Physiotherapy and PROCEDURE: Manual techniques for the removal of bronchial secretions: percussion

Procedure : Chest Percussion

DEFINITION/DESCRIPTION:

The application of the minimal effective mechanical force to the thorax delivered using a cupped hand, using either single handed (slow) percussion (60 beats per minute) or double handed percussion, throughout the respiratory cycle, but with maximum effect during full inspiration followed by an inspiratory hold.

CONTRAINDICATIONS:

-           prolonged history of use of steroids

-           metabolic bone disease e.g. osteoporosis, rib metastases

-           predisposition to paroxysms of coughing

-           presence of wheeze

-           predisposition to bronchial hypersensitivity

-           subject intolerance

-           thoracic burns

-           thoracic burns

-           application directly over site of rib fractures

-           frank haemoptysis

-           low platelet count

HAZARDS/COMPLICATIONS/PRECAUTIONS:

-           a rigid & non-compliant thorax

-           increased bronchial constriction

-           precipitated paroxysm of coughing

-           breathlessness

-           pulmonary carcinoma (unless specifically indicated)

INFECTION CONTROL:

-           management of expectorated products

-           hand hygiene

-           appropriate disposal of clinical waste