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Postural drainage

Chest physical therapy; CPT

What to expect at home

Postural drainage is one way to help treat breathing problems due to swelling and too much mucus in the airways of the lungs. With postural drainage, you get into a position that helps drain fluid out of the lungs. It may help:

  • Treat or prevent an infection
  • Make breathing easier
  • Prevent more problems with the lungs

A respiratory therapist, nurse, or doctor will show you the best position for postural drainage.

How to do postural drainage

The best time to do postural drainage is either before a meal or 1 ½ hours after a meal, when your stomach is emptiest.

Use one of the following positions:

  • Sitting
  • Lying on your back, stomach, or side
  • Sitting or lying with your head flat, up, or down

Stay in the position for as long as your doctor instructed (at least 5 minutes). Wear comfortable clothes and use pillows to get as comfortable as possible. Repeat the position as often as instructed.

Breathe in slowly through your nose, and then out through your mouth. Breathing out should take about twice as long as breathing in.

Percussion or vibration

Your doctor may also recommend doing percussion or vibration.

Percussion helps break up thick fluids in the lungs. Either you or someone else claps a hand on your ribs while you are lying down. You can do this with or without clothing on your chest:

  • Form a cup shape with your hand and wrist.
  • Clap your hand and wrist against your chest (or have someone clap your back, if your doctor tells you to).
  • You should hear a hollow or popping sound, not a slapping sound.
  • Do not clap so hard that it hurts.

Vibration is like percussion, but with a flat hand that gently shakes your ribs.

  • Take a deep breath, then blow out hard.
  • With a flat hand, gently shake your ribs.

Your doctor, nurse, or respiratory therapist will show you how to do this the right way.

Do percussion or vibration for 5 to 7 minutes in each area of the chest. Do this on all of the areas of your chest or back that your doctor tells you to. When you finish, take a deep breath and cough. This helps bring up any phlegm, which you can then spit out.

When to call the doctor

Call your doctor if you have:

  • Indigestion
  • Vomiting
  • Pain
  • Severe discomfort
  • Difficulty breathing

References

Celli BR, ZuWallack RL. Pulmonary rehabilitation. In: Mason RJ, Murray JF, Broaddus VC, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 94.

Update Date: 5/14/2014

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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