Chest Physical Therapy (CPT) uses a technique called percussion to loosen mucus so the patient can get it out by coughing. To avoid injury, the technique is done with a cupped hand, never a flat hand. People often think that they must hit the chest hard to loosen mucus, but this is not true. The air that is trapped in the cupped hand is what hits the chest wall and shakes the mucus loose.
Before you begin doing percussions, there are a few ground rules you should know:
- Never percuss over bare skin. Have the patient wear a t-shirt or place a thin piece of cloth between his or her skin and your hand.
- Never percuss directly over the shoulder blade, collar bone, spine, breast bone, or breasts.
- Place a towel under the child's face to protect your clothing from any mucus coughed up during the treatment.
- Chest percussion should not hurt. If it does, you are not doing it correctly and should stop and reposition to avoid injury.
When performing percussion, the following technique should be used:
- Place the cupped hand in the proper section of the patient's chest.
- Keep the wrist anchored on the chest. Bend at the wrist as you move the hand quickly and firmly up and down in a tapping motion. This should make a loud hollow sound, not a slapping sound.
- Continue for 3 to 5 minutes, then have the patient breathe deeply and cough for a minute or two before moving to the next section. The child hould always be sitting upright during the coughing and deep breathing portion of CPT.
