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DEFINITION:-It is method of facilitating respiratory function by removing thick tenacious secretions of the
respiratory system using techniqes of percussion,vibration ,and postural drainage.

PURPOSES:-To remove secretions from bronchial wall in conditions like bronchiectasis and chronic

INDICATIONS:- 1)patient who bring out copious sputum.

2)patient who are at risk of atelectasi

2.Sputum cup with disifectant.
3.Paper tissues.
4.Adjustable pillow.
5.kidney tray.


1. Undrained lung abcess.

2. lung tumor.
3. Pneumothorax.
4. Disease of chest wall.
5. Lung hemorrhage.
6. Hemoptysis.
7. Painfull chest Pleural effusion.
8. Tuberculosis.
9. Osteoporosis.
10. Increased intracranial pressure.
11. Spinal injuries.

1.Identify patient and check instruction of Ensures that right procedure is done on right
patient and nursing care plan. patient.

2.Explain procedure to patient and check time Reassures patient and promote
for last meal. cooperation.Postural dranaige should be
avoided after meal times as it can induce

3.Wash hands and dry. Reduces transmission of micro-organism.

4.Instruct patient to perform diaphragmatic It helps patient to relax and widen airways.
Position should be selected according to the
5.position patient.
area of lung that is to be drained.

6.Cover area with towel. Reduces discomfort to the patient.

7.Percussion. Percussion helps in dislodging mucus plug and

Clap with cubed hands over chest wall for 1 to 2 mobilizes secretions into main stream bronchi
minutes in each lung area .Percuss from and trachea.
a.Lower rib to shoulder on the back.
b.Lower rib to top of chest in front .Avoid
clapping over
spine,liver,kidney,spleen,breast,clavical or

Remove towel and place hand,palm down on Vibration frees the mucus from bronchial walls.
chest area to be drainedwith one hand over
other and fingers together or place hands side
by side.

9.Insruct patient to inhale deeply and exhale

slowly through pursed lips and perform
abdominal breathing.

10.stop vibration and relieve pressure on chest

Coughing aids in the movement and expulsion
walls inhibits chest expansionn during
of mucus.

11.vibrates for 5 exalations over each affected

lung area.after 3-4 vibrations encourage patient
to cough and expectorate sputum into sputum
Presence of crackles and rhonchi indicates
presence of mucus.
13.Allow patient to rest and auscultate with
stethoscope for change in breathing sound.

15.Repeate percussion and vibrations according

to patient conditions ,usually for 10-15 minutes.
Reduces risk of infection.

16.Wash hands.

Promote comfort by removing bad taste.

17.Assist patient to comfortable position .
Enables communication between staff.
18.Assist patient to oral hygiene.

19.Record procedure and patient response.