Percussion and Postural Drainage

Some infants and children have difficulty removing secretions from the lungs by the normal cleansing mechanisms. In such cases, it is necessary to loosen the mucus by performing percussion and postural drainage. Before discharge, your child's physician will review the techniques for percussion and postural drainage

Percussion

Percussion is a tapping technique that loosens secretions and causes drainage of mucus from the lungs while your child is in different positions. The procedure involves gentle rhythmic pounding on the chest with cupped hands, manual percussor, or percussion machine.

Your child's doctor will prescribe this procedure if it is needed. Otherwise, it can be used if your child has a cold or increased secretions.

Hand Positioning for Percussion

The correct hand position for percussion

Bend from the wrist to tap your child's chest so the pounding does not hurt. A loud, hollow sound should be produced by the trapped air between the cupped hand and the chest. A slapping sound indicates that your hand is not cupped enough. Percuss only over the rib cage. Avoid the abdomen. If performed properly, percussion is painless.

Postural Drainage

Postural drainage is the positioning of the child so that gravity will help move secretions from the smaller bronchial airways to the trachea. The secretions can then be removed by coughing and suctioning.

While performing postural drainage, you should remove any constricting clothing and make your child as comfortable as possible. To minimize discomfort during the procedure, place a lightweight shirt between your hand and your child's chest. Be sure to suction your child before and after the postural drainage procedure. Do not perform postural drainage immediately after meals; it may cause vomiting.