Chest physiotherapyCChest physiotherapyChest physiotherapyEnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT000Flat ContentHealth A-Z

 

 

Chest physiotherapy2965.00000000000Chest physiotherapyChest physiotherapyCEnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT000Flat ContentHealth A-Z​​ <p>Chest physiotherapy (CPT) can include a combination of manual techniques to loosen and remove <a href="/Article?contentid=2927&language=English">secretions</a> from the lungs. When secretions are thick, they can block air from moving into and out of your child’s lungs, making it harder to breathe. If secretions sit in the lungs for too long, they can cause a lung infection, making your child very sick. CPT can help your child cough and remove secretions before they harm your child.</p><h2>CPT techniques</h2><p>CPT techniques include:<br></p><ul><li>clapping</li><li>percussion</li><li>postural drainage</li><li>deep breathing and coughing.</li></ul><h3>Clapping</h3><p>Clapping your child’s chest shakes the chest and loosens secretions so that they are easier to cough out.</p><h3>Percussion</h3><p>“Percuss” means to tap sharply. You can give your child percussions using a cupped hand, a percussing device or an electric percussor. Percussions shake the chest and loosen secretions so that they are easier to cough out.</p><h3>Postural drainage</h3><p>Postural drainage involves changing your child’s position to help move secretions. The goal is to move secretions from the lower airways at the bottom of the lungs to the large airways in the middle. Using percussions and postural drainage together will help move secretions into the large airways so that they are easier to cough out.</p><h3>Deep breathing and coughing</h3><p>You can also encourage your child to breathe deeply and cough to loosen secretions and move them up into the large airways. Using deep breathing and coughing with clapping, percussion and postural drainage will help to bring up more secretions.</p><h2>When should I do CPT?</h2><ul><li>The best times for CPT are early morning and at bedtime. Early morning CPT helps remove secretions that have built up overnight. Bedtime CPT helps remove any remaining secretions so your child has a reduced need to cough and can sleep better through the night. Your doctor may want you to do CPT more often.</li><li>It is also best to do CPT before meals or at least one to two hours after eating. This will make it less likely that the child will feel sick or vomit.</li></ul><h2>Will my child need to use any medications?</h2><p>Your doctor may prescribe medications along with CPT to help open up your child’s airways and clear secretions from the lungs. These <a href="/Article?contentid=2951&language=English">medications can be given with a puffer (called a metered dose inhaler or MDI) or a small nebulizer</a>. Usually, you will give your child their medication before starting their pulmonary clearance routine.</p><h2>How do I do CPT for my child?</h2><h3>Before you start</h3><ul><li>Take off rings and other jewellery on your hands or wrists.</li><li>If your child’s clothing is tight or has thick seams, remove it.</li><li>If your child is wearing clothing with buttons, remove it.</li><li>Have the your child wear a t-shirt or put a soft cloth over the area that you will percuss.</li><li>Gather your supplies:</li><ul><li>a clock or a timer, to time how long you will percuss</li><li>a percussor (if it has been prescribed).</li></ul><li>Position yourself and your child in a suitable place to do CPT, for example a bed, a couch or on a floor with pillows.</li></ul><h3>Performing CPT</h3><p>Your physiotherapist will assess your child and create a CPT plan for them. The physiotherapist will teach you how to safely perform the CPT techniques at home. However, there are some precautions and guidelines that are worth keeping in mind. </p><ul><li>Always percuss over the ribs. The lungs are protected by the ribs, so never percuss below the ribs or on the stomach, backbone, breastbone, nipples or on any IV tubes or feeding tubes.</li><li>One session of CPT should take 20 to 40 minutes. Usually, you will do CPT in a number of prescribed positions and percuss all the areas. Your doctor or physiotherapist may have you percuss some areas more than others.</li><li>Throughout the therapy session and immediately following therapy on your child, monitor your child’s:</li><ul><li>reaction to the therapy, including responses to pain</li><li>discomfort</li><li>shortness of breath</li><li>heart rate and rhythm</li><li>respiratory rate and pattern, including work of breathing</li><li>cough and secretion production, including colour, quantity, consistency and smell</li><li>breath sounds</li><li>skin colour</li><li>mental status (their emotions and awareness of their surroundings)</li><li> <a href="/Article?contentid=2962&language=English">oxygen saturation</a> (as measured by a pulse oximeter).</li></ul></ul><div class="caution"><h3>Pre​caution</h3><ul><li>If there is bright red blood in your child’s secretions, stop the CPT and call your doctor.​​</li></ul></div><h2>What should I expect during and after a CPT session?</h2><ul><li>Your child may cough more during or after CPT. Coughing helps your child get rid of loosened secretions.</li><li>Your child may cough up to one or two hours after CPT. Even if no secretions come up, this means the CPT is w​​orking.</li><li>After swallowing a lot of secretions, your child may feel sick to their stomach or throw up. As soon as your child is old enough to learn to spit, teach them how to spit secretions into a tissue. If your child does not stop throwing up, call your doctor.</li></ul> ​​ <p></p> <a class="btn btn-primary" href="https://www.aboutkidshealth.ca/trachvent">Return to trach-vent learning hub</a><br>Chest physiotherapyTruehttps://www.aboutkidshealth.ca/Article?contentid=2966&language=Englishhttps://www.aboutkidshealth.ca/Article?contentid=2964&language=English

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