaflet for advice specific to your child’s treatment.
• Position your child as instructed by your physiotherapist.
• Place a towel or blanket over the area you are percussing, to make it more comfortable for your child.
• Make a cupping posture with your hand (illustrated below).
• Percuss around the desired area, aiming to keep your wrist loose and your hand cupped whilst performing the technique.
• Perform for the length of time advised by your physiotherapist.
• Encourage your child to cough during or after treatment.

When is the best time to do it?
• Chest percussion must not be performed immediately after a meal/feed as it may cause discomfort, reflux or vomiting. How long you should wait is dependent on a number of factors and should be discussed with your physiotherapist.
• Mornings –to clear secretions that may have built up overnight.
• Before bedtime – clearing secretions before bed may help your child sleep better.
• A time that fits well with your routine so that it is manageable on a daily basis.
• Post nebuliser/inhaler – nebulisers help to open your child’s airways, making it easier for secretions to be cleared.
• A minimum of one hour post DNAse (some patients with CF) – to reduce the thickness of secretions.

Postural drainage
Chest percussion can be combined with postural drainage (lying in different positions) to encourage secretions to move into the larger airways, where they can be more easily cleared by coughing. The positioning will be explained by your physiotherapist and instructions on your child’s routine may be found at the back of this leaflet.

Do
• If your child has secretions on their chest or is at risk of recurrent chest infections
• Move around the area you are percussing
• Follow your physiotherapist’s instructions

Don’t
• Do not attempt if you have not received a demonstration from your physiotherapist
• If it causes your child obvious pain or discomfort
• If your child has just eaten
• If they have had a recent trauma/fracture to their head or chest
• Do not percuss over open wounds or invasive devices such as portacaths
• If your child is wheezy – percussion may increase a wheeze.

Your child’s routine…
Position:
Frequency: