Chest Physiotherapy Home Instruction

To help move secretions out of the lungs.

There are two parts to chest physiotherapy – bronchial drainage and percussion. Bronchial drainage is positioning the body to allow gravity to help in moving secretions. Different positions are used so that the area to be drained is highest. Percussion is tapping the chest wall rhythmically to loosen secretions and move it into the bronchial tubes (large airways) of the lungs. 

1. Percussion is done with a cupped hand or manual percussor cup over the rib cage. 
2. Percussion is applied for about one minute to each position on infants and two to three minutes on older children. 
3. Use a blanket or towel to cover and protect your child’s skin while percussing. 

1. Bronchial drainage should be done before your child eats or at least one hour after eating. 
2. If your child coughs or has trouble breathing during the treatment, sit them upright until they feel better. 
3. Do not percuss over: 

• bottom of rib cage 
• sternum (breast bone) 
• spinal column (back bone) 

• Place child in upright sitting position 
  • Front - Percuss between clavicle (collarbone) and nipple on each side of the chest. 
  • Back - Percuss on top half of the shoulder blade on each side of the back.
• Place child flat on back 
  • Front - Percuss between clavicle and nipple on each side of the chest. 
  • Sides - Percuss directly below armpit on both sides. 
  • Back - Percuss on top half of the shoulder blade on each side of the back. 
• Place child in a face down position, lying on tummy 
  • Front - Percuss right below nipple (right side of chest only). 
  • Sides - Percuss directly below armpit on both sides 
  • Back - Percuss below shoulder blade on each side of the back.